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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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Risk of Osteoporotic Fracture and Falls among Rural Residents in Malang: an Observational Study Pratama, Mirza Zaka; Suryana, Bagus Putu Putra; Putra, Domy; Putri, Rina Kurnia
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

Abstract

Background: Osteoporosis is a condition characterized by decreased bone density, which increases the risk of fractures, particularly in untreated osteoporosis and when falls occur. The incidence of falls in individuals with osteoporosis is quite high, with 1.5 million out of 34 million people experiencing it, emphasizing the need for awareness among sufferers to prevent it. Indonesia, the fourth most populous country in the world. Aim: The focus of this study is to determine the relationship between fracture risk (the Percentage Ten-Year Probability of Major Osteoporosis and hip fracture) and falls, in relation to sociodemographic and other risk factors in Malang. Methods: The study was conducted in Malang City using a cross-sectional design. A total of 153 participants were selected using purposive sampling. Results: The results showed a strong correlation between menopause status and gender with the percentage ten-year probability of major osteoporosis(p-value for menopause status: 0.007, p-value for gender: 0.008). There was also a strong relationship between age and the Percentage Ten-Year Probability of Hip Fracture (p-value: <0.001). However, no variable had a strong influence on the risk of falling based on the Ontario Modified Stratify-Sydney Scoring for Adultery (p-values: education: 0.271; age: 0.067; menarche status: 0.996; menopause: 0.724; gender: 0.996; BMI: 0.448; TUG: 0.058). Conclusion: Given the findings that show a heightened risk of fractures in older adults, women, and those experiencing menopause, the Malang government could develop policies aimed at early intervention.
Optimizing Cardiac Rehabilitation for Patients with Complex Coronary Disease without Revascularization Afifuddin, Mokhammad; Tjahjono, Cholid Tri; Mayangsari, Veny
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.2025.006.02.10

Abstract

Patients with complex coronary artery disease (CAD) ineligible for revascularization present considerable management challenges and a high ischemic burden. Cardiac rehabilitation (CR), a comprehensive, multidisciplinary intervention, emerges as an essential non-pharmacological therapy. This review synthesizes the principles of CR, focusing on its profound pathophysiological benefits in this specific cohort. Mechanistically, CR confers pleiotropic effects: it enhances endothelial function via the eNOS/NO pathway, mitigates systemic inflammation through myokine regulation, promotes coronary collateralization (HIF-1α/VEGF pathway), and restores autonomic balance (HRV). Furthermore, CR integrates essential psychosocial support to address the high prevalence of depression and anxiety, which are independent risk factors. A primary objective, the improvement of quality of life (QoL), is consistently achieved through reduced anginal symptoms and enhanced functional status. Despite robust clinical and economic evidence demonstrating CR's efficacy in reducing MACE, mortality, and healthcare utilization, significant barriers to referral and adherence persist. Vigilant supervision and protocol adaptations are mandated for high-risk anatomical subsets, such as those with chronic total occlusions or severe left ventricular dysfunction
Managing HIV/AIDS in a Vulnerable Population: A Case Study of Stigma, Treatment Access, and Socioeconomic Barriers in Indonesia Abdelkader, Amr
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.2025.006.02.15

Abstract

Introduction: HIV/AIDS remains a significant public health issue in Indonesia, with a high prevalence among vulnerable populations such as injecting drug users, men who have sex with men, and women. Despite progress in treatment accessibility, stigma and socioeconomic barriers persist. Background: Socioeconomic challenges, cultural barriers, and gaps in healthcare access continue to facilitate the spread of HIV/AIDS. The Indonesian government has made efforts to address the epidemic, but there remains a need for improved public health responses. Objective: This case study examines a specific instance of HIV/AIDS management in a vulnerable population in Indonesia, with a focus on stigma, treatment access, and socioeconomic barriers. Methods: A detailed analysis of the patient's history, diagnostic process, and treatment management was conducted. Interviews with healthcare providers, along with a review of relevant public health initiatives, were used to contextualize the case within the broader HIV/AIDS epidemic in Indonesia. Results: The patient faced significant challenges related to stigma, limited access to healthcare, and financial constraints. However, with community-based interventions and consistent access to antiretroviral therapy (ART), the patient showed positive outcomes in managing the disease]. Discussion: The case highlights the importance of addressing both medical and social factors, such as stigma and financial constraints, in managing HIV/AIDS. It also underscores the need for continued improvements in healthcare access and public health initiatives. Conclusion: Targeted interventions, such as community-based education, increased funding, and expanded ART access, are crucial in improving the quality of life for those living with HIV/AIDS in Indonesia and reducing transmission rate.
Dietary Intervention in Hypertension: Mechanisms, Efficacy, and Future Directions Tri Tjahjono, Cholid; Arthamin, Maimun; Prakosa, Ardani; Insanitaqwa, Aleyda
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.2025.006.02.12

Abstract

Hypertension significantly contributes to global cardiovascular morbidity and mortality, with diet being a key modifiable factor in its management. Evidence supports the effectiveness of dietary approaches including the Mediterranean, low-sodium, DASH, and plant-based diets in lowering blood pressure and enhancing cardiovascular health. These benefits are mediated by mechanisms including improved electrolyte balance, minimized oxidative stress, enhanced nitric oxide bioavailability, and favorable modulation of neurohormonal pathways. Despite strong evidence, long-term adherence is hindered by cultural food preferences, limited access to healthy options, and socioeconomic disparities. Emerging approaches, including personalized nutrition, digital health tools, and culturally adapted meal planning, show promise in overcoming these barriers. Additionally, recent insights into nutrient bioavailability, gut microbiota interactions, and gene-diet relationships are reshaping the future of dietary intervention strategies. To maximize impact, healthcare providers must take an active role in delivering tailored dietary guidance as part of routine hypertension care. Multidisciplinary collaboration and community engagement are critical for translating evidence into sustainable practice. Overall, emphasizing diet as a therapeutic tool offers an opportunity to shift the paradigm of hypertension management toward prevention, personalization, and long-term cardiovascular health.
Comparison of Carotid Intima-Media Thickness (CIMT) and Calcium-Phosphorus (Ca × P) Product Between Hemodialysis (HD) Patients and Continuous Ambulatory Peritoneal Dialysis (CAPD) Patients. Rosandy, Kharisma Ogit; Winoto, Eden Suryoiman; Samsu, Nur
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.2025.006.02.09

Abstract

Background: Cardiovascular disease is the leading cause of death in end-stage renal disease (ESRD). Carotid intima-media thickness (CIMT) and the calcium–phosphate (Ca × P) product are recognised surrogate markers of cardiovascular risk in dialysis recipients. Objective: This study aims to compare CIMT and Ca × P product levels between patients undergoing HD and CAPD. Methods: A cross-sectional study was conducted on 93 dialysis patients (49 HD, 44 CAPD) at Saiful Anwar General Hospital, Indonesia. Participants were over 18 years old, on dialysis for at least three months (HD at least twice weekly), and physically independent. Critically ill and pregnant patients were excluded. The Mann-Whitney U test compared CIMT and Ca × P levels, and Spearman's rank correlation analyzed the relationship between CIMT and Ca × P product Results: Significant differences in CIMT (p=0.0013) and Ca × P product (p<0.0001) were found between the HD and CAPD groups. A positive correlation between CIMT and Ca × P product was observed in HD patients compared to CAPD patients (r = 0.212, p = 0.044), Conclusion: This study revealed that CIMT was higher in HD patients compared to CAPD patients. Furthermore, the Ca × P product was lower in the CAPD group than in the HD group, and a positive correlation existed between CIMT and Ca × P in HD patients.
Correlation Between Serum Testosterone Levels and CD4 T Lymphocyte Counts in Naive HIV-Infected Men at dr. Mohammad Hoesin General Hospital Palembang Fahrenheit, Fahrenheit; Kusnadi, Yulianto; Hudari, Harun; Bahar, Erial; Shahab, Alwi; Anggraini, Ratna Maila Dewi; Permata, Mega; Salim, Nelda Aprilia; Yuniza; Bakrie, Muhammad
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.2025.006.02.07

Abstract

Background: HIV infection often leads to endocrine complications, including hypogonadism which characterized by low serum testosterone, potentially affects quality of life and contributes to metabolic issues, such as muscle weakness, depression, osteoporosis, and cardiovascular disease. Some studies have indicated a connection between testosterone levels and CD4 T lymphocyte counts.   Aim: To evaluate the correlation between total serum testosterone levels and CD4 T lymphocyte counts in naive HIV-infected men. Methods: A cross-sectional analitycal study was conducted at Dr. Mohammad Hoesin General Hospital, Palembang, from April to October 2024. Involving 64 naive HIV-infected men. Total serum testosterone and CD4 T cell counts were measured and analyzed. Results: Participants mean age is 36.52 ± 11.03 years with BMI of 19.52 ± 3.71 kg/m². Most subject (62.5%) are reported men who had sex with other men. Poor sleep quality was found in 81%, mild depressive symptoms in 38.1%, and mild erectile dysfunction in 28.6%. Hypogonadism occurred in 32.8% of subjects (28.1% secondary and 4.7% primary). Mean number of testosterone level was 446.75 ± 260.95 ng/dL, with a median CD4 count of 23.5 cells/µL. A significant positive correlation was observed between testosterone levels and CD4 counts (r = 0.313; p = 0.012) although testosterone levels did not significantly differ across HIV clinical stages (p = 0.464). Conclusion: There is a significant positive correlation between serum testosterone levels and CD4 T lymphocyte counts in naive HIV-infected men. Hormonal disturbances may arise in early infection. Hence, testosterone assessment is recommended during the initial evaluation on HIV patients.
The Effect of Fasting Blood Glucose (FBG) on Troponin I and Clinical Outcomes in Acute Coronary Syndrome (ACS) : A Retrospective Analysis: A Retrospective Observational Study Abshori, Nuril Farid; Ahdi, Iwal Reza; Kakiay, Ferdinandus Stevanus
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.2025.006.02.08

Abstract

Background: In the early phase of Acute Coronary Syndrome (ACS), simple parameters such as fasting blood glucose (FBG) and cardiac troponin I (cTnI) may provide prognostic information. However, evidence regarding their relationship remains inconsistent, particularly in the Indonesian population. Objective: To investigate the correlation and association between FBG and cTnI in patients with ACS at Karsa Husada Hospital, Batu, Indonesia. Methods: This retrospective observational study included 75 hospitalized ACS patients. Clinical and laboratory data were collected from medical records. Troponin values were log10-transformed. Statistical analyses included Spearman correlation, stepwise linear regression per 10 mg/dL increase in FBG, categorical FBG classification (<100, 100–125, ≥126 mg/dL), trend testing, and restricted cubic spline modeling. Fully adjusted models incorporated age, sex, diabetes, estimated glomerular filtration rate, systolic blood pressure, and heart rate. Results: The median age was 62 years, and 64% were male. FBG showed a weak, non-significant correlation with cTnI (rₛ = 0.19; p = 0.12). After adjustment, each 10 mg/dL increase in FBG was associated with an 8.6% higher cTnI level (β = 0.036; 95% CI −4.5% to +23.6%; p = 0.20). Compared with normal FBG, hyperglycemia (≥126 mg/dL) was associated with a 50.6% higher cTnI level, although this was not statistically significant (p = 0.60), and no significant linear trend was observed (p-trend = 0.55). Spline analysis revealed no significant non-linearity (p = 0.72), and no interaction by diabetes status (p = 0.67). Conclusion: In this ACS population, higher FBG tended to be associated with higher cTnI levels; however, the relationship attenuated and lost significance after adjustment. FBG may serve as an additional risk marker rather than a primary determinant of myocardial injury in the early phase. Keywords: fasting blood glucose, troponin I, acute coronary syndrome, hyperglycemia
HIV at the Crossroads: Addressing Stigma, Early Immunologic Markers, and Coinfection Burden in Indonesia Rosandi, Rulli
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.2025.006.02.01

Abstract

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