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All Journal The Indonesian Biomedical Journal Journal of Islamic Medicine CRJIM (Clinical and Research Journal in Internal Medicine) Journal of Community Health and Preventive Medicine (JOCHAPM)
Ahdi, Iwal Reza
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Biochemistry, Genetics & Molecular Biology Education Environmental Science 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
Diagnostic Delay in advanced Gastroesophageal Adenocarcinoma presenting as Chronic Neurogenic Dysphagia: Gastroesophageal Adenocarcinoma and Chronic Neurogenic Dysphagia Abshori, Nuril Farid; Kakiay, Ferdinandus Stevanus; Ahdi, Iwal Reza; Patikawa, Febria Rizky
Clinical and Research Journal in Internal Medicine Vol. 7 No. 1: Volume 7 No 1, May 2026
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.crjim.2026.007.01.15

Abstract

Advanced adenocarcinoma of the esophagogastric junction (AEGJ) may mimic benign or neurogenic swallowing disorders, leading to delayed diagnosis. We report a 65-year-old man with a two-year history of progressive dysphagia initially attributed to neurogenic causes following an ischemic stroke. The patient developed recurrent vomiting, epigastric pain, and significant weight loss (16 kg). On admission, he appeared cachectic (BMI 16.7 kg/m²) with anemia (Hb 7.7 g/dL) and hypoalbuminemia (2.4 g/dL). Contrast-enhanced CT revealed an infiltrative mass involving the distal esophagus and gastric fundus with lymphadenopathy, while endoscopy showed a friable obstructive lesion confirmed as adenocarcinoma on biopsy. A feeding jejunostomy was performed for nutritional optimization prior to oncologic therapy. The diagnostic delay resulted from anchoring bias, in which dysphagia was misinterpreted as neurogenic rather than structural. This case emphasizes the importance of early endoscopic evaluation in elderly patients with chronic progressive dysphagia, weight loss, or anemia, and highlights the need for clinician awareness of cognitive biases to prevent late-stage presentation and improve clinical outcomes.
THE RELATIONSHIP BETWEEN FASTING BLOOD GLUCOSE LEVELS AND ST- SEGMENT PATTERNS IN PATIENTS WITH ACUTE CORONARY SYNDROME AT KARSA HUSADA HOSPITAL INDONESIA: A CROSS-SECTIONAL STUDY Riskiyah , Riskiyah; Rachmawati, Ermin; Tarsadi, Tarsadi; Ahdi, Iwal Reza; Saputra, Indra Wahyu; Maulana, Syafiq
Journal of Community Health and Preventive Medicine Vol. 6 No. 1 (2026): JOCHAPM Vol. 6 No. 1 2026
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/

Abstract

Interpreting severity of acute coronary syndrome (ACS) through an electrocardiogram (ECG) requires a high level of expertise. However, the limited number of medical personnel skilled in ECG interpretation in primary healthcare facilities in Indonesia often leads to delays in determining the initial treatment. Furthermore, fasting blood glucose (FBG) levels in ACS patients tend to be elevated and are associated with various ST-segment changes on the ECG, which are thought to play a significant role in determining the severity of ACS. This study aimed to analyze the relationship between FBG levels and the types of ST-segment patterns in patients with ACS. This study used an analytical observational research design. Data were obtained from patient medical records collected between January and June 2025. The sample size was determined using the Slovin formula, yielding a total of 100 participants who met the inclusion criteria. Eligible participants were patients diagnosed with ACS, aged 18 years or older, and possessing complete medical records that included ECG data interpreted by a cardiologist and laboratory results containing FBG levels. Blood samples and ECG recordings were collected in the morning at the Cardiovascular Care Unit. Relationships between variables were analyzed using non-parametric statistical methods, specifically the Chi-square test and the contingency coefficient. Most participants were male (64%) and aged 46–65 years (59%). The majority exhibited elevated FBG levels (71%) accompanied by ECG findings of ST-segment depression (44%). A significant relationship was found between FBG levels and the type of ST-segment pattern (p = 0.02, < 0.05), although the strength of the association was weak (Cramer’s V = 0.241). FBG levels are significantly associated with ST-segment patterns in patients with ACS and may serve as an early indicator for assessing the severity of myocardial ischemia.   KEYWORDS: acute coronary syndrome; electrocardiogram;  fasting blood glucose.
Co-Authors Abshori, Nuril Farid Arief Rachman Hakim Djanggan Sargowo Ermin Rachmawati Handirosiyanto, Ikhwan Ismail, Mahrus Kakay, Ferdinandus Stevanus Kakiay, Ferdinandus Stevanus Maulana, Syafiq Patikawa, Febria Rizky Puspitasari, Alvina Riskiyah , Riskiyah riskiyah, Riskiyah - Saputra, Indra Wahyu Sasiarini, Laksmi Tarsadi, Tarsadi Wardhani, Syanindita Puspa