Nugraha, Wibisono
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Terapi Kortikosteroid Sistemik untuk Sindrom Steven Johnson (SSJ)- Nekrolisis Epidermal Toksik (NET) di RSUD DR Moewardi, Surakarta, Indonesia Novi Diana, Eka Devinta; Tri Irfanti, Rakhma; Rahma, Alfina; -, Frieda; Nugraha, Wibisono; Eko Irawanto, Muhammad
Cermin Dunia Kedokteran Vol 48, No 4 (2021): Dermatologi
Publisher : PT. Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1195.538 KB) | DOI: 10.55175/cdk.v48i4.1363

Abstract

Latar belakang :Sindrom Steven Johnson (SSJ) dan nekrolisis epidermal toksik (NET) adalah manifestasi reaksi alergi obat paling berat dan mengancam jiwa yang dimediasi sel T. Salah satu terapi SSJ-NET yaitu kortikosteroid sistemik. Tujuan : Mengetahui pola terapi kortikosteroid sistemik di Instalasi Rawat Inap RSUD Dr. Moewardi Surakarta periode Januari 2014-Desember 2018. Metode : Penelitian deskriptif retrospektif atas data rekam medis pasien SJS-NET di Instalasi Rawat Inap RSUD Dr. Moewardi Surakarta periode Januari 2014-Desember 2018. Hasil : Didapatkan 80 pasien SJS-NET, usia terbanyak 46-65 tahun (39%), lebih banyak laki-laki (52%). Diagnosis SSJ paling banyak (61%) dibandingkan SSJ overlap NET (24%) maupun NET (15%) dengan keterlibatan mukosa mulut terbanyak (64%). Penyakit penyerta terbanyak adalah diabetes melitus (18 %). Penyebab SSJ-NET terbanyak diduga lebih dari satu obat (44%). Terapi kortikosteroid sistemik berupa injeksi metilprednisolon dengan rata-rata dosis 65 mg/hari dan lama perawatan 10 hari. Simpulan :Kortikosteroid sistemik merupakan terapi semua kasus SSJ-NET di RSUD dr. Moewardi Surakarta.Background: Steven Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are the severest primarily T-cell mediated manifestation and life threatening drug reaction. Systemic corticosteroid is used for SJS-TEN management. Objective: To study the pattern of systemic corticosteroid therapy for SJS-TEN in Dr.Moewardi General Hospital Surakarta Januari 2014-December 2018. Method: A descriptive retrospective study on medical record data of SJS-TEN patients hospitalized at Dr.Moewardi General Hospital Surakarta between January 2014 and December 2018. Results: From a total 80 SJS–TEN patients in this study, 39% was 46-65 year-old, male (52%). The most frequent diagnosis was SJS (61%) followed by SJS overlap TEN (24%) and TEN (15%), mostly with mucosal mouth involvement (64%). The most frequent comorbidities was DM (18%). More than one drug were related to SJS-TEN (44%). Therapy for all cases was systemic corticosteroids with an average dose of methylprednisolone 65 mg per day in 10 days. Conclusion :Systemic corticosteroids was used in all cases of SSJ-NET in Dr.Moewardi General Hospital Surakarta.  
Media Terkondisi Sel Punca Mesenkim Wharton’s Jelly Mempercepat Penyembuhan Ulkus Tikus Diabetik strain Wistar Arrochman, Ferry; Betaubun, Ance Imelda; Tri Ifanti, Rakhma; Rinandari, Ummi; -, Mardiana; Satya Negara, Achmad; Nugraha, Wibisono; Mulianto, Nurrachmat; Julianto, Indah
Cermin Dunia Kedokteran Vol 47, No 12 (2020): Dermatologi
Publisher : PT. Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (232.214 KB) | DOI: 10.55175/cdk.v47i12.1235

Abstract

Pendahuluan: Ulkus diabetik merupakan bentuk kegagalan proses penyembuhan luka normal. Media terkondisi sel punca mesenkim Wharton’s jelly meningkatkan transkripsi m-RNA dari TGF-β2, hypoxia-inducible factor-1α, dan plasminogen activator inhibitor-1 genes pada fibroblas kulit yang berhubungan dengan penyembuhan luka. Tujuan: Meneliti efektivitas media terkondisi sel punca mesenkim Wharton’s jelly terhadap kecepatan penyembuhan ulkus pada tikus diabetik strain Wistar. Metode: Penelitian eksperimental laboratorik randomized pretest-posttest control group design. Penelitian di laboratorium bagian Farmasi Universitas Setia Budi (USB) Surakarta menggunakan 18 ekor hewan coba tikus strain Wistar yang dibuat luka di area punggung atas, dibagi 2 kelompok. Kelompok 1 diberi gel astaxanthin, kelompok 2 diberi media terkondisi sel punca mesenkim Wharton’s jelly. Perlakuan selama 14 hari. Uji visual menggunakan metode fotografi, luas ulkus diukur menggunakan software image J, persentase penyembuhan ulkus dihitung menggunakan rumus wound closure. Pengamatan dilakukan di hari ke-0, 7, 10, dan 14. Analisis perbedaan rata-rata luas ulkus menggunakan uji Mann-Whitney. Hasil: Berdasarkan luas ulkus dengan perhitungan Image J, didapatkan perbedaan signifikan pada hari ke-7 (p=0,041), hari ke-10 (p= 0,000), dan pada hari ke-14 (p= 0,000) Pada perhitungan menggunakan rumus wound closure dan data Image J, didapatkan perbedaan signifikan, pada kelompok 2 sebagian besar ulkus sudah menutup sempurna di hari ke-7, sedangkan pada kelompok 1 (kontrol) ulkus paling cepat menutup di hari ke-14 dan sebagian besar ulkus belum sembuh di hari ke-14. Simpulan: Media terkondisi sel punca mesenkim Wharton’s jelly efektif mempercepat penyembuhan ulkus pada tikus diabetik strain Wistar. Introduction: Diabetic ulcer is a sign of wound healing failure. Wharton’s Jelly enhance m-RNA transcription of TGF-β2, hypoxia-inducible factor-1α, and plasminogen activator inhibitor-1 genes in skin fibroblast related to wound healing process. Objective: To prove the effectivity of Wharton’s Jelly mesenchymal stem cell conditioned media on ulcer healing rate in diabetic Wistar rats. Method: A laboratory experimental study with randomized pretest-posttest control group design. This study was conducted at the Pharmacy Laboratory of Setia Budi University Surakarta on 18 Wistar strain rats divided into 2 groups. All rats were injured on upper back area. Group 1 was treated with Astaxanthin gel. Group 2 was treated with Wharton’s jelly mesenchymal stem cell conditioned media, for 14 days. Visual test was performed using the photographic method and ulcer area was measured using image J software; the percentage of ulcer healing was calculated with wound closure formula. Observations were made on days 0,7th,10th, and 14th. Analysis used Mann-Whitney test for data with normal distribution. Results: Wound closure on day 7th (p= 0.000), on day 10th (p= 0.000), on day 14th (p= 0.004) was significantly better in group 2. Based on ulcer area data with Image J software, the difference on day 7th (p= 0.041), on day 10th (p= 0.000), on day 14th (p=0.000) were significant. The ulcer healing rate is a significantly different between groups. In Wharton’s jelly group, most ulcers has closed completely in day 7th, while in astaxanthin group, most ulcer hasn’t closed until day 14th. Conclusion: Wharton’s Jelly mesenchymal stem cell conditioned media, compared to astaxanthin, accelerate the healing rate of diabetic ulcers in Wistar strain rats.