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All Journal Jurnal Kesehatan Andalas Indonesian Journal of Rheumatology Buletin Ilmiah Nagari Membangun Majalah Kedokteran Andalas Bioscientia Medicina : Journal of Biomedicine and Translational Research Medika Kartika : Jurnal Kedokteran dan Kesehatan Bioscientia Medicina : Journal of Biomedicine and Translational Research
Najirman Najirman
Division Of Rheumatology, Department Of Internal Medicine, Faculty Of Medicine, Andalas University/Dr. M Djamil General Hospital, Padang, Indonesia
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Lupus Eritematosus Sistemik pada Pria Fajriansyah Fajriansyah; Najirman Najirman
Jurnal Kesehatan Andalas Vol 8, No 3 (2019): Online September 2019
Publisher : Fakultas Kedokteran, Universitas Andalas

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25077/jka.v8i3.1065

Abstract

Lupus Eritematosus sistemik merupakan penyakit inflamasi autoimun kronis dengan etiologi yang belum diketahui serta memiliki manifestasi klinis dan prognosis yang sangat beragam. Insiden LES di Amerika serikat sebesar 5,1 per 100.000 penduduk, sementara prevalensi LES di Amerika dilaporkan 52 kasus per 100.000 penduduk dengan rasiowanita dan laki-laki antara 9-14:1. Kejadian LES pada pria sangatlah jarang dan gejalanya biasanya tidak khas dibanding dengan wanita. Telah dilaporkan pasien laki – laki, 27 tahun dengan keluhan utama nyeri sendi pada pergelangan kaki dan tangan. Adanya bercak warna kehitaman pada wajah, telinga, dan punggung serta rambut rontok. Pada pemeriksaan fisik: konjungtiva anemis, adanya ruam malar pada wajah dan hepatomegali tanpa splenomegali. Diidapatkan Hb: 9,7 gr/dL, gambaran darah tepi dengan eritrosit normositik normokrom, retikulosit 1,8 %, Combs test (DCT) positif, Anti ds-DNA 502,26 U/L , SGOT 62 u/L dan SGPT 120 u/L, ureum 18 mg/dL serta kreatinin 1 mg/dL. Ro. Thorax didapatkan Cor dan pulmo : normal, USG abdomen didapatkan gambaran fatty liver . Biopsi kulit : Subacute Cutaneus Luphus Erytematosus (SCLE). Pasien ini didiagnosis dengan lupus eritematosus sistemik sesuai dengan kriteria ACR (American College of Rheumatology) revisi tahun 1997, dimana bila terdapat 4 dari 11 kriteria ACR. Pasien diterapi dengan pemberian kloroquin, metilprednisolon, natrium diklofenak, osteokal, lansoprazol dan hepatoprotektor.
Karakteristik Pasien Penyakit Jantung Rematik yang Dirawat Inap di RSUP Dr. M. Djamil Padang Marhamah Hasnul; Najirman Najirman; Yanwirasti Yanwirasti
Jurnal Kesehatan Andalas Vol 4, No 3 (2015)
Publisher : Fakultas Kedokteran, Universitas Andalas

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25077/jka.v4i3.383

Abstract

Abstrak Penyakit jantung rematik (PJR) adalah penyakit jantung sebagai akibat adanya gejala sisa (sekuele) dari demam rematik (DR) yang ditandai dengan terjadinya cacat katup jantung. Tujuan penelitian ini adalah melihat karakteristik pasien penyakit jantung rematik.yang dirawat. Metode yang digunakan adalah deskriptif observasional dengan desain cross sectional study dan pendekatan retrospektif untuk menilai karakteristik pasien PJR di RSUP Dr. M. Djamil Padang dari Januari 2009 - Desember 2012. Populasi dan sampel sebanyak 54 sampel. Hasil penelitian menunjukkan distribusi pasien terbanyak pada kelompok umur 11-20 tahun (50%), perempuan (57,41%), tingkat pendidikan SD/sederajat dan SLTP/sederajat masing-masing 25,93%, pelajar/mahasiswa (53,70%), dan berasal dari daerah rural (70,37%). Sebagian besar pasien mengeluhkan keluhan utama sesak napas (62,96%). Hasil pemeriksaan elektrokardiografi memperlihatkan LVH sebesar 35,19% dan AF sebesar 27,78%. Berdasarkan pemeriksaan foto toraks umumnya pasien telah mengalami kardiomegali (92,59%). Berdasarkan pemeriksaan ekokardiografi yang paling banyak ditemukan adalah kelainan katup regurgitasi mitral (30,40%), derajat kerusakankatup berat (36,80%), dan fraksi ejeksi normal (72,97%). Pada penelitian ini dapat disimpulkan bahwa terdapat variasi karakteristik dari penderita PJR yang ada di RSUP Dr. M. Djamil Padang. Kata kunci: penyakit jantung rematik, karakteristikAbstract Rheumatic heart disease is a cardiovascular disease caused by delayed sequele of rheumatic fever characterized by heart valve damage. The objective of this study was to observe the characteristics of RHD patients.This study is a descriptive observasional with cross-sectional study design and the retrospective by observing the characteristics of RHD patients in RSUP Dr. M. Djamil Padang from Januari 2009 – December 2012. The population and sample of this study was 54 patients. The result of this study showed that majority of the patients at the age group 11-20 years (50%), female (57.41%), elementary education degree/equal and junior high/equal of each 25.93%, students/university students (53.70%), and come from rural areas (70.37%). Most patients complained experiencedbreathlessness (62.96%). The result of electrocardiography showed LVH is the the highest (35.19%) and AF 27.78%. Based on chest X-ray examination majority of the patients showed a cardiomegaly (92.59%). Based on echocardiography examination, the most heart valve damage is mitral regurgitation (30.40%), the severity is severe (36.80%), and the fraction ejection is in normal limit (72.97%). The conclusion of this research, there are variation in the characteristics of RHD patients in RSUP Dr. M. Djamil Padang.Keywords: rheumatic heart disease, characteristics
Hubungan Indeks Massa Tubuh dengan Derajat Kerusakan Sendi pada Pasien Osteoartritis Lutut di RSUP Dr. M. Djamil Padang Endang Mutiwara; Najirman Najirman; Afriwardi Afriwardi
Jurnal Kesehatan Andalas Vol 5, No 2 (2016)
Publisher : Fakultas Kedokteran, Universitas Andalas

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25077/jka.v5i2.525

Abstract

AbstrakOsteoartritis lutut adalah salah satu penyakit sendi degeneratif  yang sering ditemukan di Indonesia. Pada pemeriksaan radiologi sendi lutut penderita osteoartritis terdapat kelainan yang dapat dinilai berdasarkan kriteria Kellgren dan Lawrence. Salah satu faktor resiko utama yang mengakibatkan kerusakan sendi pada penderita osteoartritis lutut adalah kegemukan. Tujuan penelitian ini adalah menentukan hubungan Indeks Massa Tubuh (IMT) dengan derajat kerusakan sendi pada penderita osteoatritis lutut di RSUP Dr M Djamil. Penelitian ini menggunakan desain potong lintang dengan jumlah sampel 24 pasien. Subjek yang memenuhi kriteria inklusi  menurut American College of Rheumatology 1997 di Poli Rematik RSUP Dr M Djamil, dilakukan penghitungan IMT dan penilaian derajat kerusakan sendi berdasarkan pemeriksaan Rontgen dengan menggunakan kriteria Kellgren dan Lawrence. Analisis statistik dilakukan dengan menggunakan uji chi-square. Pada penelitian ini didapatkan sebanyak 88,9% pasien yang bertubuh gemuk memiliki derajat osteoartritis yang lebih berat. Analisis uji chi-square terhadap  IMT dengan derajat kerusakan sendi pada pasien osteoartritis lutut memperlihatkan hubungan yang bermakna dengan nilai p = 0,003 (p<0,05). Kesimpulan penelitian ini adalah terdapat hubungan antara Indeks Massa Tubuh dan derajat kerusakan sendi pada pasien osteoartritis lutut.Kata kunci: osteoartritis lutut, IMT, derajat kerusakan sendi AbstractKnee osteoarthritis is a common degenerative joint disease in Indonesia. The radiograph of knee osteoarthritis shows changes of knee joint which assessed based on Kellgren and Lawrence criteria. One of the major risk factor that lead joint damage in patient with knee osteoarthritis is obesity. The objective of this study was to determine association between Body Mass Index (BMI) and degree of joint damage in knee osteoarthritis patient at DR. M. Djamil hospital. This was a cross sectional study on 24 knee osteoarthritis patients that fulfilled American College of Rheumatology 1997 criteria. These patients  came to Rheumatic Poly in DR. M. Djamil hospital, then were measured the BMI and described the degree of joint demage based of Kellgren and Lawrence criteria. Statistical analysis was performed using chi-square test. The result showed 88.9% patients who were obese have a higher degree of joint damage. Chi-square test for BMI and degree of knee osteoarthritis showed significant association with p value 0.003 (p<0.05). The conclusion in this study, there is a significant association between BMI and degree of joint damage in knee osteoarthritis patients. Keywords:  knee osteoarthritis, BMI, degree of joint damage
Diagnosis and Management of Enthesopathy Hafiziani; Najirman
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 6 No. 2 (2022): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v6i2.441

Abstract

Enthesopathy is inflammation of the enthesis. Outcome Measures in Rheumatologic Clinical Trials (OMERACT) defined enthesopathy as abnormal hypoechoic (loss of normal fibrillar architecture) and/or tendon or ligament thickening at the site of bone attachment (sometimes containing hyperechoic foci that resemble calcifications) seen in two perpendicular planes on Doppler and/or bony changes including ensophytes, erosions, and irregularities. The causes of enthesopathy are categorized into two, namely, non-inflammatory causes and inflammatory causes. Non-inflammatory causes include trauma, degenerative, autoimmune, genetic, and metabolic. The causes of inflammation areas in seronegative spondyloarthropathy.
Treatment of Systemic Lupus Erythematosus with Anti SSA and SSB Positive Pregnancies Robby Satria Putra; Najirman
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 6 No. 3 (2022): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v6i3.470

Abstract

Systemic lupus erythematosus (SLE) is autoimmune disease that results in inflammation in various organ systems, frequent recurrences in the clinical course characterized by the production of antibodies against core antigens. Pregnancy will trigger flares. Increased intravascular volume in pregnancy can worsen abnormal heart and kidney function. Increasing the glomerular filtration rate by 50% exacerbated previously stable proteinuria. Pregnancy-induced hypercoagulability increases the risk of thrombosis. Anti-Ro/SSA was found in 35% of SLE patients and anti-La / SSB was found in 15% of SLE patients. The presence of Ro and La antibodies puts the fetus at a risk of developing neonatal lupus erythematosus (NLE) 6-13% and can reach up to 25% if the mother has previously given birth to a child with NLE. Neonatal lupus erythematosus including congenital heart block or cutaneous lupus. Congenital heart block (CHB) is a very serious complication. The American College of Rheumatology (ACR) recommends serial fetal echocardiography from 16 weeks of gestation continuing through to 26 weeks. Pregnancies with grade I and II CHB are treated with oral dexamethasone 4 mg daily because fluorinated glucocorticoids such as dexamethasone and betamethasone can cross the placenta, however, this therapy cannot be given in third-degree heart block. Early diagnosis and therapy will reduce the risk of congenital heart block in neonates after birth.
EDUKASI DAN PEMERIKSAAN KESEHATAN MASYARAKAT DI KAMPUNG BATU BUSUK KECAMATAN PAUH KOTA PADANG Saptino Miro; Najirman Najirman; Dinda Aprillia; Fauzar Fauzar; Andry Kurniawan; Zelly Dia Rofinda
BULETIN ILMIAH NAGARI MEMBANGUN Vol 5 No 1 (2022)
Publisher : LPPM (Institute for Research and Community Services) Universitas Andalas Padang

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25077/bina.v5i1.391

Abstract

Non-contagious diseases have continued to increase over the years. In 2016, about 71 percent of the world's causes of death were non-contagious diseases (NCD) that kill 36 million people annually. Major risk factors of the non-contagious disease are metabolic factors, behavioral factors, and environmental factors. Riskesdas 2018 shows the prevalence of non-contagious diseases increasing compared with Riskesdas 2013, including cancer, stroke, chronic kidney disease, diabetes mellitus, and hypertension. The purpose of this activity is to increase promotive and preventive effort and education in the community, as well as improved screening and early detection through health education, blood pressure, blood sugar, cholesterol levels, and the abdominal ultrasound of society in Kampung Batu Busuk, Kelurahan Limau Manis, Kecamatan Pauh, Padang on Saturday, November 13th, 2021. Such activities include medical examinations of blood pressure, cholesterol, blood sugar, and abdominal ultrasound. From the activity of the examination of the health of 41 persons, 13 were hypertensive, 2 (32%) were hyperglycemia, 24 (58.5 percent) were dyslipidemia, and 6 were fatty liver. To counter the problem of non-contagious diseases, comprehensive and holistic intervention efforts must be made, that is, promotive, preventive, curative, and rehabilitative, as a unified continum of care. Disorders that are not treatable during an activity are recommended for treatment at a nearby health care center.
Artritis Septik Najirman Najirman; Rikarni Rikarni; Rika Florensia
Majalah Kedokteran Andalas Vol 45, No 1 (2022): Online Januari 2022
Publisher : Faculty of Medicine, Universitas Andalas

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25077/mka.v45.i1.p63-68.2022

Abstract

Artritis septik (dikenal juga dengan artritis piogenik atau artritis supurativa) merupakan kondisi emergensi akibat infeksi oleh bakteri pada sendi sehingga mengakibatkan terbentuknya pus pada rongga sendi bersangkutan. Beberapa faktor risiko dapat meningkatkan insiden terjadinya artritis septik. Diagnosis dan tatalaksana dini penting dilakukan dalam kondisi ini untuk mencegah kerusakan sendi. Kami melaporkan sebuah kasus artritis septik pada laki-laki dewasa dengan DM tipe II, dislipidemia, dan tromboemboli vena. Seorang laki-laki 37 tahun dibawa ke Rumah Sakit Umum Pusat Dr. M. Djamil dengan keluhan lutut kanan nyeri, bengkak, kemerahan, dan kaku dengan riwayat DM tipe II tidak terkontrol. Pada pemeriksaan fisik, ditemukan tanda inflamasi pada lutut kanan disertai keterbatasan ROM. Punksi  dan analisis cairan sendi dilakukan untuk memastikan diagnosis yang diderita pasien tersebut. Dilakukan penatalaksanaan dengan memberikan, steroid, gabapentin, ditambahkan ketorolak serta antibiotik spektrum luas. Penyakit sekunder yang menyertainya juga ditatalaksana sebagaimana mestinya. 
Diagnosis and Management of Enthesopathy Hafiziani; Najirman
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 6 No. 2 (2022): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v6i2.441

Abstract

Enthesopathy is inflammation of the enthesis. Outcome Measures in Rheumatologic Clinical Trials (OMERACT) defined enthesopathy as abnormal hypoechoic (loss of normal fibrillar architecture) and/or tendon or ligament thickening at the site of bone attachment (sometimes containing hyperechoic foci that resemble calcifications) seen in two perpendicular planes on Doppler and/or bony changes including ensophytes, erosions, and irregularities. The causes of enthesopathy are categorized into two, namely, non-inflammatory causes and inflammatory causes. Non-inflammatory causes include trauma, degenerative, autoimmune, genetic, and metabolic. The causes of inflammation areas in seronegative spondyloarthropathy.
Treatment of Systemic Lupus Erythematosus with Anti SSA and SSB Positive Pregnancies Robby Satria Putra; Najirman
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 6 No. 3 (2022): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v6i3.470

Abstract

Systemic lupus erythematosus (SLE) is autoimmune disease that results in inflammation in various organ systems, frequent recurrences in the clinical course characterized by the production of antibodies against core antigens. Pregnancy will trigger flares. Increased intravascular volume in pregnancy can worsen abnormal heart and kidney function. Increasing the glomerular filtration rate by 50% exacerbated previously stable proteinuria. Pregnancy-induced hypercoagulability increases the risk of thrombosis. Anti-Ro/SSA was found in 35% of SLE patients and anti-La / SSB was found in 15% of SLE patients. The presence of Ro and La antibodies puts the fetus at a risk of developing neonatal lupus erythematosus (NLE) 6-13% and can reach up to 25% if the mother has previously given birth to a child with NLE. Neonatal lupus erythematosus including congenital heart block or cutaneous lupus. Congenital heart block (CHB) is a very serious complication. The American College of Rheumatology (ACR) recommends serial fetal echocardiography from 16 weeks of gestation continuing through to 26 weeks. Pregnancies with grade I and II CHB are treated with oral dexamethasone 4 mg daily because fluorinated glucocorticoids such as dexamethasone and betamethasone can cross the placenta, however, this therapy cannot be given in third-degree heart block. Early diagnosis and therapy will reduce the risk of congenital heart block in neonates after birth.
Indonesian Rheumatology Association (IRA) Recommendations for Diagnosis and Management of Osteoarthritis (Knee, Hand, Hip) Rakhma Yanti Helmi; Najirman; Ida Ayu Ratih Wulansari Manuaba; Andri Reza Rahmadi; Pande Ketut Kurniari; Malikul Chair; Ika Vemilia Warlisti; Eka Kurniawan; Harry Isbagio; Handono Kalim; Rudy Hidayat; Laniyati Hamijoyo; Cesarius Singgih Wahono; Sumariyono
Indonesian Journal of Rheumatology Vol. 15 No. 1 (2023): Indonesian Journal of Rheumatology
Publisher : Indonesian Rheumatology Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/ijr.v15i1.225

Abstract

Background: Osteoarthritis (OA) is the most common form arthritis in the world, and its prevalence is predicted to rise higher in the future due to increasing life expectancy and growing number of elderly population. With the emergence of new treatment options in the last several years, a better understanding of OA diagnosis and management is required by every physician in Indonesia. Methods: A panel of eight selected rheumatologists from the Indonesian Rheumatologist Association (IRA) developed recommendations based on key questions formulated by a steering committee from IRA. These recommendation materials were taken from several online databases such as PubMed, Science Direct, and Google Scholar. Level of evidence and grades of recommendation were then assigned, and each member of the panelist team will assign a score to express their level of agreement. Results: A total of 25 recommendations discussing the diagnosis, pharmacological and non-pharmacological therapies, as well as monitoring for OA were formulated. Conclusion: These recommendations can be used to help clinicians in accurately diagnosing OA and choosing the most suitable therapy for their patients. All recommendation statements were tailored to the clinical setting, facility, and drug availability in Indonesia.
Co-Authors Afriwardi Afriwardi Ali Ardanny Andri Reza Rahmadi Andry Kurniawan Dendi Andrean Dinda Aprillia Eka Kurniawan Endang Mutiwara Fajriansyah Fajriansyah Fauzar Fauzar Hafiziani Handono Kalim Harry Isbagio Hasbi Abdul Rozak Ida Ayu Ratih Wulansari Manuaba Ika Vemilia Warlisti Laniyati Hamijoyo Malikul Chair Marhamah Hasnul Pande Ketut Kurniari Rakhma Yanti Helmi Rika Florensia Rikarni Rikarni Robby Satria Putra Rudy Hidayat Saptino Miro Sumariyono Wahono, Cesarius Singgih Yanwirasti Yanwirasti Zelly Dia Rofinda