Siti Setiati
Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo National Hospital, Jakarta

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The Correlation between Body Fat Distribution and Medial Tibiofemoral Joint Space Width in Obese Knee Osteoarthritis Patients Herikurniawan, Herikurniawan; Isbagio, Harry; Soewondo, Pradana; Diana, Nyimas; Setiati, Siti
Indonesian Journal of Rheumatology Vol 9, No 1 (2017)
Publisher : Indonesian Rheumatology Association

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Background: Obesity is a major risk factor for knee osteoarthritis. The relationship between obesity and OA may not be simply due to a mechanical factor. Evidences suggest that metabolic factors related to body fat play important roles, but the specific type of fat that contributes to OA is unclear. The objective of this study was to examine the possible correlation between body fat distribution with knee OA.Methods: This study was a cross sectional study of OA patients with obesity visiting the Rheumatology and Geriatric-Internal Medicine clinics at Cipto Mangunkusumo Hospital between January-March 2016. Data was collected by consecutive sampling. Knee OA was diagnosed from clinical and radiologic evaluation based on American College of Rheumatology 1986 criteria. Body fat distribution was measured by bioelectrical impedance analysis (BIA). Conventional radiography of the knee was used to evaluate jointspace narrowing (JSN). The correlation between body fat distribution and joint space width was analyzed by bivariate analysisResult: A total of 56 subjects were recruited, majority were women (73.2%). Median visceral fat was 12% (7.5-16.5), median subcutaneous fat was 30.2% (16.5-37.9), and median visceral to subcutaneous fat ratio was 0,40 (0,26-0,80). The mean medial tibiofemoral joint space width was 2.34 mm (SD 0.78). Bivariate analysis revealed a correlation between visceral fat and medial tibiofemoral joint space width (r: -0,474 p: < 0,001). There is no correlation between subcutaneous fat and medial tibiofemoral joint space width (r: -0,187 p:0,169); and visceral to subcutaneous fat ratio and medialtibiofemoral joint space width (r: -0,225 p: 0,09).Conclusion: Visceral fat is correlated with medial tibiofemoral joint space width (r: -0.474 p: < 0.001). There is no correlation between subcutaneous fat, and visceral to subcutaneous fat ratio, with medial tibiofemoral joint space width.Keywords: Osteoarthritis, obesity, visceral fat, subcutaneous fat, visceral to subcutaneous fat ratio, medial tibiofemoral joint space width
KEJADIAN REAKSI OBAT YANG TIDAK DIKEHENDAKI YANG MENYEBABKAN PASIEN USIA LANJUT DIRAWAT DI RSCM Christianie, Merry; Setiati, Siti; Trisna, Yulia; Andrajati, Retnosari
JFIOnline | Print ISSN 1412-1107 | e-ISSN 2355-696X Vol 3, No 4 (2007)
Publisher : Indonesian Research Gateway

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Study had been conducted on adverse drug reaction (ADR) that cause older patient enter the internist ward Rumah Sakit Dr. Cipto Mangunkusumo in Mei-Juli 2005, to study the incidence proportion, frequent clinical manifestation, and the medication cause the event. Study had been done using cross-sectional design, and the causal evaluation was done using Naranjo algorithm. Total patient included in this study was 102. Incidence proportion of ADR that cause older patient enter the internist ward Rumah Sakit Dr. Cipto Mangunkusumo was 14.7%. One of 15 ADR was catagorized as ”definite”, while the other 14 were categorized as “probable”. The most clinical manifestations were gastrointestinal bleeding and hypoglicaemic shock. Medications responsible for these event were mostly NSAID (non-steroidal anti inflammation drug) dan oral hypoglycaemic drug.   ABSTRAK Telah dilakukan penelitian tentang kejadian reaksi obat yang tidak dikehendaki (ROTD) yang menyebabkan pasien usia lanjut dirawat di ruang perawatan penyakit dalam Instalasi Rawat Inap B Rumah Sakit Dr. Cipto Mangunkusumo, periode Mei-Juli 2005 untuk mengetahui proporsi kejadian, manifestasi klinik yang sering terjadi dan obat yang sering menyebabkannya. Penelitian dilakukan dengan menggunakan desain studi potong lintang (cross-sectional) dan untuk penilaian kausalitas ROTD digunakan algoritma Naranjo. Total pasien yang ikut serta dalam penelitian ini berjumlah 102 orang. Diperoleh proporsi kejadian ROTD yang menyebabkan pasien usia lanjut dirawat di ruang perawatan penyakit dalam Instalasi Rawat Inap B Rumah Sakit Dr. Cipto Mangunkusumo sebesar 14,7% (interval kepercayaan 95%: 11,2-18,2%). Satu dari 15 ROTD yang terjadi dikategorikan pasti (definite) dan 14 kejadian dikategorikan besar kemungkinan (probable). Manifestasi klinik terbesar adalah perdarahan saluran cerna dan penurunan kesadaran karena hipoglikemi. Obat yang sering menyebabkan pasien dirawat karena ROTD tersebut adalah obat anti-inflamasi non-steroid (NSAID) dan obat hipoglikemi oral.
KEJADIAN REAKSI OBAT YANG TIDAK DIKEHENDAKI YANG MENYEBABKAN PASIEN USIA LANJUT DIRAWAT DI RSCM Christianie, Merry; Setiati, Siti; Trisna, Yulia; Andrajati, Retnosari
Jurnal Farmasi Indonesia Vol 3, No 4 (2007)
Publisher : Jurnal Farmasi Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35617/jfi.v3i4.89

Abstract

Study had been conducted on adverse drug reaction (ADR) that cause older patient enter the internist ward Rumah Sakit Dr. Cipto Mangunkusumo in Mei-Juli 2005, to study the incidence proportion, frequent clinical manifestation, and the medication cause the event. Study had been done using cross-sectional design, and the causal evaluation was done using Naranjo algorithm. Total patient included in this study was 102. Incidence proportion of ADR that cause older patient enter the internist ward Rumah Sakit Dr. Cipto Mangunkusumo was 14.7%. One of 15 ADR was catagorized as â?definiteâ?, while the other 14 were categorized as â??probableâ?. The most clinical manifestations were gastrointestinal bleeding and hypoglicaemic shock. Medications responsible for these event were mostly NSAID (non-steroidal anti inflammation drug) dan oral hypoglycaemic drug.   ABSTRAK Telah dilakukan penelitian tentang kejadian reaksi obat yang tidak dikehendaki (ROTD) yang menyebabkan pasien usia lanjut dirawat di ruang perawatan penyakit dalam Instalasi Rawat Inap B Rumah Sakit Dr. Cipto Mangunkusumo, periode Mei-Juli 2005 untuk mengetahui proporsi kejadian, manifestasi klinik yang sering terjadi dan obat yang sering menyebabkannya. Penelitian dilakukan dengan menggunakan desain studi potong lintang (cross-sectional) dan untuk penilaian kausalitas ROTD digunakan algoritma Naranjo. Total pasien yang ikut serta dalam penelitian ini berjumlah 102 orang. Diperoleh proporsi kejadian ROTD yang menyebabkan pasien usia lanjut dirawat di ruang perawatan penyakit dalam Instalasi Rawat Inap B Rumah Sakit Dr. Cipto Mangunkusumo sebesar 14,7% (interval kepercayaan 95%: 11,2-18,2%). Satu dari 15 ROTD yang terjadi dikategorikan pasti (definite) dan 14 kejadian dikategorikan besar kemungkinan (probable). Manifestasi klinik terbesar adalah perdarahan saluran cerna dan penurunan kesadaran karena hipoglikemi. Obat yang sering menyebabkan pasien dirawat karena ROTD tersebut adalah obat anti-inflamasi non-steroid (NSAID) dan obat hipoglikemi oral.
Kejadian Reaksi Obat yang Tidak Dikehendaki yang Menyebabkan Pasien Usia Lanjut Dirawat Di Ruang Perawatan Penyakit Dalam Instalasi Rawat Inap B Rumah Sakit Dr. Cipto Mangunkusumo Christianie, Merry; Setiati, Siti; Trisna, Yulia; Andrajati, Retnosari
Majalah Ilmu Kefarmasian Vol. 5, No. 3
Publisher : UI Scholars Hub

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Objectives. To determine the prevalence of adverse drug reaction related hospital ad-missions in geriatric patients, to describe the most frequent clinical manifestations and the drugs responsible to adverse drug reaction related hospital admissions. Design. Observational cross-sectional study. Methods. Naranjo algorithm used to assess the adverse drug reaction causality. Subjects and setting. Geriatric patients admitted to geriatric inpatient installation of Cipto Mangunkusumo general hospital over one month period and assessed for cause of admissions. Results. 14,7% of 102 admissions were identified to be adverse drug reaction related hospital admissions. One adverse drug reaction was categorized as definite and 14 were probable causality. Gastrointestinal bleeding and hypoglicemia were the most common clinical manifestation found. The drugs most frequent responsible for these adverse drug reactions were nonsteroidal antiinflamatory drugs and oral antidiabetic drugs. Conclusion. Adverse drug reactions are an important cause of hospital admission in geriatric patients.
Total Lymphocyte Count as a Nutritional Parameter in Hospitalized Patients Ralph Girson Gunarsa; Marcellus Simadibrata; Ari Fahrial Syam; Ina Susianti Timan; Siti Setiati; Abdul Aziz Rani
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 12, NUMBER 2, August 2011
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (535.438 KB) | DOI: 10.24871/122201189-94

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Background: Nowadays, there are still many malnourished patients during hospitalization, which comprises around 45-50% patients. Malnutrition is related to increased mortality and morbidity rate; therefore, nutritional state should be assessed in hospitalized patients. Total lymphocyte count (TLC) is related to decreased body function in malnutrition and it is a means of nutritional assessment. Until now, there is no data showing association between malnutrition and TLC in hospitalized patients in Indonesia. The objective of this study was to identify the association between malnutrition and TLC 1,200 cell/mm3 in hospitalized patients. Method: This study was a cross-sectional study. Subjects were new patients hospitalized at internal medicine ward of Cipto Mangunkusumo Hospital. Patients were collected by consecutive sampling. We conducted the study between April and May 2008. Fifty four patients were assessed for malnutrition by the subjective global assessment (SGA) and they also had undergone complete blood count. TLC was numbered with routine complete blood count test. Patients were classified into malnutrition according to SGA. TLC was classified with cut-off point of 1,200 cell/mm3. Statistical analysis included Chi-square test, which was used to compare proportion. Results: There were 52% malnourished patients, 33% patients with TLC 1,200 cell/mm3, 57% patients with malnutrition and TLC 1,200 cell/mm3. This study showed that there was an association between malnutrition and TLC 1,200 cell/mm3 (p = 0.001). Moreover, there was also significant association between severe malnutrition (SGA C) with TLC 900 cell/mm3 (p = 0.02). Conclusion: There is an association between malnutrition and TLC 1,200 cell/mm3.   Keywords: malnutrition, total lymphocyte count, body mass index, subjective global assessment
Proportion and Factors Associated with Zinc Deficiency in Acute Diarrhea Patients Budi Tan Oto; Marcellus Simadibrata; Drupadi Harnopidjati Singh Dillon; Siti Setiati
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 12, NUMBER 2, August 2011
Publisher : The Indonesian Society for Digestive Endoscopy

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Background: Zinc may affect the intestinal immune response. No data has been available on zinc deficiency in adult patients with diarrhea, especially for Indonesian population. Zinc metabolism, etiologies, pathogenesis and clinical course of diarrhea may have various effects on zinc concentration in different population. This study aimed to determine the proportion of zinc deficiency in patients with acute diarrhea, including its associated factors. Method: A cross-sectional study was conducted in patients with acute diarrhea at outpatient clinics and emergency wards of four hospitals between August 2010 and March 2011. A serum zinc concentration of 10.7 µmol/L was set as cut-off value for zinc deficiency. Data was analyzed by using Chi-square test. Results: There were 101 subjects, 54.5% were female, the median age was 26 years, median duration of acute diarrhea was 5 days, and the median frequency was 6 times/day. About 95% patients had nutritional status of subjective global assessment (SGA) A and the mean value of body mass index was 19.3 ± 0.70 kg/m2. Approximately 88.1% patients had severe infective diarrhea based on hydration status. About 69.3% patients were zinc deficient with the mean serum zinc concentration of 9.26 ± 2.95 µ mol/L. We found a significant correlation between the severity of diarrhea and zinc deficiency in patients with acute diarrhea. Conclusion: The proportion of zinc deficiency in acute diarrhea patients was quite large although the mean serum zinc level was still below the National Health and Nutrition Examination Survey (NHANES) reference value. The severity of diarrhea has been proven to be significant that affects zinc deficiency in acute diarrhea patients. Keywords: zinc deficiency, acute diarrhea, adult
The Effect of Branched Chain Amino Acids and L-Ornithine L-Aspartate Combination as The Late Evening Snacks on Nutritional Status and Minimal Hepatic Encephalopathy in Liver Cirrhosis Eric Daniel Tenda; Irsan Hasan; Andri Sanityoso; Siti Setiati
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 13, NUMBER 3, Desember 2012
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (325.89 KB) | DOI: 10.24871/1332012151-156

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ABSTRACTBackground:Minimal hepatic encephalopathy (MHE) in liver cirrhotic patients is critical manifestation of low grade hepatic encephalopaty (HE), is caused quality of life decrease and risk of deteriorating into distinct HE. The study was conducted to asses the effect of combination of branched-chain amino acids (BCAA) and L-ornithine L-aspartate (LOLA), which was given late evening, on nutritional status and degree of HE.Method: This single-blind randomized study was conducted on liver cirrhotic outpatients in hepatology clinic of Cipto Mangunkusumo Hospital period June 2011-June 2012. The study subjects were divided into two groups, group of late evening snack (LS) and day snack (DS). Each group was supplemented with combination of milk of BCAAs and LOLA (3.7 g/serving). Evaluation based on history, physical examination, laboratory tests and critical flicker frequency (CFF) was performed one month after the intervention. Data were statistically analyzed with SPSS 15.Results: Thirty-two patients whose the inclusion criteria were divided into 16 subjects for each group, LS and DS. After one month of the intervention, the average level of prealbumin for DS group was increased statistically significant (p 0.001), but not significant for LS group (p = 0.259). The increase of average body weight,mid-arm muscle circumference (MAMC) and CFF test result in both groups. There was no improvement on subject global assessment (SGA) score after one month intervention in both groups.Conclusion: This study proved that giving combination of BCAAs and LOLA may improve the condition of MHE, however for nutritional status can not be assessed. Keywords: minimal hepatic encephalopathy, BCAAs, LOLA, prealbumin, SGA score, nutritional status
Predictors of Handgrip Strength Changes in Elderly Patients Madina, Ummi Ulfah; Setiati, Siti; Laksmi, Purwita Wijaya; Mansjoer, Arif
Jurnal Penyakit Dalam Indonesia Vol. 8, No. 3
Publisher : UI Scholars Hub

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Introduction. The increasing elderly population throughout the world has been related to the increased prevalence of sarcopenia and frailty. Handgrip strength is a component of sarcopenia, one of frailty syndrome phenotypes. Previous studies have assessed the association of age, sex, nutritional status, functional status, mental status, and comorbidity, but varied results. No longitudinal study has been done to determine the correlation of handgrip strength changes with age, sex, nutritional status, functional status, mental status, and comorbidity in Indonesia. The aim of this study was to determine the correlation between age, sex, nutritional status, functional status, depressive symptoms, comorbidity, and handgrip strength changes in elderly patients. Methods. A prospective cohort study using secondary data of elderly patients who were routinely visiting Geriatric OutPatients Clinic at Cipto Mangunkusumo Hospital, Jakarta, from the INA-FRAGILE register observed for one year (2013- 2014). The multivariate logistic regression analysis was used to assess the correlation between sex, age, nutritional status (MNA score), functional status (ADL score), depressive symptoms (GDS-SF score), comorbidities (CIRS score), and handgrip strength changes. Results. From 162 subjects which were included in the study, the mean age was 72.9 (SD 5.9) years, predominantly female (57.41%), with good nutrition (83.9%), independent (median 9- 20), not depressed (median 0-11), has average comorbidity index 11.8 (SD 3.7), and 53.1% experienced decreased handgrip strength. Nutritional status (OR = 2.7, p = 0.033) and comorbidity (OR 0.3, p <0.002) correlated with handgrip strength changes
Determinant Factors and Added Value of Osteoprotegerin (OPG) to Detect Carotid Intima-Media Thickness (CIMT) in Type 2 Diabetes Mellitus Patient Tedjasaputra, Shirly Elisa; Yunir, Em; Wijaya, Ika Prasetya; Setiati, Siti
Jurnal Penyakit Dalam Indonesia Vol. 5, No. 2
Publisher : UI Scholars Hub

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Effect of Structured Education and Antihypertensive MedicationsAdherence to Decrease Blood Pressure for Hypertension inElderly: a Randomized Controlled Trial Khomaini, Ayatullah; Setiati, Siti; Lydia, Aida; Dewiasty, Esthika
Jurnal Penyakit Dalam Indonesia Vol. 4, No. 1
Publisher : UI Scholars Hub

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Introduction. Hypertension is one of the important problems in elderly due to high impact of cardiovascular complications. Education and antihypertensive medication adherence are considered as influence factors in a holistic and comprehensive hypertension treatment. This study was conducted to determine the effect of structured education and antihypertensive medication adherence in decreasing blood pressure as part of the hypertension treatment in elderly patients. Methods. A randomized clinical trial was conducted in October 2012 to February 2013 on hypertensive elderly patients at Cipto Mangunkusumo hospital, Jakarta. Subjects were divided into 3 groups: group I was received structured education and checklist, group II was received structured education, and group III was received checklist without structured education. Structured education was given 3 times per month for 90 days. Systolic and diastolic blood pressure (SBP and DBP) were measured on day-1 and day-90, then analyzed with anova test. Results. A total of 182 subjects that consisted of 60 subjects in group I, 61 subjects in group II and 61 subjects in group III was included in this study. Analysis results showed a decrease of SBP in group I, II and III to 130 (range 90-179) mmHg, 135 (range 80-174) mmHg and 133 (range 102-209) mmHg, respectively (p=0.04). Diastolic blood pressure (DBP) in group I, II, and III decreased to 70 (range 48-100) mmHg, 74 (range 45-103) mmHg and 78 (range 60-102) mmHg, respectively (p <0.001). Conclusions. Structured education significantly decreased systolic and diastolic blood pressure in elderly hypertensive patients, while adherence to antihypertensive medication did not affect signicifantly.
Co-Authors Abdul Aziz Rani Abdul Aziz Rani Abellia, Gaby Adityo Susilo, Adityo Afistianto, Muhammad Fikri Agus Rizal Ardy Hariandy Hamid, Agus Rizal Ardy Hariandy Agus Siswanto Aida Lydia, Aida Alimuddin, Suriani Alvina Widhani, Alvina Amalialjinan, Nadia Andreas Arie Setiawan, Andreas Arie Andri Sanityoso Andri Sanityoso Anindyanti, Risma Debby Ardi Ardian, Ardi Ari F Syam Ari Fahrial Syam Arif Mansjoer Arya Govinda Arya Govinda Roosheroe, Arya Govinda Aulia Rizka, Aulia Ayatullah Khomaini Bambang Setyohadi Bambang Sutrisna Budi I Santoso, Budi I Budi Iman Santoso Budi Tan Oto Catarina Budyono, Catarina Ceva W. Pitoyo CHAIDIR A MOCHTAR, CHAIDIR A Cleopas M Rumende, Cleopas M Dadang Makmun Dharmeizar Dharmeizar Dian Handayani Diana, Nyimas Dienillah, Syifa Sarah Dita Adhitianingsih, Dita Djumhana Atmakusuma, Djumhana Dono Antono Drupadi Harnopidjati Singh Dillon Dyah Purnamasari E. Mudjaddid A. Siswanto Deddy N.W.Achadiono Hamzah Shatri Edy Rizal Wahyudi Em Yunir, Em Eric Daniel Tenda Ernawati Erwinanto Esthika Dewiasty, Esthika Euphemia Seto, Euphemia Febriyani Fiastuti Witjaksono Findy Prasetyawaty, Findy Firtantyo A Syahputra, Firtantyo A Ginova Nainggolan Harrina E Rahardjo, Harrina E Harrina Erlianti Rahardjo, Harrina Erlianti Harry Isbagio Herikurniawan, Herikurniawan Heru Sundaru Idrus Alwi Ika P Wijaya, Ika P Ika Prasetya Wijaya Imam Subekti Ina Susianti Timan Indra G Mansur, Indra G Iris Rengganis Irsan Hasan Jimmy Tesiman, Jimmy Joedo Prihartono Junizaf Junizaf Kuntjoro Harimurti Laura A Siahaan, Laura A Lugyanti Sukrisman Lukman Hakim M Sadikin M Yamin Marcel Prasetyo Marcellus Simadibrata Marcellus Simadibrata Martini, Rose D Marulam Panggabean, Marulam Megantara, Marcelino A. Meilania Saraswati Merry Christianie Merry Christianie, Merry Muhammad Yamin Murdani Abdullah Nadia Ayu Mulansari, Nadia Ayu Nafrialdi Nafrialdi Nanang Sukmana Nasrun, Martina W. Noto Dwimartutie Nur Rasyid Nur Riviati, Nur Nurhadi Ibrahim Partini P Trihono, Partini P Ponco Birowo Pradana Soewondo Pudji Rahardjo Purwita W Laksmi, Purwita W Purwita Wijaya Laksmi Rachmat Hamonangan, Rachmat Radhiyatam Mardhiyah, Radhiyatam Ralph Girson Gunarsa Retnosari Andrajati Rino A Gani Rochani Sumardi, Rochani Roza Mulyana Rudi Putranto Rudy Hidayat Saraswati, Mita Hafsah Savitri, Ary Indriana Simon Salim Siti A Nuhonni, Siti A Stevent Sumantri, Stevent Suhendro Suwarto, Suhendro Suksmono Haricahyo Sumariyono Supartondo Supartondo Surahman Hakim Suzanna Immanuel Tanadi, Caroline Tedjasaputra, Shirly Elisa Teguh H Karjadi, Teguh H Teguh H. Karjadi, Teguh H. Tirza Z Tamin Tities Anggraeni Indra, Tities Anggraeni Tri B.W. Rahardjo Uiterwaal, Cuno Ummi Ulfah Madina, Ummi Ulfah vera vera, vera Vidhia Umami, Vidhia Wasilah Rochmah Widayat Djoko Santoso, Widayat Djoko Widi Atmoko Widjajalaksmi Kusumaningsih, Widjajalaksmi Wiguno Prodjosudjadi Wijaya, Indra Wismandari Wisnu Wresti Indriatmi B. Makes Wulyo Rajabto Yulia Trisna Yulia Trisna, Yulia