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All Journal Indonesian Journal of Clinical Pathology and Medical Laboratory (IJCPML) The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy Cakradonya Dental Journal The International Journal of Medical Science and Health Research Journal of Dental and Biosciences
Rachmad Aji Saksana
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Biochemistry, Genetics & Molecular Biology Dentistry Health Professions Medicine & Pharmacology Neuroscience Nursing Public Health Veterinary

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Correlation between the Severity of Liver Cirrhosis (Chil-Pugh Score) and QTc Interval Prolongation Rachmad Aji Saksana; Putut Bayupurnama; Fahmi Indrarti; Neneng Ratnasari; Sutanto Maduseno; Catharina Triwikatmani; Siti Nurdjanah
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 13, NUMBER 3, Desember 2012
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (366.32 KB) | DOI: 10.24871/1332012157-160

Abstract

ABSTRACT Background:Liver cirrhosis causes changes in cardiovascular system. Electrographic (ECG) abnormality commonly found in cirrhosis patients is QT interval prolongation. It is part of cirrhotic cardiomyopathy. QTc interval prolongation is correlated to the incidence of life-threatening arrhythmias. The objective of this study was to recognize the correlation between the severity of liver cirrhosis and QTc interval prolongation in patients with liver cirrhosis at Sardjito General Hospital, Jogjakarta.Method: The design of this study was cross-sectional. The subjects were hospitalized patients with liver cirrhosis at the Department of Internal Medicine, Sardjito Hospital, Jogjakarta between January 2011 and March 2012. ECG was performed in all patients and QTc interval was measured. The severity of liver cirrhosis was determined by Child-Pugh score. Spearman correlation analysis was used to determine the correlation between variables of QTc interval prolongation and Child-Pugh score.Results: A total of 73 patients were enrolled, including 51 (69.9%) male and 22 (31.1%) female patients with mean age of 54.05 ± 12.55 years (range 20-80). Liver cirrhosis was caused by hepatitis B virus in 36 (49.3%) patients, hepatitis C virus in 20 (27.4%) patients and other causes in 19 (26%) patients. The Child-Pugh score for liver cirrhosis was found as follows: child A in 10 (13.6%) patients, child B in 27 (36.9%) patients and child C in 36 (49.3%) patients. The correlation between the severity of liver cirrhosis and QTc interval prolongation was weak (r = 0.255; p = 0.029).Conclusion:Severity of liver cirrhosis has a weak positive correlation with QTc interval prolongation. Keywords: liver cirrhosis, QTc interval, Child-Pugh score
Platelet-to-Lymphocyte Ratio as Coagulopathy Predictor in COVID-19 Patients at Margono Soekarjo Hospital Siswandari, Wahyu; Saksana, Rachmad Aji; Indriani, Vitasari; Fuadi, Muhammad Robiul
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 31 No. 1 (2024)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v31i1.2268

Abstract

Coronavirus Disease 2019 (COVID-19) is a disease possibly attacking various organs and systems of the body including the coagulation system causing coagulopathy. Various laboratory biomarkers have been developed to detect coagulopathy. This research aimed to determine the correlation and ability of Platelet-to-Lymphocyte Ratio (PLR) in predicting coagulopathy when compared to D-dimer. A cross-sectional research was conducted on 1580 data of COVID-19 patients at Margono Soekarjo Hospital. The research data were then analyzed using Spearman’s correlation test to figure out the correlation between PLR and D-dimer. This research was also intended to find the PLR Cut-Off Value (COV), Odds Ratio (OR), Area Under Receiver Operating Characteristic (AUROC), and diagnostic value. Platelet-to-lymphocyte ratio value had a significant correlation with D-dimer levels (r=0.260, p=0.000). The COV of PLR was 176.61 with the OR of 2.7 (2.2-3.3 95%CI), AUROC of 0.638, sensitivity of 62%, and specificity of 62%. PLR can be used as a screening biomarker to predict the occurrence of coagulopathy in COVID-19 patients.
A 61 Year Old Woman With Hypoglycemia on Diabetes Mellitus due to Sulphonylurea , Urinary Tract Infection, Hypertension, Cholelithiasis, Kidney Disorder: A Case Report Rahmat Yusuf Arifin; Rachmad Aji Saksana; Indra Setya Permana; Anggi Fitria Kusumaningtyas
The International Journal of Medical Science and Health Research Vol. 10 No. 2 (2025): The International Journal of Medical Science and Health Research
Publisher : International Medical Journal Corp. Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.70070/85sjs261

Abstract

Background : Hypoglycemia is defined as a condition of plasma glucose below normal limits. The most common cause of hypoglycemia is the use of antidiabetic drugs from sulphonylurea and can be exacerbated by renal function disorder. We report hypoglycaemia caused by sulfonylurea and kidney disorders as well as treatment selection in patients with Diabetes Mellitus (DM) with kidney disorder in Chronic Kidney Disease (CKD) patients especially with Glomerular Filtration Rate (GFR) < 30 ml/min/1.73 m 3 . Case Report : The 61-year-old woman, came with a complaint of loss of consciousness for two hours before entering the hospital, previously the patient complained of dizziness. Patients have a history of diabetes mellitus and hypertension. Patients regularly take metformin, glimepirid and captopril. Vital signs blood pressure 170/85 mmHg, heart rate 86x/min, respiratory rate 22x/min, temperature 36.3 oC , oxygen saturation 99%, lateralization not found. The blood glucose test showed 28 mg/dL. Laboratory results of kidney function showed urea 134mg/dL and creatinine 8.8mg/dL. Treatment using a hypoglycemia algorithm, with Dextrose 40% and Dexamethasone, provides a good effect so that hypoglycemia does not occur again. Discussion : The choice of antidiabetic drugs in DM patients with high risk factors for hypoglycemia and kidney disorder needs to be considered. Hypoglycaemia is caused by the failure of counter-regulation processes in the body triggered by insulin. Insulin production increases due to the effects of sulphonylurea drugs. CKD exacerbates the condition of hypoglycemia by decreasing the process of insulin degradation and gluconeogenesis. Conclusion : This case underscores the necessity of vigilant drug selection, renal-adjusted dosing, and comprehensive care to mitigate hypoglycemia risk in DM patients with CKD, ultimately improving clinical outcomes and quality of life. Prevention of hypoglycaemia and selection of DM therapy in patients with kidney disorders requires special attention by paying attention to the side effects of the drug and the success of therapy. Drug therapy options that can be given are metformin, SGLT-2 in the drug canaglifozin , thiazolidinediones, new generation sulfonylureas, DPP-4 inhibitors, and insulin with dose adjustments. Hypoglycemia can be prevented by maintaining the patient's symptoms and self-monitoring blood glucose.
Minimally Invasive Approach In The Treatment Of Lung Abscess: A Case Report Rahmat Yusuf Arifin; Rachmad Aji Saksana; Indra Setya Permana; Anggi Fitria Kusumaningtyas
The International Journal of Medical Science and Health Research Vol. 10 No. 2 (2025): The International Journal of Medical Science and Health Research
Publisher : International Medical Journal Corp. Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.70070/mrwg6s92

Abstract

Background : Lung abscess is characterized by a localized collection of pus or necrotic tissue in the lung parenchyma, which develops into a cavity. Early diagnosis and appropriate management are essential to prevent further complications. Minimally invasive procedures can be performed on lesions larger than 6cm in diameter. Case Report : A 63-year-old man came with a chief complaint of progressive shortness of breath and coughing up blood. The cough had been present for 1 month, accompanied by night sweats, and weight loss. The patient's general condition appeared thin. Physical examination showed decreased fremitus and dull percussion in the left hemithorax. Laboratory results showed leukocytosis with increased neutrophils. Chest radiography showed air-fluid level in the inferior zone and the left parahilar cavity with infiltration suggest a suspected lung abscess. Based on the findings obtained, the patient underwent percutaneous drainage guided by ultrasound ( U S -guided drainage ) using a 14-gauge abbocath needle as a therapeutic procedure. The procedure was performed twice, evacuating 400 cc and 250 cc of purulent fluid. Thoracic radiology evaluation showed resolution of the lung abscess, along with significant clinical improvement in the patient. The patient received metronidazole antibiotic therapy combined with ceftriaxone. The patient underwent treatment for 5 days, before finally being allowed to go home. Discussion: In cases of lung abscess, if conservative therapy using antibiotics does not provide adequate improvement, then invasive intervention such as open surgical procedures is needed. Minimally invasive approaches such as ultrasound-guided percutaneous drainage are an alternative option in areas with limited resources and no computed tomography (CT) facilities. This approach is considered to provide shorter hospitalization and faster recovery. In this case, the percutaneous drainage procedure in cases of lung abscess showed good clinical improvement in the patient. Conclusion: Lung abscess is a serious condition that requires rapid diagnosis and intervention. Ultrasonography-guided percutaneous drainage has been shown to be effective as a therapeutic modality in treating lung abscess . Operator reliability in operating ultrasonography can reduce the risk of complications that may occur.
TEMUAN KLINIS PSEUDOMEMBRAN ORAL CANDIDIASIS PADA PASIEN GAGAL GINJAL KRONIK Jayanti, Irene Putri; Pamungkasari, Dewanti Intan; Prihastuti, Christiana Cahyani; Saksana, Rachmad Aji
Cakradonya Dental Journal Vol 14, No 2 (2022): Agustus 2022
Publisher : FKG Universitas Syiah Kuala

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24815/cdj.v14i2.27112

Abstract

Gagal ginjal kronik (GGK) merupakan penyakit ginjal dengan glomelural filtration rate (GFR) sekitar 15-59 mL/menit/1.73m. Manifestasi oral pada pasien GGK telah banyak dilaporkan. Manifestasi tersebut dapat dipengaruhi oleh penyakit ginjal itu sendiri, obat, maupun terapi yang diberikan. Laporan kasus ini bertujuan untuk menyajikan temuan klinis pseudomembran oral candidiasis pada pasien GGK. Seorang laki-laki berusia 41 tahun menderita GGK dan sedang dirawat inap di Bangsal Mawar, RSUD Prof. Dr. Margono Soekarjo. Pasien tersebut mengeluhkan bercak putih pada lidah dan mulut kering. Pasien jarang sikat gigi selama dirawat inap. Pemeriksaan intaoral terdapat lesi berupa plak berbentuk irregular berwarna putih di area dorsum lidah yang dapat dikerok dan meninggalkan area kemerahan. Rongga mulut pasien juga tercium adanya bau uremik. Pasien didiagnosis pseudomembran oral candidiasis yang diduga akibat kondisi xerostomia karena kadar ureum yang tinggi serta penggunaan obat antihipertensi (amlodipin) dan diuretik (furosemide). Xerostomia juga dapat dipengaruhi oral hygiene yang tidak terjaga selama rawat inap, kondisi imunosupresi, dan malnutrisi yang meningkatkan risiko terjadinya pseudomembran oral candidiasis. Pilihan medikasi untuk pseudomembran oral candidiasis yang aman bagi pasien GGK adalah nistatin sediaan krim atau suspensi oral. Kesimpulannya adalah GGK merupakan penyakit sistemik yang dapat mempengaruhi timbulnya lesi oral, antara lain pseudomembran oral candidiasis.Kata Kunci: Gagal ginjal kronik, pseudomembran oral candidiasis, xerostomia.
Laporan Kasus: Kandidiasis Oral pada Pasien Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (HIV/AIDS) Dewi, Aisha Tiara; Rimawati, Adninda; Purnama, Ryana Budi; Saksana, Rachmad Aji; Silva, Ghea de
Journal of Dental and Biosciences Vol 2 No 02 (2025): Journal of Dental and Biosciences
Publisher : Jurusan Kedokteran Gigi Fakultas Kedoketaran Universitas Jenderal Soedirman

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20884/1.jdentbios.2025.2.02.11528

Abstract

Latar belakang : Pasien HIV/AIDS memiliki kekebalan tubuh yang lemah karena imunosupresi yang menyebabkan tubuh rentan terhadap infeksi sistemik. Manifestasi oral pasien HIV/AIDS antara lain kandidiasis oral, penyakit periodontal, xerostomia, Kaposi’s sarcoma, stomatitis aftosa rekuren, oral hairy leukoplakia, hiperpigmentasi oral, serta karies. Kandidiasis oral merupakan lesi yang paling sering terjadi pada pasien HIV/AIDS yang disebabkan oleh infeksi Candida albicans. Kasus : Pasien laki-laki berusia 53 tahun datang ke RSUD Margono Soekarjo, Purwokerto dengan keluhan lapisan putih seperti sariawan dan terasa tidak nyaman sejak 1 bulan yang lalu, demam, nafsu makan dan minum menurun, merasa kebingungan, keringat dingin, dan tangan terkadang tremor. Rapid test anti-HIV menunjukkan hasil positif. Penegakan diagnosis kandidiasis oral pada kasus ini yaitu melalui anamnesis, pemeriksaan klinis, dan pemeriksaan penunjang. Tanda dan gejala klinis dari kandidiasis oral yaitu adanya plak berwarna putih multipel pada mukosa rongga mulut, dapat dikerok yang meninggalkan bekas kemerahan, dan terasa nyeri. Manajemen Kasus : Obat yang diberikan pada pasien HIV dengan kondisi kandidiasis adalah ARV berupa FDC TLD, antijamur berupa Nystatin dan Fluconazole, obat kumur Chlorhexidine Gluconate 0,2%, dan kombinasi antibiotik berupa Azithromycin serta Cotrimoxazole. Simpulan : Keberhasilan pengobatan kandidiasis oral merupakan kombinasi keberhasilan pengobatan penyakit sistemik, pengobatan penyakit mulutnya, serta didukung oleh kedisiplinan pasien dalam menggunakan obat secara benar dan teratur dan menjaga kebersihan rongga mulut.
Co-Authors Anggi Fitria Kusumaningtyas Catharina Triwikatmani Dewi, Aisha Tiara Fahmi Indrarti Fuadi, Muhammad Robiul Indra Setya Permana Indriani, Vitasari Jayanti, Irene Putri Neneng Ratnasari Pamungkasari, Dewanti Intan Prihastuti, Christiana Cahyani Purnama, Ryana Budi Putut Bayupurnama Putut Bayupurnama Rahmat Yusuf Arifin Rimawati, Adninda SATRIYAS ILYAS Silva, Ghea De Siti Nurdjanah Siti Nurdjanah Sutanto Maduseno Sutanto Maduseno Wahyu Siswandari