Diagnostic Criteria of Knee Osteoarthritis in Rheumatology Outpatient Clinic, Dr. Sardjito Hospital, YOGYAKARTA

Background: Osteoarthritis (OA) is a chronic condition characterized by the breakdown of joints cartilage. Approximately 25% of persons 55 years of age or older have knee pain on most days and about half of them have radiographic OA in the knee. Prevalence of knee OA increases with age and it is more common in women than men. It is not easy to establish the diagnosis of knee OA since other knee disorders have similar clinicalsigns and symptoms.Objective: The purpose of this study was to observe the diagnosis pattern of knee OA in rheumatology outpatient clinic at Dr. Sardjito Hospital based on clinical and radiographic criteria of American College of Rheumatology (ACR). Method: The design of this study was cross-sectional. Data of the patients with knee OA were investigated from their medical records. Results: There were 212 subjects diagnosed with knee OA during the year 2000–2010. Most of the subjects (90.56%) were more than 50 years old. Women were more frequent affected by OA than men. All of the subjects (100%) had knee pain. Crepitus was found in98.11% subjects. Morning stiffness less than 30 minutes was found in 86.79% subjects. Osteophyte appearances were found in 79.72% subjects.Conclusion: Knee pain, crepitus, and age more than 50 years old were the most frequent criteria used to diagnose knee OA. Morning stiffness less than 30 minutes and osteophyte appearances were also frequent in knee OA

Pengaruh Terapi Kurkuminoid Ekstrak Rimpang Kunyit Dibandingkan dengan Natrium Diklofenak terhadap Fungsi Ginjal Penderita Osteoartritis

Background: Osteoarthritis is a joint disease most often found in the community. Patients with osteoarthritis are frequently drink non steroidal anti inflammatory drugs such diclofenac sodium. Data has shown too many side effects of diclofenac sodium especially to the kidney function. A research data in Malang shows that people who use herbs were 476 persons in city area and 580 persons in distric area per thousand patients with arthritis. Curcuma domestica Val. is one of Asia's native plants used to make herbal medicine mainly used to reduce inflammation. The purpose of this study was to assess the safety of curcuminoid from Curcuma domestica Val. rhizome extract compared to diclofenac sodium to the kidney function of patients with osteoarthritis. Methods: This was a prospective randomized open and blinded evaluation (PROBE) study. Subjects with knee osteoarthritis were divided randomly into two groups: the group who received 30 mg 3 times daily of curcuminoid from Curcuma domestica Val rhizome extrac (curcuminoid group) and group who received 25 mg 3 times daily of diclofenac sodium (diclofenac group). Assessment of results including serum blood urea nitrogen (BUN) and creatinine level was performed before and after 4 weeks period of treatment. Data analysis compared the change of those levels in each group during the treatment period by student t test analysis. Results: In the curcuminoid group there was no significant decrease of serum BUN level (p=0.52) and there was a significant decrease of serum creatinine level (p=0.03). In the diclofenac group there was a significant increase of serum BUN level (p<0.01) and no significant increase of serum creatinine level (p=0.39). Increasing the serum level of BUN and creatinine in diclofenac group were significantly different compared to decreasing of those level in the curcuminoid group with p=0.01 and p=0.03 respectively. Conclusion: Treatment with Curcuminoid from Curcuma domestica Val. rhizome extract was significantly decreased the serum BUN and creatinin level compared to those increased level in diclofenac sodium treatment

Diagnostic criteria of knee osteoarthritis in rheumatology outpatient clinic, Dr. Sardjito Hospital, Yogyakarta

Background: Osteoarthritis (OA) is a chronic condition characterized by the breakdown of joints cartilage. Approximately 25% of persons 55 years of age or older have knee pain on most days and about half of them have radiographic OA in the knee. Prevalence of knee OA increases with age and it is more common in women than men. It is not easy to establish the diagnosis of knee OA since other knee disorders have similar clinicalsigns and symptoms.Objective: The purpose of this study was to observe the diagnosis pattern of knee OA in rheumatology outpatient clinic at Dr. Sardjito Hospital based on clinical and radiographic criteria of American College of Rheumatology (ACR). Method: The design of this study was cross-sectional. Data of the patients with knee OA were investigated from their medical records. Results: There were 212 subjects diagnosed with knee OA during the year 2000–2010. Most of the subjects (90.56%) were more than 50 years old. Women were more frequent affected by OA than men. All of the subjects (100%) had knee pain. Crepitus was found in98.11% subjects. Morning stiffness less than 30 minutes was found in 86.79% subjects. Osteophyte appearances were found in 79.72% subjects.Conclusion: Knee pain, crepitus, and age more than 50 years old were the most frequent criteria used to diagnose knee OA. Morning stiffness less than 30 minutes and osteophyte appearances were also frequent in knee OA

Berbagai Keluhan Fisik yang Dialami Pasien Osteoartritis Akibat Terapi Natrium Diklofenak Dibandingkan Kurkuminoid Ekstrak Rimpang Kunyit

Background: The prevalence of osteoarthritis (OA) in the community is high and this disease is the second largest cause of physical disability in the world. Degeneration and joint inflammation occurred in OA. Curcuminoid is a secondary metabolite present in the rhyzome of turmeric and ginger. Curcuminoid could be used to treat rheumatic diseases. Diclofenac sodium is able to inhibite the production of prostaglandin-E2 (PG-E2) by inhibition the cycloxygenase-2 (COX-2) activity. On the other hand diclofenac sodium also inhibite the physiologic enzyme cycloxygenase-l (COX-I) activity, this inhibition may produce some complaints to the patients since the COX-l is important in body equilibrium. Objective: To assess some complaints of patients with osteoarthritis in treatment using curcuminoid from Curcuma domestica Val. rhyzome extract compared to diclofenac sodium. Method: This study was conducted with the prospective randomized open end blinded evaluation (PROBE) design. A total of 80 patients with knee osteoarthritis were included in this study (39 patients received 3x30 mg daily of curcuminoid from Curcuma domestica Val. rhyzome extract for 28 days treatment and 41 patients received 3x25 mg daily of diclofenac sodium for 28 days). The number needed to harm analysis was conducted in comparing the symptoms of head, chest, gastrointestinal and urinary tract complaints. Results: The number needed to harm (NNH) for headache was 500, palpitation was 42, shortness of breath was 42, nausea was 21, diarrhea was 42 and micturition complaints was 500. Conclusion: Although the number of patient who have chest and gastrointestinal complaints was higher in using diclofenac sodium, but no statistically significant difference either of head, chest, gastrointestinal and urinary tract complaints between the curcuminoid and diclofenac sodium treatment groups

PENGARUH KOMBINASI EKSTRAK TEMULAWAK, JAHE, KEDELAI DAN KULIT UDANG TERHADAP FUNGSI HATI DAN GINJAL DIBANDINGKAN DENGAN NATRIUM DIKLOFENAK PADA PENDERITA OSTEOARTRITIS

Objectives To evaluate the effect of Curcuma xanthorrhyza Roxb extract, ginger, soybean and shrimp shell in combination compared to diclofenac sodium to liver and kidney function of patients with osteoarthritis. Methods twenty one subjects randomly allocated to different groups (Trial and control = diclofenac group). The trial group were treated by the combination of 50 mg temulawak extract, 100 mg ginger, 50 mg soybean and 100 mg shrimp shell three times daily while the control groupwere treated by 25 mg diclofenac sodium three times daily for a couple of week. Blood sample was obtained before and after two weeks therapy to determine the liver enzymes SGOT and SGPT and also serum ureum and creatinin in order to monitor the kidney function. The study was a prospective randomized open end blinded evaluation (PROBE). Result both trial and diclofenac group show significantly increase of SGOT levels (p0.05). In the trial group there was decreasing of serum ureum level although not significant (p=0.214). Both trial and diclofenac group showed no statistically significant increasing of creatinin serum levels (p>0.05). Conclusion there is no statistically difference effect between using the combination of temulawak extract, ginger, soybean and shrimp shell compared to diclofenac sodium toward liver and kidney function of osteoarthritis patients during this two weeks treatment.Untuk menilai pengaruh kombinasi ekstrak rimpang temulawak, jahe, kedelai dan kulit udang dibandingkan dengan natrium diklofenak terhadap fungsi hati dan ginjal pasien osteoartritis. Dua puluh satu subjek dibagi menjadi dua kelompok secara acak (kelompok uji dan kelompok kontrol = kelompok natrium diklofenak). Kelompok uji diberikan terapi kombinasi 50 mg ekstrak temulawak, 100 mg jahe, 50 mg kedelai and 100 mg kulit udang tiga kali sehari, sementara kelompok kontrol diberikan terapi 25 mg natrium diklofenak tiga kali sehari selama dua minggu. Pemeriksaan darah dilakukan sebelum dan setelah 2 minggu terapi untuk menilai kadar enzim hati SGOT dan SGPT dan juga kadar ureum dan kreatinin serum untuk mengamati fungsi ginjal. Desain penelitian ini adalah prospective randomized open end blinded evaluation (PROBE). Pada masing-masing kelompok perlakuan terjadi peningkatan kadar SGOTyang bermakna (p0,05). Pada kelompok uji terjadi penurunan kadar ureum serum yang tidak bermakna (p=0,214). Baik pada kelompok uji maupun pada kelompok diklofenak tidak terjadi perubahan kadar kreatinin serum yang bermakna (p>0,05). Tidak ada perbedaan yang bermakna terhadap fungsi hati dan ginjal akibat terapi kombinasi ekstrak temulawak, jahe, kedelai dan kulit udang dibandingkan dengan natrium diklofenak selama 2 minggu pada penderita osteoartritis

Impulsivity and novel object recognition test of rat model for vascular cognitive impairment after antipsychotics treatment

ABSTRACTVascular cognitive impairment (VCI) is a common condition in which no standard treatment has been approved. VCI is often accompanied by behavioral problems which require psychiatric interventions. The common therapeutic agent used for the acute management is antipsychotic injections. Current findings showed that atypical antipsychotic possess better safety profile for treating behavioral problems related to VCI compared to typical antipsychotic. In this study, we induced VCI in Sprague Dawley rats between 6-8 weeks old using bilateral carotid communist artery occlusion technique. The subjects were divided into 4 treatment groups: sham, olanzapine, haloperidol, and risperidone groups. Subjects received intramuscular injections of subsequent drugs for 3 days post VCI induction. Impulsive behavior and object recognition were examined using cliff jumping test and novel object recognition test. The analyses results showed that impulsive behavior was lower in the olanzapine and haloperidol groups compared to sham group, although it was not statistically significant (p = 0.651). The results also showed that there were no significant differences in the time spent exploring old and novel objects in all groups (p = 0.945;0.637 respectively). In conclusion, antipsychotic injection might not be effective to control impulsive behavior post VCI induction

Impulsivity and novel object recognition test of rat model for vascular cognitive impairment after antipsychotics treatment

ABSTRACT Vascular cognitive impairment (VCI) is a common condition in which no standard treatment has been approved. VCI is often accompanied by behavioral problems which require psychiatric interventions. The common therapeutic agent used for the acute management is antipsychotic injections. Current findings showed that atypical antipsychotic possess better safety profile for treating behavioral problems related to VCI compared to typical antipsychotic. In this study, we induced VCI in Sprague Dawley rats between 6-8 weeks old using bilateral carotid communist artery occlusion technique. The subjects were divided into 4 treatment groups: sham, olanzapine, haloperidol, and risperidone groups. Subjects received intramuscular injections of subsequent drugs for 3 days post VCI induction. Impulsive behavior and object recognition were examined using cliff jumping test and novel object recognition test. The analyses results showed that impulsive behavior was lower in the olanzapine and haloperidol groups compared to sham group, although it was not statistically significant (p = 0.651). The results also showed that there were no significant differences in the time spent exploring old and novel objects in all groups (p = 0.945;0.637 respectively). In conclusion, antipsychotic injection might not be effective to control impulsive behavior post VCI induction

Prevalence and Severity of Periodontitis in Indonesian Patients With Rheumatoid Arthritis

<p>Background: Patients with rheumatoid arthritis (RA) may have more prevalent and severe periodontitis than healthy controls. Periodontitis may increase the systemic inflammation in RA. The aim of this study is to assess periodontitis prevalence and severity and its potential association with systemic inflammation in Indonesian patients with RA.</p><p>Methods: A full-mouth periodontal examination including probing depth, gingival recession, plaque index, and bleeding on probing was performed in 75 Indonesians with RA and 75 age-, sex-, and smoking-matched Indonesian controls. A validated questionnaire was used to assess smoking, body mass index, education, and medical conditions. In addition, in all participants, the use of drugs was noted, and erythrocyte sedimentation rates and serum levels of high-sensitivity C-reactive protein (hsCRP), rheumatoid factor, and anti-citrullinated protein antibodies were measured. Differences in periodontitis prevalence and 12 measures of periodontitis severity between patients with RA and controls were analyzed using univariate analyses.</p><p>Results: No significant differences in periodontitis prevalence and 11 measures of periodontitis severity between patients with RA and controls were observed. Conversely, patients with RA had a significantly lower surface area of healthy pocket epithelium versus controls (P = 0.008), and a tendency toward higher hsCRP levels was observed in patients with RA with severe periodontitis compared with patients with RA with no mild or moderate periodontitis (P = 0.063). It has to be noted that all patients with RA were on anti-inflammatory drugs, whereas none of the controls used such drugs.</p><p>Conclusion: Prevalence and severity of periodontitis in Indonesian patients with RA is comparable to controls but with less healthy pocket epithelium than in controls and a tendency toward a higher inflammatory state in patients with RA and severe periodontitis.</p>