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Validity and reliability fatigue severity scale in patients with Systemic Lupus Erythematosus (SLE) in Indonesia RifaÃ¢Â€Â™i, A; Kalim, Handono; Handono, Kusworini; Wahono, Cesarius Singgih
Indonesian Journal of Rheumatology Vol 8, No 1 (2016)
Publisher : Indonesian Rheumatology Association

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Background: Fatigue is one symptom of Systemic Lupus Erythematosus (SLE), which has an important effect on the quality of life. Fatigue Severity Scale (FSS)is one parameter fatigue symptom in SLE. The purpose of this study was to determine the validity and reliabilitybetween FSS with duration of ilness and disease activity of SLE patients in Indonesia.Methods: FSS performed on 40 patients with SLE. FSS original English version has been converted-translated into Indonesian version by a team of RheumatologyImmunology Medical Faculty of Brawijaya University. Reliability determined by Cronbachâs Alpha values (>0.6). Validity was determined by the value of Corrected Item-Total Correlation which each item was a valid question if below value of Cronbachâs Alpha.Results: The reliability value was determined by Cronbachâs Alpha values (>0.6) in which the SLE patients in this study had a Cronbachâs Alpha value of 0.946. Value of Corrected Item-Total Correlation overall under Cronbachâs Alpha value (range = 0.684-0.859) which indicates that each item was a valid question. There were correlation between the FSS Indonesian version with disease duration (p = 0.000) as well as the value of r = 0.581, with SLEDAI (p = 0.000) with a value of r = 0.833. Conclusion: FSS in Indonesian version has a good reliability and validity and can be used by clinicians andother researchers to assess the condition of fatigue in SLE patients in Indonesia.Keywords: validity, reliability, fatigue, fatigue severity scale, systemic lupus erythematosus

Erosive polyarthritis in multicentric reticulohistiocytosis mimics rheumatoid arthritis Suryana, Bagus Putu Putra; Puspitasari, L; Wahono, Cesarius Singgih; Kalim, H
Indonesian Journal of Rheumatology Vol 4, No 1 (2013)
Publisher : Indonesian Rheumatology Association

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Multicentric reticulohistiocytosis (MRH) is a very rare multisystemic syndrome.1,2 The first case of MRH was described by Goltz and Layman in 1954 and so far only less than 200 cases have been reported.3-5 It is characterized by the insidious onset of polyarthritis that often evolves into a severe erosive deforming arthritis and characteristic skin lesions composed of nodules and plaques containing lipid-laden (periodic acidSchiff-positive) histiocytes and multinucleated giant cells.6 It most commonly affects the handsand cervical spine.7 MRH is also known as lipoid dermatoarthritis, lipoid rheumatism, and giant cell reticulohistiocytosis.4 MRH is occured due to infiltration of multinucleated giant cells and histiocytes into various tissues. The typical pictures include skin nodules and destructive polyarthritis.3 This entity is frequently mistaken for rheumatoid arthritis (RA).3 MRH is often associated with systemic complication and various types ofmalignancy. Therefore, sometimes it is considered a paraneoplastic syndrome

Validation of Modified COPCORD Questionnaire Indonesian Version as Screening Tool for Joint Pain and Musculoskeletal Diseases Anshory, Muhammad; Wahono, Cesarius Singgih; Kalim, Handono; Al Rasyid, Harun
Indonesian Journal of Rheumatology Vol 10, No 1 (2018)
Publisher : Indonesian Rheumatology Association

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Background: WHO-ILAR COPCORD Program is a program that aimed to obtain data on joints pain and musculoskeletal diseases in developing countries, one aspect which has not been studied is the ability of COPCORD questionnaire as a screening tool which standardized for Â screening Â joint pain and musculoskeletal diseases. Objective of this study is to assess the validity of modified COPCORD questionnaire Indonesian version in screening joint pain and musculoskeletal disease compared to examination by rheumatologists.Methods: The initial phase of the research is determining essential points, translation to Indonesian, and back translation. The second stage is testing questionnaires in communities which 100 respondents involved. Dependent variable is the diagnosis of rheumatic diseases and independent variables are pain in less and more than 7 days, high degree pain in less and more than 7 days, history of NSAIDs/Steroids/DMARDs use, and disabilities. Validation test was assessed by calculating the sensitivity, specificity, PPV, NPV, LR+, and ROC curve. Bivariate analysis using Chi Square analysis, and multivariate analysis using logistic regression.Results: The sensitivity test results is best obtained on the question history of NSAIDs/steroids/DMARDs use (100%)Â and specificity is best obtained on the question about disability (98%). ROC curve analysis which the results >85% obtained on the question of pain >7 days (90%), high degree pain >7 days (93%), and history of NSAIDs/steroids/DMARDs use (92%). Â LR+ to diagnose rheumatic diseases found in all questions. Chi square analysis showed that all questions were significant with p <0.05 and odds ratio (OR) obtained most on high degree pain more than 7 days (OR: 180.167; 95% CI: 38.196-849.834).Conclusion: The modified COPCORD questionnaire Indonesian version has been adapted and can be a good tool in the screening of joint pain and musculoskeletal diseases compared to examination by rheumatologists.Â Keyword: Validation, Questionnaire, COPCORD

Correlation between anti-cyclic citrullinated peptide antibodies and the severity of clinical manifestation, laboratory manifestation, and radiological joint destruction in rheumatoid arthritis patients Suwito, Mat; Handono, Kusworini; Suryana, Bagus Putu Putra; Kalim, Handono; Wahono, Cesarius Singgih
Indonesian Journal of Rheumatology Vol 2, No 1 (2010)
Publisher : Indonesian Rheumatology Association

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Background. The second generation anti-cyclic citrullinated peptide test (CCP2) displays sensitivity comparable to that of rheumatoid factor (RF) (approximately 80%) but with superior specificity (98%) . Several observations have indicated that early rheumatoid arthritis (RA) patients with positive anti-CCP may develop a more erosive disease than those without anti-CCP.Objective. The purpose of this cross-sectional study was to investigate the correlation between anti-CCP antibodies and clinical and laboratory parameters and radiological joint destruction in RA patients.Methods. We studied 31 patients with RA fulfilling the 1987 revised criteria of American College of Rheumatology in Rheumatology Clinic of Saiful Anwar General Hospital, Malang, Indonesia. Clinical parameters were collected such as age, sex, visual analog scale,disease duration and diseases activity score (DAS28-3(CRP)). Laboratory parameters were WBC, hemoglobin, platelet count, erythrocyte sedimentation rate, and Creactive protein. Analyzed autoantibody profiles were RF and anti-CCP (ELISA methode). Radiological jointdestruction was evaluated from bilateral postero-anterior manus x ray (Sharp score).Results. Anti-CCP antibodies were detected in 48.4% of RA patients with mean antibody concentration was 291.24Â±143.67 (range 16-523.8) units. Anti CCP level was significantly correlated with duration of RA (month) (p=0.04, r=0.371), RF level (p=0.002, r=0.542) andSharp score (p=0.048, r=0.358), but was not significantly correlated with other clinical and laboratory parameters.Conclusion. Anti-CCP level was correlated with duration of disease, RF, and Sharp score.

Effect of vitamin D supplementation on disease activity (SLEDAI) and fatigue in Systemic Lupus Erythematosus patients with hipovitamin D: An Open Clinical Trial RifaÃ¢Â€Â™i, Achmad; Kalim, Handono; Kusworini, Kusworini; Wahono, Cesarius Singgih
Indonesian Journal of Rheumatology Vol 8, No 2 (2016)
Publisher : Indonesian Rheumatology Association

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Background : Low level of vitamin D impact the disease activity and the degree of fatigue in SLE patients. This study aims to determine the effect of vitamin D supplementation on disease activity and fatigue condition in Systemic Lupus Erythematosus (SLE) patients with hipovitamin D.Methods: We performed an open clinical trial. Subjects were randomized into two different groups (supplementation or placebo) using simple random sampling. The treatment group got vitamin D3 softgel/ cholecalciferol 1200 IU/day or 30 mg/day, while the control group gotplacebo for 3 months. SLEDAI scores and FSS scores were calculated at pre and posttreatment.Results: There were 20 subjectsfor supplementation group and 19 subjects in the placebo group. From this study, before and after treatment, we found a significant difference of mean level of vitamin D in supplementation group (p=0.000), and no significant difference inpatients with placebo (p=0.427). Moreover, from the SLEDAI score analysis, observed a significant difference bothin the supplemented group (p=0.000) and the placebo group (p=0.006). FSS scores significantly different in the supplemented group (p=0.000). Incorrelation test,there was a negative correlation (r=-0763) between vitamin D level and disease activity (SLEDAI), and both showing stastistical significance between thepre supplementation (p=0.000) and post supplementation (r=-0846; p=0.000). Similarly to theFSS scores, there was a meaningfulnegative correlation (r=-0.931, p=0.000) between the level of vitamin D with FSS scores pre and post supplementation (r=-0.911; p= 0.000). Furthermore, there was a significant correlation between disease activity (SLEDAI) pre supplementation with fatigue condition pre supplementation (r=0.846; p = 0.000) and postsupplementation (r=0.913; p= 0.000).Conclusion: The supplementation of vitamin D 1200 IU per day in patients with SLE improve disease activity and degree of fatigue. Keywords: vitamin D, disease activity, fatigue, SLE

A Successful Management of 29 year old Female with Left Central Retinal Artery Occlusion due to Manifestation of Primary Antiphospholipid Syndrome Trianto, Herman Bagus; Wahono, Cesarius Singgih; Dewi, Nadia Artha
Indonesian Journal of Rheumatology Vol 8, No 2 (2016)
Publisher : Indonesian Rheumatology Association

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Ocular involvement in Anti Phospolipid Syndrome (APS) includes a broad spectrum of manifestations from the anterior and posterior segment or the presence of neuro-ophthalmologic features. A female, 29 years old, came to ER handled by ophthalmology department, with chief complaint left visual loss suddenly since 4 hours before admission. Investigations revealed stable vital signs, VOD 20/20, VOS 1/300, funduscopy showedpale and cherry red spot on left retina, OCT revealed hyperreflective of left inner retinal layer, IgG aCL 51.7 U/mL (50.8 U/mL in OPD 3 months later), and the other examinations were within normal limit. Patient was diagnosed with Central Retinal Artery Occlusion due toPrimary Antiphospolipid syndrome. She was performed occular massage and anterior chamber paracintesis procedure, and given O2 6-8 lpm NRBM, Timolol 0.5% eye drop left eye bid, acetazolamide 250 mg bid, Kalium Slow Release 1 tab qd, Levofloxacine eye drop 1 drop/hour post surgery. After the result of IgM aCL available, we added warfarin 2 mg qd and aspirin 320 mg qd. Patient was discharged 2 days later as visual acuity improved with VOD 20/20 and VOS 0.5/60. Key words: Central retina artery occlusion, primary anti phospolipid syndrome, anti cardiolipin antibody

Membangun Desa Binaan Tanggap COVID-19, Lupus, Reumatik, dan Alergi: Upaya Menurunkan Angka Kejadian dan Mencegah Kekambuhan di Malang Handono, Kusworini; Wahono, Cesarius Singgih; Barlianto, Wisnu; Dewi, Elvira Sari; Sari, Tita Luthfia; Hasanah, Dian; Rahman, Perdana Aditya; Anshory, Muhammad; Wulandari, Desy; Sari, Dewi Purnama; Endharti, Agustina Tri; Nurdiana, Nurdiana; Kalsum, Umi; Susianti, Hani; Kalim, Handono
International Journal of Community Service Learning Vol 5, No 1 (2021): February 2021
Publisher : Universitas Pendidikan Ganesha

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.23887/ijcsl.v5i1.30161

Kurangnya pengetahuan masyarakat tentang COVID-19, lupus, reumatik, dan alergi mempengaruhi keberhasilan terapi, penurunan angka kejadian, dan pencegahan kekambuhan.Â Tujuan pengabdian masyarakat adalah membangun desa-desa binaan tanggap COVID-19, lupus, reumatik, dan alergi di Malang oleh Tim Kelompok Kajian Lupus, Autoimun, Reumatik, dan Alergi (LAURA) Universitas Brawijaya. Warga desa binaan diberikan penyuluhan berupa seminar awam dan pelatihan tentang pertolongan awal pada penyakit COVID-19, lupus, reumatik, dan alergi, kemudian diminta mengisi kuesioner posttest untuk mengukur pemahaman. Desa-desa binaan diberikan thermo-gun dan wastafel untuk menerapkan protokol kesehatan. Satu bulan kemudian dievaluasi adanya kejadian COVID-19, lupus, reumatik, dan alergi di desa binaan.Â Hasil evaluasi menunjukkan rata-rata warga desa binaan memahami 78,3% materi yang diberikan dan menerapkan protokol kesehatan sesuai yang diajarkan saat penyuluhan. Dilaporkan tidak ada kejadian COVID-19 serta kekambuhan lupus, reumatik, dan alergi dalam satu bulan terakhir kegiatan. Kesimpulan: pembangunan desa-desa binaan di Malang meningkatkan tanggap warga terhadap COVID-19, lupus, reumatik, dan alergi.

Validity and reliability fatigue severity scale in patients with Systemic Lupus Erythematosus (SLE) in Indonesia A Rifaâ€™i; Handono Kalim; Kusworini Handono; Cesarius Singgih Wahono
Indonesian Journal of Rheumatology Vol. 8 No. 1 (2016): Indonesian Journal of Rheumatology
Publisher : Indonesian Rheumatology Association

Background: Fatigue is one symptom of Systemic Lupus Erythematosus (SLE), which has an important effect on the quality of life. Fatigue Severity Scale (FSS)is one parameter fatigue symptom in SLE. The purpose of this study was to determine the validity and reliabilitybetween FSS with duration of ilness and disease activity of SLE patients in Indonesia.Methods: FSS performed on 40 patients with SLE. FSS original English version has been converted-translated into Indonesian version by a team of RheumatologyImmunology Medical Faculty of Brawijaya University. Reliability determined by Cronbachâ€™s Alpha values (>0.6). Validity was determined by the value of Corrected Item-Total Correlation which each item was a valid question if below value of Cronbachâ€™s Alpha.Results: The reliability value was determined by Cronbachâ€™s Alpha values (>0.6) in which the SLE patients in this study had a Cronbachâ€™s Alpha value of 0.946. Value of Corrected Item-Total Correlation overall under Cronbachâ€™s Alpha value (range = 0.684-0.859) which indicates that each item was a valid question. There were correlation between the FSS Indonesian version with disease duration (p = 0.000) as well as the value of r = 0.581, with SLEDAI (p = 0.000) with a value of r = 0.833. Conclusion: FSS in Indonesian version has a good reliability and validity and can be used by clinicians andother researchers to assess the condition of fatigue in SLE patients in Indonesia.Keywords: validity, reliability, fatigue, fatigue severity scale, systemic lupus erythematosus

Correlation between anti-cyclic citrullinated peptide antibodies and the severity of clinical manifestation, laboratory manifestation, and radiological joint destruction in rheumatoid arthritis patients Mat Suwito; Kusworini Handono; Bagus Putu Putra Suryana; Handono Kalim; Cesarius Singgih Wahono
Indonesian Journal of Rheumatology Vol. 1 No. 2 (2009): Indonesian Journal of Rheumatology
Publisher : Indonesian Rheumatology Association

Background. The second generation anti-cyclic citrullinated peptide test (CCP2) displays sensitivity comparable to that of rheumatoid factor (RF) (approximately 80%) but with superior specificity (98%) . Several observations have indicated that early rheumatoid arthritis (RA) patients with positive anti-CCP may develop a more erosive disease than those without anti-CCP.Objective. The purpose of this cross-sectional study was to investigate the correlation between anti-CCP antibodies and clinical and laboratory parameters and radiological joint destruction in RA patients.Methods. We studied 31 patients with RA fulfilling the 1987 revised criteria of American College of Rheumatology in Rheumatology Clinic of Saiful Anwar General Hospital, Malang, Indonesia. Clinical parameters were collected such as age, sex, visual analog scale,disease duration and diseases activity score (DAS28-3(CRP)). Laboratory parameters were WBC, hemoglobin, platelet count, erythrocyte sedimentation rate, and Creactive protein. Analyzed autoantibody profiles were RF and anti-CCP (ELISA methode). Radiological jointdestruction was evaluated from bilateral postero-anterior manus x ray (Sharp score).Results. Anti-CCP antibodies were detected in 48.4% of RA patients with mean antibody concentration was 291.24Â±143.67 (range 16-523.8) units. Anti CCP level was significantly correlated with duration of RA (month) (p=0.04, r=0.371), RF level (p=0.002, r=0.542) andSharp score (p=0.048, r=0.358), but was not significantly correlated with other clinical and laboratory parameters.Conclusion. Anti-CCP level was correlated with duration of disease, RF, and Sharp score.

Effect of vitamin D supplementation on disease activity (SLEDAI) and fatigue in Systemic Lupus Erythematosus patients with hipovitamin D: An Open Clinical Trial Achmad Rifaâ€™i; Handono Kalim; Kusworini Kusworini; Cesarius Singgih Wahono
Indonesian Journal of Rheumatology Vol. 8 No. 2 (2016): Indonesian Journal of Rheumatology
Publisher : Indonesian Rheumatology Association

Background : Low level of vitamin D impact the disease activity and the degree of fatigue in SLE patients. This study aims to determine the effect of vitamin D supplementation on disease activity and fatigue condition in Systemic Lupus Erythematosus (SLE) patients with hipovitamin D.Methods: We performed an open clinical trial. Subjects were randomized into two different groups (supplementation or placebo) using simple random sampling. The treatment group got vitamin D3 softgel/ cholecalciferol 1200 IU/day or 30 mg/day, while the control group gotplacebo for 3 months. SLEDAI scores and FSS scores were calculated at pre and posttreatment.Results: There were 20 subjectsfor supplementation group and 19 subjects in the placebo group. From this study, before and after treatment, we found a significant difference of mean level of vitamin D in supplementation group (p=0.000), and no significant difference inpatients with placebo (p=0.427). Moreover, from the SLEDAI score analysis, observed a significant difference bothin the supplemented group (p=0.000) and the placebo group (p=0.006). FSS scores significantly different in the supplemented group (p=0.000). Incorrelation test,there was a negative correlation (r=-0763) between vitamin D level and disease activity (SLEDAI), and both showing stastistical significance between thepre supplementation (p=0.000) and post supplementation (r=-0846; p=0.000). Similarly to theFSS scores, there was a meaningfulnegative correlation (r=-0.931, p=0.000) between the level of vitamin D with FSS scores pre and post supplementation (r=-0.911; p= 0.000). Furthermore, there was a significant correlation between disease activity (SLEDAI) pre supplementation with fatigue condition pre supplementation (r=0.846; p = 0.000) and postsupplementation (r=0.913; p= 0.000).Conclusion: The supplementation of vitamin D 1200 IU per day in patients with SLE improve disease activity and degree of fatigue. Keywords: vitamin D, disease activity, fatigue, SLE

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