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All Journal Medicina journal of internal medicine E-Jurnal Medika Udayana Indonesian Journal of Rheumatology Jurnal Penyakit Dalam Udayana Callosum Neurology Journal : Jurnal Berkala Neurologi Bali Oceana Biomedicina Journal ISM (Intisari Sains Medis) : Jurnal Kedokteran Cermin Dunia Kedokteran Oceana Biomedicina Journal
Gede Kambayana
Departemen Ilmu Penyakit Dalam, FK Universitas Udayana/RSUP Sanglah, Denpasar, Bali, Indonesia
Biochemistry, Genetics & Molecular Biology Dentistry Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Nursing Public Health

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Correlation between Severity of Knee Osteoarthritis and Serum Levels of Cartilage Oligomeric Matrix Protein Gede Kambayana; Pande Kurniari; Andriyasa Andriyasa; T R Putra
Indonesian Journal of Rheumatology Vol. 5 No. 1 (2014): Indonesian Journal of Rheumatology
Publisher : Indonesian Rheumatology Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (217.032 KB) | DOI: 10.37275/ijr.v5i1.49

Abstract

Background: The sensitivity of radiographic examination in the diagnosis and severity assessment of knee osteoarthritis (OA) is still low. Various attempts have been made to find more reliable indicators of cartilage damage. One potential marker is cartilage oligomeric matrix protein (COMP), a substance that in previous animal studies had been shown to be released in proportion to the extent of joint cartilage damage.Objective: To evaluate the correlation between the severity of knee OA and serum level of COMP in human with normal renal function. Methods: This was a cross-sectional study performed at the outpatient clinic in Department of Internal Medicine, Sanglah Hospital, Denpasar. The diagnosis of knee OA was based on the American College of Rheumatology (ACR) criteria. The degreeof knee OA severity was determined by using the Kellgren-Lawrence criteria, while COMP values were checked by enzyme-linked immunosorbent assay (ELISA) method.Results: Forty five patients who were recruited were examined: 19 (42.2%) were female and 26 (57.8%) were male. The mean age of patients was 64.1±7.1 years. There were 4.4%, 26.7%, 46.7%, and 22.2% patients who had grade 1st, 2nd, 3rd, and 4th degree joint damage based on the Kellgren-Lawrence score, respectively. Mean serum level of COMP was 1081.4 ng/mL. We found a significant correlation ofthe severity of knee OA with serum level of COMP (r = 0.41, p = 0.005).Conclusion: Among the patients in this study, there was a significant correlation between the severity of joint damage in knee OA and serum level of COMP.
The Relationship between Neutrophil Lymphocyte Ratio with Disease Activity in Systemic Lupus Erythematosus Gede Kambayana; I Gusti Agung Friskha Surya Putra; Pande Ketut Kurniari; Tjokorda Raka Putra
Indonesian Journal of Rheumatology Vol. 11 No. 1 (2019): Indonesian Journal of Rheumatology
Publisher : Indonesian Rheumatology Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/ijr.v11i1.126

Abstract

Background. Systemic Lupus Erythematosus (SLE) is an Autoimmune inflammatory disease that is systemic and chronic inflammation with heterogeneous of history, clinical manifestations, and prognosis. The disease activity of SLE has been proven as a predictor of organ damage and death by evidenced of inflammatory markers involved in this disease. Neutrophil to Lymphocyte Ratio (NLR) is useful for estimating the activity of autoimmune disease and inflammation that easily obtained from blood test and low cost and measurable as new biomarker to assess inflammatory response or activity of SLE. This study aimed to determine the relationship between NRL and Disease Activity based on Mex-SLEDAI in patients SLE. Methods. This study is an analytic study with cross sectional design. It started from November 2016 until March 2017. Mex-SLEDAI and blood sampling used in this study. Result. Total sample in this study is 54 patients with median age was 28.5 years, with mostly female (85,2%). Result analysis with positive correlation between NLR with disease activity on SLE (r=0.399 p=0.003 n=54), thus the Scatter plot shows there is a correlation between NRL with Mex-SLEDAI. Conclusion. Positive correlation between NLR and disease activity of the SLE, the higher of the disease activity/Mex-SLEDAI will be followed by the increase of NLR.
Characteristics of Patients with Autoimmune Rheumatic Disease in the Era of COVID-19 Pandemic in Indonesia Rudy Hidayat; Harry Isbagio; Anna Ariane; Faisal Parlindungan; Laniyati Hamijoyo; I Nyoman Suarjana; Dwi Budi Darmawati; Rakhma Yanti Hellmi; Gede Kambayana; IA Ratih Wulansari Manuaba; Awalia Awalia
Indonesian Journal of Rheumatology Vol. 12 No. 1 (2020): Indonesian Journal of Rheumatology
Publisher : Indonesian Rheumatology Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/ijr.v12i1.159

Abstract

Background Coronavirus Disease 2019 (COVID-19) could be fatal in high-risk patient including autoimmune rheumatic patients. Nowadays, the management of these patients becomes dilemma because the use of steroids and disease-modifying anti-rheumatic drugs could suppress the immune system however, poor control of the underlying disease increases the infection risk. Understanding the characteristics of these patients in the COVID-19 pandemic is essentials to establish management guidelines and identify patients who are more susceptible to COVID-19. This study aimed to determine the characteristics of autoimmune rheumatic patients in the era of COVID-19 pandemic in Indonesia. MethodA descriptive study using national scale survey method was conducted. The subjects were autoimmune rheumatic patients in Indonesia and recruited using consecutive sampling. The variables evaluated in this study were demographic data, history of disease, current medications taken, daily activities in the COVID-19 pandemic, and also data related to COVID-19. The surveys distributed in online form to patients with autoimmune rheumatic disease in Indonesia. ResultTotal participants in this study were 570 patients, mostly women (93.9%), aged <60 years old (97.2%), and diagnosed with systemic lupus erythematosus (62.8%). Glucocorticoid (70.2%) especially low dose glucocorticoid (52.6%) is the most medication taken by patients. A 30.5% of patients is taking hydroxychloroquine/chloroquine and 88.1% of them have good compliance. During COVID-19 pandemic, 76.5% respondents still do normal activities/work and only 53.2% use personal protective equipment. Eleven of 541 respondents had positive PCR test and confirmed to COVID-19. The risk of COVID-19 infection based on British Society of Rheumatology (BSR) scoring system showed that 57.9%, 28.6%, and 13.5% patients in high, moderate and low risk, respectively. ConclusionPatients with autoimmune rheumatic diseases might be more susceptible to COVID-19 than the general population. Interplay of aging, therapies and disease-specific factors, comorbidities and the proper use of personal protective equipment seem to contribute. Keywords :autoimmune rheumatic disease, characteristic, COVID-19, Indonesia
Effect of Vitamin D Supplementation in Disease Activity, Activity-Related Markers, Inflammatory Marker and Serum Calcium of Systemic Lupus Erythematosus Patiens: A Systematic Review and Meta-Analysis G Kambayana; Dwijo Anargha Sindhughosa; Pande Ketut Kurniari; Wira Gotera; Yenny Kandarini
Indonesian Journal of Rheumatology Vol. 13 No. 1 (2021): Indonesian Journal of Rheumatology
Publisher : Indonesian Rheumatology Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/ijr.v13i1.168

Abstract

Background: Effect of additional supplementation of vitamin D toward Systemic lupus erythematosus (SLE) disease activity still differ in results obtained between studies being conducted. The current meta-analysis systematically analyzed the effect of vitamin D supplementation on SLE disease activity with updated literature, also its effect toward other parameters. Material and Methods: Relevant literatures were obtained from PubMed database and Google Scholar. The obtained studies were analyzed using fixed effect model or random effect model. Results: Five eligible studies with a total of 318 participants were included. Vitamin D supplementation did not affect the total SLEDAI score in SLE patients with pooled mean difference of -0.96 (p =0.09; 95% CI: -2.06 to 0.14). Serum vitamin D level increased after administration of vitamin D with pooled mean difference of 12.67 (p =0.001; 95% CI: 5.04 to 20.29). vitamin D supplementation increase serum calcium levels, with pooled difference of 0.07 (p = 0.006; 95% CI: 0.02 to 0.12). Pooled results from two studies obtained vitamin D supplementation did not affect ESR, C3 and C4. Conclusions: Current meta-analysis obtained no significant changes in SLEDAI scores due to vitamin D supplementation. In contrast, serum vitamin D and serum calcium levels were increased.
Prinsip Latihan Penderita Osteoartritis I.B. Aditya Nugraha; Gede Kambayana
Cermin Dunia Kedokteran Vol 44, No 2 (2017): Neurologi
Publisher : PT. Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v44i2.826

Abstract

Osteoartritis (OA) lutut merupakan penyakit degeneratif kartilago sendi, prevalensinya meningkat pada usia >65 tahun. Penyakit ini dapat menimbulkan berbagai impairment, disability, serta handicap. Beberapa jenis latihan dapat dikembangkan untuk pasien OA seperti latihan stretching, strengthening, aerobik, dan fungsional. Semua latihan ini untuk mengurangi komplikasi imobilisasi dan membuat pasien lebih nyaman.Knee osteoarthritis is a cartilage degenerative disease, causing impairment, disability, and handicap. The management is pharmacological pain therapy. Exercises such as stretching, strengthening, aerobic, and functional exercises are to decrease the complication of immobilisation, and also to increase the quality of life.
Target Terapi Imunosupresan pada Lupus Eritematosus Sistemik Ni Ketut Donna Prisilia; Pande Ketut Kurniari; Gede Kambayana
Cermin Dunia Kedokteran Vol 41, No 1 (2014): Neurologi
Publisher : PT. Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v41i1.1176

Abstract

Lupus eritematosus sistemik (Systemic Lupus Erythematosus / SLE) merupakan suatu kompleks penyakit melibatkan kelainan imun yang multipel meliputi fungsi abnormal sel B dan sel T, pembersihan abnormal kompleks imun berakibat penumpukan dalam jaringan, aktivasi komplemen dan apoptosis sel cacat menyebabkan penumpukan autoantigen yang potensial. Akibatnya terjadi induksi radang, gagal organ seperti pada ginjal, jantung, kulit dan sistem saraf. Terapi SLE berat antara lain imunosupresi dengan target sel B, sel T, menghambat sitokin, dan menghambat komplemen berfungsi menekan sistem imun (imunosupresif), efektif mengurangi gejala sisa SLE namun dapat meningkatkan risiko infeksi serius.Sytemic Lupus Erythematosus (SLE) is a complex of diseases involving multiple immune abnormality with abnormal cell T and cell B functions, abnormal immune complex clearance resulting accumulation in the tissue, complement activation and apoptosis of defective cell which caused potential autoantigen accumulation. The consequences are induction of inflammation, failure of organs such as kidney, heart, skin and nervous system. Immunosuppressive therapy targeted to B cell, T cell, the cytokines and complement is effective to reduce sequelae but increase the risk of serious infection. 
Keganasan Kolorektal dengan Fenomena Raynaud Sekunder Ni Made Dwi Adnyani; Ida Bagus Aditya Nugraha; Gede Kambayana
Cermin Dunia Kedokteran Vol 46, No 12 (2019): Kardiovaskular
Publisher : PT. Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v46i12.399

Abstract

Penyakit Raynaud adalah penyakit vaskular primer yang ditandai dengan spasme temporer arteri kecil dan arteriol, biasanya di jari tangan atau, yang lebih jarang, jari kaki. Penyebab penyakit Raynaud dapat primer atau sekunder; salah satu penyebab sekunder adalah proses malignansi. Dilaporkan kasus Fenomena Raynaud Sekunder diduga akibat kanker kororektal pada laki-laki, 46 tahun, suku Jawa.Raynaud's disease is a primary vascular disease characterized by temporary spasm of small arteries and arterioles, usually in fingers or, rarely, in toes. The cause of Raynaud's disease can be primary and secondary; one of the secondary causes is malignancy. This is a case of a 46 year-old Javanese male with secondary Raynaud's phenomenon associated with colorectal cancer.  
Seorang Penderita SLE dengan Emboli Paru Akut dan Hipertensi Pulmonal (Studi Kasus) Hendrata Erry Andisari; Gede Kambayana; Ketut Suega
Denta Journal Kedokteran Gigi Vol 3 No 1 (2020): Oceana Biomedicina Journal Volume 3 Issue (No) 1 January - June 2020
Publisher : Universitas Hang Tuah

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

Abstract

Kondisi Pulmonary embolism (PE) merupakan bagian dari spektrum penyakit yang disebut Venous thromboembolism (VTE). Seorang pasien dengan keluhan utama batuk yang mengeluarkan dahak berwarna keputihan datang ke RSUP Sanglah, Bali untuk mendapatkan terapi. Riwayat sebelumnya, pasien pernah dirawat inap di RSUP Sanglah tersebut.Saat ini diagnosis akhir pasien ini: SLE on treatment dengan moderate pulmonary hipertension dan suspek emboli paru, suspek pneumonia (HCAP) dengan severe sepsis dan syok sepsis, asidosis metabolik, observasi transaminitis ec reaktif dan hiponatremia kronik asimptomatik hipoosmoler euvolemic cb SIADH. Selanjutnya dilakukan tindakan terapi dan evaluasi terhadap terapi yang diberikan.
Seorang Penderita SLE dengan Emboli Paru Akut dan Hipertensi Pulmonal (Studi Kasus) Hendrata Erry Andisari; Gede Kambayana; Ketut Suega
Oceana Biomedicina Journal Vol 3 No 1 (2020): Oceana Biomedicina Journal Volume 3 Issue (No) 1 January - June 2020
Publisher : Universitas Hang Tuah

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30649/obj.v3i1.31

Abstract

Kondisi Pulmonary embolism (PE) merupakan bagian dari spektrum penyakit yang disebut Venous thromboembolism (VTE). Seorang pasien dengan keluhan utama batuk yang mengeluarkan dahak berwarna keputihan datang ke RSUP Sanglah, Bali untuk mendapatkan terapi. Riwayat sebelumnya, pasien pernah dirawat inap di RSUP Sanglah tersebut.Saat ini diagnosis akhir pasien ini: SLE on treatment dengan moderate pulmonary hipertension dan suspek emboli paru, suspek pneumonia (HCAP) dengan severe sepsis dan syok sepsis, asidosis metabolik, observasi transaminitis ec reaktif dan hiponatremia kronik asimptomatik hipoosmoler euvolemic cb SIADH. Selanjutnya dilakukan tindakan terapi dan evaluasi terhadap terapi yang diberikan.
Keberhasilan Terapi Rituximab pada Seorang Pasien dengan Lupus Nephritis Berat: Laporan Kasus Ni Putu Dewi Indriyani; Pande Ketut Kurniari; Gede Kambayana
Intisari Sains Medis Vol. 11 No. 3 (2020): (Available online: 1 December 2020)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (658.839 KB) | DOI: 10.15562/ism.v11i3.631

Abstract

Background: Lupus nephritis is one of complication of systemic lupus erythematosus (SLE) which manifests to the kidneys. Lupus nephritis occur in 50-60% of cases in the first ten years of the onset of SLE. Standard therapy for lupus nephritis are immunosuppressive drugs such as corticosteroids and cytostatics. In a refracter case, biologic agent has giving new hope.Case description: We report a case of seventeen years old female with chief complaints of edema in both feet, skin rash caused by sun exposure, joint pain, mouth ulcer with positive ANA test, proteinuria and high blood sugar level. Patient was then diagnosed with SLE, lupus nephritis and other types of DM. Patient was treated with combination theraphy of cycloposphamide and Rituximab. Patient then discharged in good condition.Conclusion:  we suggest that combination of cycloposphamide and Rituximab is effective in controlling SLE and reducing the dose of steroid theraphy.Keyword: biological agents, systemic lupus erythematosus, lupus nephritis  Latar belakang: Lupus nephritis merupakan salah satu komplikasi penyakit Systemic Lupus Erythematosus (SLE) yang bermanifestasi ke ginjal. Komplikasi lupus nephritis terjadi pada 50-60% kasus dalam sepuluh tahun pertama onset penyakit SLE. Terapi lupus nephritis meliputi obat-obatan imunosupresif seperti kortikosteroid dan sitostatika. Pada kasus-kasus yang refrakter, terapi dengan agen biologis memberikan harapan baru. Harapan hidup jangka panjang dan renal survival pasien SLE dengan lupus nephritis secara progresif telah mengalami peningkatan sejak ditemukannya agen biologis, rujukan yang lebih dini, dan kriteria diagnostik yang lebih baik.Deskripsi kasus:Kami melaporkan kasus seorang perempuan, berusia 17 tahun, suku Timor, datang dengan keluhan utama bengkak pada kedua punggung kaki, kemerahan pada kulit bila terkena sinar matahari, nyeri sendi, ulserasi pada mulut, dengan hasil laboratorium ANA test positif, proteinuria, disertai kadar gula darah yang tinggi. Pasien didiagnosis dengan SLE, lupus nephritis, dan DM Tipe lain. Setelah diberikan terapi cycloposphamide dan Rituximab, kondisi pasien membaik. Kesimpulan: regimen terapi ini efektif untuk mengontrol penyakit SLE dan memungkinkan untuk penurunan dosis terapi steroid.
Co-Authors Abd. Halim Adnyani, Ni Made Dwi Ali Djamhuri Anak Agung Mas Putrawati Triningrat Andisari, Hendrata Erry Andriyasa Andriyasa Andriyasa, Andriyasa Anna Ariane Anwar Santoso Awalia Awalia Bagus Rhama Dwi Budi Darmawati Dwijo Anargha Sindhughosa Faisal Parlindungan Gede Putu Arsana Harry Isbagio Hendrata Erry Andisari I Gusti Agung Friskha Surya Putra I Gusti Agung Indra Adi Kusuma I Gusti Ngurah Wien Aryana I K Rina I Ketut Suastika I Nyoman Suarjana I.B. Aditya Nugraha IA Ratih Wulansari Manuaba Ida Ayu Sri Indrayani Ida Bagus Aditya Nugraha IGN Eka Imbawan Indrawan, IGNM Budiana Ketut Suega Laniyati Hamijoyo Made Agus Kusumadjaja Made Paramita Wijayanti Manaek, Andi Ni Ketut Donna Prisilia Ni Made Dwi Adnyani Ni Made Dwi Adnyani Ni Putu Dewi Indriyani Nugraha, I.B. Aditya Pande Ketut Kurniari Prisilia, Ni Ketut Donna Putra, T R Putu Imayati Rakhma Yanti Hellmi Rima Febry Lesmana Rudy Hidayat T R Putra T R Putra Tjokorda Raka Putra Tonny, Tonny Try Parama Arthika Wira Gotera Yenny Kandarini Yuliandari KK, Cok Istri