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All Journal Medical Journal of Indonesia Indonesian Journal of Cancer Indonesian Journal of Rheumatology World Nutrition Journal Indonesian Journal of Cancer The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy Jurnal Penyakit Dalam Indonesia Kesmas: Jurnal Kesehatan Masyarakat Nasional (National Public Health Journal)
Ikhwan Rinaldi
Divisi Hematologi Onkologi Medik, Departemen Ilmu Penyakit Dalam, Fakultas Kedokteran Universitas Indonesia, Rumah Sakit Dr. Cipto Mangunkusumo
Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Public Health

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Polisitemia Sekunder pada Pasien Laki-Laki Muda dengan Sindrom Nefrotik Wardhani, Ariani Intan; Nugroho, Pringgodigdo; Rinaldi, Ikhwan; Sarasawati, Meilania; Miranda, Monik Ediana; Harahap, Agnes Stephanie
Jurnal Penyakit Dalam Indonesia Vol. 12, No. 4
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Polycythemia is a condition characterized by an abnormal increase in the total red blood cell mass and is classified into primary and secondary polycythemia. Secondary polycythemia occurs as a physiological response to tissue hypoxia or increased erythropoietin production, without intrinsic abnormalities in erythroid progenitor cells. This condition is rare, particularly when associated with nephrotic syndrome. This report aims to describe a case of secondary polycythemia associated with focal segmental glomerulosclerosis (FSGS). A 20-year-old man presented with generalized edema for five months prior to admission, accompanied by foamy urine. Physical examination revealed peripheral edema and minimal ascites. Laboratory investigations demonstrated massive proteinuria and elevated hemoglobin levels. Renal biopsy confirmed the diagnosis of FSGS, while bone marrow biopsy showed normocellular findings without evidence of malignancy or fibrosis. The patient was treated with methylprednisolone, ramipril, and simvastatin, and underwent four sessions of phlebotomy along with antiplatelet therapy. Following treatment, there was improvement in hemoglobin levels, proteinuria, and blood pressure control. Secondary polycythemia has been reported to be associated with various parenchymal kidney diseases, including FSGS. The proposed mechanisms include increased erythropoietin production due to renal ischemia or dysregulation of erythropoiesis feedback mechanisms. Phlebotomy is an important therapeutic intervention to prevent complications related to hyperviscosity and thromboembolism and has been shown to result in clinical improvement. This case illustrates a rare occurrence of secondary polycythemia in a patient with nephrotic syndrome due to FSGS. Accurate diagnosis and comprehensive management, including phlebotomy, can lead to meaningful clinical improvement. This report is expected to contribute to the literature on the diagnosis and management of secondary polycythemia in kidney disease.
Optimalisasi Rekam Medis Elektronik Berbasis Artificial Intelligence Rinaldi, Ikhwan; Sulistiadi, Wahyu
Jurnal Penyakit Dalam Indonesia Vol. 12, No. 4
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Electronic medical records (EMRs) are essential to modern healthcare systems, yet their implementation continues to face challenges such as disruption of doctor–patient communication, administrative burden, and documentation structures misaligned with clinicians’ clinical reasoning processes. This narrative review aims to assess the limitations of conventional EMRs and examine the potential of artificial intelligence (AI) to improve documentation efficiency, accuracy, and overall clinical performance. The literature indicates that AI technologies, including machine learning, deep learning, and natural language processing, can automate documentation, streamline workflows, enhance decision support, and reduce physician burnout, thereby allowing clinicians to devote more attention to patient care. Nevertheless, the integration of AI into EMRs must address ethical concerns such as algorithmic bias, data privacy, and accountability for AI-assisted decisions. In conclusion, AI-driven EMR optimization has the potential to create a more human-centered, efficient, and data-driven documentation ecosystem when supported by strong regulatory and ethical frameworks.
Prevalensi COVID-19 Derajat Berat dan Kritis saat Admisi pada Pasien Penyakit Reumatik Autoimun dan Faktor-Faktor yang Berhubungan Destini, Mulia; Ariane, Anna; Yulianti, Mira; Rizka, Aulia; Rinaldi, Ikhwan; Mansjoer, Arif; Maulahela, Hasan; Wafa, Syahidatul
Jurnal Penyakit Dalam Indonesia Vol. 13, No. 1
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Introduction. Patients with autoimmune rheumatic diseases are known to be more vulnerable to severe and critical infections, including COVID-19. Although it is no longer classified as a pandemic, SARS- CoV-2 infection still persists, and several surges of cases have been reported, including in Indonesia. To date, no data are available regarding the prevalence of severe and critical COVID-19 at admission in patients with autoimmune rheumatic diseases in Indonesia and the associated factors. This study aimed to determine the prevalence of severe and critical COVID-19 at admission in patients with autoimmune rheumatic diseases at Dr. Cipto Mangunkusumo National General Hospital, and to identify the associated factors. Methods. This was a cross-sectional study using secondary data from the medical records of patients with autoimmune rheumatic diseases confirmed with COVID-19 and hospitalized at Dr. Cipto Mangunkusumo National General Hospital between July 2020 and August 2024. Analyses were performed up to multivariate logistic regression to evaluate the association between predictor variables and severe and critical COVID-19 at admission. Results. Among 171 subjects, the majority were female (n=158). The median age was 31 years, ranging from 18 to 74 years. The prevalence of severe and critical COVID-19 at admission in patients with autoimmune rheumatic diseases was 41.5%. Routine corticosteroid use (adjusted prevalence ratio (aPR) 2.58; 95% CI 1.40–5.17; p=0.004), the presence of comorbidities (aPR 2.24; 95% CI 1.19–4.59; p=0.018), moderate–high disease activity (aPR 5.12; 95% CI 1.74–21.96; p=0.009), and combination immune-modifying therapy (aPR 1.79; 95% CI 1.06–3.17; p=0.034) were independently associated with severe and critical COVID-19 at admission in the final multivariate analysis. Conclusions. The prevalence of severe and critical COVID-19 at admission in patients with autoimmune rheumatic diseases was 41,5%. The associated factors were routine corticosteroid use, the presence of comorbidities, moderate–high disease activity, and combination immune-modifying therapy.
Short-Term Survival and Prognostic Factors in Cervical Cancer Patients Requiring Hemodialysis: A Retrospective Cohort Study Bundjali, Muhammad Trihatmowijoyo; Marbun, Maruhum Bonar Hasiholan; Rajabto, Wulyo; Rinaldi, Ikhwan; Shatri, Hamzah; Partiningrum, Dwi Lestari; Makmun, Dadang; Nugroho, Pringgodigdo; Koesnoe, Sukamto; Soewondo, Pradana
Kesmas Vol. 21, No. 1
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Cervical cancer is a common gynecological malignancy, particularly in developing countries, where it coexists with renal impairment in over one-third of patients. This disease typically presents acutely and progresses rapidly. Consequently, kidney replacement therapy, including hemodialysis (HD), is commonly required. To assess survival rates and associated factors, this retrospective cohort study analyzed the medical records of 252 cervical cancer patients who began HD across a three-month follow-up period. Kaplan–Meier analysis indicated a median short-term survival duration of 71.5 days (range: 7–90), with 1-, 2-, and 3-month survival rates of 56%, 51%, and 49%, respectively. Multivariate Cox regression identified post-HD systolic blood pressure <110 mmHg (hazard ratio [HR] 3.354; 95% confidence interval [CI]: 2.346–4.795; p-value <0.001) and interdialytic weight gain ≥5% (HR 1.685; 95% CI: 1.125–2.521; p-value <0.011) as significant predictors of decreased survival. Other variables, including age, urea, albumin, vascular access, baseline creatinine, and cancer stage, were not significantly associated with short-term survival. These findings underscore the critical role of salt and fluid management, adherence to dietary and dialysis regimens, and close monitoring of weight in improving outcomes. Interventions targeting modifiable factors may improve the survival of cervical cancer patients who require HD. Such approaches, therefore, warrant further investigation.
Co-Authors Achmad Fauzi Achmad Fauzy, Achmad Adhiatma, Kresna Adityo Susilo, Adityo Adna, Rury Maharani Afifah Is Agnes Stephanie Harahap Agus Sudiro Waspodo Aida Lydia Andhika Rachman Andri Sanityoso Sulaiman Angraeni, Sri Anna Ariane, Anna Anna Rozaliyani Ari Fahrial Syam Arif Harryanto Reksodiputro Arif Harryanto Reksodiputro, Arif Harryanto Arif Mansjoer Arini Setiawati Arry Haryanto Reksodiputro Artati Murwaningrum, Artati Aulia Rizka, Aulia Bambang Setyohadi Bambang Setyohadi Birry Karim Bundjali, Muhammad Trihatmowijoyo C Rinaldi A Lesmana Ceva W. Pitoyo Cleopas Martin Rumende Cleopas Martin Rumende Cosphiadi Irawan Czeresna Heriawan Soejono Dadang Makmun Destini, Mulia Dewi Mira Ratih Diana Sunardi Djatikusumo, Ari Dono Antono Dwi Lestari Partiningrum Dyah Purnamasari E. Mudjaddid A. Siswanto Deddy N.W.Achadiono Hamzah Shatri Edy Rizal Wahyudi Em Yunir Em Yunir, Em Endang Susalit Endy Novianto Endy Novianto, Endy Evy Yunihastuti Findy Prasetyawati Findy Prasetyawati, Findy Firsyada, Fajar Gurmeet Singh Hasan Maulahela Henry Ratno Diono Silalahi Henry Ratno Diono Silalahi, Henry Ratno Diono HILMAN TADJOEDIN, HILMAN Ibrahim, Febiansyah Ika Prasetya Wijaya Ilyas, Mohammad Imelda Maria Loho, Imelda Maria Iris Rengganis Irsan Hasan Jerry Eddya Putra Boer Juferdy Kurniawan Kaka Renaldi Karmel L Tambunan, Karmel L Kuntjoro Harimurti Kusumaningrum, Profitasari Kusumowidagdo, Gladys Lestari, Regina Lianda Siregar Lisnawati Rachmadi Lugyanti Sukrisman Lukman Edwar Lutfiah, Evah Marbun, Maruhum Bonar Hasiholan Mardianto, Umar Margaluta, Ariansah Martin, Cleopas Maruhum B.H. Marbun Mira Yulianti, Mira Miranda, Monik Ediana Mohammad, Nurhidayat Muhadi Muhadi Muhadi Muhadi, Muhadi MUHAMMAD SYAFIQ Muningtya Philiyanisa Alam Murdani Abdullah Murdani Abdullah Mustopa, Inna Intani Nabil Mubtadi Falah Nabil Mubtadi Falah, Nabil Mubtadi Nikko Darnindro Noto Dwimartutie Nunuk Mardiana, Nunuk Pradana Soewondo Pratiwi, Amalia Nur Pringgodigdo Nugroho, Pringgodigdo Purwita Wijaya Laksmi Rahmat Cahyanur Rahmat Cahyanur Rasco Sandy Sihombing Rasco Sandy Sihombing, Rasco Sandy Ratih, Dewi Mira Regina Lestari Reinaldo Alexander Reksodiputro, Arry H. Reza Yogaswara Rino Alvani Gani Robert Sinto Rudi Putranto Rudi Putranto Rudy Hidayat Sabrina Munggarani Yusuf Sarasawati, Meilania Saskia Aziza Nursyirwan, Saskia Aziza Sepmeitutu, Iwandheny Shufrie Effendi, Shufrie Sukamto Koesnoe Sulaiman, Andri Andri Syahidatul Wafa, Syahidatul T. Djumhana Atmakusuma, T. Djumhana Tanadi, Caroline Tengku Riza Zarzani N Tri Juli Edi Tarigan Triyanta Yuli Pramana Virnanda Amu, Ivan Wahyu Sulistiadi Wardhani, Ariani Intan Wardoyo, Elizabeth Y Wardoyo, Elizabeth Yasmine Wulyo Rajabto Yogaswara, Reza Yudantha, Anggun R.