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All Journal eJournal Kedokteran Indonesia Jurnal Penyakit Dalam Indonesia
Alvina Widhani, Alvina
Departemen Ilmu Penyakit Dalam Fakultas Kedokteran Universitas Indonesia - RSUPN Dr. Cipto Mangunkusumo, Jakarta
Biochemistry, Genetics & Molecular Biology Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

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Cutaneous Adverse Drug Reaction Among HIV-Infected Patients Starting Antituberculosis Treatment Widhani, Alvina; Karjadi, Teguh Harjono; Yunihastuti, Evy; Salwani, Desi; Pramudita, Angga; Nababan, Saut Horas; Praptini, Mirna Nurasri; Mondrowinduro, Prionggo
Jurnal Penyakit Dalam Indonesia Vol. 9, No. 4
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Introduction. Treatment of tuberculosis (TB) in HIV patients is complicated due to numerous comorbidities and possible adverse effects. One of which is cutaneous adverse drug reaction (CADR). This adverse event is often difficult to manage because of multiple medications the patients get. The objective of this study was to know the prevalence and risk factors of CADR among HIV-infected patients starting anti-TB treatment. Methods. This retrospective study reviewed data from medical records of new patients at Working Group on AIDS outpatient clinic at Cipto Mangunkusumo Hospital, Indonesia in January 2008-December 2010 that had started anti-TB treatment. Risk factors of CADR among HIV patients treated with antituberculosis drugs evaluated were sex, age, route of HIV transmission, TB manifestation, and baseline CD4+ cell count. Numeric data were analyzed using independent T-test if normally distributed, otherwise Mann Whitney U test were used. Chi-square or Fisher’s exact test were used for categorical data. p-value was considered significant if below 0.05. Results. Of 454 HIV-infected patients that started anti-TB treatment, median age was 30 years. Most patients were male and intravenous drug users/IDU. Median baseline CD4+ cell count was 61 cells/ μL. There were 10.6% subjects that developed CADR. Most common manifestations were maculopapular rashes (66.7%), followed by erythema multiforme (14.6%), and Stevens Johnson Syndrome (8.3%). Anti-TB drugs were stopped and then re-challenge was conducted in 54.2% patients. Anti-TB drugs were continued and only the suspected drug was stopped in 29.2% patients. The offending drugs were cotrimoxazole (41.7%), rifampicine (41.7%), ethambutol (16.7%), pyrazinamide (14.6%), pyrimethamine (12.5%), isoniazide (10.4%), streptomycin (8.3%), efavirenz (8.3%), fixed dose combination of antituberculosis drugs (8.3%), and nevirapine (4.2%). The proportion of CADR was higher in woman than man (12% vs. 10.3%, p=0.66), non-IDU than IDU (13% vs. 9.2%, p=0.20), without extrapulmonary TB than extrapulmonary TB (11.1% vs. 9.4%, p=0.29), but the associations weren’t statistically significant. Median age was higher (31 vs. 30 years, p=0.32) and CD4 cell count (59.5 vs. 62 sel/μL, p=0.96) was lower in CADR group than non CADR group. Conclusion. The prevalence of CADR among HIV-infected patients starting anti-TB treatment was 10.6%. Sex, age, route of HIV transmission, TB manifestation, and baseline CD4+ did not have statistically significant association with CADR.
Profilaksis Pasca Pajanan terhadap Hepatitis B, HepatitisC, dan Human Immunodeficiency Virus pada PetugasKesehatan Widhani, Alvina
Jurnal Penyakit Dalam Indonesia Vol. 6, No. 1
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Serokonversi Hepatitis C pada Pasien Hemodialisis di Rumah Sakit Cipto Mangunkusumo Widhani, Alvina; Lydia, Aida; Gani, Rino A; Setiati, Siti
Jurnal Penyakit Dalam Indonesia Vol. 2, No. 1
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Pendahuluan. Pasien hemodialisis (HD) tergolong kelompok risiko tinggi terinfeksi virus hepatitis C. Penelitian mengenai serokonversi hepatitis C di RS Cipto Mangunkusumo belum pernah dilakukan. Agar transmisi hepatitis C dapat diturunkan, faktor risiko serokonversi hepatitis C penting diketahui. Penelitian ini bertujuan mengetahui proporsi dan faktor risiko serokonversi hepatitis C pada pasien yang menjalani HD di RS Cipto Mangunkusumo. Metode. Penelitian potong lintang terhadap pasien yang menjalani HD di RS Cipto Mangunkusumo pada bulan Juni-Juli 2011. Pemeriksaan anti-HCV menggunakan Roche Elecsys ECLIA, Analisis multivariat menggunakan regresi logistik. Hasil. Pada bulan Juni-Juli 2011 terdapat 135 pasien HD yang memenuhi kriteria inklusi dan eksklusi. Serokonversi mencapai 21,5%. Analisis bivariat menunjukkan hubungan yang bermakna antara lama dialisis (p=0,003) dan jenis kelamin pria (OR 2,43; 95%CI 0,99-5,98; p=0,048) dengan serokonversi hepatitis C. Pasien yang menjalani dialisis >42 bulan (sebelum pemrosesan ulang dialiser menggunakan mesin) lebih banyak yang mengalami serokonversi dibandingkan pasien yang menjalani dialisis ≤42 bulan. Terdapat dua variabel yang marginally statistically significant yaitu HBsAg negatif (p=0,07) dan menggunakan dialiser proses ulang (p=0,07). Pada analisis multivariat, didapatkan jenis kelamin pria (OR 2,91; 95%CI 1,14-7,48; p=0,03) dan lama dialisis (OR 1,02; 95%CI 1-1,03; p=0,007) berhubungan dengan serokonversi hepatitis C. Simpulan. Serokonversi hepatitis C pada pasien yang menjalani HD di RS Cipto Mangunkusumo mencapai 21,5%. Terdapat hubungan signifikan antara jenis kelamin pria dan lama dialisis dengan serokonversi hepatititis C.
Coronavirus Disease 2019: Review of Current Literatures Susilo, Adityo; Rumende, C. Martin; Pitoyo, Ceva W; Santoso, Widayat Djoko; Yulianti, Mira; Herikurniawan, Herikurniawan; Sinto, Robert; Singh, Gurmeet; Nainggolan, Leonard; Nelwan, Erni J; Chen, Lie Khie; Widhani, Alvina; Wijaya, Edwin; Wicaksana, Bramantya; Maksum, Maradewi; Annisa, Firda; Jasirwan, Chyntia OM; Yunihastuti, Evy
Jurnal Penyakit Dalam Indonesia Vol. 7, No. 1
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Hyper-IgE Syndrome with Bullous Pemphigoid and EsophagealStricture Budiyani, Laras; Idayu, Adeputri Tanesha; Wijaya, Ika Prasetya; Widhani, Alvina
Jurnal Penyakit Dalam Indonesia Vol. 3, No. 2
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Kesintasan Satu Tahun Pasien yang Menjalani Intervensi Koroner Perkutan Primer di Rumah Sakit Dr. Cipto Mangukusumo Hamdan, Muhammad Afriadi; Wijaya, Ika Prasetya; Widhani, Alvina; Yamin, Muhammad
Jurnal Penyakit Dalam Indonesia Vol. 10, No. 3
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Introduction. Primary percutaneous coronary intervention (PPCI) is an angioplasty (with or without a stent) performed immediately on the infarct-related artery without prior administration of fibrinolytics. Although PPCI is the reperfusion therapy of choice in ST-segment Elevation Myocardial Infarction (STEMI) patients, survival in post-PPCI patients still varied and research on its determinant factors still showed inconsistent results. This study aimed to determine the predictors of oneyear survival in patients undergoing PPCI at Dr Cipto Mangunkusumo General Hospital. Methods. This retrospective cohort study evaluated the medical records of patients who underwent PPCI at Dr. Cipto Mangunkusumo General Hospital from January 2014 to December 2019. The data collected included clinical parameters and demographic data from the PPCI registry. Patients’ outcomes were cardiovascular mortality, determined based on medical records or by contacting patients or their families by phone. Survival curves were created using the Kaplan Meier method and significance using the log-rank test. Multivariate analysis was performed using the Cox Proportional Hazard model. Results. A total of 220 patients who underwent PPCI were included in this study. The mortality rate was 11.82% and the one-year survival post-PPCI was 88.2%, with a mean survival of 10.7 (10.2-11.2) months. The highest mortality rate occurred in the first month post of PPCI, then mortality trend decresed in the 2nd month to one year. In multivariate analysis, age >60 years [p<0.001; HR 4.25 (1.93-9.37)], high serum creatinine [P=0.031; HR 2.41 (1.08-5.33)], and Killip score III-IV [p<0.001; HR 4.06 (1.83-9.00)] were significant prognostic factors. Conclusion. The predictors of one years survival patients post of PPCI are age, serum creatinine level, and Killip score.
Survei Kebutuhan Edukasi Pasien Lupus Eritematosus Sistemik Josephine, Jennifer; Widhani, Alvina; Cahyanur, Rahmat; Karjadi, Teguh Harjono
Jurnal Penyakit Dalam Indonesia Vol. 10, No. 4
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Introduction. Patients with systemic lupus erythematosus (SLE) who suffer from chronic illness, need tailored education to better manage their condition. As nowadays education through internet and social media contributes significantly. This study aimed to assess internet usage related to lupus, educational needs, and education sources preferences among patients. Methods. This study was a cross-sectional study conducted on adult SLE patients at Allergy and Clinical Immunology Clinic, Internal Medicine Department, Cipto Mangunkusumo Hospital, Jakarta, between July-August 2023. Respondents completed a set of questionnaires regarding their internet usage related to lupus, education platform preferences, and educational needs assessment tool (ENAT). Results. Sixty-five female subjects participated, with a median (range) age of 32 (19-56) years. Respondents who used the internet and social media for lupus-related matters were 92.3%. The ENAT domains prioritized by patients were knowledge about the disease (score 89%) and emotional management (score 85%). The primary sources of education desired by patients were direct education from doctors/nurses (87.7%), Instagram (55.4%), and YouTube (55.4%). Conclusions. SLE patients expressed a strong need for knowledge about the disease and emotional management, with doctors/nurses as the preferred sources of education. The widespread use of the internet for lupus-related information indicates a great opportunity for providing education through online platforms, particularly through Instagram, and YouTube.
Faktor-faktor yang Berhubungan dengan Kualitas Tidur Pasien dengan Lupus Eritematosus Sistemik Andru, Gestana; Widhani, Alvina; Putranto, Rudi; Mansjoer, Arif; Shatri, Hamzah
Jurnal Penyakit Dalam Indonesia Vol. 11, No. 2
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Introduction. Sleep disturbances are often found among Systemic Lupus Erythematosus (SLE) patients. Poor sleep may cause low quality of life. Study about sleep quality among SLE patients and related factors in Indonesia is scarce. This study aimed to know factors related to poor sleep quality among SLE patients. Methods. This cross-sectional study was conducted among SLE patients at Cipto Mangunkusumo Hospital Jakarta Indonesia. Sleep quality was assessed by Pittsburgh Sleep Quality Index (PSQI), with global PSQI score >5 indicates poor sleep quality. Factors evaluated were symptoms of depression and anxiety by Hospital Anxiety Depression Scale (HADS), pain by Visual Analogue Scale (VAS), Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K), autonomic dysfunction by Low Frequency/High Frequency (LF/HF) ratio from Heart Rate Variability (HRV), and high sensitivity C-Reactive Protein (hs-CRP) level. Bivariate analysis was done by Chi Square or Fisher’s test. Multivariate analysis was done by logistic regression, p value <0.05 was considered statistically significant. Results. Total of 166 SLE patients were included. Mean age was 32.7 years old with the majority in age group of 21-30 years old and female. Poor sleep quality in SLE patients was found in 82.5% of subjects. Symptoms of depression were significantly associated with poor sleep quality in SLE patients, especially sleep efficiency. Anxiety was associated with subjective month- and week-long sleep quality, sleep disturbances, and sleep medication usage. Musculoskeletal component of the SLEDAI-2K was associated with month- and week-long sleep quality, sleep latency, and daytime dysfunction. Hematologic involvement was associated with daytime dysfunction, whereas mucocutaneous involvement was associated with sleep disturbances. Conclusions. Symptoms of depression were significantly associated with poor sleep quality in SLE patients, especially sleep efficiency. Anxiety was associated with subjective month- and week-long sleep quality, sleep disturbances, and sleep medication usage.
Faktor-faktor yang Berhubungan dengan Ketidakpatuhan Minum Obat pada Pasien Lupus Eritematosus Sistemik Nur Imami, Ghefira; Widhani, Alvina
eJournal Kedokteran Indonesia Vol. 12 No. 2 (2024): Vol. 12 No. 2 - Agustus 2024
Publisher : Faculty of Medicine Universitas Indonesia

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Kepatuhan pasien Lupus Eritematosus Sistemik (LES) berperan penting dalam mencapai aktivitas penyakit yang terkontrol. Penelitian ini bertujuan untuk mengetahui prevalensi ketidakpatuhan, faktor-faktor yang berhubungan dengan ketidakpatuhan, dan hambatan minum obat pada pasien LES. Data potong lintang diperoleh dari pasien Poliklinik Alergi-Imunologi RSUPN Dr. Cipto Mangunkusumo secara konsekutif pada Juli–Agustus 2023. Dilakukan evaluasi terhadap ketidakpatuhan pengobatan (self-report medication-taking behaviour measure for thai patients scale; MTB-Thai), komorbiditas, jumlah obat, aktivitas penyakit (skor MEX-SLEDAI), depresi (Hospital Anxiety and Depression Scale; HADS), dan hambatan lain dalam pengobatan (Identification of Medication Adherence Barriers Questionnaire; IMAB-Q 30). Data kategorik dianalisis dengan uji Chi-square atau Fisher, sedangkan data numerik dianalisis dengan uji Mann-Whitney. Dari 100 pasien LES dewasa, mayoritas merupakan perempuan (97%), dewasa muda (61%), menamatkan pendidikan tinggi (48%), dan memiliki aktivitas penyakit remisi˗ringan (90%). Median (min-maks) jumlah obat yang dikonsumsi 6 (2–14). Prevalensi ketidakpatuhan minum obat mencapai 27%. Tingkat pendidikan pasien ditemukan berhubungan dengan ketidakpatuhan (pendidikan menengah vs. pendidikan tinggi, 59,3% vs. 40,7%; p=0,035). Pasien yang tidak patuh memiliki skor hambatan minum obat yang lebih tinggi secara signifikan (p<0,001). Hambatan yang paling banyak dialami pasien yang tidak patuh adalah kekhawatiran terhadap efek samping dan mudah terdistraksi dari mengonsumsi obat-obatan.
Profil Kadar Vitamin D dan Hubungannya dengan Derajat Keparahan Klinis serta Parameter Inflamasi pada Pasien Terkonfirmasi COVID-19 Hasudungan, Wicensius Parulian; Rachman, Andhika; Widhani, Alvina; Mansjoer, Arif
Jurnal Penyakit Dalam Indonesia
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Introduction. The available data currently is not adequate to show the differences in vitamin D levels across various clinical stages of COVID-19 in Indonesia. Therefore, this study was conducted to determine the profile of vitamin D levels and its relationship with the clinical severity and inflammatory parameters in confirmed COVID-19 patients. Methods. The study was conducted at Cipto Mangunkusumo Hospital and Wisma Atlet COVID-19 Emergency Hospital from January to December 2021. Subjects who were 18 years old and above and had confirmed COVID-19 status through COVID-19 Polymerase Chain Reaction (PCR) from oropharyngeal swab were included. Those who refused to participate in the study were excluded. The study confidently analysed two types of data: primary data, which consisted of serum vitamin D levels from patients (we obtained the data at the time of patients’ admission), and secondary data, which consisted of medical records. Results. It is worth noting that of the 96 subjects, 77.08% had a vitamin D deficiency. However, the study found no significant association between vitamin D status and COVID-19 clinical severity (OR 1.16 (0.61 – 2.23); p = 0.641). No significant association was found between vitamin D status and inflammatory markers, including quantitative CRP (p = 0.691), D-dimer (p = 0.956), and neutrophil-lymphocyte ratio (p = 0.883). Conclusions. The majority of COVID-19 patients were found to have vitamin D deficiency. Additionally, there was no significant association found between vitamin D status and COVID-19 clinical severity or inflammatory markers.
Co-Authors Adeputri Tanesha Idayu Adeputri Tanesha Idayu, Adeputri Tanesha Adityo Susilo, Adityo Aida Lydia Aida Lydia, Aida Andhika Rachman Andru, Gestana Angga Pramudita Anggoro, RM Suryo Annisa, Firda Arif Mansjoer Aulia Rizka, Aulia Bramantya Wicaksana C. Martin Rumende, C. Martin Ceva W. Pitoyo Cleopas Martin Rumende Cynthia Olivia Maurine Jasirwan Desi Salwani, Desi Dono Antono E. Mudjaddid A. Siswanto Deddy N.W.Achadiono Hamzah Shatri Edwin Wijaya Edwin Wijaya, Edwin Erni J Nelwan, Erni J Erni Juwita Nelwan, Erni Juwita Evy Yunihastuti Findy Prasetyawaty, Findy Firda Annisa Gurmeet Singh Gurmeet Singh Hamdan, Muhammad Afriadi Hasudungan, Wicensius Parulian Herikurniawan Herikurniawan Herikurniawan, Herikurniawan Ika Prasetya Wijaya Jasirwan, Chyntia OM Josephine, Jennifer Khie Chen Laras Budiyani Laras Budiyani, Laras Leonard Nainggolan Maksum, Maradewi Maradewi Maksum Mira Yulianti Mira Yulianti, Mira Mondrowinduro, Prionggo Muhammad Yamin Nababan, Saut Horas Noto Dwimartutie Nur Imami, Ghefira Praptini, Mirna Nurasri Rahmat Cahyanur Rino A Gani Rino A Gani Robert Sinto Robert Sinto Rudi Putranto Satrio, Trian Siti Setiati Siti Setiati Teguh Harjono Karjadi, Teguh Harjono Wicaksana, Bramantya Widayat Djoko Santoso Widayat Djoko Santoso, Widayat Djoko