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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. 7, No. 4" : 9 Documents clear
Peran Penting Pengendalian Resistensi Antibiotik pada Pandemi COVID-19 Sinto, Robert
Jurnal Penyakit Dalam Indonesia Vol. 7, No. 4
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Level of Disability and Limitation of Shoulder Motion in Post Mastectomy at Hasan Sadikin Hospital Bandung in 2019 Rachmawati, Nadya; Prabowo, Tertianto; Fathurrachman, Fathurrachman
Jurnal Penyakit Dalam Indonesia Vol. 7, No. 4
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Introduction. Post-mastectomy complications in breast cancer patients can be a long-term disabilities such as limitation of shoulder function that only appears after several months to years after surgery and may remain for the rest of the patient’s life. This study aims to describe the level of disability and limitation of the shoulder joint’s range of motion in breast cancer patients following mastectomy at Hasan Sadikin Hospital, Bandung 2019. Methods. This research was conducted by using descriptive method with cross-sectional study design. Sampling technique using consecutive sampling method during one-month study period. Samples were post-mastectomy breast cancer patients who came to the Surgical Oncology Department of Hasan Sadikin Hospital Bandung on October-November 2019. Upper limb disability level obtained based on the results of quickDASH score filled by the patient while the range of motion of the shoulder joint measured by the researcher itself using a goniometer. Results. The QuickDASH scores from 84 patients studied, showed a median of 4.6 (range 0 - 59.1) with the majority falling in the category of minimum disability (score 1-20). The measurement of shoulder joint’s range of motion using goniometer showed a decrease in abduction on 52% of patients, decrease in flexion on 44% of patients, and decrease in external rotation on 20% of patients. Conclusions. The level of disability of the shoulder joint in the department of post-mastectomy Dr. Hasan Sadikin Bandung October-November 2019 showed the majority of minimum disability and limitation of motion of the shoulder joint occurs dominant abduction motion. Keywords: Breast cancer, mastectomy, quickDASH score, range of motion
The Impact of “CODE STEMI” Program Implementation on Door to Balloon Time and Major Adverse Cardiac Events of Patients with ST Elevation Myocardial Infarction Funay, Prijander L B; Wijaya, Ika Prasetya; Ginanjar, Eka; Shatri, Hamzah
Jurnal Penyakit Dalam Indonesia Vol. 7, No. 4
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Introduction. Delay in the management of ST Elevation Myocardial Infarction (STEMI) patients is a cause of high mortality and the incidence of major adverse cardiac events (MACE). Efforts that can be made in health facilities with primary percutaneous coronary intervention (PCI) capability are achieving timely reperfusion of STEMI patients. Various strategies were carried out to achieve timely reperfusion including implementation the CODE STEMI program. This study aimed to determine the effect of the implementation of the CODE STEMI program on Door to Balloon Time (D2BT) and MACE of STEMI patients undergoing primary PCI. Methods. This was a retrospective cohort study conducted among STEMI patients undergoing primary PCI before the application of the CODE STEMI program (2015-2016) and after the application of the CODE STEMI program (2017-2018). Data were obtained from patients’ medical record. Analysis was performed quantitatively by Mann Whitney test for D2BT and chi square for MACE. Results. There were 111 patients in the non-CODE STEMI group and 144 patients in the CODE STEMI group. D2BT decreased significantly 110 minutes from 275 (99-2356) minutes in the non-CODE STEMI group to 165 (67-1165) minutes in the CODE STEMI group (p < 0.001). Analysis in both group (CODE STEMI vs. non-CODE STEMI) showed as follows: MACE events (48.4% vs 51.6%; p = 0.120), heart failure (46.6% vs 42%; p = 0.288), cardiogenic shock (27% vs 19.4%; p = 0.152), arrhythmia (12.6% vs 6.2%; p = 0.079), stroke (4.5% vs 5.6%; p = 0.705), and mortality rate (7.2% vs 3.5%; p = 0.179) which were similar between the two groups. The incidence of reinfarction (4.5% vs 0.7%; p = 0.047) and repeated PCI (2.7% vs 0.0%; p = 0.047) were significantly reduced in the CODE STEMI group. Conclusions. The CODE STEMI program reduces D2BT. The CODE STEMI program did not reduce the overall MACE incidence but reduced the incidence of reinfarction and repeated PCI of STEMI patients undergoing primary PCI
Profile of Patients Neutropenia Fever Unrelated to Chemotherapy in Dr. Cipto Mangunkusumo General Hospital Danasasmita, Gantira; Chen, Lie Khie; Sinto, Robert; Nugroho, Pringgodigdo
Jurnal Penyakit Dalam Indonesia Vol. 7, No. 4
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Introduction. The condition of neutropenia increases the risk of infection. The causes of neutropenia are widely discussed as side effects of chemotherapy, but patients with neutropenia who are not due to side effects of chemotherapy are increasing in number. This study aims to provide an overview of the characteristics of neutropenic fever population unrelated to chemotherapy. Method. The study was conducted retrospectively on the medical records of neutropenic fever patients who were not chemotherapy-related in the National Hospital Dr. Cipto Mangunkusumo in January 2018-November 2019. Variables studied included demographic, clinical characteristics, classification of multinational association of supportive care in cancer (MASCC) scores and their etiology, and mortality outcomes within 5 days of treatment. Results. Total of 68 subjects were included in this study, consist of 50% female and 50% male with median age was 38.5 years (interquartile range 27). Diagnosis data showed that 86.8% subjects were patients with hematological abnormalities, 3 patients had solid tumors (lymphoma, colon cancer and lung cancer), and the rest were non-malignant diseases. Analysis showed that 72.1% onset of fever was found in outpatient care, the rest was inpatient care. The mean value of absolute neutrophil count was 201.50 (SD 173.18), meanwhile the mean MASCC score was 21 (SD 4.54) in the low-risk category. A total of 35 subjects (51.5%) had a MASCC low risk score and 33 subjects (48.5%) had a high risk. The median procalcitonin subject was 1.99 ng / mL (range 0.11 - 178.30). The 5-days mortality incidence was 54.4%. Chi-square analysis of the two groups found significant differences in care mortality (p <0.05). Analysis with Independent T-test also showed a significant differences in the parameters of age and systolic blood pressure values between the high risk and low risk groups. Conclusions. The majority etiologies among subjects were haematological disorders. Based on the MASCC score, most of the subjects were in the high-risk group. Total of mortality incidence was 54.4%.
Fever-Induced Brugada Syndrome in an Acute Gastroenteritis Patient: A Case Report Cikutra, Rio Yansen; Irwin, Irwin
Jurnal Penyakit Dalam Indonesia Vol. 7, No. 4
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Brugada syndrome (BS) is a disease caused by autosomal dominant sodium channel mutation in the heart. The prevalence of BS worldwide is estimated to be 1-5/10,000 population and the highest prevalence is in Southeast Asia which is >5/10,000 population. Brugada syndrome is a dangerous condition because it predisposes to malignant arrhythmias (ventricular tachycardia/VT and ventricular fibrillation/VS) and sudden cardiac death (SCD). Fever is a trigger for malignant arrhythmias, syncope, or SCD in BS. This article discusses about a case of 64-year-od man patient with complaint of syncope, preceded by chest pain and palpitation. The patient also had a fever and enteritis for two days. Electrocardiographic (ECG) examination was performed on the patient and a coved-type ST-segment elevation of ≥2 mm was obtained followed by a negative T wave in the right precordial leads (V1 and V2). Based on these results, the patient was diagnosed with type 1 BS. To date, the implantation of implantable cardioverter defibrillator (ICD) is the only therapy that has proven effective in preventing SCD in BS.
Low Serum Irisin as A Risk Factor of Sarcopenia in Elderly Aryana, I Gust Putu Suka; Putrawan, I.B.; Purnami, Ni Ketut Rai; Kuswardhani, R.A. Tuty; Astika, I Nyoman; Suastika, Ketut; Adiatmika, I Putu Gede; Jawi, I Made; Wande, I Nyoman
Jurnal Penyakit Dalam Indonesia Vol. 7, No. 4
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Introduction. Sarcopenia is a condition characterized by a decrease in muscle mass accompanied by a decrease in strength and/or function. Sarcopenia is closely related to the aging process, but the mechanism of its occurrence is still not fully understood. Skeletal muscle is the largest organ in the human body, so the myokine produced through muscle contraction opens a new paradigm regarding the central role of muscles in regulating metabolism and other organ functions. One of the myokines that are currently found to affect physical activity is Irisin. This study aims to determine the role of low Irisin levels in serum as a risk factor for sarcopenia in the elderly. Methods. This case-control study was conducted in Denpasar City from January 2020 to October 2020. The sample was selected using purposive consecutive sampling with matching age and gender, with 54 subjects, 27 case groups, and 27 control groups aged ≥60 years. Sarcopenia status is enforced by the criteria of the Asian Working Group for Sarcopenia (AWGS). Irisin serum levels were measured by enzyme-linked immunosorbent assay (ELISA). Results. Based on 54 subjects, the mean age in cases was 69.79 (SD 5.00) years and controls 67.89 (SD 4.50) years (p = 0.152), the proportion of male:female both in cases and controls group was 9:18. The cut-off point value wass based on the irisin ROC curve 4.51 ng/L. Nutritional status (OR = 3.40 (95% CI = 1.11 - 10.40); p = 0.029) and irisin (OR = 25.30 (95% CI = 6,00 - 106.66); p = <0.001) had an effect on sarcopenia. Factors that purely influence sarcopenia were found in low irisin (OR = 103.41 (95% CI = 7.83 – 1,364.99; p = <0.001). Conclusions. Low Irisin level is a risk factor for sarcopenia in the elderly. Irisin could be considered for further investigation in an effort to become a target for both preventive and curative therapy for sarcopenia.
Correlation of the Quality of Antibiotic Usage by Utilising Gyssens Flow and The Success of Treatment in Negative Gram MDR Sepsis in Tertiary Hospital Lardo, Soroy; Chen, Lie Khie; Santoso, Widayat Djoko; Rumende, Cleopas Martin
Jurnal Penyakit Dalam Indonesia Vol. 7, No. 4
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Introduction. Multi Drug Resistance (MDR) antibiotics have become a global health threat to the community. The use of appropriate antibiotics makes preventive and curative measures very important for the success of overcoming MDR and intervening the complexity of resistance, at least slowing the rate of occurrence of MDR. This study aimed to identify the difference in the quality of antibiotic use quality of use using gyssens flowchart and the success in sepsis patients’ treatment due to gram-negative MDR bacteria with non-MDR bacterial infections in tertiary hospitals. Methods. A retrospective cohort study was conducted using secondary data from patient with age more or equal than 18 years who were hospitalized in inpatient unit or ICU in Indonesia Army Central Hospital Gatot Soebroto from 2017-2019. Both the MDR and non-MDR gram-negative inclusion groups were assessed for the quality of antibiotic using the Gyssen flowchart. Results. There was a significant difference between antibiotic quality on gram negative MDR bacteria and non-MDR (20.6% vs. 13.6%; RR 1.517 (CI 95% 1.1 – 2.1); p value = 0.015) which showed that gram-negative MDR experienced 1.517 times better quality than non-MDR. This study also found that there was a significant difference between therapeutic success on gram negative MDR bacteria and non-MDR (57.4% vs. 39.1%; RR 1,431 (CI 95% 1.0 – 2.1); p value = 0.02). Conclusions. There is a better quality on the utilization of antibiotics with Gyssens index patients resulted from MDR negative gram bacterial infection in comparison to non-MDR in tertiary hospital. There is also a better success in treating the sepsis patient with MDR negative gram bacterial infection in comparison with non-MDR.
Validity and Reliability Test of European Organization for Research and Treatment of Cancer Quality of Life QuestionnaireBreast 23 in Breast Cancer Patient on Treatment Adli, Mizanul; Shatri, Hamzah; Sutandyo, Noorwati; Suwarto, Suhendro
Jurnal Penyakit Dalam Indonesia Vol. 7, No. 4
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Introduction. Improved survival of breast cancer patients are not necessarily followed by improvement of quality of life. According to the European Organization for Research and Treatment of Cancer (EORTC), cancer patients’ quality of life are very important to be evaluated. In Indonesia, breast cancer patients cannot be assessed their quality of life accurately because there is no valid and reliable questionnaire. This study aims to prove that the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Breast 23 (EORTC QLQ-BR23) is a valid and reliable measuring instrument to be used in Indonesia. Methods. This study was a cross-sectional study. The EORTC QLQ-BR23 questionnaire was first translated into Indonesian language before being tested on 10 respondents. The translation results were then used in 100 breast cancer patients. Test-retest was assessed with intraclass correlation coefficient (ICC), while the internal consistency was assessed by Cronbach’s alpha. Construct validity was assessed by multi-trait scaling analysis and the criteria validity assessed by identifying the correlation between domains of European Organization for Research and Treatment of Cancer Quality of Life QuestionnaireCancer 30 (EORTC QLQC30) and EORTC QLQ-BR23 with Short Form 36 (SF36). Results. From September to October 2015, a total of 100 breast cancer patients on treatment were enrolled in this study. ICC value (1 hour interval) of all EORTC QLQ-BR23 domains were very good (ICC> 0.8). ICC values (30 day interval) decrease in all EORTC QLQ-BR23 domains. Almost all of the EORTC QLQ-BR23 domains have a cronbach’s alpha value > 0.7 except for the arm symptom domain (Cronbach’s alpha: 0.643). Multi-trait scaling analysis showed a fairly high correlation between the score of the questions with a score of his own domain, while the relationship of the questions to different domains always have a lower correlation than the domain itself. In criteria validity test, obtained 19 correlation with r > 0.3 between domains of EORTC QLQ-C30 and EORTC QLQ-BR23 with SF36. Conclusion. EORTC QLQ-BR23 is a valid and reliable instrument for assessing quality of life of breast cancer patients in Indonesia
The Selection of Oral Antidiabetic Drugs in Type 2 Diabetes Mellitus Patients with High Risk for Cardiovascular Events Leander, Derlin J.; Tahapary, Dicky L.
Jurnal Penyakit Dalam Indonesia Vol. 7, No. 4
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Type 2 diabetes mellitus (DMT2) patients are associated with an increased risk of cardiovascular events. Prior to the era of cardio-vascular trial outcome (CVOT) evidence on the efficacy of old oral diabetes (OAD) drugs such as metformin, sulfonylurea, thiazolidindion, glinid, and alpha glucosidase inhibitors in reducing the risk of cardiovascular events was very limited. Since 2008, all OADs must have CVOT data. DPP-4 inhibitors are neutral against the risk of cardiovascular events while SGLT-2 inhibitors are reported to significantly reduce the risk of cardiovascular events. This finding even helped to change the DMT2 management guidelines issued by American Diabetes Association (ADA-EASD) in late 2018. However, SGLT-2 inhibitor applications in Indonesia are likely to be constrained in terms of costs. When compared with an intensive multifactorial approach that seeks to reduce blood glucose, lipids, blood pressure, weight, and aspirin; it turns out that this multifactorial approach is associated with a lower risk of higher cardiovascular events and lower costs. In the JKN era, where quality control and cost control are needed, it seems that the multifactorial approach will still be the main choice in reducing cardiovascular events in people with T2DM in Indonesia.

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