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All Journal JURNAL GIZI INDONESIA Nexus Kedokteran Klinik Biomedika Jurnal Aisyah : Jurnal Ilmu Kesehatan Community Development Journal: Jurnal Pengabdian Masyarakat Narra J Gema Lingkungan Kesehatan Jurnal Info Kesehatan Indonesian Basic and Experimental Health Sciences
Arief Nurudhin
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Humanities Biochemistry, Genetics & Molecular Biology Chemistry Dentistry Economics, Econometrics & Finance Education Environmental Science Health Professions Immunology & microbiology Medicine & Pharmacology Nursing Public Health Veterinary

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Mesenchymal Stem Cell Secretome Improves Bone Quality in Autoimmune Rheumatic Patients (AIIRD): A Case Report Werdiningsih, Yulyani; Nurudhin, Arief; sunarso, indrayana
Indonesian Basic and Experimental Health Sciences Vol. 13 No. 1 (2024): November
Publisher : Rumah Sakit Umum Daerah Dr. Moewardi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.11594/ibehs.vol13iss1pp11-15

Abstract

ABSTRAK Autoimmune Inflammatory Rheumatic Disease (AIIRD) is a group of different disorders, which have similar clinical, laboratory and immunological manifestations. In East Asia, the top 3 diseases included in AIIRD are Systemic Lupus Erythematosus, Rheumatoid Arthritis, and Sjogren's Syndrome. Glucocorticoids are still one of the therapeutic modalities for AIIIRD with their antiinflammatory and immunosuppressive effects. However, glucocorticoids have some side effects. One side effect of concern is decreased bone density. The condition of glucocorticoid induced osteoporosis (GIOP) is reported with increasing prevalence. The main effect of the use of glucocorticoids on bones is the presence of impaired bone formation regardless of the role of inflammation.  Secretome stem cells contain bioactives that exhibit diverse physiological functions such as immunomodulation, anti-inflammatory, angiogenesis, anti-apoptotic and anti-oxidation. Secretome can modulate cell differentiation by promoting osteogenesis and inhibiting adipogenesis. In this case report, it showed improvements in markers of bone damage, inflamation, and vitamin D levels after stem cell secretome administration in AIIRD patients with long-term corticosteroid use.
Effect of the Period of Glucocorticoid Administration on Bone Quality in Patients with Autoimmune Inflammatory Rheumatism Disease (AIIRD) Werdiningsih, Yulyani; Sunarso, indrayana; Nurudhin, Arief
Indonesian Basic and Experimental Health Sciences Vol. 13 No. 2 (2025): APRIL
Publisher : Rumah Sakit Umum Daerah Dr. Moewardi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.11594/ibehs.vol13iss2pp52-58

Abstract

Introduction Inflammatory autoimmune rheumatic disease (AIIRD) such as rheumatoid arthritis, systemic lupus erythematosus, and Sjogren's syndrome often requires long-term glucocorticoid therapy. Despite its effectiveness, glucocorticoids are recognized to cause decreased bone quality and increase the risk of osteoporosis. This study aims to evaluate the effect of the period of glucocorticoid administration on bone quality parameters in AIIRD patients. Methods This study was an observational analytical study with a cross-sectional design. A total of 28 female patients with AIIRD were divided into two groups based on the period of glucocorticoid administration: less than 24 months and more than 24 months. The parameters to be measured included bone mineral density (BMD), Collagen Type I C-Telopeptide (CTX), Vitamin D3 levels, and Calcium Ions. Data analysis was conducted using the Mann-Whitney test and the unpaired t-test with a significance level of p<0.05. Results There was no statistically significant difference between the two groups on all measured parameters. The mean BMD in the group of less than 24 months was 0.9471 kg/m², while in the group of more than 24 months it was 0.8920 kg/m² (p>0.05). The mean CTX also did not differ significantly between the two groups (0.2474 vs. 0.2508 ng/mL; p>0.05). Vitamin D3 and Calcium Ion levels showed similar results in the absence of significant differences (Vitamin D3: 15,596 vs. 16,255 ng/mL; Calcium Ion: 1,075 vs. 1,040 mmol/L; p>0.05). Conclusions The period of glucocorticoid administration does not show a significant effect on bone quality in AIIRD patients in this study. Nonetheless, regular monitoring and an individualized approach are still necessary to prevent bone complications in patients receiving long-term glucocorticoid therapy.
The Correlation of D- Dimer and Neutrophil Lymphocyte Ratio (NLR) Levels on COVID-19 Mortality Nurhayatun, Evi; Ayu Safira, Meilani; Nurudhin, Arief
JURNAL INFO KESEHATAN Vol 21 No 3 (2023): JURNAL INFO KESEHATAN
Publisher : Research and Community Service Unit, Poltekkes Kemenkes Kupang

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.31965/infokes.Vol21.Iss3.1207

Abstract

Coronavirus disease 2019 (COVID-19) is a disease caused by a novel coronavirus or a new type of corona virus, namely severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). D-dimer and Neutrophil Lymphocyte Ratio are parameters that can be used as a predictor of mortality in COVID-19, so this study aims to determine the relationship between D-dimer levels and NLR with mortality in COVID-19 patients. The study used an analytic observational method with a cross sectional approach from medical record data at UNS Hospital. The population in this study were COVID-19 patients at UNS Hospital who had their D-dimer and NLR levels checked in the period November 2020-January 2021. The sample was taken using a simple random sampling technique. Bivariate data analysis with Spearman Rank Correlation Test. Obtained 72 samples. 46 male patients and 26 female patients with the highest age range of 40-59 years as many as 34 patients. Patients who experienced mortality as many as 24 people while the rest survived. Spearman's Rank test obtained p-values of D-dimer and neutrophil lymphocyte ratio (NLR) with mortality of COVID-19 patients 0.009 and <0.001, respectively. While the correlation coefficients for D-dimer and NLR on mortality were 0.308 and 0.515, respectively. There is a relationship between D-dimer and NLR levels with mortality in COVID-19 patients with a positive correlation.
Umbilical Cord Mesenchymal Stem Cells Secretome in Osteoarthritis Patients: A Case Report Nurudhin, Arief; Prabowo, Nurhasan Agung; Wedhiningsih, Yulyani; Sunarso, Indrayana
Gema Lingkungan Kesehatan Vol. 23 No. 4 (2025): Gema Lingkungan Kesehatan
Publisher : Poltekkes Kemenkes Surabaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36568/

Abstract

We report a case study of a 58-year-old lady diagnosed with symptomatic knee osteoarthritis (OA) who received umbilical cord-derived mesenchymal stem cell (UC-MSC) secretome via intra-articular injections once weekly for a total of five weeks. This treatment significantly reduced pain compared to the control, using a Visual Analog Scale, with pain scores reducing from 7/10 to 3/10. Moreover, the patient showed marked functional capacity improvement, as indicated by a Western Ontario and McMaster Universities Osteoarthritis Index score from 65 to 30. Her Kellgren-Lawrence grade also improved radiographically from 4 to 2 indicating either an initiation of cartilage regeneration or a reduction in degenerative change. These favorable results position the UC-MSC secretome as a novel and safe treatment for knee osteoarthritis, making it a potent non-invasive replacement therapy to classical treatments. The researchers advise that these findings must be confirmed in bigger, controlled trials before the therapeutic effects of UC-MSC secretome can be established in broader patient populations.
The Effect of TNF-α and FIB-4 Score on Diastolic Dysfunction in Child Pugh C Liver Cirrhosis Karim, Muhammad Yusuf; Pramana, Triyanta Yuli; Sulastomo, Heru; Nurudhin, Arief; Pamungkasari, Eti Poncorini
Gema Lingkungan Kesehatan Vol. 23 No. 4 (2025): Gema Lingkungan Kesehatan
Publisher : Poltekkes Kemenkes Surabaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36568/gelinkes.v23i4.384

Abstract

Liver cirrhosis is a major global health concern, often complicated by cardiac dysfunction such as diastolic heart failure. Tumor necrosis factor-alpha (TNF-α) and FIB-4 score are widely used biomarkers in cirrhotic patients, but their predictive value for cardiac complications remains unclear. To determine the effect of TNF-α and FIB-4 scores on the severity of diastolic dysfunction in patients with Child-Pugh C liver cirrhosis. This analytical cross-sectional study included 40 Child-Pugh C cirrhotic patients. Serum TNF-α levels were measured using ELISA. Diastolic function was evaluated using echocardiography. Ordinal logistic regression was used to analyze the association between TNF-α, FIB-4, and diastolic dysfunction grades. The majority of participants had moderate (65.0%) or severe (35.0%) chronic inflammation based on TNF-α levels, with a median TNF-α of 45.52 pg/mL. Significant liver fibrosis (FIB-4 >3.25) was observed in 82.5% of participants. Grade I diastolic dysfunction was the most prevalent (52.5%). TNF-α levels were significantly associated with the degree of diastolic dysfunction (p=0.042), whereas FIB-4 scores showed no significant correlation (p=0.533). Elevated TNF-α is strongly associated with worsening diastolic dysfunction in Child-Pugh C cirrhosis, suggesting its role in systemic inflammation and myocardial injury. In contrast, the FIB-4 index may not reflect cardiac involvement in advanced cirrhosis. TNF-α may serve as a potential biomarker for cardiovascular risk stratification in cirrhotic patients, supporting early intervention and integrated care approaches.
Co-Authors Adnan, Zainal Arifin Affandi, Andri Akrim Permitasari Ayu Safira, Meilani BAGUS WICAKSONO Bagus Wicaksono Damayani, Aritantri Eti Poncorini Pamungkasari Gazali, Itqan Indah Putri Maharani Karim, Muhammad Yusuf Maharani, Indah Putri Marwanta, Sri Nurhayatun, Evi Prabowo, Nurhasan A. Prabowo, Nurhasan Agung Rohman, Yulia Safitri, Ayu SI. Shanti Listyawati Shiddiqi, Toumi Sholehah, Laila Sidarta, Brigitte RA. Sulastomo, Heru Sunarso, Indrayana Toumi Shiddiqi Triyanta Yuli Pramana Wardhani, Lusi Oka Wedhiningsih, Yulyani Werdiningsih, Yulyani Zainal Arifin Adnan