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All Journal Majalah Kedokteran Bandung Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Damianus Journal of Medicine The Indonesian Journal of Infectious Diseases Jurnal Respirologi Indonesia Jurnal Pendidikan Kedokteran Indonesia: The Indonesian Journal of Medical Education Journal of the Indonesian Medical Association : Majalah Kedokteran Indonesia The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy JIMKI: Jurnal Ilmiah Mahasiswa Kedokteran Indonesia
Mario Steffanus
Department Of Internal Medicine, Faculty Of Medicine, Atma Jaya Catholic University Of Indonesia, Jakarta
Biochemistry, Genetics & Molecular Biology Education Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

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HUBUNGAN KADAR HBA1C DENGAN ALBUMINURIA PADA PASIEN DM TIPE II DI RS ATMA JAYA Gracenidy Mutiara Hermawan; Luse; Febie Chriestya; Mario Steffanus
Majalah Kedokteran Indonesia Vol 70 No 2 (2020): Journal of the Indonesian Medical Association Majalah Kedokteran Indonesia Volum
Publisher : PENGURUS BESAR IKATAN DOKTER INDONESIA (PB IDI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.1234/jinma.v70i2.171

Abstract

Pendahuluan: World Health Organization (WHO) memperkirakan kejadian diabetes melitus (DM) di Indonesia dapat mencapai 21,3 juta orang pada tahun 2030. Studi ini bertujuan untuk mengetahui hubungan kadar HbA1c dengan albuminuria pada pasien DM tipe 2.Metode: Data meliputi usia, jenis kelamin, kadar HbA1c, tekanan darah, proteinuria, merokok, penggunaan ACEI atau ARB, dan lama berobat diambil dari rekam medis pasien DMT2 di RS Atma Jaya dengan studi cross-sectional sesuai kriteria inklusi dan eksklusi dengan metode korelasi Spearman pada interval kepercayaan 95% (á = 0.05).Hasil: Adanya hubungan signifikan antara kadar HbA1c dengan albuminuria (p<0,0001) yang berkorelasi cukup kuat (r=0,439). Faktor lain yang berhubungan adalah usia (p<0.05), sedangkan tekanan darah, merokok, dan penggunaan ACE-Inhibitor atau Angiotensin Receptor Blocker (p=0,386) tidak bermakna.Kesimpulan: Terdapat hubungan bermakna antara kadar HbA1c dengan albuminuria pada pasien DM tipe 2 di RS Atma Jaya.
PERBEDAAN NILAI RASIO NEUTROFIL TERHADAP LIMFOSIT PADA PASIEN TUBERKULOSIS DEWASA SEBELUM DAN SETELAH TERAPI FASE INTENSIF DI RS ATMA JAYA Alius Cahyadi; Mario Steffanus
Majalah Kedokteran Indonesia Vol 68 No 10 (2018): Journal of The Indonesian Medical Association Majalah Kedokteran Indonesia Volu
Publisher : PENGURUS BESAR IKATAN DOKTER INDONESIA (PB IDI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.1234/jinma.v68i10.211

Abstract

Pendahuluan: Tuberkulosis (TB) merupakan masalah kesehatan yang penting di negara berkembang. Infeksi bakteri ini akan mengakibatkan neutrofilia dan limfopenia. Rasio neutrofil terhadap limfosit/ neutrophil to lymphocyte ratio (NLR) merupakan pemeriksaan yang mudah, biaya terjangkau, dan cukup sensitif. Nilai NLR pengidap TB lebih tinggi dibandingkan orang normal, dengan nilai cut off >2,16. Penelitian ini bertujuan untuk mengetahui perbedaan nilai NLR pada pasien TB dewasa sebelum dan setelah terapi fase intensif.Metode: Subjek penelitian adalah pasien TB dewasa kasus baru yang datang ke poli klinik Penyakit Dalam RS Atma Jaya, tanpa adanya HIV, gagal ginjal kronik, diabetes melitus, penyakit paru obstruktif kronik, dan pneumonia bakterial. Jumlah leukosit, neutrofil dan limfosit, serta perhitungan NLR sebelum dan setelah terapi fase intensif dicatat. Analisis data menggunakan SPSS. Hasil: Dari 44 pasien TB, 23 (52,3%) diantaranya berjenis kelamin laki-laki, dengan usia median 37 tahun. Delapan puluh delapan persen sampel menderita TB paru. Nilai NLR sebelum terapi (2,77) lebih tinggi daripada setelah terapi (2) fase intensif (p<0,001). Kesimpulan: Adanya penurunan nilai rasio neutrofil terhadap limfosit yang bermakna secara statistik pada pasien TB dewasa yang telah mendapatkan terapi fase intensif
ANEMIA PENYAKIT KRONIS Jessica Novia Hadiyanto; Margareth Gracia; Alius Cahyadi; Mario Steffanus
Majalah Kedokteran Indonesia Vol 68 No 10 (2018): Journal of The Indonesian Medical Association Majalah Kedokteran Indonesia Volu
Publisher : PENGURUS BESAR IKATAN DOKTER INDONESIA (PB IDI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.1234/jinma.v68i10.216

Abstract

Anemia sering dijumpai pada pasien dengan penyakit kronis dan meningkatkan morbiditas dan mortalitas dari pasien. Prevalensi anemia penyakit kronis terdapat pada urutan kedua tersering setelah anemia defisiensi besi. Anemia penyakit kronis sering terjadi bersamaan dengan anemia defisiensi besi dan keduanya memberikan gambaran penurunan besi dalam serum. Namun, kedua jenis anemia ini perlu dibedakan karena terdapat perbedaan patogenesis dan tata laksana keduanya. Beberapa parameter besi lain perlu diperiksa untuk membedakannya. Terapi utama pada anemia penyakit kronis adalah dengan mengatasi penyakit yang mendasari.
Correlation between Quality of Life and Gastroesophageal Reflux Disease Kevin Tandarto; Riki Tenggara; Febie Chriestya; Mario Steffanus
Majalah Kedokteran Bandung Vol 52, No 2 (2020)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15395/mkb.v52n2.2003

Abstract

Gastroesophageal reflux disease (GERD) is a disease characterized by the rise of stomach acid into the esophagus which leads to heartburn and regurgitation. The prevalence of adult GERD cases worldwide is 11-38.8%. This study aimed to determine the correlation between GERD and quality of life among patients affected by this disease. This was a cross-sectional study conducted on 92 GERD patients in Atma Jaya Hospital, Jakarta, Indonesia from April 2018 to June 2018. Two questionnaires, GERD-Q and GERD-HRQL were used in this study. A validation of the Indonesian version of the GERD-HRQL questionnaire was performed prior to this study. The Mann Whitney test was used to identify the correlation between GERD and the quality of life in patients with upper gastrointestinal symptoms. This study indicated that the GERD-HRQL questionnaire showed good validity and reliability. Results showed that there was a correlation between GERD and quality of life (p = 0.005) in patients with upper gastrointestinal symptoms. In conclusion, GERD affects the quality of life of patients affected by this disease. Korelasi antara Kualitas Hidup dan Penyakit Refluks GastroesofagusGastroesophageal reflux disease (GERD) atau penyakit refluks gastroesofagus adalah penyakit yang ditandai dengan naiknya asam lambung ke kerongkongan yang menyebabkan sensasi terbakar di dada dan regurgitasi. Prevalensi kasus GERD di seluruh dunia pada orang dewasa adalah 11–38,8%. Penelitian ini bertujuan mengetahui korelasi antara GERD dan kualitas hidup di antara pasien yang terkena penyakit ini. Penelitian dilakukan pada 92 pasien GERD di Rumah Sakit Atma Jaya, Jakarta, Indonesia dari April 2018 hingga Juni 2018. Dua kuesioner, GERD-Q dan GERD-HRQL digunakan dalam penelitian ini. Validasi kuesioner GERD-HRQL versi bahasa Indonesia dilakukan sebelum penelitian ini. Analisis uji Mann Whitney digunakan untuk mengidentifikasi korelasi antara GERD dan kualitas hidup pada pasien dengan gejala gastrointestinal bagian atas. Penelitian ini menunjukkan bahwa kuesioner GERD-HRQL memperlihatkan validitas dan reliabilitas yang baik. Hasil penelitian ini juga menunjukkan erdapat korelasi antara GERD dan kualitas hidup (p=0,005) pada pasien dengan gejala gastrointestinal atas. Simpulan, GERD mempengaruhi kualitas hidup pasien yang terkena penyakit ini.
Correlation Between Type 2 Diabetes Mellitus and Pulmonary Tuberculosis at Atma Jaya Hospital Mario Steffanus; Anastasia Pratiwi Fodianto; Jessica Novia Hadiyanto
Jurnal Respirologi Indonesia Vol 41, No 3 (2021)
Publisher : Perhimpunan Dokter Paru Indonesia (PDPI)/The Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497/jri.v41i3.184

Abstract

Background: Diabetes Mellitus (DM) is considered one of the factors that increase the risk of pulmonary tuberculosis (TB). Tuberculosis in Indonesia is severe and ranked second in the world after India. Previous studies suggested that DM increased the risk of developing pulmonary TB by 2–5 times. This study was conducted to determine the effect of type 2 DM on the incidence of pulmonary TB at Atma Jaya Hospital. Methods: This was a case-control study conducted at Atma Jaya Hospital from December 2016 to April 2017 using medical records. Data were further processed by pairing gender and age between case and control groups. A total of 121 samples were obtained and tested using McNemar paired correlation non-parametric analysis. Results: The incidence of pulmonary TB was higher in men than women with a ratio of 2.1:1 and within the productive age range of 27–46 years. The percentage of type 2 DM in pulmonary TB cases was 70% (35 samples) compared to 30% (15 samples) without DM with a total of 50 samples in the case group. The percentage of type 2 DM in the control group without pulmonary TB was 46.5% (33 samples) compared to 53.5% (38 samples) without DM with a total of 71 samples in the control group. Based on the statistical analysis, the P=0.013 and the OR (odds ratio) was 2.20. Conclusion: There was a significant correlation between type 2 DM and the incidence of pulmonary TB in Atma Jaya Hospital with the risk of pulmonary TB 2.20 times higher than those without type 2 DM.
Positive Correlation between Degree of Liver Cirrhosis and N Terminal–Pro Brain Natriuretic Peptide (NT-pro-BNP) Mario Steffanus; IDN Wibawa; I Ketut Badjra Nadha
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 16, No 2 (2015): VOLUME 16, NUMBER 2, August 2015
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (450.874 KB) | DOI: 10.24871/162201573-77

Abstract

Background: Liver cirrhosis (LC) is a chronic disease characterized by damage of liver parenchyme with wide fibrosis and nodules formation. One of LC complications is cirrhotic cardiomyopathy (CC). CC is diagnosed when there are more than one of the following signs: diastolic dysfunction (DD), systolic dysfunction (SD), enlargement of the cardiac chamber, electrophysiology dysfunction, and increasing of natriuretic peptide such as N Terminal–Pro Brain Natriuretic Peptide (NT-proBNP). The aim of this study was to determine the correlation between degree of liver cirrhosis and increasing of the NT-proBNP.Method: Cross-sectional analytic study was performed with 72 LC patients from May 2014 to May 2015 in Sanglah General Hospital, Denpasar. Degree of liver cirrhosis was determined by child turcotte pugh (CTP) criteria and NT-proBNP was examined by electro chemiluminescence immunoassay (ECLIA) method. LC patients with other disorders which can cause the increase of NT-proBNP were excluded.  Statistical analysis used was Spearman’s correlation test.  Results: Of 72 LC patients, 79.2% were male. Patients with CTP A were 9 (12,5%), CTP B 19 (26,4%) and CTP C 44 (61,19%). Median of NT-proBNP in CTP A was 112 pg/mL, CTP B 130 pg/mL, and CTP C 315 pg/ml. There was a strong possitive correlation between degree of liver cirrhosis and NT-proBNP (r = 0.686; p = 0.000). In this study, there was also significant comparison between NT-proBNP and CTP A,B, and C (p = 0,000) and there was no significant relation between NT-proBNP and those cofounding variables (p 0.05).Conclusion: there was a strong possitive correlation between degree of LC and NT-proBNP. 
Diagnosis and Management Pancolitis in Patient with Ulcerative Colitis Cindy Cindy; Riki Tenggara; Yudistira Panji Santoso; Mario Steffanus
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 11, NUMBER 2, August 2010
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/112201096-99

Abstract

ABSTRACT Ulcerative colitis (UC) is a form of inflammatory bowel disease (IBD) that usually affects the rectum and part of the colon, which spreads continuously with no skip area. Pancolitis occurs in 20% of patients with UC. Patients with chronic UC, especially pancolitis, have a higher risk of colon cancer. In patients with pancolitis, the risk of cancer increases by 0.5-1% per year after having 8-10 years of disease. A 72-year-old man came with complaint of bloody-mucus diarrhea associated with abdominal cramps. The colonoscopic appearance of colitis was observed in whole lumen throughout colon. Histopathological analysis demonstrated dense infiltrates of granulocytes and macrophages formed by severe inflammation. Normal appearances were observed in the remaining epithelial cells. No parasites, specific process, or malignancy were found. Moreover, no acid-resistant bacteria were found. However, atypical cells were found in one of the biopsy specimens. The patient was diagnosed with extensive type of severe UC. The initial management of treatment included improvement of his general condition along with antibacterial therapy of metronidazole and ciprofloxacin. Specific treatment of sulphasalazine and prednisone were given after pancolitis appearance was revealed, which has similar clinical manifestations in accordance with UC.   Keywords: pancolitis, ulcerative colitis, chronic diarrhea, inflammatory bowel disease
The Correlation Between Depression and GERD-Q Score Among Dyspepsia Patient in Atma Jaya Hospital Nadya Hanjani; Mario Steffanus
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 20, No 3 (2019): VOLUME 20, NUMBER 3, December 2019
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (141.754 KB) | DOI: 10.24871/2032019150-153

Abstract

Background: In adults, the symptoms of gastroesophageal reflux disease (GERD) are often complained of in daily life and their prevalence has increased. Symptoms of GERD are often found along with the occurrence of dyspepsia. One of the factors that affect the symptoms of GERD is depression. Due to the limited data available in Indonesia, this study was conducted to see the correlation between depression and gastroesophageal reflux disease questionnaire score (GERD-Q).Method: This study was conducted on dyspepsia patients at Atma Jaya Hospital (RSAJ) beginning at June to September 2018. The study was conducted using a cross-sectional design and using the GERD-Q and Depression questionnaire, Anxiety, Stress Scale 42 (DASS 42) which has been translated and validated by other researchers to measure GERD scores and depression scores.Results: The total respondents of this study were 53, with the percentage of men and women being 30.2% and 69.8% respectively. The average age of patients was 57.2, with those who were overweight / obese as many as 64.2%, and those who smoked as many as 9.4%. As many as 73.6% respondents had a GERD-Q score of ≥ 8. Moreover, 35.8% of respondents had mild depression, 15.1% had moderate depression, and 3.8% had severe depression. The results showed a significant correlation between depression and GERD-Q score in Atma Jaya Hospital dyspepsia patients (p = 0,000, r = 0,496).Conclusion: There is a correlation between depression and GERD-Q score of dyspepsia patients at Atma Jaya Hospital  
Sindrom Gitelman dengan manifestasi paralisis hipokalemia pada wanita hamil Adisuhanto, Marcella; Santosa, Yudistira Panji; Sejati, Arif; Riani, Mutiara; Steffanus, Mario; Yuwono, Angelina; Wiranatha, Jennifer; Cendana, Adrian Surya; Iryaningrum, Maria Riastuti
Bahasa Indonesia Vol 23 No 1 (2024): Damianus Journal of Medicine
Publisher : Atma Jaya Catholic University of Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25170/djm.v23i1.4231

Abstract

Pendahuluan: Sindrom Gitelman merupakan kondisi tubulopati kehilangan garam yang ditandai dengan alkalosis metabolik dengan hipokalemia, hipomagnesemia, dan hipokalsiuria. Kasus sindrom Gitelman pada kehamilan jarang dipublikasikan hingga saat ini. Laporan Kasus: Seorang wanita berusia 23 tahun pada kehamilan ketiga dengan usia gestasi 21 minggu datang dengan kelemahan pada kedua tungkai dan kekakuan pada kedua tangan, kemudian terdiagnosis dengan sindrom Gitelman (SG). Pasien memiliki riwayat emesis gravidarum dan defek septum atrium (DSA). Pada pemeriksaan neurologis didapatkan penurunan kekuatan motorik pada kedua tungkai. Pemeriksaan elektrolit menunjukkan adanya hiponatremia, hipokalemia, hipokalsemia, dan hipomagnesemia, serta terdapat peningkatan kadar natrium, kalium, dan klorida pada urin. Ekokardiografi menunjukkan adanya defek septum atrium sekundum dengan left-to-right shunt. Selama perawatan, pasien diberikan natrium, kalium, kalsium, dan magnesium secara intravena yang kemudian dilanjutkan secara oral. Pasien kemudian melahirkan bayi yang sehat dan tidak ditemukan komplikasi selama dan sesudah persalinan. Dua bulan setelah persalinan, pasien kontrol ke poliklinik penyakit dalam dan kondisinya stabil dengan dosis suplementasi kalium yang diturunkan. Diskusi: Pasien dengan SG mengalami gangguan dalam kon-servasi kadar kalium dan magnesium. Kondisi ini dapat diperburuk dengan perubahan fisiologis yang terjadi selama kehamilan, meliputi ekspansi volume serta meningkatnya aliran darah ke ginjal dan laju filtrasi glomerulus, yang berkontribusi terhadap hipo-kalemia. Selain itu, terdapat peningkatan kebutuhan kalium dan magnesium pada populasi ibu hamil. Efek protektif yang menurun juga semakin memperburuk penurunan kadar kalium dan magnesium. Simpulan: Diagnosis dan tatalaksana yang baik dapat membantu ibu hamil dengan SG dan DSA menjalani persalinan dengan lancar dan melahirkan bayi yang sehat.
A rare case of Salmonella sp septic arthritis in a patient with systematic lupus erythematosus (SLE) Steffanus, Mario; Yusuf, Cindy; Hadiyanto, Jessica Novia
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 55, No 3 (2023)
Publisher : Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19106/JMedSci005503202306

Abstract

Septic arthritis is considered as a medical emergency which can lead to significant morbidity and cause substantial mortality, especially if the diagnosis is delayed. Prolonged use of immunosuppressive and cytotoxic medications as therapy for systemic lupus erythematosus (SLE) causing patient susceptible to secondary infection. However, septic arthritis due to Salmonella sp. is very rare,  makes this is an important extraintestinal manifestation especially in immunosuppressed patients. We presented a case of 25 y.o. female diagnosed with SLE 3 m.o. earlier presented with fever and arthritis on her left genu for 1 wk duration. Genu ultrasonography showed synovitis genu sinistra with fluid volume of 1-2 cc on recessus lateral genu sinistra. The patient was further analysis on her synovial fluid was conducted, the gram stained smear of the fluid showed >25 leucocytes, low power field, and Salmonella sp. was isolated from her synovial fluid analysis. The patient was given intravenous ciprofloxacin and discharged home well. Septic arthritis should always be considered in any patients on long-term immunosuppression state who present with acutely swollen joints. It considered as an important medical emergency with high mortality and morbidity. Hence, prompt recognition, joint aspiration with administration of systemic antibiotics and appropriate surgical intervention plays a pivotal role to minimize morbidity and mortality.
Co-Authors Alius Cahyadi Anastasia Pratiwi Fodianto Arif Sejati Caroline Ciptasari Cendana, Adrian Surya Cindy Cindy CINDY CINDY Eva Suryani Febie Chriestya Gracenidy Mutiara Hermawan Gracenidy Mutiara Hermawan Hadiyanto, Jessica Novia I Dewa Nyoman Wibawa I Ketut Badjra Nadha IDN Wibawa Jessica Novia Hadiyanto Jessica Novia Hadiyanto Jessica Novia Hadiyanto Kevin Tandarto Luse Luse Luse Marcella Adisuhanto Margareth Gracia Margareth Gracia MARIA BINTANG Maria Riastuti Iryaningrum Nadya Hanjani Regina Pebriana Riani, Mutiara Riki Tenggara Stefanus Lembar Vanessa, Irene Wiranatha, Jennifer Yanto Budiman Yudistira Panji Santosa Yudistira Panji Santoso Yusuf, Cindy Yuwono, Angelina