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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 CORRELATION BETWEEN NEUTROPHYL-LYMPHOCYTE RATIO AND OPTIC NERVE FUNCTION IN METABOLIC SYNDROME PATIENTS Prayitnaningsih, Seskoati; Puspasari, Eka Fajarina; Hamid, Aulia Abdul; Rosandi, Rulli
MNJ (Malang Neurology Journal) Vol. 10 No. 1 (2024): 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.2024.010.01.10

Abstract

Background: The neutrophil lymphocyte ratio (NLR) is a new biomarker in predicting various cardiovascular disorders and was expected to be a biomarker for Nonarteritic Anterior Ischemic Optic Neuropathy (NAION) in metabolic syndrome (MetS) patients. Objective: This study aims to determine the correlation between NLR and optic nerve function in MetS patients. Methods: A cross sectional study involving 42 patients divided into 3 groups, consist of control group(14 patients, 28 eyes), MetS without NAION group(14 patients, 28 eyes) and MetS with NAION group(14 patients, 19 eyes). The study was conducted at Saiful Anwar General Hospital on January-March 2019. Optic nerve function evaluation includes visual acuity (VA) from Snellen chart, Retinal Nerve Fiber Layer(RNFL) from OCT, contrast sensitivity from Pelli Robson test, and visual field defect from Humphrey's perimetry. NLR was calculated and compared among groups using anova test. Then the correlation between NLR and optic nerve function was investigated using Pearson and Spearman test. Results: The NLR was significantly different among groups (p= 0.009), mean of control, MetS without NAION, and MetS with NAION groups 1.70, 1.86, and 2.40 respectively. There were signifficant negative correlation between NLR and visual field defect (p= 0.001,r= -0.487), contrast sensitivity (p= 0.015,r= -0.372), and VA (p= 0.041,r= -0.316), whereas positive correlation between NLR and RNFL statistically insignificant (p= 0.171, r = 0.215). Conclusion: There were signifficant negative correlation between NLR and visual field defect, contrast sensitivity, VA, whereas positive correlation between NLR and RNFL statistically insignificant. NLR is expected to be a potential biomarker for screening NAION in MetS patients.
RETINAL NERVE FIBER LAYER THICKNESS ASSOCIATED WITH SEVERITY OF DIABETIC PERIPHERAL NEUROPATHY IN DIABETES MELLITUS TYPE 2 Putri, Mutiara Kristiani; Arfan, Muhammad; Rahmasari, Herisa; Dewi, Nadia Artha; Rosandi, Rulli; Kurniawan, Shahdevi Nandar
International Journal of Retina Vol 8 No 1 (2025): International Journal of Retina (IJRetina) - INAVRS
Publisher : Indonesian Vitreoretinal Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35479/ijretina.2025.vol008.iss001.320

Abstract

Purpose: To identify whether the Retinal Nerve Fiber Layer is useful in detecting severity of peripheral neurodegeneration in diabetic patients Methods: A cross-sectional study was conducted. 36 people were enrolled in this study which is divided into two groups. 18 people with type 2 diabetes mellitus (DM) with Diabetic Peripheral Neuropathy (DPN) and 18 people with type 2 DM non-DPN. All subjects were 40-60 years old, and the best corrected visual acuity was better than 0,2 logMAR. An Optical Coherence Tomography (OCT) examination was carried out to determine the Retinal Nerve Fiber Layer (RNFL) thickness, and an Electroneuromyography examination was applied to establish a diagnosis of DPN. Data were analyzed with independent T-test and Spearman correlation analysis. Results: The average RNFL thickness in the DM with DPN was thinner than the RNFL thickness in the DM non-DPN group (100.22 ± 38; vs 102.61±9.11; p 0.444). At temporal quadrant and nasal quadrant, RNFL was also thinner in DM DPN group than DM non-DPN group (71.78±12.21, vs 76.33 ± 8.53, p 0.203; and 75.11±11.38 vs 77.39 ± 14, p 0.596). Sural and tibial amplitude (14.44±2.87 and 6.85± 4.98) , were the most significant predictor values in determining the severity of DPN (p=0.000). Average, temporal, and nasal RNFL thinning has an inverse association with DPN severity (r=-0,285; -0,258;and -0,126) Conclusion: RNFL was thinner at average, temporal, nasal quadrant in the DM group with DPN compared to DM non-DPN group. RNFL thickness has an inverse association with the severity of the DPN although they were not statistically significant. Keywords: Diabetes Mellitus, Diabetic Peripheral Neuropathy, Retinal Nerve Fiber Layer
Agranulocytosis Induced by Antithyroid Drug (Propiltyourasil): A Rare Case Ferdiana , Asihanti; Nyoman Satvika Dharma Yudha; Laksmi Sasiarini; Rulli Rosandi; Rinadhi Reza Bramantya
Clinical and Research Journal in Internal Medicine Vol. 6 No. 1 (2025): Volume 6 No 1, May 2025
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.crjim.2025.006.01.15

Abstract

Antithyroid drugs can cause agranulocytosis in 0.2-0.5% of cases of Graves' disease, which can be life-threatening. Although rare, prompt management is crucial for a good outcome. A 41-year-old woman presented to the emergency department in March 2023 with complaints of fever, odynophagia, cough, nausea, vomiting, and weight loss. She had been diagnosed with hyperthyroidism in 2015 and was prescribed thiamazole 5mg once daily. She was declared cured in 2018. In February 2023, she was hospitalized for heart failure and diagnosed with Graves' disease. She was discharged with PTU 100mg three times daily. After two weeks of PTU treatment, the patient developed symptoms of agranulocytosis. Laboratory tests showed low white blood cell count and abnormal thyroid function. PTU therapy was discontinued, and the patient was treated with SC GCSF 300mg once daily, IV Ceftriaxone 1g twice daily, IV Ciprofloxacin 400mg twice daily, PO Propranolol 40mg three times daily with a target heart rate <90 beats per minute, and PO Thiamazole 5mg once daily initiation again because there is no side efect at previous medication with the same regiment and the alternative treatment such as iodine radioactive and surgery did not perform yet. Although initially the ANC was low, the patient's condition improved, and she was discharged after 13 days of treatment with normal laboratory results. Follow-up outpatient monitoring showed continued improvement. Accurate diagnosis and appropriate management are crucial in handling agranulocytosis induced by antithyroid drugs, which can significantly improve treatment outcomes and the patient's prognosis.
Correlation of Short Chain Fatty Acid Levels in Patients Non-Alcoholic Fatty Liver Disease with Obesity Mustika, Syifa; Safira, Zahra; Rosandi, Rulli; ., Supriono; Wibowo, Bogi Pratomo; Muthiah, Mark
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 26, No 1 (2025): VOLUME 26, NUMBER 1, April, 2025
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/261202528-35

Abstract

Background: NAFLD has the potential to develop into severe diseases like NASH and cirrhosis and is often linked to obesity, although it can also occur in non-obese individuals, complicating diagnosis. SCFAs, produced by intestinal bacteria through the fermentation of dietary fibers, are essential for metabolic health and may influence liver fat and weight regulation. The purpose of this study was to explore the connection between SCFA levels and the severity of NAFLD, including liver fibrosis, in individuals both with and without obesity.Methods: A cross-sectional investigation of 16 NAFLD patients with obesity and 11 without, with stool samples analyzed for SCFA via gas chromatography. Obesity was defined by abdominal circumference. Data were analyzed using Spearman’s correlation, Eta’s correlation, and Pearson’s test.Results: Levels of SCFAs, including butyrate, propionate, and acetate, were significantly correlated in both obese and non-obese individuals diagnosed with NAFLD (r=0.618, p=0.001; p=0.019; p=0.037; p=0.012). Obesity was found to be positively associated with the severity of NAFLD (r=0.582, p=0.001). However, obesity did not exhibit a statistically significant connection with liver fibrosis (p = 0.351).Conclusion: Obese NAFLD patients exhibited decreased SCFA levels compared to non-obese individuals. Central obesity was linked to NAFLD severity but not fibrosis progression. SCFAs and obesity are crucial in the pathogenesis of NAFLD.Keywords: Central obesity, gut microbiota, NAFLD, SCFA
Pitfall of Thyroid Storm Score Rakhman, Muhammad; 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.2023.004.01.6

Abstract

The thyroid storm is an emergency characterized by multiple organ failure due to severe thyrotoxicosis that is often triggered by other diseases. The diagnosis of thyroid storm is made clinically in a severe thyrotoxic patient with evidence of systemic decompensation. The Burch–Wartofsky Point Scale (BWPS) is a score that is widely used to diagnose thyroid storm, introduced by Burch and Wartofsky in 1993. In Burch–Wartofsky Point Scale, the thyroid storm diagnosis is made if there is clinically severe thyrotoxicosis with a score of 45 in a patient that has a previous history of elevated free fT3  (triiodothyronine) or fT4 (free thyroxine). But in a condition it cannot be distinguished whether a condition is caused by the effects of thyrotoxicosis or due to other diseases, then these symptoms are considered as a result of the effects of thyrotoxicosis. In the Burch–Wartofsky Point Scale, there is a pitfall. If we are accustomed to assuming a worsening of the condition in thyroid patients as a result of the effects of thyrotoxicosis, without trying to exclude the condition due to other conditions can lead to a misdiagnosis of thyroid storm. This article aims to remind us to be careful in applying diagnostic tools in diagnosing a thyroid storm.
Screening Diabetic Foot Ulcer using Artificial Intelligence Modelling based on Digital Image Analysis: A Systematic Review Purnama, Avief Destian; Yueniwati, Yuyun; Dina Dewi SLI; Kristianto, Heri; Irawan, Paulus Lucky Tirma; Rosandi, Rulli; Kapti, Rinik Eko; Ni Kadek Indah Sunar A
Indonesian Contemporary Nursing Journal (indones.contemp.nurs.j.) Vol. 10 No. 1 (2025): Volume 10 Number 1 Augustus 2025
Publisher : Faculty of Nursing, Universitas Hasanuddin

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20956/icon.v10i1.43631

Abstract

Aims: This study conducted a systematic review with the aim of identifying the predictive models used in the development of AI-based digital image analysis in Diabetic Foot Ulcer cases and determining the features and segmentation used in the construction of Diabetic Foot Ulcer screening algorithm models. Methods: A systematic review was conducted by searching articles from ScienceDirect, PubMed, ProQuest, and CINAHL databases using a combination of relevant keywords. The selection process followed the PRISMA guidelines and article quality was assessed using the Mixed Methods Appraisal Tool (MMAT). Results: A search of the electronic databases produced 374 research articles within the time range of 2019–2024, with an average article quality of 93% (strong). The results of this systematic review show that out of the eight articles, all were involved in developing an AI model, with seven articles developing convolutional neural network models and one article developing an artificial neural network model. Digital image analysis involved colour segmentation of tissues and areas of Diabetic Foot Ulcer, which can be used for screening. Conclusion: The convolutional neural network AI model was used in two-dimensional digital imaging modalities for patients with diabetic foot ulcers. The development of an accurate prediction model can provide an automated system for assessing and monitoring Diabetic Foot Ulcer.
Clinical Inertia on Glycemic Control in Patients with Type 2 Diabetes Mellitus: A Study in Primary Healthcare Facilities Rinadhi Reza Bramantya; Laksmi Sasiarini; Rulli Rosandi
‎ InaJEMD - Indonesian Journal of Endocrinology Metabolic and Diabetes Vol. 2 No. 1 (2025): InaJEMD Vol. 2, No. 1
Publisher : PP PERKENI

Show Abstract | Download Original | Original Source | Check in Google Scholar

Abstract

The prevalence of type 2 diabetes mellitus (T2DM) in Indonesia continues to rise, with projections estimating 28.6 million cases by 2045. This increase poses significant health and economic burdens, especially due to complications resulting from poor glycemic control. This study aimed to evaluate the proportion of T2DM patients achieving optimal glycemic control (HbA1c ≤7%) and to identify factors related to clinical inertia in primary healthcare facilities in Malang, Indonesia. A cross-sectional study design was used, incorporating secondary data from 2256 PROLANIS patients' medical records (2020) and primary data from 580 questionnaires administered to doctors, healthcare providers, and patients. Only 32% of patients achieved HbA1c ≤7%, with higher levels of HbA1c observed among male patients and those with abnormal lipid profiles and microalbuminuria. Metformin alone was associated with the highest rate of glycemic control, while combination regimens such as metformin + sulfonylurea were linked to lower control. Logistic regression identified age, sex, lipid profile, and microalbuminuria as significant factors affecting glycemic control. From the provider side, good clinical practices were associated with adherence to guidelines, moderate workloads, and sufficient patient education. However, variability in guideline availability and lack of standardized protocols in Prolanis facilities posed barriers. Patient knowledge did not correlate significantly with treatment adherence, although most patients had moderate understanding of their condition. These findings underscore the need for standardized care guidelines and targeted interventions at the patient, provider, and system levels to improve glycemic outcomes and reduce diabetes-related complications in primary care settings.
Characterization of TPO Enzyme and its Immunogenecity in New Zealand White Rabbits (Oryctolagus cuniculus) Ramadani, Devi; Wijaya, Andreas Budi; Srihardyastutie, Arie; Wuragil, Dyah Kinasih; Rosandi, Rulli; Rudijanto, Achmad; Aulanni'am, Aulanni'am
Jurnal Penelitian Pendidikan IPA Vol 10 No 12 (2024): December
Publisher : Postgraduate, University of Mataram

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.29303/jppipa.v10i12.9539

Abstract

Hypothyroidism is characterized by inadequate production of thyroid hormones, chiefly thyroxine (T4) and triiodothyronine (T3). Thyroid peroxidase (TPO), is an enzyme and crucial for producing thyroid hormones, and also serves as a primary autoantigen in autoimmune thyroid conditions, such as Hashimoto's thyroiditis and Graves' disease. The existence of anti-thyroid peroxidase antibodies (anti-TPO) indicates an autoimmune response in which the immune system TPO which is normally recognized as part of the body (self), begins to be identified by the immune system as a something foreign (non-self). This study aimed to characterize, measure TPO activity, and evaluate the immunogenicity of TPO protein derived from patient serum and its ability to induce TPO antibody production in New Zealand White Rabbits. TPO protein isolation was achieved through SDS-PAGE and confirmed by western blot technique have molecular weight of 52 kDa. In samples from normal patients, the average TPO enzyme activity was 31.34 U/mL, while in hypothyroid patients, the average activity increased to 49.46 U/mL. TPO polyclonal antibody production in rabbits indicated its immunogenicity, peaking in week eight post-immunization, with an ELISA absorbance of 0.555. Dot blot analysis further confirmed anti-TPO sensitivity at various dilutions, anti-TPO has a high sensitivity at 1:80 dilution still detects TPO in sera patient.
HIV at the Crossroads: Addressing Stigma, Early Immunologic Markers, and Coinfection Burden in Indonesia Rosandi, Rulli
Clinical and Research Journal in Internal Medicine Vol. 6 No. 2 (2025): Volume 6 No 2, November 2025
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.crjim.2025.006.02.01

Abstract

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