No abstract

<p>Osteoarthritis (OA) is the most common rheumatologic disease and one of the leading causes of disability worldwide. Hand OA is the most common OA types after knee and hip OA. Risk factors include age, obesity, and family history. Abnormal mechanical loads, sex hormones, and inflammatory changes play role in pathogenesis of hand OA. Diagnosis is primarily based on clinical examination according to ACR guidelines. Plain radiography may support the diagnosis. ACR 2019 recommends comprehensive individualized treatment which include single or combination of physical, psychosocial, and/or pharmacological intervention. Topical NSAIDs are conditionally recommended. For initial oral medication, oral NSAIDs are strongly recommended and preferable to other medications. Exercise is also strongly recommended. Hand orthoses are highly recommended for patients with first CMCJ OA and conditionally recommended for patients with OA in other joints of the hand.</p><p>Osteoartritis (OA) adalah penyakit reumatologis paling umum dan salah satu penyebab utama kecacatan di seluruh dunia. Osteoartritis tangan adalah jenis OA yang paling umum setelah OA lutut dan pinggul. Faktor risiko penyakit ini adalah usia, obesitas, dan riwayat keluarga. Beban mekanis abnormal, hormon seks, dan reaksi inflamasi juga berperan pada patogenesis OA tangan. Diagnosis OA tangan dapat ditegakkan klinis sesuai pedoman ACR. Pemeriksaan radiologis dapat membantu diagnosis. Pedoman ACR 2019 merekomendasikan tatalaksana komprehensif tunggal atau gabungan dari intervensi fisik, psikososial, dan/atau farmakologis sesuai kebutuhan pasien. OAINS topikal direkomendasikan untuk OA tangan pada kondisi tertentu. Untuk pengobatan oral awal, OAINS oral direkomendasikan sebagai pilihan utama. Olahraga sangat direkomendasikan termasuk untuk OA tangan. Orthosis tangan sangat dianjurkan untuk pasien CMCJ OA awal dan direkomendasikan pada pasien OA persendian tangan lain dengan kondisi tertentu.</p><p> </p>

Objective: Anemia in chronic kidney disease (CKD) contributes in decreasing quality life, but specific hemoglobin associated with quality of life is still in debate. Anemia was thought to be one of contributing factors of low physical activity in CKD, but this finding is inconsistent across studies. This research study aims to investigate the association of hemoglobin levels with quality of life and physical activity in hemodialysis patients in our settings. Methods: This study was conducted between March 30, 2020, and April 30, 2020, in hemodialysis unit, Wangaya Regional General Hospital, Bali. The study included 50 subjects on regular hemodialysis. Subject-reported quality of life was evaluated by interview, based on Kidney Disease Quality of Life (KDQOL)-36TM questionnaire. Self-reported physical activity level was assessed by International Physical Activity Questionnaires (IPAQ). Results: Quality of life in burden of kidney disease categories is different significantly between hemoglobin levels group (*p=0.034). There is significant difference between hemoglobin levels < 8 g/dL with 8.1–12 g/dL (**p=0.01) and hemoglobin levels < 8 g/dL with > 12 g/dL (*p=0.034). For self-reported physical activity, hemoglobin level was not associated with physical activity in Fisher’s exact test analysis (p=1.000). Conclusion: We found that hemoglobin levels > 8 g/dL were associated with higher quality of life in hemodialysis patient. Hemoglobin levels were not associated with physical activity. Recommended hemoglobin levels to support the best quality of life and physical activity without increasing mortality rate are still in need to be further evaluated.