cover
Contact Name
Nur Samsu
Contact Email
crjim@ub.ac.id
Phone
+6281911005600
Journal Mail Official
crjim@ub.ac.id
Editorial Address
Jl. JA Suprapto No. 2 Kec. Klojen Malang 65112, Indonesia. Laboratory of Internal Medicine, Department of Internal Medicine, Faculty of Medicine, dr. Saiful Anwar General Hospital, IRNA 1 Building 2nd Floor
Location
Kota malang,
Jawa timur
INDONESIA
CRJIM (Clinical and Research Journal in Internal Medicine)
Published by Universitas Brawijaya
ISSN : 27235130     EISSN : 27235122     DOI : https://doi.org/10.21776/ub.crjim
Clinical and Research Journal in Internal Medicine is the official open access journal of Internal Medicine Research Center, Department of Internal Medicine, Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia. It publishes articles two times per year. It is a peer reviewed publication of Indonesian Internal Medicine journals and accepting articles for publication from around the world. CRJIM only publishes articles in the English version. The objective of this journal is to publish the selected clinical and basic research relevant to Internal Medicine. It covers the following topics, nephrology, endocrinology, metabolic, and diabetes, rheumatology, geriatrics, tropic infection, hematology oncology. CRJIM publishes original researches, reviews, brief reports, editorial, case series, case reports, and commentary. Additionally, it also considers publishing animal studies relevant to Internal Medicine topic. It is an international journal dedicated to providing new information that could give new insight for alternative solutions, diagnosis, therapy and prevention for researchers and practitioners in Internal Medicine.
Articles 93 Documents
Renal Artery Stenosis: Diagnostic and Management Problems Samsu, Nur; Waafi, Affa Kiysa
Clinical and Research Journal in Internal Medicine Vol 1, No 2 (2020): New: The Second Issue is Coming!
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.crjim.2020.001.02.6

Abstract

Renal artery stenosis is one common clinical problem. It has wide spectrum of pathophysiology with 3 most common clinical syndromes, ischemic nephropathy, hypertension, and cardiac destabilization syndrome. Aim: To date there was not any specific diagnostic criteria for renal artery stenosis. Method: Clinicians only used some clinical syndromes to guide the diagnostic possibility of renal artery stenosis. RADUS as one sensitive and specific diagnostic method, still had some disadvantages. Results: it gives false negative results in 10-20% of patients due to confounding factors such as operator capability, obesity, or abdominal gas distribution. CTA and MRA was excellent, but possessed some risks for the patient. Therefore, CTA was mostly recommended in patient with the planning of revascularization. Management of renal artery stenosis was still debated between optimal medical management and revascularization because the complexities of mechanisms underlying the renal artery stenosis. Because of the complicated pathophysiology of renal artery stenosis, revascularization could not entirely improve renovascular hypertension and nephropathy. Revascularization offered best results in fibromuscular dysplasia, although procedure related complication was still high. Revascularization, even though it might have high success rate in atherosclerotic renal artery stenosis, but the incidence of re-stenosis was also fairly high. Conclusion: Overall, revascularization was recommended in FMD, but should only be preserved for atherosclerotic renal artery stenosis after the failure of optimal medical management.
Lean Non-Alcoholic Fatty Liver Disease (NAFLD) Fachrureza, Mochamad; Pratomo, Bogi
Clinical and Research Journal in Internal Medicine Vol 1, No 1 (2020): New: The First Volume of Clinical and Research Journal in Internal Medicine
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.crjim.2020.001.01.6

Abstract

Non-Alcoholic Fatty Liver Disease (NAFLD) is a condition that can develop into advanced liver disease. The NAFLD spectrum includes simple steatosis, non-alcoholic steatohepatitis (NASH), liver fibrosis, and liver cirrhosis to hepatocellular carcinoma. One of the underlying pathophysiologies is insulin resistance found in metabolic syndrome. People with metabolic syndrome are not always obese, and NAFLD can also be found in this group, known as lean NAFLD, which has different metabolic characteristics. Metabolic characteristics of lean NAFLD include high levels of transaminases and insulin, low insulin sensitivity, low fasting glucose, low necroinflammatory activity, and liver fibrosis. Some related factors are methionine and choline deficiency, excessive acyl-coA expression, and PNPLA3 gene polymorphism. Lean NAFLD is an interesting topic to discuss because practitioners' awareness of lean NAFLD is lower compared to obese patients. NAFLD is a risk factor for chronic diseases such as cardiovascular disease, kidney disease, colorectal, atrial fibrillation, and hypothyroidism, so it is essential to be recognized by clinicians. To date, there are no guidelines or recommendations that discuss specific treatments in this lean NAFLD population.  
Challenges in Diagnostic and Management of Nephritic Syndrome in Diabetic Nephropathy Patient: a Case Report Novitasari, Adinda Dian; Samsu, Nur
Clinical and Research Journal in Internal Medicine Vol 2, No 1 (2021): First Issue of 2021
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.crjim.2021.002.01.7

Abstract

The clinical presentation of patients with acute glomerulonephritis (GN) varies widely, from asymptomatic to clinical presentations of acute kidney injury (AKI), edema, and hypertension. Diagnosis of GN in patients with diabetic nephropathy (DN) is a challenge due to pre-existing edema, hypertension, and decreased renal function. Likewise in terms of management of steroid immunosuppressants related to blood sugar regulation. It has been reported that 35-year-old male patients with diabetes mellitus (DM) with DN whose kidney function deteriorated rapidly. The patient complained of cola-red urine and decreased urine volume the day before admission. Physical examination showed blood pressure of 160/95 mmHg, bilateral leg edema, active chronic ulcer in the left lower leg, hemoglobin level was 8.7 g / dl, leukocytes 17.400 / ul, serum urea level 96 mg / dl, serum creatinine level 7.01 mg / dl, ASTO titer + 800 IU / ml, macroscopic hematuria, and albuminuria +4 on urinalysis. Ultrasonography revealed enlarged kidney size and signs of acute renal inflammation. Based on these data the patient was diagnosed clinically as rapidly progressive GN due to post-infectious GN. The patient received 3 days of pulse methyl prednisolone therapy continued orally, blood sugar regulation with insulin, RAS blockers, intravenous antibiotics and ulcer debridement. After 1 week of therapy, clinical and laboratory improvements were found and at the next follow-up renal function returned to baseline about 2 weeks later.
Correlation between Risk Stratification of Complications and Types of Antihyperglycemia Drugs with Incidence of Acute Diabetic Complications in Patients with Diabetes Mellitus during Ramadan Fasting Sasiarini, Laksmi; Simatupang, Charisma Dian; Arsana, Putu Moda
Clinical and Research Journal in Internal Medicine Vol 1, No 2 (2020): New: The Second Issue is Coming!
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.crjim.2020.001.02.3

Abstract

Ramadan fasting for Diabetes Mellitus (DM) patients can lead to acute complications such as hypoglycemia, hyperglycemia, diabetic ketoacidosis (DKA) and thrombosis. Risk stratification predicts fasting safety of DM patients. Dose and timing of antihyperglycemia drugs adjusted during Ramadan fasting. Aim: To know the correlation between the risk stratification of Ramadan fasting and type of antihyperglycemia drugs with the incidence of acute complications in DM patients undergoing Ramadan fasting. Methods: DM patients in Endocrinology Clinic, dr. Saiful Anwar, General Hospital Malang who intend to fast during Ramadan classified in IDF-DAR risk stratification, conduct blood glucose monitoring and filled out a daily logbook during fasting. Results: Thirty-seven subjects were included in the study, only 1 patient with type-1 DM. Average fasting time is 18 days. Acute complications found higher in very high-risk group (5/6) compared to mild/moderate (2/13) and high-risk group (7/18) (p=0.009). Acute complications found higher in group with OAD and insulin combination regiment (2/4) compared to OAD (9/24) or insulin group (3/9) (p= 0. 731). One subject in very high-risk group suffered from acute coronary syndrome. Relationship between risk stratification and the incidence of hypoglycemia (p=0.040) and hyperglycemia (p=0.031) was significant. Relative risk in the very high-risk group was 2.538 compared to mild/moderate risk RR (95% CI)= 0.77 (0.62-0.96). Conclusions: There is a correlations between risk stratification and acute complications in DM patients undergoing Ramadan fasting. No relationship between type of antihyperglycemia drugs with acute complications of Ramadan fasting.
The Diagnostic Dilemma of Charcot Foot in 73 Year-Old-Female Helena, Helena; Rosandi, Rulli
Clinical and Research Journal in Internal Medicine Vol 1, No 1 (2020): New: The First Volume of Clinical and Research Journal in Internal Medicine
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.crjim.2020.001.01.7

Abstract

Charcot neuroarthropathy (CN) is a progressive degenerative arthropathy of weight-bearing joints, which rarely complicates diabetes mellitus, usually in the foot or ankle. Commonly, when affecting the foot, it seems to be determined by the interaction of neuropathy, osteopenia, and proinflammatory cytokines on a calcified peripheral vasculature that maintains its ability to vasodilate despite widespread arteriosclerosis. Although often unrecalled, this arthropathy is probably triggered by trauma. Diagnosis is primarily clinical, given the lack and non-specificity of radiological and biochemical findings at the acute stage. CN should be considered in the differential diagnosis of any diabetic patient presenting with a warm swollen lower extremity. Offloading is essential and improves limb survival. Failure to institute corrective measures at an early stage results in a foot that is prone to deformity, ulceration, amputation, and loss of function. We report a case of Charcot foot in a 73 years old female and review of diagnostic modalities.
The Duration of Hemodialysis and its Implication to Barthel Score and Laboratory Parameters among End Stage Renal Disease Patients Jahidi, Savero Mizan; Mardiana, Nunuk; Wardhani, Indrayuni Lukitra
Clinical and Research Journal in Internal Medicine Vol 2, No 1 (2021): First Issue of 2021
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.crjim.2021.002.01.3

Abstract

Background: While it was proven that hemodialysis for treating patients with end stage renal disease (ESRD) provided the reduced mortality rate, the reports on its adequacy in the context of laboratory parameters and psychological function were limited. Aim: To assess the implication of hemodialysis duration on Barthel score and laboratory parameters among ESRD patients.  Methods: During the period, a cross-sectional study was conducted at Dr. Soetomo General Hospital. Information related to age, gender, history of hypertension, history of diabetes mellitus, and the levels of hemoglobin, albumin, calcium, and phosphor were retrieved from medical records. While, we performed the interview to each participant using Barthel index questionnaire to assess the function independence. We used multiple logistic regression analysis to determine the correlation and estimate of effect. Results: We totally include we included 65 patients with the hemodialysis duration of more than one year and 16 patients with the hemodialysis duration of less than one year. Our results found that the higher levels of albumin and hemoglobin were observed in patients with hemodialysis duration of more than one year. While, the duration of hemodialysis did not affect the Barthel score and serum mineral parameters. Conclusion:  The duration of hemodialysis of more than one year is associated with the improvement of albumin and hemoglobin levels
Effect of Chemotherapy and Hormonal Therapy on Bone Mineral Density in Patients with Breast Cancer in Saiful Anwar Hospital Malang Nurshanty, Ade; Wardhani, Shinta Oktya; Suryana, Bagus Putu Putra
Clinical and Research Journal in Internal Medicine Vol 1, No 1 (2020): New: The First Volume of Clinical and Research Journal in Internal Medicine
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.crjim.2020.001.01.4

Abstract

Osteoporosis is an important health problem, and the number of patients who suffered from it is increasing. Breast cancer is a condition that has a  high risk of osteoporosis. Cancer induced bone disease results from the primary disease, metastatic process, or from therapies against the prime condition, causing bone fragility. Therefore, there are still different opinions regarding the therapeutic effect of breast cancer on bone mineral density. Aim: to determine the effect of chemotherapy and hormonal therapy on bone mineral density in patients with breast cancer in Saiful Anwar Hospital Malang. Method: this is a case-control study conducted in 30 patients with breast cancer who had undergone chemotherapy and hormonal therapy are compared to 30 patients without breast cancer as controls.  Bone Mineral Density (BMD) was measured by DEXA. Result: there are 53% of breast carcinoma patients having osteopenia and 13% having osteoporosis, with one patient has osteoporosis located in the femoral neck and three patients in lumbar (L1-L4). We obtain a significant T-score (p=0.02) in the great trochanter. Odds Ratio (OR) 0.233 with p = 0.008 showed a protective effect of chemotherapy and hormonal therapy for breast cancer to the bone density. Conclusion: the incidence of osteoporosis in the study was 13%, with the most location in the lumbar spine. Chemotherapy and hormonal therapy had a protective effect on BMD in patients with breast cancer in Saiful Anwar Hospital Malang.
Shorter All-oral Bedaquiline-containing MDR-TB Regimen : The Backgrounds & Implementations Winoto, Eden Suryoiman; Candradikusuma, Didi
Clinical and Research Journal in Internal Medicine Vol 2, No 1 (2021): First Issue of 2021
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.crjim.2021.002.01.6

Abstract

The continuing spread of Multidrug-Resistant Tuberculosis (MDR-TB), which is defined as TB that shows resistance to both isoniazid and rifampicin, become one of the most urgent and difficult challenges in TB control. In Indonesia, the estimated total DR-TB case incidence of 24,000 or 8.8/100,000 population (2.4% of total new TB patients). The first-ever MDR-TB treatment guideline published by WHO required a long duration (up to 20–24 months) and contained toxic second-line drugs with less effective & unfavorable outcomes. About ten years ago, a short regimen lasting nine instead of 20 months, called “Bangladesh regimen”, revolutionized MDR-TB treatment. The advent of rapid molecular diagnostic tests, discoveries of new and repurposed drugs, promising results based on trials and meta-analysis had prompted WHO to update its guidelines. Notably, drugs such as bedaquiline and clofazimine are now strongly recommended for the treatment of MDR-TB. At the same time, older injectables drugs have been downgraded due to poor effectiveness and side-effect profiles. In 2019, based on the programmatic data from the shorter all-oral bedaquiline-containing regimen implemented routinely in South Africa, WHO revised its recommendations on the use of a standardized shorter regimen. Based on the analysis, WHO affirmed its conditional recommendation for the shorter all-oral bedaquiline-containing MDR -TB regimen to be offered as a treatment option to MDR -TB patients who satisfy the eligibility criteria. The implementation of this all-oral shorter regimen is expected to improve the programmatic management of the MDR-TB worldwide.
The Impact of Subchronic Soybean Milk and Genistein Supplementation on Pancreatic Fatty Infiltrations of Sprague Dawley Male Mice Sasiarini, Laksmi; Soeatmadji, Djoko Wahono; Santoso, Aktaruddin Arief
Clinical and Research Journal in Internal Medicine Vol 1, No 2 (2020): New: The Second Issue is Coming!
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.crjim.2020.001.02.4

Abstract

Isoflavones (genistein, daidzein) on soybean milk have phytoestrogenic properties. In Asia, the blood phytoestrogen levels can reach 160 ng/ml (80 times higher than Western). This may potentially disrupt endocrine functions regarding its binding with estrogen receptors.. Since the function and distribution of adipose tissues are regulated by estrogen receptors, the reduction of estrogen receptor-α(ERα) results in ectopic fats distribution around visceral tissues, such as the pancreas. Aim: To investigate the impact of subchronic soybean milk and genistein supplementation on pancreatic fatty infiltrations in mice. Methods: The experiment used 35 Sprague dawley male mice under 7 treatment groups within 60 days: negative control with standard rationed food, 3 groups with a variable dose of soybean milk: 100 mg, 200 mg, and 400 mg, and 3 groups with a variable dose of genistein: 0.4 mg, 0.8 mg, and 1.6 mg. Histological measurements on the level of pancreatic fatty infiltrations were conducted after. Analyses used Kruskal-Wallis and post-hoc Mann-Whitney. Results: Medium to a high level of pancreatic fatty infiltrations were found at the control group while there is a decreasing trend on the level of pancreatic fatty infiltrations on groups with soybean milk and subchronic genistein compared with the control group, proportional to higher dosage supplementation. The reduction of pancreatic fatty infiltration levels on groups with soybean milk and subchronic genistein supplementation is not statistically significant compared to control. Conclusion:  Supplementation of soybean milk and subchronic genistein do not significantly reduce the levels of pancreatic fatty infiltrations in Sprague dawley male mice.
Differences in Carotid Intima-Media Thickness (CIMT) In Patients With Newly Diagnosed Hypertension, and Chronic Hypertensive Patients Treated by Calcium Channel Blockers (CCB) or Angiotensin Converting Enzyme (ACE)-Inhibitors Tantri, Ni Luh; Rudijanto, Achmad; Samsu, Nur; Wursito, Wursito
Clinical and Research Journal in Internal Medicine Vol 1, No 1 (2020): New: The First Volume of Clinical and Research Journal in Internal Medicine
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.crjim.2020.001.01.2

Abstract

 Hypertension is a significant risk factor for cardiovascular diseases. It closely related to the inflammatory process and resulting in chronic inflammation, which had a critical role in the progression of atherosclerosis. Carotid Intima-Media Thickness (CIMT) was known as a surrogate marker of atherosclerosis. Anti-hypertensive drugs are expected to affect CIMT. Aim: to examine the difference CIMT between newly diagnosed hypertension and chronic hypertensive treated by ACE-I or CCB. Method: this cross-sectional study was conducted on 12 newly diagnosed hypertensive patients (control or group 1), 9 hypertensive patients treated by CCB (group 2), and 9 hypertensive patients treated by ACE-I (group 3). Their hypertensive condition was controlled at least for 6 months. We compared CIMT of patients and Tumour Necrosis Factor Alfa (TNF-α) also Interleukin-6 (IL-6) among the groups. Result: there was a significant difference in CIMT between the group 1 and 2 (0.86 vs 0.70; p = 0.027), group 1 and 3 (0.86 vs 0.69; p = 0.018). There was no significant difference between group 2 and 3 (0.70 vs 0.69; p = 0.88). There was no association between CIMT and TNF-α, IL-6, Low-Density Lipoprotein (LDL), triglycerides (TGs) levels, and body mass index (BMI), systolic blood pressure. Conclusion: we found that the CIMT of the control group was thicker than those of the treatment groups. Moreover, differences in the thickness of CIMT of the three groups were not associsted with level of TNF-α, IL-6, TG, and LDL, also BMI, and systolic blood pressure.

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