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Proportion of Diabetes Mellitus in Koja Hospital Ndraha, Suzanna; Dwicahya Putra, Hervico; Dwicahya Putra, Hervico; Derza Polas, Caesaredo; Derza Polas, Caesaredo; Laura Sabrina, Ratih; Laura Sabrina, Ratih; Huda, Khairul; Huda, Khairul
Jurnal Kedokteran YARSI Vol 27, No 1 (2019): JANUARI - APRIL 2019
Publisher : Lembaga Penelitian Universitas YARSI

Diabetes mellitus (DM) is one of the most common disease found in clinical practice in Koja General Hospital. According to the previous research, the prevalence of diabetes patients has never been investigated. Aim of this study was to find out the proportion of diabetes subjects hospitalized in Koja General Hospital.This was a descriptive study with a cross sectional approach. Data was taken by consecutive sampling method from diabetes mellitus subjects aged ≥18 years who were hospitalized in the department of internal medicine Koja General Hospital in the period of August 20, until September 30, 2018.The proportion of diabetes subjects in Koja General Hospital was 42% (155 patients) out of a total of 368 subjects. The age of diabetes subjects with the majority of elderly adults (26-65 years) as much as 84% (131 patients) of 155 diabetes subjects. Gender were dominated by woman as 59% (91 patients) out of a total of 155 subjects and the remaining men were 41% (64 patients). The most frequent indication of treatment in diabetes subjects is chronic kidney failure (CKD) as much as 22 patients (14.2%).The proportion of diabetes subjects who were hospitalized was 42% (155 people) of a total of 368 subjects.

PROFIL HIPERTENSI DI POLIKLINIK PENYAKIT DALAM RSUD KOJA Ndraha, Suzanna; Caesar, Zulfikar; Afdilla, Winda; Rianas, Wiwin; Kamala, Yurri; Farras, Zahra; El, Zegovine
Jurnal Kedokteran YARSI Vol 27, No 2 (2019): MEI-AGUSTUS 2019
Publisher : Lembaga Penelitian Universitas YARSI

Prevalensi hipertensi meningkat di seluruh dunia, terutama di negara-negara sedang berkembang. Kesadaran berobat dan pengendalian hipertensi lebih berhasil di Amerika Utara dibandingkan negara sedang berkembang dan negara miskin, termasuk Indonesia. Tujuan penelitian ini adalah untuk mendapatkan profil penderita hipertensi di rawat jalan Penyakit Dalam RSUD Koja.Penelitian ini dilakukan dengan pendekatan deskriptif secara cross sectional. Populasi dari sampel adalah pasien poliklinik rawat jalan RSUD Koja yang didiagnosis hipertensi sepanjang bulan Oktober-Desember 2018.Proporsi hipertensi di rawat jalan RSUD Koja didapatkan sebesar 36,2% dari total 334 pasien. Jenis kelamin terbanyak adalah perempuan (71,1%), rentang usia antara 21?87 tahun, kelompok usia terbanyak 41?60 tahun, rerata tekanan darah sistolik (TDS) 153 (19.3) mmHg dan rerata tekanan darah diastolik (TDD) 84 (14.3) mmHg, sebagian besar IMT normal, sebanyak 60 % tidak rutin minum obat dan tekanan darahnya tidak mencapai target. Pasien hipertensi pada umumnya kurang patuh terhadap pengobatan karena ketidaktahuan mengenai cara mengkonsumsi obat. Banyak pasien (47%) beranggapan bahwa apabila tekanan darah sudah stabil maka obat tidak perlu dikonsumsi lagi. Proporsi hipertensi sebesar 36.2% dari total pasien rawat jalan, sebagian besar (60%) tidak terkendali karena tidak rutin berobat dengan alasan terbanyak adalah karena ketidaktahuan (47%)

Ensefalopati Hepatikum Minimal Ndraha, Suzanna
Cermin Dunia Kedokteran Vol 42, No 11 (2015): Kanker
Publisher : PT. Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v42i11.944

Ensefalopati hepatik (EH) merupakan salah satu komplikasi sirosis hati, angka kejadiannya lebih tinggi pada penderita sirosis hati malnutrisi. Ensefalopati hepatik minimal (EHM) adalah keadaan tidak terdapat gangguan klinis, namun pada tes psikometrik ditemukan kelainan. EHM penting karena mengurangi kualitas hidup. Dewasa ini tes critical flicker frequency (CFF) telah dikembangkan untuk mendiagnosis EHM. Tes ini telah divalidasi terhadap baku emas PHES. ESPEN 2006 merekomendasikan diet 35-40 Kcal/kgBB/hari dan protein 1,5 g/kgBB/hari untuk sirosis hati dengan malnutrisi. L-ornitin-L-aspartat (LOLA) terbukti dapat menurunkan kadar amonia darah. Beberapa studi telah membuktikan manfaat LOLA dan protein 1,5 g/kgBB/hari pada EHM malnutrisi dengan hasil baik.Hepatic encephalopathy (HE) is one of the complications in liver cirrhosis, the incidence is higher in malnutrition. Minimal hepatic encephalopathy (MHE) is clinically asymptomatic, detected by impaired psychometric test. MHE has been found to affect the quality of life and is a risk to develop overt HE. In recent years, critical flicker frequency (CFF) test has been developed for the diagnosis of MHE. Recent studies proved the efficacy of LOLA with a diet of 35-40 cal / kgBW and 1.5 g protein/kgBW including BCAA improve encephalopathy as well as nutritional status.

Ensefalopati Hepatikum Minimal Suzanna Ndraha
Cermin Dunia Kedokteran Vol 42, No 11 (2015): Kanker
Publisher : PT. Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v42i11.944

Ensefalopati hepatik (EH) merupakan salah satu komplikasi sirosis hati, angka kejadiannya lebih tinggi pada penderita sirosis hati malnutrisi. Ensefalopati hepatik minimal (EHM) adalah keadaan tidak terdapat gangguan klinis, namun pada tes psikometrik ditemukan kelainan. EHM penting karena mengurangi kualitas hidup. Dewasa ini tes critical flicker frequency (CFF) telah dikembangkan untuk mendiagnosis EHM. Tes ini telah divalidasi terhadap baku emas PHES. ESPEN 2006 merekomendasikan diet 35-40 Kcal/kgBB/hari dan protein 1,5 g/kgBB/hari untuk sirosis hati dengan malnutrisi. L-ornitin-L-aspartat (LOLA) terbukti dapat menurunkan kadar amonia darah. Beberapa studi telah membuktikan manfaat LOLA dan protein 1,5 g/kgBB/hari pada EHM malnutrisi dengan hasil baik.Hepatic encephalopathy (HE) is one of the complications in liver cirrhosis, the incidence is higher in malnutrition. Minimal hepatic encephalopathy (MHE) is clinically asymptomatic, detected by impaired psychometric test. MHE has been found to affect the quality of life and is a risk to develop overt HE. In recent years, critical flicker frequency (CFF) test has been developed for the diagnosis of MHE. Recent studies proved the efficacy of LOLA with a diet of 35-40 cal / kgBW and 1.5 g protein/kgBW including BCAA improve encephalopathy as well as nutritional status.

Liver Disorders in Type 2 Diabetes Mellitus Suzanna Ndraha; Marshell Tendean; Fendra Wician; Henny Tanadi Tan; Helena Yap
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 14, NUMBER 3, December 2013
Publisher : The Indonesian Society for Digestive Endoscopy

Background: Patients with type 2 diabetes mellitus (T2DM) are frequently diagnosed with some abnormal liver features. These liver abnormalities are suggested to be correlated with insulin resistance. The aim of thisstudy was to evaluate liver abnormalities and fasting insulin levels in patients with T2DM.Method: This study was conducted in Koja Hospital from February to July 2013. Study design was analytical study. Data for sex, age, complication, body mass index (BMI), liver function, liver enzyme, and fasting insulinlevel were collected. Univariate and bivariate statistical analyses were done using SPSS 20.Results: Twenty eight patients were included in this study, 71.43% of them were female. The age group of 40-60 years was the highest among the patients (64.28%). Highest complication was neuropathy, BMI of mostpatients were obese. Liver abnormalities were documented in 35.8% patients, liver enzyme increased in 21.4% patients. Non alcoholic fatty liver disease (NAFLD) were noted in 46.6% patients, and one patient was positive for hepatitis B. Mean fasting insulin in T2DM with NAFLD were higher than in T2DM without NAFLD. However, it was not statistically significant (40.08 ± 36.8 μU/mL vs. 54.3 ± 37.1 μU/mL; p = 0.27).Conclusion: Liver abnormalities found in T2DM patients were elevated liver enzyme, decreased albumin and increased of bilirubin. Through ultrasound, NAFLD and liver cirrhosis were found. Fasting insulin levelwas higher in T2DM with NAFLD but it was not statistically significant.Keywords: type 2 diabetes mellitus, non alcoholic steato-hepatitis, fasting insulin

Frequency Scale for the Symptoms of GERD Score for Gastroesophageal Reflux Disease in Koja Hospital Suzanna Ndraha
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: 10.24871/112201075-78

Background: The frequency scale for the symptoms of GERD (FSSG) was a specific questionnaire to gastroesophageal reflux disease (GERD), which has been validated against the endoscopic findings in Japan. The high score FSSG is one of the factors related to failure of proton pump inhibitor (PPI) mono therapy. The purpose of this study is to determine FSSG score in patients with GERD at Koja hospital, in order to predict the need for combination therapy of PPI with pro- kinetic drug or PPI only. Method: Dyspeptic patients which had have heartburn and/or regurgitation were collected in the period of March until July 2010. The FSSG score was obtain containing 12 questions which consisted of seven questions for reflux symptoms and five questions for dysmotility/dyspeptic symptoms. Results: There were 129 patients, 51 (39.5%) males and 78 (60.5%) females, mostly in the age group of 40 years (55.8%), body mass index of most patients (66.6%) were normal, only 12.4% were overweight. FSSG score revealed the mean of total score of 17.6 ± 6.9. From 129 dyspepsia patients who complained heartburn and or regurgitation, obtained 121 (94%) met criteria for GERD with cutoff eight. The mean of reflux score was 7.4 ± 4.6 while the mean of dyspeptic/dysmotility score was 10.1 ± 4. Thus from 129 patients studied, the symptoms of dyspeptic/dysmotility more dominant than symptoms of reflux Conclusion: GERD patients in Koja hospital have a high mean FSSG score, whereas dysmotility symptoms was proved to be more dominant than acid reflux Keywords: GERD, FSSG, dyspeptic/dysmotility score, reflux score

Upper Gastrointestinal Endoscopic and Histopathological Findings in Patients with Dyspepsia Suzanna Ndraha; Marcellus Simadibrata
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 13, NUMBER 1, April 2012
Publisher : The Indonesian Society for Digestive Endoscopy

Background: Dyspepsia is a syndrome located in the epigastric area. Upper gastrointestinal (UGI) tract endoscopy and histopathological examination are important diagnostic tools for dyspepsia. This study aimed to evaluate the pattern of dyspepsia in patients who underwent endoscopy examination at Koja Hospital, Jakarta. Method: All patients with dyspepsia who visited Koja Hospital from January until December 2011 were evaluated in this observational study. The data taken was age, gender, clinical symptoms, risk factors, alarm symptoms, body mass index, UGI tract endoscopic and histopathological findings. Data was analyzed using descriptive statistical analysis. Results: Of 1,279 patients with dyspepsia symptoms, 148 patients underwent UGI tract endoscopy. The main symptom was epigastric pain (91.2%). The most common risk factor was female (60.1%). The most common finding of alarm symptoms was history of UGI bleeding (21.6%). The most frequent result of UGI tract endoscopy was gastritis (79.7%). The most widely found of gastritis type was moderate antral gastritis (56%). The most common gastritis histopathological finding was non-active, non- atrophic, non-dysplastic chronic moderate gastritis (56%). All biopsy results included those with gastritis as well as gastric ulcer, which revealed negative results of Helicobacter pylori (H. pylori). Conclusion: The pattern of dyspepsia at Koja Hospital includes female predominant, most patients had alarm symptom history of UGI bleeding, gastritis on endoscopic findings, but H. pylori was not found in histopathological results. Keywords: dyspepsia, symptoms, risk factors, endoscopy, histopathological

A Deterioration of Anemia in Hemoglobin E Disease caused by Cholestatic Hepatitis A Helena Fabiani; Suzanna Ndraha; Henny Tanadi Tan; Fendra Wician; Mardi Santoso
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 13, NUMBER 3, Desember 2012
Publisher : The Indonesian Society for Digestive Endoscopy

ABSTRACTPatients with hemoglobin E disease usually have mild hemolytic anemia and mild splenomegaly. Acute infection including acute inflammatory disease of the liver caused by hepatitis A viral, which attacks patients with previous hemolytic anemia, may result in deterioration of anemia.A 17-year-old female patient was admitted with chief complaint of having jaundiced body and non-specific prodromal symptoms within one week prior to admission. Physical examination revealed jaundiced skin and sclera as well as tenderness in right upper quadrant of the abdomen. Laboratory tests revealed microcytic hypochromic anemia with hemoglobin (Hb) level of 6.3 g/dL, increased reticulocyte count and abnormal morphology of erythrocyteson blood smear. Hemoglobin electrophoresis indicated hemoglobin E disease and serologic tests suggested a positive anti-HAV immunoglobulin M (IgM) with increased level of liver enzymes and functions. Abdominal ultrasound showed hepatosplenomegaly without extra-hepatic cholestasis. The working diagnosis was hepatitis A with intrahepatic cholestasis and hemoglobin E disease. The patient was treated with hepatoprotector and ursodeoxycholic acid. Anemia was not treated specifically. It was assumed that hemolytic anemia was worsened by acute infection of hepatitis A viral. The assumption had been proven to be right since there was improvement of anemia after the acute infection had recovered. Patients with hemoglobin E disease usually have mild anemia; however, in this case, the hemoglobin level decreased significantly due to the acute co-infection. Keywords: hemoglobin E disease, anemia, acute infection, acute hepatitis A infection

Clinical Efficacy and Side Effects of Nabumeton Compared to Meloxicam in Osteoarthritis Pain Ade John Nursalim; Suzanna Ndraha
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 14, NUMBER 1, April 2013
Publisher : The Indonesian Society for Digestive Endoscopy

Background: Most patients who use non steroid anti-inflammatory drug (NSAID) in long-term or high-dose will experience NSAID gastropathy that appears as dyspepsia complaints. The aim of this study is to assessthe efficacy of nabumeton and incidence of dyspepsia as side effect of treatment using nabumeton compared to meloxicam in patients with pain due to osteoarthritis. Methods: Sixty patients with pain due to osteoarthritis at internal medicine clinic in Koja Hospital were included in this study and were given meloxicam or nabumeton within February 29th to March 25 in double-blind manner. Primary disease pain degree and heartburn pain degree were evaluated three days after administration of the drug and a week was added if necessary. The statistical analysis used were student t-test to compare changes in pain scores between the 2 groups, and Chi-square test to assess differences in the number of dyspepsia in both groups.Results: Pain scale reduction in meloxicam group was 0.57 ± 0.67 points, which is less than 1.27 ± 0.74 points in nabumeton group. In addition, the average recurrence of heartburn in the meloxicam was 18 out of 30 (60%) patients in total, while the average recurrence of heartburn in nabumeton was 2 out of 30 (60%) patients.Conclusion: The use of nabumeton pain medication is better in terms of efficacy and side effects of heartburn compared to meloxicam.Keywords: osteoarthritis, joint pain, meloxicam, nabumeton

Improvement of Nutritional Status in Liver Cirrhotic Patients with Adequate Dietary Feeding and High Branched-chain Amino Acids Supplementation Suzanna Ndraha; Marcellus Simadibrata
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 13, NUMBER 2, August 2012
Publisher : The Indonesian Society for Digestive Endoscopy

Background: There is still a high prevalence of malnutrition among liver cirrhotic patients despite the fact that it deteriorates their prognosis. Pre-albumin can be used as a parameter to evaluate short-term nutritional status. This study was conducted to find out the overall outcome of calories and protein diet, and substitution of branched-chain amino acids (BCAA) to enhance pre-albumin serum level in cirrhotic patients with malnutrition. Method: This was a quasi-experimental study conducted in liver cirrhotic patients who visited Koja Hospital between April and September 2009. Mid-arm muscle circumference (MAMC) was used to evaluate nutritional status. Those with MAMC below the 15th percentile were considered as malnourished. Diet of adequate calories and protein with the substitution of 2 x 4 scoop (± 60 g) BCAA milk powder in 200 mL warm water twice daily (± 7.3 g BCAA) was given for two weeks. Pre-albumin serum level was subsequently monitored (before and after intervention) to see if there were any nutritional status changes. Data was analyzed using dependent student T-test with SPSS version 15.0. Results: There were eligible 16 patients. The average pre-albumin level after diet intervention for two weeks was significantly higher than those before the intervention; i.e. from 5.8 (2.2) mg/dL to 6.8 (2.1) mg/dL, with p = 0.004. Conclusion: Diet of adequate calories and branched-chain amino acid can improve the pre-albumin serum level in liver cirrhotic patients with malnutrition. Keywords: cirrhosis, malnutrition, pre-albumin, BCAA

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