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Journal : Acta Interna : The Journal of Internal Medicine

Relationship Between Systemic Lupus Activity Measurement (SLAM) Score and Mortality in Systemic Lupus Erytemathosus (SLE) Inpatients Paramaiswari, Ayu; Kertia, Nyoman; Achadiyono, Deddy Wachid
Acta Interna The JOurnal of Internal Medicine Vol 4, No 1 (2014): Acta Interna The Journal Of Internal Medicine
Publisher : Acta Interna The JOurnal of Internal Medicine

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Abstract

ABSTRACTBackground: Systemic Lupus Erythematosus (SLE) is a chronic autoimmune disorder that can be severeand life threatening. Mortality in SLE may due to lupus activity or long-term sequel. Systemic Lupus ActivityMeasurement (SLAM) score is a tool that can count lupus disease activity inpatients.Aims: To analyze the relationship between SLAM score and mortality in lupus inpatients.Methods: Retrospective cohort study used for reaching objective of the study. Lupus inpatients was usedas research population. Medical record was used as study data collection over periods of 2006 until 2011.Independent variable was a SLAM score. The cut point of SLAM score was made based on the mean ofSLAM score (16.7 point score). Dependent variable was mortality.Results: There were differences between number of ACR criteria fi ndings, pneumonia, heart rate withSLAM score (p value 0.001; 0.001; 0.002 respectively).There was a difference of median survival between less and more than 16.7 point score, 45 and 28 respectively (p 0.034). There was a relationship betweenSLAM score (more than 16.7 point score) and mortality HR 2.78 (96% CI 1.01-7.53).There was a differenceof mortality incidence between more and less than 16.7 point score, 0.35 and 0.10 respectively. There wasa relationship between SLAM score (more than 16.7 point score) and mortality RR 3.5 (95% CI). Mortalityin lupus inpatients was 23%.Conclusion: There was a relationship between SLAM score and mortality on lupus inpatients.Keywords: SLE, SLAM, Mortality
Relationship Between Systemic Lupus Activity Measurement (SLAM) Score and Mortality in Systemic Lupus Erytemathosus (SLE) Inpatients Paramaiswari, Ayu; Kertia, Nyoman; Achadiyono, Deddy Wachid
Acta Interna The Journal of Internal Medicine Vol 4, No 1 (2014): Acta Interna The Journal Of Internal Medicine
Publisher : Acta Interna The Journal of Internal Medicine

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (228.179 KB)

Abstract

ABSTRACTBackground: Systemic Lupus Erythematosus (SLE) is a chronic autoimmune disorder that can be severe and life threatening. Mortality in SLE may due to lupus activity or long-term sequel. Systemic Lupus Activity Measurement (SLAM) score is a tool that can count lupus disease activity inpatients.Aims: To analyze the relationship between SLAM score and mortality in lupus inpatients.Methods: Retrospective cohort study used for reaching objective of the study. Lupus inpatients was used as research population. Medical record was used as study data collection over periods of 2006 until 2011. Independent variable was a SLAM score. The cut point of SLAM score was made based on the mean of SLAM score (16.7 point score). Dependent variable was mortality.Results: There were differences between number of ACR criteria fi ndings, pneumonia, heart rate with SLAM score (p value 0.001; 0.001; 0.002 respectively).There was a difference of median survival between less and more than 16.7 point score, 45 and 28 respectively (p 0.034). There was a relationship between SLAM score (more than 16.7 point score) and mortality HR 2.78 (96% CI 1.01-7.53). There was a difference of mortality incidence between more and less than 16.7 point score, 0.35 and 0.10 respectively. There was a relationship between SLAM score (more than 16.7 point score) and mortality RR 3.5 (95% CI). Mortality in lupus inpatients was 23%.Conclusion: There was a relationship between SLAM score and mortality on lupus inpatients.Keywords: SLE, SLAM, Mortality
ANTI-INFLAMMATORY ACTIVITIES OF TEMULAWAK, GINGER, SOYBEAN AND SHRIMP SHELL EXTRACTS IN COMBINATION COMPARED TO DICLOFENAC SODIUM Kertia, Nyoman; Akhadiono, Deddy Nur Wachid; Paramaiswari, Ayu; Fadlilah, Arina Syarifa; Harinawantara, Hangga
Acta Interna The Journal of Internal Medicine Vol 1, No 1 (2011): Acta Interna The Journal of Internal Medicine
Publisher : Acta Interna The Journal of Internal Medicine

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (853.846 KB)

Abstract

ABSTRACT Background: The prevalence of osteoarthritis (OA) in the community is high. This disease is the second most common cause of physical disability worldwide. Pain in OA is caused by several factors, such as inflammation. Non steroidal anti-inflammatory drugs (NSAIDs) were the most common drugs given worldwide to reduce pain in OA. NSAIDs were also associated with a high incidence of gastrointestinal side effects. An alternative to manage this problem is by using the combination of Curcuma xantorrhyza Roxb. (commonly known as temulawak) extract, ginger (Zingiber officinale) extract, soybean (Glycine max), and shrimp shell. Curcuma xantorrhyza contains curcumin which has anti-inflammatory effect by suppressing cyclo-oxygenase (COX-2) enzyme activity, suppressing lipo-oxygenase enzyme activity, and play a role as a free radical scavenger. Ginger can inhibit COX-2 activity in PGE-2 production. Shrimps shell contains glucosamine and chondroitin which can increase proteoglycan in articular chondrocytes and inhibit COX-2 synthesis. Isoflavone in soybean can inhibit articular cartilage degradation and COX-2 synthesis.Study Aims: The purpose of this study is to compare the effect of the combination to diclofenac sodium in reducing synovial fluid leukocyte count and joint pain in patients with osteoarthritis.Study Method:This study was a prospective randomized open end blinded evaluation (PROBE). Twenty one patients with knee osteoarthritis diagnosed by American College of Rheumatology criteria were included in this study. Patients were randomized into two groups to receive either diclofenac sodium 25 mg (control group) or the combination of Curcuma xantorrhyza extract 50 mg, ginger extract 100 mg, shrimp shell 100 mg, and soy bean flour 50 mg (treatment group) three times daily for 14 days. Independent t-tests and Mann-Whitney-Wilcoxon tests were used to evaluate changes between prior and post intervention.Results:  There were significantly reduction of synovial fluid leukocyte count in both control group (p=0.017) and treatment group (p=0.008) respectively.  The reduction of synovial fluid leukocyte count was not significantly different between control group and treatment group (p=0.929).  There were significant improvement of joint pain (VAS score) in both control group (p=0.012) and treatment group (p<0.001).  The reduction of VAS score was not significantly different between diclofenac group and treatment group (p=0.607).Conclution: These results indicate that the evicacy of this combiation was not significantly different with diclofenac sodium in reducing the synovial fluid leukocyte count and joint pain in patients with osteoarthritis.Keywords: osteoarthritis, Synovial fluid leukocyte count, Pain, VAS, Diclofenac sodium,Combinaion of curcuma, ginger, shrimp shell and soybean.
ANTI-INFLAMMATORY ACTIVITIES OF TEMULAWAK, GINGER, SOYBEAN AND SHRIMP SHELL EXTRACTS IN COMBINATION COMPARED TO DICLOFENAC SODIUM Nyoman Kertia; Deddy Nur Wachid Akhadiono; Ayu Paramaiswari; Arina Syarifa Fadlilah; Hangga Harinawantara
Acta Interna The Journal of Internal Medicine Vol 1, No 1 (2011): Acta Interna The Journal of Internal Medicine
Publisher : Faculty of Medicine Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (853.846 KB) | DOI: 10.22146/acta interna.3858

Abstract

ABSTRACT Background: The prevalence of osteoarthritis (OA) in the community is high. This disease is the second most common cause of physical disability worldwide. Pain in OA is caused by several factors, such as inflammation. Non steroidal anti-inflammatory drugs (NSAIDs) were the most common drugs given worldwide to reduce pain in OA. NSAIDs were also associated with a high incidence of gastrointestinal side effects. An alternative to manage this problem is by using the combination of Curcuma xantorrhyza Roxb. (commonly known as temulawak) extract, ginger (Zingiber officinale) extract, soybean (Glycine max), and shrimp shell. Curcuma xantorrhyza contains curcumin which has anti-inflammatory effect by suppressing cyclo-oxygenase (COX-2) enzyme activity, suppressing lipo-oxygenase enzyme activity, and play a role as a free radical scavenger. Ginger can inhibit COX-2 activity in PGE-2 production. Shrimps shell contains glucosamine and chondroitin which can increase proteoglycan in articular chondrocytes and inhibit COX-2 synthesis. Isoflavone in soybean can inhibit articular cartilage degradation and COX-2 synthesis.Study Aims: The purpose of this study is to compare the effect of the combination to diclofenac sodium in reducing synovial fluid leukocyte count and joint pain in patients with osteoarthritis.Study Method:This study was a prospective randomized open end blinded evaluation (PROBE). Twenty one patients with knee osteoarthritis diagnosed by American College of Rheumatology criteria were included in this study. Patients were randomized into two groups to receive either diclofenac sodium 25 mg (control group) or the combination of Curcuma xantorrhyza extract 50 mg, ginger extract 100 mg, shrimp shell 100 mg, and soy bean flour 50 mg (treatment group) three times daily for 14 days. Independent t-tests and Mann-Whitney-Wilcoxon tests were used to evaluate changes between prior and post intervention.Results:  There were significantly reduction of synovial fluid leukocyte count in both control group (p=0.017) and treatment group (p=0.008) respectively.  The reduction of synovial fluid leukocyte count was not significantly different between control group and treatment group (p=0.929).  There were significant improvement of joint pain (VAS score) in both control group (p=0.012) and treatment group (p<0.001).  The reduction of VAS score was not significantly different between diclofenac group and treatment group (p=0.607).Conclution: These results indicate that the evicacy of this combiation was not significantly different with diclofenac sodium in reducing the synovial fluid leukocyte count and joint pain in patients with osteoarthritis.Keywords: osteoarthritis, Synovial fluid leukocyte count, Pain, VAS, Diclofenac sodium,Combinaion of curcuma, ginger, shrimp shell and soybean.
Relationship Between Systemic Lupus Activity Measurement (SLAM) Score and Mortality in Systemic Lupus Erytemathosus (SLE) Inpatients Ayu Paramaiswari; Nyoman Kertia; Deddy Wachid Achadiyono
Acta Interna The Journal of Internal Medicine Vol 4, No 1 (2014): Acta Interna The Journal Of Internal Medicine
Publisher : Faculty of Medicine Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (228.179 KB) | DOI: 10.22146/acta interna.5729

Abstract

ABSTRACTBackground: Systemic Lupus Erythematosus (SLE) is a chronic autoimmune disorder that can be severe and life threatening. Mortality in SLE may due to lupus activity or long-term sequel. Systemic Lupus Activity Measurement (SLAM) score is a tool that can count lupus disease activity inpatients.Aims: To analyze the relationship between SLAM score and mortality in lupus inpatients.Methods: Retrospective cohort study used for reaching objective of the study. Lupus inpatients was used as research population. Medical record was used as study data collection over periods of 2006 until 2011. Independent variable was a SLAM score. The cut point of SLAM score was made based on the mean of SLAM score (16.7 point score). Dependent variable was mortality.Results: There were differences between number of ACR criteria fi ndings, pneumonia, heart rate with SLAM score (p value 0.001; 0.001; 0.002 respectively).There was a difference of median survival between less and more than 16.7 point score, 45 and 28 respectively (p 0.034). There was a relationship between SLAM score (more than 16.7 point score) and mortality HR 2.78 (96% CI 1.01-7.53). There was a difference of mortality incidence between more and less than 16.7 point score, 0.35 and 0.10 respectively. There was a relationship between SLAM score (more than 16.7 point score) and mortality RR 3.5 (95% CI). Mortality in lupus inpatients was 23%.Conclusion: There was a relationship between SLAM score and mortality on lupus inpatients.Keywords: SLE, SLAM, Mortality
Maxillary Reconstruction Timing in Severe Systemic Lupus Erythematous (SLE) Patient with Bone Destruction due to Invasive Aspergillosis: Case Report Yulyani Werdhiningsih; Ayu Paramaiswari; Deddy Nur Wachid Achadiono; Nyoman Kertia
Acta Interna The Journal of Internal Medicine Vol 10, No 2 (2020): Acta Interna The Journal of Internal Medicine
Publisher : Faculty of Medicine Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/actainterna.62845

Abstract

Severe Systemic Lupus Erythematosus patient was in the third of 28-days-cycle cyclophosphamide chemotherapy when the early symptoms of aspergillus infection occurred. This developed into extensive cranial bone damage. It was planned to get a biopsy and debridement for bone and soft tissue to diagnose and therapy palate osteonecrosis, followed by reconstruction surgery. This case report aimed to report the successful management of a severe patient on chemotherapy undergoing several operations so that the SLE aspergillosis is optimally managed.
Thyrotropin Receptor Antibody as a Risk Factor for the Occurrence and Severity of Graves' Ophthalmopathy Ikhsan, Mohammad Robikhul; Kertia, Nyoman; Supanji, Supanji; Rianto, Bambang Udji Djoko
Acta Interna The Journal of Internal Medicine Vol 12, No 1 (2023): Acta Interna The Journal of Internal Medicine
Publisher : Faculty of Medicine Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/actainterna.98158

Abstract

Background. Graves' disease (GD) is an autoimmune disorder known to be the most common cause of hyperthyroidism. Thyrotropin receptor antibody (TRAb) might be involved in the occurrence and the disease process of Graves’ ophthalmopathy (GO).Objectives. This study aimed to evaluate whether TRAb levels are associated with the occurrence and severity of GO based on the clinical severity of The European Group on Graves' Orbitopathy (EUGOGO).Methods. A case-control study of 44 patients with newly diagnosed Graves’ disease (22 with GO compared to 22 without GO). Diagnosis of GO was made according to Bartley and Gorman’s criteria. Level of thyrotropin receptor antibody was tested with electrochemiluminescence immunoassay (ECLIA) method. Assessment of the clinical severity of GO was documented with EUGOGO scores.Results. Baseline characteristics were similar between 22 patients with GO compared to 22 patients non-GO group. Thyrotropin receptor antibody (TRAb) significantly increased in the GO group (11.223±7.116 IU/L) when compared to non-GO (6.720±3.442 IU/L; P=0.035). Multiple logistic regression analysis shows that 1 IU/L increase of TRAb has a 1.610-fold higher risk for developing GO. In the GO group, there is correlation between TRAb and the severity of GO-based on EUGOGO (r =0.794, P<0.001).Conclusion. Thyrotropin receptors antibody is a risk factor for the occurrence and severity of GO-based on EUGOGO.
The Relationship between the Number of Major Organ Involvement and Therapeutic Response of Pulse Dose Methylprednisolone in Systemic Lupus Erythematosus Patients Kartyanto, Adhita; Paramaiswari, Ayu; Kertia, Nyoman
Acta Interna The Journal of Internal Medicine Vol 12, No 1 (2023): Acta Interna The Journal of Internal Medicine
Publisher : Faculty of Medicine Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/actainterna.98165

Abstract

Background. Systemic Lupus Erythematosus (SLE) requires comprehensive and integrated treatment because it can manifest in various organ systems, both non-major and major organs. Pulse doses Methylprednisolone used as induction therapy, it provides dramatic improvement in prognosis in severe lupus through its nongenomic effects. Not all SLE patients who received pulse dose methylprednisolone therapy gives complete response, several factors may influence the therapeutic response, one of which is thought to influence the difference in therapeutic response is the number of major organ involvement.Objectives. To determine the relationship between the number of major organ involvement and therapeutic response of pulse dose methylprednisolone therapy in SLE patients at Dr. Sardjito Hospital Yogyakarta.Methods. This study used a retrospective cross-sectional study. The subjects of this study were adult patients with SLE treated in the internal medicine ward at Dr. Sardjito Hospital Yogyakarta and met the inclusion and exclusion criteria from January 1, 2016 to December 31, 2019. The data on the characteristics of the research subjects were taken from the patient's medical records and laboratory data before giving pulse methylprednisolone.Results. A total of 88 research subjects were taken from medical records. Patients with major organ involvement 1 experienced more complete response (53.8%), major organ involvement 2 mostly partial response (66.7%), major organ involvement 3 (48.6%) and major organ involvement 4 (53.8%) no response, and major organ involvement 5 (75%) partial response. There is a significant relationship with the number of major organ involvement with therapeutic response p<0.001. The correlation coefficient r=0.382 means that the more major organ involvement the less therapeutic response. The results of multivariate analysis showed that only the number of major organ involvement had a dominant effect on the therapeutic response, p=0.001. Regression coefficient 0.797.Conclusion. The number of major organ involvement significantly affects the success of pulse dose methylprednisolone therapy in SLE patients.
The Impact of Starting Urate-Lowering Therapy (ULT) During A Gout Flare on The Ongoing Episode: A Systematic Review of Randomized Controlled Trials Yogiswara, Komang Satvika; Widhiarta, Putu Raka; Wiwekananda, Ketut Shri Satya; Paramaiswari, Ayu; Achadiono, Dedy Nurwachid; Kambayana, Gede; Kertia, Nyoman
Acta Interna The Journal of Internal Medicine Vol 13, No 1 (2024): Acta Interna The Journal of Internal Medicine
Publisher : Faculty of Medicine Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/actainterna.101289

Abstract

Background. Gout is a prevalent form of arthritis caused by the accumulation of monosodium urate (MSU) crystals. Urate-lowering therapy (ULT) may be started once an acute flare has subsided to prevent the present episode from lasting longer. Nevertheless, ULT may be commenced during an acute flare-up in order to decrease the frequency of outpatient appointments and enhance patient adherence. The objective of this study was to conduct whether the commencement of urate-lowering therapy (ULT) during an acute gout flare is effective. Method. We performed a systematic review of articles published in MEDLINE, PubMed, Cochrane library, and EMBASE databases from 2018 to 2023. The search was limited to articles published in English, and RCTs in patients older than 18 years.Results and Discussions. Among 242 recorded studies, only four with 323 patients were eligible for this research. The treatment with Allopurinol began with a daily dose    of 100 mg for the initial 14 days, followed by an increase to a daily dose of 200 mg for     the subsequent 14 days. The reported time to resolution was 15.4 days for the group receiving allopurinol and 13.4 days for the group receiving the placebo. According to this review, the start of ULT (uric acid-lowering therapy) should be determined by sufficient anti-inflammatory measures. Commencing ULT during a gout flare has no impact on the intensity, duration, or likelihood of recurrence of the flare within the following 28 to 30 days.Conclusions. This study demonstrated that the commencement of urate-lowering therapy (ULT) during an acute gout flare did not result in a longer duration of the flare. Nevertheless, it is necessary to conduct a clinical  studies with a bigger sample size in order to validate this review.
Co-Authors Abdul Khairul Rizki Purba Mustofa Indwiani Astuti Achadiono, Deddy Achadiono, Dedy Nurwachid Ahmad Husain Asdie Ahmad Husain Asdie Ahmad Husain Asdie Arif Nurrochmad Arif Prassetyo Arina Syarifa Fadlilah Asdie, Achmad Husain Ayu Paramaiswari Ayu Paramaiswari Baiq R Rhadianaa Bambang Udji Djoko Rianto Bambang Udji Djoko Riyanto, Bambang Udji Djoko Danang ., Danang Deddy Nur Wachid Deddy Nur Wachid Achadiono Deddy Nur Wachid Akhadiono Deddy Wachid Achadiyono Dewa Ayu G. N. Dewa Ayu G. N., Dewa Ayu Dyah Ariani Perwitasari Dyah Aryani Perwitasari Ema Madyaningrum Endang Mahati Eny Catur, Eny F, Melani Farah Nuriannisa Gede Kambayana Gunawan, I Made Alit Hangga Harinawantara Haslinda Haslinda Haslinda Haslinda, Haslinda Heru Yulianto I Dewa Putu Pramantara I Made Alit Gunawan I Made Alit Gunawan Ika Puspitaningrum Imono A.D., Imono Indwiani Astuti Irwan Supriyanto Kartyanto, Adhita Khasana, Tri Mei Krishnan, P N Lily Arsanti Lestari M. Marsetyawan Mae Sri Hartati Wahyuningsih Maria Caecilia Nanny Setiawati Maria Caecilia Setiawati Marsetyawan -, Marsetyawan Marsetyawan Marsetyawan Marsetyawan Marsetyawan Metalia Puspitasari Mohammad Robikhul Ikhsan Mufrod ., Mufrod Mustika Muthaharah Mustika Muthaharah mustika muthaharah muthaharah, mustika N. Setiawati, M. Caecilia Nastiti Hemas M. Nastiti Hemas M., Nastiti Hemas Nugroho, Dhite Nunu N Madjid Nur Arfian Nur Mahdi Nurrochmad, Arif P N Krishnan Poerwono Rahardjo Pratiwi, Woro Rukmi Probosuseno Probosuseno Probosuseno Probosuseno, Probosuseno Rochmach, Wasilah Ronny T Wirasto Sinarta, Armin SRI SETIYARINI, SRI Srinalesti Mahanani, Srinalesti Sugeng Sugeng Supanji, Supanji Susini R Sari Tri Mei Khasana W.N., Meika Wachid, Deddy Nur Wasilah Rochmah Wasilah Rochmah Wasilah Rochmah Widhiarta, Putu Raka Wiwekananda, Ketut Shri Satya Wiwin Lismidiati Yenny Kandarini Yogiswara, Komang Satvika Yolanda Dyah Kartika Yuliani, Kartika Yulyani Werdhiningsih Z, Ikawati Zulies Ikawati