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Effect of Ankle Pumping Exercise to Ankle Brachial Index in Type 2 Diabetes Mellitus Patients with Ulcer Tjie Haming Setiadi; Widjajalaksmi; Elida Ilyas; Em Yunir; Arini Setiawati
Indonesian Journal of Physical Medicine & Rehabilitation Vol 1 No 1 (2012): Indonesian Journal Of Physical Medicine and Rehabilitation
Publisher : Indonesian Journal of Physical Medicine & Rehabilitation

Objectives: To analyze the effect of ankle pumping exercise and other factors such as gender, age, duration of Diabetic Mellitus, nutritional status, history of smoking, hypercholesterolemia, ulcer degreeand HbA1c to Ankle Brachial Index (ABI) in type 2 Diabetes Mellitus patients with diabetic ulcer.Methods: The quasi experimental design study with consecutive sampling and one-week interval of intervention was conducted in this study. Analysis of changes in pre-post test ABI used paired t-testwhile other factors were measured with multiple regression.Results: Ankle pumping effect to right foot after exercise as 0.048 while ABI 0,017 on left foot and ABI 0.038 after exercise on both feet. It was not a statistically significant increase on both feet (p>0.05). The relations of multifactors to ABI : Gender 0.47(p 0.829), age 51.32 (p 0.743), duration of DM 83.16(p 0.490), BMI 21.82 (p 0.452), history of smoking 0.47 (p 0.769), hypercholesterolemia 0.11 (p 0.195), degree of ulcer 3.74 (p 0.635), HbA1c 0.89 (p 0.798).Conclusions: There is statistically no effect of ankle pumping exercise to ABI. We also did not find an effect of gender, age, and duration of DM, nutritional status, history of smoking, history of hypercholesterolemia, ulcer grade and HbA1c to increase of ABI in diabetic subjects with foot ulcer after ankle pumping exercise. Nevertheless, we found a sufficiently noted increase of systolic blood pressure of Dorsal Pedis Artery and Posterior Tibia Artery after ankle pumping exercise in type 2 DM subjects although this not statistically significant.Keywords : Diabetes Mellitus, diabetic ulcer ankle pumping, ankle-brachial index.

Effect of Ankle Pumping Exercise to Ankle Brachial Index in Type 2 Diabetes Mellitus Patients with Ulcer Tjie Haming Setiadi; Widjajalaksmi; Elida Ilyas; Em Yunir; Arini Setiawati
Indonesian Journal of Physical Medicine & Rehabilitation Vol 1 No 1 (2012): Indonesian Journal Of Physical Medicine and Rehabilitation
Publisher : Indonesian Journal of Physical Medicine & Rehabilitation

Objectives: To analyze the effect of ankle pumping exercise and other factors such as gender, age, duration of Diabetic Mellitus, nutritional status, history of smoking, hypercholesterolemia, ulcer degreeand HbA1c to Ankle Brachial Index (ABI) in type 2 Diabetes Mellitus patients with diabetic ulcer.Methods: The quasi experimental design study with consecutive sampling and one-week interval of intervention was conducted in this study. Analysis of changes in pre-post test ABI used paired t-testwhile other factors were measured with multiple regression.Results: Ankle pumping effect to right foot after exercise as 0.048 while ABI 0,017 on left foot and ABI 0.038 after exercise on both feet. It was not a statistically significant increase on both feet (p>0.05). The relations of multifactors to ABI : Gender 0.47(p 0.829), age 51.32 (p 0.743), duration of DM 83.16(p 0.490), BMI 21.82 (p 0.452), history of smoking 0.47 (p 0.769), hypercholesterolemia 0.11 (p 0.195), degree of ulcer 3.74 (p 0.635), HbA1c 0.89 (p 0.798).Conclusions: There is statistically no effect of ankle pumping exercise to ABI. We also did not find an effect of gender, age, and duration of DM, nutritional status, history of smoking, history of hypercholesterolemia, ulcer grade and HbA1c to increase of ABI in diabetic subjects with foot ulcer after ankle pumping exercise. Nevertheless, we found a sufficiently noted increase of systolic blood pressure of Dorsal Pedis Artery and Posterior Tibia Artery after ankle pumping exercise in type 2 DM subjects although this not statistically significant.Keywords : Diabetes Mellitus, diabetic ulcer ankle pumping, ankle-brachial index.

ERYTHROCYTE INDICES TO DIFFERENTIATE IRON DEFICIENCY ANEMIA FROM β TRAIT THALASSEMIA (Indeks Eritrosit untuk Membedakan Anemia Defisiensi Besi dengan Thalassemia β Trait) Yohanes Salim; Ninik Sukartini; Arini Setiawati
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 23, No 1 (2016)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v23i1.1184

Anemia defisiensi zat besi dan thalassemia β trait merupakan penyebab tersering anemia mikrositik hipokrom di Indonesia. Keduapenyakit tersebut sulit dibedakan hanya dengan pemeriksaan hematologi, oleh karena itu diperlukan pemeriksaan tambahan sepertiferitin dan analisis hemoglobin. Banyak penelitian yang membedakan kedua penyakit tersebut dengan indeks eritrosit. Berbagai indekseritrosit memiliki nilai diagnostik yang berbeda di setiap negara dan belum ada data di Indonesia. Penelitian ini melakukan uji diagnostikIndeks Mentzer, RDW, Green-King, Sirdah dan mencari nilai cut-off baru yang dapat memberikan nilai diagnostik lebih baik. Penelitianterdiri dari 98 subjek definitif anemia defisiensi besi dan 80 subjek thalassemia β trait. Indeks Mentzer didapatkan kepekaan 83,6%,kekhasan 66,2%, NPP 75,2%, NPN 76,8% dan Indeks RDW mempunyai kepekaan 91,8%, kekhasan 75%, NPP 81,8%, NPN 88,2%. Nilaidiagnostik Indeks Green-King didapat kepekaan 96,9%, kekhasan 67,5%, NPP 78,5%, NPN 94,7%, sedangkan Indeks Sirdah adalahkepekaan 92,8%, kekhasan 58,7%, NPP 73,3%, NPN 87,0%. Nilai cut-off baru Indeks Mentzer adalah 13,44, RDWI 233,4, Green-King75,06 dan Sirdah 32,52. Keempat Indeks eritrosit dapat diterapkan untuk orang Indonesia dengan Indeks Green-King sebagai indeksyang terbaik.

CASPASE-3 AKTIF DI LEUKEMIA MIELOSITIK AKUT (LMA) DAN LEUKEMIA LIMFOBLASTIK AKUT (LLA) Agus Setiawan; Indarini Indarini; Lyana Setiawan; Siti Boedina Kresno; Nugroho Prayogo; Arini Setiawati
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 19, No 3 (2013)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v19i3.411

Dysregulation of apoptosis plays an essential role either in leukemogenesis or treatment response. Caspase-3 is a cysteine protease that functions as the final common mediator of apoptosis. The expression of the active caspase-3 is presumed as a predictor of prognosis and is able to predict the chemotherapy sensitivity. The aim of this study is to identify and to know the profile of active caspase-3 in Acute Myeloid Leukaemia (AML) and Acute Lymphoblastic Leukaemia (ALL), to correlate its expression in marrow and peripheral blood mononuclear cells, and to verify the extent of its use as a complete remission predictor after induction treatment. The study subjects consisted of patients who were diagnosed as AML and ALL with marrow and peripheral blood examination performed at the Department of Clinical Pathology Dharmais Cancer Hospital and CiptoMangunkusumo Hospital. Based on this study, it is revealed that the active caspase-3 expression in mononuclear marrow cells was higher in AML compared to ALL (p=0.033), active caspase-3 expression in marrow showed a strong correlation (r=0.764; p=0.001) to peripheral blood mononuclear cells in ALL and a medium correlation (r=0.594; p=0.042) in AML. The expression of the active caspase-3 in ALL patients was lower in complete remission patients compared to the non-complete remission patients. Regarding to this study it is recommended to measure the active caspase-3 along with molecules integrating in apoptosis signaling pathways such as cytochrome-c and in the formation of apoptosome.

Randomized Trial Comparing Adjuvant Intravitreal Triamcinolone Acetonide 2mg and Bevacizumab 12,5mg for Diabetic Macular Edema maria Larasati; Arini Setiawati; Ari Djatikusumo
Medicinus Vol 7, No 2 (2018): February 2018 - May 2018
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v7i2.1792

ObjectivesTo evaluate the efficacy and safety of Intravitreal Triamcinolone Acetonide (IVTA) 2 mg and Bevacizumab (IVB) 12,5 mg for adjuvant therapy of Diabetic Macular Edema (DME)DesignThis was a prospective, randomized clinical trial. Each participants with DME was randomized to received single intravitreal injection of IVTA or IVB and then being followed until fourth week after injection. The efficacy parameters were the improvement in Best Corrected Visual Acuity (BCVA) in logMAR and Standardized Central Macular Thickness (SCMT) by Optical Coherence Tomography. The safety parameters were the Intra Ocular Pressure (IOP) and Posterior Capsular cataract progression using LOCSIII criteria.ResultsTwenty five eyes of 20 participants were randomly assigned to receive IVTA 2 mg (n=12) and IVB (n=13). At 4 weeks, mean BCVA was better in IVTA group than in IVB group -0,39 logMAR (p<0,05). CMT reduction were significant in all visits of both groups. The SCMT showed 78,37% at final follow-up for IVTA group. There were no statistic significant difference in the mean IOP and posterior capsular cataract changes among two groups. (p>0,05)ConclusionAdjuvant IVTA injections were more effective than IVB injections in patients with DME. However, it was associated with higher increment in IOP, despite not reaching statistical significance.

Perbandingan terapi radiofrekuensi disertai steroid topikal dan steroid topikal saja pada rinitis alergi persisten Meila Sutanti; Retno Sulistyo Wardani; Nina Irawati; Arini Setiawati
Oto Rhino Laryngologica Indonesiana Vol 43, No 1 (2013): Volume 43, No. 1 January - June 2013
Publisher : PERHATI-KL

Latar belakang: Kasus rinitis alergi dengan gejala persisten sedang-berat di RSCM ditemukan pada 357pasien selama 2 tahun. Terjadinya gejala sedang-berat pada rinitis alergi lebih sering menimbulkan penurunankualitas hidup dan produktivitas kerja. Efektivitas terapi steroid topikal adalah 67%, dibandingkan plasebo 39%.Penelitian yang menilai efek tambah reduksi konka radiofrekuensi terhadap terapi rinitis alergi persisten sedangberat(steroid topikal hidung) belum pernah ada. Tujuan: Untuk mendapatkan gambaran hasil terapi reduksikonka radiofrekuensi disertai dengan steroid topikal dibandingkan steroid topikal saja pada rinitis alergi persistensedang-berat. Metode: Penelitian pendahuluan dengan metode uji klinis acak. Sebanyak 14 pasien dilakukanreduksi konka radiofrekuensi disertai steroid topikal hidung, 16 pasien mendapat steroid topikal saja. Penilaianskala analog visual (SAV) terhadap 4 gejala utama rinitis alergi, nasoendoskopi untuk menilai ukuran konkainferior, pemeriksaan peak nasal inspiratory flow (PNIF) dilakukan sebelum terapi dan minggu ke-6 pascaterapi.Hasil: Perbedaan bermakna pada minggu ke-6 pascaterapi antara kedua kelompok didapati pada nilai SAV gatalhidung. Perbedaan bermakna nilai SAV bersin, gatal hidung, ingus encer, dan sumbatan hidung, sebelum terapidengan minggu ke-6 pascaterapi, ditemukan baik pada kelompok reduksi konka radiofrekuensi maupunkelompok steroid topikal saja. Perbedaan bermakna nilai PNIF sebelum terapi dengan minggu ke-6 pascaterapihanya ditemukan pada kelompok terapi reduksi konka radiofrekuensi disertai steroid topikal. Kesimpulan: Baikreduksi konka radiofrekuensi disertai steroid topikal maupun steroid topikal saja memberikan perbaikan gejalarinitis alergi persisten sedang-berat. Pada penelitian ini, penambahan terapi reduksi konka radiofrekuensimengurangi keluhan gatal hidung dan meningkatkan nilai PNIF pada minggu ke-6 pascaterapi.Kata kunci: rinitis alergi persisten sedang-berat, reduksi konka radiofrekuensi, steroid topikal hidung, skalaanalog visual, peak nasal inspiratory flow.ABSTRACTBackground: There were 357 patients with moderate/severe persistent allergic rhinitis in 2 years period at Dr.Cipto Mangunkusumo Hospital. Moderate/severe symptoms in allergic rhinitis reduce quality of life and productivity.Efectivity of nasal steroid in controlling allergic rhinitis symptoms is 67% compared to placebo 39%. The effect ofradiofrequency turbinoplasty added to nasal steroid in controlling allergic rhinitis symptoms were sought. Purpose:This study was performed to evaluate added value of radiofrequency turbinoplasty to nasal steroid in treatment ofmoderate/severe allergic rhinitis. Methods: A pilot study of randomized clinical trial was designed. Fourteen patientswere given combined treatment consist of radiofrequency turbinoplasty and nasal steroid, sixteen patients were givennasal steroid only. Visual analogue scale (VAS) for 4 major symptoms of allergic rhinitis (sneezing, nose itching,rhinorhea, nose obstruction), nasoendoscopy to evaluate inferior turbinate size, peak nasal inspiratory flow (PNIF)were performed before treatment and 6 weeks after treatment. Results: Statistical significance was found only in noseitching symptom if compared between 2 treatment group at 6 weeks after treatment. If comparison performed withintreatment group itself (before treatment and 6 weeks after treatment), there were improvement in all major symptomsof allergic rhinitis. Peak nasal inspiratory flow was found statiscally significance within group, only in group treatedwith combined treatment. Conclusion: Both treatment groups give improvement in all symptoms of allergic rhinitis. Inthis research, addition of radiofrequency turbinoplasty reduces nose itching compared to nasal steroid alone and alsoincreases result of PNIF within 6 weeks of treatment.Keywords: moderate/severe persistent allergic rhinitis, radiofrequency turbinoplasty, nasal steroid, visualanalogue scale, peak nasal inspiratory flow.

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