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All Journal Medical Journal of Indonesia Universa Medicina Majalah Kedokteran Andalas Media Dermato-Venereologica Indonesiana Journal of General Procedural Dermatology and Venereology Indonesia Bali Dermatology Venereology and Aesthetic Journal Jurnal Kedokteran Meditek Ophthalmologica Indonesiana
Wresti Indriatmi B. Makes
Departemen Dermatologi Dan Venereologi, Fakultas Kedokteran Universitas Indonesia, RSUPN Dr. Cipto Mangunkusumo, Jakarta, Indonesia
Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

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DIAGNOSIS DAN TATA LAKSANA KEKAMBUHAN KUSTA Caroline Oktarina; Melani Marissa; Wresti Indriatmi; Sri Linuwih Menaldi
Media Dermato-Venereologica Indonesiana Vol 49 No 2 (2022): Media Dermato-Venereologica Indonesiana
Publisher : Perhimpunan Dokter Spesialis Kulit dan Kelamin Indonesia (PERDOSKI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33820/mdvi.v49i2.340

Abstract

Leprosy relapse is defined as the reappearance of leprosy’s signs and symptoms following completion of adequate Multidrug Therapy (MDT) regimen. Indonesia is the third biggest contributor for leprosy relapse with 284 cases in 2018. Several factors contribute to the occurrence of relapse, which include presence of persisters, history of inadequate therapy, drug resistance, history of irregular treatment, history of dapsone monotherapy, high initial bacteriological index, high number of skin and nerve lesions, negative lepromin test, history of antireaction therapy, human immunodeficiency virus (HIV) infection, and pregnancy. Diagnosis of relapse can be established based on clinical, bacteriological, and therapeutic criteria, also histopathological and serological criteria, if possible. With those criteria, it should be easier to differentiate relapse from reaction, resistance, reactivation, and reinfection. The principal management for leprosy relapse is re-administration of MDT according to the type of relapse; however, therapy should be modified if there are any evidences of drug resistance. Things which are important to be taken into account during relapse treatment are leprosy type, past medication history, and the possibility of drug resistance. With proper knowledge and diagnostic algorithm, it is expected that the treatment can be administered immediately in order to prevent disability and transmission of infection.
Cotton swabs for the measurement of NF-ĸB, IFN-γ, and FOXP3+Treg from lesions of anogenital wart patients Hutabarat, Hernayati; Bramono, Kusmarinah; Indriatmi, Wresti; Wibowo, Heri; Budianti, Windy Keumala; Suyatna, Fransiscus Dhyanagiri; Prihartono, Joedo; Mawardi, Prasetya
Medical Journal of Indonesia Vol. 33 No. 3 (2024): September
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.oa.247496

Abstract

BACKGROUND Local tissue immunity plays a significant role in anogenital warts’ (AGW) pathomechanism and persistence. Assessing biomarkers from lesions instead of serum is recommended to evaluate therapeutic response. Since biopsy is invasive, it is necessary to find less invasive and more comfortable methods. This study aimed to assess the reliability of cotton swabs and tape stripping for evaluating AGW’s lesions biomarkers. METHODS We compared cotton swab versus tape stripping method to quantify nuclear factor-κappaB (NF-ĸB), interferon-gamma (IFN-γ), and FOXP3+regulatory T cell (FOXP3+Treg) from 3 patients with AGW in the preliminary study. The method was selected based on contamination possibility, side effects, and a simpler approach. The main study examined 48 patients with AGW for reliability and reproducibility using the best sampling method from preliminary result and Spearman’s Rho analysis, while considering the HIV status and CD4+ counts. RESULTS Both cotton swabs and tape stripping obtained adequate protein content for biomarkers examination. However, the tape stripping method was causing serum contamination and painful for patients due to the stripping. The total lesion volume in cotton swab method was positively correlated with all patients’ NF-ĸB (p = 0.001). IFN-γ had a negative correlation in all reactive HIV patients (p = 0.012). FOXP3+Treg and CD4+ counts were negatively correlated with total volume in reactive HIV patients (p = 0.046 and 0.017, respectively). CONCLUSIONS The cotton swab method was reliable in examining NF-ĸB, IFN-γ, and FOXP3+Treg due to its convenience and lack of serum contamination from AGW lesions, potentially improving patient comfort and practical benefits.
Developing an online reproductive health module on sexually transmitted infections for Indonesian adolescents: a qualitative mixed methods study Nilasari, Hanny; Indriatmi, Wresti; Gunardi, Hartono; Kayika, I Putu Gede; Kekalih, Aria; Siregar, Kemal Nazaruddin; Kurniawan, Kristian; Lesmana, Elvira; Haswinzky, Rose Amalia
Medical Journal of Indonesia Vol. 33 No. 4 (2024): December
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.oa.247635

Abstract

BACKGROUND A notable rise in sexually transmitted infection (STI) cases among youth correlates with a lack of reproductive health awareness, affecting nearly 80% of Indonesian adolescents. Additionally, sociocultural taboo acts as a challenge to reproductive health implementation in Indonesia. Therefore, this study aimed to develop an online reproductive health module focused on STIs for Indonesian adolescents. METHODS This research was a mixed methods approach, integrating quantitative study using univariate analysis (survey and questionnaire) and qualitative study using the Delphi method (open discussion and focus group discussion). The study was conducted between March 2 and July 28, 2022. We began by conceptualizing a literature-based module, an online survey, and virtual discussions involving students, teachers, and parents. Then, we consulted with clinical psychologists and dermatovenereologists. Additionally, students completed an assessment to establish a baseline of their knowledge, attitudes, and behaviors (KAB) regarding reproductive health and STIs. RESULTS Of 327 high school students across Jakarta, analysis of the 129 completed KAB surveys showed that only 56.6% and 65.1% attained acceptable scores (>65) for knowledge and behavior, respectively, with 24.8% being at risk for STIs. Key recommendations included incorporating multimedia elements, ensuring clarity and simplicity in language, adopting non-judgmental tone, providing comprehensive explanations of STIs and their long-term impact, and supporting learning with face-to-face sessions and ongoing access to concise, cost-effective educational resources. CONCLUSIONS Adolescents need a comprehensive, interactive, instructive, accessible, non-discriminatory reproductive module that strengthens the self-concept that upholds Indonesian values and norms.
INOSINE PRANOBEX SEBAGAI TERAPI TAMBAHAN PADA KUTIL GENITAL: SEBUAH LAPORAN KASUS Adisasmito, Ayutika Saraswati; Nur Azizah, Anggita; Halim, Melissa; Irawan, Yudo; Marissa, Melani; Nilasari, Hanny; Indriatmi, Wresti
Media Dermato-Venereologica Indonesiana Vol 52 No 3 (2025): Media Dermato Venereologica Indonesiana
Publisher : Perhimpunan Dokter Spesialis Kulit dan Kelamin Indonesia (PERDOSKI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33820/mdvi.v52i3.446

Abstract

Pendahuluan: Beberapa modalitas terapi telah tersedia untuk mengobati kondiloma akuminata. Pendekatan tata laksana multimodalitas diperlukan pada kasus yang sulit sembuh. Inosine pranobex (IP) telah dilaporkan sebagai terapi tambahan untuk kutil anogenital. Kemampuan IP memanipulasi imunitas seluler dan humoral dapat bersifat antivirus. Pada laporan kasus ini, kami melaporkan keberhasilan terapi IP pada pasien imunokompeten yang sebelumnya mengeluhkan progresivitas kutil walaupun dalam terapi konvensional. Kasus: Seorang laki-laki berusia 26 tahun datang dengan keluhan kutil pada sisi kanan orifisium uretra eksternal (OUE) sejak 2 bulan yang lalu. Setelah empat sesi terapi asam trikloroasetat (TCA) 90%, pasien mengeluhkan kutil bertambah pada sisi kiri OUE. Terapi IP 3 gram per hari ditambahkan ke dalam regimen terapi pasien. Setelah pasien mengonsumsi IP secara rutin selama 2 minggu dan menyelesaikan 6 sesi tambahan tutul TCA 90%, kutil menghilang secara klinis. Pasien menyangkal timbulnya efek samping setelah konsumsi rutin IP. Diskusi: Respons terapi yang terbatas terhadap TCA 90% pada pasien ini menunjukkan kemungkinan manfaat terapi lainnya. Penambahan IP, sebagai imunomodulator yang meningkatkan imunitas seluler dan humoral, memberikan perbaikan klinis dengan efek samping minimal hingga tidak ada. Hasil ini mendukung penerapan kombinasi TCA 90% dan IP sebagai alternatif terapi pada kutil anogenital yang memberi respons minimal terhadap monoterapi. Kesimpulan: Penambahan IP pada terapi konvensional memberikan perbaikan klinis pada pasien kutil anogenital yang tidak membaik dengan terapi TCA 90% saja.
Discrepancy of PCR and serologic test on genital herpes: a case report Jhauharina Rizki Fadhilla; Wresti Indriatmi; Hanny Nilasari; Yudo Irawan
Bali Dermatology Venereology and Aesthetic Journal BDVJ - Vol. 4 No. 1 (June 2021)
Publisher : Explorer Front

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51559/s440xr58

Abstract

Background: Laboratory investigation for genital herpes (GH) includes serologic tests and polymerase chain reaction (PCR) with different sensitivity and specificity; occasionally, the results are not conclusive. Clinical symptoms are often atypical. We report a case of GH in HIV-infected patients with a non-reactive serologic test but positive PCR. Case Description: A 29-years old HIV-positive man presented with multiple painful shallow ulcers with pus on his penis in the last five days. PCR examination showed a positive result, whereas anti-HSV 1 IgM, anti-HSV 2 IgM, anti-HSV 2 IgG, VDRL, and TPHA were negative. The anti-HSV- 1 IgG result was reactive with a CD4 value of 122 cells/μL. The patient was given Acyclovir 3x400 mg for ten days and Co-amoxiclav 3x625 mg for seven days. Significant improvement was obtained, and the pain subsided. Conclusion: Clinical features of GH in infected HIV patients are often atypical and resemble other genital ulcers, thus requiring additional investigations. The serologic test may sometimes present a false negative, whereas PCR is much more sensitive and specific, nearing 100%. In patients with HIV infection, GH diagnosis at an early stage can shorten the course of the disease and prevent complications.
INFEKSI MENULAR SEKSUAL PADA PEREMPUAN YANG BERHUBUNGAN SEKS DENGAN PEREMPUAN Halim, Melissa; Krisanti, Roro Inge Ade; Indriatmi, Wresti; Nilasari, Hanny; Irawan, Yudo
Media Dermato-Venereologica Indonesiana Vol 51 No 1 (2024): Media Dermato Venereologica Indonesiana
Publisher : Perhimpunan Dokter Spesialis Kulit dan Kelamin Indonesia (PERDOSKI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33820/mdvi.v51i1.426

Abstract

ABSTRAK Sebagian perempuan menunjukkan orientasi atau ketertarikan seksual, identitas gender, dan perilaku seksual yang berbeda. Infeksi menular seksual (IMS) pada perempuan yang berhubungan seks dengan perempuan (PSP), perempuan yang berhubungan seks dengan perempuan dan laki-laki (PSPL) baik riwayat lampau atau saat ini, maupun transgender laki-laki, jarang mendapat perhatian. Terdapat beragam faktor risiko penularan IMS pada kelompok PSP, PSPL, dan transgender laki-laki. IMS yang dialami dapat disebabkan oleh virus, bakteri, atau pun protozoa. Strategi pencegahan IMS termasuk pemeriksaan penapisan perlu disesuaikan dengan anatomi dan aktivitas seks setiap orang. Prinsip tata laksana IMS pada kelompok minoritas seksual tersebut sama dengan tata laksana IMS secara umum. Keterbatasan studi mengenai IMS pada kelompok ini menyebabkan belum tersedia data epidemiologi yang representatif. Pemahaman mengenai IMS pada PSP, PSPL, dan transgender laki-laki dapat meningkatkan kualitas pelayanan kesehatan pada kelompok minoritas ini.
Kegel exercises with a guidebook for stress urinary incontinence treatment Hakim, Surahman; Santoso, Budi Iman; Rahardjo, Harrina Erlianti; Setiati, Siti; Kusumaningsih, Widjajalaksmi; Prihartono, Joedo; Ibrahim, Nurhadi; Indriatmi, Wresti; Erwinanto
Medical Journal of Indonesia Vol. 33 No. 2 (2024): June
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.oa.247142

Abstract

BACKGROUND Stress urinary incontinence (SUI) is uncontrollable urine leakage when intra-abdominal pressure increases. Behavioral therapy with Kegel exercise is currently the best conservative management recommendation for treating SUI patients. This study aimed to investigate the success of supervised Kegel exercises using the Kegel exercises guidebook in women with SUI. METHODS This quasi-experimental study involved both groups being taught the same regiment of Kegel exercises, but the intervention group was given the Kegel exercises guidebook. After 12 weeks, the compliance, subjective, and objective success rates were evaluated through the patient’s notes, Urinary Distress Inventory-6, Incontinence Impact Questionnaire-7, perineometer, and pad test. RESULTS Patients with a higher level of education had lower compliance to Kegel exercises (p = 0.01; odds ratio [OR] 0.38; 0.18–0.79). No significant difference was observed in the subjective symptom improvement between the two groups. The intervention group had a significantly higher success rate based on objective success by analyzing the 1-hour pad test results. The intervention group was also more adherent (p<0.001; OR 4.78; 2.51–9.0). CONCLUSIONS Patients who received the Kegel exercises guidebook were more compliant and more objectively successful than those who did not receive the manuals.
DNA quality and quantity in adipose tissue: a comparison of the effects of bomb explosion Leonardo; Sugiharto, Ade Firmansyah; Indriatmi, Wresti; Atmadja, Djaja Surya; Yudianto, Ahmad; Herkutanto; Widodo, Wahyu
Medical Journal of Indonesia Vol. 32 No. 4 (2023): December
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.oa.247206

Abstract

BACKGROUND Adipose tissue is often overlooked in DNA testing due to misconceptions about its DNA content. However, its shock-absorbing qualities may be useful for high-pressure scenarios like bomb blasts. This study aimed to evaluate DNA quality and quantity in adipose tissue affected by blasts compared to that in unaffected tissue. METHODS 10 adipose tissue samples were taken from regions near and far from the blast, representing the blast-exposed and non-blast-exposed groups. The adipose tissue was stored at a low temperature for 5 days, after which an organic extraction method was applied. The purity of the DNA extract was assessed using a NanoDrop spectrophotometer, and its integrity was evaluated using 0.8% concentration gel electrophoresis at 60 V for 90 min. DNA typing was conducted using the GlobalFiler™ kit, and DNA quantity was determined with the Quantifiler™ Trio DNA Quantification kit. RESULTS Of 20 DNA extracts from adipose tissue, all samples demonstrated purity, integrity, and complete typing results. Adequate integrity was found in 90% of samples in both groups. A 50% incidence of allele shifting was observed at the D7S820 locus within the blast-exposed group. CONCLUSIONS DNA from blast-exposed adipose tissue exhibited no significant quality or quantity differences from non-blast-exposed tissue. This suggested adipose tissue’s potential as an alternative DNA source in a bomb explosion.
Psoriasis Genomics: A Review Hutasuhut, Magna; Budianti, Windy Keumala; Indriatmi, Wresti; Setyorini, Mirawati
Journal of General - Procedural Dermatology & Venereology Indonesia Vol. 9, No. 1
Publisher : UI Scholars Hub

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

Abstract

Background: Psoriasis is a dermatological condition influenced by genetic and epigenetic factors, environmental triggers, as well as immune responses. Genomics refers to the study of individual genes (genomes) and their interactions with environmental influences. In the context of psoriasis genomics, the interplay between genetic predisposition and environmental factors contributes to the manifestation and variations of the disease. With advancements in molecular genotyping technology and genome-wide association studies (GWASs), researchers have identified 50 genetic markers linked to psoriasis. Discussion: Several genetic loci associated with psoriasis have been identified, including PSORS 1-15. The genetics of psoriasis is also linked to its onset, precipitating factors, associated comorbidities, and clinical variations. Advances in psoriasis genomics are leading to more targeted and innovative treatment approaches. The latest therapeutic developments for psoriasis mainly focus on the interleukin-23 (IL-23)/T-helper 17 (Th17) pathways. Conclusion: The development of GWASs provides new knowledge about psoriasis, including its pathogenesis and specific treatments.
Co-Authors Adisasmito, Ayutika Saraswati Ahmad Yudianto Aldri Frinaldi Andi Yasmon Anggraini, Ika Anissa, Lidwina Aria Kekalih Arlha Aporia Debinta Benny Nelson Budi Iman Santoso Caroline Oktarina Christa Desire Gracia Djaja Surya Atmadja Efendi, Ida Effendi, Ida Emma Rusmayani Endi Novianto Erwinanto Evita Halim Effendi Evita Halim Effendi Fathan, Hafiza Fauziah, Siti Nurani Fourina, Peppy Githa Rahmayunita Gultom, Desy A. Hafiza Fathan Halim, Melissa Hanny Nilasari Harrina Erlianti Rahardjo, Harrina Erlianti Hartono Gunardi Haswinzky, Rose Amalia Heri Wibowo Herkutanto Hutabarat, Hernayati Hutasuhut, Magna Ika Anggraini Indina Sastrini Inge Ade Krisanti Irawan, Yudo Irene Dorthy Santoso Jacoeb, Tjut N.A. Jhauharina Rizki Fadhilla Joedo Prihartono Kayika, I Putu Gede Kemal N. Siregar Krisanti, Inge Ade Krisanti, Roro Inge Ade Kuraga, Rahmaniar Desianti Kurniawan, Kristian Kusmarinah Bramono Larisa Paramitha Leonardo Lesmana, Elvira Lidwina Anissa Lili Legiawati Manalu, Patricsia Marissa, Melani Martinus Tarina Martinus, Martinus Mawardi, Prasetya Melani Marissa Melani Marissa Nelson, Benny Nur Azizah, Anggita Nurhadi Ibrahim Patricsia Manalu Peppy Fourina Pusponegoro, Erdina H.D. Rahadi Rihamadja Rahadi Rihatmadja Rahadi Rihatmadja Rahmaniar Desianti Kuraga Santoso, Irene Dorthy Sastrini, Indina Satya Wydya Yenny Setyorini, Mirawati Shannaz Nadia Yusharyahya Sirait, Sondang P. Siti Nurani Fauziah Siti Setiati Sondang Pandjaitan Sirait Sri L. Menaldi Sugiharto, Ade Firmansyah Surahman Hakim Suyatna, Fransiscus Dhyanagiri Wahyu Widodo Widjajalaksmi Kusumaningsih, Widjajalaksmi Widya Artini Windy Keumala Budianti Winnugroho Wiratman, Manfaluthy Hakim, Tiara Aninditha, Aru W. Sudoyo, Joedo Prihartono Yeva Rosana Yudo Irawan Yudo Irawan Zainal Hakim