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

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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 64.1Â±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.

Kadar interleukin-17 (IL-17) serum berkorelasi dengan rasio receptor activator of NF-ÎºB ligand/osteoprotegerin (RANKL/OPG) pada penderita Sistemik Lupus Eritematosus Tonny, Tonny; Kambayana, Gede; Putra, Tjokorda Raka; Kurniari, Pande Ketut
Jurnal Penyakit Dalam Udayana Vol 2 No 1 (2018): Vol 2 No 1 (2018) January-June 2018
Publisher : PAPDI BALI

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Latar belakang : Proses inflamasi berperan penting dalam patogenesis SLE. Proses inflamasi yang terjadi pada penderita SLE juga akan mempengaruhi diferensiasi osteoklas dan osteoblast. Interleukin-17 (IL-17) merupakan mediator pro-inflamasi yang dihasilkan akibat proses inflamasi sistemik. Peningkatan kadar sitokin pro-inflamasi diketahui mengakibatkan perubahan regulasi RANKL, yang selanjutnya akan mempengaruhi osteoprotegerin (OPG). Peningkatan kadar sitokin pro-inflamasi pada penderita SLE dapat mengakibatkan ketidakseimbangan RANKL/OPG. Tujuan : Mengetahui korelasi antara kadar IL-17 serum dengan rasio RANKL/OPG pada penderita SLE. Metode : Penelitian ini merupakan studi observasional analitik potong lintang yang dilakukan di poliklinik dan bangsal rawat inap. Penyakit Dalam RSUP Sanglah Denpasar, Bali, Indonesia dari bulan Januari-Maret 2018. Penderita SLE berjenis kelamin wanita yang berusia lebih dari 18 tahun dan belum mengalami menopause serta bersedia mengikuti penelitian dengan menandatangani informed consent diikutsertakan dalam penelitian. Kadar IL-17 serum diperiksa dengan menggunakan metode high sensitivity ELISA (Enzyme-linked immunosorbent assay). RANKL diukur menggunakan metode Human sRANKL (TOTAL) ELISA, sedangkan OPG diukur menggunakan metode Human Osteoprotegerin ELISA. Rasio RANKL/OPG didapatkan dari perbandingan antara kadar RANKL dan OPG. Hasil : Penelitian ini melibatkan 68 subyek penelitian. Median umur subyek penelitian yaitu 31,32 (17-54). Kadar IL-17 dan rasio RANKL/OPG pada seluruh subyek yaitu 0,435 (0,23-30,65) dan 70,18 (4,98-1060,46). Didapatkan korelasi yang bermakna antara kadar IL-17 dan rasio RANKL/OPG dengan p=0,010. Dari analisis multivariat didapatkan bahwa kadar IL-17 berkorelasi dengan rasio RANKL/OPG (B=6,554, SE(B)=2,686, p=0,018). Simpulan : Pada penelitian ini terdapat korelasi antara kadar IL-17 serum dengan rasio RANKL/OPG pada penderita SLE.

HUBUNGAN HIPERURISEMIA DAN FRACTION URIC ACID CLEARANCE DI DESA TENGANAN PEGRINGSINGAN KARANGASEM BALI Kurniari, Pande Ketut; Kambayana, Gde; Raka Putra, Tjokorda
journal of internal medicine Vol. 12, No. 2 Mei 2011
Publisher : journal of internal medicine

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Hyperuricemia is a condition of high consentration of uric acid in the blood. In most epidemiology study hyperuricemiais defined as level uric acid more than 7.0 mg/dl in men and more than 6.0 mg/dl in women. Hyperuricemia can be caused byseveral factors. Regarding the etiology hyperuricemia can be classified as primary, secondary and idiopathic hyperuricemia.Primary hyperuricemia related to genetic factor while secondary hyperuricemia caused by condition or other factors besidesgenetic factor such as high purin consumption, chronic kidney disease, certain drugs, alcohol and hypertension. Hyperuricemiacan be caused by inceased of uric acid metabolism (overproduction), decreased of urine uric acid excretion (underexcretion),or mix of both. Fraction Uric Acid Clearance (FUAC) is one of the method used to differentiate either hyperuricemia caused byoverproduction or underexcretion. The aim of this studi is to determine the prevalence of hyperuricemia, means value of FUACand association between hyperuricemia and FUAC in Tenganan Pegringsingan Karangasem region Bali.A cross sectional analytic study was conducted on Balinesse in Tenganan Pegringsingan Karangasem region. Samplestudy was Balinese at age of 13 years old or above, agree to participate by informed consent. Descriptive statistic analysis onnumeric data presented as mean mean ± SD, nominal and ordinal data in proportion. Pearson?s correlation method is used incomparing the correlation between hyperuricemia and FUAC. Of 100 eligible samples, mean age was 37.20 ± 13.59 y.o, 51(51%) men and 49 (49%) women. Youngest age was 13 y.o and oldest was 69 y.o. Mean of blood uric acid level was 5.69 ± 1.43mg/dl. Prevalence of hyperuricemia on this study was 28%, 21% men and 7% women. Means value of FUAC is 6.41 + 1.99%;6.94 + 2.01% in normal uric acid level and 5.04 ± 1.1% in hyperuricemia. There is close correlation between hyperuricemia andFUAC (r = 0.43; p = 0.00)

INTERLEUKIN 8 BERHUBUNGAN DENGAN DERAJAT GASTRITIS PADA PASIEN TERINFEKSI HELICOBACTER PYLORI Mariadi, IK; Kurniari, PK; Wibawa, IDN; Purwadi, N; Suryadarma, IGA
journal of internal medicine Vol. 12, No. 2 Mei 2011
Publisher : journal of internal medicine

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Helicobacter pylori infection induces a local pro-inflammatory cytokine response. The secretion of IL-8 by epithelialcells is probably a key factor in host defenses at mucosal sites, permitting a rapid polymorph response against infectious agents.Interleukin-8 is an important chemotactic and activating factor for neutrophils. If defense mechanisms fail and chronic infectionresults, continued up regulation of IL-8 and neutrophil activation could lead to mucosal damage and increased free radicalformation. Mucosal IL-8 production in Helicobacter pylori infection may be an important factor in the immunopathogenesisof gastritis and peptic ulcer disease. This study aim to investigate correlation between IL-8 and severity of gastritis in ourpopulation. We performed a cross-sectional analytic study in Helicobacter pylori infected patients. Severity of gastritis wasdetermined base on The Updated Sydney System. IL-8 level was analyzed from gastric mucosa biopsy using ELISA method.We included 65 samples. 31 (47.7%) men and the rest was women. Base on Kruskalwallis test we found significant associationbetween IL-8 gastric mucosa and severity of gastritis (x2 = 12.8; p = 0.002). We also found significant association between IL-8gastric mucosa and density of H pylori infection (x2 = 10.6; p = 0.01), severity of atrophy (x2 = 9.4; p = 0.02) and neutrophilscount (x2 = 11.0; p = 0.01). But notmethaplasia (x2 = 3.3; p = 0.18). Base on this study we concluded that IL-8 was associatedwith severity of gastritis in Helicobacter pylori infected patients.

Target Terapi Imunosupresan pada Lupus Eritematosus Sistemik Prisilia, Ni Ketut Donna; Kurniari, Pande Ketut; Kambayana, Gede
Cermin Dunia Kedokteran Vol 41, No 1 (2014): Neurologi
Publisher : PT. Kalbe Farma Tbk.

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.Â

KARAKTERISTIK MANIFESTASI KLINIS PASIEN SISTEMIK LUPUS ERITEMATOSUS DI POLIKLINIK REMATOLOGI RSUP SANGLAH PERIODE JUNI – SEPTEMBER 2018 Nyoman Angga P Darma; Tjokorda Istri Anom Saturti; Pande Ketut Kurniari
E-Jurnal Medika Udayana Vol 9 No 5 (2020): Vol 9 No 05(2020): E-Jurnal Medika Udayana
Publisher : Universitas Udayana

Systemic Lupus Erytmatosus (SLE) adalah penyakit autoimun yang melibatkan berbagai organ dengan manifestasi klinis bervariasi dari yang ringan sampai berat. Tingkat prevalensi SLE di dunia berkisar antara 20 sampai 70 per 100.000 penduduk. Kepala Badan Litbang Kesehatan Kementrian Kesehatan RI, dr. Dr. Trihono,MSc menyatakan bahwa di Indonesia, orang penderita lupus (ODAPUS) diperkirakan berjumlah 1,5 juta orang dengan 100.000 ODAPUS baru ditemukan setiap tahunnya. Penelitian ini bertujuan untuk mengetahui gambaran manifestasi klinis yang dialami oleh pasien SLE di Poliklinik Imun-Rematologi RSUP Sanglah Denpasar periode Juni – September 2018. Penelitian ini merupakan penelitian deskriptif retrospektif yang menggunakan data sekunder yaitu rekam medis pasien. Sampel penelitian adalah 56 pasien SLE yang dipilih secara random sampling. Hasil penelitian menunjukan bahwa dari 56 pasien mayoritas berada pada rentang usia 20-29 tahun yaitu sebanyak 24 pasien (42,85%). 51 pasen merupakan perempuan (91,07%). Manifestasi terbanyak yang dialami adalah fatigue ( 55,35%) diikuti demam (51,78%), nyeri sendi (44,64%), ruam malar (35,71%), Sindrom (33,93%), Fotosensitifitas (30,35%), Anemia (28,57%), rambut rontok (26,78%), gangguan pencernaan (23,21%), trombositopenia (16,07%), leukopenia ( 14,28%), xerostomia (14,28%), fenomena raynaud, serositis (7,14%), gangguan pernapasan (7,14%), gangguan neurologi (7,14%), dan ulser oral (3,57%). Kata Kunci : SLE, Manifestasi Klinis

KARAKTERISTIK PENDERITA OSTEOARTRITIS LUTUT DI RSUP SANGLAH PERIODE JANUARI-JUNI 2018 Grace Claudia; Tjokorda Istri Anom Saturti; Pande Ketut Kurniari
E-Jurnal Medika Udayana Vol 9 No 7 (2020): Vol 9 No 07(2020): E-Jurnal Medika Udayana
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24843/MU.2020.V09.i7.P05

ABSTRAKOsteoatritis (OA) lutut adalah penyakit radang sendi lutut yang degeneratif dan multifaktorial. OA lututdapat menimbulkan nyeri dan kaku sendi sehingga menganggu aktivitas sehari-hari. Namun informasimengenai karakteristik OA lutut yang ada belum memberikan penjelasan secara lengkap sehingga angkakejadian OA lutut di masyarakat tergolong tinggi. Maka dari itu penelitian ini bertujuan untuk mengetahuikarakteristik penderita OA lutut di RSUP Sanglah periode Januari-Juni 2018 berdasarkan usia, jeniskelamin, indeks massa tubuh (IMT), diagnosis OA lutut unilateral atau bilateral, jenis terapi, dan pekerjaanpasien. Penelitian ini merupakan penelitian potong lintang deskriptif yang menggunakan rekam medispasien. Subyek penelitian ini berjumlah 61 orang penderita OA lutut di RSUP Sanglah periode Januari-Juni2018 yang dipilih dengan teknik consecutive sampling. OA lutut banyak ditemukan pada pasien denganrentang usia 60-69 tahun (41,7%), dan sebagian besar adalah perempuan (73,33%). Subyek penelitian inisebanyak 23 pasien (38,3%) merupakan penderita obesitas I. Pasien OA lutut bilateral lebih banyakdibandingkan OA unilateral, yakni sebesar 65%. Terapi pilihan yang diberikan kepada pasien adalah terapinon-operasi dan operasi, pada penelitian ini menunjukkan persentase yang sama sebesar 50%. Sebanyak 19orang dari subyek penelitian bekerja sebagai Ibu Rumah Tangga (IRT). Kata Kunci: OA lutut, karakteristik penderita OA lutut. Knee osteoarthritis (OA) is a multifactorial degenerative knee disease. Knee OA could cause pain and stiffness in the joints so that interfere patients’ daily activities. However, information of the characteristics of knee OA that exist have not provided a complete explanation so that the number of knee OA events insociety is high. Therefore this study aimed to know the characteristics of knee OA patients were at Sanglah on January-June 2018 based on age, gender, Body Mass Index (BMI), the diagnosis of knee OA unilateral or bilateral, type of therapy, and occupation. This study was descriptive cross-sectional with consecutivesampling method that used medical record of the patients. The subjects of this study was 61 of knee OA patients at Sanglah Hospital on January-June 2018. Knee OA was found in patients with an age range 60 69 years (41.7%), and most of them were women (73.33%). The subject of this study as many as 23 patients (38.3%) was obesity I. Most of patients had bilateral knee OA, the amount was 65%. The choice of therapy given to patients was non-surgery and surgery, and the result on this study indicated the same percentage of 50%. As many as 19 sample of this study worked as a housewife. Keywords: Knee OA, characteristic of Knee OA patients.

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

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 64.1Â±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

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.

Should Patient with Autoimmune Inflammatory Rheumatic Diseases (AIIRD) be vaccinated with COVID-19 Vaccines? Cesarius Singgih Wahono; Perdana Aditya; Faisal Parlindungan; RM. Suryo Anggoro KW; Anna Ariane; Herlina Yani; Andi Raga Ginting; Lisa Kurnia Sari; Pande Ketut Kurniari; Ratih Manuaba; Ika Vemilia; Rudy Hidayat; Sumariyono Sarmidi; Harry Isbagjo
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.v13i1.167

Vaccination is a very important measure for the prevention of various infections worldwide including the recent COVID-19 disease. However, until now the COVID-19 vaccine with various platforms has not been clinically tested on autoimmune inflammatory rheumatic disease (AIIRD) patients, due to caution against possible side effects and unknown efficacy. Several recent studies proved that there is increased risk of SARS-CoV-2 infection in AIIRD patients and moreover, those patients also have worse COVID-19 outcomes. Thus, patients with AIIRD should be prioritized for vaccination because they have an increased burden of infections, including COVID-19. Many studies showed that inactivated/non-live vaccine is safe for AIIRD patients and do not cause disease exacerbations. We conclude that benefits of vaccination greatly outweigh the risks of infection and therefore, COVID-19 vaccines can also be administered safely in stable AIIRD patients.

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