Medicine and Health Sciences Commons^™

The Challenges Of Diagnosis And Management Of Suspectedautoimmune Hepatitis In A 34-Year-Old Woman With Periodicparalysis And Graves’ Disease, Yeni Larasati, C. Singgih Wahono

Jurnal Penyakit Dalam Indonesia

Periodic paralysis hypokalemia is a muscle weakness that can be caused by hyperthyroidism due to Graves’ disease. The prevalence reaches 10% of patients with periodic paralysis hypokalemia with symptoms of thyrotoxicosis. Graves’ disease is an immune system disorder that can cause other organ dysfunction, such as autoimmune hepatitis. Currently, the diagnosis of autoimmune hepatitis is still a challenge for clinicians due to limited supporting examination facilities, such as SMA, AMA, anti-LKM-1. This article discusses a case of a 34-year-old woman with limb weakness for 3 months, losing 4 kg of weight in 1 month, often feeling hungry, restless, having trouble …

Management Of Chronic Kidney Disease-Mineral And Bone Disorder (Ckd-Mbd), Pringgodigdo Nugroho

Jurnal Penyakit Dalam Indonesia

Chronic kidney disease (CKD) is still a burden on worldwide health issues affecting about 11-13% of the general population. Chronic kidney disease-mineral and bone disorder (CKD-MBD) is a common complication in CKD, which occurs early in the disease, and progresses as kidney function deteriorates. With declining kidney function, mineral homeostasis becomes progressively dysregulated, including alterations in several parameters such as calcium, phosphate, intact parathyroid hormone (iPTH). Changes in these parameters are associated with bone disorders and vascular abnormalities, which are strongly correlated with increased cardiovascular (CV) morbidity and mortality, and overall mortality. Currently, CKD-MBD and its complication management have been …

Factors Associated With Length Of Stay Of Covid-19 Patients At Serui Regional General Hospital Papua Province: Cross-Sectional Study, Fahri Ahmad Baihaqi, Henny Rumaropen

Jurnal Penyakit Dalam Indonesia

Introduction. Coronavirus Disease 2019 (COVID-19) is a respiratory infectious disease caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2 has become a global health problem. The length of stay of the patient is related to the use of hospital resources. COVID-19 patients are at risk of increasing length of stay due to various factors and the increased length of stay can increase the burden of health services. The purpose of this study was to determine the factors that influence the length of stay of COVID-19 patients.Methods. An observational analytic study with a cross-sectional design was conducted at Serui Regional General …

Depresi Pada Populasi Lanjut Usia Yang Menjalani Hemodialisis, Edward Faisal

Jurnal Penyakit Dalam Indonesia

Menurut laporan tahunan European Renal Association–European Dialysis and Transplant Association (ERA-EDTA), pasien yang menjalani transplantasi ginjal dari tahun 2014 sampai 2018 memiliki kesempatan hidup hanya setengah dari usia dengan sisa fungsi ginjal yang ditransplantasikan, sedangkan untuk pasien yang dilakukan hemodialisis (HD) adalah 70% lebih pendek.

The Difference In Nutrition Intake Adequacy Amonginstitutionalized Elderly Residents With And Without Sarcopeniaat Nursing Homes In Bandung, West Java, Delia Anastasia Tirtadjaja, Muhamad Apandi, Lazuardhi Dwipa

Jurnal Penyakit Dalam Indonesia

Introduction. The changes in the elderly’s daily routine including dietary intake and nutritional pattern may cause them to be more susceptible to malnutrition. The changes also increase the risk of sarcopenia that may lead to poor health outcomes such as fall injury, fracture, hospitalization, disability, or even death. Sarcopenia is more likely to occur in a nursing home compared to community settings. This study aimed to determine the difference in nutrition intake adequacy between institutionalized elderly subjects with and without sarcopenia in Bandung, West Java. Methods. A cross-sectional study was held in Ciparay and Budi Istri Nursing Home, Bandung, West …

Comparison Of Lipid Profiles In Patients With Type 2 Diabetes Mellitus With Good Glycemic Control And Poor Glycemic Control In Rsud Dr. Saiful Anwar Malang, Nyoman Satvika Dharma Yudha, Putu Moda Arsana, Rulli Rosandi

Jurnal Penyakit Dalam Indonesia

Introduction. Diabetes mellitus (DM) is a group of metabolic diseases characterized by hyperglycemia due to insulin resistance, deficiency of insulin action, or both with a prevalence of 8.5% in Indonesia. Evidence regarding the relationship between HbA1c and lipid profile in type 2 DM is currently contradictory, therefore a study was conducted to examine the relationship between glycemic control and lipid profile for DM patients.Methods. This survey research was conducted at the outpatient endocrine clinic Dr. Saiful Anwar Malang Hospital in 2014-2019 with a total of 1,308 patients. Patients were then classified into type 2 DM patients with good (HbA1c < 7%, n = 291) and poor glycemic control (HbA1c > 7%, …

Depressive Symptoms As A Predictor Factor Of All-Cause Mortality Within Six Months In Elderly Hemodialysis Patients, Langgeng Perdhana, Shofa Chasan, Yudo Murti Mupangati, Siti Nuraini

Jurnal Penyakit Dalam Indonesia

Introduction. Depression is a mental disorder that is often found in the elderly and hemodialysis patients, resulting in bad effects on patients. There is no study on the relationship between depression and all-cause mortality risk in elderly hemodialysis patients in Indonesia. This study aimed to determine the role of depression as a predictor factor of all-cause mortality within 6 months in elderly hemodialysis patients. Methods. A prospective cohort study was conducted from February to August 2020 at the hemodialysis unit of Roemani Muhammadiyah Hospital, Semarang. The inclusion criteria were elderly patients (aged ≥60 years), undergoing hemodialysis ≥3 months, hemodialysis frequency …

The Relationship Of Subjective Global Assessment (Sga) With Energy Intake, Protein, Hand Grip Strength And Body Mass Index In Chronic Kidney Disease (Ckd) Patients With Continuous Ambulatory Peritoneal Dialysis (Capd), Yudhi Adrianto, Ni Made Hustrini, Triyani Kresnawan, Annisa Eka Amelia, Fitri Hudayani

Jurnal Penyakit Dalam Indonesia

Introduction. Energy and protein intake in chronic kidney disease (CKD) with continuous ambulatory peritoneal dialysis (CAPD) therapy plays an important role in balancing hypercatabolic conditions. Unbalanced intake will result in energy and protein deficits which are increasing the risk of muscle catabolism, decreasing body mass index (BMI), and malnutrition. Subjective global assessment (SGA) as the gold standard in nutritional assessment is needed in assessing nutritional status and determining malnutrition, therefore nutritional intervention can be delivered and improve CAPD patients’ quality of life. This study was conducted to determine the relationship between SGA with energy and protein intake, hand grip strength, …

Correlation Between Polypharmacy And Length Of Stay Geriatric Patient In Mohammad Hoesin Palembang Hospital, Iswadi Tanzil, Nur Riviati, Irsan Saleh

Jurnal Penyakit Dalam Indonesia

Introduction. Geriatric patients have multipathological characteristics, low physiologic reserves, atypical clinical signs and symptoms, decreased functional status, and nutritional disturbances. This situation is a risk factor for polypharmacy. Polypharmacy is closely related to drug side effects, drug interactions, and patient compliance. Polypharmacy is thought to have a relationship with the length of stay in geriatric patients. The purpose of this study was to determine the correlation between polypharmacy and length of stay in geriatric patients at Moehammad Hoesin Hospital Palembang. Methods. This was a cross-sectional study with a correlation test design conducted at Dr. Mohammad Hoesin Hospital (RSMH) Palembang from …

Depression In Heart Failure: Psychosomatic Approachv, Rudi Putranto, Hamzah Shatri, Ika Prasetya Wijaya, Edward Faisal

Jurnal Penyakit Dalam Indonesia

Depression is a common condition in heart failure (HF) and is considered a risk factor for cardiovascular disease. Depression disorder in patients with heart disease paradigmatically defines a psychosomatic-somatopsychic challenge to any health delivery. However, despite the devastating effects of depression, it is often underdiagnosed and receives little attention in heart failure patients. This review provides an extensive overview of HF regarding epidemiology, disease pathophysiology, diagnosis, and management from the latest literature. Based on the literature review, the prevalence of depression in heart failure in Indonesian patients was 5.3-42%. Psychological stress experienced by people suffering from depression can cause dysregulation …

Neutrophil Lymphocyte Ratio, Three Year Survival Of Locally Advanced And Advanced Nasopharyngeal Carcinoma, Rahmat Cahyanur, Hayatun Nufus, Cosphiadi Irawan

Jurnal Penyakit Dalam Indonesia

Introduction. Nasopharyngeal carcinoma (NPC) is the most prevalent head and neck malignancy in Indonesia, as NPC-related mortality in Indonesia is the second-highest in Asia after China. Inflammation has been studied to be associated with cancer progression. Neutrophil lymphocyte ratio describes the balance between the unfavorable suppression of immune response against cancer by neutrophils and the beneficial effect of adaptive immunity by lymphocytes. This study aimed to determine the relationship between NLR and the survival of locally advanced and advanced NPC patients.Methods. A retrospective cohort study was conducted using the medical records of NPC patients treated at the hematology clinic RSCM …

The Role Of Albumin And Hemoglobin As Predictors Of 28-Day Mortality In Elderly Sepsis Patients In Mohammad Hoesin Hospital Palembang, Widya Mandala Sari Gultom, Nur Riviati, Rizky Perdana, Syarif Husin

Jurnal Penyakit Dalam Indonesia

Introduction. Sepsis is defined as organ dysfunction caused by dysregulation of the host’s response to infection. The majority of sepsis are experienced by elderly patients with high mortality rates. In the condition of sepsis, there are various body mechanisms that cause a decrease in albumin and hemoglobin. This study is to determine the predictive value of albumin and hemoglobin levels on 28-day mortality of elderly sepsis patients.

In-Hospital Mortality Risk Factors Among Hospitalized Geriatric Patients: A Cohort Study On Tertiary Referral Hospital In Indonesia, Fadhil Abiyyu Yofi, Arlia Ayu Damayanti, Novira Widajanti

Jurnal Penyakit Dalam Indonesia

Introduction. Decreasing fertility rates and increasing life expectancy cause an increase in the population of the elderly, with the number of elderly in the world is estimated to increase from 9.3% in 2020 to 16.0% in 2050. 24.35% of the elderly in Indonesia experience illness, and 8.71% have been hospitalized in one year. This study aimed to determine the risk factors for the death of elderly who were hospitalized.

Cutaneous Anthrax In Gunung Kidul, Yogyakarta: A Case Report, Riswanto Riswanto, Dhani Redhono, Evi Nurhayatun

Jurnal Penyakit Dalam Indonesia

Bacillus anthracis is an aerobic, gram-positive, and spore-forming Bacillus species. The most common form of anthrax infection is the cutaneous form. The infection usually develops several days after exposure to products of infected animals and manifest as a black sore with severe swelling on the skin. In this report, a 60-year-old man with a black and swollen lesion on her index finger presented in Gunung Kidul in December 2019. ELISA antibody anthrax serum was performed. The patient was then treated with antibiotics after diagnosis. This patient had a history of contact with the beef of a slaughtered sheep. The patient …

Predictors Of Handgrip Strength Changes In Elderly Patients, Ummi Ulfah Madina, Siti Setiati, Purwita Wijaya Laksmi, Arif Mansjoer

Jurnal Penyakit Dalam Indonesia

Introduction. The increasing elderly population throughout the world has been related to the increased prevalence of sarcopenia and frailty. Handgrip strength is a component of sarcopenia, one of frailty syndrome phenotypes. Previous studies have assessed the association of age, sex, nutritional status, functional status, mental status, and comorbidity, but varied results. No longitudinal study has been done to determine the correlation of handgrip strength changes with age, sex, nutritional status, functional status, mental status, and comorbidity in Indonesia. The aim of this study was to determine the correlation between age, sex, nutritional status, functional status, depressive symptoms, comorbidity, and handgrip …

The Influence Of Characteristics And Behavior On The Incidence Of Pulmonary Tuberclosis In Al-Hidayah Pesantren, Kejuruan Muda Subdistric Tamiang District, Aceh Province, 2019, Indah Anggraini, Basaria Hutabarat

Jurnal Penyakit Dalam Indonesia

Introduction. Pulmonary tuberculosis is a chronic infectious disease that is a global issue. Some factors influence the occurrence of pulmonary tuberculosis, among others, the source of infection, a high amount of virulence bacilli, and decreased endurance. This study aims to determine the effect of characteristics and behavior on the incidence of pulmonary TB disease in Al-Hidayah Islamic Boarding School, Vocational School, Aceh Tamiang Regency. Method. This research is analytic with a cross-sectional research design. Data analysis uses Chi-Square test and Logistic Regression) to determine the influence of the most dominant risk factors with pulmonary TB disease incidence. Results. The results …

Nucleoside/Nucleotide Analogues For The Treatment Of Chronic Hepatitis B: A 3-Year Follow Up Study, Andri Sanityoso Sulaiman, Irsan Hasan, Cosmas Rinaldi A Lesmana, Chyntia Olivia M Jasirwan, Saut Horas H. Nababan, Kemal Fariz Kalista, Gita Aprilicia, Rino Alvani Gani

Jurnal Penyakit Dalam Indonesia

Introduction. Chronic hepatitis B (CHB) is endemic in Indonesia, where it is usually treated with pegylated interferon and nucleoside/nucleotide analogs (NA). The aim of this study was to determine the efficacy of treating CHB infection among Indonesian patients with NA (lamivudine, telbivudine, and tenofovir) for a 3-year period.Methods. We retrospectively reviewed the records of patients with CHB infection attending the Hepatology Clinic Cipto Mangunkusumo during 2010-2013 period. Subjects with inclusion criteria were all patients aged above 18 years treated with NA for at least three years. The degree of liver stiffness, hepatitis B virus deoxyribonucleic acid (HBV-DNA), alanine aminotransferase (ALT) …

Perkembangan Terapi Hepatitis B Kronis Di Indonesia, Juferdy Kurniawan

Jurnal Penyakit Dalam Indonesia

Indonesia merupakan salah satu negara dengan prevalensi hepatitis B yang tinggi di Asia Tenggara (kedua setelah Vietnam). Berdasarkan Riskesdas yang dilakukan oleh Kementerian Kesehatan Republik Indonesia, pada studi yang dilakukan pada sampel darah PMI, 10 dari 100 orang Indonesia terinfeksi hepatitis B atau C. Maka dari itu, dibutuhkan penanganan yang ekstra untuk penanggulangan masalah infeksi hepatitis B

Comparison Of Red Cell Distribution Width Values Towardsmortality In Adult And Elderly Hospital-Acquired Pneumoniapatients In Dr. Sardjito Hospital, Desty Gusti Sari, Rizka Humardewayanti Asdie, Heni Retnowulan

Jurnal Penyakit Dalam Indonesia

Introduction. Hospital-acquired pneumonia (HAP) is a major cause of morbidity and mortality. Red cell distribution width (RDW) is associated with mortality in patients with septic shock and community-acquired pneumonia (CAP). However, little is known about the effect of elevation of RDW value on mortality in HAP patients, especially in the elderly population who have a worse prognosis. This study aimed to determine the proportion of adult and elderly HAP patients who have an increase in RDW value and the relation between the increase in RDW value to the risk of mortality in HAP patients during hospitalization. Methods. A cross-sectional and …

Correlation Of Sun Exposure Score And Vitamin D Intake Withserum 25(Oh)D Levels In Older Women, Kholidatul Husna, Novira Widajanti, Sri Sumarmi, Hadiq Firdaus

Jurnal Penyakit Dalam Indonesia

Introduction. Indonesia is a tropical country, but the prevalence of vitamin D deficiency in older women is high due to the lack of sun exposure and low vitamin D intake. Some previous studies have reported that people from rural areas have higher serum 25(OH)D levels compared to those from urban areas. This study was conducted to analyze the correlation between sun exposure score and vitamin D intake with serum 25(OH)D levels of older women from rural areas. Methods. This was an analytic cross-sectional study involving older women in two villages from Wonorejo and Kraton Districts, Pasuruan Regency, in June 2020 …

Controlled Blood Pressure Factors In Hypertension Patients Atarifin Achmad Hospital, Riau Province: Cross Sectional Study, Dimas Pramita Nugraha, Eka Bebasari

Jurnal Penyakit Dalam Indonesia

Introduction. Hypertension is a chronic disease that causes 1 in every 7 deaths. Controlled blood pressure will reduce the complication of hypertension. The aim of this study was to determine the factors that influence controlled blood pressure. Methods.This research was conduct by using an observational method with a cross-sectional study design to analyze factors for controlled blood pressure. The population of this research was all of the hypertension patients at the internal medicine polyclinic in Arifin Achmad Hospital Riau Province. The sample was selected using accidental sampling method. Patient adherence level factor was measured using the Morisky medication adherence scale-8 …

The Effect Of Angiotensin-Converting Enzyme Genepolymorphism And Angiotensin Ii Levels In Coronary Slowflow Phenomenon At Mohammad Hoesin General Hospitalpalembang, Arlis Karlina, Taufik Indrajaya, Ali Ghanie, Erwin Sukandi, Ferry Usnizar, Syamsu Indra, Rukiah Chodilawati, Imran Saleh

Jurnal Penyakit Dalam Indonesia

Introduction. The presence of ACE gene polymorphism is expected to have a role in cardiovascular diseases, including coronary slow flow phenomenon (CSFP). Angiotensin converting enzyme (ACE) gene polymorphism also plays an essential role in increasing angiotensin II levels. Therefore, this study aimed to analyze the effect of angiotensin-converting enzyme gene polymorphism and angiotensin II levels in the coronary slow flow phenomenon in Mohammad Hoesin General Hospital Palembang. Methods. This case-control study was started from July 2019 to July 2020 at RSMH Palembang with 32 subjects for each case (CSFP patients) and the control group (non-CSF patients). This study used a …

Association Of Proprotein Convertase Kexin/Type 9 With Atherosclerosis In People With Type 2 Diabetes Mellitus: A Systematic Review, Farissa Luthfia, Wismandari Wisnu, Dicky Levenus Tahapary, Pringgodigdo Nugroho

Jurnal Penyakit Dalam Indonesia

Introduction. Type 2 diabetes melitus is the leading cause of cardiovascular event with high level of low-density lipoprotein as the main predictor marker of atherosclerosis. PCSK9 plays a role in LDL-receptor regulation, its association with atherosclerosis had been investigated but the result is inconsistent. This study aimed to examine the association between PCSK9 level and atherosclerosis in people with type 2 diabetes.

Methods. A systematic review was done in July 18 – September 02, 2020 and registered in PROSPERO. Risk of bias of each study was analyzed with Newcastle Ottawa scale tools. Studies involved in this systematic …

Current Clinical Approach Of Nosocomial Clostridium Difficileinfection, Frans Liwang, Robert Sinto

Jurnal Penyakit Dalam Indonesia

Hospital-acquired Clostridium difficile infection (CDI) has become one of the global threats because the incidence has increased in recent decades. This nosocomial infection is closely related to antibiotic use in health services and is commonly found in the elderly. Antibiotics can promote colonization and CDI by intestinal microbiota dysbiosis and complex innate immune system activation. The manifestation also has a wide spectrum, ranging from mild diarrhea to fulminant colonic mucosal necrosis. Given that not all colonized subjects will be infected, further investigations such as toxigenic culture, nucleic-acid detection, and stool immunologic tests are only useful in symptomatic cases. In all …

Proportion Of Pre-Dialysis Prolonged Qt Dispersion In Twiceweekly Chronic Hemodialysis Patients And Its Associated Factors, Arief Pattiiha, Muhammad Yamin, Aida Lydia, Murdani Abdullah

Jurnal Penyakit Dalam Indonesia

Introduction. Cardiovascular disease (CVD) is the common cause of mortality in end-stage renal disease (ESRD) patients undergoing hemodialysis (HD). Causes of CVD in ESRD patients are multifactorial. Ventricular arrhythmia is known as the leading cause of sudden death in dialysis patients. QT dispersion, which is measured from electrocardiography (ECG), is known as one of the parameters to assess the risk of arrhythmia in HD patients. This study aimed to determine the proportion of pre-dialysis prolonged QT dispersion in chronic twice-weekly HD patients and the associated factors. Methods. A cross-sectional study was conducted among HD patients age ≥18 years with dialysis …

Dispersi Gelombang Qt, Simon Salim

Jurnal Penyakit Dalam Indonesia

Sejak elektrokardiografi (EKG) dibawa ke perhatian klinisi oleh Einthoven1 sampai dengan saat ini, EKG masih merupakan modalitas yang tidak dapat dipisahkan dalam penilaian sistem kardiovaskular. Namun, pemeriksaan yang sederhana dan tidak invasif ini, tidak selalu mudah untuk diintepretasikan. Hasil yang tergambar di kertas EKG tidak murni dipengaruhi jaringan otot jantung saja, namun dipengaruhi juga oleh jaringan tubuh lain yang terdapat di antara jantung dan lokasi dimana elektroda diletakkan. Dengan demikian, hal ini juga harus dipertimbangkan dalam menginterpretasikan hasil EKG.

Non-Operative Management Of Diabetic Foot Osteomyelitis: Acase Report, Em Yunir, Yully Astika Nugrahayning Aziza

Jurnal Penyakit Dalam Indonesia

Diabetic foot osteomyelitis is an advanced complication of diabetic foot infection which can increase the risk of amputation. This report discusses a case of a 50-year-old female with a wound on the thumb of her left foot that became more swollen with a bluish red color within one month. The patient delayed her treatment due to the COVID-19 pandemic. She has had diabetes and hypertension for 20 years which is uncontrolled. Physical examination showed a sausage toe digiti 1 left pedis with wound 4 x 2 cm with purulent discharge, Probe to Bone (PTB) positive. Laboratory and x-ray examination showed …

Puasa Ramadan Dan Diabetes Melitus: Risiko, Manfaat Dan Peluang Penelitian, Dicky L Tahapary, Syahidatul Wafa, Dante S. Harbuwono

Jurnal Penyakit Dalam Indonesia

No abstract provided.

The Pattern Of Microorganism On Adult Acute Leukemia Patientsduring Bacterial Surveillance And Febrile Neutropenia At Ciptomangunkusumo Hospital, Lugyanti Sukrisman

Jurnal Penyakit Dalam Indonesia

Introduction. The standard intensive chemotherapy in acute leukemia patients will cause severe neutropenia and infection (febrile neutropenia) with high fatality rate. The availability of accurate data on causative pathogens is essential to the appropriate selection of empirical therapy and usually obtained from bacterial surveillance. This study was intended to evaluate bacterial pathogens found on surveillance and during febrile neutropenia in acute leukemia patients undergoing chemotherapy at Cipto Mangunkusumo Hospital and to provide information for antimicrobial policy in the hospital. Methods. A retrospective study from data of bacterial surveillance of acute leukemia patients undergoing chemotherapy during 2008-2010 in isolation room for …

Management Of Diabetic Ketoacidosis In Patient With Heartfailure, Dicky Febrianto, Est Hindariati

Jurnal Penyakit Dalam Indonesia

Diabetic ketoacidosis (DKA) is diabetes mellitus emergency which is defined by the biochemical triad of hyperglycemia, ketonemia, and acidemia. Diabetic ketoacidosis continues to have high rates of morbidity and mortality despite advances in the treatment of diabetes. Crucial aspects of DKA management involve adequate replacement of fluids and electrolytes, particularly potassium, and the continuous administration of insulin. Hydration status in patients with DKA and heart failure can be assessed by physical examination, such as consciousness, vital signs, capillary refill time, skin turgor, jugular venous pressure, and signs of pulmonary edema. Invasive and non-invasive methods can also assess fluid adequacy in …