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All Journal Media Penelitian dan Pengembangan Kesehatan Jurnal Biotek Medisiana Indonesia Medical Journal of Indonesia Paediatrica Indonesiana Indonesian Journal of Rheumatology Media Karya Kesehatan Medica Hospitalia J-Kesmas: Jurnal Kesehatan Masyarakat (Indonesian Journal of Public Health) Narra J Indonesian Journal of Health Science The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy Jurnal Penyakit Dalam Indonesia Sentra Dedikasi: Jurnal Pengabdian Masyarakat Kesmas: Jurnal Kesehatan Masyarakat Nasional (National Public Health Journal)
Rudi Putranto
Department Of Internal Medicine, Faculty Of Medicine, Universitas Indonesia
Agriculture, Biological Sciences & Forestry Biochemistry, Genetics & Molecular Biology Computer Science & IT Decision Sciences, Operations Research & Management Dentistry Education Health Professions Immunology & microbiology Medicine & Pharmacology Nursing Public Health Social Sciences Veterinary

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Cost of Care Saving of Terminal Cancer Adult Patient UsingPalliative Care Consultation in Cipto Mangunkusumo Hospital Putranto, Rudi; Trisnantoro, Laksono; Hendra, Yos
Jurnal Penyakit Dalam Indonesia Vol. 4, No. 1
Publisher : UI Scholars Hub

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Introduction. Terminal cancer patients was increasing in Indonesia, and need attention to approach palliative and end of life care. Terminal cancer management was burden the hospital, because it causes high costly and the length of stay This study aimed to get a general picture of service palliative at Cipto Mangunkusumo, then to evaluate the relationship hospitalization and rates of inpatient services people with terminal cancer adults who received the intervention palliative care and to evaluate the relationship variable rates for accommodation (room), doctor visit, procedure/surgery, medicines and consumables, laboratory and radiology to palliative interventions in patients with terminal cancer in inpatient Dr. Cipto Mangunkusumo Hospital. Methods. This research was descriptive study with case control design and performed in the inpatient unit, Dr Cipto Mangunkusumo Hospital, during the month of January to December 2015. The subjects were medical records and billing of terminal cancer patients were .hospitalized adults in class III in January - December 2015 with National Health Insurance (BPJS). Inclusion criteria are terminal cancer patients, beusia ≥ 18 years, received palliative care consultation team while exclusion criteria are patients receiving palliative consultation on treatment days ≥ 25 days. Results. It is known that there is a significant relationship between palliative interventions to patients with hospital rates (p= 0.041), whereas there was no significant relationship between palliative interventions by the length of stay (p = 0.873). There is a significant relationship between palliative interventions and expenditures room rates, visite, action and medicine and palliative interventions. Conclusions. There is a significant relationship between palliative interventions with hospital rates. There is a significant relationship between palliative interventions and expenditures room rates, visite, action and medicine and palliative interventions. These data showed that palliative care intervention was saving money for hospital.
Peripheral Blood Count Characteristics, Neutrophil-Lymphocyte Ratio, and Platelet-Lymphocyte Ratio Pulmonary Tuberculosis Patients with Depression Shatri, Hamzah; Alexander, Reinaldo; Putranto, Rudi; Rumende, Cleopas Martin
Jurnal Penyakit Dalam Indonesia Vol. 6, No. 2
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Introduction. Patients with pulmonary tuberculosis (TB) had an increased risk for depression up to 1.53 times from a large cohort study. Studies have found an increase in the neutrophil - lymphocyte ratio (NLR) in various mood disorders including depression, also the value of the platelet-lymphocyte ratio (PLR) associated with major depression accompanied by psychotic symptoms. This study aimed to describe the peripheral blood characteristics, NLR, and PLR in pulmonary TB patients with depression. Methods. A cross-sectional study of 106 non-multidrug-resistant pulmonary TB patients was done at outpatient department of Cipto Mangunkusumo General Hospital, Jakarta from August to October 2018. The diagnosis of depression was made by interview according to Diagnostic and Statistical Manual of Mental Disorder-V (DSM-V) criteria, and severity of depression is determined using Beck Depression Inventory-II (BDI-II). The laboratory tests were done to obtain complete peripheral blood results, NLR, and TLR. Parametric test was used for numeric variables with even distribution, and nonparametric test for variables with uneven distribution. Results. From 106 patients with non-multidrug-resistant pulmonary TB, the proportion of depression was 32%. White blood cell count (p=0.024), and absolute lymphocte count (p=0.004) is lower in depressed TB patients compared to nondepressed TB patients. There were no significant relationship between NLR and TLR and the severity of depression in depressed pulmonary TB patients (p>0.05). Conclusion. White blood cell count and absolute lymphocyte count are lower in depressed pulmonary TB patients. Meanwhile, RNL and PLR are higher in depressed pulmonary TB patients eventhough not statistically significant.
The Prevalence of Irritable Bowel Syndrome Using Rome IV Criteria in Medical Student and The Related Factors Ahani, Ardhi Rahman; Syam, Ari Fahrial; Putranto, Rudi; Nugroho, Pringgodigdo
Jurnal Penyakit Dalam Indonesia Vol. 9, No. 1
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Introduction. Medicine is a long study time. Medical student will take five years study to accomplish the education. Because the lot of task and some taken test, some medical student will face irritable bowel syndrome in their study periods. This study aims to identify the prevalence of IBS in medical student and related factors.Methods. A cross-sectional study of 350 medical student Universitas Indonesia from first grade until fifth grade was done during November-December 2016. This study used stratified randomized sampling. The Rome IV criteria was used for diagnosing IBS. Interview with questionnaire guided was applied to all subjects. A bivariate analysis was done to know relationship between IBS and its related factors using chi-square, unpaired t-test, and their alternatives. Multivariate analysis was done using logistic regression test.Results. The IBS proportions were 18.3% in the female medical students and 9.7% in the male medical students (95% CI 1.11- 3.91). The highest subtype was diarrhea subtype (53.1%). Both student-life stress inventory score (stressor and response to stressor) were higher in IBS group than in non-IBS group (For stressor (66.4 (SB 11.4) vs 60.0 (SB 12.2), p=0,001) and for responseto stressor (64.0 (41-97) vs 55,0 (35-88), p<0,0001). Female sex and anxiety were related to IBS ((aOR 2.14; 95% CI 1.12-4.08) and (aOR 2.89; 95% CI 1.43-5.83)).Conclusions. The IBS proportions were 18.3% in the female medical students and 9.7% in the male medical students (95% CI 1.11- 3.91) with predominant diarrhea subtype (53.1%). Anxiety and woman were related to IBS.
Kasabach-Merritt Syndrome in Liver Hemangioma: A Case Report Frastica, Michelle; Putranto, Rudi; Jasirwan, Chyntia Olivia Maurine; Adhiatma, Kresna
Jurnal Penyakit Dalam Indonesia Vol. 9, No. 3
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Hemangioma is the most common congenital benign liver tumor. It affects mostly female, with the incidence of 0.4- 20%. Giant liver hemangioma induce the Kasabach Merritt syndome, a life threathening coagulation disorder which occur due to consumptive coagulopathy: trombocyte sequestration and agregation inside the hemangioma. The mortality rate is around 60%, with the most common cause is multiorgan complication which may end up with sepsis. The core management is hemangioma decompression by surgical measure. However, this often considered as a very risky procedure leading to massive bleeding. In most cases, conservative treatment is the preferred option. It is important to consider Kasabach Merritt syndome as one of the differential diagnosis when facing cases with enlarged abdomen in order to plan for its treatment as well as educate the patients regarding the prognosis.
Pengaruh Depresi Terhadap Perbaikan Infeksi Ulkus Kaki Diabetik Auliana, Arshita; Yunir, Em; Putranto, Rudi; Nugroho, Pringgodigdo
Jurnal Penyakit Dalam Indonesia Vol. 2, No. 4
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Pendahuluan. Pasien Diabetes Melitus (DM) dengan ulkus kaki lebih banyak yang mengalami depresi dan memiliki kualitas hidup yang buruk. Dalam tatalaksana ulkus kaki diabetik perlu diperhatikan faktor psikososial karena diperkirakan dapat mempengaruhi penyembuhan luka melalui induksi gangguan keseimbangan neuroendokrin-imun. Penelitian ini bertujuan untuk mengetahui pengaruh depresi terhadap proses perbaikan infeksi ulkus kaki diabetik, serta tingkat depresi pada pasien ulkus kaki diabetik yang dirawat inap. Metode. Studi kohort prospektif dilakukan pada 95 pasien ulkus kaki diabetik terinfeksi yang dirawat di RSCM dan RS jejaring pada Maret-Oktober 2014. Subjek dibagi ke dalam dua kelompok yaitu kelompok depresi dan kelompok tidak depresi. Data klinis, penilaian depresi, dan data laboratorium diambil saat pasien masuk rumah sakit kemudian dinilai perbaikan infeksi ulkus kaki diabetik dalam 21 hari masa perawatan. Hasil. Dari 95 subyek penelitian, 57 orang (60%) masuk dalam kelompok depresi, yang didominasi oleh kelompok perempuan (70%). Penyakit komorbid terbanyak adalah hipertensi, dengan angka komorbiditas dan penyakit kardivaskular lebih tinggi pada kelompok depresi. Malnutrisi dan obesitas juga lebih banyak pada kelompok depresi (64,9% dan 31,6%), demikian pula dengan kontrol glikemik yang buruk (73,7%). Sebagian besar pasien (73,7%) yang masuk dalam kelompok depresi memiliki depresi ringan. Pada kelompok depresi 40,4% mengalami perbaikan infeksi dalam 21 hari masa perawatan, sedangkan 68,4% pada kelompok tidak depresi. Depresi cenderung meningkatkan risiko atau kemungkinan tidak terjadinya perbaikan infeksi ulkus kaki diabetik, walaupun setelah dilakukan penyesuaian terhadap variabel perancu, hasil tersebut tidak bermakna secara statistik (p = 0,07, adjusted OR 2,429 dengan IK 95% 0,890-6,632). Lebih banyak subjek dengan depresi sedang yang tidak mengalami perbaikan infeksi ulkus kaki diabetik dibandingkan dengan subjek dengan depresi ringan (93,3% dan 47,6%). Simpulan. Depresi cenderung meningkatkan risiko atau kemungkinan tidak terjadinya perbaikan infeksi ulkus kaki diabetik.
The Role of Antioxidants as Adjuvants of Fibromyalgia Management Sabrina Chusnul Chotimah; Hamzah Shatri; Rudi Putranto; Edward Faisal; Vinandia Irvianita; Yanuar Ardhani; Dika Sinulingga
Indonesian Journal of Rheumatology Vol. 15 No. 1 (2023): Indonesian Journal of Rheumatology
Publisher : Indonesian Rheumatology Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/ijr.v15i1.233

Abstract

Fibromyalgia is a condition with complex polysymptomatology characterized by chronic widespread pain, fatigue, sleep disturbances, and functional symptoms. Oxidative stress plays a role in the etiology of pain which is the main symptom of fibromyalgia. The symptoms of fibromyalgia are related to the balance of oxidant and antioxidant. Antioxidants from certain nutrients can act to counter the high level of free radicals, in order to maintain the oxidative stress/antioxidant balance. Antioxidant such as coenzyme Q10, vitamin C and E, magnesium, and acetyl-L-carnitine have the potential benefit as adjuvants in treating fibromyalgia by reducing pain.
Palliative Care Case Report: A Man with End Stage Lung Cancer with Brain Metastases Yanuar Ardani; Hamzah Shatri; Rudi Putranto; Rendi Faris Anggono
Medica Hospitalia : Journal of Clinical Medicine Vol. 10 No. 2 (2023): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36408/mhjcm.v10i2.901

Abstract

INTRODUCTION : Lung cancer accounts for 13% of malignancies in the world and the most common type of cancer suffered by men in Indonesia. The 5-year survival rate for patients with lung cancer is only 18.1%. About 25-30% will develop brain metastases. Overall palliative care is needed including biologically targeted therapy, chemotherapy, stereotactic radiosurgery (SRS), surgery in selected cases, and whole brain radiotherapy treatment (WBRT). Rare studies that take into account surgical palliation in advanced NSCLC. It has been demonstrated that metastaticectomy generally improves survival and, in some patients, even long-term survival. CASE REPORT : A 65-year-old male patient with Non-Small Cell Carcinoma favor Lung Adenocarcinoma and cerebellum metastases. The patient underwent surgery to remove a brain tumor. The patient received 8 radiotherapies and Erlotinib chemotherapy for 4 cycles for 6 months. The dose of Erlotinib 150g/24 hours was used in the first month. The dose was reduced in the 2nd to 6th month to 100g/24 hours. Assessment of palliative care was carried out using the Karnopsky Questionnaire, Fatigue Severity Scale (FSS), and Palliative Performance Scale (PPS). CONCLUSION : . Despite major improvements in the way lung cancer patients are treated in recent years, morbidity and death rates are still high. Palliative care (PC) is an approach to treating patients with life-threatening diseases, one of which is lung cancer
Perbedaan Serotonin Plasma dan Kortisol Saliva terhadap Gejala Depresi pada Pasien Pasca Sindrom Koroner Akut Firmansyah, Irman; Shatri, Hamzah; Putranto, Rudi; Ardani, Yanuar; Ginanjar, Eka; koesnoe, sukamto; Rizka, Aulia; Isbagio, Harry; Yunir, Em
Jurnal Penyakit Dalam Indonesia Vol. 10, No. 3
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Introduction. Psychological disorders are closely associated with hormonal factors, including cortisol and serotonin. In patients with acute coronary syndrome (ACS), autonomic dysfunction and dysregulation of the hypothalamic-pituitaryadrenal (HPA) axis can occur, leading to an increase in cortisol levels that may worsen the prognosis of ACS patients. Therefore, it is important to understand the hormonal impact, namely cortisol and serotonin levels, on depressive symptoms, which will be examined in this study. Methods. This was a cross-sectional study to determine the impact of cortisol and serotonin in the incidence of depression in post-treatment ACS patients at the ICCU RSUPN dr. Cipto Mangunkusumo, Jakarta. Data collection from patients meeting the inclusion criteria was carried out 10-14 days post-treatment through interviews, HADS questionnaire completion, physical examinations, and laboratory tests. The Mann-Whitney test was used to examine the differences between serotonin and salivary cortisol levels in patients with and without depression. Results. Among the 73 ACS patients included in this study, the average age was 57.53 (9.97) years, with 68.5% was male. Posttreatment depression was observed in 15.1% of subjects. The median serotonin levels were lower in patients with depression [175 (147 – 227.64) ng/mL vs. 189.31 (152.87-235.44) ng/mL], while cortisol levels were higher in patients with depression [3.09 (1.46-6.26) ng/mL vs. 2.15 (0.92-3.91) ng/mL]. However, the statistical analysis showed no significant differences between plasma serotonin and depression (p=0.482) or saliva cortisol and depression (p=0.275). Conclusions. There were no significant differences in cortisol and serotonin levels concerning depressive symptoms among post-acute coronary syndrome patients. Nevertheless, this study holds clinical importance due to the observed lower plasma serotonin levels and higher saliva cortisol levels in ACS patients with depression.
Faktor-faktor yang Berhubungan dengan Kualitas Tidur Pasien dengan Lupus Eritematosus Sistemik Andru, Gestana; Widhani, Alvina; Putranto, Rudi; Mansjoer, Arif; Shatri, Hamzah
Jurnal Penyakit Dalam Indonesia Vol. 11, No. 2
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Introduction. Sleep disturbances are often found among Systemic Lupus Erythematosus (SLE) patients. Poor sleep may cause low quality of life. Study about sleep quality among SLE patients and related factors in Indonesia is scarce. This study aimed to know factors related to poor sleep quality among SLE patients. Methods. This cross-sectional study was conducted among SLE patients at Cipto Mangunkusumo Hospital Jakarta Indonesia. Sleep quality was assessed by Pittsburgh Sleep Quality Index (PSQI), with global PSQI score >5 indicates poor sleep quality. Factors evaluated were symptoms of depression and anxiety by Hospital Anxiety Depression Scale (HADS), pain by Visual Analogue Scale (VAS), Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K), autonomic dysfunction by Low Frequency/High Frequency (LF/HF) ratio from Heart Rate Variability (HRV), and high sensitivity C-Reactive Protein (hs-CRP) level. Bivariate analysis was done by Chi Square or Fisher’s test. Multivariate analysis was done by logistic regression, p value <0.05 was considered statistically significant. Results. Total of 166 SLE patients were included. Mean age was 32.7 years old with the majority in age group of 21-30 years old and female. Poor sleep quality in SLE patients was found in 82.5% of subjects. Symptoms of depression were significantly associated with poor sleep quality in SLE patients, especially sleep efficiency. Anxiety was associated with subjective month- and week-long sleep quality, sleep disturbances, and sleep medication usage. Musculoskeletal component of the SLEDAI-2K was associated with month- and week-long sleep quality, sleep latency, and daytime dysfunction. Hematologic involvement was associated with daytime dysfunction, whereas mucocutaneous involvement was associated with sleep disturbances. Conclusions. Symptoms of depression were significantly associated with poor sleep quality in SLE patients, especially sleep efficiency. Anxiety was associated with subjective month- and week-long sleep quality, sleep disturbances, and sleep medication usage.
Selective Serotonin Reuptake Inhibitors and Risk of Gastrointesinal Bleeding In Dyspepsia: An Evidence-Based Case Report Shatri, Hamzah; Zulkifly, Steven; Putranto, Rudi; Makmun, Dadang; Fauzi, Achmad; Maulahela, Hasan; Faisal, Edward; Irvianita, Vinandia; Ardani, Yanuar
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 24, No 2 (2023): VOLUME 24, NUMBER 2, August, 2023
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24871/2422023182-191

Abstract

Aim: This evidence-based case report aims to provide the latest evidence about the risk of gastrointesinal (GI) bleeding in selective serotonin reuptake inhibitor (SSRI) users with dyspepsia.Method: The literature search was conducted in four major electronic databases (PubMed, Cochrane, Scopus, ProQuest). The selected articles were sorted through screening abstract based on the inclusion and exclusion criteria. Critical appraisal was performed by using validated critical appraisal tool.Results: Of 247 records from extensive literature searching, three eligible studies (one randomized clinical trial and two cohort studies) were obtained to answer the clinical question. All studies showed SSRIs did not increase the risk of GI bleeding in patients with functional dyspepsia and peptic ulcer. However, the adverse event of SSRIs might be under-reported.Conclusion: According to the evidence, the risk of GI bleeding in SSRIs users with dyspepsia is still unclear. Larger size of sample of controlled trial study is recommended to be conducted to calculate the precise risk of GI bleeding in SSRI users with dyspepsia.
Co-Authors Achmad Fauzi Achmad Fauzy, Achmad Adhiatma, Kresna Adityo Susilo, Adityo Adli, Mizanul Afistianto, Muhammad Fikri Agus Siswanto Agustin Kusumayati Ahani, Ardhi Rahman Alexander, Reinaldo Alfiah, Elma Alvina Widhani, Alvina Amanda, Rosvitha Andru, Gestana Anwar, Bariani Anwar, Sufyan Ardani, Yanuar Ardhi Rahman Ahani Arfah Husna Ari Fahrial Syam Ari Fahrial Syam Arif Mansjoer Arshita Auliana Arshita Auliana Aulia Rizka, Aulia Badriul Hegar Bambang Setyohadi Bambang Setyohadi Bambang Subangkit Birry Karim Browijoyo, Isa A. Budi Sampurna Budi Sampurna Chairani, Aisha Putri Chyntia Olivia Maurine Jasirwan, Chyntia Olivia Maurine Cleopas Martin Rumende Cophiadi Irawan Cosphiadi Irawan Dadang Makmun Diah Martina, Diah Dika Sinulingga Dono Antono E. Mudjaddid A. Siswanto Deddy N.W.Achadiono Hamzah Shatri Eddy Mart Salim Eddy Mart Salim, Eddy Mart Edward Faisal Edward Faisal Edward Faisal Edward Faisal Edward Faisal Edward Faisal Eka Ginanjar Em Yunir Em Yunir, Em Erlita, Diana Evy Yunihastuti Faisal, Edward Fiastuti Witjaksono Fita Fitrianti Fitrawan, Ahmad Frastica, Michelle Hamzah Shatri Hamzah Shatri Hamzah Shatri Hapsari, Aljira Fitya Harna, Harna Harry Isbagio Hasan Maulahela Herqutanto - Ika Prasetya Wijaya Ikhwan Rinaldi Imam Subekti Iris Rengganis Irman Firmansyah Irvianita, Vinandia Iskandar Iskandar Jeger, Dian P. Juferdy Kurniawan Jufri , Jufri Kambang Sariadji Kamilia, Nisrina Kemal Fariz Kalista, Kemal Fariz Kosasih, Kartika Anastasia Kuntjoro Harimurti Kurniawan , Ade Laksono Trisnantoro Leonard Nainggolan Luxi Riajuni Marbun, Maruhum Bonar Hasiholan Marcellus Simadibrata K Marniati Marniati, Marniati Megantara, Marcelino A. Muh Asrul Irawan, Andi Muhadi Muhadi, Muhadi Muhammad Ali Apriansyah Muhammad Ali Apriansyah, Muhammad Ali Murdani Abdullah Nabil Mubtadi Falah Nabil Mubtadi Falah, Nabil Mubtadi Nasrun, Martina W. Natali, Veritea nFN Abdurrahman, nFN nFN Sunarno, nFN Noer Endah Pracoyo Noto Dwimartutie Novita, Anisah Nurfitria, Nandika Nurrahmah , Awalia Pane, Meivina Ramadhani Poespitasari, Vinandya Irvianita Pratama, Metra Adi Pringgodigdo Nugroho, Pringgodigdo Putri, Enda Silvia Rachmawati, Elvie Zulka Kautzia Raniah, Nida Ratih Arianita Agung Reinaldo Alexander Rendi Faris Anggono Restuti, Ratna Dwi Sabililhaq, Muhammad Adnan Sabrina Chusnul Chotimah Sabrina Munggarani Yusuf Sally A Nasution, Sally A Sariadji Kambang, Sariadji Shafira Puspadina Sihwastuti Sihwastuti Sihwastuti, Sihwastuti Sinulingga, Dika Sinulingga, Dika I. Siswahyudianto Siti Setiati Suhendro Suwarto, Suhendro Sukamto Koesnoe Sumariyono Sumariyono Sumariyono Sumariyono Suzanna Immanuel Su’udi, Amir Syahrani, Aisyah Syamsuar Manyullei Tri Juli Edi Tarigan Triyani Sukarso Ukkas, Ummu Kalsum Vinandia Irvianita Wismandari Wisnu Wulyo Rajabto Wulyo Rajabto Yanuar Ardani Yanuar Ardhani Yos Hendra Yos Hendra, Yos Yunizaf, Rahmanofa Yusuf, Andi Mukramin Zulkifly, Steven