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All Journal Jurnal Penyakit Dalam Indonesia Journal Medical Informatics Technology
Artati Murwaningrum, Artati
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Computer Science & IT Dentistry Engineering Medicine & Pharmacology Public Health

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Diagnostic Approach and Treatment of Instestinal Tuberculosis Murwaningrum, Artati; Abdullah, Murdani; Makmun, Dadang
Jurnal Penyakit Dalam Indonesia Vol. 3, No. 3
Publisher : UI Scholars Hub

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Tuberculosis (TB) has become a resurgent global problem with increasing numbers of patients. TB infection is still common and remains an important cause of morbidity and mortality, particularly in underdeveloped and developing nations. Intestinal tuberculosis (intestinal TB) rates are rising, consistet with the overall trend. In 2014 Indonesia has the second highest TB prevalence in South East Asia after Timor Leste. Intestinal TB is the sixth highest manifestation of extrapulmonal TB. Manifestations can be non-specific and mimic many conditions, including malignancies causes’ intestinal TB diagnosis more difficult to be accurately determined. Findings from endoscopy and radiological imaging are countless, and depend on the stage of the disease and the time at which investigations are carried out. Hence, diagnosis can be difficult. Until recently there is no single method to identify intestinal TB accurately, various investigative methods have been used to aid in the diagnosis of intestinal TB. Early diagnosis and initiation of antituberculous therapy and surgical treatment are essential to prevent morbidity and mortality. Combined clinical assessment and some modalities examinations are needed to determine intestinal TB. Patient whom has been diagnosed with intestinal TB will be given anti tuberculosis therapy and surgery if any complications occur.
Pica sebagai Manifestasi Anemia Defisiensi Besi: Suatu Laporan Kasus murwaningrum, artati; Rinaldi, Ikhwan; Mustopa, Inna Intani
Jurnal Penyakit Dalam Indonesia Vol. 10, No. 2
Publisher : UI Scholars Hub

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Prevalence of anemia in Indonesia based on Basic Health Research (2018) was 23.7%. Symptoms of iron deficiency anemia were pallor, malaise, palpitation, shortness of breath, headache, sore tongue. But sometimes can be found abnormal behavior in the form of PICA. This article reports on a-52-year-old man who sought medical treatment and was diagnosed with iron deficiency anemia with pica manifestation. The pica manifestation was characterized by a repeated desire to consume raw rice due to bleeding from hemorrhoids. Patient was given oral iron replacement therapy contain 100 mg of Fe (III) hydroxide polymaltose complex and folic acid 0.35 mg alternating with vitamin C 500 mg daily. Total iron daily dose given were 200 mg, divided in two doses. The patient received dietary education and was advised to consult a Gastroenterohepatology Subspecialist for the management of hemorrhoids, but it has not been done yet. The desire for raw rice consumption disappeared and the hemoglobin level increased to 12.4 g/dL after six weeks of therapy. The patient continued to take iron supplements until January 2023 but did not have follow-up visits to the clinic. In January 2023, the patient underwent hemorrhoid surgery due to bleeding accompanied by and a non-reducible lump that had been present for three days. Iron supplements continued for one month post-operation and then discontinued. The latest hemoglobin level was 15.3 g/dL without iron supplements. The symptoms of pica in this patient disappeared along with an increased hemoglobin level, and the management of severe anemia in this patient showed an adequate response. Bleeding has never occurred again after the surgery. Curative measures for hemorrhoidal bleeding are crucial, while iron supplementation is only a supportive therapy.
Risk Factors for Multidrug-Resistant Bacterial Infections in Hospital-Acquired Pneumonia at Cipto Mangunkusumo Hospital Murwaningrum, Artati; Kamelia, Telly; Chen, Khie; Loho, Tonny; Abdullah, Murdani
Journal Medical Informatics Technology Volume 2 No. 4, December 2024
Publisher : SAFE-Network

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37034/medinftech.v2i4.94

Abstract

Multidrug-resistant (MDR) hospital-acquired pneumonia (HAP) is linked to high mortality, extended hospital stays, and increased healthcare costs. Identifying risk factors for MDR HAP is essential to formulate effective management strategies. This study analyzed the proportion of risk factors associated with MDR bacterial infections in HAP patients treated at Cipto Mangunkusumo General Hospital. Using a retrospective cohort design, data were collected from medical records of HAP patients hospitalized between 2015 and 2016. A total of 68 patients met the inclusion criteria, while 10 were excluded due to fungal or non-pathogenic bacterial growth in sputum cultures. Patients were categorized as infected with MDR or non-MDR bacteria based on the resistance profile of their initial sputum cultures. Descriptive analysis was conducted using Microsoft Excel to calculate proportions of risk factors, without applying inferential statistical tests due to the limited sample size. The incidence of HAP was 6.12 per 1000 admissions in 2015 and 6.15 in 2016. MDR bacterial infections were observed in 95% of cases in 2015 and 82.1% in 2016. Key risk factors for MDR infections included prior antibiotic use within 90 days (100%), albumin levels <2.5 g/dL (100%), Charlson Comorbidity Index ≥3 (95.9%), age >60 years (95.2%), hospitalization >5 days (92.5%), nasogastric tube (NGT) insertion (92.1%), prior ICU/HCU admission within 90 days (81.8%), and steroid use >10 mg/day for >14 days (28.6%). These results emphasize that most HAP cases were caused by MDR bacteria, with prior antibiotic use and low albumin as predominant risk factors, necessitating targeted interventions for at-risk populations.
Co-Authors Dadang Makmun Ikhwan Rinaldi Khie Chen Murdani Abdullah Mustopa, Inna Intani Telly Kamelia Tonny Loho