Medical Specialties Commons^™

Challenge In Diagnosis And Management Of Lentigo Maligna And Lentigo Maligna Melanoma, Ika Anggraini, Elisa Miranda, Larisa Paramitha Wibawa, Roro Inge Ade Krisanti, Adhimukti T. Sampurna

Journal of General - Procedural Dermatology and Venereology Indonesia

Lentigo maligna (LM) is a subtype of melanoma in situ, which can evolve into lentigo maligna melanoma (LMM) if treated inadequately. LM and LMM are usually found on chronically sun damaged skin such as the face (cheek and nose) of the elderly on seventh or eight decades. Clinical manifestation of LM may be quite subtle, so early diagnosis is difficult to perform.The treatment of LM and LMM are challenging due to ill-defined clinical margin, predilection on the face with great size, and preponderance of the elderly, which are potential for recurrency and progressiveness from LM into LMM.

Comparison Of Efficacy Combination Oral Terbinafine Pulse-Dosed And Topical 8% Ciclopirox Olamine With Terbinafine Monotherapy For Onychomycosis: An Evidence-Based Case Report, Marsha Bianti, Teffy Nuary, Sandra Widaty

Journal of General - Procedural Dermatology and Venereology Indonesia

Background: Onychomycosis is a fungal infection of the nails, which manifested as nail discoloration, thickening, and detachment from the nail bed. It is not life-threatening, however inappropriate treatment of onychomycosis might lead to complications and affect the patient’s quality of life; making the management of the disease a challenge for clinicians.

Objective: Investigate the efficacy of pulse-dosed oral terbinafine combined with topical 8% ciclopirox olamine to treat onychomycosis.

Methods: Literature search was performed in Pubmed and Cochrane databases using the keywords 'combination' AND 'oral terbinafine' AND 'ciclopirox' AND ‘onychomycosis treatment’ along with their synonyms and related terms.

Results …

Factors Associated With Retention In Care One Year After Deliveryin Patients Undergoing Prevention Of Mother To Child Transmission(Pmtct) At Rscm, Yulidar Yulidar, Evy Yunihastuti, Samsuridjal Djauzi, Astrid Citra Padmita, Sukamto Koesnoe

Jurnal Penyakit Dalam Indonesia

Introduction. Retention in care is important to the successful of HIV treatment. This study is aimed to analyze factors associated with retention in care one year after delivery in patients undergoing PMTCT at HIV integrated clinic of RSCM. Methods. A retrospective cohort study was conducted among post-partum HIV patients who were given ARV therapy for PMTCT at HIV intergrated clinic of Cipto Mangunkusumo Hospital from January 2004 to May 2014. Evaluation of one year retention in care after PMTCT was performed by observing medical records of the patient. The collected data were factors associated with one year after delivery retention …

Clinical Characteristic And Prevalence Of Invasive Candidiasis Patient In Cipto Mangunkusumo Hospital, Kemal Fariz Kalista, Lie Khie Chen, Retno Wahyuningsih, Cleopas Martin Rumende

Jurnal Penyakit Dalam Indonesia

Introduction. Incidence of invasive fungal infections (IFI) are reportedly increasing in many countries. Candida is the most common cause of IFI. This study was conducted to determine the prevalence, clinical characteristics, and etiologic pathogen in adult patients with invasive candidiasis (IC) at Cipto Mangunkusumo Hhospital. Methods. This was a cross sectional study with restropective data collection fromof septic patients that’ medical records hospitalized in January 2012 until June 2014. Subjects were selected based on EORTC/MSG 2008 diagnostic criteria for IC. Demographic data, clinical and supporting data, diagnosis, etiologic pathogens, antibiotics, antifungal, outcome, and length of stay were recorded. Results. The …

Correlation Between Disease Duration, Disease Activity Scoreand Disability Score With Diastolic Dysfunction In Rheumatoidarthritis Women In Dr. Cipto Mangunkusumo Hospital, Dono Antono, Bernard Agus Sakti Dhaki, Harry Isbagio, Hamzah Shatri

Jurnal Penyakit Dalam Indonesia

Introduction. There are only few studies about correlation between non traditional risk factor and diastolic dysfunction in RA patients. This study aims to determinate the correlation between non traditional risk factors, including disease duration, disease activity and disability score with the diastolic dysfunction of women with RA. Methods. A cross-sectional, consecutive sampling study was conducted to 52 RA women without any previous cardiovascular disease history. All participants underwent an echocardiography to assess diastolic dysfunction and other findings associated. Duration of disease was assesed by direct interview, while the disease activity by calculating DAS28 and disability score by HAQ-DI. Results. Diastolic …

Diagnostic Approach And Treatment Of Dieulafoy's Lesion, Anshari Saifuddin, Kaka Renaldi, Indah Situmorang

Jurnal Penyakit Dalam Indonesia

Dieulafoy’s lesion is a rare cause of upper gastrointestinal bleeding but become an important etiology. Pathogenesis of the disease evolved from earlier of its invention till now. It has been stated in recent study that the etiology of this disease is vary, from age to genetic. Size and arteriol configuration abnormality has been known as the main pathogenesis of the disease. Endoscopic procedure become the primary diagnostic tool, which effectiveness reached more than 90%. However, in some situation, it’s difficult to find the abnormality by endoscopic procedure. Hemostatic procedure via endoscopy is the main therapy of Dieulafoy’s lesion, which has …

Risiko Kardiovaskuler Pada Pasien Artritis Reumatoid, Rudy Hidayat

Jurnal Penyakit Dalam Indonesia

No abstract provided.

Validation Of Rapid Emergency Medicine Score (Rems) In Predicting30 Days Mortality In Elderly Visiting Emergency Department, Aulia Rizka, Kuntjoro Harimurti, Ceva W. Pitoyo, Soekamto Koesno

Jurnal Penyakit Dalam Indonesia

Introduction. Rapid Emergency Medicine Score (REMS) has been known as a useful instrument to stratify patients in emergency department (ED) based on its ability to predict short term mortality. As the clinical characteristics of elderly patients visiting ED are frequently aypical, validation of REMS in this specific population is very important. To measure predictive validity of REMS in elderly patients visiting ED Methods. Prospective cohort study in elderly visiting ED of Cipto Mangunkusumo between September to October 2016. Subjects were followed for 30 days after visiting ED. Calibration (Hosmer Lemeshow test), discrimination (Area Under ROC Curve) and REMS predictive value …

The Changes Of Amino Terminal Pro B-Type Natriuretic Peptide(Nt-Probnp) Concentration And Left Ventricular Ejectionfraction On Doxorubicin Chemotherapy Patients, Telly Kamelia, Sarwono Waspadji, Lukman Hakim Makmun, Shufrie Effendi, Muchlis Ramli, Ina Susanti Timan

Jurnal Penyakit Dalam Indonesia

Introduction. Cancer patients who received chemotherapy regimen containing doxorubicin has been known to have serious side effect in heart, called as cardiotoxicity. The measurement of NT-proBNP proposed to be used as a new parameter to identify and evaluate cardiotoxicity in cancer patients earlier before it has been manifested, superior than measurement of left ventricle ejection fraction (LVEF). The aims of this study to examine the changes of NT-proBNP concentration and LVEF on patients with cancer who receive chemotherapy regimen containing doxorubicin. Methods. The study used pre and post test design to observe the changes of NT-proBNP concentration and LVEF on …

The Association Between Elevated Levels Of Erythropoietin Andendothelial Progenitor Cell With Improvement Of Endothelialfunction In Renal Failure Patients 3 Months After Kidneytransplantation, Linda Armelia, Endang Susalit, Maruhum Bonar Hm, Hamzah Shatri

Jurnal Penyakit Dalam Indonesia

Introduction. Endothelial progenitor cell (EPC) is considered possible to reduce asymmetric dimethylarginine (ADMA) levels, which is a marker of improved endothelial function. However, clinically, there is still a debate about the role of EPC. This study was conducted to determine the correlation of elevated levels of erythropoietin (Epo) and the number of EPC CD34 + and CD133 + with improvement of endothelial function in renal failure patients 3 months after kidney transplantation. Methods. A cross-sectional study was conducted in prior and 3 months after kidney transplantation of renal failure patients who underwent a kidney transplant in Cipto Mangunkusumo hospital. The …

A 30 Years Old Woman With Sepsis, Skin And Soft Tissueinfection, And Obesity, Franzeska Adm Widinartasari, Muhammad Ali Sodiq, Muchlis Au Sofro

Jurnal Penyakit Dalam Indonesia

Obesity increases morbidity and mortality through its multiple efects on nearly every human system. Obesity has efect on the immune response which leads to susceptibility to infections. ß lactamases are bacterial enzymes that inactivate ß-lactam antibiotics by hydrolysis. One group of ß lactamases, extended-spectrum ß lactamases (ESBLs), have the ability to hydrolyse and cause resistance to various types of the newer ß-lactam antibiotics. The management of skin and soft tissue infection with polymicrobial infection and multi drug resistance can be challenging problem. We present a case of an obese patient with polymicrobial SSTI. bPatient showed clinical sign of sepsis with …

Approach To Diagnosis And Treatment Of Drug Allergy, Roy Akur Pandapotan, Iris Rengganis

Jurnal Penyakit Dalam Indonesia

Drug allergy is a serious medical problem. Drug allergy can be defined as an adverse drug reaction involving immunological mechanism. However, it is not easy to decide whether an adverse drug reaction is an allergic reaction, and it requires a systematically diagnostic approach. Beside a thorough history taking and physical examination, there are general and specific laboratory examination to investigate drug allergy which can be done in vivo, in vitro, or biopsy. The management of drug allergy include the avoidance of the precipitating event, and specific methods to reduce the drug reaction which include threating through, dosing test, desensitization, and …

Challenges In Providing Treatment Of Severe Malaria Case In Adistrict Hospital Of Remote Area In Indonesia, Dimas Priantono, Asep Purnama, Erni Juwita Nelwan

Jurnal Penyakit Dalam Indonesia

Severe Malaria is commonly found due to Plasmodium falciparum infection, which is causing high mortality in patient. A Severe case might be difficult to treat optimally in the remote settings area that could be due to lack in awareness of disease manifestation and inadequate diagnostic facilities. We report a case of Severe Malaria Falciparum infection, confirmed by blood smear examination of Plasmodium falciparum (Pf) parasites. Patient had received Artemicinin Based Combination Therapy (ACT), which consisted of dihydroartemisinin (DHA)-piperaquine and primaquine (PQ) with no clear clinical and microscopy improvement. The second line anti malaria consisted of quinine, doxycycline, and PQ was …

Risk Factors Of Antituberculosis Induced-Hepatotoxicity Amonghiv/Aids Patients, Lies Luthariana, Teguh H. Karjadi, Irsan Hasan, C. Martin Rumende

Jurnal Penyakit Dalam Indonesia

Introduction. Antituberculosis (ATT) induced hepatotoxicity is commonly found among HIV/AIDS patients. Several risk factor related to drug-induced hepatotoxicity such as alcoholism, hepatitis B or hepatitis C infection, abnormal baseline aminotransferase/bilirubin, poor nutritional status and concomitant hepatotoxic drugs consumption, are usually found in these patients. This study was conducted to evaluate risk factor of ATT-induced hepatotoxicity in HIV/AIDS patients. Methods. This is a case control retrospective study with matching of age, sex, antituberculosis regimen, and alcohol consumption. Risk factors evaluated are hepatitis C and hepatitis B coinfection, concomitant hepatotoxic drugs consumption, abnormal baseline aminotransferase and or bilirubin. Results. We collected data …

Effect Of Structured Education And Antihypertensive Medicationsadherence To Decrease Blood Pressure For Hypertension Inelderly: A Randomized Controlled Trial, Ayatullah Khomaini, Siti Setiati, Aida Lydia, Esthika Dewiasty

Jurnal Penyakit Dalam Indonesia

Introduction. Hypertension is one of the important problems in elderly due to high impact of cardiovascular complications. Education and antihypertensive medication adherence are considered as influence factors in a holistic and comprehensive hypertension treatment. This study was conducted to determine the effect of structured education and antihypertensive medication adherence in decreasing blood pressure as part of the hypertension treatment in elderly patients. Methods. A randomized clinical trial was conducted in October 2012 to February 2013 on hypertensive elderly patients at Cipto Mangunkusumo hospital, Jakarta. Subjects were divided into 3 groups: group I was received structured education and checklist, group II …

Keberhasilan Pengobatan Antiretroviral (Arv), Teguh H. Karyadi

Jurnal Penyakit Dalam Indonesia

No abstract provided.

Factors Related To 30 Day Mortality In Critically Ill Patients Withinvasive Candidiasis In Cipto Mangunkusumo Hospital, Ardi Ardian, Ceva W. Pitoyo, Dita Adhitianingsih, Widayat Djoko Santoso, Siti Setiati

Jurnal Penyakit Dalam Indonesia

Introduction. Mortality rate of invasive candidiasis is still high, approximately 30-70%. Every study has a variety mortality rate depend on study design and sample. There is no data in Indonesia about profile and mortality factors analysis in critically ill patients with invasive candidiasis. Methods. The Study design was cross sectional. We studied 102 hospitalized critically ill patients with invasive candidiasis. The demographic, clinical and laboratory data, the risk factors for invasive candidiasis and the outcome of each patient in 30 days were recorded. An analysis bivariate with chi square or Fisher’s test was carried out to analyse some factors such …

The Association Between Vitamin D 25(Oh)D Level Andalbuminuria In Type 2 Diabetes Mellitus, Tities Anggraeni Indra, Aida Lydia, Dyah Purnamasari, Siti Setiati

Jurnal Penyakit Dalam Indonesia

Introduction. Vitamin D 25(OH)D deficiency was reported as a possible risk factor for the development of diabetic nephropathy in several epidemiologic studies. Whether vitamin D 25(OH)D deficiency plays a role in the development of diabetic nephropathy in Indonesia is unknown. This study aims to determinate the association between vitamin D 25(OH)D level with albuminuria in patients with type 2 diabetes mellitus in Indonesia. Methods. A cross-sectional study was conducted in 96 patients with type 2 diabetes mellitus at outpatient clinic of MetabolicEndocrine Cipto Mangunkusumo Hospital. Serum vitamin D level was assessed using Diasorin kit with CLIA method, while albuminuria was …

Predictors Of Virological Failure In Hiv Patients Receiving Firstline Antiretroviral Therapy With Good Adherence, Farid Kurniawan, Samsuridjal Djauzi, Evy Yunihastuti, Pringgodigdo Nugroho

Jurnal Penyakit Dalam Indonesia

Introduction. Antiretroviral therapy (ART) effectively suppress HIV replication. Viral load (VL) measurement is better predictor than clinical or immunological criteria to evaluate success or failure of ART. However, in country with limited resources, viral load measurement is not easily accessible by HIV patients receiving ART. Therefore, it is necessary to know which factors that can predict virological failure. In previous studies, adherence was an important factor for suppression of HIV viral load. This study is aimed to know predictors of virological failure in HIV patients receiving recent first line ART regimen with good adherence in Indonesia. Methods. A retrospective cohort …

Cost Of Care Saving Of Terminal Cancer Adult Patient Usingpalliative Care Consultation In Cipto Mangunkusumo Hospital, Rudi Putranto, Laksono Trisnantoro, Yos Hendra

Jurnal Penyakit Dalam Indonesia

Introduction. Terminal cancer patients was increasing in Indonesia, and need attention to approach palliative and end of life care. Terminal cancer management was burden the hospital, because it causes high costly and the length of stay This study aimed to get a general picture of service palliative at Cipto Mangunkusumo, then to evaluate the relationship hospitalization and rates of inpatient services people with terminal cancer adults who received the intervention palliative care and to evaluate the relationship variable rates for accommodation (room), doctor visit, procedure/surgery, medicines and consumables, laboratory and radiology to palliative interventions in patients with terminal cancer in …

Fungsi Ginjal Dan Kematian Akibat Sindrom Koroner Akut, Eka Ginanjar

Jurnal Penyakit Dalam Indonesia

Penyakit kardiovaskuler merupakan salah satu penyebab kematian utama di dunia. World Health Organization (WHO) melaporkan 17,5 juta orang meninggal akibat penyakit kardiovaskuler pada tahun 2012, atau diperkirakan 3 dari 10 kematian terjadi akibat penyakit jantung.

Occupational Skin Cancer And Precancerous Lesions, Fifinela Raissa, Githa Rahmayunita, Sri Linuwih Menaldi, Dewi Soemarko

Journal of General - Procedural Dermatology and Venereology Indonesia

Occupational skin cancer and precancerous lesions are skin disorders caused by exposure to chemical carcinogens such as polycyclic hydrocarbons and arsenic, or radiation, such as ultraviolet light and ionizing light in the workplace. Annual increase in skin cancer incidence is believed to be related to various factors such as frequent intense sunlight exposure (i.e. at work, recreational activities, and sun-tanning habit), ozone depletion, an increase in number of geriatric population, and an increase of public awareness in skin cancer. The most common occupational skin cancers are basal cell carcinoma, squamous cell carcinoma, and melanoma. Examples of occupational precancerous lesion of …

Vaginal Microbiota In Menopause, Martinus Martinus, Larisa Paramitha Wibawa, Evita Halim Effendi, Shannaz Nadia Yusharyahya, Hanny Nilasari, Wresti Indriatmi

Journal of General - Procedural Dermatology and Venereology Indonesia

The human vagina together with its resident, microbiota, comprise a dynamic ecosystem. Normal microbiota is dominated by Lactobacillus species, and pathogen microbiota such as Gardnerella species and Bacteroides species can occur due to decrease in Lactobacillus domination. Lactobacillus plays an essential role in keeping normal vaginal microbiota in balance. Vaginal microbiota adapts to pH change and hormonal value. Changes in the vaginal microbiota over a woman’s lifespan will influence the colonization of pathogenic microbes. They include changes in child, puberty, reproductive state, menopause, and postmenopause. Estrogen levels change will affect the colonization of pathogenic microbium, leading to genitourinary syndrome of …

Papuloerythroderma Of Ofuji: A First Case Report From Indonesia, Graciella Regina, Listya Paramita, Sunard Radiono, Yohanes Widodo Wirohadidjojo, William R. Faber

Journal of General - Procedural Dermatology and Venereology Indonesia

Papuloerythroderma (PE) is a rare skin disease which was first described by Ofuji et al. in 1984, with a typical sign that the lesions spare the large cutaneous folds, known as the deck chair sign. Due to its recent identification, this disease is still underrecognized and may lead to misdiagnosis. We reported the first case report of PE of Ofuji from Indonesia in which the diagnosis was delayed for two years. Besides the deck chair sign in the large cutaneous fold, we also found that the area between and above his eyebrows that was relatively spared in contrast to the …

Suspected Resistance Of Mdt-Mb In Multibacillary Leprosy Of Hansen's Disease: Two Case Reports, Yudo Irawan, Sri Linuwih Menaldi, Emmy Soedarmi Sd, Melani Marissa, Erika Zoulba

Journal of General - Procedural Dermatology and Venereology Indonesia

Resistance to multidrug therapy (MDT) is one of the complications in the treatment of Hansen’s disease/Morbus Hansen (MH). There are two types of resistancy, which are primary and secondary. MDT-multibacillary (MB) resistance must be suspected when no clinical improvement and the acid-fast bacilli (AFB) index is not reduced after 12 months of therapy. A 28-year-old woman with paresthesia on her face, arms and legs since 2.5 years ago, accompanied by thickening of the right posterior tibial nerve. The AFB examination showed a bacteriological index (BI) of 15/6 and morphological index (MI) of 0.50%. The second case, a 42-year-old man came …

Neural Leprosy: A Case Report, Alida Widiawaty, Emmy Soedarmi Sjamsoe-Daili, Taruli Olivia, Sri Linuwih Menaldi, Melani Marissa, Fitri Octaviana

Journal of General - Procedural Dermatology and Venereology Indonesia

Neural leprosy is characterized by neurological deficit without skin lesions, with a prevalence ranging from 1% to 17.7%. Diagnosis might be difficult and need a multidisciplinary approach. This is a case of axonal type motor and sensory polyradiculoneuropathy of the peripheral facial nerve. A 26-year-old woman was referred from the neurology clinic with facial paralysis, suspected as leprosy. Physical examinations were as follows: no skin lesions, left eye lagophthalmos, thickening of right lateral peroneal and bilateral posterior tibial nerves, sensory impairment, peripheral bilateral facial palsy, and wasting of bilateral distal small muscles of the hands, with normal autonomic function. Nerve …

Pulsed-Dye Laser Efficacy In The Treatment Of Psoriasis In Adult Patients: An Evidence-Based Case Report, Made Ananda Krisna, Hanny Nilasari

Journal of General - Procedural Dermatology and Venereology Indonesia

Psoriasis is a chronic inflammatory skin disease known to be highly responsive to phototherapy. Narrow-band UVB (NBUVB) phototherapy has been one of the standard treatments for its moderate to severe form. However, its lack of efficacy in treating stable psoriatic plaques on extremities has lead researchers to find alternative treatments, one of which is pulsed-dye laser (PDL). Laser has been known to be effective in treating vascular lesions; in psoriasis, elongation of rete ridge along with tortuous dermal capillaries are one of the first pathologies identified early in the disease progression. Several in vivo and preliminary studies have found the …

Factors Related To Diagnosis Of Community-Acquired Pneumonia In The Elderly, Elza Febria Sari, C. Martin Rumende, Kuntjoro Harimurti

Jurnal Penyakit Dalam Indonesia

Introduction. Diagnosing community-acquired pneumonia (CAP) in the elderly remains a clinical challenge for various reasons. The clinical manifestation in the elderly is not frank and atypical manifestations, e.g. falls, decrease of functional status and food intake or urinary incontinence, may be present. These reasons may be associated with under or over diagnosis, which consequently contribute to the higher observed mortality rate in the elderly population with CAP. Study about factors related to diagnosis of CAP in the elderly was ra rely performed.

Methods. From January to October 2010, 158 elderly patients suspected of having pneumonia at RSCM were registered. Relationship …

Estimated Glomerular Filtration Rate (Egfr) As An In-Hospital Mortality Predictor In Acute Coronary Syndrome Patients In Iccu, Esthika Dewiasty, Idrus Alwi, Dharmeizar Dharmeizar, Kuntjoro Harimurti

Jurnal Penyakit Dalam Indonesia

No abstract provided.

Correlation Of Forced Expiratory Volume In 1 Second Prediction With Mean Pulmonary Arterial Pressure Using Echocardiography In Stable Chronic Obstructive Pulmonary Disease, Munadi Munadi, M. Yamin, Anna Ujainah, Cleopas Martin Rumende

Jurnal Penyakit Dalam Indonesia

No abstract provided.