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"Often considered the prototypic autoimmune disease, Lupus is characterized by protean manifestations and affects a wide range of organ systems. Despite widespread availability of anti nuclear antibody testing and other technological diagnostic advances, the diagnosis of lupus can be elusive, difficult, and inexact. Treatment of the disease can also be challenging. Advances in immunology and biotechnology have led to a burgeoning world of new therapies in development that offer patients the real possibility of new therapies and physicians and scientists novel insights into the pathogenesis of this complicated immunological disease. Lupus erythematosus : clinical evaluation and treatment summarizes the clinical aspects of lupus facing the general clinician in the 21st century. In this invaluable, practical book, the reader will find introductory chapters regarding general diagnostic and treatment principles, followed by chapters addressing the lupus-specific organ manifestations. Special topics regarding pregnancy and comorbidities are also presented. Written by highly experienced physicians with special expertise in lupus."

"Seorang wanita usia 22 tahun datang dengan keluhan utama timbul bercak kemerahan dan rasa gatal pada wajah sejak 5 hari sebelum masuk rumah sakit. Keluhan lainnya adalah timbul bengkak pada kedua tungkai, nyeri tenggorokan, dan batuk. Pasien sedang dalam pengobatan untuk lupus eritematosus sistemik dan tuberkulosis paru (sejak 12 hari yang lalu). Pada pemeriksaan fisik, pasien kompos mentis, hemodinamik stabil, dengan edema anasarka, lesi multipel makulo purpura yang tersebar pada tubuhnya, konjungtivis pada kedua mata, lesi multipel ulserasi di rongga mulut, dan tampak eritema pada mukosa genitalia. Hasil laboratorium menunjukkan anemia, lekopenia, hipoalbuminemia, proteinuria. Kami mencurigai pasien ini menderita sindrom Stevens Johnson akibat obat antituberkulosis. Selama perawatan, kami menghentikan pemberian obat antituberkulosis, dan memberikan metilprednisolon parenteral, serta terapi suportif lainnya. Pasien diizinkan untuk rawat jalan setelah terjadi perbaikan klinis dan dapat mobilisasi sendiri.

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AbstractA 22-year-old woman was admitted to the hospital because of 5-days history of redness and itch on her face. Additional complains were swelling on her feet, sore throat, and cough. Patient was on treatment for systemic lupus erythematosus and pulmonary tuberculosis (since 12 days). On physical examination, patient was alert, stable hemodynamic, anasarca edema, multiple purpuric macules lesion spread on her body, conjunctivitis of both eyes, multiple oral ulcers, erythema on genital mucosa. Laboratory results were anemia, leucopenia, hypoalbuminemia, proteinuria. We suspected this patient as Stevens Johnson syndrome due to tuberculostatic drugs. During treatment, we stopped the tuberculostatic drugs, and gave her parenteral methylprednisolone, with other supportive treatments. The patient was discharge after improvement of clinical condition and capable of self mobilization."

"Disertasi ini menganalisis hubungan profil Human Leukocyte Antigen DRB1 dan DQB serta polimorfisme alel yang dominan, dengan terjadinya ulser mulut pada pasien Systemic Lupus Erythematosus (SLE), dengan memperhatikan faktor usia, jenis kelamin, ras dan stres. Penelitian dilakukan di Rumah Sakit Kramat 128 Jakarta pada 96 pasien SLE dengan dan tanpa ulser mulut, dengan pengambilan data secara cross sectional. Hasil penelitian menunjukkan dominasi alel DRB1*15:01 dan DQB*05:01 pada SLE dengan ulser mulut. Terdapat hubungan bermakna antara HLA-DRB1*15:01 dengan terjadinya ulser mulut (p<0,05), dan terdapat hubungan bermakna antara stres dengan terjadinya ulser mulut. Kejadian ulser mulut pada pasien SLE dengan HLA-DRB1*15:01 yang mengalami stress meningkat 3,7 kali (OR=3,77). Terdapat kesamaan sequence DNA HLA dengan HLA-DRB1*15:01 pada alel yang sama diantara pasien dengan ulser mulut.

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The present study was design to analize the association of HLA-DRB1, DQB profile, and polymorphisms of dominant alel with oral ulcers SLE. This study included an evaluation association of age, gender, race and stress. A cross sectional of 96 SLE patients with or without oral ulcers followed up at the Kramat 128 Hospital Jakarta. The result shows that the HLA-DRB1*15:01 and DQB*05:01was more frequent in SLE patients with oral ulcers. HLA-DRB1*15:01 was significantly associated with susceptibility to oral ulcers SLE (p<0.05). Stress was also significance association with oral ulcers SLE. Patiens with HLA-DRB1*15:01 and stress, have a higher risk of oral ulcers (OR=3.77). There is similarity sequens DNA HLA with HLA-DRB1*15:01 in the same alel in SLE patients with oral ulcers."

"Deciding which are the best performing wastewater treatment plants can be complicated, as their operations comprise different parameters which are either dependent or non-dependent on each other, and are important when deciding the type of treatment. The relative importance of these parameters in terms of weight indicates the priority assigned by decision-makers to the criteria when ranking the alternatives. These weights are calculated by statistical relativity and Saaty’s nine point scale. The sensitivity of both of these approaches is analyzed. The performance of six municipal wastewater treatment plants is evaluated using the Multi-criteria Decision Making (MCDM) Technique for Order of Preference by Similarity to Ideal Solution (TOPSIS). Efficiency is monitored on the basis of nine wastewater characteristics and compared with the limits established by the Central Pollution Control Board of India. The analysis uses both qualitative and quantitative approaches, which result in differential rankings; accordingly, plants with maximum organic loading removal efficiency were found to be most efficient when weights were applied as per Saaty’s scale. The study proposes a field base approach with regard to the suitability of the weight allocation method for respective utilization of the fuzzy approach in environmental monitoring systems."