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Ogilvie's Syndrome: Acute Colonic Pseudoobstruction. A Review For Residents., Tyler Bayliss, Caleb Clark, Errington C. Thompson

Marshall Journal of Medicine

Ogilvie's syndrome (acute colonic pseudoobstruction) was first described in 1948. Acute colonic pseudoobstruction can occur in a variety of clinical settings, including postsurgical, obstetrics, pelvic surgery, critical care and sepsis. Clinicians need to recognize the syndrome early. Colonic distention without evidence of obstruction can be seen on plain films of the abdomen or CT scan. Successful therapies, including bowel rest, neostigmine and colonoscopic decompression, have been used. Avoiding respiratory compromise from abdominal distention and colonic perforation of the primary goals of treatment. Surgical intervention should be reserved for patients who are refractory to medical treatment or develops signs and symptoms …

Autoimmune Hepatitis: An Unusual Presentation., Ahmed Ali Aziz, Muhammad Ali Aziz, Deep Mehta, Muhammad Humayoun Rashid

Journal of Community Hospital Internal Medicine Perspectives

Autoimmune hepatitis (AIH) is a chronic inflammatory liver disease that occurs in a bimodal age distribution in the second and fifth-sixth decade of life. The disease is more prevalent in females and presents with variable clinical manifestations ranging from being asymptomatic to acute liver failure. AIH is often overlooked and not worked up in elderly patients who present with liver failure. This can lead to increased morbidity and mortality in elderly patients. AIH should be considered as a differential diagnosis in patients who present with elevated transaminases regardless of age or gender as early recognition and treatment leads to improved …

Cases From A Community Hospital…Jchimp Series #2: 66-Year-Old Man With Recurrent Painful Rashes And Oral Ulcerations, Fatima Halilu, Jing Wu, Joseph Fuscaldo, Nathan Dunsmore, Zain Syed, Pauline Daley

Journal of Community Hospital Internal Medicine Perspectives

This is part of a series of case reports detailing scenarios from our community hospital. The cases are selected to feature clinical dilemmas, provide a review on what is currently known about the topic with expert perspective. A 66-year-old black man presented to the primary care clinic with his fourth episode of generalized painful rash and oral ulcerations without a diagnosis despite two emergency room (ED) visits alongside doxycycline treatment. Symptoms interfered with daily activities with skin exam notable for widespread erythematous patches and plaques. In office biopsies were obtained with final diagnosis of erythema multiforme. Etiologic workup revealed positive …

Rare Case Of Mycobacterium Avium Complex Peritonitis In A Patient With Multiple Myeloma Undergoing Peritoneal Dialysis, Sacide S. Ozgur, Nida Ansari, Dhruv Patel, Ryan Rahman, Raymond Shih

Journal of Community Hospital Internal Medicine Perspectives

Mycobacterium avium complex (MAC) infections can present as a variety of severe diseases. While it has a predilection for immunocompromised patients such as those with Human immunodeficiency virus (HIV), it can also affect immunocompetent patients as well. One of the rare yet severe diseases that MAC infections can present is MAC peritonitis. Often hard to distinguish from other causes of peritonitis, high clinical suspicion should be maintained for those who are susceptible. Here we present an 85-year-old female with a past medical history of end-stage renal disease on peritoneal dialysis who presented with nausea and vomiting. She was found to …

De-Implementation Of Fecal Occult Blood Testing In The Emergency Department And Hospital Units: A Quality Improvement Project, Adewale Ajumobi, Joline De Castro, Ammar Qureshi

Journal of Community Hospital Internal Medicine Perspectives

Background: Fecal occult blood tests (FOBT) are inappropriately used in patients with melena, hematochezia, coffee ground emesis, iron deficiency anemia, and diarrhea. The use of FOBT for reasons other than screening for colorectal cancer is considered low-value and unnecessary. Methods: Quality Improvement Project that utilized education, Best Practice Advisory (BPA) and modification of order sets in the electronic health record (EHR). The interventions were done in a sequential order based on the Plan-Do-Study-Act (PDSA) method. An annotated run chart was used to analyze the collected data. Results: Education and Best Practice Advisory within the EHR led to significant reduction in …

Comparison Of Risk Factors Of Mortality During The Two Coronavirus Disease 2019 Waves In Delhi, India, Neena Katoch, Ajay K. Gupta, Rachna Gulati, Ketan Garg, Vikas Kumar

Journal of Medicine in Scientific Research

Objective To determine the risk factors of mortality (in terms of age, sex, and comorbidities) among hospitalized patients in an Indian tertiary care hospital during the first and second waves. Patients and methods A retrospective observational study was conducted, where the patients’ mortality data were collected over two coronavirus disease 2019 (COVID-19) periods, and their characteristics were compared. The first phase was from May 2020 to January 2021 and the second wave was from March 2021 to August 2021. Results A mortality rate of 23.84% (874 deaths among 3666 patients) and 1.36% (232 deaths among 17 000 patients) was noted …

Pentingnya Edukasi Pasien Lupus Eritematosus Sistemik, Evy Yunihastuti, Fadlika Harinda

Jurnal Penyakit Dalam Indonesia

Lupus eritematosus sistemik (LES) merupakan penyakit kronik yang dapat mengenai berbagai macam organ dengan manifestasi ringan hingga serius. Karakteristik LES adalah sangat dinamis, bervariasi, dengan perjalanan penyakit yang kadang tidak dapat diprediksi. Walau saat ini semakin tinggi pengetahuan tentang patofisiologi, optimalisasi penanganan, dan banyak ditemukan obat yang lebih baik untuk terapi LES, masih banyak ODAPUS (orang dengan lupus) mengalami morbiditas, mortalitas, dan kualitas hidup yang kurang baik. Tanpa penanganan yang baik, pemantauan dan pengobatan yang teratur, tentu luaran yang baik akan lebih sulit didapatkan.

Uji Coba Pemberian Snack Bars Berbahan Dasar Tape Ketan Hitam Sebagai Sumber Serat Terhadap Penurunan Kadar Glukosa Darah Puasa Pasien Diabetes Melitus Tipe 2, Muhammad Muayyad Billah, Budiyanti Wiboworini, Adi Prayitno

Jurnal Penyakit Dalam Indonesia

Introduction. Managing dietary pattern, including snack schedule, is one of the most important factors in maintaining blood glucose levels in patients with type 2 diabetes mellitus (T2DM). Black glutinous rice tape is one of the foods that contains bioactive nutrient and fiber beneficial to health. This study aimed to determine the effect of snack bars made from black glutinous rice tape on fasting blood glucose levels in T2DM patients.

Methods. The study employed a quasi-experimental pre and post-test design with a control group which was conducted among T2DM patients undergoing treatment at Bhayangkara Tk. II Sartika Asih Hospital, …

Survei Kebutuhan Edukasi Pasien Lupus Eritematosus Sistemik, Jennifer Josephine, Alvina Widhani, Rahmat Cahyanur, Teguh Harjono Karjadi

Jurnal Penyakit Dalam Indonesia

Introduction. Patients with systemic lupus erythematosus (SLE) who suffer from chronic illness, need tailored education to better manage their condition. As nowadays education through internet and social media contributes significantly. This study aimed to assess internet usage related to lupus, educational needs, and education sources preferences among patients.

Methods. This study was a cross-sectional study conducted on adult SLE patients at Allergy and Clinical Immunology Clinic, Internal Medicine Department, Cipto Mangunkusumo Hospital, Jakarta, between July-August 2023. Respondents completed a set of questionnaires regarding their internet usage related to lupus, education platform preferences, and educational needs assessment tool (ENAT). …

Modifikasi Skor Timi Sebagai Model Prediksi Mortalitas 30 Hari Pasien Stemi Muda, M. Tasrif Mansur, Muhammad Yamin, Lusiani Rusdi, Murdani Abdullah, Birry Karim, Cleopas Martin Rumende, Maruhum Bonar H. Marbun, Hamzah Shatri

Jurnal Penyakit Dalam Indonesia

Introduction. Cardiovascular disease is a leading cause of death worldwide. Three-quarters of these deaths occur in lowand middle-income countries among individuals in their productive years. ST-segment elevation myocardial infarction (STEMI) is a dangerous manifestation of coronary artery disease (CAD) and can lead to sudden death. Smoking and a family history of early CAD are major risk factors for STEMI cases. However, their role in any risk stratification system for patients has not been clearly established. The most widely used score in assessing the prognosis of STEMI patients is the TIMI score, but its accuracy in the young patient population …

Penyakit Sel Sabit Pada Pasien Laki-Laki Berusia 27 Tahun Yang Sebelumnya Didiagnosis Sebagai Talasemia: Sebuah Laporan Kasus, Rahmat Cahyanur, Andree Kurniawan, Ratuafni Sharfina, Nadia Ayu Mulansari

Jurnal Penyakit Dalam Indonesia

Sickle cell disease (SCD) is a hemoglobinopathy inherited in an autosomal recessive pattern arising from a mutation causing substitution of valine for glutamic acid in the sixth amino acid of the β-globin chain. The clinical manifestation of SCD varies from acute pain, chronic anemia, to multi-organ infarct and failure. SCD is known to be rare in Indonesia. However, we recently encountered a SCD patient presenting with recurrent pain and hypesthesia since a year ago. The diagnosis of SCD in this patient was established based on the results of peripheral blood smear and hemoglobin electrophoresis. The patient had previously been diagnosed …

Kombinasi Sofosbuvir-Ledipasvir Dan Sofosbuvir- Daclatasvir Pada Pengobatan Pasien Hepatitis C Di Indonesia, Andri Sanityoso Sulaiman Dr, Irsan Hasan Dr, Cosmas Rinaldi Adithya Lesmana Dr, Juferdy Kurniawan Dr, Gita Aprilicia, Yayah Nugroho Dr, Nunuk Tri Wahyuni Dr, Budiman Sujatmika Sulaiman

Jurnal Penyakit Dalam Indonesia

Introduction. Direct-acting antivirals (DAAs) has been developed for treatment hepatitis C virus (HCV). Therapy of HCV using DAA has shown high sustained virologic response (SVR) and shortening duration of therapy. Sofosbuvir-ledipasvir (SOF/LDV) is fixed dose combination tablet of DAAs which recommended for genotype 1, 4, 5, and 6 infected patients. In developing countries, SOF/LDV still can be used as cost-effective regimen in all genotype compared with sofosbuvir-daclatasvir (SOF/ DCV). This study aimed to evaluate the efficacy of combination sofosbuvir-ledipasvir in all genotypes of HCV patients compared with available DAA in Indonesia (sofosbuvir- daclatasvir).

Methods. A retrospective study was …

Angka Kejadian Dan Karakteristik Klinis Pasien Infeksi Jamur Invasif Di Rsup Dr. Hasan Sadikin Tahun 2020 – 2022, Ariella Alessandro, Nisa Fauziah, Imam Megantara, Rudi Wisaksana, Intan Mauli Warma Dewi

Jurnal Penyakit Dalam Indonesia

Introduction. Invasive fungal infection (IFI) is increasingly common in patients at risk, especially those with impaired immune response. In Indonesia, there is currently a low prevalence of IFI which may be influenced by challenges in diagnosis. This study aimed to determine the prevalence and clinical characteristics of IFI patients in Dr. Hasan Sadikin Hospital in Bandung, Indonesia.

Methods. This cross-sectional study was conducted at Dr. Hasan Sadikin Hospital. Data were collected using medical records of IFI patients diagnosed between 2020 and 2022 which were selected using total sampling method. Demographic data, clinical symptoms, radiological appearance, and laboratory results …

Efektivitas Sacubitril/Valsartan Dalam Mencegah Gagal Jantung Pada Stemi Pasca Percutaneous Coronary Intervention, Nobian Andre, Lana Adila, Aulia Rizka, Lusiani Rusdi

Jurnal Penyakit Dalam Indonesia

Heart failure is a possible complication following ST-elevation myocardial infarction (STEMI) even after revascularization. Neuroendocrine activation in the process of ventricular remodeling can be regulated by angiotensin receptor-neprilysin inhibitor (ARNI) as well as angiotensin-converting enzyme (ACE) inhibitor. The use of ARNI in heart failure with reduced ejection fraction has been found to be superior to ACE inhibitor. The role of ARNI on cardiac function in STEMI has not been established. A clinician treating a patient with STEMI considered giving sacubitril/valsartan to reduce the risk of developing heart failure. Literature search was performed in three electronic databases: PubMed, Embase, and Cochrane. …

On The Discontinuation Of Enteral Feeding In Head And Neck Cancer: A Case Report, Kyle Fisk, Ana Sanchez

HCA Healthcare Journal of Medicine

Introduction

The goal of palliative care is to preserve the quality of life or patient “comfort” in patients with serious diseases. Palliative care providers serve a wide range of patients: from those who seek curative treatment to those who are actively dying. Given this range, palliative care must mirror the dynamic goals of the patient at different stages of life and treatment. Throughout these stages, a goal of the palliative care provider would be to avoid hastening death; however, this often leads to clinical decisions that directly pit the patient’s comfort against the patient’s life span. This is most salient …

A Rare Case Of Candida Glabrata Cervical Spondylodiscitis, Angelina Hong, Lily Hyungjung Lim, Ali Tariq Alvi, Pallavi Aneja

HCA Healthcare Journal of Medicine

Introduction

Invasive candidiasis can lead to numerous life-threatening sequelae. Candida glabrata is the second-most common causative species of invasive candidiasis. This species possesses a high risk for persistent infection and candidemia. An uncommon complication of invasive candidiasis is spondylodiscitis and can rarely affect the cervical spine.

Case Presentation

The patient is a female in her late 50s with a complex medical history inclusive of chronic obstructive pulmonary disease, chronic pain, multiple abdominal surgeries, prolonged intensive care unit admission, and administration of total parenteral nutrition and broad-spectrum antibiotics who presented with complaints of worsening neck pain. She was last hospitalized 3 …

Kounis Syndrome – Anaphylaxis-Induced Acute Coronary Syndrome, Austin T. Thacker Do, Brachman Herzig Oms, Brendan Robinson Do, Ahad Anjum Do

Advances in Clinical Medical Research and Healthcare Delivery

Kounis syndrome is an underdiagnosed condition in which anaphylaxis triggers vasospastic acute coronary syndrome, either with or without underlying coronary artery disease. The prevalence of this syndrome among hospitalized patients for allergic/hypersensitivity/anaphylactic reactions in the United States is 1.1%, with a 7% rate of all-cause inpatient mortality. This article presents an anaphylaxis-induced acute coronary syndrome case in a patient with underlying coronary artery disease. The pathophysiological mechanism of anaphylactic-induced acute coronary syndrome involves the inflammatory mediators of type I hypersensitivity reactions.

Minoca - A Rarity Of It's Own And The Importance Of Cardiac Mri, Abdullah A. Orakzai, Deeptanshu Jain Md, Muhammad Osama, Syeda Sarah Raza, Soon-Il Song

Advances in Clinical Medical Research and Healthcare Delivery

Myocardial infarction with non-obstructive coronary arteries (MINOCA) disease is a diagnostic dilemma with clinical evidence of acute myocardial infarction (AMI) with normal coronary arteries. MINOCA is a complex issue; the management of the patients needs to be focused on identifying the core problem. Cardiac magnetic resonance (CMR) imaging is a non-invasive diagnostic tool that can play an important role in enabling clinicians to build a differential diagnosis in patients with MINOCA and also identify other non-ischemic aetiologies of myocardial injury. We present a challenging case of a patient with MINOCA with MI in small proximal septal artery distribution revealed on …

Adult Ileoileal Intussusception Caused By Diffuse Large B-Cell Lymphoma, Scarlet Louis-Jean, Shire Chaudhry, Stephanie Richards

Journal of Community Hospital Internal Medicine Perspectives

Adult intussusception is a rare diagnosis that can be caused by non-Hodgkin’s diffuse large B-cell lymphoma (DLBCL). In this case report, we discuss a middle-aged man who presented with non-specific symptoms of intussusception and absence of classic B symptoms. He was found to have intussusception secondary to stage IIIE, CD20 positive DLBCL. The patient underwent small bowel resection with anastomosis, followed by 6 cycles of R-CHOP, which resulted in complete remission of his neoplasm. In reporting this case, we hope to further highlight the role of malignancy in intussusception and guidance on appropriate therapy.

Ciprofloxacin-Induced Peripheral Neuropathy: A Case Report, Alexander Refaeian, Eric L. Vest, Michael Schmidt, Jorge D. Guerra, Mohd N. Refaei, Michael Refaeian, Ryan A. Floresca, Manouchehr Refaeian

HCA Healthcare Journal of Medicine

Introduction

Fluoroquinolones, a class of antibiotics, are commonly employed in the treatment of a wide array of bacterial infections. Recognized for their effectiveness against a broad spectrum of pathogens, fluoroquinolones have played a pivotal role in managing conditions like urinary tract infections and respiratory diseases. Nevertheless, their usage is not without contention due to their association with a variety of adverse effects, including tendon rupture and the less frequently reported issue of peripheral neuropathy.

Case Presentation

We present the case of a 42-year-old male who developed peripheral neuropathy several days after completing a 10-day course of ciprofloxacin for gastroenteritis. The …

Exploration Of Burnout, Emotional Thriving, And Emotional Recovery In An Academic Medical Center: A Mixed Methods Quality Improvement Project, Roxana Naderi, Katherine T. Morrison, Zuzanna Czernik, James E. Carter Jr, Katherine N. Dickerman, Alexandra Gallant, Lara Kirkbride-Romeo, Lauren Mcbeth, Angela Keniston, Kristin M. Jensen

Journal of Wellness

Introduction: Healthcare provider burnout, an indicator of wellbeing, impacts patient safety, provider distress, and employee turnover. In this mixed methods, multi-site quality improvement study conductedpandemic, we assessed employee wellbeing in a large clinical department.

Methods: Wellbeing surveys were sent electronically to Department of Medicine clinicians, researchers, administrators, and staff from August-September 2019 assessing perceptions of Burnout, Emotional Thriving (ET), and Emotional Recovery (ER). Qualitative responses were reviewed for themes using mixed inductive-deductive analysis. The initial coding was done by small teams with consensus obtained through large group discussions. This study was IRB-approved as non-human subjects research.

Results: Of the 671 …

Perbedaan Kadar Insulin-Like Growth Factor-1 Dan Tumor Necrosis Factor-Α Serum Pada Berbagai Derajat Sarkopenia Pasien Lanjut Usia: Studi Potong Lintang, Auliangi Tamayo, Roza Mulyana, Rose Dinda Martini

Jurnal Penyakit Dalam Indonesia

Introduction. Sarcopenia is a phenomenon of progressive decline in muscle function that occurs due to the aging process. Insulin-like growth factor-1 (IGF-1) and tumor necrosis factor-α (TNF-α) have an important role in the occurrence of sarcopenia as a positive and negative regulator of muscle mass. Research shows differences in IGF-1 and TNF-α levels between sarcopenia and non-sarcopenia groups, but research on differences in severity of sarcopenia remains unclear. The purpose of this study was to determine the difference in levels of IGF-1 and TNF-α in various degrees of sarcopenia in elderly patients.

Methods. This was an analytical observational …

Manajemen Koinfeksi Malaria Berat Dengan Hiv Belum Mendapat Terapi Antiretrovirus Di Era Pandemi Covid-19: Sebuah Laporan Kasus, Paul Harijanto, Rosye Mawuntu, Novia Rusli, Randy Adiwinata, Agung Nugroho

Jurnal Penyakit Dalam Indonesia

Severe malaria is a serious infectious disease that required immediate diagnosis and prompt treatment. Severe malaria may result several organ failures which is similar with other infectious diseases like SARS-CoV-2, sepsis, dengue, and HIV infection. Most of those infection have similar symptoms such as fever, myalgia, and headache, therefore physician should have high suspicion regarding co-infection with other infectious agents. The overlapping symptoms of co-infections may become a challenge for physician in diagnosing and delivering prompt therapy. Failure to deliver prompt treatment may lead to fatal outcome such as in severe malaria case. Stigmatization of all patients with fever and …

Perlemakan Hati Non-Alkoholik Dan Risiko Fibrosis Hati Pada Pasien Hepatitis B Kronik, Andri Sanityoso Sulaiman, Irsan Hasan, Cosmas Rinaldi A. Lesmana, Juferdy Kurniawan, Chyntia Olivia Maurine Jasirwan, Saut Horas H. Nababan, Kemal Fariz Kalista, Gita Aprilicia, Rino Alvani Gani

Jurnal Penyakit Dalam Indonesia

Introduction. Prevalence of non-alcoholic fatty liver disease (NAFLD) is increasing throughout the world due to sedentary lifestyle and dietary habit, including in patients with chronic hepatitis B (CHB). In several studies, advanced of liver disease were more likely observed among those CHB patients with NAFLD. NAFLD might increase the risk of liver disease progression in CHB patients, but prior investigations were still limited. This study aimed to determine the association between NAFLD and risk of liver fibrosis in CHB patients.

Methods. All patients with positive serum hepatitis B surface antigen in the Hepatobilier Data Registry, Cipto Mangunkusumo Hospital, …

Faktor-Faktor Yang Memengaruhi Kesintasan Pasien Yang Dilakukan Intervensi Koroner Perkutan Primer, Birry Karim

Jurnal Penyakit Dalam Indonesia

No abstract provided.

Profilaksis Vs. Terapi Preemtif Penyakit Cytomegalovirus (Cmv) Pada Pasien Transplantasi Ginjal Risiko Tinggi: Suatu Laporan Kasus Berbasis Bukti, Ariani Intan Wardhani, Rahajeng N. Tunjungputri, Erpryta Nurdia Tetrasiwi, Maruhum Bonar Marbun

Jurnal Penyakit Dalam Indonesia

Kidney transplant recipients require the use of immunosuppressive agents to prevent multiple organ rejection. Administration of immunosuppressive agents triggers an increased risk of impaired immunity and microbial infections, one of which is cytomegalovirus (CMV). Prevention of cytomegalovirus infection can be given as a prophylaxis or preemptive therapy. However, the efficacy of choosing prophylaxis or preemptive therapy is still under debate, thus we conducted this study to identify current approach in preventing CMV disease in clinical practice. A literature search was carried out using the PubMed, Cochrane Library, Embase and Scopus databases with the keywords “high risk …

Kesintasan Satu Tahun Pasien Yang Menjalani Intervensi Koroner Perkutan Primer Di Rumah Sakit Dr. Cipto Mangukusumo, Muhammad Afriadi Hamdan, Ika Prasetya Wijaya, Alvina Widhani, Muhammad Yamin

Jurnal Penyakit Dalam Indonesia

Introduction. Primary percutaneous coronary intervention (PPCI) is an angioplasty (with or without a stent) performed immediately on the infarct-related artery without prior administration of fibrinolytics. Although PPCI is the reperfusion therapy of choice in ST-segment Elevation Myocardial Infarction (STEMI) patients, survival in post-PPCI patients still varied and research on its determinant factors still showed inconsistent results. This study aimed to determine the predictors of oneyear survival in patients undergoing PPCI at Dr Cipto Mangunkusumo General Hospital.

Methods. This retrospective cohort study evaluated the medical records of patients who underwent PPCI at Dr. Cipto Mangunkusumo General Hospital from January …

Perbedaan Serotonin Plasma Dan Kortisol Saliva Terhadap Gejala Depresi Pada Pasien Pasca Sindrom Koroner Akut, Irman Firmansyah, Hamzah Shatri, Rudi Putranto, Yanuar Ardani, Eka Ginanjar, Sukamto Koesnoe, Aulia Rizka, Harry Isbagio, Em Yunir

Jurnal Penyakit Dalam Indonesia

Introduction. Psychological disorders are closely associated with hormonal factors, including cortisol and serotonin. In patients with acute coronary syndrome (ACS), autonomic dysfunction and dysregulation of the hypothalamic-pituitaryadrenal (HPA) axis can occur, leading to an increase in cortisol levels that may worsen the prognosis of ACS patients. Therefore, it is important to understand the hormonal impact, namely cortisol and serotonin levels, on depressive symptoms, which will be examined in this study.

Methods. This was a cross-sectional study to determine the impact of cortisol and serotonin in the incidence of depression in post-treatment ACS patients at the ICCU RSUPN dr. …

Profil Pasien Ketoasidosis Diabetikum Di Rumah Sakit Rujukan Tersier Di Bali, Indonesia, Noviana Joenputri Nj, Ketut Suastika Ks, Wira Gotera Wg, Made Ratna Saraswati Mrs, I Made Pande Dwipayana Impd, I Made Siswadi Semadi Imss, Ida Bagus Aditya Nugraha Iban

Jurnal Penyakit Dalam Indonesia

Introduction. Diabetic ketoacidosis (DKA) is one of life-threatening acute complication of diabetes mellitus (DM) characterized by hyperglycemia, ketosis, and acidosis. The prevalence of DM is increasing, therefore the incidence of DKA is predicted to continue to increase. The aim of this study was to obtain the profile of DKA patients in RSUP Prof. Dr. IGNG. Ngoerah (RSPN), Denpasar, Bali as a tertiary refferal hospital of Bali and Nusa Tenggara region.

Methods. This study was a cohort retrospective study. All patients aged 18 years or older with a diagnosis of DKA during Januari 2022 to February 2023 at RSPN, …

Sarkopenia Pada Lanjut Usia: Patogenesis, Diagnosis Dan Tata Laksana, Edwin Nugroho Njoto, I Gusti Putu Suka Aryana

Jurnal Penyakit Dalam Indonesia

‘Sarcopenia’ involves a progressive age-related loss of muscle mass and associated muscle weakness that renders frail elders susceptible to serious injury from sudden falls and fractures and losing their functional independence. This disease has a complex multifactorial pathogenesis, which involves not only age-related changes in neuromuscular function, muscle protein turnover, and hormone levels and sensitivity, but also a chronic pro-inflammatory state, oxidative stress, and behavioral factors – in particular, nutritional status and degree of physical activity. In the previous definition by the European Working Group on Sarcopenia in Older People (EWGSOP) in 2010, the diagnosis of sarcopenia requires the presence …