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Effect of vitamin D supplementation on disease activity (SLEDAI) and fatigue in Systemic Lupus Erythematosus patients with hipovitamin D: An Open Clinical Trial Achmad Rifa’i; Handono Kalim; Kusworini Kusworini; Cesarius Singgih Wahono
Indonesian Journal of Rheumatology Vol. 8 No. 2 (2016): Indonesian Journal of Rheumatology
Publisher : Indonesian Rheumatology Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (381.299 KB) | DOI: 10.37275/ijr.v8i2.59

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
Validation of Modified COPCORD Questionnaire Indonesian Version as Screening Tool for Joint Pain and Musculoskeletal Diseases Muhammad Anshory; Cesarius Singgih Wahono; Handono Kalim; Harun Al Rasyid
Indonesian Journal of Rheumatology Vol. 10 No. 1 (2018): Indonesian Journal of Rheumatology
Publisher : Indonesian Rheumatology Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (348.818 KB) | DOI: 10.37275/ijr.v10i1.95

Abstract

Background: WHO-ILAR COPCORD Program is a program that aimed to obtain data on joints pain and musculoskeletal diseases in developing countries, one aspect which has not been studied is the ability of COPCORD questionnaire as a screening tool which standardized for  screening  joint pain and musculoskeletal diseases. Objective of this study is to assess the validity of modified COPCORD questionnaire Indonesian version in screening joint pain and musculoskeletal disease compared to examination by rheumatologists.Methods: The initial phase of the research is determining essential points, translation to Indonesian, and back translation. The second stage is testing questionnaires in communities which 100 respondents involved. Dependent variable is the diagnosis of rheumatic diseases and independent variables are pain in less and more than 7 days, high degree pain in less and more than 7 days, history of NSAIDs/Steroids/DMARDs use, and disabilities. Validation test was assessed by calculating the sensitivity, specificity, PPV, NPV, LR+, and ROC curve. Bivariate analysis using Chi Square analysis, and multivariate analysis using logistic regression.Results: The sensitivity test results is best obtained on the question history of NSAIDs/steroids/DMARDs use (100%)  and specificity is best obtained on the question about disability (98%). ROC curve analysis which the results >85% obtained on the question of pain >7 days (90%), high degree pain >7 days (93%), and history of NSAIDs/steroids/DMARDs use (92%).  LR+ to diagnose rheumatic diseases found in all questions. Chi square analysis showed that all questions were significant with p <0.05 and odds ratio (OR) obtained most on high degree pain more than 7 days (OR: 180.167; 95% CI: 38.196-849.834).Conclusion: The modified COPCORD questionnaire Indonesian version has been adapted and can be a good tool in the screening of joint pain and musculoskeletal diseases compared to examination by rheumatologists. Keyword: Validation, Questionnaire, COPCORD
The Correlation between Serum Concentration of Vitamin D with Vitamin D Receptor Expression and Disease Activity in Indonesian Patients with Systemic Lupus Erythematosus: Preliminary Study Kusworini Handono; Laksmi Karunia Tanuwijaya; Loeki Enggar Fitri; Handono Kalim
Journal of Tropical Life Science Vol. 4 No. 2 (2014)
Publisher : Journal of Tropical Life Science

Show Abstract | Download Original | Original Source | Check in Google Scholar

Abstract

The vitamin D role on the immune response of systemic lupus erythematosus (SLE) patient is mediated by vitamin D receptor (VDR). Low level of vitamin D correlated with disease activity in SLE patients, and circulating levels of activated vitamin D (1,25(OH)2D) contribute to VDR protein levels and its function. The objective of this study was to determine the correlation between vitamin D status with expression of VDR in peripheral blood mononuclear cell (PBMC) and the disease activity in SLE patients. The Research Subjects were 15 SLE patients (ACR 1997 criteria) from the Rheumato-Immunology Division, dr. Saiful Anwar Hospital, Malang and 5 healthy controls. Serum vitamin D (25(OH)D3) level was assessed using ELISA method. VDR expression in PBMC was assessed using immunocytochemistry technique. The disease activity was measured by Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) score. This study showed no difference on VDR expression in PBMC between patient and healthy control group, but patient with vitamin D deficiency had lower VDR expression in PBMC than the other group. No difference on SLEDAI score between the group. Vitamin D status correlated positively with VDR expression in PBMC (p < 0,035, r = 0,473). However vitamin D status did not correlate with disease activity scores (p = 0,686).
HUBUNGAN ANTARA PENANDA sCD28 DAN sCTLA-4 TERHADAP PERSENTASE SEL LIMFOSIT T CD8+CD45RA+ PADA PENUAAN IMUN: - Handono, Kusworini; Susanti, Hani; Pratama, Mirza Zaka; Kalim, Handono; Wahono, Caesarius Singgih; Ria Famuji, Siti Roziah; Firdaningrum, Nimas Eka; Sumarta, Norma Hanifah; Rizky Fachry, Ade Wlidan
Majalah Kesehatan Vol. 10 No. 4 (2023): Majalah Kesehatan
Publisher : Faculty of Medicine Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/majalahkesehatan.2023.010.04.1

Abstract

Penuaan merupakan proses alami dan kompleks yang ditandai dengan penurunan fungsi fisiologis manusia sehingga berakibat pada perubahan sistem imun. Sampai saat ini, deteksi penuaan imun (immunosenescence) masih memiliki kendala yang berarti. Penanda satu-satunya yang diyakini sebagai prediktor penuaan imun adalah immune risk profile (IRP). Namun, IRP hanya dapat diamati dengan pemeriksaan flowsitometri yang membutuhkan alat canggih dan keterampilan khusus. Oleh karena itu, diperlukan penelitian yang menemukan suatu penanda deteksi penuaan imun melalui metode yang lebih mudah. Beberapa marker kostimulator memiliki bentuk terlarut di dalam serum. Penanda CD28 dan CTLA-4 pada membran memainkan peran utama pada regulasi aktivasi limfosit T dan marker diagnostik pada autoimun ataupun penuaan imun. Meskipun demikian, bentuk terlarut dari penanda tersebut masih belum banyak diteliti.  Tujuan dari penelitian ini adalah meneliti keterkaitan antara penanda sCD28 dan sCTLA-4 terhadap persentase IRP sel limfosit T CD8+CD45RA+ pada penuaan imun. Molekul kostimulator sCD28 dan sCTLA4 diukur menggunakan ELISA, sedangkan persentase sel limfosit T CD8+CD45RA+ menggunakan flowsitometri. Pada penelitian ini didapatkan 87 responden terdiri dari 23,0% responden kelompok individu muda, 40,2% kelompok pasien Lupus Eritematosus Sistemik (LES), dan 36,8% responden kelompok lansia. Kadar sCD28 dan sCTLA-4 terhadap persentase sel limfosit T CD8+CD45RA+ memiliki hubungan yang tidak signifikan pada penuaan imun. Pada penuaan imun, fungsi sel limfosit T yang mengekspresikan CD45RA menampilkan cacat proliferatif dan pensinyalan, tetapi tetap polifungsional.
Strengthening Moral and Material Support for Lupus Patients and Their Families at the Kupu Parahita Indonesia Foundation Through Cinematherapy Handono, Kusworini; Dewi, Elvira Sari; Desfryda, Elynca Putri; Dwinadella, Sephia; Putri, Choirinnisa Meilia Ayu; Kalim, Handono; Wahono, Cesarius Singgih; Barlianto, Wisnu; Erawati, Dini Rachma; Pratama, Mirza Zaka; Sari, Tita Luthfia; Nurdiana, Nurdiana; Kusuma, Zaenal
Journal of Innovation and Applied Technology Vol 9, No 2 (2023)
Publisher : Lembaga Penelitian dan Pengabdian Kepada Masyarakat Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jiat.2023.9.2.13

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Lupus patients and their families require adequate support to manage the disease's progression. This community service aims to help the Kupu Parahita Indonesia Foundation provide strengthened moral and material support for lupus patients and their families at the Kupu Parahita Indonesia Foundation. Results: The cinematherapy planned by the PKNM and Community Service Team received much positive feedback from patients and families. The sharing session expressed that patients and their families are grateful for the opportunity to enjoy free recreation together. Enthusiasm comes with enthusiasm to meet people with fellow lupus. . In conclusion, cinematherapy can help the Kupu Parahita Indonesia Foundation provide lupus patients and their families with more substantial moral and material support.
Optimalisasi Dukungan Sosial Bagi Pasien Lupus dan Keluarga Pasca Pandemi Covid-19 di Yayasan Kupu Parahita Indonesia Dewi, Elvira Sari; Putri, Choirinnisa Meilia Ayu; Desfryda, Elynca Putri; Dwinadella, Sephia; Wahono, Cesarius Singgih; Sari, Dewi Purnama; Handono, Kusworini; Kalim, Handono
International Journal of Community Service Learning Vol. 7 No. 2 (2023): May 2023
Publisher : Universitas Pendidikan Ganesha

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.23887/ijcsl.v7i2.56434

Abstract

Selama pandemi Covid-19, pasien lupus dan keluarga dihadapkan dengan berbagai stresor dan tantangan yang dapat mempengaruhi dukungan sosial. Kegiatan pengabdian pada masyarakat ini bertujuan untuk mengoptimalkan dukungan sosial bagi pasien lupus dan keluarga pasca pandemi Covid-19 di Yayasan Kupu Parahita Indonesia. Metode yang digunakan dalam kegiatan pengabdian pada masyarakat ini adalah dengan melakukan Forum Group Discussion (FGD) untuk menggali kebutuhan pasien lupus dan keluarga akan dukungan sosial; menyelenggarakan pertemuan offline antara pasien lupus, keluarga, dan tenaga kesehatan pemerhati lupus; serta memberikan edukasi intens secara online. Hasil kegiatan menunjukkan bahwa dari kegiatan FGD, didapatkan permasalahan bahwa belum semua pasien lupus dan keluarga di Yayasan Kupu Parahita Indonesia mengenal dan memahami lupus dengan baik. Melalui kegiatan yang diselenggarakan secara offline maupun online, masalah yang didapat saat FGD teratasi, di mana pasien lupus dan keluarga lebih memahami lupus dan dengan sharing sesama pejuang lupus, kebutuhan dukungan sosial pasien lupus dan keluarga terpenuhi. Dapat disimpulkan bahwa pendekatan secara intens baik secara offline maupun online sangat diperlukan untuk mengoptimalkan dukungan sosial bagi pasien lupus dan keluarga.
A complex case of severe thrombocytopenia in systemic lupus erythematosus complicated by Corynebacterium spp. infection Akbar, Muhamad; Kalim, Handono
Deka in Medicine Vol. 1 No. 3 (2024): December 2024
Publisher : PT. DEKA RESEARCH INSTITUTE

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.69863/dim.2024.e472

Abstract

BACKGROUND: Systemic Lupus Erythematosus (SLE) is a chronic autoimmune inflammatory disease the course of which is still indefinite. Thrombocytopenia concurrent with Corynebacterium spp.—an infrequent complication in SLE patients—is seldom reported. CASE A 34-year-old female was admitted for continuous bleeding from the gums that had been ongoing for three days. The patient had been suffering from SLE since 2018 and took immunosuppressive medication regularly. The anemia, lymphocytopenia, and severe thrombocytopenia were shown in her laboratory tests. Besides, the infection of Corynebacterium spp. was detected in the patient. In fact, hematologic abnormalities and infections in SLE patients usually mutually overlap for the reason that these conditions possess the potential to influence each other. Infection can be both the cause and result of hematologic abnormalities in SLE. Thus, the pathophysiology of hematologic abnormalities in SLE patients can often be related to the use of immunosuppressive drugs. However, some theories suppose that increased SLE activity correlates with infection occurrence in SLE—even without the use of immunosuppressive drugs. CONCLUSION Thrombocytopenia and Corynebacterium spp. infection in SLE patients is a case rarely reported, and establishing the diagnosis requires detailed examination.
Menurunkan Angka Kejadian dan Mencegah Kekambuhan COVID-19, Lupus, Reumatik, dan Alergi Melalui Pembentukan Desa Binaan Dewi, Elvira Sari; Wahono, Cesarius Singgih; Barlianto, Wisnu; Handono, Kusworini; Sari, Tita Luthfia; Hasanah, Dian; Rahman, Perdana Aditya; Anshory, Muhammad; Wulandari, Desy; Sari, Dewi Purnama; Endharti, Agustina Tri; Nurdiana, Nurdiana; Kalsum, Umi; Susianti, Hani; Kalim, Handono
International Journal of Community Service Learning Vol. 5 No. 1 (2021): February 2021
Publisher : Universitas Pendidikan Ganesha

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (189.075 KB) | DOI: 10.23887/ijcsl.v5i1.30161

Abstract

Kurangnya pengetahuan masyarakat tentang COVID-19, lupus, reumatik, dan alergi mempengaruhi keberhasilan terapi, penurunan angka kejadian, dan pencegahan kekambuhan. Tujuan pengabdian masyarakat adalah membangun desa-desa binaan tanggap COVID-19, lupus, reumatik, dan alergi di Malang oleh Tim Kelompok Kajian Lupus, Autoimun, Reumatik, dan Alergi (LAURA) Universitas Brawijaya. Warga desa binaan diberikan penyuluhan berupa seminar awam dan pelatihan tentang pertolongan awal pada penyakit COVID-19, lupus, reumatik, dan alergi, kemudian diminta mengisi kuesioner posttest untuk mengukur pemahaman. Desa-desa binaan diberikan thermo-gun dan wastafel untuk menerapkan protokol kesehatan. Satu bulan kemudian dievaluasi adanya kejadian COVID-19, lupus, reumatik, dan alergi di desa binaan. Hasil evaluasi menunjukkan rata-rata warga desa binaan memahami 78,3% materi yang diberikan dan menerapkan protokol kesehatan sesuai yang diajarkan saat penyuluhan. Dilaporkan tidak ada kejadian COVID-19 serta kekambuhan lupus, reumatik, dan alergi dalam satu bulan terakhir kegiatan. Kesimpulan: pembangunan desa-desa binaan di Malang meningkatkan tanggap warga terhadap COVID-19, lupus, reumatik, dan alergi.
Co-Authors A Rifa’i Abd. Rasyid Syamsuri Abdurrachman Abdurrachman Achmad Rifa’i, Achmad Achmad Rifa’i Achmad Rudijanto Agustina T Endharti, Agustina T Agustina Tri Endharti Aru W Sudoyo Asri Nugraheni Ati Rastini Atma Gunawan Atma Gunawan Bambang Setyohadi Benny A Pradana, Benny A BP Putra Suryana Dany Farida Deddy Nur Wachid Achadiono Desfryda, Elynca Putri desy wulandari Dewi Purnama Sari Dian Hasanah Djoko W. Soeatmadji Djoko Wahono S Dona Marisa, Dona Dwinadella, Sephia Eko, Mudjiwijono Handaru Elvira Sari Dewi Engli, Katherina Erawati, Dini Rachma fatchiyah . Fatchiyah Fatchiyah Ferdinandus Maria Judajana Fikriah, Ika Firdaningrum, Nimas Eka Hani Susanti, Hani Hani Susianti Hanik Ruliani Harry Isbagio Harun Al Rasyid Harun Al Rasyid I Putu A.S Ibrahim Njoto Ivan A Hartono, Ivan A Joewono Soeroso Joewono Soeroso Kusworini Handono Kusworini Handono Kusworini Handono Kusworini Handono Kusworini Kusworini Laksmi Karunia Tanuwijaya Laksmi Karunia Tanuwijaya Loeki Enggar Fitri M Aris Widodo Mat Suwito Moch Sasmito Djati Mudjiwijono Handaru Eko Muhammad Anshory Muhammad Anshory, Muhammad Muhammad Darwin P Nurdiana Nurdiana Perdana Aditya Rahman Pratama, Mirza Zaka Putri, Choirinnisa Meilia Ayu R.I R.I Rachmat Gunadi Wachjudi Radhitio A Nugroho, Radhitio A Respati Suryanto Dradjat Ria Famuji, Siti Roziah Rifa’i, A Rizky Fachry, Ade Wlidan Rooije R.H. Rumende Sari, Tita Luthfia Solly Aryza Sumarta, Norma Hanifah Supriono Supriono Suryana, Bagus Putu Putra Suwito, Mat Tamaulina Br Sembiring Torajasa Achamar Wahono, Caesarius Singgih Wahono, Cesarius Singgih Wisnu Barlianto Yona One Sidarta, Yona One Zaenal Kusuma