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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
 1 
Search results for , issue "Vol. 3, No. 3" : 9 Documents clear
Change of Interleukin-6, C-Reactive Protein and Soluble VascularCell Adhesion Molecule-1 Concentrations in HemodialysisPatients with Reprocessed Dialyzer Nugroho, Pringgodigdo; Lydia, Aida; Panggabean, Marulam MP
Jurnal Penyakit Dalam Indonesia Vol. 3, No. 3
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Introduction. Cardiovascular disease is a major cause of morbidity and mortality in hemodialysis patients. In addition to traditional cardiovascular risk factors, non-traditional cardiovascular risk factors such as inflammation were also involved. Reprocessed dialyzer has been showed to induce less inflammation than new dialyzer, but data in diacetate cellulose membrane have not been presented. Methods. Twenty hemodialysis (HD) patients were enrolled. Pre and post study design was conducted to know post dialysis concentration changes of interleukin 6 (IL-6), C-reactive protein (CRP) and soluble vascular cell adhesion molecule-1 (sVCAM-1) at reuse 0, 5 and 10. Patients were recruited if medically stable, on maintenance HD >3 months, using reprocessed diacetate cellulose membrane by automated machine with mixture of periacetic acid and hydrogen peroxide solution. Urea reduction ratio (URR) and delivered dialysis dose were used to evaluate dialysis adequacy at reuse 0, 5, and 10. Results. CRP concentration was decreased. Median concentration of CRP at reuse 0, 5 and 10 were 3.55 mg/L, 2.97 mg/L and 2.92 mg/L, p=0.074. There were no significant changes of IL-6 concentration. Median concentration of IL-6 at reuse 0, 5, and 10 were 9.05 pg/ml, 10.64 pg/ml and 8.51 pg/ml, p=0.316. Concentration of sVCAM-1 was not changed significantly, with mean sVCAM-1 concentration 3078±786 ng/ml, 3260±836 ng/ml and 3154±631 ng/ml at reuse 0, 5 and 10,p=0.746. During use of reprocessed dialyzer through 10 times, there were no significant changes of hemodialysis adequacy using URR and Kt/V.
The Difference of C-Reactive Protein Levels in Acute Fever causedby Dengue and Typhoid Infections Idhayu, Adeputri Tanesha; Chen, Lie Khie; Suhendro, Suhendro
Jurnal Penyakit Dalam Indonesia Vol. 3, No. 3
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Introduction. Dengue infection and typhoid fever are endemic disease in Indonesia. But in the early days of onset sometimes it is difficult to distinguish them. A simple modality test is needed to support the diagnosis. C-Reactive Protein (CRP) is an affordable, fast and relatively less expensive diagnostic tool to diagnose the causes of acute fever. This study was aimed to determine the differences of CRP level in the acute febrile caused by dengue infection or typhoid fever. Methods. A cross sectional study has been conducted among acute febrile patients with diagnosis of dengue fever/ dengue hemorrhagic fever or typhoid fever who admitted to the emergency room or hospitalized in Cipto Mangunkusumo Hospital, Pluit Hospital, and Metropolitan Medical Center Hospital Jakarta between January 2010 and December 2013. Data obtained from medical records. CRP used in this study was examined at 2-5 days after onset of fever. The other collected data were demographic data, clinical data, use of antibiotics, leukocytes, platelets, neutrophils, ESR, and length of stay in hospital. Results. 188 subjects met the inclusion criteria; 102 patients with dengue and 86 patients with typhoid fever. Median CRP levels in dengue infection was 11.65 (16) mg/L and in typhoid fever was 53 (75) mg/L. There were significant differences in median CRP levels between dengue infection and typhoid fever (p < 0.001). At the 99% percentile cut-off point, CRP levels for dengue infection was 45.91 mg/L and CRP levels for typhoid fever at 1% percentile was 8 mg / L. Conclusions. There was significantly different levels of CRP in acute fever due to dengue infection and typhoid fever. At the 99% percentile cut-off point, CRP level >45.91 mg/L was diagnostic for typhoid fever, CRP level /L was diagnostic for dengue infection. CRP level between 8 to 45.91 mg/L was a gray area for determinating diagnosis of dengue infection and typhoid fever.
The Effect of Long-Term Proton Pump Inhibitor Use on FrailtySyndrome in Elderly Patients Dewi, Stephanie; Laksmi, Purwita W.; Syam, Ari Fahrial
Jurnal Penyakit Dalam Indonesia Vol. 3, No. 3
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Introduction. Frailty syndrome, the newest elderly health predictor, associated with higher morbidity and mortality. PPI are often used in elderly due to presence of upper gastrointestinal complaints, and relates with polypharmacy as one of the risk factor for frailty syndrome. There is no study of the relationship between long term PPI use and frailty syndrome in elderly. Methods. A case control study included subjects 60 years and above with good cognitive status. All subjects with history of hypersensitivity of PPI were excluded. Elderly who were frail based on FI-40 item were defined as cases, while individuals that were not frail were classified as control. Primary data (included frailty status) was collected on March-June 2013 by Seto E and Sumantri S, et al. Secondary data used in this current study were gathered from the primary data of previous research and from the medical record taken from geriatric and diabetic outpatient clinics Cipto Mangunkusumo Hospital. Results. There were 225 subjects collected (75 cases: 150 controls), 59,6% were female (mean age 72,14 years old, SD ± 6,4 years) and 47,1% with higher education. Lower education, divorced, poor nutrition, dependent, needed caregiver, economically insufficient, more comorbidity and poor health condition were seen in frail group. The proportion of long term PPI use were 40,9%. Long term PPI medication increased the risk of frailty syndrome (Crude OR 2,154; CI 95% 1,225-3,778; p<0,007) with adjusted OR 1,83 (CI 95% 1,02-3,37) after adjusting with nutrition and smoking variables. Conclusions. Long term use of PPI significantly increase the risk of frailty syndrome compared to the non-users.
Factors Related to Delayed Antiretroviral Therapy Initiation inHIV Patients NLP, Dwi Rahayu; Karjadi, Teguh H; Nelwan, Erni J
Jurnal Penyakit Dalam Indonesia Vol. 3, No. 3
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Introduction. Increase access towards antiretroviral therapy (ART) contribute to global decrease of HIV-associated morbidity and mortality. Time to initiation of ART in eligible HIV-infected patients is associated with reduction in mortality and morbidity. Delayed initiation of antiretroviral therapy can lead to increased of mortality rate more than 10% compare to early initiation. Methods. This study was a cross sectional study among adult HIV patients in Out-patient Clinic of HIV Integrated Clinic Cipto Mangunkusumo General Hospital who started ARV therapy for the first time (ART-naïve patients) enrolled from January 2013 to December 2014. The data were extracted from medical records to identify factors associated with delayed initiation ART among HIV patient. Delayed initiation ART was defined as eligible patients didn’t initiate ART within 10 weeks after the diagnosis of HIV infection. Factors identified were gender, education level, employment, marital status, WHO clinical stage, BMI, functional status, and the presence of opportunistic infection. Logistic regression test was used to find factors associated with delayed initiation of ART. Results. There were 444 subjects in this study, which consisted of 107 patients (24.1%) who delayed initiation of ART and 337 patients (75.9%) who didn’t delayed initiation of ART. Based on the bivariate analysis, there were three variables statistically significance, which were advanced WHO clinical stage (p<0.001), lower functional status (p<0.001) and the presence of opportunistic infection (p<0.001). Further multivariate analysis showed that there were two variables associated with delayed initiation of ART, which were advanced WHO clinical stage (OR: 2.92, 95%CI 1.53-7.40, p=0.02) and the presence of opportunistic infection (OR 1.99, 95%CI 1.21-3.29, p=0.01). Conclusions. Advanced WHO clinical stage and the presence of opportunistic infections are factors associated with delayed initiation of ART among HIV patients.
Diagnostic and Treatment Problems of Primary SclerosingCholangitis Nurleili, Rezky Aulia; F, Intan Airlina; Lubis, Anna Mira
Jurnal Penyakit Dalam Indonesia Vol. 3, No. 3
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Primary sclerosing cholangitis (PSC) is a chronic cholestatic liver disease with high incidence reported in America (1/100.000 population), but there is still no data available in Indonesia. The best management of this disease is still not found. Thus, in this article author will discuss about the case of PSC in 49-years male patients hospitalized in Cipto Mangunkusumo hospital Jakarta and its treatment.
Diagnostic Approach and Treatment of Instestinal Tuberculosis Murwaningrum, Artati; Abdullah, Murdani; Makmun, Dadang
Jurnal Penyakit Dalam Indonesia Vol. 3, No. 3
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Tuberculosis (TB) has become a resurgent global problem with increasing numbers of patients. TB infection is still common and remains an important cause of morbidity and mortality, particularly in underdeveloped and developing nations. Intestinal tuberculosis (intestinal TB) rates are rising, consistet with the overall trend. In 2014 Indonesia has the second highest TB prevalence in South East Asia after Timor Leste. Intestinal TB is the sixth highest manifestation of extrapulmonal TB. Manifestations can be non-specific and mimic many conditions, including malignancies causes’ intestinal TB diagnosis more difficult to be accurately determined. Findings from endoscopy and radiological imaging are countless, and depend on the stage of the disease and the time at which investigations are carried out. Hence, diagnosis can be difficult. Until recently there is no single method to identify intestinal TB accurately, various investigative methods have been used to aid in the diagnosis of intestinal TB. Early diagnosis and initiation of antituberculous therapy and surgical treatment are essential to prevent morbidity and mortality. Combined clinical assessment and some modalities examinations are needed to determine intestinal TB. Patient whom has been diagnosed with intestinal TB will be given anti tuberculosis therapy and surgery if any complications occur.
Benarkah Dialiser Proses Ulang Memicu Inflamasi? Suhardjono, Suhardjono
Jurnal Penyakit Dalam Indonesia Vol. 3, No. 3
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Predictors of Health-Related Quality of Life in Adult HemophiliaPatients in Cipto Mangunkusumo Hospital Prasetyawaty, Findy; Sukrisman, Lugyanti; Setyohadi, Bambang
Jurnal Penyakit Dalam Indonesia Vol. 3, No. 3
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Introduction. Currently, one of the main focus of hemophilia treatment is to increase health-related quality of life. Due to financial constraints, factor VIII substitution is used only on demand in Indonesia, which might contribute to musculoskeletal complications and affect the quality of life of adult hemophilia patients. This study aimed to evaluate quality of life of adult hemophilic patients and its related factors. Methods. A cross-sectional study on hemophilia patients aged 18 years or older was conducted at the Hematology-Medical Oncology outpatient clinic, Cipto Mangunkusumo Hospital Jakarta from March to May 2012. The radiologic assessment for arthropathy used the Arnold-Hilgartner score and health-related quality of life was assessed by the SF-36 questionnaire, using norm-based scoring system with normal value of 45 (individual) and 47 (group scale score). Subjects were categorized based on the level of factor VIII or IX and clinical severity (the number of bleeding episodes during the last 12 months). Results. In 66 subjects aged 18-57 (median 28) years old, the scores of the SF-36 ranged from 42.1 (role physical) to 60.9 (vitality). The physical and mental component summary scored 40.0 and 57.7. Clinical severity (p=0.001) and the severity of arthropathy (p=0.034) significantly influenced the SF-36 scores. The multivariate analysis showed that clinical severity significantly influenced the SF-36 scores (p=0.004; AUC 73%). The combination of clinical severity and severity of arthropaty increased the AUC to 76.6%. Conclusions. Health-related quality of life in adult hemophilia showed poor results in physical components. The clinical severity and arthropathy were predictors of health-related quality of life in adult hemophilic patients. The combination of clinical severity and arthropathy had better value in predicting health-related quality of life in adult hemophilia.
The Role of Hydration and N-Acetyl Cysteine Combination in 48Hours Contrast-Induced Nephropaty after Percutaneous CoronaryIntervention in Stage Three Chronic Kidney Disease Patients Simatupang, Lydia D; Susalit, Endang; Wijaya, Ika Prasetya
Jurnal Penyakit Dalam Indonesia Vol. 3, No. 3
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Introduction. Contrast Induced Nephropathy (CIN) after percutaneous coronary intervention (PCI) is common in stage 3 chronic kidney disease (CKD) patients. While there is no cure for CIN and some cases are fatal for the kidney or even life, it is preventable. Eventhough controversial, hydration and N-Acetyl Cysteine (NAC) are modalities to prevent CIN. Not having a certain guideline to prevent CIN in Integrated Cardiac Services (ICS) Cipto Mangunkusumo Hospital for PCI patients generates interest to study it. Methods. A prospective cohort is conducted to evaluate plasma creatinine before and 48 hours after PCI, meanwhile recording whom is given combined hydration and NAC and which not. Results. 43,4% of stage 3 CKD patients are given hydration and NAC, and incidence of CIN occurred in 5.26% patients all belonging to the non hydration and NAC group. Attributable risk is 100% means CIN can be prevented with hydration and NAC. Conclusions. Hydation and NAC is indicated to be protective against CIN in stage 3 CKD patients undergoing PCI.

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