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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. 13, no. 1" : 9 Documents clear
Faktor Risiko Perdarahan Gastrointestinal pada Pasien dengan Sindrom Koroner Akut: Sebuah Tinjauan Sistematis setyobudi, Assyadilla Kirana; Vidyani, Amie; Sutadji, Jonathan Christianto; Kurniawati, Lady Aqnes; Suhardi, Kevin Fernando
Jurnal Penyakit Dalam Indonesia Vol. 13, No. 1
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Introduction. Gastrointestinal bleeding (GIB) is a serious but potentially preventable condition. Its symptoms include hematemesis, hematochezia, and melena. Risk factors for GIB include medications such as antiplatelets and anticoagulants, which are standard treatments for acute coronary syndrome (ACS). GIB is strongly associated with ACS and represents the most common bleeding complication in these patients. This study aimed to systematically review the factors contributing to GIB in patients with ACS. Methods. Relevant articles were retrieved from PubMed, ScienceDirect, Springer, and EBSCO databases, covering studies on GIB risk factors in ACS patients published between March 31, 2003, and March 31, 2025. The search was conducted using specific keywords and Boolean operators. Data were then extracted and comprehensively evaluated. Results. A total of 17 studies were included, with varied patient populations, including general ACS patients, as well as those specifically diagnosed with acute myocardial infarction (AMI), ST-elevation myocardial infarction (STEMI), or non-ST-elevation myocardial infarction (NSTEMI). The follow-up periods ranged widely, from 15 days to 4 years. Based on the initial evaluation, 23 potential risk factors were identified. GIB was more likely to occur in older individuals, females, and those with a history of smoking and alcohol consumption. Comorbidities, including anemia, diabetes, peptic ulcer disease, cirrhosis, and chronic kidney disease, were also more frequently observed among ACS patients with GIB events. The use of proton pump inhibitors (PPIs) was identified as the only protective factor. Conclusion. This systematic review identified several risk factors associated with GIB in ACS patients. Careful monitoring and appropriate management should be implemented in patients with these risk factors to prevent bleeding events, which may be fatal.
Campak: Refleksi Keberhasilan Program Vaksinasi Nelwan, Erni Juwita
Jurnal Penyakit Dalam Indonesia Vol. 13, No. 1
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Kesintasan Hidup Satu Tahun Pasien Sirosis Hati yang Dirawat di Rumah Sakit Cipto Mangunkusumo pada Periode COVID-19 Aprilicia, Gita; Baihaki, Ichwan; Banjarnahor, Riri Oktavani; Kalista, Kemal Fariz; Gani, Rino Alvani
Jurnal Penyakit Dalam Indonesia Vol. 13, No. 1
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Introduction. Liver cirrhosis represents the terminal stage of chronic liver disease and is characterized by a markedly reduced survival rate. Understanding the characteristics and laboratory parameters of patients with liver cirrhosis can provide valuable insights into their prognosis and potential interventions. This study was conducted during the COVID-19 pandemic period, which may have influenced patient outcomes due to potential impact of COVID-19 infection on patients with chronic liver disease. This study aimed to evaluate the one-year survival rate of hospitalized liver cirrhosis patients at Cipto Mangunkusumo Hospital during the COVID-19 and to identify clinical and laboratory factors associated with patient survival. Methods. This retrospective study analyzed data from 73 in-hospital liver cirrhosis patients during January to December 2020. Demographic characteristics, comorbidities, diagnosis upon admission, and laboratory parameters were collected. Patients were categorized into two groups: those who survived and those who died within one year of hospitalization. Survival analysis was performed using the Kaplan–Meier method to estimate 1 year survival probability of cirrhosis patients. Results. The analysis revealed significant differences in several characteristics and laboratory parameters between the survival and death groups during COVID-19 period. The etiology of liver cirrhosis was predominantly related to HBV (41.1%) and HCV (23.3%), which constituted the most common causes. Diagnosis upon admission showed a significant association with survival, with bleeding esophageal varices (53.4%) being the most prevalent. Laboratory parameters such as SGOT, SGPT, albumin, bilirubin, prothrombin time, INR, and Child Pugh score demonstrated significant differences between the two groups. The 1-year survival rate for the Child Pugh class A, B and C was approximately 100%, 61.2% (CI 95% 42.2 - 80.2%) and 0%, respectively. The overall 1-year survival rate of in-hospital liver cirrhosis patients was 52.6% (CI 95% 38.7 - 66.5%). Conclusions. This study found the overall survival of in-hospital liver cirrhosis patients during COVID-19 period was low. It’s essential to develop a comprehensive and personalized treatment plan for optimal patient outcomes.
Prevalensi COVID-19 Derajat Berat dan Kritis saat Admisi pada Pasien Penyakit Reumatik Autoimun dan Faktor-Faktor yang Berhubungan Destini, Mulia; Ariane, Anna; Yulianti, Mira; Rizka, Aulia; Rinaldi, Ikhwan; Mansjoer, Arif; Maulahela, Hasan; Wafa, Syahidatul
Jurnal Penyakit Dalam Indonesia Vol. 13, No. 1
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Introduction. Patients with autoimmune rheumatic diseases are known to be more vulnerable to severe and critical infections, including COVID-19. Although it is no longer classified as a pandemic, SARS- CoV-2 infection still persists, and several surges of cases have been reported, including in Indonesia. To date, no data are available regarding the prevalence of severe and critical COVID-19 at admission in patients with autoimmune rheumatic diseases in Indonesia and the associated factors. This study aimed to determine the prevalence of severe and critical COVID-19 at admission in patients with autoimmune rheumatic diseases at Dr. Cipto Mangunkusumo National General Hospital, and to identify the associated factors. Methods. This was a cross-sectional study using secondary data from the medical records of patients with autoimmune rheumatic diseases confirmed with COVID-19 and hospitalized at Dr. Cipto Mangunkusumo National General Hospital between July 2020 and August 2024. Analyses were performed up to multivariate logistic regression to evaluate the association between predictor variables and severe and critical COVID-19 at admission. Results. Among 171 subjects, the majority were female (n=158). The median age was 31 years, ranging from 18 to 74 years. The prevalence of severe and critical COVID-19 at admission in patients with autoimmune rheumatic diseases was 41.5%. Routine corticosteroid use (adjusted prevalence ratio (aPR) 2.58; 95% CI 1.40–5.17; p=0.004), the presence of comorbidities (aPR 2.24; 95% CI 1.19–4.59; p=0.018), moderate–high disease activity (aPR 5.12; 95% CI 1.74–21.96; p=0.009), and combination immune-modifying therapy (aPR 1.79; 95% CI 1.06–3.17; p=0.034) were independently associated with severe and critical COVID-19 at admission in the final multivariate analysis. Conclusions. The prevalence of severe and critical COVID-19 at admission in patients with autoimmune rheumatic diseases was 41,5%. The associated factors were routine corticosteroid use, the presence of comorbidities, moderate–high disease activity, and combination immune-modifying therapy.
Waktu Pemulihan Saturasi Oksigen pada Pasien COVID-19 di RSND Semarang: Pengaruh Usia, Derajat Keparahan, dan Komorbiditas Hapsari, Hererapratita Aysha; Purwoko, Yosef; Basyar, Edwin; Ngestiningsih, Dwi
Jurnal Penyakit Dalam Indonesia Vol. 13, No. 1
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Introduction. COVID-19 may cause impaired oxygenation that affects the recovery process, making oxygen saturation an important parameter in clinical monitoring. Age, disease severity, and comorbidities are suspected to influence the duration of oxygen saturation recovery. This study aimed to analyze differences in oxygen saturation recovery time based on age, disease severity, and comorbidity status in hospitalized COVID-19 patients. Methods. This was an observational analytic study with a retrospective cohort design using a survival analysis approach. The study was conducted at Diponegoro National Hospital (RSND) Semarang from October to November 2021 using medical records of hospitalized COVID-19 patients from March 2020 to February 2021. A total of 82 patients were selected using consecutive sampling based on inclusion and exclusion criteria. The variables analyzed included age, disease severity, and comorbidity status, with oxygen saturation recovery time as the outcome. Recovery time was defined as the duration (in days) from hospital admission until oxygen saturation (SpO2) ≥95% was achieved in stable condition. Data were analyzed using Kaplan–Meier, log-rank test, and Cox regression. Results. Bivariate analysis showed significant differences in oxygen saturation recovery time based on age (p < 0.001), severity (p < 0.001), and comorbidity status (p = 0.006). Median recovery time was longer in the elderly, those with severe cases, and those with comorbidities. Multivariate analysis showed that only severity was significantly associated with recovery time (HR = 1.98; 95% CI: 1.12–3.48; p = 0.018). Conclusion. There was a significant association between severity and oxygen saturation recovery time.
Skoring Risiko Mortalitas pada Pneumonia Komunitas Sedang-Berat Kusuma, Ni Nyoman Indirawati; Singh, Gurmeet; Wulani, Vally; Rumende, Cleopas Martin Martin; Fauzar, Fauzar; Kamelia, Telly; Koesnoe, Sukamto; Susilo, Adityo; Shatri, Hamzah
Jurnal Penyakit Dalam Indonesia Vol. 13, No. 1
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Introduction. Community Acquired Pneumonia (CAP) is a lung parenchyma infection acquired outside of the hospital and is significantly associated with morbidity and mortality rates. Identifying patients with moderate-severe CAP at high risk of mortality through a combination of these variables is expected to serve as a basis for prompt and appropriate intervention, ultimately improving clinical outcomes for CAP patients. This study aimed to develop a scoring system using clinical characteristics, radiological findings, and serum biomarkers to assess the mortality risk in patients with moderate-severe CAP. Methods. This study employs a retrospective cohort design with moderate-severe CAP patients treated at Dr. Ciptomangunkusumo Hospital, Jakarta. The sample data were secondary, derived from medical records of patients diagnosed with moderate-severe CAP between January 2022 and December 2023. Predictor variables for mortality risk were obtained through multivariate analysis using Cox regression. Results. The study included 277 subjects, with 124 (44.77%) deaths and 153 (55.23%) survivors. Predictor variables consistently influencing mortality risk in moderate-severe CAP patients were low BMI (HR 1.609, 95% CI 1.047 – 2.472), procalcitonin (HR 1.778, 95% CI 1.200 – 2.634), and lactate levels (HR 1.451, 95% CI 0.994 – 2.119). The prediction model’s performance, based on the ROC curve analysis, showed moderate predictive ability (AUC = 0.641), and calibration performance, as assessed by the Hosmer-Lemeshow test, showed good validation (p = 0.082). Conclusions. There is an association between BMI, procalcitonin, and lactate levels with the mortality risk in moderate-severe CAP patients. A mortality risk scoring model for moderate-to-severe CAP patients has been established.
Manfaat Latihan Kekuatan Otot terhadap Kadar HbA1c pada Orang Dewasa dengan Prediabetes: Laporan Kasus Berbasis Bukti Simanjuntak, Owen Paruhum; Lubis, Anna Mira
Jurnal Penyakit Dalam Indonesia Vol. 13, No. 1
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Prediabetes is a metabolic condition of impaired glucose homeostasis which results in elevated blood glucose levels. Besides the higher risk of developing diabetes, prediabetes is associated with increased risk of cancer, dementia, heart failures, and coronary artery disease. The common first line treatment regimen given to this group are healthy diet and aerobic exercise. However, some conditions might prevent patients from doing aerobic exercises therefore there is a need for alternatives. This evidence-based case report aims to evaluate the benefit of resistance training on HbA1c levels compared to control group (no exercise) in prediabetic adults. Literature search was conducted across several databases (PubMed, Cochrane, Scopus, and Wiley). Included articles are then critically appraised with the Oxford Center for Evidence-Based Medicine (CEBM) tool. Levels of evidence for each included study are assessed with the Oxford CEBM 2011 levels of evidence table.  Out of 658 studies screened, 15 studies were selected and 2 were included. A systematic review and meta-analysis found that resistance training with low-to-moderate load resulted in a significant reduction of HbA1c compared to the control group. A randomized controlled trial (RCT) also found significant reduction in HbA1c levels after 12 and 24 months of resistance training, compared to the control group. However, study found that resistance training with high load does not significantly reduce HbA1c levels. Current evidence supports the regimen of low-to-moderate resistance training (performed three times per week for 50-60 minutes per session at an intensity of 50-75% of one-repetition maximum) to lower HbA1c levels in adult prediabetic populations.
Koeksistensi Spondiloartritis Perifer dan Fokal Segmental Glomerulosklerosis: Sebuah Laporan Kasus Jarang Zulaifah, Zakiya; Hapsari, Florentina Carolin Puspita; Muzellina, Virly Nanda
Jurnal Penyakit Dalam Indonesia Vol. 13, No. 1
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Spondyloarthritis is a group of inflammatory rheumatic diseases characterized by shared clinical features, genetic predispositions, and pathogenic mechanisms. Without appropriate management, it carries a risk of various complications. We report the case of a young male patient with a one-year history of nephrotic syndrome prior to admission, presenting with chronic polyarthritis. Initially, systemic lupus erythematosus (SLE) with renal and musculoskeletal involvement was suspected, although SLE is relatively uncommon in young males. However, based on the clinical presentation of arthritis, imaging findings of sacroiliitis, and the absence of diagnostic criteria supporting SLE, the patient was subsequently diagnosed with peripheral spondyloarthritis and nephrotic syndrome secondary to focal segmental glomerulosclerosis (FSGS). Patients with spondyloarthritis have approximately a twofold increased risk of renal complications compared with the general population, with IgA nephropathy being the most common abnormality. Although rare, cases of spondyloarthritis occurring in patients with FSGS have been reported. The relationship between these two conditions remains unclear—whether causal or coincidental—and warrants further investigation. A careful diagnostic approach is essential in patients with chronic polyarthritis, particularly when differential diagnoses do not align with demographic characteristics or clinical presentation. This is crucial to improve diagnostic accuracy, guide appropriate therapy, enable earlier prevention of disease progression, and reduce the risk of complications.
Campak dan Vaksinasi Campak pada Orang Dewasa Sinto, Robert; Koesnoe, Sukamto; Nelwan, Erni Juwita; Widhani, Alvina; Shakinah, Sharifah; Pasaribu, Adeline; Duindrahajeng, Bernadine Gracia; Suwarto, Suhendro; Nainggolan, Leonard; Chen, Lie Khie; Susilo, Adityo; Maria, Suzy; Hasibuan, Anshari Saifuddin; Wicaksana, Bramantya
Jurnal Penyakit Dalam Indonesia Vol. 13, No. 1
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Measles is a highly contagious viral infection that remains a significant global health problem despite the availability of an effective vaccine. Measles re-emergence is driven by gaps in immunization coverage, waning post-vaccination immunity, and increased population mobility. In adults, measles infection is associated with greater disease severity compared to children. This literature review was conducted by reviewing recent scientific publications addressing the epidemiology, pathogenesis, clinical manifestations, diagnosis, management, complications, and prevention of measles, with a focus on the adult population.  Measles is caused by an RNA virus of the Paramyxoviridae family and is transmitted through respiratory droplets and aerosols. Typical clinical features include fever, cough, coryza, conjunctivitis, and a maculopapular rash with a centrifugal and cephalocaudal distribution. Diagnosis is based on clinical findings and confirmed by laboratory tests such as RT-PCR and measles-specific IgM serology. Measles infection causes significant immunosuppression, including immune amnesia, which increases susceptibility to secondary infections. Management is primarily supportive and vitamin A supplementation has been shown to reduce mortality in certain populations. In adults, complications tend to be more severe, particularly pneumonia as the leading cause of morbidity and mortality, as well as neurological complications such as encephalitis and subacute sclerosing panencephalitis (SSPE). Measles vaccination with the MMR vaccine remains the main prevention strategy. However, its implementation faces challenges, including gaps in immunization coverage, vaccine hesitancy, and limited adult immunization record system. Measles in adults remains a significant health concern with a high risk of severe complication. Strengthening immunization program, improving public education, and developing integrated surveillance system are essential to reduce disease incidence and burden.

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