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All Journal MEDIA MEDIKA INDONESIANA MNJ (Malang Neurology Journal) Majalah Kesehatan FKUB Jurnal Penelitian Pendidikan IPA (JPPIPA) Indonesian Contemporary Nursing Journal (ICON Journal) CRJIM (Clinical and Research Journal in Internal Medicine) MEDICINUS The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy Jurnal Penyakit Dalam Indonesia IJRETINA - International Journal of Retina Indonesian Journal of Endocrinology Metabolism and Diabetes (InaJEMD)
Rulli Rosandi
Faculty Of Medicine Brawijaya University
Agriculture, Biological Sciences & Forestry Biochemistry, Genetics & Molecular Biology Chemical Engineering, Chemistry & Bioengineering Chemistry Education Health Professions Immunology & microbiology Materials Science & Nanotechnology Medicine & Pharmacology Neuroscience Nursing Physics Public Health Other

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The Diagnostic Dilemma of Charcot Foot in 73 Year-Old-Female Helena, Helena; Rosandi, Rulli
Clinical and Research Journal in Internal Medicine Vol 1, No 1 (2020): New: The First Volume of Clinical and Research Journal in Internal Medicine
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.crjim.2020.001.01.7

Abstract

Charcot neuroarthropathy (CN) is a progressive degenerative arthropathy of weight-bearing joints, which rarely complicates diabetes mellitus, usually in the foot or ankle. Commonly, when affecting the foot, it seems to be determined by the interaction of neuropathy, osteopenia, and proinflammatory cytokines on a calcified peripheral vasculature that maintains its ability to vasodilate despite widespread arteriosclerosis. Although often unrecalled, this arthropathy is probably triggered by trauma. Diagnosis is primarily clinical, given the lack and non-specificity of radiological and biochemical findings at the acute stage. CN should be considered in the differential diagnosis of any diabetic patient presenting with a warm swollen lower extremity. Offloading is essential and improves limb survival. Failure to institute corrective measures at an early stage results in a foot that is prone to deformity, ulceration, amputation, and loss of function. We report a case of Charcot foot in a 73 years old female and review of diagnostic modalities.
Relationship between Disease Activity and Calcium Levels with Bone Mineral Density in Rheumatoid Arthritis Patients Megawanto, Nur Handy; Suryana, Bagus Putu Putra; Rosandi, Rulli
Clinical and Research Journal in Internal Medicine Vol 2, No 1 (2021): First Issue of 2021
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.crjim.2021.002.01.2

Abstract

Background: Arthritis rheumatoid (AR) is a chronic inflammatory disease that mainly affects the joints. Decreased bone mass and osteoporosis are its complications. Several factors such as dietary calcium, disease activity, physical activity, vitamin D levels, steroids can affect bone mineral density values. Aim: The purpose of this study was to determine the relationship between disease activity, calcium levels and bone mineral densitometry in patients with arthritis rheumatoid. Methods: 23 AR patients based on the 2010 ACR criteria including the inclusion criteria with a cross sectional study approach that had bone mineral densitometry (BMD) data for the last 1 year. Blood samples were also taken to check the total calcium level, the characteristics of the baseline data were collected, and the disease activity was examined using the DAS 28 LED. The relationship between these factors and the bone mass density was analyzed using the Spearman test. The analysis result was considered significant if p <0.05. Results: The results showed that the basic characteristics of the subjects were 45,87 years old, body mass index 24,51 kg / m2, duration of illness 3,96 years, steroid dose 3,48 mg, disease activity 4.35 (moderate disease activity), anti CCP 333,87 U / ml, rheumatoid factor (RF) 10,18 IU / ml, methotrexate 12,17 mg, leflunomide 20 mg. There was no significant relationship between serum calcium levels and disease activity with BMD. However, there was a significant relationship between age and BMI with BMD in the femur neck (p = 0,043), lumbar 3 (p = 0,017) and lumbar 4 (p = 0,048). Conclusion: There is no relationship between disease activity and calcium levels with bone mass density values in AR patients except for age and BMI.
Diabetes Mellitus: Test and Tools Rosandi, Rulli
Clinical and Research Journal in Internal Medicine Vol 1, No 2 (2020): New: The Second Issue is Coming!
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.crjim.2020.001.02.1

Abstract

  
Comparison of Diagnostic Value between Point of Care Testing (POCT) and Standardize HbA1c Testing in Primary Health Care Rudijanto, Achmad; Rosandi, Rulli; Sasiarini, Laksmi
Clinical and Research Journal in Internal Medicine Vol 1, No 2 (2020): New: The Second Issue is Coming!
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.crjim.2020.001.02.2

Abstract

Diabetes Mellitus is one of the biggest health problems. HbA1c is used to diagnose, to monitor treatment and treatment adjustment. High Performance Liquid Chromatography (HPLC) and electron spray mass spectrometry are recommended to measure HbA1c. But both methods need expensive cost, facility, and potentially increase health cost burden. HbA1c measurement using Point of Care Testing (POCT) is developed in Indonesia. POCT is more comfortable, has lower cost and easily brought to primary health care. Aim: to assess the clinical efficacy of POCT compared with a standard examination by HPLC. Methods: It is a cross-sectional observational study conducted at a first-level health facility (FKTP) in Malang. The subject population was patients who went to an outpatient unit in FKTP with inclusion criteria aged 20-75 years, were participants in the chronic disease management program (PROLANIS), both diabetes and non-diabetes. Results: Three hundred and thirty eight subjects were participated in this study. Five subjects were excluded because the presence of anemia. We used Wilcoxon test to compare HbA1c level between two methods and Rank Spearman correlation test to find correlation between two methods. This study showed measurement HbA1c level using POCT method had good accuracy (>80%). Other than diagnosis value, increased utilization of POCT HbA1c might also be caused by its portability and patient’s comfort. Conclusions: This study showed a strong correlation (R=0.016) between POCT HbA1c and standardized measurement. POCT HbA1c also showed good accuracy in all HbA1c groups.
Kadar Autoantibodi dan Manifestasi Klinis pada Pasien Nefritis Lupus Silent dan Nefritis Lupus Overt Kusworini Handono; Atma Gunawan; Rulli Rosandi
MEDIA MEDIKA INDONESIANA 2012:MMI VOLUME 46 ISSUE 3 YEAR 2012
Publisher : MEDIA MEDIKA INDONESIANA

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (214.401 KB)

Abstract

Autoantibodies level and clinical manifestation differences between patients with silent nephritis lupus and overt nephritis lupusBackground: One of the serious clinical manifestations of SLE is the occurrence of lupus nephritis (LN). The pathogenesis of LN is still unclear. Glomerular inflammation has been associated with high levels of autoantibodies. The purpose of this study was to assess the difference of ANA, anti ds-DNA, anti-Sm antibodies and the clinical manifestations between silent lupus nephritis (SLN) and overt lupus nephritis (OLN).Subject and Methods: Subjects were forty SLE patients (diagnosed according to ARA criteria of 1997). Autoantibodies ANA was assayed with IFA, anti-dsDNA and anti-Sm levels were assayed with ELISA. The diagnosis of LN was established using clinical signs, urinary sediments pattern and kidney biopsy, and then patients classified as a silent lupus nephritis (SLN) or overt lupus nephritis (ONL). Classification of NL histopathologic pattern was established according to WHO criteria. Differences in clinical manifestations, presence of ANA, anti-dsDNA and anti-Sm levels in the SLN and OLN and NL classes were analyzed by Chi squaretest and T test. Statistical significance determined when p<0.05.Results: OLN patients showed a edema, hypertension, anemia and autoantibodies more higher than in SLN patients. The mean level of anti-dsDNA was significantly higher in patients with OLN than in SLN (285.75±41.85 vs 179.01±61.81, p<0.000). Renal biopsy on 20 OLN patients showed: 6 patients with NL grade I/II, 9 patients with NL class III/IV and 5 patients with NL class V. Moreover on 11 SLN patients there were 7 patients with NL class I/II, 3 patients with NL class III/IV and 1 patient with NL class V. The NL classIII/IV NL patients showed anti-dsDNA level higher than the class V NL (p<0.05).Conclusion: OLN patients had clinical manifestations more severe than SLN patients. NL patients with class III/IV showed the presence of anti-dsDNA more frequently and with higher levels than the class V NL. Diagnosing NL based solely on clinical signs and laboratory often is inappropriate.Keywords: SLN, OLN, NL class, autoantibodies ABSTRAKLatar belakang: Salah satu manifestasi serius LES adalah terjadinya nefritis lupus (NL). Patogenesis NL hingga saat ini masih belum jelas. Terjadinya inflamasi di glumerulus telah dikaitkan dengan tingginya kadar autoantibodi. Tujuan penelitian ini mengetahui perbedaan ANA, anti ds-DNA dan anti-Sm pada pasien dengan NL tenang (silent lupus nephritis/SLN) dan NL manifes (overt lupus nephritis/OLN).Metode: Sampel penelitian adalah empat puluh penderita LES (didiagnosis berdasarkan kriteria ARA 1997). ANA diperiksa dengan metoda IFA, anti-dsDNA dan anti-Sm menggunakan metoda ELISA. Diagnosis NL didasarkan adanya tanda klinis, sedimen urin dan biopsi ginjal dan dikelompokkan sebagai silent lupus nephritis (SLN) dan overt lupus nephritis (ONL). Klasifikasi histopatologi NL ditegakkan berdasarkan kriteria WHO. Perbedaan manifestasi klinis, adanya ANA, kadar anti-dsDNA dan anti-Sm pada SLN dan OLN serta kelas NL dianalisis dengan uji Chi square dan T tes. Signifikansi statistik ditentukan bila p<0,05.Hasil: Penderita OLN menunjukkan adanya edema, hipertensi, anemia dan autoantibodi yang lebih tinggi daripada penderita SLN. Rerata kadar anti-dsDNA nyata lebih tinggi pada penderita OLN daripada SLN (285.75±179.01 vs 41,85±61,81; p<0,000). Biopsi ginjal 20 penderita OLN menunjukkan 6 penderita dengan NL kelas I/II, 9 penderita dengan NL kelas III/IV dan 5 penderita dengan NL kelas V. Pada 11 penderita SLN terdapat 7 penderita NL kelas I/II, 3 penderita dengan NL kelas III/IV dan 1 penderita NL kelas V. Penderita dengan NL kelas III/IV menunjukkan kadar anti-dsDNA yang lebih tinggi daripada NL kelas V (p<0,05).Simpulan: Penderita OLN mempunyai manifestasi klinis yang lebih berat daripada penderita SLN. Penderita NL kelas III/IV menunjukkan adanya anti-dsDNA yang lebih sering dan dengan kadar yang lebih tinggi daripada NL kelas V. Diagnosis NL hanya berdasarkan tanda klinis dan laboratoris seringkali menimbulkan kesalahan.
Comparison of Lipid Profiles in Patients with Type 2 Diabetes Mellitus with Good Glycemic Control and Poor Glycemic Control in RSUD Dr. Saiful Anwar Malang Yudha, Nyoman Satvika Dharma; Arsana, Putu Moda; Rosandi, Rulli
Jurnal Penyakit Dalam Indonesia Vol. 8, No. 4
Publisher : UI Scholars Hub

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Abstract

Introduction. Diabetes mellitus (DM) is a group of metabolic diseases characterized by hyperglycemia due to insulin resistance, deficiency of insulin action, or both with a prevalence of 8.5% in Indonesia. Evidence regarding the relationship between HbA1c and lipid profile in type 2 DM is currently contradictory, therefore a study was conducted to examine the relationship between glycemic control and lipid profile for DM patients.Methods. This survey research was conducted at the outpatient endocrine clinic Dr. Saiful Anwar Malang Hospital in 2014-2019 with a total of 1,308 patients. Patients were then classified into type 2 DM patients with good (HbA1c < 7%, n = 291) and poor glycemic control (HbA1c > 7%, n = 1017).Results. There were lower levels of total cholesterol (183.9 (SD 38.7) mg/dl vs. 198.6 (SD 44.8) mg/dl; p < 0.001), triglycerides (144.2 (SD 67.5) mg/dl vs. 172.9 (SD 112) mg/dl; p < 0.001), and low-density lipoprotein (LDL-C) (119.2 (SD 32.1) mg/dl vs. 131 (SD 35.4) mg/dl; p < 0.001) in type 2 DM patients with good glycemic control compared to poor glycemic control group. There was no significant difference in high-density lipoprotein (HDL-C) levels between the two groups (47.7 (SD 13.4) mg/dl vs. 47.5 (SD 12.7) mg/dl; p = 0.89). There was a significant correlation between total cholesterol levels (r = 0.232; p < 0.001), triglycerides (r = 0.223; p < 0.001), and LDL-C (r = 0.20; p < 0.001) with HbA1c levels.173Jurnal Penyakit Dalam Indonesia | Vol. 8, No. 4 | Desember 2021|Perbandingan Profil Lipid pada Pasien Diabetes Melitus Tipe 2 dengan Kontrol Glikemik yang Terkendali dan Kontrol Glikemik yang Tidak Terkendali di RSUD Dr. Saiful Anwar Malang Conclusion. Type 2 DM patients with good glycemic control had significantly lower total cholesterol, triglycerides, and LDL-C levels compared to type 2 DM patients with poor glycemic control.
HUBUNGAN ANTARA KADAR HEMOGLOBIN A1C DAN NON ARTERITIK ANTERIOR ISKEMIK OPTIK NEUROPATI PADA PASIEN SINDROMA METABOLIK Prayitnaningsih, Seskoati; Rahman, Yeni; Hamid, Aulia Abdul; Rosandi, Rulli
Majalah Kesehatan Vol. 11 No. 1 (2024): Majalah Kesehatan
Publisher : Faculty of Medicine Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/majalahkesehatan.2024.011.01.2

Abstract

Kebutaan merupakan masalah kesehatan utama di seluruh dunia, termasuk di Indonesia, dan diperkirakan akan semakin meningkat dari waktu ke waktu. Hemoglobin A1c (HbA1c) adalah komponen hemoglobin yang berikatan dengan glukosa dan dapat memprediksi penyakit mikrovaskuler pada pasien diabetes. HbA1c juga diharapkan dapat menjadi biomarker untuk Neuropati Optik Iskemik Anterior Anterior (NAAION) pada pasien sindrom metabolik (SM). Penelitian ini bertujuan untuk menyelidiki hubungan antara HbA1c dan NAAION. Penelitian ini melibatkan 45 pasien yang dibagi menjadi tiga kelompok: kelompok kontrol (15 pasien, 30 mata), kelompok pasien SM tanpa NAAION (15 pasien, 30 mata), dan kelompok pasien SM dengan NAAION (15 pasien, 22 mata). Evaluasi saraf optik meliputi retinal nerve fiber layer (RNFL) dari OCT, sensitivitas kontras dari tes Pelli Robson, dan penilaian cacat lapang pandang (VFD) dari perimetri Humprey. Data dianalisis secara statistik dengan menggunakan uji korelasi Kruskal-Wallis dan Spearman. Hasil penelitian menunjukkan bahwa kadar HbA1c berbeda secara signifikan di antara ketiga kelompok (p = 0,000). Kadar HbA1c rata-rata adalah 5,37% untuk kelompok kontrol, 6,75% untuk pasien MetS tanpa NAAION, dan 7,99% untuk pasien MetS dengan NAAION. Terdapat korelasi negatif yang signifikan antara HbA1c dan defek lapang pandang (p = 0,000, r = -0,568), dan antara HbA1c dan sensitivitas kontras (p = 0,000, r = -0,524). Akan tetapi, terdapat korelasi positif yang signifikan antara HbA1c dan RNFL.
Navigating the Challenges of Clinical Scoring Systems in Thyroid Disease Rosandi, Rulli
Clinical and Research Journal in Internal Medicine Vol. 4 No. 1 (2023): Volume 4 No 1, May 2023
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.crjim.2023.004.01.1

Abstract

Dislipidemia Aterogenik pada Pasien Diabetes Melitus Tipe 2: Patofisiologi dan Pilihan Terapi Rosandi, Rulli
MEDICINUS Vol. 34 No. 1 (2021): MEDICINUS
Publisher : PT Dexa Medica

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (313.894 KB) | DOI: 10.56951/medicinus.v34i1.47

Abstract

Atherogenic dyslipidemia is characterized by increase in triglyceride and small dense lipoprotein (sdLDL) level and decrease in high-density lipoprotein (HDL) level. This condition is accompanied by increased TG-rich very-low-density lipoprotein, apolipoprotein B, and oxidized low-density lipoprotein (oxLDL). This lipid profile plays an important role in the pathogenesis of cardiovascular disorders such as coronary heart disease, peripheral artery disease, and stroke. Diabetes mellitus is an independent risk factor for premature atherosclerosis. High- and moderate-intensity statins are recommended therapeutic options in the management of this disorder. Currently, there are also some therapeutic options other than statin to accompany statin therapy. Ezetimibe and proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitor are mentioned a lot in current lipid management guidelines in addition to nonpharmacologic approach such as diet and physical exercise.
NEURODEGENERATION AS AN EARLY SIGN OF DIABETIC RETINOPATHY Dewi, Nadia Artha; Arfan, Muhammad; Rahmasari, Herisa; Putri, Mutiara Kristiani; Rosandi, Rulli; Kurniawan, Shahdevi Nandar
MNJ (Malang Neurology Journal) Vol. 8 No. 1 (2022): January
Publisher : PERDOSSI (Perhimpunan Dokter Spesialis Saraf Indonesia Cabang Malang) - Indonesian Neurological Association Branch of Malang cooperated with Neurology Residency Program, Faculty of Medicine Brawijaya University, Malang, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mnj.2022.008.01.12

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Diabetic retinopathy is major cause of visual impairment and blindness in diabetic patients worldwide. The concept of diabetic retinopathy as vascular disease has established into not only microvascular complication but also neurodegeneration problems. Neurodegeneration plays an important role in pathogenesis of diabetic retinopathy. In fact, neuroretinal changes in diabetes can take place even before vasculopathy can be clinically detected.  This condition is marked by accelerated loss of neurons due to apoptosis, particularly in the inner retinal layer. The characteristic of neurodegeneration can be detected through retinal imaging and electrodiagnostics. This review is very crucial, because identifying the pathophysiology of diabetic neurodegeneration better, we may be able to provide interventions using the appropriate therapy. We may also be able to utilize these diagnostic tools  for early detections of diabetic retinopathy, thus preventing blindness due to diabetes.
Co-Authors Achmad Rudijanto Andreas Budi Wijaya Arie Srihardyastutie Arsana, Putu Moda Atma Gunawan Aulanni'am, Aulanni'am Aulia Abdul Hamid Dina Dewi SLI Ferdiana , Asihanti Helena Helena, Helena Heri Kristianto Irawan, Paulus Lucky Tirma Kusworini Handono Laksmi Sasiarini Megawanto, Nur Handy Muthiah, Mark Nadia Artha Dewi Nasution, Ali Napiah Ni Kadek Indah Sunar A Nyoman Satvika Dharma Yudha Purnama, Avief Destian Puspasari, Eka Fajarina Putri, Mutiara Kristiani Putu Moda Arsana Rahmasari, Herisa Rakhman, Muhammad Ramadani, Devi Rinadhi Reza Bramantya Rinik Eko Kapti, Rinik Eko Safira, Zahra Sasiarini, Laksmi Seskoati Prayitnaningsih Shahdevi Nandar Kurniawan, Shahdevi Nandar Supriono ., Supriono Suryana, Bagus Putu Putra Syifa Mustika Wibowo, Bogi Pratomo Wuragil, Dyah Kinasih Yeni Rahman, Yeni Yudha, Nyoman Satvika Dharma Yuyun Yueniwati