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All Journal Indonesian Journal of Rheumatology The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy
Bantar Suntoko
Staf pengajar bagian Ilmu Penyakit Dalam, Fakultas Kedokteran Universitas
Health Professions Medicine & Pharmacology

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Correlation between osteoarthritis grading in femoropatella joint and patella malalignment with pain and disability using WOMAC score Kiswati, S; Suntoko, Bantar; Sukmaningtyas, H
Indonesian Journal of Rheumatology Vol 8, No 1 (2016)
Publisher : Indonesian Rheumatology Association

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Abstract

Background: Osteoarthritis (OA) in femoropatella often causes pain and disabilities in the lower extremities. In 2011 found a significance association between knee pain with osteophytes in femoropatella joints compared with osteophytes in femorotibia joints. Niu J et al. found knee joint with lateral patellar malalignment and lateral patellar tilt had increased prevalence of femoropatella OA, similar study in Caucasian and African Americans patients found an association between patellar malalignment with severe knee pain and diseaseprogressivity. In this study, researchers correlate grading OA genu with pain and disability using WOMAC scores and malalignment correlate with pain and disability with WOMAC scores without assessing the progression of the disease. In this study, using cross-sectional at one time whereas previous studies using multi-center cohort were evaluated 3 to 5 years later to assess the progression of the disease. Objective of this study is to establish a correlation between OA grading in femoropatella joint and patellar malalignmentwith pain and disability using WOMAC Score.Method: Observational analytic study with crosssectional and consecutive sampling was performed in this study. In the WOMAC correlation with KellgrenLawrence grading on the WOMAC OA genu and grading narrowing between joints using the Rank Spearmanwhile the different test WOMAC with malalignment using T test Results: WOMAC OA genu of the grading (AP/LAT/Skyline) r = 0.488; p = 0.003, WOMAC OA genu of the grading (AP/LAT) r = 0.452 ; p = 0.006, WOMAC OA genu of the grading (AP/Skyline) r = 0.362 ; p = 0.033, WOMAC towards narrowing between joints gradingfemoropatella r = 0.370 ; p = 0.026, no differences between patellar malalignment with WOMAC score, with malalignment (p = 0.711) without malalignment(p = 0.751).Conclusion: In AP/LAT/Skyline, AP/LAT, AP/Skyline position and grading narrowing femoropatella joint space was found a significant positive correlation between OA knee’s grading and WOMAC score. No differences in T test between patella malalignment with pain and disability using WOMAC score.Keywords: femoropatella osteoarthritis, patellar malalignment, WOMAC score.
Correlations between osteoartritis grading in femorotibial joint (kellgren lawrence) with cartilage defects grading Permatasari, Yuliati; Zulqarnain, Nasirun; Sukmaningtyas, Hermina; Suntoko, Bantar
Indonesian Journal of Rheumatology Vol 8, No 2 (2016)
Publisher : Indonesian Rheumatology Association

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Background : Osteoarthritis (OA) is the most common chronic rheumatic diseases that causing pain and disability. The imaging of knee OA were found in 15,5%  men and 12,7% women of Indonesia population. Radiography is still used as a standard modalities in assesing OA progression, and Kellgren-Lawrence scale (KL) is the most common measurement used byclinicians. Superficial cartilage degradation is the first sign of OA, the early detection of the superficial cartilage degradation is very important for diagnosis. Our study was established to assess the correlation between OA grading in femorotibial joint examined by standard Kellgren-Lawrence scale (KL) measurement with cartilage defects examined by ultrasound.Methods : Observational analytic study with cross sectional and consecutive sampling was performed. Rank Spearman test for correlation of OA grading, cartilage defect, BMI and joint malalignment. McNemar test for correspondence between the location of the narrowing of the femorotibial joint and location of cartilage defects.Result : Correlation of OA grading of femorotibial joints (KL) with cartilage defects grading on ultrasound resulted r =0.459, p<0.05; correlation of OA grading of femorotibial joints (KL) with BMI or joint malalignment resulted p>0,05; correlation of cartilage defect grading with BMI or joint malalignment also resulted p>0.05. McNemar test for location of the narrowing of thefemorotibial joint with location of cartilage defects on ultrasound resulted p = 1.00, k = 0.714. There was a significant positive correlation of OA grading of femorotibial joints (KL) with cartilage defects grading on ultrasound. There was no significant correlation between OA grading of femorotibial joints (KL) with BMI and joint malignment, and no significant correlationbetween cartilage defects grading with BMI and joint malalignment. There is a correspondence between the location of the narrowing of the femorotibial joint with location of cartilage defects on ultrasound.Conclusion: For assesing the grade of osteoartritis, cartilage defect grading and assesment by ultrasound can be used as an alternative to X-Ray KellgrenLawrence scale (KL) measurement.Keywords : femorotibial joint, cartilage defects grading, osteoartritis grading examination, BMI, joint malalignment.
Hyperuricemia and Pro Inflammatory Cytokine (IL-1β, IL-6, and TNF-α) Hadi, Suyanto; Sudarsono, D; Suntoko, Bantar
Indonesian Journal of Rheumatology Vol 2, No 1 (2010)
Publisher : Indonesian Rheumatology Association

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Background. Rugerio et al 2006 reported that there were a positive correlation between the level of hyperuricemia and the level of IL-1β, IL-6, and TNF-α pro infl ammatory cytokines value. On the other hand, Choi et al reported a negative correlation between hyperuricemia and the level of pro infl ammatory cytokine in the late phase of hyperuricemia.Methods. Venous blood samples were collected and stored at a temperature of - 80oC from in- and outpatients with hyperuricemia with age of more than 17years old at Dr. Kariadi Hospital, Semarang. The level of uric acids (mg/dl) were examined with enzymatic colorimetric technique (Roche Diagnostics) whereasthe levels of IL-1β, IL-6, and TNF-α pro infl ammatory cytokines (pg/ml) were examined with enzyme linked immunosorbent assay (ELISA) technique using ultrasensitive commercial kit (Human ultra sensitive, Biosource International Inc Europe), and ELX 800, 2002 machine. The normality of the data was tested withOne-Sample Kolmogorov-Smirnov technique and the correlation was tested with Spearman correlation (data with abnormal distribution) or Pearson correlation (datawith normal distribution).Results. There was a weak positive correlation between the level of hyperuricemia and the level of IL-1 β cytokine in Spearman correlation test with r value = 0.246 and p value > 0.05 in Spearman correlation test. On the other hand, there was a weak negative correlation between the level of hyperuricemia and the level of TNF-α cytokine with r value = - 0.096 and p value > 0.05. There was also weak negative correlation between the level of hyperuricemia and the level of IL-6 cytokine with r value = - 0.072 and p value > 0.05 in Pearson correlation test.Conclusion. There was a weak positive correlation but not sifnificant between the level of hyperuricemia and the level of IL-1β.
The Efficacy of Low Dose Captopril Adjuvant for Natriuresis in Patient with Liver Cirrhosis with Ascites Who Have Received Furosemide and Spironolacton Suyatmi, Suyatmi; Suntoko, Bantar; Sumanto, F.; Hirlan, Hirlan
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 2, NUMBER 3, December 2001
Publisher : The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (0.036 KB) | DOI: 10.24871/2320011-5

Abstract

Background: The ideal therapy for ascites in liver cirrhosis is a low sodium diet and a combination of furosemide and spironolacton. However, this still sometimes does not produce satisfactory Results, even after increasing the dose of the diuretic. Such failure occurs due to the influence of the Renin Angiotensin Aldosterone (RAA) system. Low doses of ACE inhibitors (captopril) should improve renal blood flow and increase filtration at the glomeruli, thus increasing natriuresis without causing haemodynamic imbalance. Study aim: To discover the natriuretic and diuretic effects of low dose captopril adjuvant in patients with liver cirrhosis who have received furosemide and spironolacton by measuring urinary sodium and 24-hour urine output. Materials and method: This study was conducted on in- and out- patients with liver cirrhosis and Ascites at the Dr. Kariadi Central Public Hospital, Semarang, who met the inclusion and exclusion criteria. The study took place from June 1st, 1997 to March 31st, 1998, and included 40 cases of liver cirrhosis with ascites. Study design: Open comparative randomized clinical trial with permuted blocks. All of the patients received a low fat diet, 40 mg of furosemide, 3x50 mg of spironolacton for 2 weeks, and patients with a urinary sodium level was below 80 mEq/L were randomized into two groups: group A receiving 3 x 6.25 mg of captopril, and group B receiving standard therapy.  Results:  Variable            Pre- treatment       Post – treatment      p  Group A : Urinary sodium level (meq/L)   65.450 ± 16.577       109.950 ± 49.109     0.001 24-hour urine output (cc)     1138.750 ± 480.438     1381.250 ± 394.441    0.004 Group B: Urinary sodium level (meq/L)  68.30 ± 12.85         91.750 ± 64.04      0.103 24-hour urine output (cc)       1390 ± 448.27        1392.50 ± 713.46     0.988   The pre- and post- treatment Results for Group A were significantly different. The pre- and post- treatment Results for Group B were not significantly different. Conclusion: Low dose (3 x 6.25 mg) captopril adjuvant in patients with liver cirrhosis and ascites who have received standard doses of furosemide and spironolacton could increase natriuresis and diuresis without causing haemodynamic imbalance.    Key words: Captopril, liver cirrhosis, ascites
Co-Authors F. Sumanto Hermina Sukmaningtyas Hirlan Hirlan Kiswati, S Permatasari, Yuliati Sudarsono, D Sukmaningtyas, H Suyanto Hadi Suyatmi Suyatmi Zulqarnain, Nasirun