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Kombinasi Artesunat Injeksi dan Ekstrak Brotowali (Tinospora crispa (L) Miers) Menurunkan Derajat Parasitemia serta Meningkatkan Ekspresi HSP70 dan Endoglin pada Mencit C57BL/6J yang Diinfeksi Plasmodium berghei Swastomo, Rahadi; Budiarti, Niniek; Fitri, Loeki Enggar; Poeranto, Sri
Jurnal Kedokteran Brawijaya Vol 29, No. 4 (2017)
Publisher : Fakultas Kedokteran Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jkb.2017.029.04.3

Penemuan kombinasi terapi baru untuk malaria dianggap penting karena kemampuan resistensi dari Plasmodium terhadap pengobatan terdahulu. Sebanyak 18 mencit dibagi ke dalam kelompok kontrol negatif, kontrol positif, kelompok artesunat, serta kelompok kombinasi artesunat dengan brotowali (dosis 50 mg, 60 mg dan 70 mg). Selain kontrol negatif, semua mencit diinfeksi Plasmodium berghei. Selanjutnya diamati derajat parasitemianya sampai hari ke-7, kemudian dilakukan pemeriksaaan imunohistokimia guna mengetahui ekspresi HSP70 dan endoglin pada otak mencit. Kombinasi artesunat injeksi dan ekstrak brotowali terbukti dapat menurunkan derajat parasitemia lebih baik dari pemberian terapi tunggal artesunat dan meningkatkan ekspresi HSP70 dan endoglin. Kesimpulannya, kombinasi terapi malaria menggunakan artesunat dan brotowali terbukti berpotensi sebagai terapi kombinasi yang efektif terhadap malaria karena mampu menurunkan derajat parasitemia sampai 0% dan meningkatkan ekspresi HSP70 dan endoglin pada otak mencit C57BL/6J secara signifikan.Â

Terapi ARV Meningkatkan Kadar IL-17 Serum pada Pasien HIV Wahyudi, Hendrik; Candradikusuma, Didi; B, Niniek Budiarti; Ismanoe, Gatoet
Jurnal Kedokteran Brawijaya Vol 27, No 4 (2013)
Publisher : Fakultas Kedokteran Universitas Brawijaya

Penurunan jumlah atau fungsi Th-17 mempengaruhi produksi IL-17 sehingga virus HIV lebih mudah mengalami replikasi. Pemberiaan ARV yang dapat menekan replikasi virus HIV diharapkan dapat memperbaiki produksi IL-17 dan menyebabkan pulihnya fungsi Th-17. Penelitian dilakukan untuk mengetahui rerata kadar IL-17 serum pada pasien HIV sebelum dan setelah 3 bulan mendapat terapi ARV. Survei pre dan post tes dilakukan padaÂ pasien infeksi HIV yang baru terdiagnosa di RSU Dr. Saiful Anwar-Malang. Diagnosa HIV berdasarkanÂ kriteria WHO, dan IL-17 serum diukur dengan metode ELISA. Hitung limfosit T-CD4 absolut menggunakan metode flowcytometry. Analisa statistik yang digunakan untuk komparasi numerikÂ adalah uji t berpasangan danÂ analisa korelasi menggunakan uji Spearman. Kadar IL-17 serum penderita HIV sebelum dan sesudah 3 bulan mendapat terapi ARV adalah 44,17Â±12,56 pg/mL dan 52,91Â±9,90 pg/mL (p=0,005). Hitung sel limfosit T-CD4 absolutÂ sebelum dan sesudah 3 bulan mendapat terapi ARV adalah 69,41Â±95,06 cells/mL dan 180,72Â±73,15 cells/mL (p=0,000). Kadar IL-17 serum didapatkan tidak berkorelasi dengan hitung sel T-CD4 absolut (p=0,914, r=-0,024). Dapat disimpulkan kadar IL-17 serum dan CD4 penderita HIV setelah 3 bulan mendapat terapi ARV lebih tinggi dibandingkan sebelum mendapat terapi ARV, namun, kadar IL-17 tidak berhubungan dengan hitung sel limfosit T-CD4.Kata Kunci: CD4, infeksi HIV, IL-17 serum, Th-17

Gender Differences in Denial-Acceptance Duration Based on KÃ¼bler-Ross Cycle After HIV Diagnosis Burhan, Niniek Budiarti; Febriliant, Muhammad Reza
Jurnal Kedokteran Brawijaya Vol 31, No 3 (2021)
Publisher : Fakultas Kedokteran Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jkb.2021.031.03.7

Patients who have been diagnosed with HIV often suffer from sadness and grief that, in turn, affect the adherence to HIV treatment. This study aimed to examine gender differences in the denial-acceptance duration based on the KÃ¼bler-Ross cycle in patients after diagnosed with HIV. A cross-sectional survey was conducted on 63 adult HIV patients aged 19-60 years who received routine treatment at the HIV/VCT outpatient department of Saiful Anwar General Hospital Malang. Subjects were interviewed using the Acceptance of Disease and Impairments Questionnaire (ADIQ). Gender differences in denial-acceptance duration after diagnosed with HIV were analyzed using the unpaired T-test. Results were statistically significant if p value <0.05. The median duration of denial-acceptance in male subjects was 16 weeks with the shortest duration of 1 week and the longest duration of 144 weeks, while the median duration of female subjects was 12 weeks with the shortest duration of 1 week and the longest duration of 240 weeks. There are no gender differences in the denial-acceptance duration (p value = 0.629). In conclusion, there are no gender differences in denial-acceptance duration based on the KÃ¼bler-Ross cycle after diagnosed with HIV.

The Effect of Artesunate and Brotowali (Tinospora Crispa) Combination on Histopathological, and Expression of Nuclear Factor Kappa B (NF-kÎ²) in Renal Tubules of Mice Infected With Plasmodium Berghei Merici, Angela; Fitri, Loeki Enggar; Budiarti, Niniek
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.2020.001.01.5

Brotowali (BR) extract (Tinospora crispa) can be used as an antimalarial. Aim: to determine the effect of BR extract in histopathological and expression of NFÎºB in mice tubules infected by Plasmodium berghei treated by artesunate (AR). Method: we used 42 C57BL / 6J strain mice as experimental animals, which were randomly divided into 7 groups : negative control (NC), positive control (PC), treatment group consist of AR 32 mg/kb (group 1); BR 70 mg/kg (group 2), combination of AR+BR 50 mg/kg (group 3), AR+BR 60 mg/kg (group 4), and AR+BR 70 mg/kg (group 5). Â Histological examination (hematoxylin-eosin (HE) staining) and expression of NFKB (immunohistochemical staining) in the kidneys were performed on 7th and 14th. Result: compared to PC group, BR with doses of 70 mg until 14th day, improved the degree of tubular necrosis, interstitial fibrosis, tubular degeneration, and inflammatory cell infiltration (p <0.001) but did not reach NC group (p <0.05). The combination of AR+BR until the 14thÂ day with dose of 50, 60, 70 mg all of dose improves significantly in-term of degree of tubular cell necrosis and inflammatory cell infiltration. The degree of interstitial fibrosis on 14th day only improved in group 4 and 5 (p<0.001 and p=0.003). The level of NF-kB expression on day 7 and day 14 was reduced in group 2, group 4, and group 5 compared to PC group. There was positive correlation on 7th and 14th between NF-kÎ² expression and tubular degeneration, tubular cell necrosis, inflammatory cell infiltration, and interstitial fibrosis. Conclusion: the combination of AR+BR extract can improve histopathological features and reduce NF-kÎ² expression in mice tubules infected by Plasmodium berghei with an optimal dose was 60 mg/day for 7-14 days or 70 mg for 7 days.

Clinical Response of Convalescent Plasma Therapy in COVID-19 Patients in Dr. Saiful Anwar General Hospital Burhan, Niniek Budiarti; Brahmantyo, Herwindo Pudjo; Hermanto, Djoko Heri; Arsana, Putu Moda
Jurnal Kedokteran Brawijaya Vol 31, No 4 (2021)
Publisher : Fakultas Kedokteran Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jkb.2021.031.04.5

The use of convalescent plasma has been beneficial for more than a century to treat various infections.Â The lack of effective treatment currently available for COVID-19 has reemerged the use of convalescent plasma as a potential therapeutic option. This is an observational descriptive study in 13 COVID-19 patient who got convalescent Plasma. Consist of 11 (84%) male patient, 2 (16%) female patient. Divided into two groups based on severity, and outcome. 38% patient included in severe disesase and 62% patient in critically Ill condition. 30% patient who got convalescent plasma deceased, and 70% had a resolve condition.

Dengue Hemorrhagic Fever: Past, Present, and Future Rahmad Budianto; Niniek Budiarti
Berkala Kedokteran Vol 15, No 1 (2019)
Publisher : Fakultas Kedokteran Universitas Lambung Mangkurat

Abstract: Dengue viral infection is a global disease with a spectrum of clinical manifestations mild fever to severe disease both dengue hemorrhagic fever (DHF) and dengue shock syndrome (DSS). DHF is severe form of dengue fever (DF), which can be life-threatening. Climate changes is not the only factor that affects dengue transmission, but also globalization changes includes travel and trade. The pathogenesis of dengue infection is complex. The mechanism involved antibody-dependent enhancement, NS1 and its antibodies, T cells, and DENV genomics. There are several novel methods to detect the presence of dengue virus in the body of infected patients. These include ELISA-specific IgM and IgG detection, detection of monoclonal antibodies and mosquito cell strains, and PCR reverse transcriptase detection. Several trials found novel methods to predict the severity of dengue hemorrhagic fever earlier. These include platelet count, Aspartate aminotransferase / platelet count index (APRI) Index, serum chymase level, serum cytokine/chemokine profile, Tropomyosin-alpha 1 (TPM 1), Reticulocyte Production Index (RPI), and Immature Platelet Fraction (IPF). Several pharmacological therapies are known to have potential antidengue effect. Some of these are corticosteroids, antimalarial drugs, doxycycline and tetracycline, anticholesterol drugs, IVIG, celgosivir, balapiravir, pentoxifylline and calcium supplementation. Some natural products are known to have activity against Aedes aegypti through antiviral mechanisms, larvacidal activity, mosquitocidal, and mosquito repellants. It can be developed as the latest therapy of dengue hemorrhagic fever on the future. The objective of this paper is to provide new insight about the development of dengue hemorrhagic fever related to the history of its distribution, pathogenesis, and the latest developments related to detection methods, severity prediction methods, and the management of dengue hemorrhagic fever on the future. Keywords: globalization changes, novel detection methods, severity prediction methods, latest development in DHF therapy

COVID-19 Mortality Characteristics During First to Third Pandemic Wave in Malang Dewi Indiastari; Nur Samsu; Didi Candradikusuma; Niniek Budiarti; Heri Sutanto; Siti Fatma
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.2022.003.02.5

Background: The epidemic of SARS-CoV-2 has spread worldwide for about one and half years, including in Indonesia, with several peaks in cases and mortality rates. A descriptive pattern of Covid 19 inpatients in Saiful Anwar General Hospital Malang needed to improve health service quality and reduce mortality rates. Aim: Determine the descriptive pattern of inpatients Covid 19 in the internal medicine ward in Saiful Anwar General Hospital from March 2020 until February 2022. Methods: This descriptive study was conducted from March 2020 to July 2021 and used convenience sampling due to sample availability. A total of 137 hospitalized patients in December 2020, 387 in July 2021, and 113 in February 2022 patients were included with information about age, sex, medical diagnosis, comorbid, and outcome, which was obtained from medical records. Descriptive analysis was used to explore frequency distribution and analysis. Results: We found several factors associated with the frequency of SARS-CoV-2 cases. Overall, these results emphasize the role of comorbidity as a possible driver of the COVID‑19 case fatality rate. Conclusion: In the three waves of Covid 19 in Indonesia, the highest case fatality rate was during the Delta variant in July 2021, where more factors significantly affected case mortality.

Gender Differences in Denial-Acceptance Duration Based on KÃ¼bler-Ross Cycle After HIV Diagnosis Niniek Budiarti Burhan; Muhammad Reza Febriliant
Jurnal Kedokteran Brawijaya Vol. 31 No. 3 (2021)
Publisher : Fakultas Kedokteran Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jkb.2021.031.03.7

Patients who have been diagnosed with HIV often suffer from sadness and grief that, in turn, affect the adherence to HIV treatment. This study aimed to examine gender differences in the denial-acceptance duration based on the KÃ¼bler-Ross cycle in patients after diagnosed with HIV. A cross-sectional survey was conducted on 63 adult HIV patients aged 19-60 years who received routine treatment at the HIV/VCT outpatient department of Saiful Anwar General Hospital Malang. Subjects were interviewed using the Acceptance of Disease and Impairments Questionnaire (ADIQ). Gender differences in denial-acceptance duration after diagnosed with HIV were analyzed using the unpaired T-test. Results were statistically significant if p value <0.05. The median duration of denial-acceptance in male subjects was 16 weeks with the shortest duration of 1 week and the longest duration of 144 weeks, while the median duration of female subjects was 12 weeks with the shortest duration of 1 week and the longest duration of 240 weeks. There are no gender differences in the denial-acceptance duration (p value = 0.629). In conclusion, there are no gender differences in denial-acceptance duration based on the KÃ¼bler-Ross cycle after diagnosed with HIV.

Clinical Response of Convalescent Plasma Therapy in COVID-19 Patients in Dr. Saiful Anwar General Hospital Niniek Budiarti Burhan; Herwindo Pudjo Brahmantyo; Djoko Heri Hermanto; Putu Moda Arsana
Jurnal Kedokteran Brawijaya Vol. 31 No. 4 (2021)
Publisher : Fakultas Kedokteran Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jkb.2021.031.04.5

The use of convalescent plasma has been beneficial for more than a century to treat various infections.Â The lack of effective treatment currently available for COVID-19 has reemerged the use of convalescent plasma as a potential therapeutic option. This is an observational descriptive study in 13 COVID-19 patient who got convalescent Plasma. Consist of 11 (84%) male patient, 2 (16%) female patient. Divided into two groups based on severity, and outcome. 38% patient included in severe disesase and 62% patient in critically Ill condition. 30% patient who got convalescent plasma deceased, and 70% had a resolve condition.

EVALUASI KUALITAS HIDUP DAN SKALA NYERI PADA LANJUT USIA PENYINTAS COVID-19 PASCA RAWAT INAP Sri Soenarti; Heri Sutanto; Dewi Indiastari; Niniek Budiarti; Djoko Heri Hermanto; Jefri Pratama Susanto
Majalah Kesehatan Vol. 10 No. 2 (2023): Majalah Kesehatan
Publisher : Faculty of Medicine Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/majalahkesehatan.2022.010.02.5

COVID-19 menyebabkan banyaknya kematian pada populasi lanjut usia (lansia). Di Indonesia, hingga akhir Mei 2021 terdapat 49% kematian akibat COVID-19 dan pada pasien di atas 60 tahun (lansia) hanya didapatkan 10% kasus sembuh. Lansia dikategorikan sebagai kelompok berisiko terinfeksi virus Corona. Â Wabah penyakit ini tidak hanya berdampak pada kesehatan fisik tetapi juga kesehatan mental. Pada saat pandemi, memahami kualitas hidup lansia yang sembuh dari COVID-19 pasca perawatan di rumah sakit adalah tantangan global yang baru. Penelitian ini dilakukan dengan mengambil data lansia yang selamat dari COVID-19 pasca rawat inap untuk dinilai kualitas hidupnya dan kesehatan diri. Penilaian dengan wawancara melalui telepon. Data demografi, sosial ekonomi, status kesehatan diambil dari rekam medis pasien. Responden memperoleh rerata skor kualitas hidup (EQ-5D) 0,911 dan rerata skor VAS 89,6. Nyeri sendi memiliki korelasi yang signifikan secara statistik dengan ketidaknyamanan (p < 0,000). Lama rawat inap kurang dari 14 hari memiliki hubungan yang bermakna dengan ketidaknyamanan (p < 0,05).Â Sedangkan dimensi lain seperti mobilitas, perawatan diri, aktivitas sehari-hari dan kecemasan/depresi tidak berkorelasi dengan ketidaknyamanan secara signifikan.Â Kesimpulannya, kualitas hidup dan kesehatan diri yang dilaporkan oleh lansia penyintas COVID-19 relatifÂ bagus. Adanya keluhan nyeri sendi dikaitkan dengan kualitas hidup yang lebih buruk (dimensi ketidaknyamanan), sementara risiko ketidaknyamanan meningkat secara signifikan dengan lama rawat yang lebih singkat.

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