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All Journal Plexus Medical Journal Indonesian Journal of Endocrinology Metabolism and Diabetes (InaJEMD)
Eva Niamuzisilawati
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Health Professions Medicine & Pharmacology Public Health

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Hubungan HbA1c dan Asam Urat dengan Derajat Keparahan Disfungsi Ereksi pada Pasien Diabetes Melitus Tipe 2 di RSUD Dr. Moewardi Surakarta Gladera Wedpavica Zealtito Zulfan; Eva Niamuzisilawati; Arifin; Dhani Redhono Harioputro
Plexus Medical Journal Vol. 4 No. 3 (2025): Juni
Publisher : Fakultas Kedokteran, Universitas Sebelas Maret

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20961/plexus.v4i3.1960

Abstract

Pendahuluan: Disfungsi ereksi merupakan salah satu komplikasi tersering pada pasien diabetes melitus tipe 2 yang sering dihubungkan dengan penyakit kardiovaskular. Mendeteksi dini potensi adanya disfungsi ereksi sebagai prediktor penyakit kardiovaskular penting dilakukan. Penelitian ini bertujuan mengetahui hubungan Hemoglobin A1c dan asam urat sebagai indikator dalam memberikan gambaran keparahan disfungsi ereksi. Metode: Penelitian cross-sectional terhadap pasien laki-laki dengan diabetes melitus tpe 2 di poliklinik endokrin Rumah Sakit Umum Daerah Dr. Moewardi. 32 sampel yang memenuhi kriteria inklusi mengisi kuesioner International Index of Erectile Function (IIEF-5) sebagai klasifikasi derajat disfungsi ereksi. Data diolah menggunakan uji Rank Spearman. Hasil: Tidak terdapat hubungan yang signifikan antara keparahan disfungsi ereksi dengan Hemoglobin A1c (p>0.05 dan r=0.347) dan asam urat (p>0.05 dan r=0.140) meskipun keduanya memiliki korelasi positif. Kesimpulan: Tidak terdapat hubungan yang signifikan antara Hemoglobin A1c dan asam urat dengan derajat keparahan disfungsi ereksi.
Multiple Autoimmune Syndrome (Graves’ Disease, Autoimmune Hepatitis, SLE) in Young Male with ASD Secundum: A Rare Case Dinar Dewi Miftah Tyas Arum; Herlina Kusuma Dewi; Eva Niamuzisilawati; Aritantri Darmayani; Agus Joko Susanto; Astri Kurniati Martiana; Brian Wasita
‎ InaJEMD - Indonesian Journal of Endocrinology Metabolic and Diabetes Vol. 2 No. 1 (2025): InaJEMD Vol. 2, No. 1
Publisher : PP PERKENI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.66266/inajemd.v2i1.45

Abstract

Multiple autoimmune syndrome (MAS) is characterized by the presence of at least three autoimmune diseases, presenting complex clinical challenges due to overlapping conditions and varied manifestations. Multiple autoimmune syndrome is rarely reported in men, particularly with the combination of Graves’ disease, systemic lupus erythematosus (SLE), and autoimmune hepatitis (AIH). We report a case of a 22-year-old male who presented with symptoms of jaundice, significant weight loss, and classic signs of hyperthyroidism, including palpitations and tremors. Physical examination revealed jaundice, exophthalmos, and an enlarged thyroid gland, and he was diagnosed with Graves' disease, SLE, and AIH. Additional findings included stasis dermatitis and an atrial septal defect (ASD) with a moderate risk of pulmonary hypertension. The patient received thiamazole, propranolol, and corticosteroids, leading to clinical stabilization and symptom resolution. This rare MAS case with concurrent Graves’ disease, SLE, and AIH highlights the need for accurate diagnosis and individualized management. The immunological interplay among these diseases contributes to diverse clinical manifestations, requiring a multidisciplinary approach. Our patient’s management strategy effectively controlled hyperthyroidism, mitigated hepatic inflammation, and stabilized cardiac function, illustrating the effectiveness of comprehensive therapy. In young patients presenting with multiple autoimmune symptoms, MAS should be considered, especially with unusual combinations. Early detection and tailored treatment approaches, along with interdisciplinary collaboration, are essential to manage MAS and its associated complications.
A Rare Coexistence of Thyrotoxic Cardiomyopathy and Asthma in Graves’ Disease: Clinical Challenges and Management Strategies: A Case Report Mutiara Lirendra; Eva Niamuzisilawati; Ega Caesaria; Brilliant Van Fitof; A Farih Raharjo; Adi Bestara
‎ InaJEMD - Indonesian Journal of Endocrinology Metabolic and Diabetes Vol. 2 No. 2 (2025): InaJEMD Vol. 2, No. 2
Publisher : PP PERKENI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.66266/inajemd.v2i2.64

Abstract

Graves' disease is the most common autoimmune hyperthyroid disorder. Thyrotoxic cardiomyopathy (TCM) is a rare but potentially lethal complication of thyrotoxicosis, with an incidence of <1%. Betablocker is one of the drugs of choice in treating TCM. However, in asthma patient, beta-blocker may induce bronchoconstriction. We report a rare case of a 36-year-old male presented with complaints of shortness of breath, wheezing, cough, and palpitation. The patient had a history of asthma. Physical examination revealed diffuse thyroid enlargement, exophthalmos, tremor, cardiomegaly, irregular heart sounds, rales, wheezing in both lungs, and BMI was underweight. Wayne index was 20 (hyperthyroid) and Burch Wartofsky score was 35 (impending storm). Laboratory results showed low Thyroid-stimulating hormone level and high level of Free-T3, Free-T4, Thyroid-Stimulating Hormone Receptor Antibodies, and N-terminal pro-B-type natriuretic peptide. Chest X-ray showed cardiomegaly. electrocardiogram showed atrial fibrillation RVR. Echocardiography showed segmental wall motion abnormality EF 48%. Patient was diagnosed with Graves’ disease with hyperthyroidism, acute asthma exacerbation, Heart failure with mildly reduced ejection fraction NYHA III due to thyrotoxic cardiomyopathy. Patient was treated with methimazole, shortacting beta-agonists, corticosteroid, digitalis, diuretics, anticoagulant, and angiotensin receptor blockers. During follow up, laboratory results, ECG, and clinical symptoms were improved. The management of Graves' disease with hyperthyroidism and TCM focuses primarily on controlling the thyroid hormone levels to prevent further cardiac deterioration. The complex interplay between managing thyroid hormone levels and preventing asthma exacerbation in this patient highlights the need for a multidisciplinary approach to optimize treatment outcomes. Graves' hyperthyroid patients with cardiomyopathy and asthma require holistic, comprehensive, and meticulous drug selection to prevent exacerbation.
Fibrocalculous Pancreatic Diabetes (FCPD): A Rare Type of Pancreatogenic Diabetes Ega Caesaria Pratama Putra; Eva Niamuzisilawati; Yulia Sekarsari; Brilliant Van Fitof Songso Rhomado; Supriyanto Kartodarsono
‎ InaJEMD - Indonesian Journal of Endocrinology Metabolic and Diabetes Vol. 2 No. 2 (2025): InaJEMD Vol. 2, No. 2
Publisher : PP PERKENI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.66266/inajemd.v2i2.68

Abstract

FCPD is a rare form of secondary diabetes. FCPD is mainly found in the tropical region; it is characterized by diabetes, chronic abdominal pain, calcification of the pancreas, and steatorrhea. The Incidence of FCPD is often misdiagnosed with type 2 or type 1 diabetes mellitus. A 46-year-old man came with chief complaints of chronic abdominal pain. Abdominal radiography showed calcification in the pancreas. The patient was malnourished. Abdominal X-ray revealed pancreatic calcification, which was confirmed by an abdominal MSCT scan. C-Peptide decreased with an intermediate degree. The patient was given supportive therapy,and insulin was given to control his diabetes. FCPD is a morphological pancreas change caused by chronic tropical pancreatitis. The aetiology of chronic tropical pancreatitis is unknown. FCPD can be diagnosed by history taking and supporting examinations such as abdominal X-ray examination, ultrasound and abdominal CT Scan. C-peptide was examined to assess the function of pancreatic beta cells. The primary treatment for FCPD is insulin therapy; metformin or Sulfonylureas can be used in the early phase of diabetes. In reducing pain, non-steroidal analgesics are used as an option. The use of pancreatic enzyme supplementation can improve the nutritional status of patients. FCPD is a rare case, occurring mainly in tropical countries and in people who are malnourished. The primary treatment for FCPD is insulin therapy.
Co-Authors A Farih Raharjo Adi Bestara Agus Joko Susanto Arifin Aritantri Darmayani Astri Kurniati Martiana Brian Wasita Brilliant Van Fitof Brilliant Van Fitof Songso Rhomado Dhani Redhono Harioputro Dinar Dewi Miftah Tyas Arum Ega Caesaria Ega Caesaria Pratama Putra Gladera Wedpavica Zealtito Zulfan Herlina Kusuma Dewi Mutiara Lirendra Supriyanto Kartodarsono Yulia Sekarsari