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Factors Affecting Patient Adherence to Pharmacological Therapy in Gout Arthritis and Hyperuricemia Dzaki Edmonda Setyawan; Endang Mahati; Nani Maharani
JURNAL KEDOKTERAN DIPONEGORO (DIPONEGORO MEDICAL JOURNAL) Vol 11, No 3 (2022): JURNAL KEDOKTERAN DIPONEGORO (DIPONEGORO MEDICAL JOURNAL)
Publisher : Faculty of Medicine, Universitas Diponegoro, Semarang, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14710/dmj.v11i3.32688

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Abstract Background: Pharmacological therapy to reduce serum uric acid levels in gouty arthritis and hyperuricemia patients is essential to prevent gout flare and other hyperuricemia-related morbidities. However, only about 50% of gout arthritis patients adhered to their treatment. Knowing the factors influencing adherence to therapy can be used as a reference for health services to improve adherence.Objective: This study aimed to analyze the factors that influenced the patient's adherence to gouty arthritis and hyperuricemia pharmacological therapy.Methods: This was an observational study with a cross-sectional approach. Subjects were the patients in Wuryantoro Community Health Center, Wonogiri Regency, diagnosed with gouty arthritis or hyperuricemia due to a disorder in purine metabolism. Sampling was done by a consecutive sampling method. Questionnaires with the related medical record were used to collect the necessary data. Research variables were knowledge, attitudes and behavior, gender, age, occupation, insurance, distance from residence to health care facilities, and adherence to therapy which was in binary.Results: Sixty-one percent from a total of 41 respondents were found to be non-adherence to pharmacological therapy. Knowledge, attitudes, and behavior towards therapy, educational level, availability of health insurance, and distance to health facilities were significantly correlated to treatment adherence (p < 0.05). Sex, age, and occupation were not correlated to adherence.Conclusion: Factors influencing adherence were knowledge, attitudes and behavior, academic background, insurance, and the distance from residence to health care facilities.
Effect of Mangosteen Peel Extract on SGOT and SGPT in Rats Fed Reused Cooking Oil Widyastuti, Esti; Maharani, Nani; Utomo, Astika Widy
Sains Medika: Jurnal Kedokteran dan Kesehatan Vol 9, No 2 (2018): December 2018
Publisher : Faculty of Medicine, Universitas Islam Sultan Agung (UNISSULA), Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (995.324 KB) | DOI: 10.30659/sainsmed.v9i2.2286

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Background: Free radicals that enter the body due to consumption of reused cooking oil can cause liver cell damage. Mangosteen peel extract (Garcinia mangostana L) is known to contain mangostin as an ntioxidant. However, it is not known whether it can repair liver damage.Objective: To deter mine the ef fect of mangosteen peel extract on the levels of SGOT and SGPT of Wistar rats fed with reused cooking oil.the ef fect of mangosteen peel extract on the levels of SGOT and SGPT of Wistar rats fed with reused cooking oil.Methods: This study was a tr ue experimental study with post-test only controlled group design. Twenty four male Wistar rats were randomly divided into 4 groups randomly. The CN-G group was given the standard diet, the MJ-G group was given a standard diet and cooking oil, the MJM- 400 group was given standard diet, reused cooking oil, and mangosteen peel extract at a dose of 400 mg/KgBW, and the MJM-800 group was fed with a standard, reused cooking oil, and mangosteen peel extract at 800mg/KgBW. The treatment was car ried out for 28 days, and then continued with examination of reused cooking oil, and mangosteen peel extract at 800mg/KgBW. The treatment was car ried out for 28 days, and then continued with examination of SGOT and SGPT levels using the Inter national Federation of Clinical Chemistr y (IFCC) method without Pyridoxal Phosphate 37ºC.Results: Kr uskal Walis test showed that SGOT and SGPT levels showed no signif icant dif ferences between groups (p = 0.197 and 0.063, respectively).Conclusion: administration of mangosteen (Garcinia mangostana L) peel extract did not af fect SGOT levels, even tended to increase SGPT levels in ratsinduced by cooking oil.
PENGARUH SUPLEMENTASI KOMBINASI BAWANG PUTIH (ALLIUM SATIVUM), BERAS RAGI MERAH (MONASCUS PURPUREUS), DAN JAHE MERAH (ZINGIBER OFFICINALE VAR. RUBRUM) TERHADAP KADAR TRIGLISERIDA DAN HDL PASIEN STROKE ISKEMIK DENGAN DISLIPIDEMIA Aisy, Rihadatul; Maharani, Nani; Jaeri, Santoso; Retnaningsih, Retnaningsih
Journal of Nutrition College Vol 13, No 1 (2024): Januari
Publisher : Department of Nutrition Science, Faculty of Medicine, Universitas Diponegoro

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14710/jnc.v13i1.42033

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ABSTRACTBackground: The incidence of stroke in the world is reported as many as 15 million people each year and around 185 thousand experience recurrent strokes. The incidence of recurrent stroke can be avoided by controlling risk factors, especially dyslipidemia. There is a relationship between dyslipidemia and the risk of atherosclerosis, especially ischemic stroke and peripheral arterial disease. Nutraceuticals can be used as an adjuvant to conventional drugs. Objectives: The purpose of this study was to determine the effect of giving herbs containing garlic (Allium sativum) 675 mg, red yeast rice (Monascus purpureus) 750 mg, and red ginger (zingiber officinale var. rubrum) 375 mg, hereinafter referred to as BJR 22 on TG and HDL levels.Materials and Methods: This research was pre and posttest Control Group Design with double blind method. The research subjects were selected consecutively with 20 intervention groups receiving standard therapy (statins) and BJR 22 3 capsules/day and 20 control groups receiving standard therapy (statins) and placebo once daily, each group being given for 30 days. The data were analyzed used the Shapiro wilk test, Wilcoxon, Chi Square, Fisher's exact and Paired T-test. Results: The average change in TG levels before and after treatment in the intervention group was -5.95 ± 86.88 (p=0.575), while the control group was 4.3 ± 97.08 (p=0.845). There was no significant difference between the two group. The change in HDL levels in the intervention group was 10 ± 13.46, indicating a significant change (p = 0.004). In the control group it was 5.3 ± 27.25 indicating a change that was not significant (p = 0.273). The regression test shows that the factors that influence TG levels are calorie intake and those that influence HDL levels are smoking status, hypertension and fat intake.Conclusion: BJR 22 supplementation of 3 capsules/day for 30 days can improve HDL levels but does not significantly affect triglyceride levels.Keywords: Garlic, Red Yeast Rice, Dyslipidemia, Red Ginger, Stroke ABSTRAKLatar belakang: Penderita stroke memiliki risiko serangan berulang sekitar 11,1 % dalam 1 tahun. Insiden stroke berulang dihindari dengan upaya pengendalian faktor risiko salah satunya dislipidemia. Terdapat hubungan dislipidemia dengan risiko kejadian aterosklerosis terutama penyakit stroke iskemik dan penyakit arteri perifer. Prevalensi penderita statin intoleran ada 9,1%. Nutrasetikal dapat digunakan sebagai terapi adjuvant/pendamping obat konvensional. Tujuan penelitian ini untuk mengetahui efek pemberian herbal yang mengandung bawang putih (Allium sativum) 675 mg, Red Yeast Rice (RYR)/beras ragi merah (Monascus purpureus) 750 mg, dan jahe merah (zingiber officinale var. rubrum) 375 mg yang selanjutnya disebut BJR 22 terhadap kadar trigliserida (TG) dan High Density Lipoprotein (HDL).Metode: Penelitian dengan menggunakan pre and posttest control group design dengan cara double blind. Subjek penelitian dipilih secara konsekutif dengan jumlah 20 orang dalam kelompok intervensi yang mendapatkan terapi standar (statin) dan BJR 22 sebanyak 3 kapsul/hari dan 20 orang dalam kelompok kontrol yang mendapatkan terapi standar (statin) dan plasebo 3x1. Durasi penelitian adalah 30 hari. Data dianalisis menggunakan uji Saphiro Wilk, Wilcoxon, Chi Square, Fisher exact dan Paired T-test.Hasil: Rata-rata perubahan kadar TG sebelum dan sesudah perlakuan di kelompok intervensi adalah -5,95 ± 86,88 mg/dL (p=0,575), sedangkan kelompok kontrol 4,3 ± 97,08 mg/dL (p=0.845) Tidak ada perbedaan signifikan antara kedua kelompok. Perubahan kadar HDL di kelompok intervensi adalah 10 ± 13,46 mg/dL menunjukkan perubahan yang bermakna (p=0,004). Pada kelompok kontrol adalah 5,3 ± 27,25 mg/dL menunjukkan perubahan yang tidak bermakna (p=0,273). Uji regresi menunjukkan faktor yang memengaruhi kadar TG adalah asupan kalori dan yang memengaruhi kadar HDL adalah status merokok, hipertensi dan asupan lemak.Kesimpulan: Suplementasi BJR 22 dosis 3 kapsul/hari dapat memperbaiki kadar HDL namun tidak mempengaruhi kadar trigliserida secara bermakna.Kata Kunci: Bawang putih, Beras Ragi Merah, Dislipidemia, Jahe merah, Stroke
Pengaruh Kombinasi Suplementasi Omega 3 dengan Kalori Restriksi Terhadap Penyembuhan Luka Bakar Pada Tikus Sprague Dawley Kajian Pada: Tumor Nekrosis Faktor - Alfa dan Perbaikan Luas Luka Bakar Wibowo, Erwin; Dharmana, Edi; Maharani, Nani; Budijitno, Selamat
Medica Hospitalia : Journal of Clinical Medicine Vol. 7 No. 1 (2020): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (291.137 KB) | DOI: 10.36408/mhjcm.v7i1.432

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Latar Belakang: Luka bakar merupakan masalah klinis dengan komplikasi yang sering menyebabkan morbiditas dan mortalitas. Omega 3 memiliki efek anti inflamasi dan restriksi kalori memiliki efek anti oksidan yang diduga mampu mempercepat proses penyembuhan pada luka. Penelitian bertujuan untuk mengetahui apakah kombinasi suplementasi Omega 3 dan restriksi kalori dapat membantu dalam proses penyembuhan luka bakar yang dapat ditinjau dari kadar TNF Alfa dan perbaikan luas luka bakar. Metode: Penelitian eksperimental dengan desain “Randomized post test with control group” pada tikus yang di intervensi luka bakar pada punggungnya. Random alokasi dilakukan untuk membagi tikus Sprague Dawley dalam 4 kelompok yaitu kelompok kontrol(K1) dengan diet biasa, kelompok restriksi kalori(P1), kelompok suplementasi omega 3(P2) dan kelompok kombinasi restriksi kalori dengan suplementasi omega 3 (P3). Data dianalisis dan diolah menggunakan uji hipotesis Kruskall Wallis - Post Hoc test Mann-Whitney. Hasil: Penelitian didapatkan perbedaan bermakna yang signifikan kadar TNF Alfa pada kelompok Kontrol dengan kelompok P1, P2, dan P3 dengan p < 0,001. Luas luka bakar didapatkan hasil bermakna signifikan antar kelompok dengan p < 0,001. Post Hoc test kadar TNF alfa dan luas luka bakar menunjukkan tidak ada perbedaan bermakna antara kelompok P2 dengan P3. Kesimpulan: Kombinasi pemberian suplementasi omega 3 dengan restriksi kalori dapat menurunkan kadar TNF Alfa dan memperkecil ukuran luas luka bakar secara bermakna namun tidak untuk restriksi kalori saja Kata Kunci: penyembuhan luka, Omega 3, Kalori Restriksi, TNF Alfa Background: Burns are clinical problem with complications that often cause morbidity and mortality. Omega 3 has an anti-inflammatory effect and calorie restriction has an anti-oxidant effect which is thougth to accelerate the healing process in wounds. The research aims to determine wheteher the combination of Omega 3 supplementation and calorie restriction is expected to help in the process of healing burns that can be viewed from the level of tumor necrosis factor alpha and large burn healing. Methods: This study an experimental study with design of “randomized post test with control group” in rats given burns to their backs. Random allocation was made to divide Sprague Dawley rats into 4 groups: the control group with a normal diet (K1), the calorie restriction group (P1), the omega 3 supplementation group (P2), and the combination of omega 3 with calorie restriction group (P3). Data were analyzed and processed using the Kruskall Wallis - Post Hoc Mann-Whitney hypothesis test. Results: The study found significant differences in levels of TNF Alpha in the control group with groups P1, P2, and P3 with p<0.001. Burn area showed significant results between groups with p<0.001. Post Hoc tests for levels of TNF alpha and burn area showed no significant diffrence between P2 and P3 groups. Conclusion: The combination of omega 3 supplementation with calorie restriction can significantly reduce TNF alpha levels and significantly reduce the area of burns but not for calorie restriction only. Keywords: wound healing, omega 3, calorie restriction, TNF Alpha
PENGARUH EKSTRAK EDAMAME KAYA GENISTEIN TERHADAP KADAR LOW DENSITY LIPOPROTEIN, HIGH SENSITIVITY-C REACTIVE PROTEIN, SERTA RASIO NEUTROFIL LIMFOSIT DAN MONOSIT LIMFOSIT: Studi Experimental pada Tikus Jantan yang Diinduksi Aterosklerosis Pratama, Reza Dian; Maharani, Nani; Bahrudin, Udin
Medica Hospitalia : Journal of Clinical Medicine Vol. 8 No. 1 (2021): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (323.892 KB) | DOI: 10.36408/mhjcm.v8i1.450

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ABSTRACT Background: Atherosclerosis is related to hypercholesterolaemia and inflammation. Edamame is one of the soybeans with high levels of genistein which protects the formation of atherosclerosis. Purpose: This research aimed to evaluate the effects of genistein-rich edamame on LDL, hs-CRP, Neutrophil-Lymphocyte Ratio (NLR) and Monocyte-Lymphocyte Ratio (MLR) on atherosclerosis-induced mice. Method: This research is a true experimental study with posttest only-controlled group design. Thirty male rats were divided randomly into five groups: negative control group without any intervention, positive control group with atherosclerosis induction, first intervention group with edamame extract supplementation, second intervention group with genistein-rich edamame extract supplementation, and third intervention group treated with atorvastatin. After 28 days, serum LDL, hs-CRP, LDL and MLR were measured. Results: There were significant differences (p<0.001) of hs-CRP values between the second intervention group compared to the negative control, positive control and first intervention group. Edamame extract lowered LDL cholesterol levels in the second intervention group compared to positive control, but the difference were not statistically significant. There were significant differences (p<0.05) of MLR values between the second intervention group and the negative control and also the first intervention group, and significant differences between the second intervention group and the negative control and also the first intervention group. There was no significant difference on NLR values between all groups. Conclusion: The administration of genistein rich edamame may reduces the inflammation in the blood vessels better than edamame extract represented by lower hs-CRP and MLR values compared to the edamame extract. Keywords: Genistein rich-edamame, LDL, hsCRP, neutrophil-lymphocyte ratio, monocyte-lymphocyte ratio
Pemberian Krim Ekstrak Moringa oleifera L. pada Tikus dengan Luka Insisi: Studi terhadap Kadar IL-1, IL-10 dan rasio IL-1:IL-10: The Application of Moringa oleifera L. Cream on Rats with Incision Wound: Study on the IL-1 Level, IL-10 Level and IL-1:IL-10 ratio Surya Utoyo, Frederick; Bahrudin, Udin; Prajoko, Yan Wisnu; Mahati, Endang; Maharani, Nani
Medica Hospitalia : Journal of Clinical Medicine Vol. 9 No. 3 (2022): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36408/mhjcm.v9i3.778

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LATAR BELAKANG : Saat ini, berbagai tanaman asli Indonesia dikembangkan sebagai bahan perawatan luka untuk hasil penyembuhan yang lebih baik. Salah satunya, yaitu Moringa oleifera L., yang  merupakan tanaman asli Indonesia serta berpotensi dapat membantu penyembuhan luka  melalui regulasi jalur sitokin inflamasi, interleukin (IL)-1 dan IL-10. TUJUAN : Untuk mengetahui pengaruh pemberian ekstrak Moringa oleifera L. terhadap IL-1, IL-10, dan rasio IL-1: IL-10 di jaringan kulit, pada tikus dengan luka insisi. METODE : Penelitian ini menggunakan desain post test only controlled group dengan sampel berupa 15 tikus Wistar yang dilakukan luka insisi. Sampel dibagi menjadi 3 kelompok perlakuan: perawatan luka dengan framycetin sulphate (KP), krim ekstrak Moringa oleifera L. 15% (M), dan krim plasebo (KN). Pengukuran kadar IL-1, IL-10, dan rasio IL-1:  IL-10 dilakukan pada hari ke-10 perlakuan melalui pengambilan jaringan. HASIL :  Kadar IL-1 pada kelompok perlakuan (M) tidak berbeda bermakna dibanding KN dan KP (33,56±4,68 vs 40,92±27,32 vs 30,23±3,92 pg/mL, p=0,543). Kelompok KP memiliki IL-10 lebih tinggi dibandingkan kelompok M dan KN (113,95±9,38; 91,75±5,65 dan 94,93±2,39 pg/mL, p<0,001), dan tidak didapatkan perbedaan antara kelompok M dan KN (p=0,296). Rasio IL-1: IL-10 kelompok KP, M, dan KN tidak menunjukan perbedaan bermakna (0,27±0,05, 0,37±0,06 dan 0,44±0,30, p=0,249). KESIMPULAN: Pemberian ekstrak Moringa oleifera L. secara topikal tidak mempengaruhi kadar IL-1 dan rasio IL-1 : IL-10 di jaringan kulit tikus dengan luka insisi. Kadar IL-10 di jaringan kulit tidak berbeda dibanding kelompok kontrol negatif, serta lebih rendah dibanding kelompok framycetin sulphate. KATA KUNCI           : Luka insisi, Moringa oleifera L., perawatan luka
Maternal hair lead and cytokine pro-inflammatory effects in preterm birth Qolby, Qonita Nur; Dewantiningrum, Julian; Pramono, Besari Adi; Maharani, Nani; Nugraha, Eka Djatnika; Muniroh, Muflihatul
International Journal of Public Health Science (IJPHS) Vol 13, No 4: December 2024
Publisher : Intelektual Pustaka Media Utama

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.11591/ijphs.v13i4.24146

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This case-control study analyzed the lead (Pb), interleukin 6 (IL-6), and tumor necrosis factor alpha (TNF-α) levels in pregnant women with preterm birth (PTB) in Central Java, Indonesia. Hair samples from 72 pregnant women were collected non-invasively. The prenatal exposure to Pb was determined with the total reflection X-ray fluorescence (TXRF) method. Serum IL-6 and TNF-α were examined using enzyme-linked immunosorbent assays (ELISA). The Pb concentration in hair was slightly higher in women with PTB than those without PTB; however, this difference was not statistically significant. An elevated hair Pb level was not associated with increased PTB risk (OR 24.69, 95% CI 0.93–653.82, p>0.05). A serum TNF-α level ≥27 pg/ml, a serum IL-6 level ≥9 pg/ml, and the spouse’s smoking frequency were significantly associated with increased PTB risk (TNF-α OR 42.25, 95% CI 5.26–339.61; IL-6 OR 22.33, 95% CI 3.12–158.54; spouse’s smoking frequency OR 1.28, 95% CI 1.09–1.5), while the maternal hemoglobin concentration significantly decreased PTB risk (OR 0.43, 95% CI 0.2–0.927). This study demonstrates that maternal hair Pb concentration has no significant relationship with PTB. Serum TNF-α, IL-6, and the spouse’s smoking frequency potentially increased PTB risk, while the maternal hemoglobin level is a protective factor.
Correlation between Blood Vitamin D Levels and Lipid Profiles in Post-Ischemic Stroke Patients Jaeri, Santoso; Retnaningsih, Retnaningsih; Husni, Amin; Maharani, Nani; Anjani, Gemala
Mutiara Medika: Jurnal Kedokteran dan Kesehatan Vol 24, No 2 (2024): July
Publisher : Universitas Muhammadiyah Yogyakarta

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18196/mmjkk.v24i2.22202

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Dyslipidemia and vitamin D deficiency are the predisposing factors for stroke. It is also established that vitamin D contributes to cholesterol metabolisms. Unfortunately, there is no evidence regarding the correlation between blood vitamin D levels and lipid profiles in patients with post-ischemic stroke. Herewith, the authors determine the correlation between blood vitamin D levels and lipid profiles among patients with post-ischemic stroke. A cross-sectional approach among 40 patients with post-ischemic stroke was obtained consecutively. Demographic characteristics, as well as the history of other diseases and 24 24-hour recall diet, were recorded. Then, the measurement of blood vitamin D levels and lipid profiles, such as total, LDL, HDL cholesterol, and triglyceride levels, were performed. Their correlations were determined using the Spearman correlation test. Among 40 subjects, no significant correlation was revealed between blood vitamin D levels and the serum total, LDL, HDL cholesterol, and triglycerides levels (p=0.898, 0.560, 0.361, and 0.622 respectively, and r=0.021, -0.095, 0.080, and 0.080 respectively). To summarize, there is no significant correlation between blood vitamin D levels and all lipid profiles in patients with post-ischemic stroke.
Edwards Syndrome and Trisomy 8: a case report of a newborn with multiple congenital anomalies with double aneuploidy Utari, Agustini; Maharani, Nani; Indriyati, Rita; Sihombing, Nydia Rena Benita; Sarosa, Gatot Irawan; Winarni, Tri Indah
Paediatrica Indonesiana Vol. 65 No. 4 (2025): July 2025
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi65.4.2025.350-6

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Chromosomal aneuploidy is the most common genetic cause of multiple congenital anomalies (MCA), contributing to high neonatal mortality and morbidity rates in intensive care units. Prevalence of live birth double trisomy is rarely reported, with previous studies reporting the involvement of autosomal aneuploidy combined with sex chromosomal aneuploidy that is a more tolerable or benign phenotype. Mostly, a live-born baby with a double trisomy is associated with mosaicism.  This report aims to present a rare case of a viable baby with non-mosaic double autosomal trisomy involving chromosomes 8 and 18. A term baby from advanced maternal and paternal age with low birth weight and height was born from spontaneous vaginal delivery from unremarkable pregnancy. The phenotype was suitable with Edward syndrome with congenital heart anomalies confirmed by cytogenetic analysis with additional extra chromosome 8 (48, XX,+8,+18). The baby was on and off the mechanical ventilator due to respiratory failures, and her health condition gradually deteriorated, leading to her death at the age of 2.5 months due to neonatal pneumonia.