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Hasibuan, Anshari Saifuddin
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Medicine & Pharmacology

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Saatnya Memberikan Vaksin Influenza untuk Tenaga Kesehatan Hasibuan, Anshari Saifuddin
Jurnal Penyakit Dalam Indonesia Vol. 11, No. 4
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Penghambat Kanal Kalsium sebagai Kontrol Glukosa Darah pada Insulinoma: Sebuah Laporan Kasus Nizam, Nadhira; Putra, Ryan Tresna; Hasibuan, Anshari Saifuddin
Jurnal Penyakit Dalam Indonesia Vol. 12, No. 1
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Insulinoma is a rare neuroendocrine tumor of the pancreas arising from β-cells, leading to excessive insulin secretion and resultant hypoglycaemia. Surgical resection is the first-line treatment for insulinoma, but when surgery is not feasible, medical therapy is an important option. Calcium channel blockers (CCBs) such as verapamil can inhibit insulin release from β-cells and have been proposed as an adjunct therapy to help control blood glucose levels in insulinoma. We report a 43-year-old man who presented to the emergency department with decreased consciousness due to hypoglycaemia. His capillary blood glucose at home was 35 mg/dL, about 8 hours after his last meal. He had a history of recurring hypoglycaemic episodes in the past month, with recorded blood glucose ranging from 26–100 mg/dL during a prior hospitalization. On examination, he was hemodynamically stable but had mild epigastric tenderness. Laboratory tests confirmed hyperinsulinemic hypoglycaemia (plasma glucose 58 mg/dL with concurrent serum insulin 47 µIU/mL and C-peptide 13.1 ng/mL), consistent with insulinoma. Abdominal imaging revealed a heterogeneous pancreatic mass suspected as an insulinoma. Initial management included a continuous infusion of 10% dextrose (500 mL/24h) with IV boluses of 40% dextrose as needed for blood glucose <70 mg/dL. Despite this, the patient experienced recurrent hypoglycaemia, so octreotide 50 µg three times daily was added. Octreotide alone did not fully stabilize his blood glucose levels. On the 6th day of hospitalization, oral verapamil 80 mg once daily was initiated – chosen both to treat the patient’s concurrent hypertension and for its potential to suppress insulin release. Following the addition of verapamil, the patient’s blood glucose levels improved and remained above 100 mg/dL with markedly reduced hypoglycemic episodes. The patient subsequently underwent a debulking surgery of the pancreatic tumor. This case highlights the importance of controlling blood glucose in insulinoma patients and demonstrates that the addition of verapamil can stabilize blood glucose when used alongside standard medical therapy (such as octreotide). Verapamil may serve as a useful adjunct in the management of insulinoma-related hypoglycemia, especially in patients awaiting surgery or those who are not surgical candidates.
Campak dan Vaksinasi Campak pada Orang Dewasa Sinto, Robert; Koesnoe, Sukamto; Nelwan, Erni Juwita; Widhani, Alvina; Shakinah, Sharifah; Pasaribu, Adeline; Duindrahajeng, Bernadine Gracia; Suwarto, Suhendro; Nainggolan, Leonard; Chen, Lie Khie; Susilo, Adityo; Maria, Suzy; Hasibuan, Anshari Saifuddin; Wicaksana, Bramantya
Jurnal Penyakit Dalam Indonesia Vol. 13, No. 1
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Measles is a highly contagious viral infection that remains a significant global health problem despite the availability of an effective vaccine. Measles re-emergence is driven by gaps in immunization coverage, waning post-vaccination immunity, and increased population mobility. In adults, measles infection is associated with greater disease severity compared to children. This literature review was conducted by reviewing recent scientific publications addressing the epidemiology, pathogenesis, clinical manifestations, diagnosis, management, complications, and prevention of measles, with a focus on the adult population.  Measles is caused by an RNA virus of the Paramyxoviridae family and is transmitted through respiratory droplets and aerosols. Typical clinical features include fever, cough, coryza, conjunctivitis, and a maculopapular rash with a centrifugal and cephalocaudal distribution. Diagnosis is based on clinical findings and confirmed by laboratory tests such as RT-PCR and measles-specific IgM serology. Measles infection causes significant immunosuppression, including immune amnesia, which increases susceptibility to secondary infections. Management is primarily supportive and vitamin A supplementation has been shown to reduce mortality in certain populations. In adults, complications tend to be more severe, particularly pneumonia as the leading cause of morbidity and mortality, as well as neurological complications such as encephalitis and subacute sclerosing panencephalitis (SSPE). Measles vaccination with the MMR vaccine remains the main prevention strategy. However, its implementation faces challenges, including gaps in immunization coverage, vaccine hesitancy, and limited adult immunization record system. Measles in adults remains a significant health concern with a high risk of severe complication. Strengthening immunization program, improving public education, and developing integrated surveillance system are essential to reduce disease incidence and burden.
Co-Authors Adityo Susilo, Adityo Alvina Widhani, Alvina Duindrahajeng, Bernadine Gracia Erni Juwita Nelwan, Erni Juwita Khie Chen Leonard Nainggolan Nizam, Nadhira Pasaribu, Adeline Putra, Ryan Tresna Robert Sinto Shakinah, Sharifah Suhendro Suwarto, Suhendro Sukamto Koesnoe Suzy Maria Wicaksana, Bramantya