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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. 6, No. 1" : 9 Documents clear
Profilaksis Pasca Pajanan terhadap Hepatitis B, HepatitisC, dan Human Immunodeficiency Virus pada PetugasKesehatan Widhani, Alvina
Jurnal Penyakit Dalam Indonesia Vol. 6, No. 1
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Validation of ARISCAT Model Score to Predict PostoperativePulmonary Complications in Tertiary Referral Hospital inIndonesia Alkaff, Muhammad; Pitoyo, Ceva Wicaksono; Heriwardito, Aldy; Koesnoe, Sukamto
Jurnal Penyakit Dalam Indonesia Vol. 6, No. 1
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Introduction. There are several prediction model score instruments that can help to assess pulmonary preoperative evaluation and it is believed that ARISCAT model score is very simple to do and have good performance, but not widely used. This score has not been yet validated in Indonesia. This study aimed to assess the performance of discrimination and calibration of ARISCAT score in predicting postoperative pulmonary complication who underwent surgery in a tertiary referral hospital in Indonesia. Methods. A retrospective cohort study was conducted to assess the external validation of ARISCAT scores in the Indonesian population. This study involved patients underwent surgery at Cipto Mangunkusumo Hospital in 2017. Several variables were collected such as age, oxygen saturation, history of pulmonary infection, anemia, type of surgery, duration of operation, emergency surgery, and PPC that observed within 30 days after surgery. Discrimination was assessed by the area under the curve (AUC). Calibration was assessed by the Hosmer-Lemeshow test and calibration plot. Results. Of 428 patients studied, PPC was observed in 32% of patients. Discrimination of ARISCAT score was shown by AUC value of 88.2% (CI 95%; 84.1-92.2%). Hosmer-Lemeshow test showed p=0.052 and calibration plot revealed coefficient Jurnal Penyakit Dalam Indonesia | Vol. 6, No. 1| Maret 2019 | 3 Uji Validasi Skor ARISCAT dalam Memprediksi Komplikasi Paru Pascaoperasi di RS Rujukan Tersier di Indonesia r=0.968. Conclusion. ARISCAT model score has good discrimination and calibration performance and can be applied in the Indonesian population.
Clinical Profile of Cirrhotic Patient with Esophageal Varices WhoUndergone Band Ligation in Cipto Mangunkusumo Hospital Kalista, Kemal Fariz; Lesmana, Cosmas Rinaldi Adithya; Sulaiman, Andri Sanityoso; Gani, Rino Alvani; Hasan, Irsan
Jurnal Penyakit Dalam Indonesia Vol. 6, No. 1
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Introduction. Liver cirrhosis (LC) is the end stage of chronic liver disease. One of the main complication caused by LC is esophageal varices (EV). Bleeding due to EV rupture is the main cause of mortality in patient with LC. EV band ligation can be used for primary or secondary prophylaxis to prevent bleeding. The purpose of this study was to know the clinical profile of LC patient with EV who underwent band ligation and who not underwent band ligation. Methods. A cross-sectional study was conducted in LC patients who underwent esophagogastroduodenoscopy (EGD) in Procedure Room Division of Hepatobiliary, Departement of Internal Medicine, Cipto Mangunkusumo Hospital from 2016 to 2017. Results. During January 2016-December 2017, a total of 313 patients underwent EGD. Most of them ( 73.2%) were male and predominantly > 60 years (34,2%). Most common LC etiology was hepatitis B (51.8%., There were 22% subjects with hepatocellular carcinoma (HCC). EV band ligations were done in 146 (46.7%) patients. In the ligation group, 56.2% patients were from outpatient clinic. The most common EGD indication (39%) was evaluation from previous ligation. Of 41.8% patients had Child-Turcotte-Pugh (CTP) class-A condition, 82.9% patients had MELD score < 15, 61.6% patients had large EV, 22.1% had red color sign (RCS) and 84,9% patients had portal hypertensive gastropathy. There were significant differences in CTP class, ascites, platelet, bilirubin, and albumin between ligation group compare to non-ligation group. Conclussion. Most of LC patients who underwent EV band ligation had CTP class-A, came from the outpatient clinic. The Jurnal Penyakit Dalam Indonesia | Vol. 6, No. 1 | Maret 2019 | 37 Profil Klinis Pasien Sirosis Hati dengan Varises Esofagus yang Menjalani Ligasi Varises Esofagus di Rumah Sakit Dr. Cipto Mangunkusumo main finding in EGD was large EV with portal hypertensive gastropathy. There were significant differences in liver functions between patient in ligation group compared to patient in non-ligation group.
Immunotherapy for Food Allergy: Myth or Reality? Soegiarto, Gatot
Jurnal Penyakit Dalam Indonesia Vol. 6, No. 1
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Allergic reaction to food can have serious consequences. The only treatment option is strict allergen avoidance, but accidental ingestions happen frequently and can lead to severe and potentially life-threatening allergic reactions. Food allergy is one of the most common causes of anaphylactic reactions. Therefore self-injectable epinephrine should always be at hand in case of accidental exposure. Many food allergies may resolve over time, but most patients with persistent food allergies live with fear of anaphylactic reactions. Within the last several years, the usefulness of immunotherapy for food allergies has been investigated. Several food immunotherapies are being developed; which include oral, sublingual, epicutaneous, or subcutaneous administration. The approach follows the same principles as immunotherapy for other allergic disorders, consisted of an induction phase followed by a maintenance phase with regular intake of maximum tolerated amount of food. Although immunotherapy seems promising for food allergic patients, it remains an investigational treatment that need to be studied further before advancing into clinical practice. Hopefully, multicentre and randomizedcontrolled studies can provide answer to multiple questions including optimal dose, ideal duration of immunotherapy, degree of protection, efficacy for different ages, severity and type of food allergy responsive to treatment.
Invasive Candidiasis Prevalence Among Patients in IntensiveCare Unit, Hasan Sadikin Hospital Maulana, Hafizh Ridwan; Sumardi, Uun; Koesoemadinata, Raspati C.
Jurnal Penyakit Dalam Indonesia Vol. 6, No. 1
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Introduction. Intensive care unit (ICU) patients have a high risk of invasive candidiasis (IC), which increase mortality and prolong length of stay in hospitals, resulting greater costs. This study aimed to determine the prevalence of IC and associated risk factors in ICU patients. Methods. A cross-sectional study was conducted including medical records of patients treated in ICU Hasan Sadikin Hospital Bandung admitted in June 2016-June 2017 whose blood sample were sent for culture. The prevalence of IC and corresponding 95% confidence interval (95% CI) was determined. A case-control study was done comparing the characteristics of patients with positive culture for Candida (cases) with those who have a negative culture admitted to ICU in the same week as the cases (control), with ratio 1 to 4. Multivariate analysis was performed to determine the adjusted odds ratio (AOR), 95% CI, and p value. Results. Blood cultures were performed on 313 ICU patients. The prevalence of IC was 3.5% (95%CI: 1.8-6.2), and 9 patients died. There were 8 cases and 33 controls with complete data to be compared. Characteristics associated with invasive candidiasis were: use of ventilator more than 6 days (AOR=15.52; 95%CI: 1.51-159.15; p=0.021); use of urine catheter more than 8 days (AOR=10.77; 95%CI: 1.05-110.86; p=0.046); and positive sputum culture for Candida (AOR=9.54; 95%CI: 1.44- 63.44; p=0.020). Conclusions. Invasive candidiasis has a high mortality rate. Long-term use of ventilator and urine cathether, and positive sputum culture result were important risk factors for IC among adult patients in ICU.
A Case Series Hemichorea-Hemiballism Syndrome Related toNonketotic Hyperglycemia: A Challenge to Diagnostic Process Sasiarini, Laksmi; Budianto, Rahmad; Tarigan, Ricky C.
Jurnal Penyakit Dalam Indonesia Vol. 6, No. 1
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Diabetes mellitus is quite familiar to health-care personnel but occasionally presents with unusual manifestations. One of them is hemichorea-hemiballismus syndrome, a spectrum of involuntary, continuous non-patterned movement involving one side of the body which is related to nonketotic hyperglycemia in uncontrolled diabetes. Here we present two cases of nonketotic hyperglycemic diabetic patients who presented with the hemichorea-hemiballismus syndrome. First – a 57 years old woman was presented with involuntary, arrhythmic, and repetitive movement on the right arm and leg, accompanied by twitching on the right face for two weeks. She had an uncontrolled history of diabetes mellitus. The second- a 60 years old man was presented with recurrent general tonic-clonic seizure for about four days. The history of diabetes was unknown. Initial diagnosis on admission was general tonic-clonic seizure due to thrombotic cerebrovascular accident (CVA). Intravenous diazepam did not give any response to the seizures. Their brain CT scan imaging showed non-enhancing hyperdensities in the basal ganglia due to non-ketotic hyperglycemia, but the lesion was more extensive on the second patient. An involuntary movement was resolved after achieving blood glucose target by rehydration and continuous intravenous insulin therapy. Clinical response in these cases were reversible while the hyperdensities lesion will be persistent for a few months.
Profil of Implementation of Post Exposure Prophylaxis of Hepatitis B, Hepatitis C and Human Immunodeficiency Virus to Health Care Worker in Cipto Mangunkusomo Hospital 2014-2016 Ratih, Dewi Mira; Yunihastuti, Evy; Lestari, Regina; Sulaiman, Andri Andri; Rinaldi, Ikhwan
Jurnal Penyakit Dalam Indonesia Vol. 6, No. 1
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Introduction. Health care workers (HCW) have a high risk of infectious substance exposure. Hepatitis B, hepatitis C, or human immunodeficiency virus (HIV) are some diseases transmitted by body fluid or body tissue. Cipto Mangunkusumo Hospital Jakarta has been implementing post-exposure prophylaxis (PEP)s towards HIV, hepatitis B, and hepatitis C. This study aimed to identify the implementation of post-exposure prophylaxis of HIV, Hepatitis B, and Hepatitis C among HCW in Cipto Mangunkusumo Hospital Jakarta. Methods. A cross-sectional study was conducted to exposed workers in Cipto Mangunkusumo Hospital Jakarta between 2014-2016 who had been recorded by report. Demographic data were collected through medical record and interview was conducted to gather additional data. Statistical analysis was conducted with SPSS 20. Results. Among 196 reports, most HCW were female (69.9%), worked as nurse (38.3%), medical doctor (49.5%), and exposed percutaneously (93.4%). There were 183 risky exposures, with 19 (10.4%) reactive anti-HIV, 11 (6.0%) positive HBsAg, and 12 (6.6%) reactive anti-HCV in source of exposure. Almost all of the HCW has no HIV, hepatitis B, nor hepatitis C at the moment of exposure. Recommendation for antiretroviral (ARV) was given to 81 HCW, but only 49.4% completed the course. Anti-HIV follow up was done only by 21.3% workers. Recommendation of PEP for hepatitis B was given to 37 HCW. But, only 13.5% and 13.3% receive hepatitis B vaccination and hepatitis B immunoglobulin, respectively. Follow-up of HBsAg and anti-HBs on 3rd and 6th months were done by 41 (31.1%), 38 (28.8%), and 2 (1.5%) workers who were recommended to receive prophylaxis. In 182 workers recommended to do the follow-up of anti-HCV, 39 (21.4%), and 37 (20.3%) workers did the follow-up on 3rd and 6th month. Majority of exposed workers were not re-evaluated for HBsAg (64.9%) and anti-HCV (69.9%). Conclusions. The implementation of post-exposure prophylaxis for HIV, Hepatitis B, and Hepatitis C was still low especially in re-evaluation serologic marker. Comprehensive management is recommended including improving knowledge of health care workers, re-evaluation of operational procedure standard, and effective communication.
The Effect of Green Tea Extract Supplementation on PlasmaMalondialdehyde (MDA) in Human with Sub-Maximal PhysicalActivity, Double-Blind and Placebo-Controlled Trials Arsana, Putu Moda; Sasiarini, Laksmi; Nugraha, Bayu Eka
Jurnal Penyakit Dalam Indonesia Vol. 6, No. 1
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Introduction. Green Tea extract has been proven in vitro to have the ability as an antioxidant. Submaximal physical activity causes an increase in free radicals. The increase of MDA can detect the increase of free radicals. This study aimed to determine the effects of green tea extract supplementation against free radicals in submaximal physical activity by measuring plasma MDA. Methods. This double-blind controlled trial study was performed in 20 students of faculty of sports science with submaximal physical activity in the form of 1,500 meters running in 12 minutes using a treadmill. Subjects were divided into two groups: green tea extract group (250 mg) and the control group (placebo). Supplement/placebo was given as one caps a day for fourteen days before submaximal physical activity. The plasma MDA was taken before, 2 hours after, and 48 hours after the submaximal physical activity. Analysis of the results used ANOVA and post hoc Tukey. The study has been assessed by 24 | Jurnal Penyakit Dalam Indonesia | Vol. 6, No. 1 | Maret 2019 Putu Moda Arsana, Laksmi Sasiarini, Bayu Eka Nugraha Medical Research Ethical Committee at Medical Faculty of Universitas Brawijaya. Results. In the control group, the mean value of plasma MDA levels in basal conditions, 2 hours and 48 hours after submaximal physical activity were 52.43 nmol/ml (standard deviation [SD] 12.52 nmol/ml), 55.57 nmol/ml (SD 13.84 nmol/ml), and 63.86 nmol/ml (SD 12.17 nmol/ml), respectively. However, this result was not statistically significant (p = 0.158). In the treatment group, the mean value of plasma MDA level at 48 hours after submaximal physical activity was significantly decreased compared to basal condition with mean value in basal and 48 hours after submaximal physical activity were 36.14 nmol/ ml (SD 5.88 nmol/ml) and 19.86 nmol/ml (SD 8.92 nmol/ml), respectively (p <0.001). Further analysis showed a significant difference in plasma MDA levels between the two groups at basal, 2 hours, and 48 hours after submaximal physical activity (p values were 0.012; <0.001, and <0.001 respectively). Conclusion. Green tea extract can decrease the plasma level of MDA at basal, 2 hours, and 48 hours after submaximal physical activity.
Correlation Between the Severity of Coronary Heart Disease andQT Dispersion in Patients with Obstructive Sleep Apnea Rasmijon, Rasmijon; Yamin, Muhammad; Hutauruk, Syahrial M.; Rumende, Cleopas Martin
Jurnal Penyakit Dalam Indonesia Vol. 6, No. 1
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Introduction. Coronary heart disease (CHD) and obstructive sleep apnea (OSA) are common and complex clinical problems. Both have a high risk of sudden cardiac death (SCD). QT dispersion (QTd) in electrogram is a measure of heterogeneity of myocardial repolarization that can predict the occurrence of ventricular arrhythmias that cause SCD QTd is a predictor of ventricular arrhythmias and sudden cardiac death. So far, there is no publication about the severity relationship CHD with QTd in OSA patients in Indonesia. Methods. A cross-sectional study was conducted on twenty-nine CHD patients accompanied OSA in 2015 who had undergone coronary angiography and polysomnography against the QT dispersion by electrocardiography in Cipto Mangunkusumo Hospital, Jakarta. QTd obtained from maximum QTc difference with minimum QTc. The severity of CHD was assessed by the Gensini score obtained from the recording of coronary angiography in the cath lab. Results. The median value of Gensini score was 10 (range 1-112). Mean value of QTc max and QTc min were 459.76 ms (standard deviation [SD] 41.39 ms) and 386.72 ms (SD 31.61), respectively. Meanwhile, the median value of QTd was 56 ms (range 14-201 ms). The Spearman correlation test showed a weak positive correlation between Gensini score and QTd (r = 0.464; p value = 0.006). Conclusion. The severity of coronary heart disease by Gensini score is weakly correlated with QT dispersion.

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