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Profil Tingkat Keparahan Retinopati Diabetik Dengan Atau Tanpa Hipertensi pada di RSUP Dr. M. Djamil Padang Putri Nirmala Dewi; Fadrian Fadrian; Havriza Vitresia
Jurnal Kesehatan Andalas Vol 8, No 2 (2019): Online Juni 2019
Publisher : Fakultas Kedokteran, Universitas Andalas

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25077/jka.v8i2.993

Abstract

Retinopati diabetik merupakan komplikasi mikrovaskular dari Diabetes Melitus (DM) berupa mikroangiopati progresif yang ditandai oleh kerusakan mikrovaskular pada retina. Retinopati diabetik menempati urutan ke-4 sebagai penyebab kebutaan secara global setelah katarak, glukoma, dan degenerasi makula. Terdapat berbagai faktor yang memengaruhi derajat keparahan retinopati diabetik seperti hiperglikemia, lama durasi DM, dan hipertensi. Tujuan penelitian ini adalah mengetahui profil tingkat keparahan retinopati diabetik dengan atau tanpa hipertensi pada pasien diabetes melitus di RSUP Dr. M. Djamil Padang. Jenis penelitian ini adalah deskriptif observasional retrospektif  dengan menggunakan data sekunder, yaitu rekam medik pasien retinopati diabetik di RSUP Dr. M. Djamil Padang periode Januari-Desember 2016. Data diolah menggunakan microsoft excel dan analisis data disajikan melalui analisis univariat. Populasi untuk penderita diabetes melitus sebanyak 1500 orang dengan penderita retinopati diabetik sebanyak 187 orang (12,5%) dan yang memenuhi kriteria inklusi sebanyak 162 orang. Hasil penelitian berdasarkan karakteristik penderita menurut usia terbanyak pada usia 45-65 tahun yaitu 129 orang (79,6%), menurut jenis kelamin lebih banyak pada laki-laki yaitu 87 orang (53,7%), menurut durasi menderita DM lebih banyak pada penderita >5 tahun sebesar 110 orang (68%), menurut ada tidaknya dislipdemia lebih banyak pada penderita dengan dislipdemia sebanyak 116 orang (71,7%). Profil tingkat keparahan retinopati diabetik terbanyak ada pada pasien dengan hipertensi pada stadium retinopatidiabetik proliferative sebanyak 56 orang (69,6%).
TERAPI ANTIVIRAL PADA SIROSIS HATI DEKOMPENSATA TERKAIT INFEKSI VIRUS HEPATITIS B Fadrian Fadrian
Majalah Kedokteran Andalas Vol 39, No 1 (2016): Published in April 2016
Publisher : Faculty of Medicine, Universitas Andalas

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (320.199 KB) | DOI: 10.22338/mka.v39.i1.p35-41.2016

Abstract

Hepatitis B masih merupakan masalah kesehatan global. Diperkirakan sekitar 2 miliar penduduk dunia pernah terpapar virus hepatitis B (VHB) dan lebih dari 350 juta diantaranya menjadi kronik. Sirosis hati, gagal hati, dan karsinoma hati dapat terjadi pada 15-40% penderita dengan infeksi virus hepatitis B kronik. Pada saat ini sekitar 1 juta kematian per tahun akibat penyakit hati berhubungan dengan VHB. Terapi antiviral pada sirosis hati dekompensata terkait VHB merupakan suatu tantangan dalam pengobatan. Tujuan terapi pada pasien sirosis hati dekompensata terkait VHB diantaranya penekanan replikasi virus, serokonversi HBeAg, pembalikan dekompensasi hati, dan pengurangan risiko kanker hati. Terapi antiviral diindikasikan pada semua pasien sirosis hati dekompensata jika DNA VHB terdeteksi, terlepas dari kadar ALT atau status HBeAg. Terapi antiviral pilihan adalah nucleosida/tida analog, seperti lamivudine, telbivudine, adefovir dipifoxil, tenofovir, entecavir. Lama pengobatan biasanya seumur hidup, dan penghentian terapi dipertimbangkan apabila terdapat risiko reaktivasi virus, perburukan dekompensasi hati, dan regresi histologis.
Antibiotics Used in Leptospirosis: A Narrative Literature Review Amelia F. Dewi; Armen Ahmad; Fadrian
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 6 No. 12 (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.v6i12.628

Abstract

Leptospirosis is an acute infectious disease that affects both humans and animals (zoonosis). This disease is caused by the Leptospira species, a bacterium with 250 serovar variations which thus detecting its cases is prominently challenging. In Indonesia, Leptospirosis is regarded as an iceberg phenomenon since such a challenge prevents this disease from being diagnosed in clinical practice, despite study data indicating that a significant percentage of reservoir rats in Indonesia are positive for Leptospira bacteria. As such, this disease has a high mortality of rats due to therapeutic delays. The usage of antibiotics is consequently considered an optimal therapy for leptospirosis. Antibiotics are chosen based on the clinical severity of the disease and should be administered as prophylaxis in high-risk groups in order to lower morbidity and mortality.
Characteristics of Adult Sepsis Patients Admitted to Department of Internal Medicine, Dr. M. Djamil General Hospital, Padang, Indonesia Elvia Fataya; Fadrian; Mustafa Noer; Dwitya Elvira; Yuliarni Syafrita; Netti Suharti
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 7 No. 3 (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.v7i3.791

Abstract

Background: Sepsis is a life-threatening organ dysfunction resulting from a dysregulated host response to infection. Septic shock is the most dangerous complication of sepsis, characterized by abnormalities in the circulatory and metabolic systems. This study aimed to determine the characteristics of adult sepsis patients admitted to the department of internal medicine of Dr. M. Djamil General Hospital, Padang, Indonesia. Methods: This research was a descriptive study and used secondary data from medical records. Samples in this study were medical record data from the medical record installation of Dr. M. Djamil General Hospital, Padang, Indonesia. The inclusion criteria were adult patients aged more than 18 years old, diagnosed with sepsis, and hospitalized in the department of internal medicine for the period of January 2020 to December 2021. Results: Most of the sepsis patients were mostly aged more than 60 years old (51.7%), female (57.2%), and had normal BMI scores (59.3%). The infections mainly originated from the lungs (80%), the most common comorbid disease was chronic kidney disease (26.4%), the most frequent causing microorganism was Escherichia coli (15.9%), the frequent degree of severity was a septic shock (60%), and cefepime was used as the initial empirical antibiotic (44.8%). Conclusion: Most sepsis patients were adults aged more than 60 years old and females, with the focus on infection originating from the lungs, degree of severity in the form of septic shock, and the most used initial empirical antibiotic, namely cefepime.
Diagnosis and Management of Paraquat Intoxication Lydia Sarah Shabrina; Armen Ahmad; Fadrian Fadrian
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 7 No. 8 (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.v7i8.848

Abstract

Paraquat poisoning is a clinical toxicological emergency due to the active ingredient of this type of herbicide, gramoxone, with a high mortality rate due to high toxicity, and no antidote has yet been found. Paraquat intoxication can cause multi-organ failure if ingested accidentally or spontaneously because paraquat quickly produces ROS (reactive oxygen species), which causes cell damage through lipid peroxidation, NF-kB activation, mitochondrial damage, and apoptosis in many organs. This results in rapid nephrotoxic and hepatotoxic as well as pulmonary fibrosis. Clinical manifestations depend on the level of paraquat ingested, which can be in the form of local toxicological and systemic toxicological effects. Laboratory tests for diagnosing paraquat toxicity can be used for toxicological analysis of plasma and urine. Management of paraquat intoxication is primarily to remove paraquat from the gastrointestinal tract (prevent absorption) by using activated charcoal, changing the toxicokinetics of the herbicide (increasing serum paraquat elimination) by hemoperfusion and hemodialysis, as well as modifying its toxicodynamics with anti-inflammatory drugs such as immunosuppressants (corticosteroids and cyclophosphamide) and antioxidants (N -acetylcysteine and vitamin C).
Hubungan Indeks Massa Tubuh dengan Kadar Glukosa Darah Puasa dan Tekanan Darah Pada Tenaga Kependidikan Fakultas Kedokteran Universitas Andalas Hidayatul Hasnah; Dwi Yulia; Desmawati desmawati; fadrian fadrian; yustini alioes; dessy arisanty
Majalah Kedokteran Andalas Vol 46, No 10 (2024): Supplementary April 2024
Publisher : Faculty of Medicine, Universitas Andalas

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25077/mka.v46.i10.p1532-1544.2024

Abstract

Tujuan : mengetahui hubungan indeks massa tubuh dengan kadar glukosa darah puasa dan tekanan darah pada tenaga kependidikan Fakultas Kedokteran Universitas Andalas. Metode : Jenis penelitian ini merupakan penelitian analitik dengan desain penelitian cross-sectional dengan subjek penelitian sebanyak 37 orang yang dilaksanakan di Fakultas Kedokteran Universitas Andalas pada tanggal 08 September 2021. Metode pengambilan sampel ini dengan total sampling, analisis data hubungan indeks massa tubuh dengan kadar glukosa darah puasa dan tekanan darah menggunakan uji korelasi Spearman. Hasil: Nilai median indeks massa tubuh sebesar 24,22 Kg/, nilai rerata 24,94 Kg/, nilai minimum sebesar 16,23 Kg/ dan nilai maksimum 40,15 Kg/. Nilai median kadar glukosa darah puasa 127 mg/dL, nilai rerata 143,65 mg/dL, nilai minimum sebesar 93 mg/dL dan nilai maksimum 399 mg/dL. Nilai median dari tekanan darah 126 mmHg,nilai rerata 128,7 mmHg,  nilai minimum 94 mmHg, dan nilai maksimum 213 mmHg. Tidak terdapat korelasi bermakna antara indeks massa tubuh dengan kadar glukosa darah puasa (p=0,203) ataupun pada indeks massa tubuh dengan tekanan darah (p= 0,097) pada subjek penelitian. Kesimpulan: tidak terdapat korelasi bermakna antara indeks massa tubuh dengan kadar glukosa darah puasa dan antara indeks massa tubuh dengan tekanan darah pada tenaga kependidikan pada Fakultas Kedokteran Universitas Andalas.  
Warm Autoimmune Hemolytic Anemia with Chronic Hepatitis B Adefri Wahyudi; Fadrian; Rudy Afriant
Sumatera Medical Journal Vol. 7 No. 1 (2024): Sumatera Medical Journal (SUMEJ)
Publisher : Talenta Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32734/sumej.v7i1.11836

Abstract

Warm autoimmune hemolytic anemia (wAIHA) is caused by erithrocytes destruction by IgG or IgG plus C3d-mediated autoantibody. Long use steroids are first line therapy of wAIHA. It  has risk infection reactivation, like chronic hepatitis B.  Man, 64 y.o, hospitalized with diagnosis wAIHA and chronic hepatitis B. Diagnosis of wAIHA is built by: severe normocytic normochromic anemia, reticulocytosis 42.29%, increasing lactate dehydrogenase 397 U/L, direct Coombs test (+4), antibody screening IgG (+4). Anothers laboratorium findings: HbsAg (+), albumin 3.5 g/dL, ALT U/L, rapid HIV (-), anti HCV (-). There is no blast found in peripheral blood and bone marrow smear. Patient also diagnosed chronic hepatitis B inactive phase with negative HbeAg, HBV DNA 547 IU/L, normal liver finding in abdominal USG and moderate fibrosis from fibroscan. Washed red cell transfussion was administered, 2 x 125 mg methilprednisolone iv (3 days) tapering off until to 40 mg/day doses. He did not get antiviral prophylaxis and be planned to reevaluate in next 6 months.  Steroid is first line therapy in wAIHA. When wAIHA is diagnosed, determination of chronic hepatitis B status should confirmed.  There is a risk of reactivation of chronic hepatitis B infection so monitoring is needed.
Virological and Clinical Studies of Viral Hemorrhagic Fever (VHF): A Systematic Literature Review Fadrian; Armen Ahmad; Zaki Mahmudi Dasril
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 8 No. 9 (2024): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v8i9.1065

Abstract

Background: Viral hemorrhagic fever (VHF) is a group of zoonotic diseases caused by various RNA viruses, such as Ebola, Marburg, Lassa, Crimean-Congo hemorrhagic fever (CCHF), and Dengue. VHF poses a serious threat to global public health due to high morbidity and mortality rates. This study aims to conduct a systematic literature review of virological and clinical studies of VHF to understand the characteristics of the virus, pathogenesis, clinical manifestations, risk factors, diagnosis, and current therapeutic options. Methods: A comprehensive literature search was conducted on PubMed, Scopus, and Web of Science databases to identify relevant studies published between 2018 and 2024. Studies that met the inclusion criteria were evaluated for quality and narratively synthesized. Results: This review included 20 studies involving 2,350 VHF patients. Results demonstrated significant diversity in virologic characteristics, pathogenesis, and clinical manifestations among different types of VHF. These studies also highlight advances in molecular and serological diagnosis, as well as the development of antiviral and immunomodulatory therapies. Conclusion: This systematic literature review provides a comprehensive summary of current knowledge regarding the virology and clinical practice of VHF. These findings may guide the development of more effective prevention, diagnosis, and treatment strategies for this life-threatening disease.
Compliance in medication control of hypertension patients during the transition period of the COVID-19 pandemic Hilary Priscilla; Rima Semiarty; Nice Rachmawati Masnadi; Abdiana; Fadrian
BKM Public Health and Community Medicine Vol 39 No 10 (2023)
Publisher : Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/bkm.v39i10.9850

Abstract

Purpose: This study aims to determine the relationship between adherence to medication control and blood pressure in hypertensive patients at the Talawi Public Health Center, Sawahlunto, during the transition period of the COVID-19 pandemic. Methods: This observational analytic study with a cross-sectional design was conducted from May to June 2023 at the Talawi Public Health Center, Sawahlunto, with 83 research subjects. The research instrument used primary data from the MMAS-8 questionnaire with short interviews and secondary data in medical records of hypertension patients at the Talawi Public Health Center, Sawahlunto, in 2021–2023. The research results were analyzed by chi-square test. Results: The results of this study were that the majority of hypertensive patients were not compliant in controlling their medication (65.1%), and the majority of hypertensive patients had uncontrolled blood pressure (61.4%). Conclusion: This study concludes a significant relationship between adherence to medication control and blood pressure in hypertensive patients at the Talawi Public Health Center, Sawahlunto (p=0.041).
Successful Management of Panuveitis and Associated Complications in a Patient with Clinical Stage III HIV: A Case Report Putra, Ikhsan Amanda; Fadrian; Rohayat Bilmahdi
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 8 No. 12 (2024): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v8i12.1144

Abstract

Background: Human immunodeficiency virus (HIV) infection can lead to a myriad of ocular complications, including panuveitis, an inflammatory condition affecting the entire uvea and surrounding structures. The management of panuveitis in HIV patients is complex, often requiring a multidisciplinary approach to address both the underlying immunodeficiency and the ocular inflammation. Case presentation: We present the case of a 37-year-old male patient with clinical stage III HIV who presented with panuveitis in the right eye (OD) secondary to herpes zoster ophthalmicus (HZO). The patient also had post-herpetic neuralgia, oral candidiasis, and malnutrition. He reported a history of unprotected sexual encounters with multiple partners. The patient's CD4 count was critically low at 15 cells/µL, indicating severe immunosuppression. He was initiated on antiretroviral therapy (ART), prophylactic medications to prevent opportunistic infections, and pain management for post-herpetic neuralgia. Conclusion: This case highlights the challenges in managing panuveitis and associated complications in patients with advanced HIV infection. Early diagnosis, prompt initiation of ART, and a multidisciplinary approach are crucial for successful management and improving patient outcomes.