Reliability and Validity of European Quality of Life 5 Dimension (EQ-5D) for Measuring Health-related Quality of Life in Knee Osteoarthritis Patients at Cipto Mangunkusumo General Hospital

Background: Quality of life is very important to knee osteoarthritis (OA) patients. The term quality of life denotes one that is health-related. One of the questionnaires most frequently used to measure the quality of life is the European Quality of Life 5-Dimension (EQ-5D) questionnaire. At Cipto Mangunkusumo General Hospital, until today there has not been any instrument for measuring the health-related quality of life in knee OA patients that has been tested for its reliability and validity.Objective: To prove the reliability and validity of EQ-5D as a measurement tool in determining the healthrelated quality of life in knee OA patients at Cipto Mangunkusumo General Hospital.Methods: This is a validity study in which all patients were asked to complete both the EQ-5D form and 36- item short form (SF-36) on their fi rst visit. They were subsequently asked again to complete only the EQ-5Dform one week after their fi rst visit.Results: Data were obtained from 86 respondents.The value of the intraclass correlation coeffi cient of each EQ-5D dimension, EQ-5D index, and visual analogue scale (VAS) was excellent (>0.75). Cronbach's α value for internal consistency reliability in this study was0.6772 (<0.7). The external validity of EQ-5D compared to SF-36 was analyzed with the Pearson's correlation test and revealed a signifi cant correlation (p<0.01) of all EQ-5D dimensions, EQ-5D index, and EQ-5D VAS with total score of SF-36 except for the dimensions of self-care, pain, and anxiety/depression. The construct validity of EQ-5D showed that all of the dimensions were signifi cantly correlated with the EQ-5D index (p<0.01) except for self-care dimension.Conclusion: EQ-5D is a valid and reliable measurement tool. It is thus recommended for measuring the healthrelated quality of life in knee OA patients at CiptoMangunkusumo General Hospital

The Correlation Between Body Fat Distribution and Medial Tibiofemoral Joint Space Width in Obese Knee Osteoarthritis Patients

Background: Obesity is a major risk factor for knee osteoarthritis. The relationship between obesity and OA may not be simply due to a mechanical factor. Evidences suggest that metabolic factors related to body fat play important roles, but the specific type of fat that contributes to OA is unclear. The objective of this study was to examine the possible correlation between body fat distribution with knee OA.Methods: This study was a cross sectional study of OA patients with obesity visiting the Rheumatology and Geriatric-Internal Medicine clinics at Cipto Mangunkusumo Hospital between January-March 2016. Data was collected by consecutive sampling. Knee OA was diagnosed from clinical and radiologic evaluation based on American College of Rheumatology 1986 criteria. Body fat distribution was measured by bioelectrical impedance analysis (BIA). Conventional radiography of the knee was used to evaluate jointspace narrowing (JSN). The correlation between body fat distribution and joint space width was analyzed by bivariate analysisResult: A total of 56 subjects were recruited, majority were women (73.2%). Median visceral fat was 12% (7.5-16.5), median subcutaneous fat was 30.2% (16.5-37.9), and median visceral to subcutaneous fat ratio was 0,40 (0,26-0,80). The mean medial tibiofemoral joint space width was 2.34 mm (SD 0.78). Bivariate analysis revealed a correlation between visceral fat and medial tibiofemoral joint space width (r: -0,474 p: < 0,001). There is no correlation between subcutaneous fat and medial tibiofemoral joint space width (r: -0,187 p:0,169); and visceral to subcutaneous fat ratio and medialtibiofemoral joint space width (r: -0,225 p: 0,09).Conclusion: Visceral fat is correlated with medial tibiofemoral joint space width (r: -0.474 p: < 0.001). There is no correlation between subcutaneous fat, and visceral to subcutaneous fat ratio, with medial tibiofemoral joint space width

Predictor Factors of Atherosclerosis and Atherosclerosis Plaque in Rheumatoid Arthritis Patients

Background: Atherosclerosis and cardiovascular diseases have been known as the cause of increasing mortality among rheumatoid arthritis (RA) patients. Carotid intima media thickness (CIMT) measurement by ultrasound has been used as surrogate marker of atherosclerosis and cardiovascular disease.Methods: A cross sectional study of 86 RA patients fulfills EULAR/ACR 2010 critera for RA was conducted to study proportion and predictor factors of atherosclerosis and atherosclerosis plaque in rheumatoid arthritis patients.Results: Atherosclerosis and plaque was found in 47,7% and 29 % of patients. Age ≥ 40 yo, hypertension and duration of illness ≥ 24 mo were associated with atherosclerosis in multivariate logistic regression analysis with OR 10.70 (95% CI: 2.93-39.10), 4.99 (95% CI: 1.15-21.61) and 3.66 (95% CI: 1.11-11.99) respectively. Whereas hypertension, presence of antiCCP antibody and age ≥ 40 yo, were associated with plaque formation with OR 3.96 (95% CI: 1.15-13.57), 3.20 (95% CI: 1.11-9.24) and 3.61 (95% CI: 1.03-12.63) respectively.Conclusions: Age ≥ 40 yo, hypertension and duration of illness ≥ 24 mo was the predictors ofatherosclerosis, while hypertension, presence of antiCCP antibody and age ≥ 40 yo was the predictors of atherosclerosis plaque

Association Between Adiponectin Levels with Markers of Atherosclerosis in Patients with Rheumatoid Arthritis

Background: Several studies have shown that atherosclerosis underlying processes of Cardiovascular disease (CVD), increased in rheumatoid arthritis (RA) and occurred early (premature). The cause of accelerated atherosclerosis in RA are still unknown.Adipokines have known that the adipokines play a role in the pathophysiology of RA and CVD. Accumulation of visceral fat associated with dysregulation of adipokinesthat influence the development of the atherosclerotic and disruption plaque. Obesity and pathological changes in fat mass and fat dysfunction as well as a change inthe pattern of secretion of proinflammatory adipokines, may have a correlation between heart disease and rheumatic diseases. Adiponectin is one of the mostwidely-studied adipokines. In RA, adiponectin is involved in the pathophysiology of RA that produces of various proinflammatory and prodestructive molecules. So far, adiponectin has been known to provide antiatherosclerotic effects in patients with non-RA. But, several recent studies in RA patients get opposite results in which increased levels of adiponectin are associated with increased prevalence of atherosclerosis. The effect of adiponectin on atherosclerosis in patient with RA is still unknown.Objective: to determine the relationship of adiponectin with atherosclerosis in patients with rheumatoid arthritis. Methods: This is a cross-sectional study conducted on outpatients of the rheumatology clinic at Cipto Mangunkusumo General Hospital from January untilApril, 2013. Subjects consisted of 50 patients were diagnosed based on ACR 1987/EULAR 2010 criteria. The collection of data obtained by consecutive sampling and evaluated the patients' medical data that included age, long-suffering of RA, body mass index (BMI), lipid profile, rheumatoid factor levels, levels of anti-cyclic citrullinated peptide (anti-CCP), C-reactive protein (CRP), erythrocyte sedimentation rates (ESR), blood pressure, fasting blood glucose, 2 hour post prandial blood glucose, ECG, examination of serum adiponectin levels and bilateral carotid ultrasound to measure the carotid artery intima media thickness.Results: From the results of the 50 patients studied, obtained 28 (56%) of patients had increased levels of adiponectin. Atherosclerosis was found in 13 (26%) subjects. The median value was 9.46 μg / ml with the lowest levels of 4 μg/ml and the highestlevels of 24μg/ml. The Spearman's test showed no significant correlation between adiponectin serum and atherosclerosis in patients with RA (p = 0706 and r = 0.055). The analysis results of the correlation of adiponectin with atherosclerosis based on age, disease duration, ESR, rheumatoid factor, DAS 28, CRP, BMI, dyslipidemia showed no significant correlation.Conclusion : From this study, researchers found no statistically significant correlation between adiponectin levels with marker of atherosclerosis (CIMT) in patients with rheumatoid arthriti

The Relationship Between Gastric Mucosa Mucous Thickness and Gastroscopic Findings in Patients Receiving Non-Steroidal Anti-Inflammatory Drugs

Non-steroid anti-inflammatory drugs (NSAID) can cause gastropathy and gastric mucosa, especially the mucous may play an important prevention role. This cross-sectional, single group study was conducted to know the difference in mucous thickness in antrum or corpus mucosa and the correlation of gastric mucous thickness to gastropathy. Patients who received NSAID from the rheumatology clinic were studied. Healthy subjects of 14 – 65 years old who never received NSAID were included as normal controls. Piroxicam 20 mg daily was given to the patients for 7 days, then gastroscopy and gastric mucosa biopsy with frozen section were performed. Specimens were stained with haematoxyline eosin and thickness of the mucous layer was measured using ocular micrometer. Thirty-two out of 70 patients participated in the study. All cases had hyperemia on gastroscopy with erosions and ulcer in 32 and 9 cases, respectively. The mean thickness of mucosa in distal antrum, proximal antrum and corpus was 28.5 ± 9, 37.4 ± 13.1 and 43.3 ± 13.1 microns, respectively. There was significant relationship between gastric mucosa mucous thickness with gastroscopic findings. In conclusion, this study confirmed that thickness of gastric mucosa mucous has an important role in preventing NSAID gastropathy and dyspeptic complaints in this kind of patients does not suggest abnormalities of gastric mucosa

Correlation Between Serum Leptin Concentration and Disease Activity in Normal Body Mass Index Premenopausal Women with Systemic Lupus Erythematosus

Background. Leptin is recognized as a cytokine-like hormone with pleiotropic actions in modulating immune responses. The role of leptin in pathogenesis of systemiclupus erythematosus (SLE) was not fully understood yet. Previous study did not fi nd the correlation between serum leptin concentration and disease activity in patients with SLE, but selection of the subjects wasn\u27t based on the classifi cation of body mass index (BMI) and menopausal status.Objective. To determine correlation between serum leptin concentration and the disease activity in normal BMI premenopausal women with SLE.Methods. Serum leptin concentration was measured by enzyme-linked immunosorbent assay and disease activity was scored using Mexican SLE disease activity index (Mex-SLEDAI). Spearman\u27s correlation coeffi cient test was used for evaluating the strength of association between leptin level and Mex-SLEDAI score.Results. Seventy normal BMI premenopausal women with SLE were included in this study. The median of serum leptin concentration was 13.4 (0.6 – 45.9) ng/ml.The median serum leptin concentration in patients with active disease was 12.4 (0.6 – 41.6) ng/dl, whereas in patients with inactive disease was 15.2 (3.9 – 45.9) ng/dl.No signifi cant different was found between serum leptin concentration in active and inactive disease (p = 0.14). A weak negative correlation was observed between leptinconcentration and Mex-SLEDAI score, but not statistically signifi cant (r = -0.22; p = 0.07).Conclusion. No correlation was found between serum leptin concentration and disease activity in normal BMI premenopausal women with SLE. Prednisone doses anddisease duration might interfere

Evaluasi Serologis dari Imunisasi Pertussis dengan Vaksin Dpt 2 dan 3 Dosis

The objective of this study is to evaluate the serological response against pertussis after completion of both 2 and 3 doses of DPT vaccination. The study has been carried out retrospectively among 766 children under 3 years of age in Tulang-an District, Sidoarjo, East Java. The antibody titres against pertussis were measured by micro agglutination test. The results showed that the percentage of children having antibody titre of 1 : 80 or more, at 1—5 months post vaccination were 80.9% and 88.3% for 2 and 3 doses, respectively. The results do not differ significantly. This insignificance was maintained up to 17 months of the post-vaccination period

Pengaruh Umur terhadap Hasil Guna Imunisasi Dasar Batuk- Rejan dengan Vaksin Dpt

A restrospective study of the influence of age on the efficacy of primary immunization against pertussis was done in Tulangan district, Sidoarjo, Surabaya. Five hundreds and seventy children under ten months of age with various vaccination status and 157 children under three years of age as a control group were taken as samples. Adjuvanted "whole-cell pertussis-vaccine", made by Bio Farma, was used in the study. One tenth of finger blood or toe blood were taken by heparinized capillary pipet for the examination of agglutinin titres against pertussis. Serological examination by micro-agglutination test, showed there was no significant differences in the antibody production following administration of 1, 2 and 3 shots of DPT vaccine among chil­dren of 0-2 months, 3-6 months and 7-10 months. The results suggested that the administration of primary DPT vaccine to babies as early as 4 weeks old is effective and can be recommended