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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

GAMBARAN KLINIS DAN PROPORSI HIPOTIROIDISME SEKUNDER PADA PASIEN ADENOMA HIPOFISIS DI RUMAH SAKIT CIPTO MANGUNKUSUMO Cahyanur, Rahmat; Soewondo, Pradana; Darmowidjojo, Budiman; Aman, Renindra Ananda; Dewiasty, Esthika
Majalah Kedokteran Indonesia Vol 68 No 6 (2018): Journal of the Indonesian Medical Association Majalah Kedokteran Indonesia Volum
Publisher : PENGURUS BESAR IKATAN DOKTER INDONESIA (PB IDI)

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Pendahuluan: Adenoma hipofisis merupakan tumor yang berasal dari jaringan hipofisis anterior. Manifestasi klinis timbul akibat pendesakan massa dan gangguan sekresi hormon. Salah satu gangguan hormonal yang ditimbulkan adalah hipotiroidisme sekunder. Hipotiroidisme sekunder terkait dengan penurunan kualitas hidup serta peningkatan risiko kardiovaskular. Tujuan: Mengetahui proporsi hipotiroidisme sekunder dan gambaran klinis pasien adenoma hipofisis. Metode: Penelitian ini adalah studi potong lintang. Data diambil dari rekam medis pasien di Rumah Sakit Cipto Mangunkusumo antara tahun 2007-2012. Data demografis (usia, jenis kelamin), karakteristik klinis, jenis adenoma, data radiologis, pemeriksaan hormon (T4 bebas dan TSH) dievaluasi pada peneltian ini. Hasil: Terdapat 45 pasien yang memenuhi kriteria penelitian ini. Sebagian besar subyek adalah wanita (62,2%). Keluhan utama subyek adalah gangguan penglihatan (55,6%). Gejala yang sering ditemukan adalah sakit kepala (86,7%), gangguan penglihatan (77,8%). Pada subyek wanita manifestasi yang pertama kali muncul adalah gangguan penglihatan dan gangguan fungsi seksual (39,3% dan 32,1%). Pada Usia muda, gejala pertama kali muncul lebih pada kelompok adenoma fungsional dibandingkan non fungsional (32,9 vs. 40,6). Hampir seluruh kasus yang ditemukan adalah makroadenoma (97,8%). Proporsi subyek yang mengalami hipotiroidisme sekunder adalah 40%. Subyek dengan hipotiroidisme sekunder lebih banyak mengeluhkan gangguan penglihatan dan gangguan ereksi. Kesimpulan: Gangguan penglihatan adalah keluhan utama yang sering ditemukan. Pada subyek wanita, keluhan gangguan fungsi seksual bersama dengan gangguan penglihatan adalah manifestasi yang pertama kali muncul. Proporsi hipotiroidisme sekunder pada penelitian ini adalah 40,0%. Subyek dengan hipotiroidisme sekunder lebih banyak mengeluhkan gangguan penglihatan, gangguan ereksi.

Pengaruh Sistem Pengingat Melalui Pengiriman Pesan Singkat (Text-Messaging Reminder System) untuk Meningkatkan Kepatuhan Pasien dalam Pengobatan Tuberkulosis: Tinjauan Kasus Berbasis Bukti Skolastika Mitzy Benedicta; Pradana Soewondo; Dhanasari Vidiawati Sanyoto
Jurnal Penelitian dan Pengembangan Pelayanan Kesehatan Vol. 3 No. 2 (2019)
Publisher : Jurnal Penelitian dan Pengembangan Pelayanan Kesehatan (Journal of Research and Development in Health Services)

Abstrak Indonesia merupakan negara kedua di dunia dengan insidensi Tuberkulosis (TB) terbanyak setelah India, sehingga Indonesia termasuk high-burden country dalam penyakit TB. Angka keberhasilan pengobatan TB di Indonesia baru mencapai 84% pada tahun 2016 sehingga perlu ditingkatkan. Inovasi yang banyak dikembangkan untuk meningkatkan kepatuhan pasien dalam pengobatan TB adalah metode pengingat dengan menggunakan media elektronik, salah satunya melalui SMS mengingat pengguna aktif telepon genggam di Indonesia cukup banyak, yaitu mencapai 70,2 juta untuk smartphone pada tahun 2017 dan terus meningkat. Tujuannya untuk mengetahui pengaruh sistem pengingat melalui pesan singkat (text-messaging reminder system) dalam kepatuhan pasien terhadap pengobatan TB. Pencarian literatur dilakukan pada beberapa pangkalan data jurnal ilmiah kedokteran besar seperti Pubmed, Cochrane, EBSCOhost, dan Science Direct. Artikel disaring sesuai desain yang dibutuhkan untuk tinjauan intervensi, kriteria inklusi, dan kriteria eksklusi. Telaah kritis menggunakan metode intervensi sesuai Oxford Center for Evidence Based Medicine 2011. Telaah kritis dilakukan pada dua artikel terpilih dengan metode RCT dan telaah sistematis. Pada studi RCT terhadap 2207 pasien di Pakistan, diperoleh penggunaan sistem pengingat SMS tidak berpengaruh terhadap kepatuhan pengobatan TB. Pada telaah sistematis yang meninjau empat artikel, diperoleh kesimpulan bahwa sistem SMS mampu meningkatkan kepatuhan pengobatan TB. Namun, signifikansinya masih diragukan karena studi yang diinklusi merupakan studi dengan tingkatan bukti rendah berdasarkan kategori GRADE. Pengaruh metode pengingat berupa SMS terhadap kepatuhan pengobatan TB masih inkonklusif. Diperlukan penelitian lebih lanjut dengan populasi besar serta desain penelitian yang sesuai (RCT). Kata kunci: Tuberkulosis, SMS, Sistem Pengingat, Kepatuhan, Pengobatan Abstract Indonesia ranked second in the world for its Tuberculosis (TB) incidence. Therefore, Indonesia is included in the list of high burden countries for TB. TB treatment success rate in Indonesia for 2016 is 84%, but this number still needs to be increased. Many innovations using electronic devices such as handphones are developed to increase patient’s adherence to TB treatment. One of the easiest applicable methods is through SMS. Indonesia is also a developing country with developing technology usage, with 70.2 million active smartphone users in 2017. To determine whether a text messaging reminder system can increase adherence in patients with Tuberculosis treatment. Literature searching was conducted in large medical journal databases such as Pubmed, Cochrane, EBSCOhost, and Science Direct. The articles are selected by considering the study designs that correlate with the intervention appraisal method, inclusions, and exclusions criteria. Intervention type appraisal was conducted using the guideline of the Oxford Center for Evidence-Based Medicine 2011. Appraisals were made for two chosen articles: one with the RCT method, and the other with a systematic review method. RCT study conducted in Pakistan showed that text messaging reminder system does not affect adherence in patients with TB treatment. The other study that reviews four articles concludes that a text messaging reminder system may increase adherence in TB patients undergoing treatment. But, the significance is still doubted as the studies included in this review are of low evidence level based on the GRADE category. The impact of the text messaging reminder system in increasing treatment adherence of TB patients is still inconclusive. Further research with a large population, better design and methodology are still needed. Keywords: Tuberculosis, SMS, Text Messaging, Reminder System, Adherence, Treatment

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

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

Pengaruh Edukasi dan Perawatan Kaki terhadap Pencegahan Luka Kaki Diabetik Rizki Hidayat; Pradana Soewondo; Dewi Irawaty
Malahayati Nursing Journal Vol 4, No 8 (2022): Volume 4 Nomor 8 2022
Publisher : Universitas Malahayati Lampung

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/mnj.v4i8.7113

ABSTRACT Diabetic foot ulcer (DFU) is classified as an incurable chronic wound that causes skin irritation with a long and frustrating healing process. DFU can be prevented and the frequency of lower extremity amputations can be reduced by 49-87% by preventing the development of DFU. Evidence in the literature suggests that early detection and treatment of diabetic foot complications can reduce the prevalence of ulceration by 44% to 85%. Foot care, especially diabetes, is becoming a new standard of care and the mainstay of therapy in preventing the development of DFU. To See The Effect Of The Combination Of Education And Foot Care Model On The Prevention Of Diabetic Foot Wounds. Systematic Review, through systematic searches on 9 databases (Hindawi, Pubmed, Researchgate, Science Direct, Journal of diabetes & metabolism, National Public Health Journal, American Journal of Nursing Science, & International Journal of Foot and Ankle). published since 2010, Of the 30 references that have been identified, 30 references have been examined in detail, of that number, 12 research references meet the inclusion and exclusion criteria, all of which contain instruments relevant to the variables in this systematic review. From 12 References Used The Results Show Foot Education and Care Affect the Healing Process of Diabetic Foot Wounds. Diabetic foot ulcers are a complication of diabetes mellitus and have complex problems so that the wound is difficult or delays wound healing, prevention with education and foot care is very helpful to avoid this condition, especially in reducing the risk in wound prevention. Keywords: Diabetic Foot Wound, Education, Foot Care, Wound Prevention ABSTRAK Diabetic foot ulcer (DFU) diklasifikasikan sebagai luka kronis yang tidak dapat disembuhkan yang menyebabkan gangguan pada kulit dengan proses penyembuhan yang lama dan frustrasi. DFU dapat dicegah dan frekuensi amputasi ekstremitas bawah dapat diturunkan hingga 49-87% dengan mencegah perkembangan DFU. Bukti dalam literatur menunjukkan bahwa deteksi dini dan pengobatan komplikasi kaki diabetik dapat mengurangi prevalensi ulserasi sebesar 44% hingga 85% (Wirsing, 2015). Perawatan kaki khususnya diabetes menjadi standar perawatan baru dan terapi andalan dalam mencegah perkembangan DFU. Untuk Melihat Pengaruh Model Kombinasi Edukasi Dan Perawatan Kaki Terhadap Pencegahan Luka Kaki Diabetik. Sistematika Review, melalui penelusuran secara sistematis pada 9 database (Hindawi, Pubmed, Researchgate, Science Direct, Jurnal Of diabetes & metabolism, National Public Health Jurnal, American Journal Of Nursing Science, & International Jurnal Of Foot and Ankle). yang dipublikasikan sejak tahun 2010, Dari 30 jumlah referensi yang telah diidentifikasi, ada 30 referensi yang diperiksa dengan detail, dari jumlah tersebut, terdapat 12 referensi penelitian yang memenuhi kriteria inklusi dan eksklusi , dimana seluruhnya memuat instrument yang relevan dengan variabel pada sistematika review ini . Dari 12 Referensi Yang Digunakan Hasil Nya Menunjukkan Edukasi dan perawatan kaki Mempengaruhi Proses Penyembuhan Luka Kaki Diabetik. Luka kaki diabetic merupakan Kompilkasi dari diabetes militus serta mengalami kompleksitas masalah sehingga luka sulit atau mengalami penundaan penyembuhan luka, pencegahan dengan edukasi dan perawatan kaki sangat membantu untuk menghindari kondisi tersebut, terutama dalam menurunkan resiko dalam pencegahan luka. Keyword: Luka Kaki Diabetic, Edukasi, Perawatan Kaki, Pencegahan Luka.

Gastrointestinal Bleeding as a Manifestation of IntestinalTuberculosis in Leprosy Patients with Reversal Reaction andHistory of Long-Term Steroid Therapy Gebrina, Meutia; Nursyirwan, Saskia Aziza; Soewondo, Pradana; Fauzi, Achmad; Renaldi, Kaka
Jurnal Penyakit Dalam Indonesia Vol. 3, No. 1
Publisher : UI Scholars Hub

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Intestinal tuberculosis is difficult to be diagnosed. Signs and symptoms usually are not specific, and the results of diagnostic tools are frequently negative. One of the unusual symptoms of intestinal tuberculosis is gastrointestinal bleeding, which should increase the awareness of clinical practitioners.

Association between Thyroid Status and Glucose Intolerance inHyperthyroid Patients Wisnu, Wismandari; Soewondo, Pradana; Subekti, Imam
Jurnal Penyakit Dalam Indonesia Vol. 5, No. 1
Publisher : UI Scholars Hub

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Introduction. The most common endocrinopathy in adults are diabetes mellitus (DM) and thyroid disease. Hyperthyroidism decreases blood glucose control and increased the need of insulin. However, the mechanism of abnormal glucose metabolism in hyperthyroidism is not fully understood. This study aims to determine the relationship of thyroid status with incidence of glucose intolerance in hyperthyroid patients compared to hyperthyroid patients who have achieved clinical status of eutyroid and normal population. Methods. This study was cross sectional design in outpatients with hyperthyroidism in hyperthyroid and euthyroid/subclinical hyperthyroid status, and healthy volunteers who had matching age and sex. An oral glucose test and Homeostatic Model Assesment Insulin Resistance was performed after the diagnosis of hyperthyroidism by FT4 and TSH measurement. Data analysis was performed using SPSS for Windows version 20.0. Results. There were 114 eligible patients (40 case hyperthyroid, 40 case euthyroidism/subclinical hyperthyroidism and 34 healthy subjects). Proportion of glucose intolerance in hyperthyroidism is 52,5% (10% DM, 32,5% impaired glucose tolerance (IGT), and 10% impaired fasting glucose (IFG)), in euthyroidism/subclinical hyperthyroidism was 20% (5% DM, 15% IGT, and 0% IFG), and in healthy subjects was 11,8% (0% DM, 8,8% IGT, and 2,9% IFG). Glucose intolerance in hyperthyroidism was significantly different than euthyroidism/subclinical hyperthyroidism (p=0.002). We also found that the association between thyroid status and glucose intolerance in the group without insulin resistance was significantly different (p=0.004). Conclusions. Our study conclude that there is association between hyperthyroidism and glucose intolerance. Hyperthyroid patients in euthyroidism/subclinical hyperthyroidism status have the same risk as the healthy subject to became glucose intolerance.

CONCEPT ANALYSIS OF SELF-MANAGEMENT IN PATIENT WITH DIABETES NEPHROPATHY Dayan Hisni; Pradana Soewondo; Debie Dahlia; Dian Ayubi
Jurnal Endurance Vol. 8 No. 2 (2023): Jurnal Endurance : Kajian Ilmiah Problema Kesehatan
Publisher : LLDIKTI Wilayah X

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22216/jen.v8i2.2247

ABSTRACT Diabetes mellitus (DM) is a metabolic disease with characterized by hyperglycemia and it has some complications both macrovascular and microvascular. There have been reported that 40% of DM patient has developed diabetic nephropathy (DN) in the early of diagnosed. Therefore, some nursing intervention should be done to prevent DM including DN. One of them is self-management. This article aims to explain the concept of self-management to prevent DN in patient with DM. The method used is the Walker and Avant concept approach. The Walker and Avant framework clarifies current self-management understanding and use in practice and research across multiple disciplines. This concept’s critical attributes include personal skills, self-management, lifetime task, problem solving in health area, and decision making properly. The conclusion of this analysis concept is to increase nurses’ knowledge regarding self-management in patient with DN.

The Impact of Self-Management on the Quality of Life of Patient with Diabetes Mellitus: A Systematic Review Sukma Wicaturatmashudi; Pradana Soewondo; Debie Dahlia; Sali Rahadi Asih; Dewi Gayatri; Ratna Aryani
Jurnal Promkes: The Indonesian Journal of Health Promotion and Health Education Vol. 12 No. 1 (2024): Jurnal Promkes: The Indonesian Journal of Health Promotion and Health Educatio
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jpk.V12.I1.2024.120-128

Background: Diabetes mellitus is a hereditary and degenerative disease that requires management throughout the patient's life to maintain blood sugar stability and psychosocial factors. Aims: This systematic review aims to determine the effect of self-management on the quality of life of patients with Type 2 DM. Methods: The selection of the studies refers to Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines and JBI's checklist was used to assess the quality of the study. The study selection came from 7 databases Scopus, ScienceDirect, Sage Journals, ProQuest, Emerald Insight, Pubmed dan Taylor & Francis. The number of studies included in the review was 7 articles, 5 articles used an RCT design, and 2 articles were quasi-experimental. Results: The finding showed 2 articles that provide interventions in the form of DSME, 1 article emphasizes self-management interventions based on self-efficacy theory that is oriented towards active family involvement, 1 article specifies interprofessional-based DSM through telemonitoring media, 1 article focuses on community-based self-management interventions, and 1 article specializes in the use of weblogs in conducting self-management. Special 2 articles emphasize nurse leadership in managing interventions during the study. Five articles showed a significant effect of self-management on quality of life and 2 articles had no effect. Conclusion: The findings can be used to optimize self-management intervention in DM patients to improve their quality of life.

Treatment Adherence and Incidence of Coronary Heart Disease in Type 2 Diabetes Mellitus Patients Baniu, Ahmad Sahlan; Sauriasari, Rani; Riyadina, Woro; Soewondo, Pradana
Kesmas Vol. 17, No. 2
Publisher : UI Scholars Hub

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Previous studies showed that uncontrolled blood sugar and long-term use of several types of antidiabetic could increase the risk of coronary heart disease (CHD). This study aimed to compare the incidence of CHD in type 2 diabetes mellitus (T2DM) patients showing treatment adherence and non-adherence behavior over four years. This was a retrospective cohort study with data sets obtained from the Bogor Cohort Study of Non-Communicable Disease Risk Factors. All study subjects were not diagnosed with CHD at the beginning of the study. The sample was divided into two groups; one had adhered to treatment from health centers and followed the treatment instructions (adherent group), while the other had not followed the treatment instructions (non-adherent group). Of 5,690 subjects, 276 were eligible for this study (84 in the adherent and 192 in the non-adherent group). The incidence of CHD in the non-adherent group was 2.3% higher than in the adherent group (p-value = 0.564) and had a 1.7 times greater risk of developing CHD, but not statistically significant (adjusted HR = 1.739; 95% CI = 0.673-4.490). The non-adherent T2DM patients had a greater risk of developing CHD than adherent T2DM patients.

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