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HUBUNGAN KADAR HBA1C DENGAN ALBUMINURIA PADA PASIEN DM TIPE II DI RS ATMA JAYA Gracenidy Mutiara Hermawan; Luse; Febie Chriestya; Mario Steffanus
Majalah Kedokteran Indonesia Vol 70 No 2 (2020): Journal of the Indonesian Medical Association Majalah Kedokteran Indonesia Volum
Publisher : PENGURUS BESAR IKATAN DOKTER INDONESIA (PB IDI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.1234/jinma.v70i2.171

Abstract

Pendahuluan: World Health Organization (WHO) memperkirakan kejadian diabetes melitus (DM) di Indonesia dapat mencapai 21,3 juta orang pada tahun 2030. Studi ini bertujuan untuk mengetahui hubungan kadar HbA1c dengan albuminuria pada pasien DM tipe 2.Metode: Data meliputi usia, jenis kelamin, kadar HbA1c, tekanan darah, proteinuria, merokok, penggunaan ACEI atau ARB, dan lama berobat diambil dari rekam medis pasien DMT2 di RS Atma Jaya dengan studi cross-sectional sesuai kriteria inklusi dan eksklusi dengan metode korelasi Spearman pada interval kepercayaan 95% (á = 0.05).Hasil: Adanya hubungan signifikan antara kadar HbA1c dengan albuminuria (p<0,0001) yang berkorelasi cukup kuat (r=0,439). Faktor lain yang berhubungan adalah usia (p<0.05), sedangkan tekanan darah, merokok, dan penggunaan ACE-Inhibitor atau Angiotensin Receptor Blocker (p=0,386) tidak bermakna.Kesimpulan: Terdapat hubungan bermakna antara kadar HbA1c dengan albuminuria pada pasien DM tipe 2 di RS Atma Jaya.
PERBEDAAN NILAI RASIO NEUTROFIL TERHADAP LIMFOSIT PADA PASIEN TUBERKULOSIS DEWASA SEBELUM DAN SETELAH TERAPI FASE INTENSIF DI RS ATMA JAYA Alius Cahyadi; Mario Steffanus
Majalah Kedokteran Indonesia Vol 68 No 10 (2018): Journal of The Indonesian Medical Association Majalah Kedokteran Indonesia Volu
Publisher : PENGURUS BESAR IKATAN DOKTER INDONESIA (PB IDI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.1234/jinma.v68i10.211

Abstract

Pendahuluan: Tuberkulosis (TB) merupakan masalah kesehatan yang penting di negara berkembang. Infeksi bakteri ini akan mengakibatkan neutrofilia dan limfopenia. Rasio neutrofil terhadap limfosit/ neutrophil to lymphocyte ratio (NLR) merupakan pemeriksaan yang mudah, biaya terjangkau, dan cukup sensitif. Nilai NLR pengidap TB lebih tinggi dibandingkan orang normal, dengan nilai cut off >2,16. Penelitian ini bertujuan untuk mengetahui perbedaan nilai NLR pada pasien TB dewasa sebelum dan setelah terapi fase intensif.Metode: Subjek penelitian adalah pasien TB dewasa kasus baru yang datang ke poli klinik Penyakit Dalam RS Atma Jaya, tanpa adanya HIV, gagal ginjal kronik, diabetes melitus, penyakit paru obstruktif kronik, dan pneumonia bakterial. Jumlah leukosit, neutrofil dan limfosit, serta perhitungan NLR sebelum dan setelah terapi fase intensif dicatat. Analisis data menggunakan SPSS. Hasil: Dari 44 pasien TB, 23 (52,3%) diantaranya berjenis kelamin laki-laki, dengan usia median 37 tahun. Delapan puluh delapan persen sampel menderita TB paru. Nilai NLR sebelum terapi (2,77) lebih tinggi daripada setelah terapi (2) fase intensif (p<0,001). Kesimpulan: Adanya penurunan nilai rasio neutrofil terhadap limfosit yang bermakna secara statistik pada pasien TB dewasa yang telah mendapatkan terapi fase intensif
ANEMIA PENYAKIT KRONIS Jessica Novia Hadiyanto; Margareth Gracia; Alius Cahyadi; Mario Steffanus
Majalah Kedokteran Indonesia Vol 68 No 10 (2018): Journal of The Indonesian Medical Association Majalah Kedokteran Indonesia Volu
Publisher : PENGURUS BESAR IKATAN DOKTER INDONESIA (PB IDI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.1234/jinma.v68i10.216

Abstract

Anemia sering dijumpai pada pasien dengan penyakit kronis dan meningkatkan morbiditas dan mortalitas dari pasien. Prevalensi anemia penyakit kronis terdapat pada urutan kedua tersering setelah anemia defisiensi besi. Anemia penyakit kronis sering terjadi bersamaan dengan anemia defisiensi besi dan keduanya memberikan gambaran penurunan besi dalam serum. Namun, kedua jenis anemia ini perlu dibedakan karena terdapat perbedaan patogenesis dan tata laksana keduanya. Beberapa parameter besi lain perlu diperiksa untuk membedakannya. Terapi utama pada anemia penyakit kronis adalah dengan mengatasi penyakit yang mendasari.
Correlation Between Type 2 Diabetes Mellitus and Pulmonary Tuberculosis at Atma Jaya Hospital Mario Steffanus; Anastasia Pratiwi Fodianto; Jessica Novia Hadiyanto
Jurnal Respirologi Indonesia Vol 41, No 3 (2021)
Publisher : Perhimpunan Dokter Paru Indonesia (PDPI)/The Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497/jri.v41i3.184

Abstract

Background: Diabetes Mellitus (DM) is considered one of the factors that increase the risk of pulmonary tuberculosis (TB). Tuberculosis in Indonesia is severe and ranked second in the world after India. Previous studies suggested that DM increased the risk of developing pulmonary TB by 2–5 times. This study was conducted to determine the effect of type 2 DM on the incidence of pulmonary TB at Atma Jaya Hospital. Methods: This was a case-control study conducted at Atma Jaya Hospital from December 2016 to April 2017 using medical records. Data were further processed by pairing gender and age between case and control groups. A total of 121 samples were obtained and tested using McNemar paired correlation non-parametric analysis. Results: The incidence of pulmonary TB was higher in men than women with a ratio of 2.1:1 and within the productive age range of 27–46 years. The percentage of type 2 DM in pulmonary TB cases was 70% (35 samples) compared to 30% (15 samples) without DM with a total of 50 samples in the case group. The percentage of type 2 DM in the control group without pulmonary TB was 46.5% (33 samples) compared to 53.5% (38 samples) without DM with a total of 71 samples in the control group. Based on the statistical analysis, the P=0.013 and the OR (odds ratio) was 2.20. Conclusion: There was a significant correlation between type 2 DM and the incidence of pulmonary TB in Atma Jaya Hospital with the risk of pulmonary TB 2.20 times higher than those without type 2 DM.
Diagnosis and Management Pancolitis in Patient with Ulcerative Colitis Cindy Cindy; Riki Tenggara; Yudistira Panji Santoso; Mario Steffanus
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 11, NUMBER 2, August 2010
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/112201096-99

Abstract

ABSTRACT Ulcerative colitis (UC) is a form of inflammatory bowel disease (IBD) that usually affects the rectum and part of the colon, which spreads continuously with no skip area. Pancolitis occurs in 20% of patients with UC. Patients with chronic UC, especially pancolitis, have a higher risk of colon cancer. In patients with pancolitis, the risk of cancer increases by 0.5-1% per year after having 8-10 years of disease. A 72-year-old man came with complaint of bloody-mucus diarrhea associated with abdominal cramps. The colonoscopic appearance of colitis was observed in whole lumen throughout colon. Histopathological analysis demonstrated dense infiltrates of granulocytes and macrophages formed by severe inflammation. Normal appearances were observed in the remaining epithelial cells. No parasites, specific process, or malignancy were found. Moreover, no acid-resistant bacteria were found. However, atypical cells were found in one of the biopsy specimens. The patient was diagnosed with extensive type of severe UC. The initial management of treatment included improvement of his general condition along with antibacterial therapy of metronidazole and ciprofloxacin. Specific treatment of sulphasalazine and prednisone were given after pancolitis appearance was revealed, which has similar clinical manifestations in accordance with UC.   Keywords: pancolitis, ulcerative colitis, chronic diarrhea, inflammatory bowel disease
Penurunan Rasio Neutrofil terhadap Limfosit pada Pasien Tuberkulosis Sesudah Terapi Intensif Caroline Ciptasari; Mario Steffanus; Stefanus Lembar
JIMKI: Jurnal Ilmiah Mahasiswa Kedokteran Indonesia Vol 6 No 1 (2018): JIMKI : Jurnal Ilmiah Mahasiswa Kedokteran Indonesia Volume 6.1 Edisi April - Sep
Publisher : BAPIN-ISMKI (Badan Analisis Pengembangan Ilmiah Nasional - Ikatan Senat Mahasiswa Kedokteran Indonesia)

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Abstract

Background: Tuberculosis is a health problem with a high incidence rate in Indonesia. This disease caused by bacterial infection of Mycobacterium tuberculosis, Bacterial infection will activate the body's immune response that will induce inflammatory process. Inflammation caused by bacterial infection is characterized by an increase in the number of neutrophils (neutrophilia) and a decrease in the number of lymphocytes (lymphocytopenia). Therapy is done to reduce the incidence of TB. TB therapy is divided into 2 phases, an intensive and continuous phase. This therapy was use to killing bacteria and suppressing the inflammatory response that occurs as a result of the bacterial infection. Objective: The purpose of this study was to determine the improvement of the body's immune response through the neutrophil to lymphocytes ratio (NLR) before and after intensive therapy in patients with tuberculosis. Method: The study was conducted at Atma Jaya Hospital, taking data was held from January 2017 to May 2017 with a total of 44 patients as samples. Data were collected secondary through medical record. The results were obtained using the wilcoxcon test.Result: The results of this study was NLR decrease after therapy and this result are parallel with the decrease in the number of neutrophils and the increase in the number of lymphocytes after intensive therapy. Conclusion: There is an improvement in the condition of the patient after undergoing intensive TB therapy