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All Journal Jurnal Kedokteran Brawijaya Journal of Innovation and Applied Technology Research Journal of Life Science Jurnal Berkala Epidemiologi Majalah Kesehatan FKUB Indonesian Journal of Rheumatology Heart Science Journal CURRENT INTERNAL MEDICINE RESEARCH AND PRACTICE SURABAYA JOURNAL CRJIM (Clinical and Research Journal in Internal Medicine) CoMPHI Journal : Community Medicine and Public Health of Indonesia Journal
Pratama, Mirza Zaka
Universitas Brawijaya
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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Exploring Knowledge Gaps in Systemic Lupus Erythematosus Among Pre-Clinical Students and Junior Doctors in Medical Faculty Pratama, Mirza Zaka; Rahman, Perdana Aditya; Wahono, Cesarius Singgih; Handono, Kusworini
CoMPHI Journal: Community Medicine and Public Health of Indonesia Journal Vol. 6 No. 1 (2025): June
Publisher : Perhimpunan Dokter Kedokteran Komunitas dan Kesehatan Masyarakat Indonesia (PDK3MI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37148/comphijournal.v6i1.299

Abstract

Understanding knowledge gaps is essential for developing more effective educational interventions that can bridge theory and practice. This study aimed to evaluate knowledge gaps in Systemic Lupus Erythematosus between pre-clinical students and junior doctors at a medical faculty. A cross-sectional study was conducted with 250 participants, divided equally between pre-clinical students and junior doctors (N=125 each). Variables such as gender, educational year, GPA, and study time were analyzed. Knowledge was assessed in five domains: pathophysiology, clinical manifestations, diagnosis, treatment, and complications. Linear regression analysis was used to identify factors associated with mean knowledge scores. No significant differences in gender distribution or study time (p = 0.899, p = 0.633, respectively). However, GPA scores were significantly higher among junior doctors (p < 0.001). Pre-clinical students scored higher than junior doctors in all SLE-related domains. GPA and study time were the strongest predictors of higher scores (Beta = 0.917, p < 0.001; Beta = 0.261, p < 0.001). GPA and study time significantly contributed to SLE knowledge scores, while gender and educational year did not. These findings suggest that academic performance and consistent study habits play critical roles in mastering SLE concepts among medical trainees.
Performance of Soluble CD28 and CTLA4 as a Potential Marker of Immunosenescence Pratama, Mirza Zaka; Handono, Kusworini; Poetri, Levrita Nindya; Maghfirah, Halimi Bidaimi
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.mrj.2025.006.01.05

Abstract

Background: Immunosenescence is a condition of decreased function of the immune system that is generally found in elderly individuals. Several costimulatory molecules, such as CD28 and CTLA-4 have been investigated for their essential role in the immune aging process. Aim: This study aimed to determine the role of the soluble costimulatory molecules in immunosenescence. Methods: This study was observational research with cross-sectional approach. Samples were tested using ELISA and flow cytometry examination. Statistical analysis was conducted using independent T-test or Kruskal-Wallis comparison test. Correlation between each biomarker was determined with Pearson or Spearman correlation test. Diagnostic performances of each biomarked were assessed using ROC curve. Results: This study involved 52 subjects, of which 20 were young individuals aged between 20 to 28 years and 32 were elderly individuals aged between 60 to 85 years. In this study we found that CD4CD28+ and CD8CD28+ T cells were lower in elderly group (p<0.001), while CD4CD57+ and CD8CD57+ T cells were higher in elderly group (p<0.001). sCD28 and sCTLA-4 were significantly higher (p 0.039 and p 0.025 respectively) in old individuals than in young individuals. CD8CD28+ and sCD28 exhibit a significant negative moderate correlation (p=0.007, r= -0.368) meanwhile sctla4 has no correlation with surface immunosenescence markers. Based on the results of roc analysis, sCTLA-4 was the best predictor to determine immunosenescence with area under curve of 0.7. The cut-off value for sCTLA-4 to determine immunosenescence is 26.5 ng/ml with sensitivity and specificity 58.6% and 63.2% respectively. Conclusion: sCTLA-4 as a soluble costimulatory molecule can be developed as promising predictive biomarkers of immunosenescence, which could be detected more quickly and efficiently using elisa as an alternative to flowcytometry.
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

Abstract

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.
THE SOCIODEMOGRAPHICS INFLUENCE IN THE KNOWLEDGE, PERCEPTION, AND BEHAVIOR OF OSTEOPOROSIS IN MALANG: A COMMUNITY-BASED STUDY: Pengaruh Sosiodemografi dengan Tingkat Pengetahuan, Persepsi, dan Perilaku tentang Osteoporosis di Malang: Studi Komunitas Pratama, Mirza Zaka; Suryana, Bagus Putu Putra; Putra, Domy Pradana; Rahmad, Rahmad; Abellia, Gaby
Jurnal Berkala Epidemiologi Vol. 12 No. 2 (2024): Jurnal Berkala Epidemiologi (Periodic Epidemiology Journal)
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jbe.V12I22024.162-172

Abstract

Background: Osteoporosis is a major global health issue that results in disability and high medical expenses. It can significantly impact both individuals and their caregivers, leading to pain, limitations in daily activities, and emotional distress. Purpose: This study observed the association of sociodemographic factors in affecting knowledge, perception, and behavior related to osteoporosis in a rural area of Malang, Indonesia. Methods: A cross-sectional study was conducted in a rural area of Malang to assess the knowledge, perception, and behavior of adults (≥18 years old) toward osteoporosis. Participants were asked to fill in a validated questionnaire, which was selected randomly using a multistage stratified sampling technique. Collected data were analyzed on SPSS for Windows version 25.0. Results: The study included 376 randomly selected participants from various rural areas in Malang. The subjects mostly were within the 51-60 age group (34.0%), with female respondents accounting for 73.4% of the sample. On average, participants scored 1.8 (±2.5) for knowledge, 12.0 (±2.1) for perception, and 12.2 (±2.9) for behavior regarding osteoporosis. Both age and education levels showed associations with knowledge and perception, while only age was significantly linked to behavior concerning osteoporosis. Conclusions: Our study revealed a strong association between low educational levels, especially among the elderly, and the lack of knowledge, perceptions, and behavior toward osteoporosis. 
Assessing Knowledge of Systemic Lupus Erythematosus Among Patients and Caregivers Insights from a Qualitative Inquiry Pratama, Mirza Zaka; Handono, Kusworini; Wahono, Cesarius Singgih; Rahman, Perdana Aditya; Wulandari, Dessy
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.2025.006.02.04

Abstract

Background: Systemic Lupus Erythematosus (SLE) is a complex autoimmune disease requiring comprehensive patient knowledge for effective management. However, gaps in understanding and educational challenges persist among patients and caregivers. Aim: This study aimed to explore the knowledge, perceptions, and educational needs of SLE patients and their caregivers through a qualitative approach. Methods: Semi-structured interviews and focus group discussions were conducted with 15 patients and 10 caregivers from rheumatology clinics at Saiful Anwar General Hospital. Participants were selected using purposive sampling. Data were analyzed using thematic analysis, identifying key themes related to understanding of SLE, sources of information, knowledge gaps, and educational needs. Results: Participants demonstrated a basic understanding of SLE, but significant misconceptions were identified, particularly regarding the disease's multi-systemic impact. Healthcare providers were the primary source of information, though time constraints limited the depth of understanding. Patients and caregivers frequently turned to online sources, encountering challenges in identifying reliable information. Complex medical terminology and the emotional burden of SLE management were significant barriers. There was a clear preference for simplified, visual educational materials and a need for ongoing, continuous education and support. Conclusion: The study highlights persistent knowledge gaps and the need for enhanced educational strategies tailored to the needs of SLE patients and caregivers. Improving communication, providing reliable resources, and offering continuous education could significantly improve disease management and patient outcomes.
Risk of Osteoporotic Fracture and Falls among Rural Residents in Malang: an Observational Study Pratama, Mirza Zaka; Suryana, Bagus Putu Putra; Putra, Domy; Putri, Rina Kurnia
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

Abstract

Background: Osteoporosis is a condition characterized by decreased bone density, which increases the risk of fractures, particularly in untreated osteoporosis and when falls occur. The incidence of falls in individuals with osteoporosis is quite high, with 1.5 million out of 34 million people experiencing it, emphasizing the need for awareness among sufferers to prevent it. Indonesia, the fourth most populous country in the world. Aim: The focus of this study is to determine the relationship between fracture risk (the Percentage Ten-Year Probability of Major Osteoporosis and hip fracture) and falls, in relation to sociodemographic and other risk factors in Malang. Methods: The study was conducted in Malang City using a cross-sectional design. A total of 153 participants were selected using purposive sampling. Results: The results showed a strong correlation between menopause status and gender with the percentage ten-year probability of major osteoporosis(p-value for menopause status: 0.007, p-value for gender: 0.008). There was also a strong relationship between age and the Percentage Ten-Year Probability of Hip Fracture (p-value: <0.001). However, no variable had a strong influence on the risk of falling based on the Ontario Modified Stratify-Sydney Scoring for Adultery (p-values: education: 0.271; age: 0.067; menarche status: 0.996; menopause: 0.724; gender: 0.996; BMI: 0.448; TUG: 0.058). Conclusion: Given the findings that show a heightened risk of fractures in older adults, women, and those experiencing menopause, the Malang government could develop policies aimed at early intervention.
Exploring Caregiver Anxiety in the Daily Care of Systemic Lupus Erythematosus Patients: A Qualitative Study Wahono, Cesarius Singgih; Pratama, Mirza Zaka; Rahman, Perdana Aditya; Handono, Kusworini
Current Internal Medicine Research and Practice Surabaya Journal Vol. 7 No. 1 (2026): CURRENT INTERNAL MEDICINE RESEARCH AND PRACTICE SURABAYA JOURNAL (IN PRESS)
Publisher : Universitas Airlangga

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

Abstract

Introduction: Caregivers of patients with Systemic Lupus Erythematosus (SLE) face significant emotional and psychological challenges due to the chronic and unpredictable nature of the disease. This study aimed to explore the anxiety experienced by caregivers in their daily caregiving roles. Methods: A qualitative, phenomenological approach was used to gain insights into the lived experiences of 15 caregivers providing daily care to SLE patients. Data were collected through in-depth, semi-structured interviews, and thematic analysis was conducted to identify key themes related to caregiver anxiety. Results: Five main themes emerged: (1) Emotional Burden and Anxiety—Caregivers reported constant worry and stress due to the unpredictability of SLE; (2) Impact on Personal Life and Relationships—Caregiving responsibilities led to feelings of isolation and strained relationships; (3) Coping Mechanisms and Resilience—Caregivers utilized social support, religious practices, and routines to manage their anxiety; (4) Perceived Lack of Professional Support—Caregivers felt overlooked by healthcare providers and expressed a need for more comprehensive support services; (5) Long-Term Outlook and Future Uncertainty—Anxiety about the future and their ability to continue caregiving as they aged was a significant concern. Conclusion: The study highlights the multifaceted nature of caregiver anxiety in the context of SLE. There is a critical need for healthcare systems to provide holistic support that addresses both the emotional and practical needs of caregivers. By enhancing caregiver support, the overall well-being of both caregivers and patients can be improved.
Co-Authors Abellia, Gaby 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 Dessy Wulandari, Dessy 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 Putra, Domy Putra, Domy Pradana Putri, Choirinnisa Meilia Ayu Putri, Rina Kurnia Ra. Aminah Maya Radiyati Umi Partan Rahmad Rahmad 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 Suryana, Bagus Putu Putra Syahrul Chilmi Wahono, Caesarius Singgih Wahono, Cesarius Singgih Wisnu Barlianto Yulyani Werdiningsih Yuni Sari Zaenal Kusuma