Rudi Putranto
Departemen Ilmu Penyakit Dalam, Fakultas Kedokteran Universitas Indonesia/RS Dr. Cipto Mangunkusumo, Jakarta

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SERO SURVEI DAN ANALISA PENGETAHUAN SIKAP PENJAMAH UNGGAS TERHADAP PENYAKIT FLU BURUNG DI INDONESIA TAHUN 2008 Pracoyo, Noer Endah; Riajuni, Luxi; Sukarso, Triyani; Subangkit, Bambang; Putranto, Rudi Hendro
Media Penelitian dan Pengembangan Kesehatan Vol 22, No 4 Des (2012)
Publisher : Badan Penelitian dan Pengembangan Kesehatan

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Abstract

Abstract The bird flu in Indonesia actually is Avian Influenza Virus H5N1 type. Is known bird flu virus in Humans occur if direct contact with infected poultry or through contact with environmental enclosure, and the carcasses of infected poultry products. The absence of the data if the handlers of poultry in the cases of bird flu virus has been exposed to the research conducted sero survey of bird flu antibody titers in handlers poultry  attitudes and knowledge of poultry against bird flu incident. The research objective measure antibodies against respondents tirer AI H5N1 virus, assess knowledge and attitudes against bird flu handlers through the interview. The study design was cross sectional. Handlers of poultry population in the region is ever going Extraordinary Cases of bird flu. Samples were responders/poultry handlers venous blood taken for H5N1 antibody titer by Ellisa, H5N1 conducted interviews using a questionnaire. The study used the respondents informed consent agreement. Research time in February to November 2007 in the island of Java. The number of samples of 80 samples of respondents. The results obtained are not found of H5N1 avian influenza antibody titer in responders. The results of the interview most of the handlers to wash Their hands after doing Their job (82.1%). A total of 52.9% residential handlers is more than a mile from where the management of poultry, (69%) lived outside market handlers/Abattoir of poultry.Handler to act entered correctly (53.3%%) and almost all handlers (97%) would bring the patient/patient ill with signs of bird flu infection to health facilities. Keywords: poultry handlers, bird flu virus, knowledge and attitudes of poultry handlers Abstrak Yang dimaksud Flu burung di Indonesia sebetulnya adalah Virus Avian Influenza dengan tipe H5N1. Selama ini diketahui penularan virus flu burung pada manusia terjadi jika kontak langsung dengan unggas yang terinfeksi atau melalui kontak dengan lingkungan kandang, karkas dan hasil produk unggas yang terinfeksi. Belum adanya data apakah penjamah unggas di daerah kasus sudah terpapar virus flu burung maka dilakukan penelitian sero survei titer antibodi flu burung dan pengetahuan sikap pada pejamah unggas terhadap kejadian flu burung. Tujuan penelitian mengukur tirer anti bodi responden terhadap virus AI H5N1, menilai pengetahuan dan sikap penjamah terhadap penyakit flu burung melalui wawancara. Desain penelitian adalah cross sectional. Populasi adalah penjamah unggas di daerah yang pernah terjadi Kasus Luar Biasa flu burung. Sampel adalah responden/penjamah unggas yang diambil darah vena untuk mendapatkan titer antibodi H5N1 dengan cara Ellisa, 5N1H5 juga dilakukan wawancara dengan menggunakan kuesioner. Penelitian menggunakan persetujuan inform consent pada responden. Waktu penelitian pada bulan Febuari sampai Nopember 2007 di daerah Pulau Jawa. Jumlah sampel sebanyak 80 sampel responden. Hasil yang diperoleh tidak ditemukan titer antibodi Avian Influenza H5N1 pada responden. Hasil wawancara sebagian besar penjamah melakukan cuci tangan setelah melakukan pekerjaannya (82,1%). Sebanyak 52,9 % tempat tinggal penjamah berjarak lebih dari satu km dari tempat pengelolaan unggas, (69%) penjamah tinggal diluar pasar/tempat pemotongan unggas.Hampir semua penjamah melakukan tindakan dengan benar (53,3%) dan hampir semua penjamah (97%) akan membawa pasien/penderita sakit dengan tanda terinfeksi flu burung ke sarana kesehatan.   Kata kunci : penjamah unggas, virus flu burung, Pengetahuan dan sikap penjamah unggas.
Penerapan Diagnostik Laboratorium pada Kasus Tersangka Positif Difteri pada Kejadian Luar Biasa di Kota Pontianak, Kalimantan Barat Sariadji, Kambang; -, Sunarno; Putranto, Rudi Hendro
Jurnal Biotek Medisiana Indonesia Vol 3, No 1 (2014)
Publisher : Central Basic Biomedical and Health Technology

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Abstract

Based on national health research 2010, the coverage of basic immunization on West Kalimantan were 52,1%. It’s causes concern of outbreaks some immunizable prevented diseases in West Kalimantan . One of them is diphtheria. It was reported incidence of diphtheria suspect in Dalam Bugis, Pontianak Timur, Kota Pontianak, West Kalimantan in April 2013. A suspect of 12 years old girl was reported with a clinical diagnosis of diphtheria. Confirmation of positive suspect of diphtheria outbreaks occurred in West Kalimantan. A suspected case of diphtheriae and her mother were taken throat swabs on April 4, 2013, then she was retaken throat swabs and also 29 of her classmate as a contacts of case on April 24th 2013. Microscopic examination by staining Albert. Culture and isolation using blood agar and blood agar telurit. Suspect colonies are followed by biochemical tests using the API Coryne commercial product. Toxigenic test performed by polymerase chain reaction. A suspected case throat swab was taken on 4 April 2013 shows a microscopic results found difteroid form. Then the results of culture, isolation and biochemical have possibility > 89.5% of bacteria Corynebacterium diphtheriae type mitis. Toxigenic test showed that positif toxigenic bacteria which characterized by amplification gene tox (dtx) along 248 bp. Meanwhile her mother is a negative culture results C.diphtheriae. On 24th April 2013 the suspected case was re-taken of throat swab including 29 contacts from her classmate which showing negative culture result of C.diphtheriae. The suspected case was infected of C.diphtheriae type mitis toxigenic. It’s cases makes an outbreak in West Kalimantan.Key words : Corynebacterium diphtheriae, Culture and isolation, Biochemical test AbstrakRendahnya cakupan imunisasi dasar di Provinsi Kalimantan Barat menyebabkan kekhawatiran timbulnya penyakit yang dapat dicegah dengan imunisasi (PD3I) salah satunya adalah difteri. Kejadian difteri yang dilaporkan ini terjadi di Kelurahan Dalam Bugis, Kecamatan Pontianak Timur, Kota Pontianak, Provinsi Kalimantan Barat pada bulan April 2013. dilaporkan adanya kasus suspek dengan diagnosis klinis difteri pada anak perempuan usia 12 tahun. Mengidentifikasi suspek positif kasus kejadian luar biasa difteri yang terjadi di Kalimantan Barat. Suspek dan ibu suspek diambil swab tenggorok tanggal 4 April 2013, kemudian suspek diambil swab tenggorok lagi beserta 29 kontak teman sekolahnya pada tanggal 24 April 2013. dilakukan pemeriksaan secara mikroskopik dengan pewarnaan Albert. Kultur dan isolasi menggunakan medium agar darah dan telurit agar darah. Koloni tersangka dilanjutkan dengan uji biokimia menggunakan produk komersial API Coryne . Uji toksigenitas dilakukan dengan polymerase chain reaction Suspek yang diambil swab tenggorok pada tanggal 4 April 2013 menunjukkan hasil mikroskopis ditemukan bentuk difteroid. Hasil kultur, isolasi dan uji biokimia menunjukan possibility > 89,5 % bakteri Corynebacterium diphtheriae tipe mitis. Uji toksigenitas menunjukkan bakteri tersebut toksigenik yang ditandai dengan terbentuk produk amplifikasi dari gen dtx (tox) sepanjang 248 pb. Sementara hasil kultur Ibu suspek negatif C.diphtheriae. Pada pengambilan swab tenggorok tanggal 24 April 2013 terhadap suspek yang sama dan 29 kontak dari teman kontak menunjukkan hasil kultur negatif C.diphtheriae. Suspek terinfeksi C.diphtheriae tipe mitis toksigenik yang menjadikan Kasus tersebut menjadi kasus Kejadian Luar Biasa di provinsi Kalimantan Barat.Kata Kunci : Corynebacterium diphtheriae, Kultur dan isolasi, Uji biokimia
Uji Diagnostik Cepat Sebagai Metode Alternatif Diagnosis Kholera yang Disebabkan oleh Agen Vibrio Cholera Sariadji, Kambang; -, Sunarno; Putranto, Rudi Hendro
Jurnal Biotek Medisiana Indonesia Vol 4, No 1 (2015)
Publisher : Central Basic Biomedical and Health Technology

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Cholera is one of health problems in Indonesia. The high fatality rate is caused by the enterotoxin. The symptoms are dehydration, electrolyte loss and increased blood acidity, so that in severe case can cause death. Diarrheal disease cholera can lead to an out break. Conventional techniques such as culture, isolation and identification are the gold standard to diagnose V.cholerae, but required considerable time and adequate equipment. thus rapid diagnostic test plays an important role to detect V.cholerae.. The use of rapid diagnostic test can be need as the initial examination, so that preventive actions can be conducted . Rapid diagnostic tests are performed by various methods such can be used directly in the field and the results can be identified quickly, so it can replace the conventional techniques. The advantages of rapid test are quick, easy, inexpensive, practice ; thus it can be used in the field. Rapid test has a sensitivity of 94-100% and a specificity of 84-100% when compared with the conventional technique.Key words : Vibrio cholerae, Diarhoeae, Rapid diagnostic test AbstrakKholera merupakan penyakit yang masih menjadi masalah kesehatan di Indonesia. Penyebabnya adalah enterotoksin yang dihasilkan oleh bakteri Vibrio cholerae . Gejala yang ditimbulkannya menyebabkan dehidrasi, kehilangan elektrolit dan meningkatnya keasaman darah, sehingga pada kasus yang berat dapat menimbulkan kematian. Penyakit diare kholera ini dapat menimbulkan kejadian luar biasa (out break) dan menyebar ke daerah sekitarnya. Mengingat standar baku diagnosis bakteri V.cholerae dengan menggunakan tehnik konvensional (kultur, isolasi dan identifikasi) memerlukan waktu yang cukup lama dan peralatan yang memadai, maka penggunaan rapid test diagnostik untuk deteksi bakteri V.cholerae sangat berperan pada kasus kejadian luar biasa kholera. Penggunaan rapid diagnostik test ini dapat menjadi pemeriksaan awal di lapangan, sehingga tindakan yang bersifat preventif dapat segera dilakukan. Uji diagnostik cepat yang dilakukan dengan berbagai metode dapat dipakai langsung di lapangan dan hasilnya dapat diketahui dengan cepat , sehingga dapat menjadi tehnik awal pengganti teknik konvensional. Kelebihan dari uji cepat ini adalah cepat, mudah, murah dan dapat dilakukan di tempat. Uji cepat t ini mempunyai sensitifitas antara 94 – 100 % dan spesifitasnya antara 84 – 100 % jika dibandingkan dengan teknik yang dilakukan secara konvensional .Kata kunci : Vibrio cholerae, Diare, Uji diagnostik Cepat
Epidemiologi Kasus Difteri di Kabupaten Lebak Provinsi Banten Tahun 2014 Kambang, Sariadji; Sunarno, nFN; Pracoyo, Noer Endah; Putranto, Rudi Hendro; Abdurrahman, nFN
Media Penelitian dan Pengembangan Kesehatan Vol 26, No 1 Mar (2016)
Publisher : Badan Penelitian dan Pengembangan Kesehatan

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AbstrakInfeksi difteri disebabkan oleh bakteri Corynebacterium diphtheriae dan hampir terdapat di seluruhdunia dalam bentuk wabah. Penyakit ini terutama menyerang anak umur 1-12 tahun, mudah menulardan menyebar melalui kontak langsung. Upaya pencegahan penyakit difteri dilakukan dengan caramelakukan program imunisasi. Data Riskesdas tahun 2013 menunjukkan cakupan imunisasi dasarlengkap untuk Provinsi Banten adalah 59,2%. Cakupan imunisasi yang rendah ini akan berdampakpada keadaan wabah, salah satunya difteri, seperti yang terjadi di Kampung Kumpay, Desa Maraya,Kecamatan Sajira, Kabupaten Lebak Provinsi Banten, dilaporkan adanya laporan kematian karenapenyakit difteri sejak April 2014. Penelitian ini bertujuan untuk mendapatkan gambaran epidemiologi danpenyebaran penyakit difteri yang menimbulkan wabah. Ada 23 sampel swab tenggorok yang dilakukanpemeriksaan laboratorium berupa kultur, mikroskopis dan Polymerase Chain Reaction (PCR). Datapenyelidikan epidemiologi dilakukan dengan wawancara terhadap tersangka dan kontak serta orangtuanya. Hasil dari 23 sampel swab tenggorok menunjukkan satu kontak positif C.diphtheriae gravistoksigenik, sementara hasil penyelidikan epidemiologi menunjukkan ada 4 kasus dengan diagnosisklinis difteri, dua diantaranya meninggal. Data cakupan imunisasi di daerah tersebut memenuhi target,sementara tingkat pendidikan orang tua rendah yakni ayah 60,3% dan ibu 90%, sebanyak 48% anaktidak diimunisasi serta kepadatan hunian rumah yang tinggi yakni 58,7%. Kesimpulan menunjukkanadanya penyebaran penyakit difteri di Kampung Kumpay, Desa Maraya, Kecamatan Sajira, KabupatenLebak, Provinsi Banten.Kata Kunci: Corynebacterium diphtheriae, epidemiologi, imunisasi AbstractDiphtheria infections caused by the Corynebacterium diphtheriae and could be outbreak in all countries.Particulary, this disease attacks the children aged 1-12 years old, contagious and spreads through directcontact. The preventing of diphtheria has been done by immunization programs. Based on national healthresearch (Riskesdas) in 2013 Banten province showed the coverage of complete basic immunizationwas 59.2%. The coverage of low immunizations would cause an outbreak, one of them is a diphtheria,such as happened in Kumpay-Maraya village, sub-district Sajira, Lebak regency of Banten provincereported the deaths of children due to diphtheria since April 2014. This study aims to know and overviewof epidemiology and spread of diphtheria disease that caused an aoutbreak. There were 23 samples ofthroat swab tested in laboratory such as culture, microscopic and Polymerase Chain Reaction (PCR).Epidemiological data was conducted by interviewing of suspects, contacts and their parents. The resultsfrom the 23 samples showed a positive contact of C.diphtheriae type toxigenic gravis, while the resultsof epidemiological investigations showed there were 4 cases with a clinical diagnosis of diphtheria, twoof them died. The immunization coverage of this region meet the target, meanwhile the educational levelof parents respondents are relatively low which 60,3% for father and 90% for mother. There were 48%children were not immunized and 58,7% respondents living in high density of residents. The conclusionwas that there were spreading in Kumpay-Maraya village, Sajira sub-districts, Lebak regency of Bantenprovince.Keywords: Corynebacterium diphtheriae, epidemiology, immunization
Value of Heart Rate Variability, Neutrophil-Lymphocyte Ratio and Quality of Life of Patients with Depressive Symptoms in Acute Myocardial Infarction Shatri, Hamzah; Adli, Mizanul; Muhadi, Muhadi; Abdullah, Murdani; Irawan, Cosphiadi; Putranto, Rudi; Koesnoe, Sukamto; Wijaya, Ika Prasetya
Jurnal Penyakit Dalam Indonesia Vol. 9, No. 4
Publisher : UI Scholars Hub

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Introduction. Major depression criteria can be found in more than 20% of coronary heart patients and more than 30% acute coronary syndrome patients have significant depressive symptoms. Several studies have shown that reduction of hearth rate variability (HRV) and enhancement of neutrophil lymphocyte ratio (NLR) can cause enhancement of morbidity and mortality in myocardial infarction patients. On the other hand, depression can cause reduction of HRV, enhancement of NLR and reduction of quality of life. This study aimed to determine differences in HRV, NLR and quality of life between acute myocardial infarction (AMI) patients with depressive symptoms and AMI patients without depressive symptoms. Methods. A cross-sectional study was conducted among AMI patients who were treated during the period of March to July 2021 at the Intensive Cardiac Care Unit (ICCU) Cipto Mangunkusumo Hospital Jakarta. Samples were taken consecutively until the amount of sample is met. Data were analyzed using unp aired T test. Results. There was a total of 46 subjects AMI patients in this study, ten subjects with depressive symptoms and 36 subjects without depressive symptoms. From the analysis, it was found that AMI patients with depressive symptoms had lower standard deviation normal to normal (SDNN) average (p=0.447), lower low frequency/high frequency (LF/HF) (p=0.323), and higher NLR average (p=0.438) than AMI patients without depressive symptom, although it was not statistically significant. Analysis showed that the mean value of SF36 total scores (p<0.001), physical function domain scores (p<0.001), energy domain scores (p<0.001), mental health domain scores (p<0.001), social function domain scores (p=0.028), bodily pain domain scores (p=0.002), and general health domain scores (p=0.002) were lower in AMI patients with depressive symptoms. Conclusion. AMI patients with depressive symptoms had lower SDNN, lower LF/HF, and higher NLR than AMI patients without depressive symptoms, although it was not statistically significant. AMI patients with depressive symptoms significantly have lower quality of life than AMI patients without depressive symptoms.
Effect of Advance Care Planning on Heart Failure Patients: An Evidence Based Case Report Shatri, Hamzah; Nurfitria, Nandika; Sinulingga, Dika; Irvianita, Vinandia; Faisal, Edward; Putranto, Rudi; Martina, Diah
Jurnal Penyakit Dalam Indonesia Vol. 9, No. 4
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Despite the advances in medical therapy, heart failure remains a disease that requires attention due to the course of the illness; it can lead to unpredictable, progressive, and fatal conditions. Existing therapy aims to improve the condition and prevent disease progression, with a balanced secondary therapy for various conditions that can trigger acute decompensated heart failure. Advances in technology and therapy may increase the prevalence of patients with heart failure, including prolonging the refractory phase of the disease. There are recommendations for advance care planning to support patient therapy and improve the quality of life of patients with heart failure. This evidence-based case report aims to investigate the benefits of advance care planning in heart failure patients. A heart failure patient is referred to the palliative care team for advance care planning. Literature searches were conducted on ProQuest, PubMed, Scopus, and Cochrane according to the clinical questions. The studies were selected based on the inclusion and exclusion criteria, then a critical review was conducted. One study showed significant results regarding the effectiveness of advance care planning on the quality of life of heart failure patients. Another study showed a significant improvement in depression among patients engaged in advance care planning. However, it showed no difference in the quality of life compared to usual care because the sample size was relatively small, and the quality of evidence was low. Therefore, it can be concluded that advance care planning can improve heart failure patients’ psychological symptoms and quality of life.
Advanced Directives in Palliative Care Shatri, Hamzah; Faisal, Edward; Putranto, Rudi; Sampurna, Budi
Jurnal Penyakit Dalam Indonesia Vol. 7, No. 2
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Initially palliative care is emphasized at the end of life, but the right thing is to begin identifying palliative care needs when the disease is diagnosed. Palliative care is the treatment needed to improve the quality of life of patients and their families that suffering from life threatening and progressive disease such as cancer, non-cancer diseases, and HIV/AIDS (human immunodeficiency virus/acquired immunodeficiency syndrome). Palliative care decision must be in place from the beginning of treatment, so the patient’s preferences are met. The goals of this care are to reduce physical, social, psychological, and spiritual suffers. Further treatment plan is based on discussion between patient, family, and health care worker. The final result is identification and decision that can be written in advanced directives.
The Correlation of Depression Level with Tumor Necrosis FactorAlpha (TNF-α) Concentration in Uncontrolled Bronchial AsthmaPatients Apriansyah, Muhammad Ali; Putranto, Rudi; Salim, Eddy Mart; Shatri, Hamzah
Jurnal Penyakit Dalam Indonesia Vol. 3, No. 2
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Introduction. Depression occurs at high rates in people with chronic diseases, including bronchial asthma, with the prevalence of depression approaches 50% in tertiary care asthma clinic. Tumor necrosis factor alpha (TNF-α) is known to play a critical role in the pathogenic mechanism of a number of chronic inflammatory disease, including bronchial asthma and depression. There has not been any research data on the subject in Indonesia. The objective of this study was to investigate the correlation between depressive level and TNF-α level in uncontrolled bronchial asthma. Methods. This was a cross sectional study conducted in 40 patients with uncontrolled bronchial asthma at the allergy immunology clinic outpatient of Dr Moh Hoesin Hospital Palembang, during June 2014 until August 2014. Uncontrolled bronchial asthma was assessed using the Asthma Control Test (ACT) questionnaire, whereas depressive symptoms were assessed by Beck Depression Inventory (BDI) questionnaire, and diagnosis was confirmed by the criteria of the Diagnostic and Statistical Manual for Psychiatry-IV Text Revision (DSM-IV TR) / International Code Diagnose 10 (ICD-10). Serum levels of TNF-α was measured by the method of quantitative enzyme-linked immunosorbent assay (ELISA). Results. The median value of the level of depression and serum TNF- α in this study were 16 (10 - 45) and 4.09 (1.29 - 19.57) pg/mL. There was no significant correlation between depressive level and TNF-α level ( r = -0.265 , p = 0.098 ). Conclusions. There was no significant correlation between depressive level and TNF-α level in uncontrolled bronchial asthma
Depression in Heart Failure: Psychosomatic Approachv Putranto, Rudi; Shatri, Hamzah; Wijaya, Ika Prasetya; Faisal, Edward
Jurnal Penyakit Dalam Indonesia Vol. 8, No. 3
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Depression is a common condition in heart failure (HF) and is considered a risk factor for cardiovascular disease. Depression disorder in patients with heart disease paradigmatically defines a psychosomatic-somatopsychic challenge to any health delivery. However, despite the devastating effects of depression, it is often underdiagnosed and receives little attention in heart failure patients. This review provides an extensive overview of HF regarding epidemiology, disease pathophysiology, diagnosis, and management from the latest literature. Based on the literature review, the prevalence of depression in heart failure in Indonesian patients was 5.3-42%. Psychological stress experienced by people suffering from depression can cause dysregulation in the sympathetic nervous system and hypothalamic–pituitary–adrenal (HPA) axis. This mechanism, in turn, has some deleterious downstream effects, including the development of hypertension, left ventricular hypertrophy, coronary vasoconstriction, endothelial dysfunction, platelet activation, and the production of pro-inflammatory cytokines. The Diagnostic and Statistical Manual of Mental Disorders-5 (DSM-5), published by the American Psychiatric Association, is used to diagnose depression in patients with HF. Meanwhile, the Patient Health Questionnaire (PHQ)-2 and PHQ-9 are commonly used as screening tools for depression in patients with HF. The Biopsychosocial-spiritual model as a psychosomatic approach have might reduce or prevent depression and thus improve quality of life and other outcomes. Evidence reveals that both psychotherapeutic treatment (e.g., cognitivebehavioral therapy) and pharmacologic treatment (e.g., use of the selective serotonin reuptake inhibitor sertraline) are safe and effective in managing depression in patients with cardiovascular disease. In conclusion, the review of articles in this paper shows that there is a high prevalence of depression in heart failure, but it is often not recognized by doctors, there is a relationship between psychosomatic, and heart failure, non-pharmacological interventions such as psychotherapy and pharmacological therapy have benefits. Future research is needed to create evidence-based evaluations and treatment algorithms tailored to the specific needs of the target population.
Reliability and Validity Test Of Indonesian Version Short Form12 Quality of Life Questionnaire in Rheumatoid Arthritis Patient Falah, Nabil Mubtadi; Putranto, Rudi; Setyohadi, Bambang
Jurnal Penyakit Dalam Indonesia Vol. 4, No. 3
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Introduction. Rheumatoid Arthritis is a chronic disease requiring a long-term medication affecting quality of life. Short Form 12 is a generic questionnaire to assess patients quality of life and has been validated in England. This study was designed to test reliability and validity of Indonesian version of SF-12 questionnaire. Methods. Sixty-five patients with clinically diagnosed RA using ACR/EULAR criterion were interviewed using Short Form 36 and Short Form 12 questionnaire. Validity was assessed with construct validity and external validity, while reliability tested with internal consistency and test-retest method. Results. Short-Form 12 (Indonesian Version) did not proved having a good validity, as it have a poor correlation between RE and MH domain in SF-36 and SF-12. Indonesian version of SF-12 shown a poor internal consistency (Cronbach Alpha: 0.561- 0.754) but a good test and retest reliability ( intraclass correlation coefficient: 0.844-0.980, p <0,05) Conclusions. Indonesian version SF-12 is not reliable nor valid to evaluate quality of life in RA patients.