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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. 8, No. 2" : 9 Documents clear
Comparison of Red Cell Distribution Width Values towardsMortality in Adult and Elderly Hospital-Acquired PneumoniaPatients in Dr. Sardjito Hospital Sari, Desty Gusti; Asdie, Rizka Humardewayanti; Retnowulan, Heni
Jurnal Penyakit Dalam Indonesia Vol. 8, No. 2
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Introduction. Hospital-acquired pneumonia (HAP) is a major cause of morbidity and mortality. Red cell distribution width (RDW) is associated with mortality in patients with septic shock and community-acquired pneumonia (CAP). However, little is known about the effect of elevation of RDW value on mortality in HAP patients, especially in the elderly population who have a worse prognosis. This study aimed to determine the proportion of adult and elderly HAP patients who have an increase in RDW value and the relation between the increase in RDW value to the risk of mortality in HAP patients during hospitalization. Methods. A cross-sectional and retrospective cohort study was performed using medical records of inpatients diagnosed with HAP in RSUP Dr. Sardjito Yogyakarta from March 2014 until March 2015. The study’s sample was chosen by a consecutive sampling method. The data were analyzed with chi-square and logistic regression. Results. During the study period, a total of 106 patients were diagnosed with HAP with fulfilled the inclusion and exclusion criteria. Sixty-eight subjects (64.15%) survived, and 38 subjects (35.84%) died. The median RDW value was 15.3% (range 11.4 – 29.8%). The proportion of adult and elderly HAP patients toward the increase in RDW value was not statistically significant (p=0.331). Factor contributing to the increase of RDW value was haemoglobin (p<0.001; RR 5.617 (95% CI 2.294 – 13.756) and thrombocyte (p=0.002; RR 4.471 (95% CI 1.720 – 11.625). There was a proportion difference between RDW value and HAP mortality (p=0.043), but it was not statistically significant. Factor contributing to the increase of HAP mortality was sepsis (p<0.001; RR 7.121 (95% CI 2.599-19.509)) and leucocyte (p=0.031; RR=3.077 (95% CI 1.108 – 8.546)). Conclusions. There is no proportion difference in increasing RDW value between adult and elderly HAP patients. We also found that RDW value was not contributing to make the increase in mortality among HAP patients. However, this study found other factors, including haemoglobin and platelet level which correlated with the increase of RDW. We also found that sepsis and high leukocyte levels are significantly correlated with the incidence of mortality among HAP patients.
Proportion of Pre-dialysis Prolonged QT Dispersion in TwiceWeekly Chronic Hemodialysis Patients and Its Associated Factors Pattiiha, Arief; Yamin, Muhammad; Lydia, Aida; Abdullah, Murdani
Jurnal Penyakit Dalam Indonesia Vol. 8, No. 2
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Introduction. Cardiovascular disease (CVD) is the common cause of mortality in end-stage renal disease (ESRD) patients undergoing hemodialysis (HD). Causes of CVD in ESRD patients are multifactorial. Ventricular arrhythmia is known as the leading cause of sudden death in dialysis patients. QT dispersion, which is measured from electrocardiography (ECG), is known as one of the parameters to assess the risk of arrhythmia in HD patients. This study aimed to determine the proportion of pre-dialysis prolonged QT dispersion in chronic twice-weekly HD patients and the associated factors. Methods. A cross-sectional study was conducted among HD patients age ≥18 years with dialysis duration of at least three months in Cipto Mangunkusumo Hospital during May–June 2019. Electrocardiography, echocardiography, and blood samples were taken before the dialysis session. Bivariate analysis using Chi-square and Fisher’s exact test was performed on each variable. Significant results were further analysed using logistic regression. Results. A total of 142 subjects were included in this study. The mean age of subjects was 49 (standard deviation (SD) 15) years. Prolonged QT dispersion was found in 51 subjects (35.9%). Multivariate analysis showed prolonged QT dispersion was significantly correlated with systolic dysfunction (PR=1.875 (CI 95% 1.234-2.848); p=0.006) and left ventricle hypertrophy (PR=2.361 (CI 95% 1.032-5.403); p=0.019). Age, diabetes mellitus, hypokalemia, hypomagnesemia, and diastolic dysfunction were not significantly correlated with QT dispersion (p>0.05). Conclusion. The proportion of pre-dialysis prolonged QT dispersion in twice-weekly chronic hemodialysis patients in RSCM is 35.9% and associated with systolic dysfunction and left ventricle hypertrophy
Correlation of Sun Exposure Score and Vitamin D Intake withSerum 25(OH)D Levels in Older Women Husna, Kholidatul; Widajanti, Novira; Sumarmi, Sri; Firdaus, Hadiq
Jurnal Penyakit Dalam Indonesia Vol. 8, No. 2
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Introduction. Indonesia is a tropical country, but the prevalence of vitamin D deficiency in older women is high due to the lack of sun exposure and low vitamin D intake. Some previous studies have reported that people from rural areas have higher serum 25(OH)D levels compared to those from urban areas. This study was conducted to analyze the correlation between sun exposure score and vitamin D intake with serum 25(OH)D levels of older women from rural areas. Methods. This was an analytic cross-sectional study involving older women in two villages from Wonorejo and Kraton Districts, Pasuruan Regency, in June 2020 during the dry season. The sun exposure score was calculated using a sun exposure questionnaire, vitamin D intake was obtained using the 2 x 24-h food recall, and serum 25(OH)D levels were measured using the chemiluminescent immunoassay. The data was analyzed using the Spearman and Pearson correlation test. Results. A total of 40 post-menopausal women aged 60 to 93 years (median age 70 years) were included in this study. The median sun exposure score was 14. The median time spent outdoors was 40 minutes, 90% of subjects wore longsleeved and long skirts, and all of the subjects never put on sunscreen. The mean value of vitamin D intake was 1.73 μg/day (SD 3.21 μg/day), all of the subjects had low vitamin D intake. The primary source of their vitamin D intake was fish (67.5%), predominantly freshwater fish. The mean value of serum 25(OH)D levels was 27.75 ng/mL (SD 13.25 ng/mL), and 30% of them had vitamin D deficiency. The sun exposure score was positively correlated with serum 25(OH)D levels (r=0.425; p=0.006). Meanwhile, there was a correlation between vitamin D intake and serum 25(OH)D levels (p=0.246). Conclusion. There is a significant positive correlation between sun exposure score and serum 25(OH)D levels, but no correlation between vitamin D intake and serum 25(OH)D levels.
The Effect of Angiotensin-Converting Enzyme GenePolymorphism and Angiotensin II Levels in Coronary SlowFlow Phenomenon at Mohammad Hoesin General HospitalPalembang Karlina, Arlis; Indrajaya, Taufik; Ghanie, Ali; Sukandi, Erwin; Usnizar, Ferry; Indra, Syamsu; Chodilawati, Rukiah; Saleh, Imran
Jurnal Penyakit Dalam Indonesia Vol. 8, No. 2
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Introduction. The presence of ACE gene polymorphism is expected to have a role in cardiovascular diseases, including coronary slow flow phenomenon (CSFP). Angiotensin converting enzyme (ACE) gene polymorphism also plays an essential role in increasing angiotensin II levels. Therefore, this study aimed to analyze the effect of angiotensin-converting enzyme gene polymorphism and angiotensin II levels in the coronary slow flow phenomenon in Mohammad Hoesin General Hospital Palembang. Methods. This case-control study was started from July 2019 to July 2020 at RSMH Palembang with 32 subjects for each case (CSFP patients) and the control group (non-CSF patients). This study used a pair of primers and onetimed PCR to detect ACE gene polymorphism. Genetic analysis was carried out in the Biotechnology Laboratory Faculty of Medicine, Universitas Sriwijaya. Statistical analysis was performed using the Spearman correlation test. Results. There were 17 subjects with II genotypes (53.1%), 14 subjects with ID genotypes (43.8%), and 1 subject with DD genotypes (3.1 %) in the CSFP group. While in the non-CSFP group, there were 11 subjects with II genotypes (34.4%), 13 subjects with ID genotypes (42.2%), and 9 subjects with DD genotypes (14.1%). The median value of angiotensin II levels in CSFP and Non-CSF group was 58 pg/mL and 32.8 pg/mL, respectively. The results of the analysis showed that there was an effect of angiotensin II levels on the incidence of CSFP (p=0.001). Further analysis showed that there was a correlation between angiotensin II levels and the I/D 287 bp alu repetitive sequence polymorphism in the intron 16 ACE gene (p=0.030, r=0.822). Conclusions. There was a correlation between I/D 287 bp alu repetitive sequence polymorphism in the intron 16 ACE gene and angiotensin II levels in the coronary slow flow phenomenon at Mohammad Hoesin General Hospital Palembang.
Non-Operative Management of Diabetic Foot Osteomyelitis: ACase Report Yunir, Em; Aziza, Yully Astika Nugrahayning
Jurnal Penyakit Dalam Indonesia Vol. 8, No. 2
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Diabetic foot osteomyelitis is an advanced complication of diabetic foot infection which can increase the risk of amputation. This report discusses a case of a 50-year-old female with a wound on the thumb of her left foot that became more swollen with a bluish red color within one month. The patient delayed her treatment due to the COVID-19 pandemic. She has had diabetes and hypertension for 20 years which is uncontrolled. Physical examination showed a sausage toe digiti 1 left pedis with wound 4 x 2 cm with purulent discharge, Probe to Bone (PTB) positive. Laboratory and x-ray examination showed leukocytosis, increased erythrocyte sedimentation rate (ESR) and c-reactive protein (CRP), glucose level 415 mg/dL, and HbA1c 13.1%, with destruction and fragmentation in first toe bone of the left foot. Because she refused minor surgery, the wound was treated regularly by removing infected bone fragments and giving intravenous (IV) antibiotics for four weeks. For glucose level control, continuous IV insulin was given with subcutaneous basal-bolus insulin, then continued by outpatient care with oral antibiotics. After seven weeks, manifestations of infection improved, the wound area was reduced, and antibiotics were discontinued, but wound care was continued. Metabolic control along with long-term antibiotics and wound care for diabetic foot osteomyelitis can be used as an alternative to surgery
Current Clinical Approach of Nosocomial Clostridium difficileInfection Liwang, Frans; Sinto, Robert
Jurnal Penyakit Dalam Indonesia Vol. 8, No. 2
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Hospital-acquired Clostridium difficile infection (CDI) has become one of the global threats because the incidence has increased in recent decades. This nosocomial infection is closely related to antibiotic use in health services and is commonly found in the elderly. Antibiotics can promote colonization and CDI by intestinal microbiota dysbiosis and complex innate immune system activation. The manifestation also has a wide spectrum, ranging from mild diarrhea to fulminant colonic mucosal necrosis. Given that not all colonized subjects will be infected, further investigations such as toxigenic culture, nucleic-acid detection, and stool immunologic tests are only useful in symptomatic cases. In all CDI cases, an effort to control and prevent infections, including rational use of antibiotics, is warranted. Besides the use of antibiotics to eradicate the bacteria, surgery is often indicated in fulminant cases—another novel therapy for recurrent CDI as follows fecal microbiota transplantation, antitoxin antibody, and novel antibiotics.
Dispersi Gelombang QT Salim, Simon
Jurnal Penyakit Dalam Indonesia Vol. 8, No. 2
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Sejak elektrokardiografi (EKG) dibawa ke perhatian klinisi oleh Einthoven1 sampai dengan saat ini, EKG masih merupakan modalitas yang tidak dapat dipisahkan dalam penilaian sistem kardiovaskular. Namun, pemeriksaan yang sederhana dan tidak invasif ini, tidak selalu mudah untuk diintepretasikan. Hasil yang tergambar di kertas EKG tidak murni dipengaruhi jaringan otot jantung saja, namun dipengaruhi juga oleh jaringan tubuh lain yang terdapat di antara jantung dan lokasi dimana elektroda diletakkan. Dengan demikian, hal ini juga harus dipertimbangkan dalam menginterpretasikan hasil EKG.
Association of Proprotein Convertase Kexin/Type 9 with Atherosclerosis in People with Type 2 Diabetes Mellitus: a Systematic Review Luthfia, Farissa; Wisnu, Wismandari; Tahapary, Dicky Levenus; Nugroho, Pringgodigdo
Jurnal Penyakit Dalam Indonesia Vol. 8, No. 2
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Introduction. Type 2 diabetes melitus is the leading cause of cardiovascular event with high level of low-density lipoprotein as the main predictor marker of atherosclerosis. PCSK9 plays a role in LDL-receptor regulation, its association with atherosclerosis had been investigated but the result is inconsistent. This study aimed to examine the association between PCSK9 level and atherosclerosis in people with type 2 diabetes. Methods. A systematic review was done in July 18 – September 02, 2020 and registered in PROSPERO. Risk of bias of each study was analyzed with Newcastle Ottawa scale tools. Studies involved in this systematic review then narratively analyzed by two independent reviewers. Results. There are 430 subjects involved from 4 studies. Guo, et al. reported that there was a significant association between PCSK9 level with atherosclerosis in type 2 diabetes melitus (OR: 1.12 (CI 95% 1.041 – 1.204), p: 0.002), those association was also reported by Ma, et al. with p value Conclusions. There is still insufficient evidence that show the association between PCSK9 level and atherosclerosis in type 2 DM. Therefore, longitudinal primary research is needed.
Controlled Blood Pressure Factors in Hypertension Patients atArifin Achmad Hospital, Riau Province: Cross Sectional Study Nugraha, Dimas Pramita; Bebasari, Eka
Jurnal Penyakit Dalam Indonesia Vol. 8, No. 2
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Introduction. Hypertension is a chronic disease that causes 1 in every 7 deaths. Controlled blood pressure will reduce the complication of hypertension. The aim of this study was to determine the factors that influence controlled blood pressure. Methods.This research was conduct by using an observational method with a cross-sectional study design to analyze factors for controlled blood pressure. The population of this research was all of the hypertension patients at the internal medicine polyclinic in Arifin Achmad Hospital Riau Province. The sample was selected using accidental sampling method. Patient adherence level factor was measured using the Morisky medication adherence scale-8 (MMAS-8) questionnaire. The stress level factor was measured using the DASS-42 questionnaire. The family support factor was assessed using a family support questionnaire that refers to Friedman and House, while the level of knowledge was measured with the Guttman adoption questionnaire. Data analysis was performed by using chi-square and logistic regression tests. Results. From the analysis, it showed that only 16.7% of 96 respondents had controlled blood pressure. In patients with controlled blood pressure, the most common antihypertensive group factor used was calcium channel blocker (18.6%, RP=0.73, p=0.51), antihypertensive monotherapy factor (21.7%, RP=2.17, p=0.15), high knowledge level factor (21.3%, RP=2.11, p=0.16), good adherence factor (22.1%, RP=6.18, p=0.14), normal stress factor (16.2%, RP=3.78, p=1.00), and high family support (23.2%, RP=10.8, p=0.053). Conclusion. In this study, there were no factors that could be predictors of controlled blood pressure at Arifin Achmad Hospital Riau Province.

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