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CORRELATION BETWEEN LEUKOCYTE COUNT WHEN ADMITTED IN EMERGENCY ROOM (ER) WITH CLINICALLY ACUTE ISCHEMIC STROKE PATIENTS Husna, Machlusil; Kusworini, Kusworini; Wulansari, Dian Ayu
Malang Neurology Journal Vol 1, No 2 (2015): July
Publisher : Malang Neurology Journal

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (604.089 KB) | DOI: 10.21776/ub.mnj.2015.001.02.1

Abstract

Background. Stroke is a local or extensive disorder of brain function that occurs suddenly and rapidly, can cause death without another cause except vascular. Based on pathophysiology of acute ischemic stroke, leukocytes play an important role against deterioration and clinical manifestations in patients by releasing three inflammatory mediators, plugging mechanism in microcirculation, and vasoconstriction. Objective. To investigate the relationship between the clinical manifestations of acute ischemic stroke (incoming, outgoing, and improvement) as measured by the NIHSS score with the number of leukocytes . Methods. The study design was a retrospective cohort sampling. Samples were taken from 62 patients with acute ischemic stroke (31 patients who have normal leukocytes and 31 patients who showed leukocytosis) in Dr. Saiful Anwar (RSSA) Malang hospital that met the inclusion criteria of the study.Results. The results of the statistical test used is Kolmogorov-Smirnov test for incoming NIHSS (p = 0.999), and Chi-Square Test for outcoming NIHSS (p = 0.000) and improved patient (p = 0.001).Conclusion. Patients who have normal leukocyte count at the beginning of treatment is likely to have clinical manifestations by category of incoming NIHSS similar to patients who showed leukocytosis, and tend to have clinical manifestations by category of outcoming NIHSS and improvement or significantly better than patients which showed leukocytosis.
Validity and reliability fatigue severity scale in patients with Systemic Lupus Erythematosus (SLE) in Indonesia Rifa’i, A; Kalim, Handono; Handono, Kusworini; Wahono, Cesarius Singgih
Indonesian Journal of Rheumatology Vol 8, No 1 (2016)
Publisher : Indonesian Rheumatology Association

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Abstract

Background: Fatigue is one symptom of Systemic Lupus Erythematosus (SLE), which has an important effect on the quality of life. Fatigue Severity Scale (FSS)is one parameter fatigue symptom in SLE. The purpose of this study was to determine the validity and reliabilitybetween FSS with duration of ilness and disease activity of SLE patients in Indonesia.Methods: FSS performed on 40 patients with SLE. FSS original English version has been converted-translated into Indonesian version by a team of RheumatologyImmunology Medical Faculty of Brawijaya University. Reliability determined by Cronbach’s Alpha values (>0.6). Validity was determined by the value of Corrected Item-Total Correlation which each item was a valid question if below value of Cronbach’s Alpha.Results: The reliability value was determined by Cronbach’s Alpha values (>0.6) in which the SLE patients in this study had a Cronbach’s Alpha value of 0.946. Value of Corrected Item-Total Correlation overall under Cronbach’s Alpha value (range = 0.684-0.859) which indicates that each item was a valid question. There were correlation between the FSS Indonesian version with disease duration (p = 0.000) as well as the value of r = 0.581, with SLEDAI (p = 0.000) with a value of r = 0.833. Conclusion: FSS in Indonesian version has a good reliability and validity and can be used by clinicians andother researchers to assess the condition of fatigue in SLE patients in Indonesia.Keywords: validity, reliability, fatigue, fatigue severity scale, systemic lupus erythematosus
Correlation between anti-cyclic citrullinated peptide antibodies and the severity of clinical manifestation, laboratory manifestation, and radiological joint destruction in rheumatoid arthritis patients Suwito, Mat; Handono, Kusworini; Suryana, Bagus Putu Putra; Kalim, Handono; Wahono, Cesarius Singgih
Indonesian Journal of Rheumatology Vol 2, No 1 (2010)
Publisher : Indonesian Rheumatology Association

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Abstract

Background. The second generation anti-cyclic citrullinated peptide test (CCP2) displays sensitivity comparable to that of rheumatoid factor (RF) (approximately 80%) but with superior specificity (98%) . Several observations have indicated that early rheumatoid arthritis (RA) patients with positive anti-CCP may develop a more erosive disease than those without anti-CCP.Objective. The purpose of this cross-sectional study was to investigate the correlation between anti-CCP antibodies and clinical and laboratory parameters and radiological joint destruction in RA patients.Methods. We studied 31 patients with RA fulfilling the 1987 revised criteria of American College of Rheumatology in Rheumatology Clinic of Saiful Anwar General Hospital, Malang, Indonesia. Clinical parameters were collected such as age, sex, visual analog scale,disease duration and diseases activity score (DAS28-3(CRP)). Laboratory parameters were WBC, hemoglobin, platelet count, erythrocyte sedimentation rate, and Creactive protein. Analyzed autoantibody profiles were RF and anti-CCP (ELISA methode). Radiological jointdestruction was evaluated from bilateral postero-anterior manus x ray (Sharp score).Results. Anti-CCP antibodies were detected in 48.4% of RA patients with mean antibody concentration was 291.24±143.67 (range 16-523.8) units. Anti CCP level was significantly correlated with duration of RA (month) (p=0.04, r=0.371), RF level (p=0.002, r=0.542) andSharp score (p=0.048, r=0.358), but was not significantly correlated with other clinical and laboratory parameters.Conclusion. Anti-CCP level was correlated with duration of disease, RF, and Sharp score.
Chronic polyarthritis mimicking rheumatoid arthritis in a patient with leprosy Haribowo, A S; Suryana, Bagus Putu Putra; Handono, Kusworini
Indonesian Journal of Rheumatology Vol 2, No 1 (2010)
Publisher : Indonesian Rheumatology Association

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Abstract

Currently leprosy is now still a global threat in the world even after the introduction of multidrug therapy (MDT), including in Indonesia.1 World Health Organization (WHO) data revealed that in 2002 there were 597,000 cases worldwide and the prevalence is only less than 1 every 10,000 populations.2 Nevertheless, the latest data showedthat 83% of leprosy cases concentrated in only 6 countries: Indonesia, India, Brazil, Madagascar, Myanmar, and Nepal.3 The most common manifestations of leprosyare cutaneous and neuritic manifestation. Rheumatologic manifestation is another common manifestation of leprosy.4-7 Prevalence of rheumatologic manifestation of leprosy is range from 1% to 77% of all leprosy patients.4-11 Study conducted by Mandal et al in India revealed that the prevalence of rheumatologic manifestation was 5.9%, in Brazil,6 another study by Pereira revealed the prevalence of 9.1%.5 Hadi, in Indonesia,showed the prevalence of arthritic manifestation was 7.5%.8 Rheumatologic  manifestations that can be found in leprosy are polyarthritis or oligoarthritis, soft tissue rheumatism, noninflammatory arthritis, and also enthesitis.4-7 We report a patient presenting with polyarthritis as the primary manifestation of leprosy.
Effect of vitamin D supplementation on disease activity (SLEDAI) and fatigue in Systemic Lupus Erythematosus patients with hipovitamin D: An Open Clinical Trial Rifa’i, Achmad; Kalim, Handono; Kusworini, Kusworini; Wahono, Cesarius Singgih
Indonesian Journal of Rheumatology Vol 8, No 2 (2016)
Publisher : Indonesian Rheumatology Association

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Abstract

Background : Low level of vitamin D impact the disease activity and the degree of fatigue in SLE patients. This study aims to determine the effect of vitamin D supplementation on disease activity and fatigue condition in Systemic Lupus Erythematosus (SLE) patients with hipovitamin D.Methods: We performed an open clinical trial. Subjects were randomized into two different groups (supplementation or placebo) using simple random sampling. The treatment group got vitamin D3 softgel/ cholecalciferol 1200 IU/day or 30 mg/day, while the control group gotplacebo for 3 months. SLEDAI scores and FSS scores were calculated at pre and posttreatment.Results: There were 20 subjectsfor supplementation group and 19 subjects in the placebo group. From this study, before and after treatment, we found a significant difference of mean level of vitamin D in supplementation group (p=0.000), and no significant difference inpatients with placebo (p=0.427). Moreover, from the SLEDAI score analysis, observed a significant difference bothin the supplemented group (p=0.000) and the placebo group (p=0.006). FSS scores significantly different in the supplemented group (p=0.000). Incorrelation test,there was a negative correlation (r=-0763) between vitamin D level and disease activity (SLEDAI), and both showing stastistical significance between thepre supplementation (p=0.000) and post supplementation (r=-0846; p=0.000). Similarly to theFSS scores, there was a meaningfulnegative correlation (r=-0.931, p=0.000) between the level of vitamin D with FSS scores pre and post supplementation (r=-0.911; p= 0.000). Furthermore, there was a significant correlation between disease activity (SLEDAI) pre supplementation with fatigue condition pre supplementation (r=0.846; p = 0.000) and postsupplementation (r=0.913; p= 0.000).Conclusion: The supplementation of vitamin D 1200 IU per day in patients with SLE improve disease activity and degree of fatigue. Keywords: vitamin D, disease activity, fatigue, SLE
Bryophyllum pinnatum leaves ethanol extract inhibit maturation and promote apoptosis of systemic lupus erythematosus BALB/c mice B cells Handono, Kusworini; Dantara, Tri W.I.; Dewi, Elvira S.; Pratama, Mirza Z.; Nurdiana, Nurdiana
Medical Journal of Indonesia Vol 26, No 4 (2017): December
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (914.21 KB) | DOI: 10.13181/mji.v26i4.1899

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Background: B cells play a key role in systemic lupus erythematosus (SLE). Targeting B cells as SLE therapy is a plausible approach. This study investigated the potential effects of Bryophyllum pinnatum leaves with ethanol extract in decreasing percentages of maturation, increasing percentages of apoptosis, and decreasing NF-κB p65 expressions of SLE BALB/c mice B cells.Methods: Culturing B cells from pristane induced SLE BALB/c mice’s spleen will resulted in this in vitro study. B cells were activated by BAFF, LPS, IL-4, and anti-CD40 yielding CD19+ >80%. B cells were cultured by adding those stimulants with and without B. pinnatum leaves (0, 0.02, 0.1, or 0.5 µg/ml) for 72 hours at 37°C. Flow cytometry was performed to determine The Percentages of maturation (CD19+CD38+) and apoptosis (Annexin V+PI+) of B cells.  Further analysis to determine the expressions of transcription factor of maturation and apoptosis of B cells, NF-ĸB p65, were performed using immunocytochemistry. Data were analyzed using SPSS version 22.Results: Flow cytometry assay showed significant decrease in percentages of maturation of B cells in all doses and significant increase in percentage of apoptosis of B cells in dose 0.5 µg/ml. Immunocytochemistry results showed significant decrease expressions of NF-ĸB p65 in all doses. Percentages of maturation, apoptosis, and expressions of NF-ĸB p65 of B cells were significantly correlated.Conclusion: This in vitro study revealed that B. pinnatum leaves with ethanol extract decreased the percentages of maturation, increased the percentage of apoptosis, and decreased NF-κB p65 expressions of SLE BALB/c mice B cells significantly.
Analisis rasio IFNy - IL 4 pada berbagai kelompok Nefritis Lupus Handono, Kusworini
Jurnal Kedokteran YARSI Vol 17, No 2 (2009): MEI - AGUSTUS 2009
Publisher : Lembaga Penelitian Universitas YARSI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33476/jky.v17i2.206

Abstract

Lupus Nephritis (LN) is a serious manifestation of Systemic Lupus Erythematosus (SLE), that is classified into 6 different classes according to WHO criteria. It has been shown that histological pattern of LN varied significantly among the class and the etiology of the difference in the histological phenotypes remains unknown to date. Several studies indicatedassociation between Th1/Th2 cytokines balance with genetic factor. The present study aims to evaluate the interferron-? (IFNy) / interleukin 4 (IL4) ratio among different histologicalphenotype of LN patients in Indonesia. The study was conducted in 40 female SLE patients at Dr. Saiful Anwar Hospital, Malang, Indonesia. Histologic phenotypes classification was based on WHO criteria (1995). The serum level of IFNy and IL4 was assayed using ELISA and the association between IFNy-IL4 ratio with the histological phenotypes was statistically analyzed using ANOVA. The study revealed that among 31 SLE subjects undergone renal biopsy, class I/II, class III/IV and class V were observed in 13, 12 and 6 subjects respectively. The IFNy-IL4 ratio in class III/IV subjects was significantly higher compared to those in the other classes (p<0.000). However, the IL4 in the class III/IV was significantly lower than the other classes. The findings indicated that the activity of the Th1 immune response tend to be higher in class III/IV LN patients whereas in class V LN patients, the Th2 response prevail. In conclusion, the study indicated that the IFNy-IL4 cytokine ratio might influence the pathogenesis of LN.
RELATIONSHIP OF URINARY C-TERMINAL TELOPEPTIDE COLLAGEN TYPE-II (CTX-II) LEVEL WITH THE DEGREE OF JOINT DAMAGE IN PATIENTS WITH KNEE OSTEOARTHITIS Handono, Kusworini; **, Farida; Suryana, BP Putra; Listyawati, Enny
Medicina Vol 43 No 3 (2012): September 2012
Publisher : Medicina

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Abstract

Radiography of the knee is used to confirm the diagnosis and classification of knee OA severity. Urinary CTX- II  is a biochemical marker for assessing cartilage degradation of knee OA. This research aimed to analyze the correlation between the level of urinary CTX-II  and the radiographic severity of knee OA. Research was conducted in 40 patients with knee OA ( ACR criteria ) and 40 age and sex matched healthy controls. Wheight bearing anteroposterior and lateral semiflexed radiographs were taken of both knee. The patients were stratified based on the Kellgreen-Lawrence (K-L) score. Urinary CTX-II level was measured using ELISA competitive method. Correlation between urinary CTX-II level and radiographic knee OA severity was analyzed with Spearman Correlation. Statistical significance level at P < 0.05. Mean urinary CTX-II level was significantly higher in patients with OA compared with healthy controls (447.7( SB 316.39) ng/ml vs 289(SB 168.01) ng/mmol respectively, P = 0.023). There was a significant difference between urinary CTX-II level in patients with  grade ? 2 K-L knee OA compared with patients with grade > 2 K-L (240.35 (SB 88.90) ng/mmol vs 728.24 (SB 295.15) ng/mmol respectively; P < 0.001). The urinary CTX-II level was significantly associated with the degree of joint lesion in patients with OA (r = 0.734; P = 0.0001). Urinary level of CTX-II is strongly associated with the degree of radiographic joint lesion of OA
Prolonged-heated High-Fat Diet Increase the Serum LDL Cholesterol Level and Induce the Early Atherosclerotic Plaque Development in Wistar Rats Yurina, Valentina; Yunita, Ema Pristi; Raras, Tri Yudani Mardining; Rudijanto, Achmad; Handono, Kusworini
Journal of Tropical Life Science Vol 9, No 1 (2019)
Publisher : Journal of Tropical Life Science

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Abstract

Rats are one of the most widely used animal models in health research. However, since rats are relatively resistant to atherosclerosis, the transgenic rats often used to study atherosclerosis in rats. Our study suggests a prolonged-heated lipid to induce atherosclerosis in rats, therefore provide a more low-cost option to study atherosclerosis in rats. Aims of this study is to compare the effect of heated high-fat diet (HFD) to the LDL and HDL cholesterol level and foam cell formation in the Wistar rat animal model. Rats were divided into three groups, control group was given with the normal diet, and the other two treated groups received oxidized HFD (heated HFD) and HFD, respectively. The heated HFD contain lard that was previously heated at 190°C for 24 h. Diet was given for 8 weeks. The serum LDL and HDL cholesterol level were measured before and 4th and 8th weeks after treatment with help of colorimetric measurement. The aorta analyzed for the foam cell formation after HE staining using the light microscope.  The prolonged- heated HFD significantly increased the LDL cholesterol from the 4th week of the treatment (p = 0.023). The rats aortic from HFD and heated HFD treated groups showed a mononuclear cells infiltration and the early foam cell formation. The heating process of the lipid caused lipid oxidation which significantly increased the LDL cholesterol level of the animal model and foam cells formation. This study suggests that Wistar rats with heated HFD could demonstrated early atherosclerosis plaque development.
Proteinuria Severity in Lupus Nephritis is Associated with Anti-dsDNA Level and Immune Complex Deposit Location in Kidney Engli, Katherina; Handono, Kusworini; Eko, Mudjiwijono Handaru; Susianti, Hani; Gunawan, Atma; Kalim, Handono
Journal of Tropical Life Science Vol 8, No 3 (2018)
Publisher : Journal of Tropical Life Science

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.11594/jtls.08.03.03

Abstract

Lupus nephritis (LN) is one of the manifestations of Systemic Lupus Erythematosus (SLE), with proteinuria being one of the clinical manifestations. The proteinuria pathogenesis is associated with anti-dsDNA antibody and the location of immune complex deposits within the kidney. This study aims to investigate the correlation of the severity of proteinuria with the location of immune complex deposits and the level of anti-dsDNA antibody in LN. Data were collected in cross-section. Fifty-three patients with LN in Saiful Anwar Hospital Malang, who underwent renal biopsy, were included. Hematoxylin-eosin staining and immunofluorescence analysis were used to assign subjects to different histopathological classes and determine the immune complex deposits. The spot urine samples were evaluated using the dipstick method for semi-quantitative proteinuria. The anti-dsDNA antibody levels were evaluated using the enzyme-linked immunosorbent assay (ELISA). Turbidity and enzymatic tests were conducted to elucidate urine protein and creatinine content, respectively. The level of proteinuria is significantly different among the different locations of immune complex based on the dipstick and protein/creatinine methods (p = 0.021 and p = 0.005, respectively). There was a significant correlation between anti-dsDNA antibody level and the severity of proteinuria (r = 0.326 based on dipstick and r = 0.28 based on protein/creatinine method). Thus, proteinuria in LN is determined by anti-dsDNA level and the location of immune complex deposits in the kidney.
Co-Authors Abd. Rasyid Syamsuri Abdurrachman Abdurrachman Achmad Rifa’i, Achmad Achmad Rudijanto Achmad Rudijanto Agustina T Endharti, Agustina T Agustina Tri E Agustina Tri Endharti Ahmad Bayhaqi Nasir Aslam Airlangga, Dimas Ikhsan Albaar, Thoha M. Alfandy, Tommy N. Asih, Sari Wulan Ati Rastini Atma Gunawan Atma Gunawan Atma Gunawan Aulanni'am, Aulanni'am Balindra, Fredlina Rossa Bambang Rahardjo Benny A Pradana, Benny A Bowo Hery Prasetyo, Bowo Hery BP Putra Suryana BP Putra Suryana Cesarius Singgih Wahono Dalhar, Mochamad Dantara, Tri W.I. Dany Farida Desfryda, Elynca Putri Dessy Setiawati desy wulandari Dewi Purnama Sari Dewi, Elvira S. Dhani, Fauzan K. Dhian E. P. Harnandari Dian Ayu Wulansari, Dian Ayu Dian Hasanah Dian Sukma Hanggara Dimas Ikhsan Airlangga Djoko W. Soeatmadji Dona Marisa, Dona Dwinadella, Sephia Eko, Mudjiwijono Handaru Elvira Sari Dewi Ema Pristi Yunita Ema Pristi Yunita, Ema Pristi Engli, Katherina Enny Listyawati Erawati, Dini Rachma Erna Amin Faisal Faisal Farida ** Fatchiyah Fatchiyah Firdaningrum, Nimas Eka Gizta, Aura Bella Handono Kalim Hani Susanti, Hani Hani Susianti Hanik Ruliani Haribowo, A S Hidayat Sujuti HMS Chandra Kusuma I Putu A.S Ibrahim Njoto Ihda Dian Kusuma Indah Jayani Ivan A Hartono, Ivan A Janasti, Laksmitha Krisni Subandiyah Kurnianingsih, Nia L Enggar Fitri Laksmi Karunia Tanuwijaya Laksmi Karunia Tanuwijaya Lisyani Suromo Loeki Enggar Fitri M Rasjad Indra Machlusil Husna, Machlusil Maghfirah, Halimi Bidaimi Marsetyawan HNE Soesatyo Muhammad Anshory, Muhammad Muhammad Masyhur Nelly Ismayasih Nurdiana Nurdiana Nurhadi, Pradana Perdana Aditya Rahman Poetri, Levrita Nindya Pramadhani, Almira Prasetyo, Dwi A. Pratama, Mirza Z. Pratama, Mirza Zaka Purnomo, Athaya F. Purwanto Adipireno Putri, Choirinnisa Meilia Ayu Putu A. Herliawati R.I R.I Radhitio A Nugroho, Radhitio A Rahmawati, Hanifa Rizky Ria Famuji, Siti Roziah Rifa’i, A Rizky Fachry, Ade Wlidan Rossy Meilani Rulli Rosandi Safrina Dewi Ratnaningrum, Safrina Dewi Sari, Riana Trinovita Sari, Tita Luthfia Satrio Wibowo Singgih Wahono Solly Aryza Sri Andarini Indreswari Sri Poeranto, Sri Subandi Subandi Suharyo Hadisaputro Sulistomo, Hikmawan Wahyu Sulistyorini Sulistyorini Sumarno . Sumarta, Norma Hanifah Suryana, Bagus Putu Putra Sutrisno Sutrisno Suwito, Mat Syahrul Chilmi Tatit Nurseta Tatit Nurseta Torajasa Achamar Tri Yudani Mardining Raras VALENTINA YURINA VALENTINA YURINA Wahono, Caesarius Singgih Wahono, Cesarius S. Wahono, Cesarius Singgih Wisnu Barlianto Wisnu Barlianto Wisnu Barlianto Yahya Irwanto Yona One Sidarta, Yona One Yudhanto, Hendy Setyo Yuliana Salman Zaenal Kusuma