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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
Articles 9 Documents
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Search results for , issue "vol. 12, no. 3" : 9 Documents clear
Hubungan Frailty dengan Kesintasan Satu Tahun pada Pasien Lanjut Usia dengan Tumor Padat Ganas Stadium Lanjut Satrio, Trian; Rizka, Aulia; Prasetyawaty, Findy; Widhani, Alvina; Dwimartutie, Noto; Anggoro, RM Suryo; Yulianti, Mira; Antono, Dono
Jurnal Penyakit Dalam Indonesia Vol. 12, No. 3
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Introduction. Frailty is characterized by a multisystem physiological decline that increases the risk of morbidity and mortality, especially in patients with advanced-stage solid malignancies. The association between frailty and one-year survival in older adults with solid malignancies in Indonesia has not yet been established. This study aimed to assess the association between frailty status and one-year survival in elderly patients with advanced-stage solid tumors. Methods. This was a retrospective cohort study conducted at Dr. Cipto Mangunkusumo National General Hospital, Jakarta utilizing patient data from a previous study conducted between November 2020 and 2021. Subjects were cancer patients aged >60 years with advanced-stage solid tumors. Frailty was assessed using the FRAIL scale, and one-year survival was determined through medical records and direct follow-up confirmation. Data analysis included bivariate tests, Kaplan-Meier survival analysis, log-rank test, and multivariate Cox regression. Results. A total of 106 elderly patients with advanced solid tumors were analyzed, with a frailty prevalence of 41.5%. A total of 44.3% of patients died within one year. Multivariate analysis showed that frailty was a significant independent predictor of survival. Frail patients had a 2.131 times higher risk of death. Other factors such as nutritional status, polypharmacy, and comorbidities were not significant. Conclusion. Frailty was identified as a significant independent predictor of reduced one-year survival in elderly patients with advanced-stage cancer.
Hubungan Visceral Adiposity Index dengan Neuropati Diabetik Perifer pada Pasien Diabetes Melitus Tipe 2 Sanusi, Muhammad Arif; Lubis, Dian Anindita; Syafril, Santi
Jurnal Penyakit Dalam Indonesia Vol. 12, No. 3
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Introduction. Type 2 diabetes mellitus (T2DM) is the leading metabolic disease in Indonesia. Diabetic peripheral neuropathy (DPN), a major complication of T2DM, was associated with insulin resistance and adipose dysfunction. Visceral adiposity index (VAI) is a tool to measure visceral fat as the indicator of adipose dysfunction and insulin sensitivity. The association between VAI and DPN has not been widely researched, especially in Indonesia. This study aims to assess the association between them. Methods. This was a cross-sectional study conducted on adult patients (aged ≥18 years) with T2DM at H. Adam Malik General Hospital, Medan, from December 2024 to March 2025. DPN was assessed using the Michigan Neuropathy Screening Instrument (MNSI), consisting of a questionnaire (MNSI A) and physical examination (MNSI B). VAI was calculated using waist circumference, body mass index (BMI), triglyceride level, and high-density lipoprotein (HDL) cholesterol level. A bivariate analysis was conducted to compare mean VAI values between patients with and without DPN and to assess correlations between VAI and MNSI scores. Results. From a total of 80 subjects, the average age was 56 years (SD 9), and the majority were female (56.3%). The median VAI value in the DPN group was 2.863 (0.401–11.665), slightly higher than in the non-DPN group, which was 2.549 (0.781–17.414), but the difference was not statistically significant (p=0.34). No statistically significant correlation was found between VAI and MNSI A score (r=0.092; p=0.42) or MNSI B score (r=0.12; p=0.31). Conclusion. There was no significant association between VAI and DPN in patients with T2DM.
Hubungan Hiperurisemia dengan Penurunan LFG pada Pasien Penyakit Ginjal Diabetes di RSCM Jakarta Adna, Rury Maharani; Marbun, Maruhum Bonar Hasiholan; Rinaldi, Ikhwan; Yunir, Em; Koesnoe, Sukamto; Singh, Gurmeet; Sinto, Robert
Jurnal Penyakit Dalam Indonesia Vol. 12, No. 3
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Introduction. Elevated serum uric acid levels are associated with the progression of kidney disease in patients with type 2 diabetes mellitus (DM), through mechanisms involving endothelial dysfunction, oxidative stress, and chronic inflammation. Research in Indonesia on the relationship between uric acid levels and the decline of glomerular filtration rate (GFR) in diabetic patients remains limited. This study aimed to determine the association between serum uric acid (SUA) levels and decline in glomerular filtration rate among patients with diabetes mellitus diagnosed with diabetic kidney disease at Cipto Mangunkusumo Hospital, Jakarta, over a one-year period. Methods. This retrospective cohort study analyzed medical records of 192 type 2 diabetes melitus patients attending the Endocrinology and or Kidney Hypertension Clinics at Cipto Mangunkusumo National General Hospital , Jakarta. Inclusion criteria were baseline glomerular filtration rate ≥60 mL/min/1.73 m², available baseline serum uric acid, and follow-up glomerular filtration rate after one year. Bivariate and multivariate analyses were performed, adjusting for confounders including age, sex, hypertension, body mass index (BMI), triglycerides, HDL, LDL, total cholesterol, HbA1c, fasting blood glucose, and albuminuria. Results. Hyperuricemia prevalence was 85.94%. Multivariate analysis revealed that elevated SUA levels (≥6 mg/dL in women, ≥7 mg/dL in men) were associated with a 13.5% higher risk of GFR decline compared to normal serum uric acid (RR 1.135; 95% CI 1.015–1.268) after adjustment. Higher Body mass index was protective against glomerular filtration rate decline, while lipid profile, HbA1c, and fasting blood glucose were not significantly associated with diabetic kidney disease progression. Conclusions. Hiperuricemia is an independent risk factor for diabetic kidney disease progression in type 2 diabetes mellitus. Regular monitoring and management of serum uric acid may be crucial in preventing kidney function decline in this population.
Hubungan Aktivitas Fisik dengan Kualitas Hidup Pasien Hemodialisis Reguler Br Manurung, Shofi 'Ainun Azzahra; Nasution, Bayu Rusfandi; Rey, Imelda
Jurnal Penyakit Dalam Indonesia Vol. 12, No. 3
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Introduction. Hemodialysis (HD) is one of the renal replacement therapies commonly used in patients with end-stage renal disease. Patients undergoing hemodialysis typically exhibit lower levels of physical activity compared to inactive yet healthy individuals. A decline in physical function and muscular strength may impair the ability to perform daily activities, ultimately affecting patients’ quality of life (QoL). This study aimed to examine the relationship between physical activity and quality of life among hemodialysis patients at Rumah Sakit Khusus Ginjal Rasyida Medan. Methods. This was an analytical observational study with a cross-sectional design involving 50 respondents undergoing hemodialysis therapy at Rumah Sakit Khusus Ginjal Rasyida Medan between July and November 2022. Participants were selected based on predetermined inclusion and exclusion criteria. The association between variables was analyzed using the Chi-square test. Results. Among the respondents, 72.0% were categorized as having a good quality of life, while 28.0% had a poor quality of life. Regarding physical activity levels, 48.0% of patients had moderate activity, 26.0% had high activity, and 26.0% had low activity. Bivariate analysis revealed significant associations between quality of life and physical activity (p = 0.007), as well as between quality of life and comorbidities (p = 0.024). Multivariate analysis indicated that physical activity was a significant predictor of quality of life, with a prevalence ratio (PR) of 4.429 (95% CI: 1.383–14.191). Conclusion. There is a significant association between physical activity and quality of life among hemodialysis patients at Rumah Sakit Khusus Ginjal Rasyida Medan.
Faktor-Faktor yang Berhubungan dengan Gejala Depresi pada Pasien Insomnia Usia Lanjut di Rawat Jalan Pratiwi, Amalia Nur; Wahyudi, Edy Rizal; Kusumaningrum, Profitasari; Shatri, Hamzah; Rinaldi, Ikhwan; Gani, Rino Alvani; Wijaya, Ika Prasetya; Susilo, Adityo; Renaldi, Kaka
Jurnal Penyakit Dalam Indonesia Vol. 12, No. 3
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Introduction. The elderly population is increasing globally, including in Indonesia, where 10.7% of the population in 2020 were elderly. Insomnia is a common health issue among older adults and has been identified as a predictor of depression. This study aims to identify factors associated with depressive symptoms in elderly outpatients with insomnia. Methods. This cross-sectional study was conducted in 2024 on patients aged ≥60 years at the outpatient unit of Cipto Mangunkusumo Hospital (RSCM), Jakarta, Indonesia, using consecutive sampling to select participants. Elderly patients were screened using the Pittsburgh sleep quality index (PSQI), and those with a score >5 (indicating insomnia) were included as study subjects. Data were collected through interviews, covering sociodemographic characteristics, level of loneliness, duration of insomnia, depressive symptoms [Geriatric Depression Scale–15 (GDS-15) items], functional status [Barthel Activities of Daily Living (B-ADL)], cognitive status [Mini-Mental State Examination (MMSE)], nutritional status [Mini Nutritional Assessment (MNA)], and chronic diseases [Cumulative Illness Rating Scale for Geriatrics (CIRSG) score]. Results. The study included 209 elderly subjects with insomnia, with a mean age of 72.88 (SD 6.98) years, and a depression prevalence of 6.7%. Bivariate analysis showed significant associations between dependency (PR 5.24; 95% CI 1.50 – 18.29), malnutrition (PR 11.54; 95% CI 4.77 – 27.92), and chronic disease with a CIRSG score ≥9 (PR 4.15; 95% CI 1.18 – 14.50) and depressive symptoms in elderly patients with insomnia. No significant associations were found between sociodemographic factors, loneliness, duration of insomnia, or cognitive status and depression. Multivariate logistic regression analysis revealed a statistically significant association between malnutrition and depressive symptoms (p < 0.001). Conclusions. There is a significant association between malnutrition and depressive symptoms in elderly outpatients with insomnia. Further cohort studies are recommended to explore the causal relationship between malnutrition and depression in elderly patients with insomnia.
Pengaruh Heart Rate Variability terhadap Kesintasan Pasien dengan Kanker: Laporan Kasus Berbasis Bukti Kosasih, Kartika Anastasia; Raniah, Nida; Putranto, Rudi; Rajabto, Wulyo; Shatri, Hamzah; Faisal, Edward; Poespitasari, Vinandya Irvianita
Jurnal Penyakit Dalam Indonesia Vol. 12, No. 3
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Depression, anxiety, and poor outcomes in cancer are possibly mediated by autonomic dysfunction. Autonomic disfunction found in cancer patients can cause increase in sympathetic tone and decrease in cardiac muscle vagal tone. Heart rate variability (HRV) is a non-invasive index for measuring vagal response and a potential stress response in autonomic dysfunction. In patients with cancer, high vagal tone measured by HRV is significantly correlated with increased overall survival. This evidence-based case report aims to investigate the role of HRV as a prognostic factor in cancer patients. Literature search was done by two authors on five databases: Pubmed, Cochrane Library, EMBASE, ProQuest dan MEDLINE (EbscoHost) in accordance with clinical question. Articles were selected using inclusion and exclusion criteria, then critical review was performed. Quality of the studies was evaluated using the Center of Evidence-Based Medicine, University of Oxford guideline. Two systematic review and four cohort study was included. Increased HRV index is consistently correlated with increased overall survival (OS) in cancer patients. One meta-analysis study found that OS is significantly longer in group with higher HRV (Hazard ratio, HR = 0.70, IK95% 0.60 – 0.82, p < 0.001, I2 = 27%). In conclusion, HRV can be used as a prognostic factor in advanced stage cancer patients. Increased HRV is associated with better OS.
Hubungan Faktor Psikologis dengan Atrium Fibrilasi: Suatu Tinjauan Kepustakaan Murni, Arina Widya; Fadella, Annesa
Jurnal Penyakit Dalam Indonesia Vol. 12, No. 3
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Psychological factors influence the onset of cardiac rhythm and dysrhythmia disorders, including atrial fibrillation (AF), which is defined as uncoordinated atrial activation resulting in ineffective contractions. Psychological factors have a bidirectional relationship with AF, as AF symptoms can lead to a decline in mental health, which in turn negatively affects the clinical course. One explanation for how psychological stress impacts the heart and contributes to AF involves the autonomic nervous system and the hypothalamic-pituitary-adrenal (HPA) axis. Anxiety and depression are common comorbidities in AF. These conditions can be assessed using standardized instruments, such as the Hospital Anxiety and Depression Scale (HADS), which includes subscales for anxiety (HADS-A) and depression (HADS-D). Additionally, the Beck Depression Inventory (BDI) can be used to assess depression, while the State-Trait Anxiety Inventory (STAI) is useful for evaluating anxiety. Management of psychosomatic disorders requires a bio-psycho-socio-spiritual approach, involving both non-pharmacological and pharmacological therapies. Key components include somatic or symptomatic therapy, psychotherapy or sociotherapy, and psychopharmacotherapy, with the choice of method depending on various factors. In AF patients, treatment of psychological stress, anxiety, and depression generally prioritizes non-pharmacological approaches, such as supportive psychotherapy. If necessary, short-term use of benzodiazepines as anti-anxiety medication can be considered. In cases requiring antidepressants, newer agents such as selective serotonin reuptake inhibitors (SSRIs) are preferred, with close monitoring of heart rhythm due to the potential arrhythmogenic effects of certain medications, especially non-selective antidepressants.
Kerentanan dan Kanker pada Usia Lanjut: Sebuah Tantangan Cahyanur, Rahmat
Jurnal Penyakit Dalam Indonesia Vol. 12, No. 3
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Penggunaan Continous Glucose Monitoring pada Pasien DM Tipe 2 dengan Insulin Dosis Tinggi Hardigaloeh, Amanda Trixie; Tahapary, Dicky; Yunir, Em; Juli Edi Tarigan, Tri
Jurnal Penyakit Dalam Indonesia Vol. 12, No. 3
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Type 2 diabetes mellitus (T2DM) is a chronic disease with a high risk of complications, requiring optimal glycemic control. This case report aims to describe the use of continuous glucose monitoring (CGM) in the evaluation of a patient with T2DM and obesity whose glycemic levels remained uncontrolled despite high-dose insulin therapy. A 58-year-old woman with an 18-year history of T2DM presented to the Endocrinology Clinic of Cipto Mangunkusumo Hospital with uncontrolled blood glucose accompanied by classic diabetic symptoms. CGM revealed that the majority of glucose levels were within the time above range (TAR) at 83% without hypoglycemia, while the time in range (TIR) was only 17%. Contributing factors included a high-carbohydrate diet, limited physical activity, and technical difficulties with insulin injection. Interventions consisted of dietary re-education, gradual physical activity, optimization of injection technique, and insulin dose adjustment. CGM provided a comprehensive glycemic profile and helped identify non-pharmacological factors hindering glycemic control. This case highlights the role of CGM as an essential tool for individualized therapy in patients with T2DM requiring high-dose insulin.

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