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Latar Belakang: Hiperusemia adalah istilah yang menggambarkan kadar asam urat darah di atas normal. Konsumsi purin tinggi merupakan salah satu faktor yang erat kaitannya dengan hiperurisemia. Tujuan: Penelitian ini bertujuan untuk mengetahui adanya hubungan konsumsi purin tinggi dengan hiperurisemia pada penduduk suku Bali di kota Denpasar. Metode: Penelitian ini adalah studi potong lintang analitik yang dilakukan pada bulan Juli sampai dengan September 2004. Populasi pada penelitian ini adalah penduduk suku Bali yang bertempat tinggal di Kota Denpasar. Sampel ditentukan dengan cara stratified random sampling. Penilaian konsumsi purin dilakukan dengan semi quantitative food frequency questionnaire. Analisis dilakukan dengan tabulasi silang dan regresi logistik. Hasil: Penelitian ini melibatkan 302 orang sampel yang memenuhi kriteria inklusi dengan rata-rata umur 43,35 ± 16,72 tahun yang terdiri dari 137 (45,4%) laki-laki dan 165 (54,6%) perempuan. Didapatkan prevalensi obesitas 22,51% dan prevalensi hiperurisemia 18,2%. Didapatkan hubungan yang bermakna antara konsumsi purin tinggi (RP 13,27; IK 95% 6,79-25,88; p < 0,001) dan obesitas (RP 3,32; IK 95% 2,11-5,23; p < 0,001) dengan hiperurisemia. Pada analisis multivariat didapatkan faktor risiko independen hiperurisemia adalah konsumi purin tinggi (OR 26,72; IK 95% 11,69-61,04; p < 0,001) dan obesitas ( OR 4,06; IK 95% 1,81-9,12; p = 0,001). Simpulan: Terdapat hubungan yang bermakna antara konsumsi purin tinggi dengan hiperurisemia pada penduduk suku Bali di kota Denpasar.

<p>Kondisi <em>Pulmonary embolism</em> (PE) merupakan bagian dari spektrum penyakit yang disebut <em>Venous thromboembolism</em> (VTE).  Seorang pasien dengan keluhan utama batuk yang mengeluarkan dahak berwarna keputihan datang ke RSUP Sanglah, Bali untuk mendapatkan terapi. Riwayat sebelumnya, pasien pernah dirawat inap di RSUP Sanglah tersebut.</p><p>Saat ini diagnosis akhir pasien ini: SLE <em>on treatment</em> dengan <em>moderate pulmonary hipertension</em> dan suspek emboli paru, suspek pneumonia (HCAP) dengan <em>severe </em>sepsis dan syok sepsis, asidosis metabolik, observasi transaminitis ec reaktif dan hiponatremia kronik asimptomatik hipoosmoler euvolemic cb SIADH. Selanjutnya dilakukan tindakan terapi dan evaluasi terhadap terapi yang diberikan.</p><p> </p><p><strong>Kata kunci: </strong>SLE, emboli paru akut, hipertensi, studi kasus</p>

Background: Systemic lupus erythematosus (SLE) is characterized by remarkable heterogeneity in clinical manifestations with underlying autoimmune mechanisms. The pleiotropic cytokine interleukin-6 (IL-6) is known to be involved in SLE immunopathogenesis and significantly related to disease activity as well as its complications. Additionally, IL-6 has been demonstrated to underlie important roles in lupus nephritis. Objective: To determine the correlation between Interleukin 6 (IL-6) Serum and Glomelular Filtration Rate (GFR) in SLE. Methods: In this study we investigated the correlation of serum IL-6 with glomerular filtration rate (GFR) to assess kidney damage in 67 premenopausal patients aged between 17-50 years with inactive SLE. The study variables including age, duration of illness, cumulative corticosteroid dose, MEX-SLEDAI score, serum creatinine, and GFR were obtained through interview and medical record review; whilst serum level of IL-6 was measured using ELISA. Results: Median level of IL-6 was found to be 2.71 (0.332-10.000) pg/ml. Pearson correlation test showed significant correlation between serum IL-6 and GFR (r = 0.288, P = 0.018). Conclusion: This study result shows that there was positive correlation observed between serum IL-6 and GFR in inactive SLE.

Leprosy is a chronic granulomatous infection caused by Mycobacterium leprae, which mainly damages the skin and peripheral nerves, and can also infect joints and bones. Clinical manifestations are complex, varied, and often underdiagnosed. The clinical manifestations vary and are called "the great imitator". musculoskeletal features are common in leprosy but infrequently reported. A case of borderline lepromatous (BL) type leprosy was initially suspected as rheumatoid arthritis in a 20-year-old Balinese male who complained of pain and swelling in small joints, accompanied by lesions in the form of multiple erythema macules, round-shaped geography, indistinct boundaries, with bilateral distribution is almost symmetrical in the face, thoracoabdominal, and extremity regions. The diagnosis of BL type leprosy is based on history taking, physical examination, and investigations in the form of Ziehl-Neelsen stain and blood tests.

Introduction: Axial spondyloarthritis is a chronic inflammatory disease that mainly affects the axial skeleton. Anti-TNF can be a therapy of choice for ankylosing spondylitis. Case Illustration: A 33-year-old male patient complained of chronic low back pain. The patient is diagnosed with ankylosing spondylitis based on New York Criteria 84. Initial therapy included NSAIDs for six months but showed no response. After we initiated the TNF inhibitor therapy, patients showed significant clinical improvement: BASDAI scores improved from 4.9 to 1.1, BASFI from 3.1 to 1.0, and ASDAS-CRP from 3.2 to 2.0. Conclusions: Patient with ankylosing spondylitis who have no response to NSAIDs should be considered for TNF inhibitor administration. After six months of TNF inhibitor therapy, the patient responded well. Keywords: Axial spondyloarthritis, ankylosing spondylitis, NSAIDs, Tumor Necrosis Factor.

Background: Neuromyelitis optica (NMO) is an in?ammatory demyelinating autoimmune disease of the central nervous system that most commonly affects the optic nerves and spinal cord. Seropositive antiAQP4 differentiates NMO from MS and the presence of manifestation in the postrema, brainsteam or diencephalic areas extend to NMO Spectrum Disorder (NMOSD). Case Description: A 18 years old male complain sudden vision loss on his left eye since 2 weeks ago. The examination show the visual acuity on the right eye was 6/6 and LPBP on the left eye. Positive RAPD on the left eye, funduscopy and the OCT RNFL within normal limits. Head MRI focus orbita with contrast show optic neuritis. Patient was diagnosed with left eye retrobulbar optic neuritis and ONTT therapy was given. The visual acuity improved to 1/60 then therapy change to oral steroid. Four months later, the patient suddenly got vision loss on the right eye accompanied by paraparesis. The visual acuity on the right eye was NLP and the left eye was 1/300, with mid-dilated papil. The results of the OCT RNFL show on the right eye edema papil and left eye atrophy papil. An MRI of the head focus orbital and whole spain was reexamined followed by VEP examination and an AntiAQP4 which showed an NMOSD. He was given ONTT then continued with immunosuppressants. The visual acuity of the right eye improved to 3/60 and the left eye remained 1/300. Discussion: This patient first presented with complain on the left eye with clinical and supporting symptoms suggesting an optic neuritis. The presence of a new attack on the right eye with paraparesis is a clinical feature of NMO supported by MRI results and seropositive AQP4 indicates an NMOSD. Conclusion: Establishment of diagnosis and administration of therapy quickly and precisely can reduce the severity and risk of recurrence which leads to greater disability and blindness. Key Words: Neuromyelitis Optica, Neuromyelitis Optica Spectrum Disorder, AQP4

Latar belakang : Proses inflamasi berperan penting dalam patogenesis SLE. Proses inflamasi yang terjadi pada penderita SLE juga akan mempengaruhi diferensiasi osteoklas dan osteoblast. Interleukin-17 (IL-17) merupakan mediator pro-inflamasi yang dihasilkan akibat proses inflamasi sistemik. Peningkatan kadar sitokin pro-inflamasi diketahui mengakibatkan perubahan regulasi RANKL, yang selanjutnya akan mempengaruhi osteoprotegerin (OPG). Peningkatan kadar sitokin pro-inflamasi pada penderita SLE dapat mengakibatkan ketidakseimbangan RANKL/OPG. Tujuan : Mengetahui korelasi antara kadar IL-17 serum dengan rasio RANKL/OPG pada penderita SLE. Metode : Penelitian ini merupakan studi observasional analitik potong lintang yang dilakukan di poliklinik dan bangsal rawat inap. Penyakit Dalam RSUP Sanglah Denpasar, Bali, Indonesia dari bulan Januari-Maret 2018. Penderita SLE berjenis kelamin wanita yang berusia lebih dari 18 tahun dan belum mengalami menopause serta bersedia mengikuti penelitian dengan menandatangani informed consent diikutsertakan dalam penelitian. Kadar IL-17 serum diperiksa dengan menggunakan metode high sensitivity ELISA (Enzyme-linked immunosorbent assay). RANKL diukur menggunakan metode Human sRANKL (TOTAL) ELISA, sedangkan OPG diukur menggunakan metode Human Osteoprotegerin ELISA. Rasio RANKL/OPG didapatkan dari perbandingan antara kadar RANKL dan OPG. Hasil : Penelitian ini melibatkan 68 subyek penelitian. Median umur subyek penelitian yaitu 31,32 (17-54). Kadar IL-17 dan rasio RANKL/OPG pada seluruh subyek yaitu 0,435 (0,23-30,65) dan 70,18 (4,98-1060,46). Didapatkan korelasi yang bermakna antara kadar IL-17 dan rasio RANKL/OPG dengan p=0,010. Dari analisis multivariat didapatkan bahwa kadar IL-17 berkorelasi dengan rasio RANKL/OPG (B=6,554, SE(B)=2,686, p=0,018). Simpulan : Pada penelitian ini terdapat korelasi antara kadar IL-17 serum dengan rasio RANKL/OPG pada penderita SLE.