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All Journal Jurnal Kedokteran dan Kesehatan : Publikasi Ilmiah Fakultas Kedokteran Universitas Sriwijaya Majalah Kedokteran Sriwijaya The Indonesian Biomedical Journal Indonesian Journal of Obstetrics & Gynecology Science SRIWIJAYA JOURNAL OF MEDICINE CRJIM (Clinical and Research Journal in Internal Medicine) Open Access Indonesian Journal of Medical Reviews Bioscientia Medicina : Journal of Biomedicine and Translational Research Journal Of World Science Indonesian Journal of Endocrinology Metabolism and Diabetes (InaJEMD)
Yulianto kusnadi
Department Of Internal Medicine, Faculty Of Medicine, Universitas Sriwijaya. Palembang, Indonesia
Biochemistry, Genetics & Molecular Biology Computer Science & IT Economics, Econometrics & Finance Education Engineering Health Professions Immunology & microbiology Law, Crime, Criminology & Criminal Justice Medicine & Pharmacology Neuroscience Nursing Public Health Social Sciences Other

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Relapse of Pheochromocytoma with Hipertensive Heart Disease Mildly Reduced Left Ventricle Ejection Fraction Filianty Sipayung, Merylla; Kusnadi, Yulianto; Shahab, Alwi; Maila Dewi, Ratna; Soleh, Imran; Pramudhya Hoesain, Fadil
Journal of World Science Vol. 2 No. 9 (2023): Journal of World Science
Publisher : Riviera Publishing

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.58344/jws.v2i9.427

Abstract

Pheochromocytoma is a tumor originating from the medulla of the adrenal gland. This tumor is rare and is caused by excessive production of catecholamines. There are three classic triads of pheochromocytoma: diaphoresis, palpitations and headaches. Elevated metanephrines and normetanephrine in plasma or urine confirm the diagnosis. At the same time, radiological examination helps in the tumor's location and the presence of local invasion or metastasis. Hypertension is a health problem that is quite dangerous worldwide because it is a significant risk factor for cardiovascular diseases such as heart attack, heart failure, stroke, and kidney disease. Hypertension can cause Hypertensive Heart Disease, which is a significant cause of morbidity and mortality due to cardiovascular disease. This scientific report presents a case study of a 19-year-old woman diagnosed with relapsed pheochromocytoma and hypertensive heart disease with mildly reduced left ventricular ejection fraction. This patient was previously diagnosed at the age of 13 with pheochromocytoma, where the patient experienced symptoms of headache, sweating, especially in the forehead area, trembling hands, and hypertension. Hence, the patient had to be treated. The patient underwent further examination and found a right adrenal tumor, so an adrenalectomy was performed on the patient. Similar complaints appeared again in the patient, and further examination was carried out. Moreover, an increase in plasma metanephrine and normetanephrine levels was found. A CT scan of the abdomen revealed a right adrenal tumor, so this patient underwent another adrenalectomy.
Seluang Fish (Rasbora sp.) Oil Improves Interleukin-17 Levels and Disease Activity in Rheumatoid Arthritis Partan, Radiyati Umi; Mikhael, Rodry; Adinata, Triawan; Darma, Surya; Reagan, Muhammad; Kriswiastiny, Rina; Kusnadi, Yulianto; Salim, Eddy Mart
The Indonesian Biomedical Journal Vol 15, No 1 (2023)
Publisher : The Prodia Education and Research Institute (PERI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18585/inabj.v15i1.2085

Abstract

BACKGROUND: Vitamin D has a role in downregulating the proinflammatory cytokines as well as promoting the antiinflammatory pathway in rheumatoid arthritis (RA). Seluang fish (Rasbora sp.) has potency as a new source of vitamin D. Previous study had proven Seluang fish oil efficacy in systemic lupus erythematosus. However, there are no trials that prove its efficacy in RA yet. Hence, this study was conducted to find out the ability of Seluang fish oil to improve proinflammatory cytokines, vitamin D levels, and disease activity in RA.METHODS: A clinical trial with a randomized and double-blind method was done in two groups, each one consisting of 17 RA subjects. One group was given 500 mL of a Seluang fish oil capsule (contains 665 IU cholecalciferol), while the other group was given a placebo daily, for 12 consecutive weeks. Measurements of the RA disease activity score 28 erythrocyte sedimentation rate (DAS28-ESR) and DAS28 C-reactive protein (DAS28-CRP), as well as measurement of interleukin (IL)-6, IL-17, and vitamin D levels by using immunoassay method were performed before and after the supplementation.RESULTS: Significant alterations in the lower levels of IL-17 were observed in the Seluang fish oil group (p=0.031), but not in the placebo group (p=0.320). Reduction of DAS28-ESR (p=0.000) and DAS28-CRP (p=0.000) score demonstrated that the Seluang fish oil supplementation was useful in reducing RA disease activity. No significant shift was observed in either vitamin D (p=0.967) or IL-6 levels (p=0.076) after Seluang Fish Oil supplementation.CONCLUSION: Seluang fish oil is effective in lowering IL-17 levels, DAS28-ESR, and DAS28-CRP, but not in improving vitamin D level or lowering IL-6 level in RA patients.KEYWORDS: rheumatoid arthritis, seluang fish oil, interleukin-6, interleukin-17, vitamin D, DAS28
Neutrophil-Lymphocyte Ratio as a Novel Biomarker for Diabetic Nephropathy in Type 2 Diabetes Mellitus Patients: A Cross-Sectional Study Pradesta, Rahnowi; Novadian; Yulianto Kusnadi; Nova Kurniati; Syarif Husin
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 3 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i3.1235

Abstract

Background: Early detection of diabetic nephropathy (DN) is crucial to prevent progression to end-stage renal disease. The gold standard for diagnosing DN involves urine microalbumin testing and renal biopsy. However, the availability of these diagnostic tools is limited in many healthcare facilities across Indonesia. Consequently, there is a pressing need for an alternative examination that is readily accessible and can effectively monitor the progression of DN. Methods: This cross-sectional study was conducted at Dr. Mohammad Hoesin General Hospital, Palembang, from February 2024 to May 2024. The study aimed to investigate the correlation between neutrophil-lymphocyte ratio (NLR) and urinary albumin levels in type 2 diabetes mellitus (DM) patients. NLR, calculated from complete blood counts, has emerged as a potential inflammatory marker for various conditions. A total of 65 participants diagnosed with type 2 DM were enrolled in the study. Data analysis involved Spearman's correlation test to assess the relationship between NLR and urinary albumin levels. Results: The majority of the 65 subjects were female (58.5%). The study found that 44 subjects had normoalbuminuria, 18 had microalbuminuria, and 3 had macroalbuminuria. A significant positive correlation was observed between NLR and albuminuria levels in type 2 DM patients (r = 0.795; p < 0.01). Conclusion: The study's findings suggest that NLR is a potential cost-effective biomarker for the early detection of DN in type 2 DM patients, especially in resource-limited settings. Further large-scale studies are recommended to validate these findings and establish specific NLR thresholds for predicting DN progression.
Multigravida at 31 Weeks with Imminent Preterm Labor, Type 2 Diabetes Mellitus, Maxillary Abscess, and Bad Obstetric History : A Case Report Sentani, Ray Suga Aulia; Bernolian, Nuswil; Muzakkie, Mufida; Kusnadi, Yulianto
Sriwijaya Journal of Medicine Vol. 8 No. 3 (2025): Vol 8, No 3, 2025
Publisher : Fakultas Kedokteran Universitas Sriwijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32539/sjm.v8i3.351

Abstract

Imminent preterm labor (IPL) is defined by irregular uterine contractions, back pain, and vaginal discharge, with approximately 25-30% of cases progressing to preterm delivery. Preterm birth remains a major global issue, contributing to 35% of neonatal deaths, and often results in long-term health complications for the infant. This case report discusses a 35-year-old woman (G4P2A1) at 30 weeks of gestation, with a history of type 2 diabetes mellitus (T2DM), bad obstetric history (BOH), and a right maxillary abscess. She presented with swelling and pus discharge from the maxillary region, along with abdominal cramps, but no signs of imminent labor. The patient’s diabetes was managed with insulin, and her clinical condition was complicated by high blood glucose and an ongoing infection. The cervical length was measured via ultrasound, which indicated a risk for preterm delivery, and the patient was diagnosed with IPL. Initial management included fluid resuscitation, tocolytics to prevent labor, and antibiotics for the maxillary abscess. The patient was closely monitored, and insulin therapy was adjusted to stabilize glucose levels. Despite the complexity of managing IPL in diabetic patients, the patient's condition improved after debridement of the abscess and management of blood glucose levels. This case emphasizes the importance of multidisciplinary care in managing complicated pregnancies with comorbidities like T2DM.
Correlation Between Serum Testosterone Levels and CD4 T Lymphocyte Counts in Naive HIV-Infected Men at dr. Mohammad Hoesin General Hospital Palembang Fahrenheit, Fahrenheit; Kusnadi, Yulianto; Hudari, Harun; Bahar, Erial; Shahab, Alwi; Anggraini, Ratna Maila Dewi; Permata, Mega; Salim, Nelda Aprilia; Yuniza; Bakrie, Muhammad
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.2025.006.02.07

Abstract

Background: HIV infection often leads to endocrine complications, including hypogonadism which characterized by low serum testosterone, potentially affects quality of life and contributes to metabolic issues, such as muscle weakness, depression, osteoporosis, and cardiovascular disease. Some studies have indicated a connection between testosterone levels and CD4 T lymphocyte counts.   Aim: To evaluate the correlation between total serum testosterone levels and CD4 T lymphocyte counts in naive HIV-infected men. Methods: A cross-sectional analitycal study was conducted at Dr. Mohammad Hoesin General Hospital, Palembang, from April to October 2024. Involving 64 naive HIV-infected men. Total serum testosterone and CD4 T cell counts were measured and analyzed. Results: Participants mean age is 36.52 ± 11.03 years with BMI of 19.52 ± 3.71 kg/m². Most subject (62.5%) are reported men who had sex with other men. Poor sleep quality was found in 81%, mild depressive symptoms in 38.1%, and mild erectile dysfunction in 28.6%. Hypogonadism occurred in 32.8% of subjects (28.1% secondary and 4.7% primary). Mean number of testosterone level was 446.75 ± 260.95 ng/dL, with a median CD4 count of 23.5 cells/µL. A significant positive correlation was observed between testosterone levels and CD4 counts (r = 0.313; p = 0.012) although testosterone levels did not significantly differ across HIV clinical stages (p = 0.464). Conclusion: There is a significant positive correlation between serum testosterone levels and CD4 T lymphocyte counts in naive HIV-infected men. Hormonal disturbances may arise in early infection. Hence, testosterone assessment is recommended during the initial evaluation on HIV patients.
Effect of Vitamin D Supplementation on Recurrence Risk in Graves’ Disease Measured By The GREAT Score at Dr. Mohammad Hoesin General Hospital Palembang Ali Rabbani, Muhammad Iqbal; Anggraini, Ratna Maila Dewi; Kusnadi, Yulianto; Maritska, Ziske
Sriwijaya Journal of Medicine Vol. 8 No. 3 (2025): Vol 8, No 3, 2025
Publisher : Fakultas Kedokteran Universitas Sriwijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32539/sjm.v8i3.370

Abstract

Graves’ disease is the most common cause of primary hyperthyroidism with a prevalence of approximately 0.5%, predominantly affecting women (female-to- male ratio 6–7:1) aged 35–40 years. Predictors of treatment outcomes and recurrence risk have been studied, among them the GREAT Score, which combines age, goiter size, FT4, and TRAb levels. The aim of this study was to analyze changes in the GREAT Score after the addition of vitamin D supplementation in Graves' disease patients at Dr. Mohammad Hoesin General Hospital, Palembang, within 3 months. This was a double-blind randomized clinical trial involving 30 patients with Graves’ disease, both inpatients and outpatients, who met the inclusion criteria. Patients were randomly assigned into two groups: the intervention group received10,000 IU of vitamin D, while the control group received placebo. Recurrence risk was assessed using the GREAT Score at the first and third months, and data were analyzed with SPSS v.25. Analysis using the Wilcoxon test showed no significant change in the GREAT Score for the vitamin D group (p=0.102). At the first month, the distribution was 53.3% class I, 40.0% class II, and 5.7% class III, while at the third month it was 40.0% class I, 40.0% class II, and 20.0% class III. In the placebo group, results were also not significant (p=0.480), with the first-month distribution of 33.3% class I, 40.0% class II, and 26.7% class III, and the third month 40.0% class I, 33.3% class II, and 13.3% class III. In summary, Vitamin D supplementation has no significant effect in reducing the recurrence of Graves' disease compared to placebo.
Adult Onset Nesidioblastosis (Non Insulinoma Pancreatogenous Hypoglycemia Syndrome): A Rare Case Rita Sriwulandari; Yulianto Kusnadi; Ratna Maila Dewi; Alwi Shahab; Anne Rivaida
‎ InaJEMD - Indonesian Journal of Endocrinology Metabolic and Diabetes Vol. 1 No. 2 (2024): InaJEMD Vol. 1, No. 2
Publisher : PP PERKENI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.66266/inajemd.v1i2.18

Abstract

Finding the etiology of hypoglycemia in adult patients can be challenging because of the wide variety of etiologies. Ninety percent of endogenous hyperinsulinemic hypoglycemia is caused by insulinoma, the rest are caused by insulin antibodies and pancreatic β cell dysfunction (nesidioblastosis) which indicates neoformation of nesidioblasts (stem cells that form the islets of Langerhans). A 28-year-old female complained of neuroglycopenia and adrenergic symptoms that improved with drinking sugar, so she had weight gain. The 72 hours of prolonged fasting test results are C-peptide ≥0.2 mmol/L, insulin ≥21 pmol/L, insulin to C-peptide molar ratio ≤1, and negative insulin antibody. Imaging tests were normal and there is no evidence of malignancies. When blood glucose falls, the first defense mechanism to prevent hypoglycemia is decreased in insulin secretion. When this mechanism fails, insulin and C-peptide levels remain high in circulation. Confirmation of Whipple's triad is required, followed by insulin tests in hypoglycemic conditions. Imaging tests, biomarkers, and hormonal malignancies were done to rule out differential diagnoses. Nuclear diagnostics, SACST, biopsy, and histopathology are currently in capable of being carried out. The diagnosis of adult-onset Nesidioblastosis/NIPHS in this patient was made through the diagnosis of exclusion, namely by eliminating all diagnostic appeals because several examination modalities cannot be carried out. The gold standard for diagnosing Nesidioblastosis/NIPHS is SACST and histopathological examination of pancreatic tissue. The patient is well-controlled with Amlodipine 2.5 mg. 
Co-Authors Adinata, Triawan Aditiawati Aditiawati, Aditiawati Albernande, Anggy Ali Rabbani, Muhammad Iqbal Alwi Shahab Alwi Shahab Anggraini, Ratna Maila Dewi Anne Rivaida Ardianto Ardianto Bakrie, Muhammad Caska - Clara Adelia Wijaya Eddy Mart Salim, Eddy Mart Eddy Yuristo Erial Bahar Erial Bahar Erial Bahar, Erial Erwin Sukandi Fadel Fikri Suharto Fahrenheit Fahrenheit, Fahrenheit Fauzan Azhari, Fauzan Filianty Sipayung, Merylla Harun Hudari Hudari, Harun Ian Effendi Imran Imran Indrayadi, Indrayadi Intan Fajrin Karimah Kriswiastiny, Rina Maila Dewi, Ratna Mikhael, Rodry Muhammad Reagan Muhlisa, Safitri Muzakkie, Mufida Nelda Aprilia Salim Nova Kuniati Nova Kurniati Novadian Noveldy Calzoum Bachry Nur Riviati, Nur Nuswil Bernolian Nyayu Fauziah Zen Peby Maulina Lestari, Peby Maulina Permata, Mega Pradesta, Rahnowi Pramudhya Hoesain, Fadil Radiyati Umi Partan, Radiyati Umi Ratna Maila Dewi Ratna Maila Dewi Anggraini Risfandi Ahmad Taskura Rita Sriwulandari RM Dewi Anggraini Rose Mafiana Sentani, Ray Suga Aulia Shahab, Alwi Soleh, Imran Sudarto Sudarto Suprapti Surya Darma Sutrisno, Muhammad Al Farisi Syamsu Indra Syarif Husin Theresia Christin Welly Salutondok Yuniza Ziske Maritska Zulkhair Ali