Zulkhair Ali
Department Of Internal Medicine, Dr. Mohammad Hoesin Hospital, Palembang, Indonesia / Department Of Internal Medicine, Faculty Of Medicine, Universitas Sriwijaya, Palembang, Indonesia

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Comparison of Omega-3 Serum Level Between Hiv-Aids Patients Along with Their Clinical Profiles and Healthy Population in Mohammad Hoesin General Hospital Palembang Lidiawati Handayani; Harun Hudari; Eddy Mart Salim; Erial Bahar; Nova Kurniati; Zulkhair Ali; Ferry Usnizar
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 5 No. 12 (2021): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32539/bsm.v5i4.382

Abstract

Introduction. Human Immunodeficiency Virus (HIV) infection has been a concerning health problem worldwide. It causes reduction in body immune system and inflammation that can affect its clinical profile. Undergoing ARV therapy patients causes intestine microbiota dysbiosis and translocation that lead to imperfect absorbtion of fatty acid. One way to control microbiota dysbiosis is by controlling the nutritional factor, especially with omega-3. However, different regions upstands different custom in fish consumption especially those of which are rich in omega-3. The purpose of this research is to compare omega-3 serum level between HIV-AIDS patients and healthy population, as well as analyzing the correlation of omega-3 serum level with of HIV-AIDS patient clinical profile.Methods. The research will be applying observational analytic study using comparative study approach which will be performed in Tropical Infection Internal Medicine polyclinic and Medical Check-Up Polyclinic in RSMH Palembang starting from April 2020 until January 2021. Sample consisted of 32 HIV-AIDS patients from 20-58 years of age and 16 healthy population from 27-35 years of age on whom will be performed physical examination as well as clinical profile and omega-3 serum level examination. All data processing and analysis will be performed using SPSS v.25 for windows.Results. Out of 32 HIV-AIDS patients, we obtained low omega-3 serum level with median value at 3 (2-4) Umol/L, while in healthy population was 4 (3-6) Umol/L. Multivariate analysis inferred that the lower omega-3 serum level correlated with HIV-AIDS stage, duration of ARV therapy, blood pressure, and sex.Conclusion. Omega-3 serum levels in HIV-AIDS patients were lower than the healthy population. There was a correlation between omega-3 serum levels and their clinical profile of HIV-AIDS patients in Mohammad Hoesin General Hospital Palembang.
The Association between Urinary Tissue Inhibitor Metalloproteinase 2 (TIMP-2) and Insulin-like Growth Factor Binding Protein 7 (IGFBP-7) and Renal Recovery in Acute Kidney Injury Emilia; Zulkhair Ali; Ian Effendi; Novadian; Suprapti; Mediarty; Taufik Indrajaya; Mgs. Irsan Saleh
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 5 No. 4 (2021): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32539/bsm.v5i4.386

Abstract

Background. Acute kidney injury (AKI) is a common and serious medical condition associated with significant increases in morbidity, mortality, cost of care and non recovery of kidney function that leads to progression to chronic kidney disease. Cell cycle arrest is implicated in the pathogenesis and repair process following AKI. The urinary cell-cycle arrest markers tissue inhibitor of metalloproteinase-2 (TIMP-2) and insulin-like growth factor binding protein 7 (IGFBP-7) have been utilized to predict the risk of AKI in many studies from specific population with good performance. However, their use in predicting recovery is still lacking. The aim of this study was to determine the association between two novel AKI biomarkers, urinary TIMP2 and IGFBP7 and renal recovery after 7 days of treatment in AKI patients at Dr. Mohammad Hoesin Hospital Palembang. Method. This was a prospective cohort study conducted in dr. Mohammad Hoesin Hospital Palembang from January 2021 until March 2021. Subjects enrolled in this study were patients whom diagnosed AKI based on KDIGO 2012 criteria. Urine samples were collected upon patients’ enrollment within 24 hours of AKI diagnosis. We utilized Sandwich Enzyme Linked Immunosorbant Assay (ELISA) method to detect urinary TIMP-2 and IGFBP-7 levels. The primary outcome is recovery from AKI after 7 days of treatment. Chi square test is used to analyze the association between urinary TIMP-2 and IGFBP-7 levels and renal recovery. Results. There were 70 subjects, only 22 of them were recovered after 7 days (31%). Median of urinary TIMP-2 and IGFBP-7 was 0,0047(0,0001-0,1439) [(ng/ml)2/1000]. There was significant association between urinary TIMP2 and IGFBP7 and renal recovery (p=0,027; OR 3,19; 95% CI 1,116-9,128). Conclusion. There was significant association between urinary TIMP2 and IGFBP7 and renal recovery in AKI patients.
Electrocardiography Predictive Value on Coronary Slow Flow Phenomenon Erwin Sukandi; Yudhie Tanta; Taufik Indrajaya; Ali Ghanie; Muhammad Irsan Saleh; Irfannuddin; Radiyati Umi Partan; Zulkhair Ali
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 6 No. 3 (2022): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v6i3.454

Abstract

Coronary Slow Flow Phenomenon (CSFP) is characterized by the slow flow of contrast in one or more epicardial coronary vessels without evidence of coronary artery stenosis during coronary angiography procedures. CSFP is fairly common at the time of elective angiography with an incidence of around 7% and accounts for about 4% of hospitalized unstable angina cases. Coronary angiography is currently still the only effective way to detect CSFP, but this procedure is an invasive procedure with high costs, there is a risk of allergy to contrast. Electrocardiography (ECG), as a widely available, inexpensive, and simple modality is felt to be an attractive alternative in early detection of this abnormality. The ECG parameters on CSFP discussed in this study include; p-wave dispersion, QT interval dispersion, QRS intrinsic (Tpeak-Tenddeflection duration), and QRS fragmentation. Further studies are needed on the ECG image in CSFP so that in the future ECG can be a cheaper and non-invasive diagnostic modality for CSFP compared to coronary angiography.
Effectiveness of Garlic Extract (Allium sativum) to Reduce Level of Malondialdehyde Serum and Improve Quality of Life in Patients with Chronic Hemodialysis: A Randomized Double-Blind Placebo-Controlled Trial Istiqomah, Amelia; Ali, Zulkhair; Saleh, Irsan
Jurnal Penyakit Dalam Indonesia Vol. 9, No. 4
Publisher : UI Scholars Hub

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Abstract

Introduction. Study reported that malondialdehyde (MDA) levels as an in vivo marker of oxidative stress were increased in patients undergoing hemodialysis. Antioxidants allicin compounds contained in garlic (Allium sativum) are known to have antioxidant activity by inducing antioxidant enzymes such as superoxide dismutase (SOD), catalase (CAT) and inhibiting prooxidant enzymes (nitric oxide synthase, xanthine, NADPH oxidase, and cyclooxygenase). This study aimed to investigate the effectiveness of Allium sativum to reduce level of MDA serum and improve quality of life in patients with chronic hemodialysis. Methods. This study was a crossover randomized double-blind placebo-controlled trial. The subjects were 40 chronic kidney disease (CKD) stage 5 patients with chronic hemodialysis (HD). Subjects were randomly divided into 2 groups, namely the group that received 1,000 mg of garlic extract per day (2 x 500 mg) for 6 weeks and the group that received a placebo, which was then carried out during a washing period for 2 weeks and then the two groups were crossover. Each group measured the levels of serum MDA before and after treatment, also fill in kidney disease quality of life (KDQOL) SF-36 questionnaire. Results. Out of 40 subjects, most of them were male (57.5%) with median of age of 48.6 (range 26-59) years. It was found that serum MDA levels before and after garlic extract administration were 2.423 (SD 0.236) nmol/l and 1.649 (SD 0.26) nmol/l (p<0,001) with a mean change of -0.782 (SD 0.735) nmol/l. Statistical analysis showed a significance difference of MDA serum between the two groups. There was significant improvement in quality of life before and after garlic extract administration from 57.81 (SD 16.95) to 67.62 (SD 13.61) with a mean change of 9.81 (SD 3.34). But there was no significant difference between quality of life and MDA serum. Conclusion. There is effectiveness of garlic extract to decrease serum MDA and improve the quality of life in patients with CKD stage 5 using chronic HD at Mohammad Hoesin Hospital, Palembang.
Correlation between Parathyroid Hormone Serum Levels andAbdominal Aortic Calcification in Chronic Hemodialysis Patientsat Dr. Mohammad Hoesin Center General Hospital Palembang Akbar, M Yusuf Arief; Ali, Zulkhair; Indrajaya, Taufik; Suhaimi, Novadian; Devi, SNA Ratnasari; Bahar, Erial
Jurnal Penyakit Dalam Indonesia Vol. 8, No. 1
Publisher : UI Scholars Hub

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Abstract

Introduction. Cardiovascular disease is the most common cause of death in patients with chronic kidney disease (CKD). This is evidenced by the finding of vascular calcification in CKD patients. The process of vascular calcification that occurs is often associated with secondary hyperparathyroid conditions that are complications of CKD patients. The aim of this study was to asses the relationship between serum PTH levels and the abdominal aorta calcification (AAC) in CKD patients undergoing hemodialysis (HD) Methods. This observational analytic study with cross-sectional correlation test was conducted in the internal medicine ward of dr. Mohammad Hoesin Palembang from July to December 2019. Subjects were patients who had undergone HD >3 months with age >18 years. All subjects were examined for serum PTH levels and measured the carotid artery wall using doppler ultrasonography and the degree of calcification of the abdominal aorta using a lateral lumbar X-ray which was calculated using the Kauppila score. Results. There were 86 of HD patients studied, 65 subjects (75.6%) had high serum PTH levels and 46 subjects (53.5%) who had AAC. The Spearman correlation analysis showed that serum PTH levels had a relationship with Kauppila score (p=0.014, r=0.264). Multivariate linear regression analysis obtained age (p<0.001, r=0.510), duration of HD (p=0.020, r=0.256), history of hypertension (p=0.031, r=0.239) and serum phosphate levels (p=0.011, r=0.281) had a relationship to the Kauppila score. Conclusions. There is a significant relationship between serum PTH levels and AAC in chronic HD patients. The presence of factors including age, duration of HD, hypertension, and serum phosphate levels also affect the incidence of AAC
Chronic Renal Failure in a Post-Kidney Transplant Patient with Kidney Graft Hydronephrosis and Renal Anemia Elfiani Elfiani; Zulkhair Ali; Fadil Pramudya; Muhammad Yusri; Huntari Harahap
Jambi Medical Journal : Jurnal Kedokteran dan Kesehatan Vol. 11 No. 4 (2023): JAMBI MEDICAL JOURNAL Jurnal Kedokteran dan Kesehatan
Publisher : FAKULTAS KEDOKTERAN DAN ILMU KESEHATAN UNIVERSITAS JAMBI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22437/jmj.v11i4.28890

Abstract

ABSTRACT   A kidney transplant is the ideal option for End Stage Renal Disease (ESRD). A successful kidney transplant will improve the excretory function of the kidney so that it can return the quality of life for patients with Chronic Kidney Disease (CKD) to normal. However, in some cases of transplant recipients, the grafted kidney does not function optimally due to several complications. Post-kidney transplant complications may occur, which are classified into two groups, namely surgical and medical complications. Cases of obstruction characterized by hydronephrosis of the graft kidney, a post-transplant surgical complication. The most common location is where the ureter implants into the bladder, namely the distal 1/3 ureter. The most important medical or non-surgical complications are rejection or rejection reactions ranging from acute, hyperacute and chronic. Chronic rejection is the gradual loss of function of the transplanted organ over several months to years after the organ is functioning normally. Chronic rejection is difficult to treat where the use of immunosuppression is of little use because the damage has already occurred, so the patient again needs another renal replacement therapy, namely hemodialysis. The following is a case report of a patient after a kidney transplant six years ago, experienced decreased kidney function again and had to receive hemodialysis therapy due to a kidney graft/hydronephrosis graft.
Nephrogenic Ascites in End-Stage Renal Disease Patients Undergoing Hemodyalisis: Case Series Mulia, Deddy Primadona; Irawan, Rico; Kartika, Herleni; Wangsa, Syahpri Putra; Akbar, Kgs. M. Yusuf Arief; Effendi, Ian; Suhaimi, Novadian; Slamet, Suprapti; Ali, Zulkhair
Indonesian Journal of Kidney and Hypertension Vol 1 No 1 (2024): Volume 1 No. 1, April 2024
Publisher : PERNEFRI (PERHIMPUNAN NEFROLOGI INDONESIA)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32867/inakidney.v1i1.121

Abstract

Ascites occurring in individuals with chronic kidney disease (CKD) undergoing hemodialysis (HD) are referred to as nephrogenic ascites (NA). The pathogenesis of NA remains uncertain but involves many interrelated factors. These factors include inadequate dialysis, low ultrafiltration, poor nutrition, increased peritoneal membrane permeability, and impaired peritoneal lymphatic reabsorption. Frequent accompanying complaints are leg edema, nausea, decreased appetite, weakness, and complaints due to hypotension during HD. NA generally carries a poor long-term prognosis, likewise, with complex therapeutic options, both medical and surgical. Management of NA includes education regarding fluid restrictions, a high protein diet, intensive HD, as well as therapeutic modalities with continuous ambulatory peritoneal dialysis (CAPD) and kidney transplantation. CAPD has been proven to improve quality of life and recovery from ascites. The NA in this case report was all related to the patient's low level of compliance against fluid intake restrictions, particularly while experiencing oliguria or anuria. In this case, intensive education regarding limiting fluid intake and high-protein nutrition seems essential for better patient outcomes. On the other hand, the presence of infectious complications gives poor outcomes. Two patients presented with umbilical hernia, which could be an obstacle for CAPD.
Papillary Renal Cell Carcinoma Type 1 Accompanied by Hemorrhagic Anemia: A Case Report Mulia, Deddy Primadona; Zulkhair Ali; Novadian Suhaimi; Suprapti Slamet; Ian Effendi; Syahpri Putra Wangsa; Kgs. M. Yusuf Arief Akbar; Mediarty Syahrir; Fadil Pramudhya Hoesain; Ika Kartika
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 7 No. 11 (2023): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v7i11.888

Abstract

Background: Kidney cancer or renal cell carcinoma (RCC) accounts for 5% and 3% of all adult malignancies in men and women, respectively, thus representing the 7th most common cancer in men, and the 10th most common cancer in women. The incidence of kidney cancer in the last two decades has shown an increase, but in recent years the death rate due to kidney cancer has decreased because it is increasing. Case Presentation: A 27 year old male patient came with complaints of bloody urination. Patients also complain of body weakness. Every time they are active, the weakness decreases if the patient rests. The patient was stated to be suffering from anemia and a left kidney tumor. There was bilateral antebrachial pitting edema. There was bilateral pretibial edema. Cytological examination revealed papillary renal cell carcinoma type 1. Conclusion: Papillary cell carcinoma type 1 is a kidney tumor that has a good prognosis, especially if found at an early stage. The classic symptoms of type 1 pRCC are anemia, hematuria and kidney swelling.
Renal Amyloidosis: A Narrative Literature Review Wangsa, Syahpri Putra; Novadian Suhaimi; Zulkhair Ali; Suprapti Slamet; Ian Effendi; Kgs M Yusuf Arief Akbar; Deddy Primadona Mulia
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 7 No. 11 (2023): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v7i11.889

Abstract

Amyloidosis is a disorder in which soluble proteins aggregate and are deposited extracellularly in tissues as insoluble fibrils, causing progressive organ dysfunction. Amyloid fibril formation begins with misfolding of amyloidogenic precursor proteins. The fibrils have a characteristic appearance by electron microscopy and produce double refraction under polarized light when stained with Congo red dye. Classification of amyloidosis is based on the precursor proteins that form amyloid fibrils and the distribution of amyloid deposition both systemically and locally. The main form of systemic amyloidosis; AL amyloid, AA amyloidosis, ATTR amyloid. The kidney is the organ most frequently involved in systemic amyloidosis. Systemic amyloidosis may originate from anomalous proteins, such as immunoglobulin light chains or serum amyloid protein in chronic inflammation or may arise from hereditary disorders. The clinical manifestations of renal amyloidosis vary with the type of amyloid protein and the location and extent of amyloid deposition. Treatment of amyloidosis should be a two-part process; managing symptoms and reducing or stabilizing amyloid protein. Treatment of amyloidosis is focused on reducing the production of amyloidogenic proteins and inhibiting their aggregation.
Diurnal Variation of Blood Pressure and Arterial Stiffness in Chronic Kidney Disease Arief Akbar, Kgs M Yusuf; Novadian Suhaimi; Zulkhair Ali; Suprapti Slamet; Ian Effendi; Syahpri Putra Wangsa; Deddy Primadona Mulia
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 7 No. 11 (2023): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v7i11.890

Abstract

Hypertension and chronic kidney disease (CKD) are interrelated public health problems throughout the world. Hypertension accompanied by CKD is mostly difficult to control. Difficulty in controlling blood pressure (BP) is known from changes in the diurnal variation of BP over 24 hours in CKD patients with a pattern of non-dipping and reverse dipping at night and an increase in pulse pressure due to arterial stiffness that occurs in CKD, resulting in a high incidence of nocturnal hypertension and masked hypertension. Nocturnal hypertension in CKD has a significant prognostic risk of increased risk of cardiovascular disease and cause of death. Therefore, guidelines for the management of hypertension strongly recommend that patients with hypertension have blood pressure well controlled at all times, especially to improve hypertension control at night in CKD patients.
Co-Authors Abdul Hakim R Ade Yonata Ade Yonata, Ade Agustina H Akbar, Kgs. M. Yusuf Arief Akbar, M Yusuf Arief Ali Ghanie Alif Fathur Rachman, Muhammad Alwi Shahab Alwi Shahab Anggelia Puspasari Arief Akbar, Kgs M Yusuf Arif, Cut Wulan Chairil Makky Christin, Theresia Citra Maharani Deddy Primadona Mulia Devi, SNA Ratnasari Dila Siti Hamidah Eddy Mart Salim Edy Nur Rachman Effendi, Ian Elfiani Elfiani Elfiani Emilia Emilia Erial Bahar Erial Bahar Erial Bahar, Erial Erwin Sukandi Eva Julita Fadil Pramudhya Hoesain Fadil Pramudhya Husein Fadil Pramudya Fauzan Azhari, Fauzan Ferawaty, Ferawaty Ferry Usnizar Ferry Yusrizal Fitri Rahmariani Fitria Koeshardani Harun Hudari Huntari Harahap Ian Effendi Ian Effendi Ian Effendi Ika Kartika Ika Kartika Edi P Indrajaya, Taufik Irawan, Rico Irfannuddin Irfannuddin Istiqomah, Amelia Junaidi A Kartika, Herleni Kendenan, Margaretha Kgs M Yusuf Arief Akbar Kgs. M. Yusuf Arief Akbar kurniati, nova Kusrini, Ida Legiran Legiran Lidiawati Handayani Lilik Pranata M Yusuf Arief Akbar Mediarty Mediarty Syahrir Muhammad Irsan Saleh Muhammad Yusri Mulia, Deddy Primadona Nova Kurniati Novadian Novadian Novadian Novadian, Novadian Novadian Suhaimi Novadian Suhaimi Novadian Suhaimi Novandra AP Nurul Ramadhani Umareta Nyimas Natasha Ayu Shafira R.M. Suryadi Tjekyan Radiyati Umi Partan Ramadhan, Philosophia Ratna Maila Dewi Anggraini Reinanda Marizki R Rery TF Yuniarti RM Suryadi Tjekyan Rostika Dewi Shahab, Alwi Slamet, Suprapti SNA Ratnasari Devi Suhaimi, Novadian Suprapti Suprapti Slamet Suprapti Suprapti Suprapti Suprapti Syahpri Putra Wangsa Taufik Indrajaya Taufik Indrajaya Trinovita Andraini Wangsa, Syahpri Putra Yudhie Tanta Yulianto kusnadi