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All Journal Jurnal Kedokteran Brawijaya Journal of Innovation and Applied Technology Research Journal of Life Science Majalah Kesehatan FKUB Indonesian Journal of Rheumatology Heart Science Journal CRJIM (Clinical and Research Journal in Internal Medicine) CoMPHI Journal : Community Medicine and Public Health of Indonesia Journal

Pratama, Mirza Zaka

Universitas Brawijaya

Author-ID : 955861

Agriculture, Biological Sciences & Forestry Biochemistry, Genetics & Molecular Biology Computer Science & IT Education Health Professions Immunology & microbiology Medicine & Pharmacology Nursing Public Health Other

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Immunomodulation Effects of Bryophyllum Pinnatum on Pregnant Pristane-Induced Lupus Mice Model Nurdiana Nurdiana; Elvira Sari Dewi; Yuni Sari; Rahmawati Wahyuni; Aminah Maya; Nursari Abdul Syukur; Mirza Zaka Pratama; Wisnu Barlianto; Umi Kalsum; Kusworini Handono
Research Journal of Life Science Vol 3, No 3 (2016)
Publisher : Lembaga Penelitian dan Pengabdian kepada Masyarakat, Universitas Brawijaya

Objective: To determine the effect of Bryophyllum pinnatum treatment in modulating immune response and the pregnancy outcomes of pregnant pristane-induced lupus mice model.Methods: Sixteen Balb/c mice were intraperitoneally injected with single 0.5 cc pristane to induce lupus manifestations. After 12 weeks of injection, mice were mated and considered as gestational day 0 (GD0). Mice were divided into 4 groups based on the dosages of Bryophyllum pinnatum: control (no treatment), B1 (10.5 mg/kg), B2 (21 mg/kg), and B3 (42 mg/kg). The treatment was given orally every day started from GD9 until 9 days. At the end of the study, blood pressure and fetal size were measured. Serum anti-dsDNA and urine albumin levels were measured by ELISA. Spleen T helper (Th) and mature B cells percentages were measured by flow cytometry.Results: Administration of Bryophyllum pinnatum reduced the percentages of Th1 (p=0.006), Th2 (p=0.005), Th17 (p=0.000), and mature B cells (p=0.007) in dose-dependent manner. B1 and B2 had significantly lower of systolic blood pressure compared to control (p=0.026 and p=0.022 respectively). Significantly lower of anti-dsDNA levels were found in B1 group compared to control (p=0.014). However, no significantly different of urine albumin levels were found between groups. Bryophyllum pinnatum also significantly increased the fetus body weight in dose-dependent manner (p=0.000).Conclusion: Treatment of Bryophyllum pinnatum could improve the pregnancy outcome and modulate the immune response in pregnant pristane-induced lupus mice. Therefore, Bryophyllum pinnatum is a potential herb which can be developed as an immunosuppressive agent in the future.

Treatment Challenge in COVID-19 Patients with Acute Kidney Injury in Hospital Mirza Zaka Pratama; Achmad Rifa'i; Duma Sianturi
Clinical and Research Journal in Internal Medicine Vol. 3 No. 2 (2022): November 2022
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.crjim.2022.003.02.9

Renal, the main characteristic of COVID-19 infection. Acute kidney injury (AKI) has been documented in 20-50% of the hospitalized COVID-19 patients. Renal involvement among COVID-19 patients might be multifactorial. COVID-19 Patients with AKI significantly had higher mortality than patients without AKI. This case series reported severe COVID-19 with respiratory failure and AKI during admission to the hospital. All patients were admitted to the intensive care unit (ICU) and obtained the standard therapeutic protocols according to the COVID-19 severities. The first patient developed AKI in the three days of admission, while the second and third patients had AKI from the first day of admission. The patients had similar complications, including type 1 or 2 respiratory failures, secondary infection with sepsis, hyperpotassemia, and metabolic acidosis. The first and second patients underwent hemodialysis as indicated on these patients. However, the evaluation of their renal functions did not improve after that. The third patient did not receive the hemodialysis therapy and only obtained supportive treatment with adequate fluid therapy. The third patient was getting better on the 16th day of admission. In addition, the renal function test was getting normal after the 16th day of admission. The patient was discharged on the 19th day of admission in stable condition. Early recognition of renal involvement in COVID-19 infection, preventive measures, renal function monitoring, and therapeutic intervention were essential to reduce the morbidity and mortality of COVID-19 patients. Hospitalized patients should be monitored closely for their renal function to prevent renal function deterioration in the future.

Knowledge of General Practitioner’s toward Spondyloarthritis (SpA): A Qualitative Study Mirza Zaka Pratama; Cesarius Wahono; Nabila Mukti; Perdana Rahman
Clinical and Research Journal in Internal Medicine Vol. 3 No. 2 (2022): November 2022
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.crjim.2022.003.02.4

Background: Low back pain (LBP) is one of major health problems experienced by 80-85% of patients in their lifetime. Spondyloarthritis (SpA) has become one of the leading causes of chronic LBP but is often undiagnosed. General practitioners (GP) have an essential role in the early diagnosis of SpA. Aim: To explore the knowledge of GP about SpA from clinical diagnosis and early management and elaborate on each GP’s clinical perspective and practice performance. Methods: A qualitative study that involved 12 GP. All was consented to participate in an in-depth interview with the experts by online meeting with 15-20 minutes duration. Analysis was focused on the definition, classification, clinical manifestation, diagnosis, and early management of SpA in primary care. Results: All GP were interviewed (12 GP, 9 men, and 3 women; mean age 29.42) with average years in clinical practice was 3.8 years. All GP could describe the definition of SpA. Only a few subjects are aware of the subtype of SpA. Most of the GP could mention chronic back pain as the main SpA symptom, some GP mentioned extra-articular manifestation, but incomplete. All GP understood the current treatment in clinical practice. Conclusion: GP is aware of SpA, but not all could completely mention the type and clinical entities. In addition, a limited resource for investigation makes a diagnosis of SpA difficult. Current early treatment has been acceptable in clinical practice. A comprehensive understanding of diagnosis and effective early treatment may reduce delayed diagnosis and improve patients' quality of life.

Indonesian Rheumatology Association (IRA) Recommendations for Diagnosis and Management of Glucocorticoid-induced Osteoporosis Bagus Putu Putra Suryana; Rudy Hidayat; Laniyati Hamijoyo; Radiyati Umi Partan; Yulyani Werdiningsih; Surya Darma; RM Suryo Anggoro; Anna Ariane; Faisal Parlindungan; Mirza Zaka Pratama; Harry Isbagio; Handono Halim; Cesarius Singgih Wahono; Sumariyono
Indonesian Journal of Rheumatology Vol. 14 No. 2 (2022): Indonesian Journal of Rheumatology
Publisher : Indonesian Rheumatology Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/ijr.v14i2.216

Background: Patients receiving long-term glucocorticoid therapy are at risk of developing GIOP. However, until today, there is still no guideline that specifically explains how to diagnose and manage GIOP patients in Indonesia. Methods: 10 selected rheumatologists from the Indonesian Rheumatologist Association (IRA) made recommendations based on key questions formed by a steering committee from IRA. These recommendation materials were taken from several online databases such as Pubmed, Science Direct, and Cochrane. Level of evidence and grades of recommendation were then assigned, and every member of the panelist team will assign a score for the level of agreement. Results: A total of 17 recommendations regarding screening, prevention, diagnosis, therapy, and monitoring for GIOP were made. Conclusion: These recommendations can be used for adult patients receiving long-term glucocorticoids with or at risk of developing GIOP. The prevention measure, diagnostic, therapy, and monitoring algorithm in this recommendation are all created with the consideration of Indonesia’s clinical setting, facility, and drug availability.

The Role of Soluble Costimulatory Molecules as the Biomarkers for Aging Predictors Kusworini Handono; Mirza Zaka Pratama; Hani Susianti; Cesarius Singgih Wahono; Nimas Eka Firdaningrum; Siti Roziah Ria Famuji; Norma Hanifah Sumarta; Ade Wildan Rizky Fachry; Levrita Nindya Poetri; Handono Kalim
Jurnal Kedokteran Brawijaya Vol. 32 No. 3 (2023)
Publisher : Fakultas Kedokteran Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jkb.2022.032.03.4

This study aimed to determine the role of the soluble costimulatory molecules in aging and the association with the presence of comorbid in aged individuals. Thirty-two elderly and twenty healthy subjects were included in this study. The soluble costimulatory molecules sCD28, sCD80, sCD86, sCD163, and sCTLA4 were measured using ELISA. The presence of comorbid was documented from medical records. Charlson Comorbidity Index (CCI) was measured to evaluate the survival/mortality risk for the subjects. The levels of the majority of soluble costimulatory molecules significantly increased in the elderly participants, while the level of sCD86 was comparable. There were weak positive correlations between the subject's age and levels of sCD28 (R=0.214, p=0.048), sCTLA4 (R=0.238, p=0.041), and sCD80 (R=0.317, p=0.012). sCD80 were discovered to be the best to predict immune aging in the elderly with AUC 0.71 [0.57-0.86], sensitivity 53,1%, specificity 80.0%, and cut off 129ng/ml. Most of the elderly participants had at least one comorbid, in which approximately 25.0% and 3.1% of the subjects were classified as mild and moderate CCI. Multivariate analysis showed that comorbidities in elderly individuals have been associated with levels of sCTLA4 ≥26.5ng/ml and sCD80 ≥129.0ng/ml. Furthermore, subjects with comorbid (CCI ≥1) were associated with sCD80 ≥129.0ng/ml (OR 12.44 [95% CI 1.32–117.03], p=0.027). Considering these results, sCD28, sCTLA4, and sCD80 can be developed as biomarkers for predicting immune aging and elderly comorbidities, respectively.

Comparison of Peritonitis Relapse Incidence in End-Stage Renal Disease Patients with Peritoneal Dialysis According to the Culture Results Mirza Zaka Pratama; Achmad Rifa'i; Atma Gunawan; Nadina Mustamsir
Clinical and Research Journal in Internal Medicine Vol. 3 No. 1 (2022): The First Issue of Third Year
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.crjim.2022.003.01.3

Background: Peritoneal dialysis (PD) is one of the modalities of renal replacement therapy (RRT) in end-stage renal disease (ESRD). One of the complications that are often found in the use of PD is peritonitis. Presence of the culture from the peritoneal fluid was known to be associated with the incidence of peritonitis relapse among ESRD patients with PD. Aim: Comparing the incidence of relapse in patients with continuous ambulatory peritoneal dialysis (CAPD) with culture-negative and culture-positive in RSUD Dr. Saiful Anwar Malang. Methods: This study measured the incidence of relapse after administration of CAPD peritonitis therapy. Descriptive data are presented in percentages, and numerical data is presented in Mean ± SD. The analysis test was carried out using the Mann-Whitney with p<0.05, significant. Results: According to the culture results, it was found that 25.4% (18 of 71 PD peritonitis cultures) were culture-negative in patients with CAPD peritonitis. This result is slightly higher than the ISPD recommendation, with 20% culture-negative results. There were 3 out of 53 relapses in culture-positive subjects and 1 in 18 relapses in culture-negative subjects. There was no significant difference in the two groups, with an OR of 0.721 in the culture-positive group lead the culture-positive tended to experience no relapse by 0.721 times less than the patient with culture-negative. Conclusion: In peritoneal dialysis peritonitis, there was no significant difference in the incidence of relapse in the positive and culture-negatives.

HUBUNGAN ANTARA PENANDA sCD28 DAN sCTLA-4 TERHADAP PERSENTASE SEL LIMFOSIT T CD8+CD45RA+ PADA PENUAAN IMUN: - Handono, Kusworini; Susanti, Hani; Pratama, Mirza Zaka; Kalim, Handono; Wahono, Caesarius Singgih; Ria Famuji, Siti Roziah; Firdaningrum, Nimas Eka; Sumarta, Norma Hanifah; Rizky Fachry, Ade Wlidan
Majalah Kesehatan Vol. 10 No. 4 (2023): Majalah Kesehatan
Publisher : Faculty of Medicine Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/majalahkesehatan.2023.010.04.1

Penuaan merupakan proses alami dan kompleks yang ditandai dengan penurunan fungsi fisiologis manusia sehingga berakibat pada perubahan sistem imun. Sampai saat ini, deteksi penuaan imun (immunosenescence) masih memiliki kendala yang berarti. Penanda satu-satunya yang diyakini sebagai prediktor penuaan imun adalah immune risk profile (IRP). Namun, IRP hanya dapat diamati dengan pemeriksaan flowsitometri yang membutuhkan alat canggih dan keterampilan khusus. Oleh karena itu, diperlukan penelitian yang menemukan suatu penanda deteksi penuaan imun melalui metode yang lebih mudah. Beberapa marker kostimulator memiliki bentuk terlarut di dalam serum. Penanda CD28 dan CTLA-4 pada membran memainkan peran utama pada regulasi aktivasi limfosit T dan marker diagnostik pada autoimun ataupun penuaan imun. Meskipun demikian, bentuk terlarut dari penanda tersebut masih belum banyak diteliti. Tujuan dari penelitian ini adalah meneliti keterkaitan antara penanda sCD28 dan sCTLA-4 terhadap persentase IRP sel limfosit T CD8+CD45RA+ pada penuaan imun. Molekul kostimulator sCD28 dan sCTLA4 diukur menggunakan ELISA, sedangkan persentase sel limfosit T CD8+CD45RA+ menggunakan flowsitometri. Pada penelitian ini didapatkan 87 responden terdiri dari 23,0% responden kelompok individu muda, 40,2% kelompok pasien Lupus Eritematosus Sistemik (LES), dan 36,8% responden kelompok lansia. Kadar sCD28 dan sCTLA-4 terhadap persentase sel limfosit T CD8+CD45RA+ memiliki hubungan yang tidak signifikan pada penuaan imun. Pada penuaan imun, fungsi sel limfosit T yang mengekspresikan CD45RA menampilkan cacat proliferatif dan pensinyalan, tetapi tetap polifungsional.

Clinical Characteristics of Rheumatoid Arthritis Patients in Malang: Where Are We Now According to the Treat-to-Target Strategy? Pratama, Mirza Zaka; Suryana, Bagus; Megawanto, Nurhandi
Clinical and Research Journal in Internal Medicine Vol. 4 No. 2 (2023): Volume 4 No 2, November 2023
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.crjim.2023.004.02.04

Background: Rheumatoid arthritis (RA) is the most frequent type of systemic inflammatory arthritis. Aim: to observe RA patients' clinical characteristics in Malang and assess the adherence of the clinical data to the existing guideline for the treat-to-target (T2T) strategy. Methods: This survey included 111 RA patients who visited the Rheumatology Clinic at Saiful Anwar Hospital in Malang. Patient's demographic information, medical and drug history, body mass index (BMI), tender joint count (TJC), swollen joint count (SJC), visual analogue scale (VAS) for pain, erythrocyte sedimentation rate (ESR), anti-cyclic citrullinated protein (CCP), and rheumatoid factor (RF) were all collected. The disease activity score for 28 joints - ESR (DAS28-ESR) was used to assess disease activity and remission. Results: The mean duration of the disease was 2.9±1.6 years. Among those patients, four patients (3.6%) got disease remission, and two patients (1.8%) had low activity. Methotrexate (MTX) was given to all subjects for an average of 78.4±11.7 months at a dose of 9.5±2.8 mg/week. Six patients (5.4%) received the DMARD combination of MTX+LEF (4.5%) and MTX+SSZ (0.9%). Most subjects had delayed MTX initiation (mean duration 6.0±2.2 months after the first onset); 77 patients (69.3%) initiated their MTX after >6 months since the first onset. Most subjects got 7.5 mg/weeks (45.0%), while only 11.7% of patients had ≥15 mg/weeks of MTX. Conclusion: The remission rate of RA patients in Malang is still low, which can be caused by inadequate adherence to the relevant guidelines and T2T strategy in clinical practices.

Strengthening Moral and Material Support for Lupus Patients and Their Families at the Kupu Parahita Indonesia Foundation Through Cinematherapy Handono, Kusworini; Dewi, Elvira Sari; Desfryda, Elynca Putri; Dwinadella, Sephia; Putri, Choirinnisa Meilia Ayu; Kalim, Handono; Wahono, Cesarius Singgih; Barlianto, Wisnu; Erawati, Dini Rachma; Pratama, Mirza Zaka; Sari, Tita Luthfia; Nurdiana, Nurdiana; Kusuma, Zaenal
Journal of Innovation and Applied Technology Vol 9, No 2 (2023)
Publisher : Lembaga Penelitian dan Pengabdian Kepada Masyarakat Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jiat.2023.9.2.13

Lupus patients and their families require adequate support to manage the disease's progression. This community service aims to help the Kupu Parahita Indonesia Foundation provide strengthened moral and material support for lupus patients and their families at the Kupu Parahita Indonesia Foundation. Results: The cinematherapy planned by the PKNM and Community Service Team received much positive feedback from patients and families. The sharing session expressed that patients and their families are grateful for the opportunity to enjoy free recreation together. Enthusiasm comes with enthusiasm to meet people with fellow lupus. . In conclusion, cinematherapy can help the Kupu Parahita Indonesia Foundation provide lupus patients and their families with more substantial moral and material support.

Association of clinical manifestations, disease activity, and medications on premature atherosclerosis in systemic lupus erythematosus Pratama, Mirza Zaka; Kusworini Handono; Cesarius Singgih Wahono; Ahmad Bayhaqi Nasir Aslam; Syahrul Chilmi
Heart Science Journal Vol. 6 No. 1 (2025): Challenges in Managing Acute Heart Failure
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2025.006.01.11

Background SLE is distinguished by the development of multiple autoantibodies that lead to chronic inflammation and increased risk of cardiovascular diseases, especially atherosclerosis. Objective This examination sought to explore the association between the disease activity, clinical manifestations, and medication with the atherosclerotic lesion from SLE patients. Methods This inquiry investigated forty-two female SLE patients (18-45 years old) who met the 2019 EULAR/ACR assortment decency with matched healthy individuals as control A cross-sectional study was sanctioned at the Rheumatology Clinic of Saiful Anwar General Hospital Malang between July and November 2023. Demographic data, clinical manifestations, and medication history was documented in the medical records. Disease activity was stelled by the SLEDAI-2K score. Carotid Intima-Media Thickness (cIMT) and Flow-Mediated Dilation (FMD) (after brachial BP cuff inflation up to 200 mmHg for five minutes) examinations were used as atherosclerosis marker. Results Markedly higher of cIMT mean was demonstrated in SLE patients compared to healthy individual (0.51±0.11 vs 0.40±0.11 mm, p<0.001). FMD was subtancially curtailed in SLE patients set side to side to control (0.00 (0.00-0.10) vs 0.10 (0.00-0.28) mm, p=0.022). There was no statistical distinctness of the cIMT and FMD among SLE patients according to the presence of clinical manifestations. Neither cIMT nor FMD showed a statistically correlated with the disease activity. Patients who received hydroxychloroquine (0.57±0.02 vs. 0.50±0.09 mm, p=0.043) and cyclophosphamide (0.55±0.09 vs. 0.48 ± 0.10 mm, p=0.031) had higher cIMT. Higher cIMT was demonstrated in subjects who received steroid (p=0.045) and the dosage of steroid was essentially enforced to cIMT (R=0.418, p=0.034). Conclusion Our study unveil that early atherosclerosis was evidenced in patients with SLE and several medications might affect the progressivity of atherosclerosis.

Co-Authors Achmad Rifa'i Achmad Rifa'i Ade Wildan Rizky Fachry Ahmad Bayhaqi Nasir Aslam Anna Ariane Atma Gunawan Cesarius Singgih Wahono Cesarius Wahono Desfryda, Elynca Putri Duma Sianturi Dwinadella, Sephia Elvira Sari Dewi Erawati, Dini Rachma Faisal Parlindungan Firdaningrum, Nimas Eka Handono Halim Handono Kalim Handono Kalim Hani Susanti, Hani Hani Susianti Harry Isbagio Kalsumy, Umi Kusworini Handono Kusworini Handono Kusworini Handono Laniyati Hamijoyo, Laniyati Levrita Nindya Poetri Maghfirah, Halimi Bidaimi Megawanto, Nurhandi Nabila Mukti Nadina Mustamsir Nimas Eka Firdaningrum Norma Hanifah Sumarta Nurdiana Nurdiana Nurdiana Nurdiana Nursari Abdul Syukur Perdana Aditya Rahman Perdana Rahman Poetri, Levrita Nindya Putri, Choirinnisa Meilia Ayu Ra. Aminah Maya Radiyati Umi Partan Rahmawati Wahyuni Ria Famuji, Siti Roziah Rizky Fachry, Ade Wlidan RM Suryo Anggoro Rudy Hidayat Sari, Tita Luthfia Siti Roziah Ria Famuji Sumariyono Sumarta, Norma Hanifah Surya Darma Suryana, Bagus Suryana, Bagus Putu Putra Syahrul Chilmi Wahono, Caesarius Singgih Wahono, Cesarius Singgih Wisnu Barlianto Yulyani Werdiningsih Yuni Sari Zaenal Kusuma

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