Internal Medicine Commons^™

The Nephrocheck Bedside System For Detecting Stage 3 Acute Kidney Injury After Open Thoracoabdominal Aortic Repair, Mark Hwang, Michael H Weisman

Faculty, Staff and Student Publications

No abstract provided.

Hiv-Associated Nephropathy Presenting As The First Manifestation Of Hiv-2 Infection, Kamil Sardarli, Rania Daboul, Sumesh Khanal, Sami Zarouk

Conference Presentation Abstracts

HIV-2 is distinguished from HIV-1 with low virulence, longer asymptomatic period, slower decline in CD4 count, low viral load, and low mortality from AIDS. While the kidney pathology associated with HIV-1 is well established, due to its low prevalence, kidney pathology in HIV-2 is not well documented. We report a case of HIV associated nephropathy (HIVAN) as the first presentation in a patient with HIV-2. A 65 year old man from Ghana presented within a few days of arrival to the United States with nausea, loss of appetite, shortness of breath, and bilateral lower extremity edema. He has a past …

Comparison Of Hospital Mortality, Length Of Stay, Renal Recovery, And Needs For Hemodialysis In Acute Kidney Injury (Aki) Patients Due To Septic And Non-Septic, And Factors Affecting Patients’ Mortality, Mochammad Jalalul Marzuki, Nursamsu Nursamsu, Achmad Rifai

Jurnal Penyakit Dalam Indonesia

Introduction. Acute kidney injury (AKI) is a major complication in critically ill patients that affects mortality. Sepsis is a major predisposing factor for AKI and provides a poor prognosis and high mortality rate. Thisstudy aimed toidentifythe difference of hospital mortality, length of stay, renal recovery, and needs for hemodialysis between AKI patients due to sepsis and non-sepsis, as well as to determine the factors that influence the mortality of patients with AKI.Methods. An analytical observational study was conducted among patients with AKI according to the KDIGO criteria and aged ≥40 years old. Data were obtained from patients’ medical records in …

Characteristics Of Patients With Non-Malignant Pleural Effusion In Dr. Zainoel Abidin Hospital Banda Aceh In 2019, Teuku Romi Imansyah Putra, Price Maya, Maryatun Hasan, Agung Pranata, Safira Salsabila, Hesti Ariandani Sariningrum

Jurnal Penyakit Dalam Indonesia

Introduction. Pleural effusion occurs when there is a pathological process causing fluid to accumulate in the pleural cavity. Pleural effusion is still the main cause of respiratory distress and can also be caused by many diseases either from pleural, lungs, or even extrapulmonary problems. The morbidity and mortality of this condition are directly associated with the underlying causes. The aim of this study is to investigate the profile of the patients, etiology, location, fluid characteristics, comorbidities, and also the bacteria pattern of non-malignant pleural effusion. Methods. This is a retrospective descriptive study thatused patient’s medical records from January to December …

Kidney Disease And Its Impact On Covid-19 Patients At Sanglah Hospital Denpasar, Bali, Indonesia In 2021, Putu Satyakumara Upadhana, I Gede Gita Sastrawan Sastrawan, I Gusti Agung Ayu Chintya Cahyarini, Anbiya Khairul Umam, Amanda Trisliana Dwi Putri, I Gede Raka Adhyatma, I Ketut Agus Somia

Jurnal Penyakit Dalam Indonesia

Introduction. Besides having an impact on the respiratory system, COVID-19 also has an impact on other organ such as the kidneys. The systemic inflammatory response thought to be associated with bad prognosis of COVID-19 patients with kidney disease. This study aimed to determine the impact of kidney disease on COVID-19 patients. Methods. This study is an observational analytic study with a cross-sectional approach. The data used is secondary data from the records of confirmed COVID-19 patients who were treated at Sanglah Hospital from 1 May 2021 to 31 August 2021 using total sampling technique.Results. There were 248 patients included in …

Abnormal Liver Function In Predicting Covid-19 Patients’ Prognosis, Sakinah Rahma Sari, Juferdy Kurniawan

Jurnal Penyakit Dalam Indonesia

Despite of the high prevalence of liver enzyme elevation in COVID-19 patients, its effect on predicting COVID-19 patients’ prognosis was still debatable. This evidence-based case report aims to evaluate the effect of abnormal liver function in the prognosis of COVID-19 patients. Literature searching was performed on August 16-17 2021 using 3 databases: PubMed, Scopus, and Proquest. The articles selected by title/abstract screening, duplication elimination, and applying eligibility criteria were then appraised using Centre of Evidence Based Medicine (CEBM), University of Oxford. Some of the studies reported there were no significant difference in the prognosis of COVID-19 patient with and without …

Prediction Model Of 30-Days Postoperative Pneumonia In Elderly Patient Undergoing Abdominal Surgery, Noto Dwimartutie, Harini Oktadiana, Gurmeet Singh, Wifanto Saditya Jeo, Kuntjoro Harimurti

Jurnal Penyakit Dalam Indonesia

Introduction. Physiologic changes in respiratory tract in elderly increase incidence of post-operative pneumonia. Post-operative pneumonia in non-thoracic surgery was found higher in abdominal surgery. This study aimed to develop a prediction model of 30-day post-operative pneumonia in elderly patients undergoing abdominal surgery.

Methods. A retrospective cohort study was conducted using elderly patient’s medical records who underwent abdominal surgery in Cipto Mangunkusumo General Hospital. Multivariate analysis using logistic regression was used to determine Odds Ratio (OR). Model’s calibration performance was determined by Hosmer-Lameshow test and its discrimination performance was determined by calculating area under the curve (AUC).

Results. Of …

Pain Management In Advanced Hepatocellular Carcinoma:A Case Study, Fita Fitrianti, Hamzah Shatri, Edward Faisal, Rud Putranto, Ratih Arianita Agung, Leonard Nainggolan, Kemal Fariz Kalista, Cophiadi Irawan

Jurnal Penyakit Dalam Indonesia

Hepatocelullar carcinoma (HCC), the most common primary liver malignancy is the fifth most common cancer and the third most frequent cause of cancer related death globally. Pain comprises one the most common symptoms of HCC and may have severely negative effects on patient’s quality life. Furthermore, patients with HCC often presented with a cirrochis,so to control pain in this patient poses a clinical challenge. This case report discuss about a young 26-years-old male patient who presented with a four-month history of right upper quadrant abdominal pain and weight loss. HbsAg positive and serum alpha-fetoprotein level was high. Computed tomography (CT) …

Mutation And Variant Of Coronavirus Disease 2019 (Covid-19): Review Of Current Literatures, Adityo Susilo, Chyntia Olivia Maurine Jasirwan, Syahidatul Wafa, Suzy Maria, Wulyo Rajabto, Akhmadu Muradi, Ihza Fachriza, Myranda Zahrah Putri, Stacy Gabriella

Jurnal Penyakit Dalam Indonesia

Since March 2020, the Coronavirus Disease 2019 (COVID-19) pandemic has engulfed the world, including Indonesia, for nearly two years. SARS-CoV-2 has undergone several mutations during its evolution as a pathogen, resulting in various variants of global concern. Variants of this virus are suspected to impede the outbreak resolution and possibly causing the outbreak to spiral out of control. There is still considerable debate and research underway regarding the new SARS-CoV-2 variants. Rapid transmission mechanisms and widespread vaccination coverage have accelerated the virus’s mutation rate and resulted in numerous new variants. To date, this has resulted in the discovery of a …

Covid-19 Dari Perspektif Penyakit Ginjal : Dalam Rangka Memperingati Hari Ginjal Sedunia (World Kidney Day 2022), Anandhara Indriani Khumaedi

Jurnal Penyakit Dalam Indonesia

Secara global, hingga saat ini pandemi Coronavirus disease-19 (COVID-19) telah menjangkit lebih dari 450 juta orang di dunia dan menyumbang kematian sebanyak 6 juta jiwa.

The Prevalence Of Irritable Bowel Syndrome Using Rome Iv Criteria In Medical Student And The Related Factors, Ardhi Rahman Ahani, Ari Fahrial Syam, Rudi Putranto, Pringgodigdo Nugroho

Jurnal Penyakit Dalam Indonesia

Introduction. Medicine is a long study time. Medical student will take five years study to accomplish the education. Because the lot of task and some taken test, some medical student will face irritable bowel syndrome in their study periods. This study aims to identify the prevalence of IBS in medical student and related factors.Methods. A cross-sectional study of 350 medical student Universitas Indonesia from first grade until fifth grade was done during November-December 2016. This study used stratified randomized sampling. The Rome IV criteria was used for diagnosing IBS. Interview with questionnaire guided was applied to all subjects. A bivariate …

Intelligent Malingering In The Setting Of Porphyria Variegata: A Rare Occurrence On Both Fronts, Gersham J. Rainone, Oleg E. Reznik, Mahrukh Majeed, Alina Popa

Transformative Medicine

Malingering can be a difficult diagnosis to discern, especially in patients with well-crafted stories presenting with signs and symptoms that align directly with the literature. This can further become a challenge when a patient is malingering in the setting of a rare disease, where many complaints can be subjective in nature and not entirely testable by physical exam alone. Malingering is responsible for billions of dollars of healthcare waste every single year, and this report can serve as a guide of history elements, signs and symptoms to look out for with patients malingering in the setting of the porphyrias. It …

Efficacy And Safety Of Direct Oral Anticoagulants With And Without Aspirin: A Systematic Review And Meta-Analysis, Talal Almas, Adeena Musheer, Arooba Ejaz, Fahd Niaz Shaikh, Anousheh Awais Paracha, Fizza Raza, Maryam Sarwar Khan, Fahad Masood, Faiza Siddiqui, Muhammad Hasnain Mankani

Medical College Documents

Background: Various anticoagulant therapies are prescribed to patients under physicians' discretion and recently Direct Oral Anticoagulants(DOAC) have been under trials to evaluate their safety and efficacy. In addition to this, the regimen of DOACs and Aspirin is of keen interest as researchers continue to find an optimal regimen to treat blood clots in patients. This study is a systematic review and meta-analysis of randomized controlled trials and observational studies that asses the safety and efficacy of DOAC with and without Aspirin.
Methods: We queried MEDLINE and Cochrane CENTRAL from their inception to April 2021, for published and randomized controlled …

Predicting Health-Related Social Needs In Medicaid And Medicare Populations Using Machine Learning, Jennifer Holcomb, Luis C Oliveira, Linda Highfield, Kevin O Hwang, Luca Giancardo, Elmer Victor Bernstam

Faculty, Staff and Student Publications

Providers currently rely on universal screening to identify health-related social needs (HRSNs). Predicting HRSNs using EHR and community-level data could be more efficient and less resource intensive. Using machine learning models, we evaluated the predictive performance of HRSN status from EHR and community-level social determinants of health (SDOH) data for Medicare and Medicaid beneficiaries participating in the Accountable Health Communities Model. We hypothesized that Medicaid insurance coverage would predict HRSN status. All models significantly outperformed the baseline Medicaid hypothesis. AUCs ranged from 0.59 to 0.68. The top performance (AUC = 0.68 CI 0.66-0.70) was achieved by the "any HRSNs" outcome, …

Self-Medication Practices In Medical Students During The Covid-19 Pandemic: A Cross-Sectional Analysis, Farah Yasmin, Muhammad Sohaib Asghar, Unaiza Naeem, Hala Najeeb, Hamza Nauman, Muhammad Nadeem Ahsan, Abdullah Khan Khattak

Medical College Documents

Background and objectives: During the pandemic, the growing influence of social media, accessibility of over-the-counter medications, and fear of contracting the virus may have led to self-medication practices among the general public. Medical students are prone to such practices due to relevant background knowledge, and access to drugs. This study was carried out to determine and analyze the prevalence of self-medication practices among medical students in Pakistan.
Materials and methods: This descriptive, cross-sectional study was conducted online in which the participants were asked about the general demographics, their self-medication practices and the reasons to use. All participants were currently enrolled …

Hyperammonemia Of Unknown Cause In A Young Postpartum Woman: A Case Report, Sadaf Hanif, Sher Muhammad Sethi

Section of Internal Medicine

Background: Hyperammonemia is a medical condition described as increased or elevated serum ammonia levels. High serum levels of ammonia can cause neurotoxicity. Sudden onset severe hyperammonemia may cause severe encephalopathy with brain damage. It can result in cerebral edema, emesis, seizures, hypotonia, and death. We report a young postpartum woman who had a sudden rise in serum ammonia levels after vaginal delivery.
Case presentation: A 24-year-old, married, postpartum Pakistani woman was admitted to the intensive care unit through the emergency department, with complaints of fever, severe abdominal pain with distension, and altered levels of consciousness. The patient had a medical …

Prognostic Value Of H2fpef Score In Covid-19, Priya Patel, Max Ruge, Joanne Michelle D. Gomez, Jeanne Du Fay De Lavallaz, Anupama Rao, Kim A. Williams, Annabelle Santos Volgman, Maria Rosa R. Costanzo, Tisha Suboc, Karolina Marinescu

Division of Internal Medicine Faculty Papers & Presentations

Study objective: This study sought to assess the predictive value of H2FPEF score in patients with COVID-19.

Design: Retrospective study.

Setting: Rush University Medical Center.

Participants: A total of 1682 patients had an echocardiogram in the year preceding their COVID-19 admission with a preserved ejection fraction (≥50%). A total of 156 patients met inclusion criteria. Interventions: Patients were divided into H2FPEF into low (0–2), intermediate (3–5), and high (6–9) score H2FPEF groups and outcomes were compared.

Main outcome measures: Adjusted multivariable logistic regression models evaluated the association between H2FPEF score group and a composite outcome for severe COVID-19 infection consisting …

Autologous Haematopoietic Stem Cell Transplantation And Systemic Sclerosis: Focus On Interstitial Lung Disease, Gianluca Bagnato, Antonio Giovanni Versace, Daniela La Rosa, Alberta De Gaetano, Egidio Imbalzano, Marianna Chiappalone, Carmelo Ioppolo, William Neal Roberts, Alessandra Bitto, Natasha Irrera, Alessandro Allegra, Giovanni Pioggia, Sebastiano Gangemi

Internal Medicine Faculty Publications

Autologous hematopoietic stem cells transplantation (AHSCT) has been employed as treatment for severe systemic sclerosis (SSc) with high risk of organ failure. In the last 25 years overall survival and treatment-related mortality have improved, in accordance with a better patient selection and mobilization and conditioning protocols. This review analyzes the evidence from the last 5 years for AHSCT-treated SSc patients, considering in particular the outcomes related to interstitial lung disease. There are increasing data supporting the use of AHSCT in selected patients with rapidly progressive SSc. However, some unmet needs remain, such as an accurate patient selection, pre-transplantation analysis to …

Intracardiac Thrombus In Coronavirus Disease-2019, Suganya Karikalan, Munish Sharma, Megha Chandna, Manju Sachdev, Ajay Gaalla, Farah Yasmin, Reena Shah, Iqbal Ratnani

Internal Medicine, East Africa

Intracardiac thrombus is often seen as a complication of ischemic heart disease (IHD) and non-ischemia cardiomyopathies (NICM). The advancements in imaging modalities and therapeutic options have helped reduce the complications arising from ventricular thrombi, such as systemic embolization. Here we present two cases of intracardiac thrombus associated with coronavirus disease (COVID) 19, one with an apical thrombus in the left ventricle and the other with a thrombus in the right ventricle adjacent to chordae tendinae. The effects of covid-19 on the cardiovascular system are yet to be thoroughly evaluated. Venous and arterial thrombosis is commonly associated with COVID-19 but in …

Secondary Infections In Patients With Covid-19 Pneumonia Treated With Tocilizumab Compared To Those Not Treated With Tocilizumab: A Retrospective Study At A Tertiary Hospital In Kenya, Reena Shah, Jasmit Shah, Jaimini Gohil, Gunturu Revathi, Salim Surani

Internal Medicine, East Africa

Introduction: From the first case of SARS-Co-2 in Wuhan, China, to the virus being declared as a pandemic in March 2020, the world has witnessed morbidity and mortality on a global scale. Scientists have worked at a record pace to deliver a vaccine for the prevention of this deadly disease. Tocilizumab, an interleukin-6 (IL-6) blocker, received an emergency use authorization (EUA) by the Federal Drug Agency (FDA) in June 2021.
Methods: This retrospective observational cohort study was conducted at the Aga Khan University Hospital, Nairobi, from March 8, 2020, to December 31, 2020. All patients with PCR confirmed …