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Abstrak :
Latar Belakang : Pada penelitian sebelumnya terdapat korelasi yang positif antara kemampuan deformabilitas, jumlah eritrosit dan shear rate yang rendah yang berakibat terhadap perfusi otak yang akhirnya akan mempengaruhi perburukan pasien stroke iskemik. Hal ini bisa dilihat dengan pemeriksaan Laju Endap Darah (LED). LED merupakan metode yang mudah dan merupakan petunjuk tidak langsumg terhadap deformabilitas eritrosit. Jika ada kondisi yang meningkatkan kadar fibrinogen atau makroglobulin lainnya akan menyebabkan eritrosit mengendap lebih cepat. Dengan melihat konsep ini kami melakukan penelitian untuk mengeksplorasi korelasi antara komponen eritrosit dengan keluaran klinis stroke iskemik. Obyektif : Apakah LED ini mempunyai nilai prognostik klinis. Desain dan Metode: Potong Lintang sesuai kriteria seleksi dan dieksplorasi apakah intensitas respon fase akut terdapat informasi keluaran klinis jangka pendek dengan melakukan uji korelasi antara LED pada pasien dalam 72 jam sejak onset stroke dengan keluaran Minis 7 hari kemudian yang diukur dengan National Institute of Health Stroke Scale (N1HSS). Hasil: 51 pasien stroke iskemik akut ,dalam 72 jam dari onset klinis. semua pasien dilakukan neuroimejing and pemeriksaan darah rutin, tennasuk LED. 28 pasien (54,9%) terdapat peningkatan LED. LED meningkat (Laki-laki >13 dan wanita > 20) sebanding dengan penigkatan NIHSS. Dengan uji korelasi Spearman Koefisien korelasinya moderat (r=0,642) dan berhubungan bermakna (p < 0,001).

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Background: In the recent study, there is a positive correlation among deformability, the amount of erythrocyte and low shear rate which impact to cerebral perfusion. By reducing the cerebral perfusion could increased the infarct size and clinical manifestation worse. The erythrocyte sedimentation rate (ESR) is a simple method and an indirect marker of erythrocyte deformability. If any conditions that increased the amount of fibrinogen and other macroglobulin will increase the ESR. By this concept we did the research to explore the correlation between erythrocyte component and the outcome of ischemic stroke. Objective: To evaluate whether the ESR can be used as a clinical prognostic value. Design and Methods: Consecutive Cross sectional study and explore the intensity of the acute-phase response by the correlation test between the ESR within 72 hour from the onset of stroke and the out come at day 7 measured by National ?Institute of Health Stroke Scale (NIHSS) and whether provided further information concerning the short term out come. Results: 51 acute ischemic stroke, within 72 hours from clinical onset. All patients had neuroimaging and routine blood tests, including erythrocyte sedimentation rate (ESR). 28 patients (54,9%) had increased ESR. The ESR was increased (men >13 and woman > 20) as the NIHSS was high. With Spearman Correlation test the coefficient correlation is moderate (r4,642) and was significant correlated (p < 0,001). Conclusion: The ESR is a predictor of short term stroke outcome. These findings might be indicative the amount of fibrinogen, hyperviscosityand the erythrocyte deformability changes. Key Words : ischemic stroke ; erythrocyte sedimentation rate ; prognosis.

Abstrak :
ABSTRACT
Artritis Reumatoid AR merupakan penyakit inflamasi kronis sistemik yang ditandai dengan pembengkakan dan nyeri sendi, serta kerusakan dari membran sinovial pada persendian. Dalam memonitor penyakit ini, digunakan Disease Activity Score-28 DAS28 yang dapat menunjukkan aktivitas penyakit AR dari waktu ke waktu. DAS28 bermanfaat untuk mengevaluasi pengobatan serta menentukan keputusan klinis lainnya. DAS28 dapat dihitung menggunakan beberapa komponen seperti jumlah sendi yang nyeri, bengkak, nilai Visual Analogue Scale VAS , serta penanda inflamasi berupa nilai Laju Endap Darah LED atau C-Reactive Protein CRP . DAS28-LED dan DAS28-CRP digunakan secara luas dan keduanya ekuivalen. Namun, nilai LED dapat dipengaruhi berbagai faktor lain, seperti kejadian infeksi, yang angkanya cukup tinggi di Indonesia. Oleh karena itu, penelitian ini bertujuan untuk melihat apakah terdapat perbedaan antara nilai DAS28-CRP dengan DAS28-LED di Indonesia. Data ini belum diketahui sebelumnya. Data mengenai jenis kelamin, usia, jumlah sendi nyeri dan bengkak, nilai VAS, LED, dan CRP diperoleh dari 40 rekam medis pasien AR yang berobat di RSCM pada tahun 2015. Dari hasil penelitian, didapatkan bahwa terdapat perbedaan bermakna rerata antara nilai DAS28-CRP dan DAS28-LED sebesar 1,0107.

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ABSTRACT
Rheumatoid Arthritis RA is a systemic chronic inflammation disease marked by swollen and tender joint, also destruction of joint rsquo s synovial membrane. To monitoring this disease, Disease Activity Score 28 DAS28 used to show disease activity of RA in times to times. DAS28 is useful to evaluate disease rsquo s treatment and guide clinician to take a decision for the treatment itself. There are some component needed to count DAS28 score, they are number of tender and swollen joint, Visual Analogue Scale, and inflammatory marker such as Erythrocyte Sedimentation Rate ESR or C Reactive Protein CRP . Either DAS28 ESR or DAS28 CRP are used widely and are said to be equivalent to each other. Otherwise, ESR influenced by many other factors, one of them is infection disease, whose the incident number in Indonesia is relatively high. Therefore, the objective of this stuy is to know the comparison between DAS28 ESR and DAS28 CRP in Indonesia, which is still unknown. Data about gnder, age, number of tender and swollen joint, VAS, ESR, and CRP are obtained from 40 RSCM RA patients rsquo medical record in 2015. From this research known that there are significant mean difference between DAS28 CRP and DAS28 ESR which is 1,0107.

Abstrak :
ABSTRAK
Latar Belakang. Tuberkulosis merupakan salah satu penyakit infeksi yang paling sering ditemukan di negara berkembang. Tuberkulosis dapat menunjukkan berbagai gejala dan mengubah parameter hematologi. Namun, belum banyak dilakuan penelitian untuk mengetahui karakteristik hematologi pada TB, khususnya LED. Metode Penelitian. Penelitian dilakukan dengan metode potong lintang. Data dikumpulkan dengan  membaca rekam medik. Populasi target ialah seluruh pasien TB  yang memeriksakan diri di Rumah Sakit Umum Persahabatan pada tahun 2016-2018. Hasil. Terdapat 132 subjek penelitian. Sebagian besar subjek memiliki durasi gejala < 3 bulan dengan jumlah 84 orang dan yang berdurasi gejala ≥3 bulan sebanyak 48 orang. Dari segi jenis kelamin, mayoritas subjek ialah pasien laki-laki dengan gejala < 3 bulan. Kelompok usia subjek terbanyak ialah 50-65 tahun denga gejala <3 bulan. Mayoritas subjek, baik yang bergejala <3 bulan dan ≥3 bulan, memiliki nilai LED yang meningkat. Semakin tua usia subjek, maka semakin banyak yang memiliki nilai LED di atas normal. Batuk non-produktif merupakan gejala terbanyak pada subjek penelitian, baik yang bergejala <3 bulan maupun ≥3 bulan. Berdasarkan analisis bivariat, tidak terdapat perbedaan nilai rerata LED antarkelompok pasien bergejala <3 bulan dengan pasien bergejala ≥3 bulan  (p=0.101, IK 95% -1.49-0.14). Kesimpulan : tidak terdapat hubungan antara durasi gejala TB dengan peningkatan LED.

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ABSTRACT
Tuberculosis is one of the most common infection in developing countries. Tuberculosis may manifest various symptoms and change hematologic parameters. However, only few studies have been conducted to reveal hematologic parameters in TB, particularly ESR. Methods. This study used cross-sectional method. Data were collected by reading laboratory result in medical record. Target population of this study is all TB patients who came to Persahabatan Hospital during 2016-2018. Result. There were 132 subjects. Most subjects have symptoms duration < 3 months, counted 84 subjects whereas subjects having symptoms duration ≥3 months counted 48 subjects. Based on the sex, most subjects were men  having symptoms duration < 3 months. Most subjects, either those having symptoms durations < 3 months or ≥3 months, have increased ESR. The older the subject, the more having increased ESR. Non-productive cough was the most common symptoms in this study, either on those having symptoms <3 months and having symptoms ≥3 months. Based on bivariate analysis, there was no difference on ESR mean between those having symptoms <3 months and having symptoms ≥3 months (p=0.101, CI 95% -1.49-0.14). Conclusion : there is no relation between TB symptoms duration and ESR increment.

Abstrak :
scleroderma is an autoimmune disease characterized by organ fibrosis, resistant to standard treatment. It is suspected the addition of Physalis angulata Linn. (Ciplukan) extract as adjuvant therapy can improve the scleroderma skin fibrosis. The aim at this study is to evaluate the effect of ciplukan extract as adjuvant on scleroderma skin fibrosis in standard therapy, based on modified Rodnan skin scale (MRSS), inflammatory biomarkers, immunology and serum fibrosis. Methods: double-blind, randomized clinical trial was performed in scleroderma patients with stable disease at Cipto Mangunkusumo hospital and Hasan Sadikin hospital during November 2015−March 2017 who met the selection criteria and continued to receive standard therapy. The subjects were randomly allocated into two groups: the study group received the ciplukan extract 3 x 250 mg / day for 12 weeks and the placebo group. Examination of MRSS, ESR, P1NP, BAFF and sCD40L was performed every 4 weeks until the end of the study. Results: fifty-nine subjects completed the study. They consisted of 29 subjects of the treatment group and 30 of the placebo group, with an average age of 41 (SD 9) years, the proportion of women: male = 9 : 1. There was a significant improvement of skin fibrosis in the study group with a highly significant decrease in MRSS (35.9% VS 6.3%, p <0.001) and a relative decrease in P1NP levels (17.8% VS 0.7%, p = 0.002). No decrease in ESR, BAFF and sCD40L levels in both groups. There was a weak but significant positive correlation between MRSS with P1NP levels (r = 0.236, p = 0.036). Conclusion: Ciplukan extract with dose 3 x 250 mg for 12 weeks as adjuvant on scleroderma standard therapy alleviates skin fibrosis significantly based on MRSS and P1NP levels.

Abstrak :
Skleroderma adalah penyakit autoimun yang melibatkan jaringan ikat. Salah satu gejala klinis skleroderma adalah Fenomena Raynaud dengan perubahan 3 warna pada kulit. Pemeriksaan marker seperti C-reactive protein (CRP) dan laju endap darah (LED) digunakan untuk memeriksa tingkat inflamasi terkait Fenomena Raynaud. Tujuan penelitian adalah menelusuri hubungan kemaknaan antara CRP maupun LED dengan Fenomena Raynaud pada pasien skleroderma. Desain penelitian adalah desain potong lintang dan non-probability sampling. Jumlah sampel adalah 73 (30 memiliki Fenomena Raynaud, 43 tidak memiliki Fenomena Raynaud). Analisis data menggunakan uji chi square (diganti menjadi uji Fisher) untuk mengetahui apakah data yang diperoleh bermakna secara statistik dan klinis. Data bermakna secara statistik jika nilai p < α. Data bermakna secara klinis jika nilai besar efek penelitian > besar efek minimal. Hasil penelitian memperoleh, pasien skleroderma terbanyak adalah 26, 38, dan 47 tahun (masing-masing 6,8%), rentang usia 20-73 tahun, mayoritas wanita (87,7%). Hasil yang diperoleh, tidak terdapat hubungan yang bermakna secara statistik maupun klinis antara CRP dengan Fenomena Raynaud, maupun antara LED wanita dengan Fenomena Raynaud. Hubungan antara LED pria dengan Fenomena Raynaud diperoleh tidak bermakna secara statistik, namun dianggap bermakna secara klinis. ......Scleroderma is an autoimmune disease that involves connective tissue. One of the clinical symptoms is Raynaud's Phenomenon with 3 colors change on the skin. Marker inflammations, such as C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) can be used for investigating inflammation level in establishing Raynaud's Phenomenon. The aim was to investigate whether there was a significant relationship between CRP and ESR level with Raynaud's Phenomenon on scleroderma patients. This research use cross sectional design and non-probability sampling. Total sample used was 73 (30 with Raynaud's Phenomenon, 43 did not have). The test used was chi square (then change into Fisher Test) to determine whether the data obtained were statistically and clinically significant. Data is considered statistically significant if the value of p < α. Data is considered clinically significant if value of research effect size > minimal effect size. The results showed that most of scleroderma patients were 26, 38, and 47 years old (6,8% respectively) with range 20-73 years old, the majority was women (87,7%). The results obtained were no statistically or clinically significant relationship between CRP and Raynaud's Phenomenon, nor between female's ESR and Raynaud's Phenomenon. The relationship between male's ESR and Raynaud's Phenomenon was not statistically significant, but was considered clinically significant.

Abstrak :
Latar belakang - Skleroderma merupakan kelainan jaringan ikat yang ditandai dengan keterlibatan multisistem organ, bersifat kronik dan progresif, dan memiliki tingkat mortalitas serta disabilitas yang tinggi. Hipertensi pulmonal merupakan salah satu penyebab utama kematian pada pasien skleroderma. Tujuan - Penelitian ini bertujuan untuk mencari hubungan antara laju endap darah dan kadar protein reaktif C dengan kejadian hipertensi pulmonal pada pasien skleroderma. Metode - Desain studi pada penelitian ini adalah potong lintang dengan menggunakan data sekunder dari 115 pasien skleroderma di RSUPN Cipto Mangunkusumo Jakarta. Hasil - Dari 115 pasien, hanya 46 subjek yang memenuhi syarat. Hipertensi pulmonal terdeteksi pada 4 pasien berdasarkan hasil ekokardiografi. Tidak ada perbedaan rerata laju endap darah yang bermakna antara kelompok yang mengalami hipertensi pulmonal dengan yang tidak (p = 0,154; perbedaan rerata = 22,58; IK95%:  -8,80 – 53,97). Rerata kadar protein reaktif C juga tidak berbeda bermakna antara kelompok hipertensi pulmonal dengan yang tidak (p = 0,748; perbedaan rerata 0,80; IK95%: 0,19 – 3,29). Simpulan - Dari penelitian ini, tidak ada hubungan antara laju endap darah dan kadar Protein reaktif C terhadap kejadian hipertensi pulmonal pada pasien skleroderma. Walaupun demikian, laju endap darah dan kadar protein reaktif C cenderung lebih tinggi pada kelompok yang tidak mengalami hipertensi pulmonal. ......Background - Scleroderma is connective tissue disease characterized by multisystem organ involvement, chronic and progressive course, and high mortality and disability rate. Objectives - This study aimed to determine the association between erythrocyte sedimentation rate and C-reactive protein level to the occurrence of pulmonary hypertension in scleroderma patients. Methods - This study design was cross-sectional. One-hundred-and-fifteen medical records of scleroderma patient in Cipto Mangunkusumo National Hospital were reviewed. Results - From 115 patients, only 46 subject eligible in this study. Pulmonary hypertension was detected in 4 patients by echocardiography. There was no significant erythrocyte sedimentation rate mean  difference between the group with pulmonary hypertension and those without (p = 0,154; mean difference = 22,58; CI95%:  -8,80 – 53,97). Mean C-reactive protein level was not significantly different between those with pulmonary hypertension and those without (p = 0,748; mean difference = 0,80; CI95%: 0,19 – 3,29). Conclusions - From this study, there was no significant association between erythrocyte sedimentation rate and C-reactive protein level to the occurrence of pulmonary hypertension in scleroderma patients. Nevertheless, erythrocyte sedimentation rate and C-reactive protein tend to be higher in those without pulmonary hypertension.

Abstrak :
Penatalaksanaan standar tuberkulosis (TB) yang disusun WHO memiliki tingkat keberhasilan yang tinggi. Namun, masalah kesehatan pasien pasca-TB, seperti anemia, belum banyak diketahui. Padahal, anemia merupakan masalah kesehatan yang umum pada pasien TB dan dapat terjadi persisten bahkan setelah pengobatan selesai. Penelitian ini bertujuan mengetahui prevalensi dan gambaran anemia pada pasien pasca-TB serta faktor-faktor yang berhubungan. Pada penelitian cross sectional ini, subjek diambil dari 3 kecamatan di Kabupaten Timor Tengah Selatan dengan metode total sampling. Karakteristik subjek dan gambaran klinis didapat dari wawancara menggunakan kuesioner. Data gambaran radiologis didapat dari foto polos toraks. Kadar hemoglobin dan laju endap darah (LED) diperoleh dari pemeriksaan darah perifer lengkap. Data indeks massa tubuh (IMT) diperoleh dari pengukuran antropometri. Dari 78 sampel, didapatkan prevalensi anemia pada pasien pasca TB sebesar 19,2% yang terdiri dari anemia mikrositik hipokrom (60%) dan normositik normokrom. Tidak terdapat hubungan antara anemia dengan gambaran klinis, baik batuk, demam atau keringat malam, sesak napas, dan nyeri dada (p>0,05). Anemia juga tidak berhubungan dengan gambaran infiltrat, kavitas, maupun peningkatan LED (p>0,05). Terdapat hubungan antara IMT<18,5 kg/m2 dengan anemia (p=0,013), OR 5,0 (95% CI 1,28-19,46). Anemia masih menjadi masalah kesehatan pada pasien pasca-TB dan berhubungan dengan rendahnya status gizi pada pasien pasca-TB. ......Standard tuberculosis (TB) treatment that has been established by WHO has high success rate. Yet, health problem among post-TB patient, such as anemia, has not been studied, though anemia is common health problem in TB patient and can persists even after successful treatment. The study aimed to fnd out prevalence of anemia in post-TB patients and its associated factors. In this cross sectional study, subject was enrolled from 3 subdistrict in Timor Tengah Selatan district, using total sampling method. Subject characteristic and clinical presentation of TB was obtained by interview based on questionnare. Data of radiologic finding was collected by conducting chest X-Ray. Hemoglobin level and erythrocyte sedimentation rate (ESR) was obtained from complete blood count. Body mass index (BMI) is calculated from anthropometric measurement. Involving 78 subject, this study found prevalence of anemia in post-TB patient is 19,2% consisted of normositic normochromic (60%) and micrositic hypochromic anemia. Neither cough, fever or night sweat, breath difficulty nor chest pain has associaton with anemia (p>0,05). Anemia also has no association with infiltrate, cavity, and elevated ESR (p>0,05). There is association between BMI <18,5 kg/m2 and anemia (p=0,013 ), OR 5,0 (95% CI 1,28-19,46). Anemia still become a health problem for post-TB patient and it is associated with poor nutritional status among post-TB patient.