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All Journal Jurnal Kedokteran Diponegoro Journal of Biomedicine and Translational Research Jurnal Kesehatan Andalas Universa Medicina Acta Biochimica Indonesiana Majalah Kedokteran Andalas Bioscientia Medicina : Journal of Biomedicine and Translational Research Healthy Tadulako Journal (Jurnal Kesehatan Tadulako) Jurnal Ilmu Kesehatan Indonesia (JIKSI) JKKI : Jurnal Kedokteran dan Kesehatan Indonesia Berita Kedokteran Masyarakat Jurnal Penyakit Dalam Indonesia JUKEJ: Jurnal Kesehatan Jompa Jurnal Riset Ilmiah Jurnal Sains, Teknologi dan Kesehatan Media Penelitian dan Pengembangan Kesehatan
Fadrian, Fadrian
Department Of Internal Medicine, Faculty Of Medicine, Universitas Andalas/Dr. M. Djamil General Hospital, Padang, Indonesia
Biochemistry, Genetics & Molecular Biology Computer Science & IT Decision Sciences, Operations Research & Management Dentistry Economics, Econometrics & Finance Engineering Environmental Science Health Professions Immunology & microbiology Law, Crime, Criminology & Criminal Justice Materials Science & Nanotechnology Medicine & Pharmacology Neuroscience Nursing Public Health Social Sciences Veterinary Other

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Korelasi Skor SOFA dengan Kadar Kortisol Darah pada Pasien Sepsis di RSUP Dr. M. Djamil Padang Fahmi, Rahmadina Zesfira; Fadrian, Fadrian; Rikarni, Rikarni; Husni, Husni; Bilmahdi, Rohayat; Irramah, Miftah
Jurnal Kesehatan Andalas Vol. 14 No. 3 (2025): November 2025
Publisher : Faculty of Medicine, Universitas Andalas

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25077/jka.v14i3.2671

Abstract

Sepsis is a life-threatening organ dysfunction due to dysregulation of the body's immune response to infection. The Sequential Organ Failure Assessment score (SOFA score) is a diagnostic tool used to quantitatively and objectively assess the level of organ dysfunction. Sepsis as a stressor of systemic inflammation, causes an increase in cortisol secretion by the adrenals to target tissues, which suppresses inflammation. Objective: To determine the correlation between SOFA score and blood cortisol levels in sepsis patients at RSUP Dr. M. Djamil Padang. Method: Observational analytic study with a cross-sectional method. The sample consisted of 55 patients who had been diagnosed with sepsis. The data used was secondary data from medical records. The data were tested using the Spearman correlation test. Result: A correlation was found between the SOFA score and blood cortisol levels, yielding a correlation coefficient of r = 0.338 and a p-value of 0.012. Conclusion: There is a significant moderate correlation between SOFA scores and blood cortisol levels. Keywords:  blood cortisol, sepsis, SOFA score
CHEMOTHERAPY-INDUCED THROMBOCYTOPENIA LEADING TO LIFE-THREATENING HYPOVOLEMIC SHOCK IN CERVICAL CANCER: A CASE REPORT Nurul Fadila; Raveinal Raveinal; Fadrian Fadrian; Roza Mulyana
Jurnal Kedokteran Diponegoro (Diponegoro Medical Journal) Vol 14, No 5 (2025): JURNAL KEDOKTERAN DIPONEGORO (DIPONEGORO MEDICAL JOURNAL)
Publisher : Faculty of Medicine, Universitas Diponegoro, Semarang, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14710/dmj.v14i5.47148

Abstract

Hypovolemic shock due to acute hemorrhage is a life-threatening condition, particularly in cancer patients undergoing chemotherapy. Although recent studies have established protocols for managing hypovolemic shock in trauma and sepsis, the role of chemotherapy-induced thrombocytopenia in exacerbating post-procedural bleeding risks remains underexplored. This case emphasizes the clinical complexity of managing hemorrhagic shock in advanced-stage cervical cancer patients following percutaneous nephrostomy (PCN). Case Presentation: A 52-year-old female with stage IVB cervical cancer and liver metastasis presented with hypovolemic shock following PCN. She exhibited severe hematuria and chemotherapy-induced thrombocytopenia, leading to prolonged bleeding and subsequent shock. Initial management involved aggressive fluid resuscitation, blood transfusions, and correction of thrombocytopenia. Despite the challenges of managing shock in a patient with concurrent chronic kidney disease (CKD) stage IV, prompt intervention led to significant clinical improvement, stabilization of vital signs, and eventual discharge. Conclusion: This case highlights the importance of early intervention in managing hypovolemic shock in oncology patients with multiple comorbidities, including chemotherapy-induced thrombocytopenia and CKD. A multidisciplinary approach and close monitoring are crucial for improving outcomes in such high-risk patients. Further research is needed to establish tailored management protocols for this patient population.
Comparison Clinical Outcomes of Sepsis Caused by Multidrug-Resistant (MDR) and Non-MDR Klebsiella pneumoniae Fadrian, Fadrian; Ahmad, Armen; Linosefa, Linosefa; Simanjuntak, Rohayat Bilmahdi; Putri, Vidola Yasena
Journal of Biomedicine and Translational Research Vol 12, No 1 (2026): April 2026
Publisher : Faculty of Medicine, Universitas Diponegoro

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14710/jbtr.v12i1.29019

Abstract

Background: Klebsiella pneumoniae is a common pathogen causing sepsis and is associated with high morbidity and mortality. The emergence of multidrug-resistant organisms (MDROs), particularly extended-spectrum β-lactamase-producing K. pneumoniae (ESBL-KP) and carbapenem-resistant K. pneumoniae (CRKP), has limited antimicrobial therapy options and may worsen clinical outcomes such as mortality and length of hospital stay (LOS). Objective: This study aims to compare the clinical characteristics and outcomes of sepsis caused by multidrug-resistant K. pneumoniae and non-resistant strains, focusing on mortality and LOS.Methods: An observational analytical study with a cohort design was conducted at Dr. M. Djamil General Hospital in Padang from October 2024 to January 2025. Subjects diagnosed with sepsis due to pneumonia and confirmed positive for K. pneumoniae through blood or respiratory cultures were included using consecutive sampling. Isolates were categorized into MDR (ESBL-KP and CRKP) and non-MDR. Clinical data were analyzed descriptively to described subject characteristics, while bivariate analysis (chi-square and independent t-test) evaluated associations between resistance profiles and outcomes, focusing on mortality and LOS (p < 0.05). Results: Of the 70 subjects, 39 (55.7%) had confirmed infection with MDR strains and 31 (44.3%) with non-MDR.Mortality was highest in the CRKP (56.5%), followed by non-MDR (38.7%) and ESBL-KP (25.0%). Statistical analysis revealed a notable association between the resistance profiles of K. pneumoniae and mortality (p < 0.001 for both CRKP and ESBL-KP vs non-MDR). However, there were no statistically significant differences in mean hospital LOS across the groups (CRKP: 16.30 ± 9.81 days; ESBL-KP: 13.63 ± 9.77 days; non-MDR: 16.06 ± 9.49 days; all p > 0.05). Conclusion: Sepsis caused by multidrug-resistant K. pneumoniae, including both ESBL and CRKP, is significantly associated with increased mortality. Early identification and appropriate antimicrobial management are essential to improve subject outcomes. 
Dose-dependent effects of Stevia rebaudiana leaf extract on malondialdehyde and catalase activity in alloxan-induced hyperglycemic rats Zhira Shada Athaya; Eti Yerizel; Dinda Aprilia; Rozi Abdullah; Fadrian; Westi Permata Wati; Husna Yetti
Acta Biochimica Indonesiana Vol. 9 No. 1 (2026): Acta Biochimica Indonesiana
Publisher : Indonesian Society for Biochemistry and Molecular Biology

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32889/actabioina.232

Abstract

Background: Diabetes mellitus-induced hyperglycemia triggers oxidative stress, characterized by elevated malondialdehyde (MDA) and impaired catalase (CAT) activity. Stevia rebaudiana, rich in steviol glycosides and polyphenols, demonstrates promising antioxidant properties, yet systematic dose-response data on oxidative stress biomarkers remain limited. Objectives: To evaluate the dose-dependent effects of stevia leaf extract on serum MDA levels and CAT activity in alloxan-induced hyperglycemic rats. Methods: Twenty-five male Wistar rats were allocated into normal control, diabetic control (alloxan 120 mg/kg), and three treatment groups receiving alloxan plus stevia extract at 100, 200, or 400 mg/kg body weight orally for 14 days (n=5/group). Serum MDA and CAT were measured spectrophotometrically. Results: Diabetic control showed significantly elevated MDA (2.68±0.62 mg/dL) versus normal control (1.78±0.30 mg/dL). Stevia extract dose-dependently reduced MDA: 1.70±0.19, 1.54±0.20, and 1.38±0.09 mg/dL at 100, 200, and 400 mg/kg, respectively, representing 36.6%, 42.5%, and 48.5% reduction. The 400 mg/kg dose achieved MDA levels comparable to normal control. CAT activity showed dose-dependent restoration trend (7.92±0.76 to 8.58±0.52 mg/dL). Conclusion: Stevia leaf extract (400 mg/kg BW) effectively reduces oxidative stress in hyperglycemic rats through significant dose-dependent MDA reduction, with potential catalase benefits requiring further investigation.
Profile of carbapenemase genes among sepsis patients at a tertiary hospital in Indonesia Fadrian, Fadrian; Linosefa, Linosefa; Ahmad, Armen; Ulvyana, Vyora; Putri, Vidola Yasena; Fasril, Thira
JKKI : Jurnal Kedokteran dan Kesehatan Indonesia JKKI, Vol 17, No 2, (2026)
Publisher : Faculty of Medicine, Universitas Islam Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20885/JKKI.Vol17.Iss2.art9

Abstract

Background: Multidrug-resistant gram-negative bacteria represent a major clinical challenge in patients with sepsis. Recent data indicate that the increasing global prevalence of carbapenemase-producing bacteria poses an urgent threat to public health. Objectives: This study aimed to describe the distribution of carbapenemase genes among sepsis patients at Dr. M. Djamil General Hospital, Padang. Methods: This was a descriptive cross-sectional study involving 211 specimens obtained from sepsis patients over a nine-month period of hospitalization at Dr. M. Djamil General Hospital. Specimens consisted of blood, respiratory, pus, and urine specimens. Detection of carbapenemase genes including blaKPC, blaOXA, blaNDM, blaVIM, blaIMP, and blaGES was performed using real-time PCR. Data were analyzed descriptively and the Chi-square test was used with IBM SPSS Statistics version 25.0. Results: Among the sepsis patients included in the study, 211 specimens were analyzed; most patients were aged over 60 years (53.1%) and were predominantly male (57.3%). The most frequent sources of infection were CAP (52.1%) and HAP (33.2%). Positive bacterial cultures were found in 58.8% of patients, with Klebsiella pneumoniae (39.8%) and Escherichia coli (7.6%) being the most prevalent isolates. The distribution of carbapenemase genes was dominated by the blaOXA gene (33.6%) and the blaNDM gene (22.3%), while blaGES (4.7%), blaVIM (4.3%), and blaIMP (0.9%) were identified in only a limited number of isolates. The mean SOFA score was 5.75 ± 3.16, and the overall mortality rate was 66.4%. The results of statistical analysis showed that there was no significant relationship between the presence of the carbapenemase gene and mortality (OR 0.683; 95% CI=0.384–1.216; p=0.195). Isolates carrying carbapenemase genes were significantly associated with carbapenem resistance (OR=11.15; 95% CI: 5.28–23.55; p<0.05).Conclusion: In this study, blaOXA and blaNDM were the predominant genes, while blaVIM, blaGES, and blaIMP were detected in a limited number of isolates.
Co-Authors Abdiana Adrial Adrial, Adrial Ahmad, Armen Amel Yanis Amelia F. Dewi Anggrainy, Fenty Arina Widya Murni Armen Ahmad Armen Ahmad Armen Ahmad Asir, Taufik Rizkian Astiena, Adila Kasni Bantar, Kevin Bilmahdi, Rohayat Daan Khambri Desmawati Desmawati Dessy Arisanty Dinda Aprilia Dwi Yulia Dwitya Elvira, Dwitya Dzulkifli Elvia Fataya Eti Yerizel Eva Decroli Fahmi, Rahmadina Zesfira Fasril, Thira Fika Tri Anggraini Firdawati Firdawati Genta Pradana, Genta Hardisman Harun Harnavi Harvindra, Astrid Hasmiwati Hasnah Hasnah Hasnah, Hidayatul Hermalina Sherli Utami Husna Yetti Husni Husni Ida Rahmah Burhan Ikhsan Amanda Putra, Ikhsan Amanda Kam, Alexander Khairat, Khairat Lili Irawati Linosefa Linosefa Lydia Sarah Shabrina Masnadi, Nice Rachmawati Miftah Irramah Muhammad Hidayat Muharramah, Disa Hijratul Mustafa Noer Netti Suharti Nurul Fadila Oktalina, Dyanti Prasetio, Ade Priscilla, Hilary Putri Nirmala Dewi Putri, Vidola Yasena Putri, Viona Salsabila RAVEINAL RAVEINAL Raveinal Raveinal Rifa, Farras Zahra Rikarni Rikarni Rima Semiarty Rini Gusya Liza, Rini Gusya Rita Hamdani Rizki Amelia Rohayat Bilmahdi Rose Dinda Martini Rosfita Rasyid Roza Mulyana Rozi Abdullah Saptino Miro, Saptino Selfi Renita Rusjdi Simanjuntak, Rohayat Bilmahdi Ulvyana, Vyora Vitresia, Havriza Vivi Triana Wati, Westi Permata Yugo Berri Putra Rio Yulia, Dwi Yuliarni Syafrita Yuniar Lestari Yustini Alioes Zaki Mahmudi Dasril Zhira Shada Athaya