Esthika Dewiasty, Esthika
Divisi Geriatri Departemen Ilmu Penyakit Dalam, Fakultas Kedokteran Universitas Indonesia/ Rumah Sakit Cipto Mangunkusumo, Jakarta

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Validity And Reliability Of Lupus Quality Of Life Questionnaire In Patients With Systemic Lupus Erythematosus In Indonesia Anindito, Bagus; Hidayat, Rudy; Koesnoe, Sukamto; Dewiasty, Esthika
Indonesian Journal of Rheumatology Vol 8, No 2 (2016)
Publisher : Indonesian Rheumatology Association

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Abstract

Background: The development of Systemic Lupus Erythematosus (SLE) treatment has led the increased of patients survival. Quality of life has became a value based medicine component that should be evaluated in treating SLE. One standardized questionnaire to asses the quality of life in SLE patients is Lupus Quality of Life (Lupus QoL). Currently, in Indonesia, there has not been any spesific questionnaire to asses the quality of life in SLE patients. This study aims to prove that Lupus QoL is valid and reliable to asses the quality of life in SLEpatients in Indonesia.Methods: This study used cross sectional study method. Firstly, we translated the Lupus QoL into Indonesian language, then we tested to 10 respondents. Then, we continued the study with larger sample size. We analyzed the reliability of the test and the re-test result using the interclass coefficient correlation and the internal consistency of the tests using cronbach alpha. Construct validity was evaluated using multi trait scaling analysis and the extrenal validity was evaluated using correlation between domains in short form 36 (SF 36)with Lupus QoL and with disease activity.Results: Data collection was done to 65 SLE patients between October – November 2015 in RSCM. The test has good external validity SF 36 (r=0.38-0.66, p<0.05) and good construct validity (r >0.4; range: 0.44-0.93). The ICC value in one week >0.7 and Cronbach α was>0.7 in each domain. The correlation between lupus QoL and the disease activity was weak and consistentwith other studies.Conclusion: Lupus QoL questionnaire is valid and reliable to asses the quality of life in SLE patients inIndonesia.Key words: Quality of Life, Systemic Lupus Erythematosus, Lupus QoL, Validity, Reliability
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.
Correlation between hair zinc level and cognitive function in elderly population Dian Sarah Mutiara; Diana Sunardi; Esthika Dewiasty
World Nutrition Journal Vol. 3 No. 2 (2020)
Publisher : Indonesian Nutrition Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25220/WNJ.V03.i2.0008

Abstract

Introduction: Neurodegenerative disease is the most problem in elderly. Amyloid β (Aβ) accumulation is the major cause of cognitive impairment. Zinc has an important role in antioxidant and Aβ accumulation process. This study aimed to evaluate the correlation between hair zinc level and cognitive function in elderly.Methods: A cross sectional study was conducted involving 58 subjects of elderly in Jakarta. Subjects were recruited by consecutive sampling. Hair zinc level was measured by inductively coupled plasma emission spectrometer (ICPS) and cognitive function assessed by abbreviated mental test (AMT). Data analysis was done by spearman rank correlation test and p-value less than 0.05 were considered statistically significant.Results: The mean of age was 65.4 ± 4.4 years old and 56.9% of subjects were female. The mean of hair zinc level was 123.23 ± 69.71 µg/gram hair and 32.8% subjects had hair zinc deficiency. There was 91.4% subjects had normal cognitive function. The study showed no correlation between hair zinc level and cognitive function in elderly (p=0.871 ; r=-0.022).Conclusions: There was no correlation between hair zinc level and cognitive function in elderly. Further research is expected to be performed with different level of cognitive function.Keywords: cognitive, elderly, hair zinc level, zinc.
Correlation between Hair Zinc Level and Cognitive Function in Elderly Dian Sarah Mutiara; Diana Sunardi; Esthika Dewiasty
World Nutrition Journal Vol. 3 No. 1 (2019): Volume 03 Issue 1 Include Supplements Oral Presentation Abstracts of 14th Sympo
Publisher : Indonesian Nutrition Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25220/WNJ.V03.i1.0007

Abstract

Background and Objectives : Neurodegenerative disease is the most problem in elderly. Amyloid β (Aβ) accumulation is the major cause of cognitive impairment. Zinc has an important role in antioxidant and Aβ accumulation process. This study aimed to evaluate the correlation between hair zinc level and cognitive function in elderly.Methods : A cross sectional study was conducted involving 58 subjects of elderly in Jakarta. Subjects were recruited by consecutive sampling. Hair zinc level was measured by inductively coupled plasma emission spectrometer (ICPS) and cognitive function assessed by abbreviated mental test (AMT). Data analysis was done by spearman rank correlation test[DN1]  and p-value less than 0.05 was considered statistically significant.Results : The mean of age was 65.4 ± 4.4 years old and 56.9% of subjects were female. The mean of hair zinc level was 123.23 ± 69.71 µg/gram hair and 32.8% subjects had hair zinc deficiency. There was 91.4% subjects had normal cognitive function. The study showed no correlation between hair zinc level and cognitive function in elderly (p=0.871 ; r=-0.022).Conclusion : There was no correlation between hair zinc level and cognitive function in elderly. Further research is expected to be performed with different level of cognitive function.
Validity And Reliability Of Lupus Quality Of Life Questionnaire In Patients With Systemic Lupus Erythematosus In Indonesia Bagus Anindito; Rudy Hidayat; Sukamto Koesnoe; Esthika Dewiasty
Indonesian Journal of Rheumatology Vol. 8 No. 2 (2016): Indonesian Journal of Rheumatology
Publisher : Indonesian Rheumatology Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (405.117 KB) | DOI: 10.37275/ijr.v8i2.60

Abstract

Background: The development of Systemic Lupus Erythematosus (SLE) treatment has led the increased of patients survival. Quality of life has became a value based medicine component that should be evaluated in treating SLE. One standardized questionnaire to asses the quality of life in SLE patients is Lupus Quality of Life (Lupus QoL). Currently, in Indonesia, there has not been any spesific questionnaire to asses the quality of life in SLE patients. This study aims to prove that Lupus QoL is valid and reliable to asses the quality of life in SLEpatients in Indonesia.Methods: This study used cross sectional study method. Firstly, we translated the Lupus QoL into Indonesian language, then we tested to 10 respondents. Then, we continued the study with larger sample size. We analyzed the reliability of the test and the re-test result using the interclass coefficient correlation and the internal consistency of the tests using cronbach alpha. Construct validity was evaluated using multi trait scaling analysis and the extrenal validity was evaluated using correlation between domains in short form 36 (SF 36)with Lupus QoL and with disease activity.Results: Data collection was done to 65 SLE patients between October – November 2015 in RSCM. The test has good external validity SF 36 (r=0.38-0.66, p<0.05) and good construct validity (r >0.4; range: 0.44-0.93). The ICC value in one week >0.7 and Cronbach α was>0.7 in each domain. The correlation between lupus QoL and the disease activity was weak and consistentwith other studies.Conclusion: Lupus QoL questionnaire is valid and reliable to asses the quality of life in SLE patients inIndonesia.Key words: Quality of Life, Systemic Lupus Erythematosus, Lupus QoL, Validity, Reliability
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.
The Role of Lactate Clearance in Severe Septic Patients Survival Hambali, Wirawan; Chen, Lie Khie; Widodo, Djoko; Dewiasty, Esthika; Pohan, Herdiman T.; Suhendro, Suhendro
Jurnal Penyakit Dalam Indonesia Vol. 3, No. 1
Publisher : UI Scholars Hub

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Introduction. Severe Sepsis is a major health problem that known to results high mortality rate, and still its incidents continue to rise. Lactate clearance represents kinetics alteration of anaerobic metabolism in severe septic patients that makes it to become a potential parameter to evaluate severity of one’s illness and intervention adequacy that received by the patient. However, the relationship between lactate clearance and occurrence of death in severe septic patients is still unknown. Methods. This is a prospective cohort study that conducted in Ciptomangunkusumo Hospital, from March to May 2011. Patients were categorized into high lactate clearance group if there were differences in lactate levels ≥ 10% in which occurred within the first 6 hours of the treatment, and contrary were categorized into low lactate clearance group. Occurrences of death were observed within the first 10 days. Afterward, the data were analyzed by means of survival analysis, Kapplan Meier curve were made, survival rate and median survival rate were determined, statistical test were calculated using log-rank test, and hazard ratios were calculated using Cox regression model test. Analysis of Confounder Variable was also performed using multivariate Cox regression test. Results. The survival rate for high and low lactate clearance group were 60.0% vs. 26.7%, respectively (p=0,004). In low lactate clearance group the median survival was 3 days, while the mortality rate did not reach 50% in high lactate clearance group. The first Interquartile for these two groups was 1 day and 4 days, respectively. The hazard ratio that obtained from the analysis was 2.87 (95% CI, 1.41 - 5.83). On multivariate analysis the presence of septic shock, SOFA score, the use of vasopresor/inotropic, blood transfusion, fluid resuscitation didn’t change the hazard ratio value more than 10%. For that reason, these parameters were not considered as confounder. Conclusions. Patients with high lactate clearance have a better survival rate compared to patients with low lactate clearance, and its relationship is not influenced by confounder.
Faktor-Faktor yang Berperan terhadap Terjadinya Lipodistrofi pada Pasien HIV yang Mendapatkan Terapi Antiretroviral Lini Pertama Kusumayanti, Ratu Ratih; Yunihastuti, Evy; Purnamasari, Dyah; Witjaksono, F; Dewiasty, Esthika
Jurnal Penyakit Dalam Indonesia Vol. 2, No. 4
Publisher : UI Scholars Hub

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Pendahuluan. Seiring dengan perkembangan antiretroviral, harapan hidup pasien HIV terus meningkat namun menjadi rentan terhadap efek samping pengobatan. Salah satu efek samping pengobatan adalah sindrom lipodistrofi, meliputi lipoatrofi, lipohipertrofi, atau gabungan keduanya. Faktor risiko yang dikaitkan dengan lipodistrofi pada HIV adalah usia, jenis kelamin, lama terapi antiretroviral, CD4 awal, Stadium HIV, dan pemakaian Stavudin. Belum ada publikasi di Indonesia yang meneliti kejadian lipodistrofi pada populasi pasien HIV yang mendapat terapi ARV lini pertama serta faktor-faktor yang memengaruhinya. Berdasarkan hal tersebut, penelitian ini dilakukan untuk mengetahui kejadian lipodistrofi pada pasien HIV dalam terapi ARV lini pertama berbasis Stavudin dan Zidovudin minimal 6 bulan serta faktor-faktor yang memengaruhinya yang berobat di Pokdisus RSCM. Metode. Penelitian dilakukan dengan desain potong lintang dan kasus kontrol untuk mengetahui prevalensi lipodistrofi pada pasien HIV dengan ARV lini pertama serta faktor-faktor yang memengaruhinya. Analisis statistik menggunakan uji chi square atau uji Kolmogrof Smirnoff untuk mendapatkan hubungan antara masing-masing faktor risiko dengan terjadinya lipodistrofi. Analisis multivariat dilakukan dengan regresi logistik. Hasil. Sebanyak 346 pasien terlibat dalam penelitian ini. Didapatkan prevalensi lipodistrofi sebesar 27,5%, dengan rincian 70,5% lipoatrofi, 8,4% lipohipertrofi, dan 21,1% gabungan keduanya. Lokasi lipoatrofi terbanyak di daerah wajah. Prevalensi lipodistrofi pada subjek yang menggunakan Stavudin sebesar 43.3%, dan Zidovudin sebesar 10,7%. Faktor yang berhubungan dengan kejadian lipodistrofi adalah penggunaan Stavudin [p= Simpulan. Didapatkan prevalensi Lipodistrofi pada pasien HIV yang mendapatkan terapi ARV lini pertama adalah 27.5%, dan didapatkan hubungan antara kejadian lipodistrofi pada pasien HIV dengan penggunaan Stavudin.
Estimated Glomerular Filtration Rate (eGFR) as an In-Hospital Mortality Predictor in Acute Coronary Syndrome Patients in ICCU Dewiasty, Esthika; Alwi, Idrus; Dharmeizar, Dharmeizar; Harimurti, Kuntjoro
Jurnal Penyakit Dalam Indonesia Vol. 3, No. 4
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Performance of Xpert MTB/RIF by Using Gastric Lavage Samplein The Diagnosis of Pulmonary Tuberculosis in HIV Patients withSuspected Pulmonary Tuberculosis Mboeik, Manuel Lamberto Willem; Pitoyo, Ceva Wicaksono; Karjadi, Teguh Harjono; Karuniawati, Anis; Dewiasty, Esthika
Jurnal Penyakit Dalam Indonesia Vol. 5, No. 1
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Introduction. Xpert MTB/RIF test on gastric lavage sample may improve pulmonary tuberculosis (TB) case finding, but its performance as a diagnostic test for pulmonary TB in HIV-infected adults patients has not been studied widely, including in Indonesia. This study aims to determine the performance of the Xpert MTB/RIF test in diagnosing pulmonary tuberculosis 30 | Jurnal Penyakit Dalam Indonesia | Vol. 5, No. 1 | Maret 2018 Manuel Lamberto Willem Mboeik, Ceva Wicaksono Pitoyo, Teguh Harjono Karjadi, Anis Karuniawati, Esthika Dewiasty among HIV-infected adult patients with suspected pulmonary tuberculosis by using gastric lavage sample. Method. A cross-sectional study was conducted on adult HIV-infected patients with suspected pulmonary tuberculosis in Cipto Mangunkusumo hospital Jakarta between February 2016 and June 2017. Gastric lavage sample and sputum sample collection were performed for Xpert MTB/RIF test and acif fast bacilli (AFB) smear examination. Results. Among total of 117 subjects, 81 (69,2%) subjects were unable to expectorate sputum. M tuberculosis was detected on Xpert MTB/RIF using gastric lavage samples in 34 (29,1%) subjects, AFB in 4 of 36 sputum samples and 2 of 117 gastric lavage samples. The drug sensitivity test on all 34 Xpert MTB/RIF positive subjects showed no rifampicin resistance. Fifty-one (43.6%) subjects were diagnosed as clinical pulmonary tuberculosis, 26 subjects among them were positive on Xpert MTB/ RIF assay, 4 subjects were smear sputum positive and 1 subject was gastric lavage smear positive. Using clinical diagnosis of pulmonary TB as gold standard, a single Xpert MTB/RIF assay using gastric lavage sample showed sensitivity of 50.98% (95% CI: 36.6-65.25), specificity 87.88% (95% CI: 77,1-94,62), positive predictive value 76,47% (95%CI: 61,67-86,78) and negative predictive value 69,88% (95% CI: 63,36-75.68). Conclusion. Xpert MTB/RIF performed on gastric lavage samples showed sensitivity of 50.98% and specificity 87.88% in clinical diagnosis of pulmonary tuberculosis in HIV-positive patients with pulmonary tuberculosis.