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Jurnal Penyakit Dalam Indonesia
Published by Universitas Indonesia
ISSN : 24068969     EISSN : 25490621     DOI : https://doi.org/10.7454/
Core Subject : Health,
Medicine & Pharmacology
Jurnal Penyakit Dalam Indonesia contains the publication of scientific papers that can fulfill the purpose of publishing this journal, which is to disseminate original articles, case reports, evidence-based case reports, and literature reviews in the field of internal medicine for internal medicine and general practitioners throughout Indonesia. Articles should provide new information, attract interest and be able to broaden practitioners insights in the field of internal medicine, as well as provide alternative solutions to problems, diagnosis, therapy, and prevention.
Arjuna Subject : Kedokteran - Kedokteran Internal
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Search results for , issue "vol. 12, no. 2" : 9 Documents clear
Mortalitas pada Pasien Hemodialisis: Masih Menjadi Tantangan Globa Khumaedi, Anandhara Indriani Indriani; Elita, Dina
Jurnal Penyakit Dalam Indonesia Vol. 12, No. 2
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Faktor-Faktor yang Berhubungan dengan Massa Otot, Kekuatan Otot, dan Performa Fisik pada Lansia Riviati, Nur; Indrajaya, Taufik; Chodilawati, Rukiah; Dibyantari, Ridzqie; Indra, Bima
Jurnal Penyakit Dalam Indonesia Vol. 12, No. 2
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Introduction. Despite its high prevalence and significant impact on health, comprehensive studies are still needed to explore the factors affecting sarcopenia parameters, such as muscle mass, muscle strength, and physical performance. This study aimed to identify the factors influencing sarcopenia parameters in the elderly, including muscle mass, muscle strength, and physical performance. Methods. A cross-sectional study was conducted from July to December 2022 on elderly individuals (>60 years old) at the Geriatric Polyclinic, Moh. Hoesin General Hospital, Palembang, selected through consecutive sampling. Muscle mass was measured using bioimpedance analysis, expressed in ASMI values; muscle strength was measured using a handheld dynamometer; and physical performance was assessed using the five-time sit-to-stand test. The SARC-F score was classified as normal (<4) and abnormal (≥4). Data on age, gender, serum albumin levels, comorbidities, and Mini Nutritional Assessment Short Form (MNA-SF) scores were collected for correlation analysis and comparison with muscle mass, muscle strength, and physical performance. Results. Of the 41 subjects, the average age was 70.75 (SD 7) years, with 56.1% being female. All subjects had low muscle mass, with an average ASMI of 3.31 (SD 0.59) kg/m² in females and 4.89 (SD 1.06) kg/m² in males. The average muscle strength for females was 16.9 (SD 6.1) kg and for males 27.5 (SD 8.3) kg. The five-time sit-to-stand test result for females was 24.2 (SD 14.2) seconds and for males, 21.8 (SD 11.1) seconds. Based on SARC-F, 8 subjects (19.5%) were categorized as at risk for sarcopenia. Serum albumin levels for all subjects were within the normal range [4.3 (SD 0.3) g/dl]. Malnutrition was found in 14 subjects (34.1%) according to the MNA-SF results. Comorbidities were present in 35 patients. Statistical analysis showed a significant correlation between serum albumin levels and muscle strength (r=0.35; p=0.005) and physical performance (r=-0.5; p<0.001). Nutritional status had no significant effect on the three parameters, but it did significantly affect muscle mass in elderly males (p=0.002). Comorbidities, including cardiovascular disease, non-insulin-dependent diabetes mellitus, and musculoskeletal disorders, were not significantly related to any of the sarcopenia parameters. Conclusions. Serum albumin is significantly associated with muscle strength and physical performance, while nutritional status is significantly associated with muscle mass in elderly males. Comorbidities were not significantly related to muscle mass, muscle strength, or physical performance in the elderly.
Gejala Neuropsikiatri Pasien HIV Setelah Menjalani Transisi Antiretrovirus Nevirapin ke Dolutegravir di Rumah Sakit Cipto Mangunkusumo, Jakarta Pratama, Metra Adi; Putranto, Rudi; Herqutanto, Herqutanto; Syahrani, Aisyah; Hapsari, Aljira Fitya; Natali, Veritea; Pane, Meivina Ramadhani; Yunihastuti, Evy
Jurnal Penyakit Dalam Indonesia Vol. 12, No. 2
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Introduction. Dolutegravir (DTG) is one of the effective antiretroviral therapies (ART) for suppressing HIV replication and has a favorable safety profile. However, reports regarding neuropsychiatric side effects, especially in patients transitioning from a nevirapine (NVP) regimen to dolutegravir, have started to emerge. This study aimed to describe the changes in neuropsychiatric symptoms before and after the transition from a NVP-based ARV regimen to DTG in HIV patients at Cipto Mangunkusumo Hospital (RSCM), Jakarta. Methods. This study employed a prospective cohort design involving 292 HIV patients at Cipto Mangunkusumo Hospital who were transitioning from NVP to DTG regimen. Participants were monitored for six months, and neuropsychiatric symptoms were assessed using a modified HIV symptom index (mHSI). Data collection was conducted at the beginning of the transition (baseline) and during follow-up through interviews regarding HIV-related symptoms and ART. Results. At the start of the study, 70.2% of participants reported at least one neuropsychiatric symptom, which increased to 80.1% after 6 months of transitioning to TLD. The most commonly reported symptoms were insomnia, headaches, and anxiety, with women reporting more symptoms than men. Statistical analysis showed a significant increase in symptoms of sadness, headaches, and irritability (p < 0.01) after the transition to dtg. Conclusions. Although DTG shows good viral suppression capabilities, significant neuropsychiatric side effects still arose, especially in patients with a history of mental disorders. Close monitoring of neuropsychiatric symptoms and adjustments to the ART regimen need to be carried out to improve the quality of life for HIV patients undergoing DTG therapy.
Peran Prediktif IL-6, IL-10, dan TNF-α Plasma terhadap Gagal Ginjal Akut pada Pasien dengan COVID-19 Derajat Sedang dan Berat Gathmyr, Dewi; Bonar, Maruhum Bonar H; Susilo, Adityo; Harimurti, Kuntjoro; Nainggolan, Ginova; Tagor, Alvin; Shatri, Hamzah; Lesmana, Cosmas Rinaldi Adithya; Amin, Zulkifli
Jurnal Penyakit Dalam Indonesia Vol. 12, No. 2
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Introduction. Acute kidney injury (AKI) is associated with higher mortality rate in COVID-19 patients due to inflammation and immune dysregulation. This study aimed to correlate serum levels of IL-6, IL-10, and TNF-α with serum creatinine changes and their roles to predict incidence of acute kidney injury (AKI) in patients with moderate and severe COVID-19. Methods. This prospective cohort study was conducted among patients with moderate to severe COVID-19 in Pertamina Central Hospital Jakarta, Indonesia during November 2020 to January 2021. All serum levels of cytokines (IL-6, IL-10, and TNF-α) and creatinine were collected on the first day and seventh day of hospitalization. They might be collected earlier if the patients died or discharged early. AKI was defined as deterioration in serum creatinine or urine output based on Kidney Disease Improving Global Outcomes (KDIGO) guideline. The correlation between cytokine and creatinine serum level changes were analyzed using Spearman test. Receiver operator characteristic curve was calculated to explore predictive roles of cytokines on AKI incidence. Results. A total of 43 patients were included in the study, with a mean age of 59.3 years (SD 12.59), and the majority were male (74%). The incidence of AKI was 7%. Serum creatinine changes were correlated with serum levels changes IL-10 (r= -0.343; p=0.024), but not for IL-6 (r=-0.198; p=0.202) and TNF-α (r=-0.129, p=0.409). Meanwhile, serum TNF-α level on the first day was able to predict AKI incidence on the seventh day of hospitalization (AUC 85%; p=0.045; 95% CI=0.737 to 0.963). Conclusions. TNF-α on the first day is potential to be predictor on AKI incidence on the seventh day in moderate and severe COVID-19 patients.
Korelasi Stenosis Penyakit Arteri Perifer di Bawah Lutut dengan Kecepatan Hantar Saraf pada Penyandang Neuropati Perifer Diabetes Melitus Tipe 2 Antono, Akbarbudhi; Antono, Dono; Karim, Birry; Hakim, Manfaluthy; Harimurti, Kuntjoro; Sulistianingsih, Dyah Purnamasari; Ginanjar, Eka; Nelwan, Erni Juwita; Nugroho, Pringgodigdo
Jurnal Penyakit Dalam Indonesia Vol. 12, No. 2
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Introduction. One consequence of DM is the emergence of peripheral artery disease (PAD) and diabetic peripheral neuropathy (DPN). Diabetic peripheral neuropathy is a complication of diabetes that presents signs and symptoms of motor and sensory disturbances, while PAD is an atherosclerosis condition that gradually develops in the arterial vessels. This study aimed to determine correlation of arterial obstruction assessed using arteriography and the nerve impairment assessed using nerve conduction velocity (NCV) in DM patients with PAD and DPN. Methods. This is a cross-sectional study that takes secondary data from previous research conducted from July 2018 to June 2021 in Cipto Mangunkusumo hospital. Subjects were people with DM type 2 who had NPD and PAP who met the inclusion criteria and did not meet the exclusion criteria. Subjects underwent an arteriography examination to assess the stenosis in the peroneal artery, anterior tibial artery, and posterior tibial artery. Subjects also underwent nerve conduction velocity (NCV) examinations in the peroneal N. communis, N. peroneal superficialis, N. tibialis, and N. suralis. The correlation between the two variables was then tested using the Spearman correlation test. Results. The peroneal artery stenosis had a moderate negative correlation (r = - 0.420) with the sensory NCV of the superficial peroneal nerve which was statistically significant (p = 0.023). Meanwhile, the correlation of stenosis and NCV disorders in the peroneal nerve with the common peroneal nerve, anterior tibial nerve with tibialis nerve and posterior tibial nerve with sural nerve was not statistically significant. This can be explained by the possibility of collaterals appearing in people with PAD, the structure of vasculature on the nerves, and the small number of samples. Conclusions. There is a moderate negative correlation between the stenosis of the peroneal nerve and the sensory NCV of the peroneal superficialis. However, insignificant results were found in the correlation between peroneal artery with common peroneal nerve, anterior tibialis artery with tibial nerve, and posterior tibial artery with sural nerve.
Laporan Kasus Hipokalemi Periodik Paralisis pada Pasien dengan Graves’ Disease Sirait, Anggi Cahaya Millenia S; Buharman, Borries Foresto; Putri, Adinda Zhafira Dyanti; Putri, Derby Ayudhia Utami Iskandar
Jurnal Penyakit Dalam Indonesia Vol. 12, No. 2
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Hypokalemia periodic paralysis (HPP) characterized by episodes of flaccid weakness or paralysis that may be associated with abnormalities of the serum potassium level. HPP often associated with hyperthyroidism and Graves’ disease. HPP prevalence is 1 in 100.000. Each individual has different clinical manifestations, so it’s necessary to adjust therapy based on the etiology. This case report was developed to provide more information regarding Graves’ disease, considering lack of information about management and description of HPP with Graves’ disease. A 27-year-old male with sudden weakness in both legs radiating to upper extremity, shortness of breath, palpitations, and sweating. Over the last 2 months, the patient’s weight has dropped drastically even though his appetite was increased. There were no complaints of nausea, vomiting, or increased frequency of defecation and urination. Previously, the patient had the similar experiences and received potassium transfusion twice. The patients revealed tachycardia, diffuse thyroid gland, fine hand tremor, superior motor streght 222/222 and inferior 111/111, hypokalemia (1.40 mmol/L), T4 total 197.80 nmol/L, and fluorescence T4 >320 m/U/mL. Graves’ disease that has become thyrotoxicosis can be accompanied by a picture of HPP or also called thyrotoxicosis periodic paralysis (TPP). Hypokalemia in TPP are not caused by potassium loss but due to intracellular potassium movement, so there’s a high possibility to hyperkalemia rebound. Treatment of TTP due to Grave’s disease is to prevent potassium transfer by administering beta blocker, potassium replacement, and treating hyperthyroidism.
Pemberian Asupan Kalori Terestriksi vs. Asupan Kalori Standar yang Berlanjut pada Pasien Penyakit Kritis dengan Refeeding Syndrome: Laporan Kasus Berbasis Bukti Hapsari, Sukma; Pribadi, Rabbinu Rangga
Jurnal Penyakit Dalam Indonesia Vol. 12, No. 2
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Refeeding syndrome is a different clinical symptom and metabolic disorder that occur during the reintroduction of nutrition in chronically malnourished patients. Calorie restriction can increase survival and reduce mortality rates. This evidence-based case report was developed to examine the influence of caloric restriction on mortality, morbidity, and duration of critical illness. A literature search was performed using PubMed, EBSCOHost, ScienceDirect, and Cochrane with the keywords: “critically ill,” “restricted caloric intake,” “standard caloric intake,” “mortality,” “morbidity,” and “duration”. Articles were appraised using the University of Oxford Centre for Evidence-Based Medicine (CEBM) tools. Two studies met the inclusion criteria. The first was a randomized controlled trial, which demonstrated that protocolized caloric restriction significantly improved 60-day survival in ICU patients with refeeding syndrome (91% vs. 78%, p = 0.002), although no significant difference was observed in days alive following ICU discharge (44.8 vs. 39.9 days, p = 0.19). The second was a meta-analysis, which suggested a trend toward reduced hospital mortality with hypocaloric feeding; however, risk ratios varied widely (0.23–5.54), and 30-day mortality differences were not statistically significant (RR: 0.79–3.00). In conclusion, while caloric restriction may not significantly impact overall mortality in chronically ill patients, it appears to improve 60- to 90-day survival in critically ill ICU patients with refeeding syndrome. One study noted a reduced risk of respiratory infection, though evidence on other complications remains inconclusive. A regimen of 20 kcal/hour for at least two days may be suitable for managing refeeding syndrome. Overall, caloric restriction may offer modest clinical benefits in this specific population.
Tata Laksana Fraktur Panggul pada Geriatri: Sudut Pandang Internis Jannah, Laila M; Dwimartutie, Noto
Jurnal Penyakit Dalam Indonesia Vol. 12, No. 2
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Hip fracture are a common issue in geriatric patients, associated with increased risk of morbidity and mortality. The complex and multimorbid characteristics of geriatric patients presents significant challenge in their management. Optimal outcomes require a comprehensive interdisciplinary approach to care, aiming to restore functional status and reduce postoperative complications. A holistic strategy, grounded in thorough Comprehensive Geriatric Assessment (CGA), is essential to guide individualized treatment and ensure effective, patient-centered management.
Faktor Risiko yang Berhubungan dengan Kematian Pasien Penyakit Ginjal Kronis pada Usia Dewasa yang Menjalani Hemodialisis Reguler di Provinsi Lampung Latupeirissa, Joue Abraham Trixie; Sudaryo, Mondastri Korib; Hadiaturahman, Muhamad Zulfikar; Sinaga, Steven Sapta Putra
Jurnal Penyakit Dalam Indonesia Vol. 12, No. 2
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Introduction. Although mortality among adult chronic kidney disease (CKD) patients on regular hemodialysis remains infrequent within the first three months, it is still a potential outcome. Given that hemodialysis is required for life, identifying risk factors for mortality is critical. This study aims to examine risk factors associated with mortality in adult CKD patients undergoing regular hemodialysis. Methods. A case-control study, without matching, was conducted using medical record data from adult CKD patients (≥18 years) receiving regular hemodialysis between 2022 and 2024 at three hospitals (types A, B, and C) in Lampung Province. The case group consisted of patients who experienced mortality, while the control group consisted of similar patients who survived. Patients with autoimmune-related CKD were excluded. Subjects were selected using convenience sampling with a 1:2 case-to-control ratio. Risk factors assessed included sociodemographics, dialysis duration, comorbidities, and nutritional status. Logistic regression analysis was performed. Results. A total of 114 cases and 228 controls were included, with the longest dialysis duration in both groups being 72 months. The oldest patient starting dialysis was 77 years in the case group and 75 years in the control group. Logistic regression analysis revealed that the following factors were associated with increased mortality: history of heart failure (OR = 2.3; 95% CI = 1.2–4.4; p = 0.009), history of post-renal obstruction (OR = 3.5; 95% CI = 1.6–7.6; p = 0.002), random blood glucose ≥140 mg/dL (OR = 2.1; 95% CI = 1.2–3.6; p = 0.011), acute kidney injury (OR = 6.5; 95% CI = 3.8–11.1; p < 0.001), and BMI Conclusion. History of heart failure, post-renal obstruction, elevated blood glucose, acute kidney injury, and low BMI are significant predictors of mortality in adult CKD patients undergoing regular hemodialysis in Lampung Province.

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