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Analysis of serum levels of B cell activating factor and soluble B cell activating factor receptor with disease activity in systemic lupus erythematosus Raveinal, Raveinal; Elvira, Dwitya; Delfin, Muhamad
Universa Medicina Vol. 44 No. 2 (2025)
Publisher : Faculty of Medicine, Universitas Trisakti

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2025.v44.181-189

Background Systemic lupus erythematosus (SLE) is caused by B-cell hyperactivity, which stimulates the production of autoantibodies, leading to the formation of immune complexes and resulting in tissue damage. Increased B-cell activation is associated with disease activity in SLE. The cytokine B-cell Activating Factor (BAFF) and its soluble BAFF receptor (sBAFF-R) play a crucial role in B-cell activation and survival. Their serum levels may serve as potential biomarkers for SLE severity. This study aimed to compare serum levels of BAFF and sBAFF-R between SLE patients with mild, moderate, and severe disease activity. Methods A cross-sectional study was conducted involving 33 female SLE patients. Subjects were divided into mild, moderate, and severe disease activity groups. Disease activity was assessed using Mexican Systemic Lupus Erythematosus Disease Activity Index (MEX-SLEDAI) scores. Serum BAFF and sBAFF-R levels were measured using ELISA. Data were analyzed using the Kruskal–Wallis and Mann-Whitney tests. A p-value < 0.05 was considered statistically significant. Results The median serum BAFF level in SLE patients was 0.51 ng/mL, and 4.66 ng/mL in sBAFF-R level.There was a statistically significant difference in serum BAFF and sBAFF-R levels between mild, moderate, and severe disease activity among SLE patients (p<0.0001). Conclusion Increased serum levels of BAFF and sBAFF-R may influence disease activity in SLE. Serum concentrations of BAFF and sBAFF-R were found to be associated with disease severity, including mild, moderate, and severe categories. These findings suggest that serum BAFF and sBAFF-R levels may serve as potential biomarkers for assessing SLE activity.

Risk, Causality and Management of Severe Allergic Reactions of RNA Messenger SARS-CoV-2 Vaccine: A Mini Review Elvira, Dwitya; Raveinal
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 6 No. 4 (2022): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v6i4.475

SARS-CoV-2 infection has become a health problem throughout the world, including Indonesia with high rates of morbidity (more than 3 million confirmed case) and mortality (more than 80 thousand) due to COVID-19 since it was announced as pandemic in March 2020. Vaccination is one of the efforts to eliminate the pandemic, and just recently Food and Drug Monitoring Agency (BPOM) and Indonesian Government have granted approval for emergency use of messenger RNA (mRNA)-based vaccines. Allergic reactions after vaccination are rare adverse events, including severe allergic reactions and anaphylaxis. Polyethylene glycol (PEG) in mRNA vaccines is thought to be a hidden allergen that trigger allergies. Screening of individuals with a previous history of allergies is necessary to prevent reaction. Experienced health workers are also needed to provide adequate management in the event of a severe allergic reaction or anaphylaxis after COVID-19 vaccination. Aim of this review is to look at the risk of allergy of mRNA vaccine SARS CoV-2; possible causes of allergies and management of individuals with severe allergies/anaphylaxis.

Risk, Causality and Management of Severe Allergic Reactions of RNA Messenger SARS-CoV-2 Vaccine: A Mini Review Elvira, Dwitya; Raveinal
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 6 No. 4 (2022): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v6i4.475

SARS-CoV-2 infection has become a health problem throughout the world, including Indonesia with high rates of morbidity (more than 3 million confirmed case) and mortality (more than 80 thousand) due to COVID-19 since it was announced as pandemic in March 2020. Vaccination is one of the efforts to eliminate the pandemic, and just recently Food and Drug Monitoring Agency (BPOM) and Indonesian Government have granted approval for emergency use of messenger RNA (mRNA)-based vaccines. Allergic reactions after vaccination are rare adverse events, including severe allergic reactions and anaphylaxis. Polyethylene glycol (PEG) in mRNA vaccines is thought to be a hidden allergen that trigger allergies. Screening of individuals with a previous history of allergies is necessary to prevent reaction. Experienced health workers are also needed to provide adequate management in the event of a severe allergic reaction or anaphylaxis after COVID-19 vaccination. Aim of this review is to look at the risk of allergy of mRNA vaccine SARS CoV-2; possible causes of allergies and management of individuals with severe allergies/anaphylaxis.

Hubungan Faktor Risiko Aloimunisasi dengan Kejadian Inkompatibilitas Crossmatch Pada Pasien Keganasan Darah Dewasa yang Ditransfusi Packed Red Cell Berulang di RSUP Dr M Djamil Padang Herinda, Dwi Putri; Rofinda, Zelly Dia; Elvira, Dwitya; Rikarni, Rikarni; Aprilia, Dinda
Jurnal Ilmu Kesehatan Indonesia Vol. 5 No. 1 (2024): Maret 2024
Publisher : Fakultas Kedokteran, Universitas Andalas

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25077/jikesi.v5i1.1132

Latar Belakang: Pasien keganasan darah yang mendapatkan transfusi packed red cell (PRC) berulang akan menyebabkan pembentukan aloantibodi yang dapat terdeteksi pada pemeriksaan crossmatch dan mempersulit proses transfusi selanjutnya. Objektif: Penelitian ini bertujuan untuk mengetahui hubungan antara usia, jenis kelamin, jenis keganasan, dan jumlah unit transfusi dengan kejadian inkompatibilitas crossmatch. Metode: Penelitian ini merupakan penelitian analitik observasional dengan desain cross- sectional. Terdapat 50 sampel yang didapatkan dari rekam medis dan laboratorium. Penelitian ini menggunakan analisis univariat dan analisis bivariat. Hasil: Hasil penelitian ini menunjukan prevalensi inkompatibilitas crossmatch sebesar 16% dengan keseluruhan inkompatibilitas minor. Kejadian terbanyak didapatkan pada usia <60 tahun, perempuan, LMA dan transfusi > 10. Hasil uji statistik menunjukan tidak adanya hubungan yang signifikan antara faktor usia (p= 0,322), jenis kelamin (p= 0,050), jenis keganasan darah (p= 0,662), dan jumlah unit transfusi (p= 0,702) dengan kejadian hasil pemeriksaan crossmatch. Kesimpulan: Faktor risiko seperti usia, jenis kelamin, jenis keganasan, dan jumlah unit transfusi tidak mempunyai hubungan signifikan dengan kejadian inkompatibilitas crossmatch pada pasien keganasan darah yang mendapatkan transfusi PRC berulang

Hubungan Anemia dengan Remisi Komplit Kemoterapi induksi pada Pasien Leukemia Mieloblastik Akut Dewasa di RSUP Dr. M. Djamil Padang Salsabila, Zahra; Afriant, Rudy; Rofinda, Zelly Dia; Elvira, Dwitya; Yaswir, Rismawati; Izzah, Amirah Zatil
Jurnal Ilmu Kesehatan Indonesia Vol. 5 No. 1 (2024): Maret 2024
Publisher : Fakultas Kedokteran, Universitas Andalas

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25077/jikesi.v5i1.1169

Latar Belakang: leukemia mieloblastik akut merupakan salah satu keganasan darah yang terjadi akibat gangguan proses pertumbuhan sel mieloid, yang menyebabkan terjadinya penumpukan sel blast di sumsum tulang, dan menekan pembentukan sel darah lain yang menyebabkan anemia. Pengobatan yang diberikan pada penderita LMA adalah kemoterapi. Kondisi anemia dapat menyebabkan hipoksia di jaringan, yang dapat mengakibatkan berkurang nya efektivitas kemoterapi. Objektif: Tujuan dari penelitian ini adalah untuk menganalisis hubungan antara derajat anemia dengan tercapainya remisi komplit pada pasien LMA yang di kemoterapi induksi. Metode: Penelitian ini dilakukan dengan menggunakan desain cross sectional dengan pendekatan observasional analitik retrospektif. Sampel pada penelitian ini berjumlah 15 sampel yang diambil dari data rekam medik. Analisis univariate dilakukan untuk mendeskripsi frekuensi variable dan analisis bivariate dengan uji statistic fisher exact test. Hasil: Hasil yang didapat dari penelitian ini adalah pasien LMA banyak yang berusia >40 tahun, berjenis kelamin perempuan, dengan klasifikasi LMA M4, keluhan utama lemah letih, derajat anemia ringan dan berhasil remisi komplit yang lebih banyak. Hasil uji statistik memperlihatkan tidak adanya hubungan derajat anemia dengan tercapainya remisi komplit pada pasien. Hasil analisi LMA dengan nilai p=1,000. Kesimpulan: kesimpulan yang didapatkan adalah tidak adanya hubungan antara derajat anemia dengan tercapainya remisi komplit pada pasien leukemia mieloblastik akut dewasa yang menjalani kemoterapi induksi di RSUP Dr. M Djamil Padang.

T Cell Dysfunction in Systemic Lupus Erythematosus Gustin, Hanna; Raveinal; Dwitya Elvira
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 8 No. 5 (2024): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v8i5.988

Systemic lupus erythematosus (SLE) is a systemic autoimmune inflammatory disease that can affect many organs in the body with very diverse clinical appearances. The prevalence of SLE in each country varies. The Lupus Foundation of America estimates that around 1.5 million cases occur in America and at least 5 million cases occur worldwide. The pathophysiology of SLE is very complex. The involvement of innate and adaptive immunity in the initiation and pathophysiology of SLE disease shows that there are interactions between leukocytes, cytokines, chemokines and tissue cells. T cells are the main component of the adaptive immune system which can kill infected host cells, activate other immune cells, produce cytokines and regulate immune responses. T cell dysfunction in SLE includes triggering inflammation through the secretion of pro-inflammatory cytokines, helping B cells produce autoantibodies and the accumulation of autoreactive T cells. Aberrations in T cells could be a therapeutic target for development and a potential SLE therapy.

HIV-1 drug resistance-associated mutations in relation to viral load among HIV/AIDS patients at Dr. M. Djamil-Hospital Padang Nadia, Rizka; Elvira, Dwitya; Raveinal, Raveinal
Universa Medicina Vol. 43 No. 1 (2024)
Publisher : Faculty of Medicine, Universitas Trisakti

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2024.v43.38-43

BackgroundAccording to the WHO, 38 million people suffer from HIV worldwide and according to the HIV Drug Resistance Report, the prevalence of antiretroviral therapy (ART) resistance is 3-29%. Drug resistance-associated mutations (DRAMs) are the presence of one or more HIV mutations that reduce the ability of certain drugs to inhibit viral replication and that will increase viral replication and HIV RNA, which can lead to therapeutic failure. The objective of this study was to determine the prevalence of HIV-1 DRAMs among patients with chronic HIV-1 infections and to compare HIV RNA viral load between M184V and K103N mutations. Methods A cross-sectional was conducted involving 80 patients with HIV who met the inclusion criteria. The study subjects were examined for genotype and HIV RNA viral load, both using the polymerase chain reaction (PCR). Data were analyzed with the Kruskal-Wallis test. Results The overall drug resistance mutation prevalence was 10.0%. The most common mutations were M184V and K103N. There was a significant difference between the median HIV RNA viral load counts in patients with either M184V or K103N, and with both M184V and K103N mutations, the values being 45.420, 13.207, and 97.517 copies/mL, respectively (p<0.001). Conclusion The HIV RNA viral load count was higher in the mutation group than in the group without mutation. Long-term and ongoing surveillance of HIV DRAMs among these patients is necessary, which will help us to adjust the treatment regimen.

T Cell Dysfunction in Systemic Lupus Erythematosus Gustin, Hanna; Raveinal; Dwitya Elvira
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 8 No. 5 (2024): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v8i5.988

Systemic lupus erythematosus (SLE) is a systemic autoimmune inflammatory disease that can affect many organs in the body with very diverse clinical appearances. The prevalence of SLE in each country varies. The Lupus Foundation of America estimates that around 1.5 million cases occur in America and at least 5 million cases occur worldwide. The pathophysiology of SLE is very complex. The involvement of innate and adaptive immunity in the initiation and pathophysiology of SLE disease shows that there are interactions between leukocytes, cytokines, chemokines and tissue cells. T cells are the main component of the adaptive immune system which can kill infected host cells, activate other immune cells, produce cytokines and regulate immune responses. T cell dysfunction in SLE includes triggering inflammation through the secretion of pro-inflammatory cytokines, helping B cells produce autoantibodies and the accumulation of autoreactive T cells. Aberrations in T cells could be a therapeutic target for development and a potential SLE therapy.

Effectiveness of Drug Allergy Management: A Meta-Analysis Saputra Poedjijo, Yanuar Surya; Raveinal; Dwitya Elvira
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 8 No. 11 (2024): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v8i11.1115

Background: Drug allergies pose a significant challenge in clinical practice, impacting patient safety and treatment options. This meta-analysis aims to evaluate the effectiveness of various drug allergy management strategies, including desensitization, graded challenges, and alternative medications. Methods: A systematic search of electronic databases (PubMed, Embase, Cochrane Library) was conducted from 2018 to 2024. Randomized controlled trials (RCTs) and observational studies assessing drug allergy management interventions were included. The primary outcome was the successful administration of the culprit drug without allergic reactions. Secondary outcomes included adverse events and quality of life. Data were extracted and pooled using random-effects models. Results: A total of 32 studies (15 RCTs, 17 observational studies) encompassing 4,215 patients were included. Desensitization protocols demonstrated a high success rate (89%) in enabling the administration of culprit drugs. Graded challenges also showed promising results (75% success rate). The use of alternative medications was associated with a lower risk of allergic reactions but may compromise treatment efficacy in some cases. Conclusion: This meta-analysis highlights the effectiveness of drug allergy management strategies, particularly desensitization and graded challenges. These interventions offer promising avenues to overcome drug allergies and optimize patient care. Further research is needed to explore long-term outcomes and refine management protocols.

Profil Pasien Lupus Eritematosus Sistemik di RSUP Dr. M. Djamil Padang Tahun 2020-2021 Akmal, Elfi Fauzana; Dwitya Elvira; Noverika Windasari; Malinda Meinapuri; Raveinal, Raveinal; Yulistini, Yulistini
Consilium Sanitatis: Journal of Health Science and Policy Vol. 2 No. 2 (2024)
Publisher : EDUPEDIA Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.56855/jhsp.v2i2.1867

Objective: To understand the profile of SLE patients at RSUP.Dr.M.Djamil Padang period of 2020-2021. Methods: The research is a descriptive type with a retrospective approach. Medical record data were collected using total sampling technique,189 samples met the inclusion criteria. Data analysis using Microsoft Excel. Results: The study found that the majority of characteristics include female patients (95.8%), age group 17-25 years (33.9%), housewives (41.8%), medium-level education (66.1%), and of Minangkabau ethnicity (86.8%). Most patients had a disease duration of ≥ 2 years (78.8%), mild disease activity (36%), the most common clinical manifestation being mucocutaneous involvement (82%). ANA Profile results, the most prevalent finding was positive dsDNA (25.4%). Patients meeting ACR 1997 criteria were 57.1%, SLICC 2012 35.4%, and EULAR 2019 10.6%. The most frequently therapy was a combination of HCQ and glucocorticoids (45%), while the most common patient outcome was survival (96.8%). Conclusion: Majority of SLE patients at RSUP Dr.M.Djamil Padang are in the productive age group with mild disease activity. The majority of patients have good outcome, indicating a favorable prognosis for SLE at RSUP Dr. M. Djamil Padang.

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