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HUBUNGAN ANTARA GANGGUAN DEPRESI DENGAN KUALITAS HIDUP, STRESOR PSIKOSOSIAL, DAN TINGKAT KONTROL ASMA PADA PASIEN ASMA DI RSUPN DR. CIPTO MANGUNKUSUMO Putro, Agung W; Kusumadewi, Irmia; Rengganis, Iris; Agiananda, Feranindhya
Majalah Kedokteran Indonesia Vol 68 No 8 (2018): Journal of the Indonesian Medical Association Majalah Kedokteran Indonesia Volum
Publisher : PENGURUS BESAR IKATAN DOKTER INDONESIA (PB IDI)

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

Pendahuluan: Tingkat kontrol asma buruk dan gangguan komorbid misalnya depresi dan stres psikososial akan memengaruhi kualitas hidup pasien asma serta meningkatkan beban ekonomi yang ditanggung oleh pasien dan keluarganya. Kami menginvestigasi korelasi antara gangguan depresi, kualitas hidup, stresor psikososial dan tingkat kontrol asma pada pasien asma. Metode: Penelitian ini menggunakan metode cross-sectional deskriptif-analitik pada 37 pasien asma penderita depresi dan 37 pasien asma bukan penderita depresi di Poliklinik Alergi dan Imunologi RSCM Jakarta menggunakan kuesioner SCID-1, WHOQOL-BREF, stresor psikososial Holmes & Rahe, dan ACT. Hasil: Terdapat hubungan antara gangguan depresi dengan skor kualitas hidup yang lebih rendah berdasarkan kesehatan fisik (p<0,001), kesehatan psikologis (p<0,001), relasi sosial (p=0,023), lingkungan (p=0,022), stresor psikososial (OR 3,85; p=0,005), dan tingkat kontrol asma (p=0,001) pada pasien asma. Kesimpulan: Pasien asma yang memiliki gangguan depresi cenderung memiliki skor kualitas hidup yang lebih rendah pada semua domain (kesehatan fisik, kesehatan psikologis, hubungan sosial, dan lingkungan) dan skor tingkat kontrol asma lebih rendah dibandingkan pasien asma yang tidak memiliki gangguan depresi. Pasien asma dengan stresor psikososial berisiko 3,8 kali lebih tinggi memiliki gangguan depresi.

Ekstrak Teh Hijau Mengurangi Luas Area Fibrosis Paru Tikus Desdiani; Iris Rengganis; Samsuridjal Djauzi; Agus Setiyono; Mohammad Sadikin; Sri Widia A. Jusman; Nurjati Chairani Siregar; Suradi; Putri C. Eyanoer
Majalah Patologi Indonesia Vol 29 No 1 (2020): MPI
Publisher : Perhimpunan Dokter Spesialis Patologi Indonesia (IAPI)

BackgroundPulmonary fibrosis is often found in infectious diseases and chemical exposure in the work environment. Antifibrotic effects can befibropreventive and fibrolysis. Bleomycin can cause inflammation and pulmonary fibrosis. Catechin is proven can repair liverdamages due to alcohol induction. The aim of this study is to examine the effect of antifibrotic green tea catechin on reducing thearea of rat lung fibrotic.MethodsThis research was carried out in vivo experimentally in the Laboratory Animal Management Unit at Faculty of Veterinary MedicineIPB in 4 groups of rat experiments, consisting of 3 rats in the negative control group, 3 rats in the positive control group, 3 rats in thegroup of rats given bleomycin on the 8th day and 28thwith green tea extract every day from day 0 to 49 days (fibropreventive), 3groups of rats given bleomycin days 0 and 21 with green tea extract every day from day 15 to 49 (fibrolysis). Histopathologicalexamination was performe for all groups of rats.ResultsThis study showed that administration of green tea extract in fibropreventive groups and fibrolysis groups could reduce the fibrosisarea in rat lungs based on Aschroft's modified scale.ConclusionBased on the results of this study it was found that the anti-fibrotic activity of green tea extract was proven to be able to suppressthe development of pulmonary fibrosis both by fibropreventive and fibrolysis

Efek Tetes Mata Kombinasi Sodium Hialuronat dan Hydroxypropyl-Guar terhadap Stabilitas Lapisan Air Mata pada Mata Kering Terkait Sindrom SjÃ¶gren Priya Darsini, Indira; Edwar, Lukman; Rengganis, Iris; -, Lisnawati; Prihartono, Joedo
Cermin Dunia Kedokteran Vol 46, No 1 (2019): Obstetri - Ginekologi
Publisher : PT. Kalbe Farma Tbk.

Penelitian ini bertujuan untuk menilai stabilitas lapisan air mata pada mata kering terkait sindrom SjÃ¶gren (SS) yang diberi terapi tetes mata kombinasi sodium hialuronat 0,1% (SH) dan hydroxypropyl (HP)-guar, atau monoterapi tetes mata sodium hialuronat (SH). Sebanyak 17 pasien SS dibagi dalam 2 kelompok. Kelompok pertama mendapat kombinasi SH dan HP-guar, kelompok kedua mendapat terapi SH. NIKBUT, Schirmer, skor pewarnaan okular, dan sitologi impresi, serta keluhan subjektif dinilai sebelum dan sesudah pemberian obat. Setelah terapi selama 28 hari, terdapat peningkatan median NIKBUT, Schirmer, skor pewarnaan okular, densitas sel Goblet, dan perbaikan keluhan subjektif pada mata kering terkait SS.The objectives of the study is to assess the stability of dry eye LAM associated with SjÃ¶gren syndrome (SS) during combination therapy of sodium hyaluronate 0.1% (SH) and hydroxypropyl (HP) -guar, or monotherapy sodium hyaluronic (SH). A total of 17 SS patients in this study were divided into 2 groups. The first group received a combination of SH and HP-guar while the second group received SH therapy. NIKBUT, Schirmer, ocular staining score, and impression cytology, as well as subjective complaints was assessed before and after drug administration. After 28 days of therapy, there was a median increase in NIKBUT, Schirmer, ocular staining scores, Goblet cell density, and subjective complaints on SS-related dry eyes.Â

Evaluasi Pemeriksaan Imunoglobulin E Spesifik Menggunakan Immunoblot Assay dengan Baku Emas Skin Prick Test -, Yudhistira; Sukartini, Ninik; Immanuel, Suzanna; Rengganis, Iris
Cermin Dunia Kedokteran Vol 46, No 2 (2019): Penyakit Dalam
Publisher : PT. Kalbe Farma Tbk.

Pendahuluan. Skin Prick Test (SPT) merupakan baku emas diagnosis alergi, tetapi tidak dapat dilakukan pada kondisi tertentu seperti dermatografisme, hamil, tidak dapat lepas obat antialergi, sehingga pemeriksaan IgE spesifik menjadi pilihan. Di Indonesia belum ada data perbandingan pemeriksaan IgE spesifik dengan SPT. Penelitian ini dilakukan untuk menentukan sensitivitas, spesifisitas, PPV, NPV, LR+ dan LR- pemeriksaan IgE spesifik menggunakan analisis immunoblot. Metode. Penelitian menggunakan desain potong lintang. Subjek penelitian adalah pasien poliklinik alergi imunologi. Pengambilan sampel dengan metode non-probability sampling dengan teknik consecutive sampling. Analisis dilakukan terhadap alergen tungau debu rumah (Dermatophagoides pteronyssinus, Dermatophagoides farinae, Blomia tropicalis) dan kecoa. Hasil. Seratus subjek yang memenuhi kiteria masukan dan tolakan (76% perempuan, rerata usia 38.9 tahun) ikut serta dalam penelitian ini. Sensitivitas empat alergen bervariasi dengan rentang 32.4%-76.8%, spesifisitas 68.0%-85.7%, PPV 54.5%-94.5%, NPV 46.2%-65.3%, LR+ 1.8-5.0, dan LR- 0.3-0.8.Sensitivitas pemeriksaan IgE spesifik cukup baik pada tiga tungau debu rumah tetapi rendah pada kecoa; spesifisitas dan PPV bervariasi cukup sampai baik; NPV cukup baik. Simpulan dan Saran. Uji diagnostik IgE spesifik tungau debu rumah menunjukkan hasil cukup baik. Pemeriksaan IgE spesifik tidak dapat digunakan untuk skrining alergi kecoa.Background. Skin Prick Test (SPT) is considered as gold standard for diagnosis of allergy, but cannot be performed in some conditions such as dermatographism, pregnancy, and unable to abstain from antiallergy drugs. In these conditions, specific-IgE test is a test of choice. But there is no comparison data on specific IgE test with SPT in Indonesia. This study was to investigate sensitivity, specificity, PPV, NPV, LR+, and LR- of specific-IgE test of immunoblot assay kit. Method. The study was cross-sectional. Subjects were patients from allergy-immunology clinic who fulfilled inclusion and exclusion criteria. Sampling was performed using non-probability sampling method with consecutive technique. Analysis was performed for house dust mite allergen (Dermatophagoides pteronyssinus, Dermatophagoides farinae, Blomia tropicalis) and cockroach. Result. Hundred subjects (76% was female, average age of 38.9 years) were involved. Sensitivity of four allergens were varied with range 32.4%-76.8%, specificity 68.0%-85.7%, PPV 54.5%-94.5%, NPV 46.2%-65.3%, LR+ 1.8-5.0, and LR- 0.3-0.8. Sensitivities of specific-IgE for three species of house dust mite were moderate, but low for cockroach; specificities and PPVs were moderate to high; NPVs were moderate. Conclusion. Diagnostic test of specific-IgE with house dust mite allergen shows adequate result. Specific IgE test cannot be utilized for screening of cockroach allergy.Â

Interleukin-13, Interleukin-10, Interferon-gamma and IDO Production in Response to Home Dust Mites in Allergic Asthma Cityta Putri Kwarta; Heri Wibowo; Yordan Khaedir; Iris Rengganis; Hanny Siti Nuraeni
The Indonesian Biomedical Journal Vol 11, No 2 (2019)
Publisher : The Prodia Education and Research Institute (PERI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18585/inabj.v11i2.714

BACKGROUND: Allergic asthma is a degenerative atopic disease caused by allergic or hypersensitivity type-1. More than 50% of people with allergic asthma are caused by the presence of house dust mites (HDMs) allergens.METHODS: The cellular immunity response was evaluated through a peripheral blood mononuclear cell (PBMC) culture isolated from blood, using the ficoll gradient technique. Subjects were atopic asthma groups and non-atopic asthma groups. PBMC from each subject cultured was stimulated with HDMs allergen, then incubated in a CO2 5% incubator, 37o C for 72 hours. With the multiplex assay method, interferon (IFN)-γ, interleukin (IL)-13 and IL-10 were measured, meanwhile indoleamine 2,3-dioxygenase level (IDO) was measured by the enzyme-linked immunosorbent assay (ELISA) sandwich methods.RESULTS: The IFN-γ production in the supernatant of PBMC cultures was stimulated by phytohemagglutinin (PHA), Roswell Park Memorial Institute (RPMI) medium and allergens. The IFN-γ production in allergen-stimulated supernatants showed higher level of IFN-γ in the nonatopic group (4,681,455±3,434,851) than atopic group (4,363,300±2,067,941) even though it was not statistically significant (p=0.078). There were no differences between the mean of IL-13 production in atopic asthma group and non-atopic group. The IL-10 production in allergenstimulated supernatants was shown to be higher in nonatopic group and were statistically significantly different (p=0.015). The IDO production in allergen-stimulated supernatants was shown to be higher in the non-atopic group (272,231±269,564) than in the actopic group (13,273±400), and it was significantly different (p=0.007).CONCLUSION: Cellular immune profile of subjects with allergic asthma to Dermatophagoides pterronyssinus (Der p) is characterized by a type-2 inflammatory response that is dominant compared to type-1 inflammation (higher IL-13 ratio compared to IFN-γ) and to the role of anti-inflammation (higher IL-13 ratio compared to IL-10). The decline in IDO production in allergic asthma subjects to Der p is thought to be related to the low cellular immune response in expressing IFN-γ compared to IL-13.KEYWORDS: interleukin-13, interleukin-10, IDO, PBMC, asthma

Antibodies in Sera of Dengue Patients with Plasma Leakage Cross-Reacting with DENV Protein and Endothelial Protein Dewi Wulandari; Alida Roswita Harahap; Suhendro Suhendro; R. Tedjo Sasmono; Aryati Aryati; Herdiman Theodorus Pohan; Iris Rengganis; Saptawati Bardosono
The Indonesian Biomedical Journal Vol 14, No 1 (2022)
Publisher : The Prodia Education and Research Institute (PERI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18585/inabj.v14i1.1771

BACKGROUND: Dengue infection remains a major public health problem in Indonesia. Severe dengue associated with plasma leakage require hospitalization and potentially life threatening. However, the mechanism remains unclear, and the occurrence is unpredictable. The role of anti-endothelial antibody is predicted play an important role in the pathogenesis of plasma leakage, as severe dengue is more prevalent in secondary infection or post vaccinated individuals.METHODS: Serum samples from 127 single Dengue Virus (DENV) serotype infected subjects were obtained in day 2 of fever onset. Subjects were divided into plasma leakage and non-plasma leakage based on World Health Organization (WHO) criteria. Anti-endothelial antibody in patient sera were detected using western blot of Human Umbilical Vein Endothelial Cells (HUVEC). To confirm cross-reactivity, the sera was preabsorb with mix-DENV lysate.RESULTS: Three prominent bands were identified on western blot strips that inhibited by pre-absorption with DENV lysate. Plasma leakage patient expressed significantly more antibodies, with 51.7% of plasma leakage patients expressed at least two bands out of those three, compared to 18.5% of non-plasma leakage.CONCLUSION: Antibodies found in sera of dengue patients with plasma leakage cross-reacted with DENV proteins and endothelial proteins 37 kDa, 75 kDa, 120 kDa, and therefore may be involved in the pathogenesis of plasma leakage. Proteomic identification of those protein targets is needed and may be useful for vaccine studies and further development of predictor marker for plasma leakage in dengue.KEYWORDS: severe dengue, plasma leakage, cross-reactive, anti-endothelial antibody.

Proporsi Defisiensi Vitamin D pada Pasien Poliklinik Alergi dan Imunologi Iris Rengganis; Aria Kekalih; Danny Rasjiid Garna
Cermin Dunia Kedokteran Vol 46, No 12 (2019): Kardiovaskular
Publisher : PT. Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v46i12.397

Vitamin D juga memengaruhi dan meregulasi fungsi sistem imun tubuh. Tujuan: Mengetahui proporsi defisiensi vitamin D-25(OH) pasien poliklinik Alergi dan Imunologi, serta untuk meninjau tatalaksana defisiensi vitamin D-25(OH) di poliklinik Alergi dan imunologi. Metode: Penelitian retrospektif data rekam medis pasien Poliklinik Alergi dan Imunologi yang mendapat terapi vitamin D serta kadar vitamin D-25 (OH). Hasil: Sejumlah 97,1% pasien memiliki kadar vitamin D kurang dari normal (insufisiensi vitamin D dan defisiensi vitamin D). Setelah pemberian vitamin D dosis tinggi (1000 IU/hari atau lebih) selama 3 bulan, terjadi peningkatan bermakna status vitamin D. Simpulan: Proporsi defisiensi vitamin D tinggi pada pasien penyakit imunologi dan pemberian vitamin D dosis tinggi (1000 IU/hari atau lebih) dapat meningkatkan status vitamin D pasien dengan penyakit imunologi.Vitamin D also plays a role in influencing and regulating the function of the immune system in the body. Objective: To determine the proportion of vitamin D-25 (OH) deficiency in patients in the Allergy and Immunology Polyclinic, and to evaluate the management of vitamin D-25 (OH) deficiency in patients in the Allergy and Immunology Polyclinic. Methods: Retrospective study on medical records data from Allergy and Immunology Polyclinic patients with vitamin D-25 (OH) level data and with vitamin D therapy. Results: Vitamin D level less than normal in 97,1% patients. After administration of high dose vitamin D (1000 IU/day or more) for 3 months, a significant increase in the patient’s vitamin D status was observed. Conclusion: The proportion of vitamin D deficiency in patients with immunological diseases is high and administration of high doses vitamin D (1000 IU/day or more) can improve the vitamin D status.

Evaluasi Pemeriksaan Imunoglobulin E Spesifik Menggunakan Immunoblot Assay dengan Baku Emas Skin Prick Test Yudhistira -; Ninik Sukartini; Suzanna Immanuel; Iris Rengganis
Cermin Dunia Kedokteran Vol 46, No 2 (2019): Penyakit Dalam
Publisher : PT. Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v46i2.517

Pendahuluan. Skin Prick Test (SPT) merupakan baku emas diagnosis alergi, tetapi tidak dapat dilakukan pada kondisi tertentu seperti dermatografisme, hamil, tidak dapat lepas obat antialergi, sehingga pemeriksaan IgE spesifik menjadi pilihan. Di Indonesia belum ada data perbandingan pemeriksaan IgE spesifik dengan SPT. Penelitian ini dilakukan untuk menentukan sensitivitas, spesifisitas, PPV, NPV, LR+ dan LR- pemeriksaan IgE spesifik menggunakan analisis immunoblot. Metode. Penelitian menggunakan desain potong lintang. Subjek penelitian adalah pasien poliklinik alergi imunologi. Pengambilan sampel dengan metode non-probability sampling dengan teknik consecutive sampling. Analisis dilakukan terhadap alergen tungau debu rumah (Dermatophagoides pteronyssinus, Dermatophagoides farinae, Blomia tropicalis) dan kecoa. Hasil. Seratus subjek yang memenuhi kiteria masukan dan tolakan (76% perempuan, rerata usia 38.9 tahun) ikut serta dalam penelitian ini. Sensitivitas empat alergen bervariasi dengan rentang 32.4%-76.8%, spesifisitas 68.0%-85.7%, PPV 54.5%-94.5%, NPV 46.2%-65.3%, LR+ 1.8-5.0, dan LR- 0.3-0.8.Sensitivitas pemeriksaan IgE spesifik cukup baik pada tiga tungau debu rumah tetapi rendah pada kecoa; spesifisitas dan PPV bervariasi cukup sampai baik; NPV cukup baik. Simpulan dan Saran. Uji diagnostik IgE spesifik tungau debu rumah menunjukkan hasil cukup baik. Pemeriksaan IgE spesifik tidak dapat digunakan untuk skrining alergi kecoa.Background. Skin Prick Test (SPT) is considered as gold standard for diagnosis of allergy, but cannot be performed in some conditions such as dermatographism, pregnancy, and unable to abstain from antiallergy drugs. In these conditions, specific-IgE test is a test of choice. But there is no comparison data on specific IgE test with SPT in Indonesia. This study was to investigate sensitivity, specificity, PPV, NPV, LR+, and LR- of specific-IgE test of immunoblot assay kit. Method. The study was cross-sectional. Subjects were patients from allergy-immunology clinic who fulfilled inclusion and exclusion criteria. Sampling was performed using non-probability sampling method with consecutive technique. Analysis was performed for house dust mite allergen (Dermatophagoides pteronyssinus, Dermatophagoides farinae, Blomia tropicalis) and cockroach. Result. Hundred subjects (76% was female, average age of 38.9 years) were involved. Sensitivity of four allergens were varied with range 32.4%-76.8%, specificity 68.0%-85.7%, PPV 54.5%-94.5%, NPV 46.2%-65.3%, LR+ 1.8-5.0, and LR- 0.3-0.8. Sensitivities of specific-IgE for three species of house dust mite were moderate, but low for cockroach; specificities and PPVs were moderate to high; NPVs were moderate. Conclusion. Diagnostic test of specific-IgE with house dust mite allergen shows adequate result. Specific IgE test cannot be utilized for screening of cockroach allergy.

Efek Tetes Mata Kombinasi Sodium Hialuronat dan Hydroxypropyl-Guar terhadap Stabilitas Lapisan Air Mata pada Mata Kering Terkait Sindrom Sjögren Indira Priya Darsini; Lukman Edwar; Iris Rengganis; Lisnawati -; Joedo Prihartono
Cermin Dunia Kedokteran Vol 46, No 1 (2019): Obstetri - Ginekologi
Publisher : PT. Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v46i1.539

Penelitian ini bertujuan untuk menilai stabilitas lapisan air mata pada mata kering terkait sindrom Sjögren (SS) yang diberi terapi tetes mata kombinasi sodium hialuronat 0,1% (SH) dan hydroxypropyl (HP)-guar, atau monoterapi tetes mata sodium hialuronat (SH). Sebanyak 17 pasien SS dibagi dalam 2 kelompok. Kelompok pertama mendapat kombinasi SH dan HP-guar, kelompok kedua mendapat terapi SH. NIKBUT, Schirmer, skor pewarnaan okular, dan sitologi impresi, serta keluhan subjektif dinilai sebelum dan sesudah pemberian obat. Setelah terapi selama 28 hari, terdapat peningkatan median NIKBUT, Schirmer, skor pewarnaan okular, densitas sel Goblet, dan perbaikan keluhan subjektif pada mata kering terkait SS.The objectives of the study is to assess the stability of dry eye LAM associated with Sjögren syndrome (SS) during combination therapy of sodium hyaluronate 0.1% (SH) and hydroxypropyl (HP) -guar, or monotherapy sodium hyaluronic (SH). A total of 17 SS patients in this study were divided into 2 groups. The first group received a combination of SH and HP-guar while the second group received SH therapy. NIKBUT, Schirmer, ocular staining score, and impression cytology, as well as subjective complaints was assessed before and after drug administration. After 28 days of therapy, there was a median increase in NIKBUT, Schirmer, ocular staining scores, Goblet cell density, and subjective complaints on SS-related dry eyes.

Proporsi Defisiensi Vitamin D pada Pasien Poliklinik Alergi dan Imunologi Iris Rengganis; Aria Kakalih; Danny Rasjiid Garna
Cermin Dunia Kedokteran Vol 46 No 12 (2019): Kardiovakular
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v46i12.394

Vitamin D mempengaruhi dan meregulasi fungsi sistem imun tubuh. Tujuan: Mengetahui proporsi defisiensi vitamin D-25(OH) pasien poliklinik Alergi dan Imunologi, serta untuk meninjau tatalaksana defisiensi vitamin D-25(OH) di poliklinik Alergi dan Imunologi. Metode: Penelitian retrospektif data rekam medis pasien Poliklinik Alergi dan Imunologi yang mendapat terapi vitamin D serta kadar vitamin D-25 (OH). Hasil: Sejumlah 97,1% pasien memiliki kadar vitamin D kurang dari normal (insufisiensi vitamin D dan defisiensi vitamin D). Setelah pemberian vitamin D dosis tinggi (1000 IU/hari atau lebih) selama 3 bulan, terjadi peningkatan bermakna status vitamin D. Simpulan: Proporsi defisiensi vitamin D tinggi pada pasien penyakit imunologi dan pemberian vitamin D dosis tinggi (1000 IU/hari atau lebih) dapat meningkatkan status vitamin D pasien dengan penyakit imunologi. Vitamin D plays a role in influencing and regulating the function of the immune system in the body. Objective: To determine the proportion of vitamin D-25 (OH) deficiency in patients in the Allergy and Immunology Polyclinic, and to evaluate the management of vitamin D-25 (OH) deficiency in patients in the Allergy and Immunology Polyclinic. Methods: Retrospective study on medical records data from Allergy and Immunology Polyclinic patients with vitamin D-25 (OH) level data and with vitamin D therapy. Results: Vitamin D level less than normal in 97,1% patients. After administration of high dose vitamin D (1000 IU/day or more) for 3 months, a significant increase in the patient’s vitamin D status was observed. conclusion: The proportion of vitamin D deficiency in patients with immunological diseases is high and administration of high doses vitamin D (1000 IU/day or more) can improve the vitamin D status

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