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Tuberkulosis: Status Quo? Cahyadi, Alius
Majalah Kedokteran Indonesia Vol 68 No 8 (2018): Journal of The Indonesian Medical Association - Majalah Kedokteran Indonesia, Vo
Publisher : PENGURUS BESAR IKATAN DOKTER INDONESIA (PB IDI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47830/jinma-vol.68.8-2018-43

Abstract

Negara Kesatuan Republik Indonesia merupakan negara kepulauan dengan luas wilayah mencapai 1,7 juta km2 yang tersebar dari Sabang sampai Merauke dan memiliki populasi sebesar 260 juta jiwa.1 Beberapa penyakit infeksi masih menjadi masalah endemik di Indonesia, termasuk tuberkulosis. Tuberkulosis tidak hanya menjadi masalah kesehatan di Indonesia tetapi masih menjadi masalah kesehatan utama di dunia. Bahkan dalam 5 tahun terakhir menjadi penyebab utama kematian yang disebabkan oleh infeksi tunggal. Diagnosis dan tata laksana yang tepat dapat menyembuhkan sebagian besar penderita tuberkulosis.2
Leptospirosis: Penyakit yang Terlupakan Cahyadi, Alius
Majalah Kedokteran Indonesia Vol 69 No 2 (2019): Journal of The Indonesian Medical Association - Majalah Kedokteran Indonesia, Vo
Publisher : PENGURUS BESAR IKATAN DOKTER INDONESIA (PB IDI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47830/jinma-vol.69.2-2019-71

Abstract

Pada dasarnya leptospirosis merupakan penyakit infeksi pada hewan (zoonotik) yang disebabkan oleh spesies patogenik Leptospira.1,2 Tetapi tidak jarang pula infeksi akut ini terjadi pada manusia, paling banyak disebabkan oleh Leptospira interogans.1-3 Penyakit ini dapat ditemukan baik pada daerah tropis maupun subtropis, terutama pada daerah dengan kondisi higienis yang buruk sehingga bakteri ini dapat bertahan hidup dan mnyebar ke penderita lain. Di banyak negara, termasuk di Indonesia, leptospirosis merupakan masalah yang kurang mendapat perhatian. Apakah di Indonesia sudah bebas dari penyakit ini? Tentunya belum. Berdasarkan data yang tercatat di kementrian kesehatan, pada tahun 2014 terdapat kejadian luar biasa leptospirosis di Kabupaten Kota Baru, Kalimantan Selatan. Data pada Kemenkes mencatat hingga November 2014 terdapat 435 kasus dengan 62 kematian akibat leptospirosis.
Gangguan Fungsi Hati pada Pasien Abses Hati Amebadengan Lama Perawatan di Rumah Sakit Atmajaya Novia, Jessica; Cahyadi, Alius
Majalah Kedokteran Indonesia Vol 68 No 2 (2018): Journal of The Indonesian Medical Association - Majalah Kedokteran Indonesia, Vo
Publisher : PENGURUS BESAR IKATAN DOKTER INDONESIA (PB IDI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47830/jinma-vol.68.2-2018-88

Abstract

Introduction : Amoebic liver abscess is a manifestation of extra-intestinal amoebiasis which is caused by Entamoeba histolytica infection. Patients with amoebic liver abscess usually have elevated liver function test results that will prolong the hospital stay.The aim of this study is to correlate liver dysfunctions and duration of hospital stay inamoebic liver abscess patients. Methods : This was a correlative analytic cross-sectional study. The participants of this study were patients diagnosed with amoebic liver abscess in Atma Jaya Hospital from January 2014 to December 2017. The length of stay and the liver function test result swere observed and analyzedusing Spearman correlation test. Results : There were 16 patients diagnosed as amoebic liver abscess, which 15 of them were male, with average age of 44.56 years old. The average length of stay was 10 days. Enlarged liver was found in 87.5% of the patients. The average AST, ALT, Alkaline phosphatase, and gamma-GT were 34 U/L, 60.63 U/L, 184.82 U/L, and 176.17 U/L respectively. The liver function test results and length of stay had neither normal distribution nor significant correlationusing Spearman correlation test. Conclusion : There is no significant correlation between liver function test results and length of hospital stay in patients with amoebic liver abscess.
Perbedaan Nilai Rasio Neutrofil Terhadap Limfosit Pada Pasien Tuberkulosis Dewasa Sebelum dan Setelah Terapi Fase Intensif di RS Atma Jaya Cahyadi, Alius; Steffanus, Mario
Majalah Kedokteran Indonesia Vol 68 No 10 (2018): Journal of The Indonesian Medical Association - Majalah Kedokteran Indonesia, V
Publisher : PENGURUS BESAR IKATAN DOKTER INDONESIA (PB IDI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47830/jinma-vol.68.10-2018-211

Abstract

Introduction: Tuberculosis (TB) is an important health problem in developing countries. This infection results neutrophilia and lymphopenia. The neutrophil to lymphocyte ratio (NLR) is an easy, inexpensive, and sensitive examination. The NLR result in tuberculosis patients showed higher compare to normal population, with cut off greater than 2.16. The aim of this study was to know the difference of NLR result in adult TB patients before and after the intensive phase treatment. Methods: We collected all new cases adult TB patients who came to out-patient department in Atma Jaya Hospital, without any HIV infection, chronic kidney disease, diabetes mellitus, chronic obstructive pulmonary disease, and bacterial pneumonia. Baseline characteristic, leukocyte count, neutrophil and lymphocyte count, also NLR were collected before and after intensive phase treatment, then were analyzed using SPSS. Results: There were 44 participants included in this study, 23 (52.3%) of them were male, with median age were 37 years old. Eighty eight percent of the subject had pulmonary tuberculosis. The NLR result before treatment (2.77) was higher compare with the NLR result (2) after intensive phase treatment (p less than 0.001). Conclusion: There was a statistically significant decrease in NLR result after intensive phase treatment of adult TB patients.
Anemia Penyakit Kronis Hadiyanto, Jessica Novia; Gracia, Margareth; Cahyadi, Alius; Steffanus, Mario
Majalah Kedokteran Indonesia Vol 68 No 10 (2018): Journal of The Indonesian Medical Association - Majalah Kedokteran Indonesia, V
Publisher : PENGURUS BESAR IKATAN DOKTER INDONESIA (PB IDI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47830/jinma-vol.68.10-2018-216

Abstract

Anemia is commonly found in patients with chronic diseases and causing increased in morbidity and mortality. The prevalence of anemia of chronic disease is the second highest after iron deficiency anemia. Anemia of chronic disease oftenly occurs with iron deficiency anemia therefore both of them showed low in serum iron level. However, we should differentiate these two kinds of anemia in order to give the specific treatment. Some iron parameters have to be extracted to differentiate them. The main management for anemia of chronic disease is to treat the underlying causes.
Drug-induced hypersensitivity syndrome with liver injury due to phenytoin: A case report Wijaya, Lorettha; Adevita, Stella; Alvianto, Steven; Christiani, Yoseveline; Cahyadi, Alius; Yolanda, Raesa
Journal of General - Procedural Dermatology & Venereology Indonesia Vol. 8, No. 2
Publisher : UI Scholars Hub

Show Abstract | Download Original | Original Source | Check in Google Scholar

Abstract

Background: Drug-induced hypersensitivity syndrome (DIHS) is a rare and severe systemic drug reaction characterized by skin involvement, internal organ complications, and hematologic disorders. Management of this condition is challenging due to its wide range of cutaneous manifestations and 10% mortality rate. Case Illustration: A 52-year-old male presented with widespread redness throughout his body with a prior history of regular phenytoin consumption. The rash continued to spread despite the patient’s abrupt discontinuation of the suspected medication. He was diagnosed with atypical DIHS according to J-SCAR criteria and was given high-dose corticosteroid. Drastic clinical improvement was observed after nine days of therapy, and complete resolution of the rash was achieved after 14 days. The steroid was stopped after four weeks, and no relapse was observed after four months of follow-up. Discussion: Discontinuing the suspected medication is the first crucial step in DIHS management. No specific pharmaceutical strategy has been established for this syndrome; however, systemic corticosteroids have been frequently prescribed as a first-line therapy. Steroids need to be tapered off slowly over 6–8 weeks, even upon clinical resolution, to prevent relapse. In the current case, the steroid was tapered off slowly over four weeks. The lack of relapse observed after steroid discontinuation could be due to the fact that the patient stopped consuming the suspected medication immediately. Conclusion: Education on the consequences of prescribing high-risk medications is important. Early detection and prompt cessation of offending medications are needed for better DIHS outcomes.