INDROPO AGUSNI
Dept. Of Dermatology, School of Medicine, Universitas Airlangga, Surabaya

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Zinc supplementation could modulate T cell to maintain interleukin-2 level in seropositive contact of leprosy patients Rahfiludin, Mohammad Z.; Wirjatmadi, Bambang; Agusni, Indropo; Dahlan, Yoes P.
Medical Journal of Indonesia Vol 20, No 3 (2011): August
Publisher : Faculty of Medicine Universitas Indonesia

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Abstract

Background: WHO classified the number of leprosy cases in Indonesia as number three in the world after India and Brazil. The number of new leprosy patients tends to increase since there is a possibility that seropositive leprosy is turning into manifest leprosy. The aim of this study was to analyze the influence of zinc supplementation on interleukin-2 (IL-2) level of seropositive contact of leprosy patients with marginal zinc deficiency.Methods: Twenty two subjects aged 20-40 years were recruited for this study. The zinc-supplemented group received 40 mg elemental Zn/d orally for 3 months. Seropositive leprosy was determined by examining IgM anti Phenolic Glycolipid–1 level and concentration of IL-2 in lymphocyte cell culture supernatant fluid were measured by Elisa method.Results: The IL-2 concentration in the subject in the zinc group was relatively not changed (p= 0.721), whereas that in placebo group tended to be significantly lower (p= 0.025) at the end of the study.Conclusion: There was a significant change of IL-2 level between both groups (p= 0.037). (Med J Indones 2011;20:201-4)Keyword: IgM anti phenolic glycolipid-1, seropositive leprosy
COMPARATIVE STUDY ON THE INTENSITY OF Mycobacterium leprae EXPOSURE TO CHILDREN WHO LIVE IN LOW AND HIGH ALTITUDE IN LOW LEPROSY ENDEMIC AREA OF SOUTH SULAWESI Rachmawati, Rachmawati; Mataallo, Timurleng Tonang; Adam, Safruddin; Adam, A. M.; Amin, Safruddin; Tabri, Farida; Adriaty, Dinar; Wahyuni, Ratna; Iswahyudi, Iswahyudi; Agusni, Indropo
Indonesian Journal of Tropical and Infectious Disease Vol 4, No 4 (2013)
Publisher : Institute of Topical Disease

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Background: The intensity of Mycobacterium leprae exposure to people who live in leprosy endemic area could be measured by serological study and detection of the bacilli in the nose cavity. Different geographical altitude might have some influences to this exposure since the bacilli prefer to live in warm areas. Aim: A combined serological and PCR study of leprosy was conducted in Selayar island, South Sulawesi to 80 school children (40 from low land and 40 from highland altitudes) in order to compare the exposure intensity between the two areas. Method: Anti PGL-1 IgM antibody (ELISA) and PCR study to detect M.leprae in the nasal cavity were performed simultaneously from each person. Result: Seropositive cases were found in 23/40 children from low land compared to 16/40 children from high land, but statistically no significant difference (p>0.05). PCR positive for M.leprae in the nasal cavity only found in 1/40 children, both in low and high altitude. Conclusion: It is concluded that although the existence of M.leprae in nasal cavity is minimal, the intensity of exposure to this bacilli still high as indicated by serological study.
LYMPHOCYTE RESPONSE TO Mycobacterium leprae ANTIGENS IN REVERSAL REACTION STATE OF LEPROSY An in vitro study of Lymphocyte Stimulation Index using MTT method Iskandar, Fanny; Yusuf, Irawan; Arif, Mansur; Agusni, Indropo
Indonesian Journal of Tropical and Infectious Disease Vol 5, No 4 (2014)
Publisher : Institute of Topical Disease

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Abstract

Reversal Reaction (RR) in Leprosy is a sudden inflammatory episode in the chronic course of the disease due to rapid change of cellular immunological status. The aim of the study is to measure the in vitro results of Lymphocyte Stimulation Index (LSI) RR leprosy derived lymphocytes after challenged with M.leprae antigens. Twenty three Borderline Leprosy with RR and 11 BorderlineLeprosy patients without RR were included in the study. Peripheral Blood Mononuclear Cells (PBMC) were separated from peripheral blood of these patients using Ficol-Hypaque column and cultured in laboratory. Using the colorimetric tetrazole (MTT) method these lymphocytes were challenged with PHA, Dharmendra antigen (1/100 and 1/10 dilutions), LAM (50 and 100 nanograms). Stimulation Index were calculated and superanatans were collected for measuring the IFN-γ and IL-10 production (ELISA). All of lymphocytesfrom RR patients showed higher Stimulation Index after challenged with the five M.leprae antigens compared to lymphocytes from non RR patients (p <0.05) . IFN-γ and IL-10 also increased but not significant (p>0.05). It is concluded that lymphocytes of leprosy patients during RR state are more sensitive to antigenic stimuli compared to non-RR leprosy patients. Further extended studies areneeded to determine the “cut off” value of lymphocyte Stimulation Index that is useful for clinicians in the field in the prediction of RR before starting anti leprotic treatment.
DAPSONE RESISTANCE IN A Mycobacterium leprae ISOLATE WITH TWO POINT MUTATIONS IN folP GENE FROM A LEPROSY PATIENT Ardiaty, Dinar; Wahyuni, Ratna; Prakoeswa, Cita; Abdullah, Rasyidin; Agusni, Indropo; Izumi, Shinzo
Indonesian Journal of Tropical and Infectious Disease Vol 3, No 2 (2012)
Publisher : Institute of Topical Disease

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Drug resistance in leprosy is important for Leprosy Control Program, since the WHO-Multidrug regiment (MDT) has been used for global treatment of leprosy for more than two decades already. A Dapsone resistance case in a Multibacillary (MB) leprosy case is reported. The patient was diagnosed and treated in Tajuddin Chalid Hospital Makassar, South Sulawesi. Previously he was treated in a health center at South Sulawesi and was given a treatment for one year, before referred to the hospital. The leprosy skin lesions are still active with erythematous skin lesions and thickened ear lobe. Bacteriological examination was positive for Acid Fast Bacilli, the Bacterial Index was 3+ and the Morphological Index was 1%. The specimens of M.leprae isolation was sent to the Institute of Tropical Disease Surabaya for drug resistance study. Using the Lp1-2 and Lp3-4 nested primers, PCR test was positive for M.leprae.Sequencing result for folP gene showed a double mutation at codon 53 (ACC / Threonin ) which become (AGG / Arginine). Simultaneous mutation at two nucleotides at one codon has never been reported in Indonesia before and this phenomenon is important for leprosy control policy.
COMPARATIVE STUDY ON THE INTENSITY OF Mycobacterium leprae EXPOSURE BETWEEN HOUSEHOLD AND NONHOUSEHOLD CONTACT OF LEPROSY Arsyad, Yuniarti; Jifanti, Friska; Amiruddin, Muhammad Dali; Anwar, Anis Irawan; Adriaty, Dinar; Wahyuni, Ratna; Iswahyudi, Iswahyudi; Agusni, Indropo
Indonesian Journal of Tropical and Infectious Disease Vol 3, No 1 (2012)
Publisher : Institute of Topical Disease

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Abstract

Leprosy stills a public health problem in West Sulawesi which has a Case Detection Rate (CDR) around 43.69/100.000 population. Household contacts of leprosy are a high risk group to be infected, due to droplet infection mode of transmission of the disease. A nose swab examination and serological study was conducted to detect exposure of M. leprae of people who live in leprosy endemic area. Detection of M. leprae in the nasal cavity will represent the exposure rate from outside and the measurement of specific antibody is represented the result of exposure to the immune system. Two group of inhabitants (30 household contacts of leprosy and 30 nonhousehold contacts) were involved in the study. They live in Banggae district, a leprosy endemic area of Majene Regency, West Sulawesi. Sixty nose swab samples and sixty capillary blood samples from the same invidividuals of the two groups were collected and sent to Leprosy laboratory of the Institute of Tropical Disease, Airlangga University Surabaya. A Polymerase Chain Reaction (PCR) was performed to the nose swab samples for detection of M. leprae. The blood samples were examined serologically to measure the level of anti PGL-1 antibody. PCR examination of nose swab samples showed 1/30 positive result in the household contact group and also 1/30 positive result in non-household contact of leprosy (statistically no significant difference, p > 0.05). Serological study showed higher sero-positive result in the household contact group (15/30 or 50%) compared to non-household contact (11/30 or 36%), but statistical calculation revealed no significant difference between the two groups (p > 0.05) on sero-positive results of leprosy. It is concluded that household and non-household contact in leprosy have the same risk to be affected by the disease. The term of household and non-household contact need to be redefined. The possible role of exposure from the environment was also discussed, especially from non-human resource of M. leprae.
Mycobacterium leprae BACILLEMIA IN BOTH TWINS, BUT ONLY MANIFEST AS LEPROSY IN ONE SIBLING Sukmawati, Netty; Agusni, Indropo; Listiawan, M. Yulianto; Prakoeswa, Cita Rosita S.; Adriaty, Dinar; Wahyuni, Ratna; Iswahyudi, Iswahyudi
Indonesian Journal of Tropical and Infectious Disease Vol 5, No 7 (2015)
Publisher : Institute of Topical Disease

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Abstract

Leprosy in twins is rarely reported. A 19 years-old male student, from Lamongan district, was diagnosed as Multibacillary (MB) leprosy in the Skin and STD Clinic of Dr. Soetomo General Hospital Surabaya. Multiple anesthetic skin lesions were found, but the bacteriologic examination was negative for Acid Fast Bacilli (AFB). Histopathology examination support the diagnosis of BL type of leprosy. His twin brother that has been lived together since born until present seems healthy without any complaints of skin lesions and have no signs of leprosy. When a serologic examination for leprosy was performed, a high anti PGL-1 antibody level was found in patient (IgM anti PGL-1 2937 and IgG anti PGL-1 3080 unit/ml) while his healthy twin brother showed only low level (IgM 745 and IgG 0 unit/ml). Interestingly when a PCR study was performed to detect M.leprae in the blood, both of them showed positive results. Using the TTC method, a genomic study of for M.leprae, it is revealed that both samples were identic ( 27x TTC repeats). According to patient’s history, he had a traffic accident and got a wound in the knee seven years ago, while the skin lesions seems started from this area around three years ago before it spread to other parts of the body. The patient was treated with Multi-drug therapy (MDT) while his sibling got a prophylactic treatment for leprosy. After 6 months of treatment, the leprosy skin lesions were diminished and the serologic anti PGL-1 has been decreased. His healthy brother also showed a decrease in anti PGL-1 level and no skin signs of leprosy.
Secreted Aspartyl Proteinase[SAP] Enzyme Profile on Vulvovaginalis Candidiasis Patients isolates Nugrahaeni, Diah; Agusni, Indropo; Ervianti, Evy
Berkala Ilmu Kesehatan Kulit dan Kelamin Vol 27, No 1 (2015): BIKKK APRIL 2015
Publisher : Faculty Of Medicine Airlangga University

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Background: Vulvovaginalis candidiasis (VVC) is an infection caused by various types of Candida, themost is Candida albicans. Candida produces two main enzymes that play a role in virulence, the secreted aspartyl proteinase (SAP) enzyme and the phospholipase enzyme. SAP is most widely produced by Candida albicans,which is one of the main pathogenicfactor of Candida infection. SAP is often found in cases of recurrent candidiasis vulvovaginalis (RVVC) Purpose: To evaluatethe SAP activity produced by VVC patients isolates. Methods: Descriptive observational cross-sectional study was conducted on 21 VVC patients to determine the SAP enzyme levels in VVC patients in Sexually Transmitted Infection (STI) Division, Outpatient Clinic Of Dermatology and Venerology, Dr. Soetomo General Hospital, Surabaya.Vaginal smear was examined to determine levels of SAP and culture examination to determine the kind of candida spesies that causes VVC. Results: Total subject of study are 21 patients. Twelve of  21 patients had SAP > 20 mm in diameter, 7 patients with SAP < 20 mm in diameter, and 2 patients with negative results of SAP. Fifty patients due to Candida albicans, 6 patients caused by non-albicans. Nine patients were accompanied by diabetes mellitus (DM), 1 patients by genital affection, 2 patients by condylomata acuminata. Additionally obtained in 10 patients who had previously received treatment with the results diameter SAP > 20 mm and 7 patients with of SAP diameter < 20 mm, 2 patients showed negative results of SAP. Conclusions: SAP was mainly produced by Candida albicans. SAP became more active in VVC patients that accompanied by diabetes melitus, affectiogenitalis, condylomata acuminate, and also in some patients who have received prior antifungal therapy.Key words: secreted aspartyl proteinase, vulvovaginalis candidiasis, Candida albicans,
Reverse Transcription Polymerase Chain Reaction (RT-PCR) untuk Mendeteksi Viabilitas Mycobacterium leprae pada Pasien Kusta Tipe Multibasiler Pascapengobatan MDT-WHO Gayatri, Lunni; Listiawan, M. Yulianto; Agusni, Indropo
Berkala Ilmu Kesehatan Kulit dan Kelamin Vol 26, No 2 (2014): BIKKK AGUSTUS 2014
Publisher : Faculty Of Medicine Airlangga University

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Latar belakang: Kusta masih menjadi masalah besar di Indonesia. Penatalaksanaan dengan MDT-WHO telah menjadi regimen standar untuk pasien kusta sejak lama. Pada pasien kusta tipe multibasiler (MB), indeks bakteriologis (IB) belum mencapai nilai nol, meskipun telah menyelesaikan terapi 12 regimen. Metode Reverse Transcription-Polymerase Chain Reaction (RT-PCR) memiliki sensitivitas tinggi untuk mendeteksi viabilitas M. leprae. Tujuan: Mengevaluasi viabilitas M. leprae dengan metode RT-PCR pada pasien kusta tipe MB yang telah menyelesaikan regimen MDT 12 di RSUD Dr. Soetomo Surabaya. Metode: 15 pasien kusta tipe MB yang telah menyelesaikan pengobatan MDT-WHO 12 regimen dengan IB positif dilakukan biopsi kulit untuk pemeriksaan RT-PCR. Hasil: Terdapat 13 pasien (86,7%) dengan viabilitas M. leprae positif sementara seluruh pasien tersebut (100%) memiliki Indeks Morfologis (IM) 0%. Dua belas pasien (80%) memiliki Indeks Bakteriologis 2+ dan 10 pasien diantaranya adalah pasien kusta tipe Lepromatous Leprosy (LL) polar. Delapan pasien yang memiliki viabilitas positif tidak mendapatkan kortikosteroid oral selama siklus MDT. Simpulan: Pasien kusta yang telah menyelesaikan terapi MDT dengan MI 0%, didapatkan viabilitas M. Leprae positif dengan metode RT-PCR. Spektrum klinis pasien yang ditentukan dari imunitas seluler nampaknya menjadi faktor terpenting dalam viabilitas M. leprae.Katakunci: viabilitas, M. leprae, kusta tipe multibasiler, RT-PCR.
Immunomodulators for a Variety of Viral infections of the Skin Wulan, I G A Kencana; Agusni, Indropo
Berkala Ilmu Kesehatan Kulit dan Kelamin Vol 27, No 1 (2015): BIKKK APRIL 2015
Publisher : Faculty Of Medicine Airlangga University

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Background: In the last decade there has been inceasing prevalence of viral infections in the world, this led to increased efforts to find a variety of new drugs and vaccines against the virus that causes. Purpose: To disccuss the provision relating to the use of immunomodulators in viral infections. Review: Some diseases caused by viruses such as varicella, herpes zoster, herpes simplex, condyloma acuminata, molluscum contagiosum and Human immunodeficiency syndrome (HIV). Immunomodulator also known as biological response modifier, a wide variety of materials imunoaugmentor is either recombinant, synthetic, or natural medicines that returns an imbalance of the immune system that is used in immunotherapy. Immunotherapy is a treatment approach by restoring, enhancing, or suppresing the immune response. Immunomodulator administration on viral infections gave varying results. Conclusion: Immunomodulatory regimens on viral infections is an attractive therapeutic approach, because the side effects are often lighter than the side effects of drugs that have been there, in addition to the more rarely cause resistance to treatment of diseases caused by viral infection.Key word: viral infection, immunomodulator, immune response.
Profil Pasien Kusta Baru pada Anak Wulan, I G.A. Kencana; Agusni, Indropo; Rosita, Cita
Berkala Ilmu Kesehatan Kulit dan Kelamin Vol 26, No 2 (2014): BIKKK AGUSTUS 2014
Publisher : Faculty Of Medicine Airlangga University

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Latar belakang: Kusta hingga saat ini masih menjadi masalah kesehatan di Indonesia. Kusta pada anak merupakan indeks epidemiologis untuk menentukan transmisi penyakit serta sebagai salah satu indikator dalam keberhasilan program pemberantasan penyakit kusta nasional. Tujuan: Mengevaluasi profil pasien kusta pada anak. Metode: Penelitian retrospektif terhadap semua kasus kusta baru pada anak (0-14 tahun) yang datang ke Unit Rawat Jalan (URJ) Kesehatan Kulit dan Kelamin RSUD Dr.Soetomo Surabaya mulai Januari 2009 sampai Desember 2011. Hasil: Didapatkan 37 pasien anak (5,5%) dari 677 kasus kusta baru. Kasus paling banyak (70,3%) terdapat pada kelompok usia 10-14 tahun. Laki-laki lebih banyak daripada perempuan. Berdasarkan klasifikasi WHO, sebanyak 29 kasus (78,4%) adalah kusta multibasiler (MB) dan 8 kasus (21,6%) adalah kusta pausibasiler (PB). Tipe terbanyak adalah kusta tipe BB (59,5%) pada kelompok MB dan diikuti tipe TT (16,2%) pada kelompok PB. Seluruh kasus mendapat pengobatan Multidrug Therapy (MDT) sesuai panduan WHO. Kontak serumah didapatkan 68,7% kasus. Simpulan: Ditemukan 37 kasus kusta baru pada anak di RSUD Dr. Soetomo Surabaya selama tiga tahun, terutama pada kelompok umur 10-14 tahun, dengan kasus terbanyak berupa kusta MB tipe BB. Kontak serumah masih memegang peranan yang penting pada transmisi kusta.Kata kunci: kusta, anak-anak, retrospektif.