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Nur Samsu
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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
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CRJIM (Clinical and Research Journal in Internal Medicine)
Published by Universitas Brawijaya
ISSN : 27235130     EISSN : 27235122     DOI : https://doi.org/10.21776/ub.crjim
Core Subject : Health, Science, Education,
Education Health Professions Immunology & microbiology Medicine & Pharmacology Nursing Public Health Other
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.
Arjuna Subject : Kedokteran - Kedokteran Internal
Articles 108 Documents
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Agranulocytosis Induced by Antithyroid Drug (Propiltyourasil): A Rare Case Ferdiana , Asihanti; Nyoman Satvika Dharma Yudha; Laksmi Sasiarini; Rulli Rosandi; Rinadhi Reza Bramantya
Clinical and Research Journal in Internal Medicine Vol. 6 No. 1 (2025): Volume 6 No 1, May 2025
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.crjim.2025.006.01.15

Abstract

Antithyroid drugs can cause agranulocytosis in 0.2-0.5% of cases of Graves' disease, which can be life-threatening. Although rare, prompt management is crucial for a good outcome. A 41-year-old woman presented to the emergency department in March 2023 with complaints of fever, odynophagia, cough, nausea, vomiting, and weight loss. She had been diagnosed with hyperthyroidism in 2015 and was prescribed thiamazole 5mg once daily. She was declared cured in 2018. In February 2023, she was hospitalized for heart failure and diagnosed with Graves' disease. She was discharged with PTU 100mg three times daily. After two weeks of PTU treatment, the patient developed symptoms of agranulocytosis. Laboratory tests showed low white blood cell count and abnormal thyroid function. PTU therapy was discontinued, and the patient was treated with SC GCSF 300mg once daily, IV Ceftriaxone 1g twice daily, IV Ciprofloxacin 400mg twice daily, PO Propranolol 40mg three times daily with a target heart rate <90 beats per minute, and PO Thiamazole 5mg once daily initiation again because there is no side efect at previous medication with the same regiment and the alternative treatment such as iodine radioactive and surgery did not perform yet. Although initially the ANC was low, the patient's condition improved, and she was discharged after 13 days of treatment with normal laboratory results. Follow-up outpatient monitoring showed continued improvement. Accurate diagnosis and appropriate management are crucial in handling agranulocytosis induced by antithyroid drugs, which can significantly improve treatment outcomes and the patient's prognosis.
Interesting Case of Acute Lung Oedema Complication of Dengue Hemorrhagic Fever-Hypercoagulability: Interesting Case of Acute Lung Oedema Complication of Dengue Hemorrhagic Fever-Hypercoagulability Abshori, Nuril Farid; Kakay, Ferdinandus Stevanus; Ahdi, Iwal Reza
Clinical and Research Journal in Internal Medicine Vol. 6 No. 1 (2025): Volume 6 No 1, May 2025
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.crjim.2025.006.01.11

Abstract

A B S T R A C T Background: Diagnosis and management of dengue hemorrhagic fever (DHF) can be challenging with confounding complications. Important confounding factors are conditions that alter hematologic parameters and prognosis of infection. We report a case of a patient with a positive DHF IgG result and hypercoagulation leading to Acute Lung Oedema (ALO), a serious condition with risk of respiratory failure leading to death. This is the first case to highlight the unique set of diagnostic and therapeutic challenges of DHF in this context. Case Presentation: A twenty-seven-year-old man presented with suspected DHF with thrombocytopenia and hypoalbumin. Pharmacologic and fluid therapy were optimal. However, the patient suddenly developed dyspnea leading to respiratory failure and had to be admitted to the intensive care unit. The patient also had severe infection as evidenced by D-dimer > 5,000 ng/ml and pulmonary edema, one of which was due to pulmonary embolism. This requires appropriate and rapid treatment, considering the patient is in critical condition. Conclusion: This patient faced two diagnostic challenges: the diagnosis of dengue fever with positive DHF IgG but with different clinical manifestations and the diagnosis of hypercoagulation related to pulmonary embolism. There were two therapeutic difficulties: that of balancing the risks and benefits of administering anticoagulants and steroids in a pulmonary embolism patient with DHF. As decisions in such cases are patient-specific, sharing individual experiences will help guide future therapeutic management decisions. Keywords: Acute Lung Oedema (ALO), Dengue Hemorrhagic Fever (DHF), Hypercoagulation
Cardiovascular Disease Risk Prediction Models: Limitations and Future Prospects Samsu, Nur
Clinical and Research Journal in Internal Medicine Vol. 6 No. 1 (2025): Volume 6 No 1, May 2025
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.crjim.2025.006.01.01

Abstract

Prevalence, Antibiotics Sensitivity & Resistance Pattern of Staphylococcus Aureus in Urinary Tract Infections-an experience from semi-urban community of India. Dhamija, Sakshi; Hora, Shilpi; Arora, Ekal; Arora, Sonalika
Clinical and Research Journal in Internal Medicine Vol. 6 No. 2 (2025): Volume 6 No 2, November 2025
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.crjim.2025.006.02.03

Abstract

Background: The urinary tract infections (UTIs) are one of the commonest infections, leading to health centre visits worldwide and in India. Staphylococcus aureus, initially was a lesser-known cause of urinary tract infection, though incidence and prevalence are rising with time and so did the use of antibiotics to treat these infections. The antibiotics pattern to treat these infections too have changed overtime due to both host and pathogen evolutionary variations. Aim: We have therefore conducted a retrospective hospital-based study, at Jhalawar Medical college, Rajasthan, India in order to understand the antibiotic sensitivity and resistance pattern of staphylococcus aureus strain, currently prevailing in our area and also calculated its prevalence in patients suffering from urinary tract infections. Material & Methods: The Mid-stream urine samples were collected from the patients using aseptic techniques, and culture and sensitivity was done using standard microbiological methods like disc diffusion and broth dilution techniques. The sensitivity pattern of staphylococcus aureus was recorded among the positive urine culture samples. Results: In our study, a total of 2703 patients urine cultures were included, and out of these 296 (10.95%) samples grew some Uro-pathogens. Out of these 296 urine cultures, 48 (16.21%) were positive for staphylococcus aureus. From these 48, there were 2 (4.16%), strains, found to have vancomycin resistance. The methicillin resistant staphylococcus aureus was found in 3 (6.25%) of urine culture samples. Conclusion: The staphylococcus aures strain, that was found resistant to five or more antibiotics were labelled as multi drug resistant pathogen. Commonly used antibiotics like cotrimoxazole, gentamycin, norfloxacin, cephalexin, ciprofloxacin, showed resistance to treat this staphylococcus aureus strain. Due to rising resistant strains, we need to devise new antibiotics use strategy and modes to conquer this challenge. Keywords- Staphylococcus aureus, Antibiotic Sensitivity, Resistance pattern, Semi-Urban, UTI
Gender Disparities in Health-Related Behaviors: A Comprehensive Analysis of Smoking, Alcohol Consumption, Physical Activity, Nutrition, and Blood Pressure Odeigah, Louis O.; Olalekan, Agede O.; Ogunjemilua, Sunday B.; Oyedepo, Dapo S.; Okoro, Peace N.; Sanni, Nasiru
Clinical and Research Journal in Internal Medicine Vol. 6 No. 2 (2025): Volume 6 No 2, November 2025
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.crjim.2025.006.02.02

Abstract

Background: Gender disparities in health-related behaviors have significant implications for public health interventions. Aim: This comprehensive analysis aims to explore variations in smoking, alcohol consumption, physical activity, nutrition, and blood pressure between genders. Methods: In the Inter-University Consortium for Political and Social Research Study (ICPSR146521), data that had been gathered prospectively were used to assess the prevalence of metabolic syndrome, its risk factors, and the linked lifestyle in adult Myanmar inhabitants. Results: The study revealed noteworthy gender disparities in various health-related behaviors. Among passive smokers, no significant gender differences were observed. However, in active smokers, males exhibited notably higher rates than females. In the category of individuals who had never smoked, females predominated. For past smokers, females were more likely to have quit smoking successfully. Concerning alcohol consumption, males reported higher rates of past and current drinking, while females were more likely never to have consumed alcohol. Regarding physical activity, females were less likely to engage in exercise activities. Sedentary lifestyle patterns showed no significant gender differences. Conclusion: This analysis underscores the importance of recognizing gender-specific health-related behaviors and their implications. Understanding these differences is essential for tailoring effective public health strategies that address the unique needs and challenges faced by each gender. By acknowledging and addressing these disparities, healthcare providers and policymakers can develop more targeted interventions to promote healthy behaviors and reduce health inequalities. These findings provide a valuable foundation for further research and the development of gender-sensitive public health initiatives.
The Acute respiratory distress syndrome in clinical tuberculosis patients with ventricular extrasystole: The Acute respiratory distress syndrome as complication clinical tuberculosis patients Yahya, Moh. Yahya Al-Hilal; Putra, Mega Memory Rahasa
Clinical and Research Journal in Internal Medicine Vol. 6 No. 2 (2025): Volume 6 No 2, November 2025
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.crjim.2025.006.02.13

Abstract

Tuberculosis (TB) is a global health issue that can lead to severe pulmonary damage and systemic complications. Ventricular extrasystole, a type of arrhythmia, is not commonly associated with TB. A 25-year-old female with a history of pulmonary TB was admitted to the intensive care unit with severe dyspnea, cough, and fever. The patient was diagnosed with ARDS and found to have ventricular extrasystoles on the electrocardiogram (ECG). The patient was managed with a multidisciplinary approach that included mechanical ventilation, initiation of anti-tubercular therapy, and anti-arrhythmic medications. The management strategy focused on stabilizing the patient's respiratory and cardiac status while treating the underlying TB infection. The patient was discharged after 5 days of hospitalization and continued the anti-TB regimen.
Evaluation Therapy with RPR and VDRL Indicators in Patients with Late Latent Syphilis Coinfected Human Immunodeficiency Virus and Hepatitis B Sari, Arista Putri Rakhmana; Lita, Setyowatie
Clinical and Research Journal in Internal Medicine Vol. 6 No. 2 (2025): Volume 6 No 2, November 2025
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.crjim.2025.006.02.14

Abstract

Syphilis is treatable sexually transmitted infection caused by Treponema pallidum. "Late latent syphilis" is a term used to describe syphilis that shows serologic reactivity without any symptoms >1 year's duration. Both treponemal and non-treponemal laboratory serological tests are necessary for the diagnosis of syphilis. Hepatitis B and Hepatitis C share the same transmission routes as syphilis. The coinfection of HIV and HBV infection is a critical clinical concern, affect the choice of appropriate medications to minimize side effects and prevent severe complications due to the high rate of serological failure. A case was reported in 22-year-old male with RPR titer at 1:128 and reactive rapid TP test, who had history of a painless genital ulcer that healed spontaneously about a year ago. The patient also complained yellowing of the eyes and tea-colored urine, ocular examination showed icteric sclera. Laboratory tests indicated elevated transaminase levels, hyperbilirubinemia, reactive HBsAg result, and reactive anti-HIV test with CD4 count of 363. Consequently, the patient was diagnosed with late latent syphilis, newly diagnosed HIV stage I, and hepatitis B. Following treatment, the serological results showed a decrease in the VDRL titer. While both VDRL and RPR tests are valid, their quantitative results cannot be directly compared due to methodological differences and RPR titers slightly higher than VDRL titers.
Validity and Reliability of Renal Dialysis Patient Dependency Classification (RDPDC) in Indonesian to Assess Dialysis Dependency in Patients Undergoing Dialysis for Chronic Kidney Disease Setyabudhi, Verina; Rifai, Achmad; Satiti, Ika Ayu Dewi; Sagala, Ida Meita
Clinical and Research Journal in Internal Medicine Vol. 6 No. 2 (2025): Volume 6 No 2, November 2025
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.crjim.2025.006.02.05

Abstract

Background: Patients with chronic kidney disease (CKD) are at risk of becoming more dependent on dialysis, which can be caused by a variety of risk factors, including physical, psychological, social, dialysis access, and medical factors. As a result, it is critical to raise awareness of this issue by using the Renal Dialysis Patient Dependency Classification (RDPDC) score tool to assess dialysis dependency in CKD patients. Aim: The purpose of this study was to determine the reliability and validity of the RDPDC scoring tool in its translated form. Methods: The RDPDC scoring tool was used to evaluate 40 CKD patients on dialysis. The assessment was carried out utilizing the Indonesian version of RDPDC. The questionnaire's reliability and validity were assessed using Cronbach's Alpha (CA) and the Pearson Validity Test. Each item's reliability was also assessed using the corrected item-total correlation. The scale is dependable if its CA value is more than 0.6 and valid if its r-value exceeds the expected r on Pearson's table. Results: The assessment tool was deemed reliable based on the CA values of both respondent groups: 0.820 for hemodialysis (HD) and 0.673 for continuous ambulatory peritoneal dialysis (CAPD). All aspects measured by RDPDC were also deemed reliable with a significance level <0.05. Pearson's validity test showed that the translated RDPDC was valid for all aspects examined, with a significance value <0.05. Conclusion: The translated RDPDC is a valid and reliable instrument for determining dialysis dependency in CKD patients undergoing regular dialysis.
Pulmonary Hypertension In Chronic Renal Failure Rifa'i, Achmad; Setiadi, Satya
Clinical and Research Journal in Internal Medicine Vol. 6 No. 2 (2025): Volume 6 No 2, November 2025
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.crjim.2025.006.02.11

Abstract

Chronic kidney disease affects more than 10% of the global population, with prevalence of 14.8% in the USA and 10.8% in Asia. The disease has more prevalence in older age individuals, women, and those with diabetes and high blood pressure, who are also at a higher risk of developing heart disease. Pulmonary hypertension is condition that occurs when the pressure in the pulmonary artery rises more than 20 mm hg. The occurrence rate of the condition is approximately 35% to 38% among hemodialysis patients and 12% to 36% among external peritoneal dialysis patients. Research indicates that a majority of individuals with chronic kidney disease also experience pulmonary hypertension. This is particularly true for individuals undergoing dialysis. The exact etiology of pulmonary hypertension in these individuals especially in ESRD is unknown, but there are numerous factors that can lead to the development of this condition. The writer want to examine the connection between pulmonary hypertension and chronic renal failure, paying particular attention to the underlying pathological mechanisms.
Assessing Knowledge of Systemic Lupus Erythematosus Among Patients and Caregivers Insights from a Qualitative Inquiry Pratama, Mirza Zaka; Handono, Kusworini; Wahono, Cesarius Singgih; Rahman, Perdana Aditya; Wulandari, Dessy
Clinical and Research Journal in Internal Medicine Vol. 6 No. 2 (2025): Volume 6 No 2, November 2025
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.crjim.2025.006.02.04

Abstract

Background: Systemic Lupus Erythematosus (SLE) is a complex autoimmune disease requiring comprehensive patient knowledge for effective management. However, gaps in understanding and educational challenges persist among patients and caregivers. Aim: This study aimed to explore the knowledge, perceptions, and educational needs of SLE patients and their caregivers through a qualitative approach. Methods: Semi-structured interviews and focus group discussions were conducted with 15 patients and 10 caregivers from rheumatology clinics at Saiful Anwar General Hospital. Participants were selected using purposive sampling. Data were analyzed using thematic analysis, identifying key themes related to understanding of SLE, sources of information, knowledge gaps, and educational needs. Results: Participants demonstrated a basic understanding of SLE, but significant misconceptions were identified, particularly regarding the disease's multi-systemic impact. Healthcare providers were the primary source of information, though time constraints limited the depth of understanding. Patients and caregivers frequently turned to online sources, encountering challenges in identifying reliable information. Complex medical terminology and the emotional burden of SLE management were significant barriers. There was a clear preference for simplified, visual educational materials and a need for ongoing, continuous education and support. Conclusion: The study highlights persistent knowledge gaps and the need for enhanced educational strategies tailored to the needs of SLE patients and caregivers. Improving communication, providing reliable resources, and offering continuous education could significantly improve disease management and patient outcomes.

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