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All Journal The Indonesian Biomedical Journal Journal of Islamic Medicine CRJIM (Clinical and Research Journal in Internal Medicine)
Ahdi, Iwal Reza
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Biochemistry, Genetics & Molecular Biology Education Health Professions Immunology & microbiology Medicine & Pharmacology Nursing Public Health Other

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Interesting Case of Acute Lung Oedema Complication of Dengue Hemorrhagic Fever-Hypercoagulability: Interesting Case of Acute Lung Oedema Complication of Dengue Hemorrhagic Fever-Hypercoagulability Abshori, Nuril Farid; Kakay, Ferdinandus Stevanus; Ahdi, Iwal Reza
Clinical and Research Journal in Internal Medicine Vol. 6 No. 1 (2025): Volume 6 No 1, May 2025
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.crjim.2025.006.01.11

Abstract

A B S T R A C T Background: Diagnosis and management of dengue hemorrhagic fever (DHF) can be challenging with confounding complications. Important confounding factors are conditions that alter hematologic parameters and prognosis of infection. We report a case of a patient with a positive DHF IgG result and hypercoagulation leading to Acute Lung Oedema (ALO), a serious condition with risk of respiratory failure leading to death. This is the first case to highlight the unique set of diagnostic and therapeutic challenges of DHF in this context. Case Presentation: A twenty-seven-year-old man presented with suspected DHF with thrombocytopenia and hypoalbumin. Pharmacologic and fluid therapy were optimal. However, the patient suddenly developed dyspnea leading to respiratory failure and had to be admitted to the intensive care unit. The patient also had severe infection as evidenced by D-dimer > 5,000 ng/ml and pulmonary edema, one of which was due to pulmonary embolism. This requires appropriate and rapid treatment, considering the patient is in critical condition. Conclusion: This patient faced two diagnostic challenges: the diagnosis of dengue fever with positive DHF IgG but with different clinical manifestations and the diagnosis of hypercoagulation related to pulmonary embolism. There were two therapeutic difficulties: that of balancing the risks and benefits of administering anticoagulants and steroids in a pulmonary embolism patient with DHF. As decisions in such cases are patient-specific, sharing individual experiences will help guide future therapeutic management decisions. Keywords: Acute Lung Oedema (ALO), Dengue Hemorrhagic Fever (DHF), Hypercoagulation
Hiperglikemia pada Pasien Diabetes Melitus Tipe 1 dan 2 yang Menjalani Puasa Ramadan : Laporan Kasus Ahdi, Iwal Reza; Sasiarini, Laksmi
Journal of Islamic Medicine Vol 6, No 1 (2022): JOURNAL OF ISLAMIC MEDICINE EDISI MARET 2022
Publisher : Faculty of Medicine and Health Science, Universitas Islam Negeri Maulana Malik Ibrahim

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18860/jim.v6i1.13741

Abstract

Background: Ramadan fasting is an obligation for every Muslim, including Muslim patients who suffer from diabetes mellitus. The most common complication in diabetic patients when fasting is hypoglycemia, but in special conditions, hyperglycemia can also occur, and even emergency occurs in both type 1 and type 2 diabetes patients. Purpose: To know the hyperglycemia complications in type 1 and 2 diabetes mellitus in Ramadhan fasting Methods: Reported a case of inpatient diabetes mellitus 1 and 2 who underwent fasting during Ramadan and complications of hyperglycemia occurred in dr. Saiful Anwar Hospital (RSSA) Malang during the month of Ramadan Results: Both patients experienced hyperglycemia which was a response to an increase in response to hypoinsulinemia in type 1 diabetes and an increase in glycogenolysis in DM type 2. Conclusion: Hyperglycemia can occur in patients with type 1 and 2 DM who fast during the month of Ramadan
Expression of Plasma miRNA-133a is Significantly Lower in Acute Coronary Syndrome (ACS) than in Healthy/Non-ACS Subjects Rachmawati, Ermin; Sargowo, Djanggan; Saputra, Indra Wahyu; Riskiyah, Riskiyah; Handirosiyanto, Ikhwan; Hakim, Arief Rachman; Ismail, Mahrus; Tarsadi, Tarsadi; Maulana, Syafiq; Ahdi, Iwal Reza; Puspitasari, Alvina; Wardhani, Syanindita Puspa
The Indonesian Biomedical Journal Vol 16, No 5 (2024)
Publisher : The Prodia Education and Research Institute (PERI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18585/inabj.v16i5.3243

Abstract

BACKGROUND: The current biomarker diagnostic modality for acute coronary syndrome (ACS), cardiac troponin, has several limitations. Emerging studies showed that micro-RNA (miR)-133a was released from infarcted heart to circulation, yet the diagnostic value of miR-133a in ACS demonstrated a conflicting result. Therefore, this study was conducted to investigate the potency of plasma miR-133a as a biomarker candidate of ACS.METHODS: This was a case-controlled study, involving ACS and control subjects. The sociodemographic and clinical characteristics were assessed through medical records. A final of 39 ACS and 31 control subjects (consist of healthy and non-ACS subjects) passed the selection procedure by demonstrating a high purity of RNA. miR-133a from ACS and control subjects were detected by quantitative polymerase chain reaction (qPCR). Expression of miR-133a was evaluated for sensitivity and specificity as an ACS biomarker diagnostic using the receiver operating characteristic (ROC) curve.RESULTS: Plasma miR-133a expression was stably found in ACS subjects. The plasma miR-133a level was lower in ACS than in control subjects. miR-133a effectively distinguished ACS subjects from healthy subjects (AUC=0.911) and exhibited high diagnostic performance, with a sensitivity of 87.1% and specificity of 100% at a cut-off value of 44.035. In an extended model including both control subjects (healthy and non-ACS with comorbid conditions), miR-133a maintained diagnostic significance (AUC=0.874), showing sensitivity of 76.9% and specificity of 100% at a cut-off value of 11.69.CONCLUSION: Plasma miR-133a is significantly lower and effectively distinguishes ACS patients from both healthy individuals and non-ACS individuals with comorbid, with a cut-off value of 11.69. Therefore, plasma miR-133a is suggested to be a good candidate for diagnostic biomarkers of ACS.KEYWORDS: circulating miRNA, miRNA-133a, acute coronary syndrome, diagnostic biomarker
The Effect of Fasting Blood Glucose (FBG) on Troponin I and Clinical Outcomes in Acute Coronary Syndrome (ACS) : A Retrospective Analysis: A Retrospective Observational Study Abshori, Nuril Farid; Ahdi, Iwal Reza; Kakiay, Ferdinandus Stevanus
Clinical and Research Journal in Internal Medicine Vol. 6 No. 2 (2025): Volume 6 No 2, November 2025
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.crjim.2025.006.02.08

Abstract

Background: In the early phase of Acute Coronary Syndrome (ACS), simple parameters such as fasting blood glucose (FBG) and cardiac troponin I (cTnI) may provide prognostic information. However, evidence regarding their relationship remains inconsistent, particularly in the Indonesian population. Objective: To investigate the correlation and association between FBG and cTnI in patients with ACS at Karsa Husada Hospital, Batu, Indonesia. Methods: This retrospective observational study included 75 hospitalized ACS patients. Clinical and laboratory data were collected from medical records. Troponin values were log10-transformed. Statistical analyses included Spearman correlation, stepwise linear regression per 10 mg/dL increase in FBG, categorical FBG classification (<100, 100–125, ≥126 mg/dL), trend testing, and restricted cubic spline modeling. Fully adjusted models incorporated age, sex, diabetes, estimated glomerular filtration rate, systolic blood pressure, and heart rate. Results: The median age was 62 years, and 64% were male. FBG showed a weak, non-significant correlation with cTnI (rₛ = 0.19; p = 0.12). After adjustment, each 10 mg/dL increase in FBG was associated with an 8.6% higher cTnI level (β = 0.036; 95% CI −4.5% to +23.6%; p = 0.20). Compared with normal FBG, hyperglycemia (≥126 mg/dL) was associated with a 50.6% higher cTnI level, although this was not statistically significant (p = 0.60), and no significant linear trend was observed (p-trend = 0.55). Spline analysis revealed no significant non-linearity (p = 0.72), and no interaction by diabetes status (p = 0.67). Conclusion: In this ACS population, higher FBG tended to be associated with higher cTnI levels; however, the relationship attenuated and lost significance after adjustment. FBG may serve as an additional risk marker rather than a primary determinant of myocardial injury in the early phase. Keywords: fasting blood glucose, troponin I, acute coronary syndrome, hyperglycemia
Co-Authors Abshori, Nuril Farid Arief Rachman Hakim Djanggan Sargowo Ermin Rachmawati Handirosiyanto, Ikhwan Ismail, Mahrus Kakay, Ferdinandus Stevanus Kakiay, Ferdinandus Stevanus Maulana, Syafiq Puspitasari, Alvina riskiyah, Riskiyah - Saputra, Indra Wahyu Sasiarini, Laksmi Tarsadi, Tarsadi Wardhani, Syanindita Puspa