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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. 4" : 9 Documents clear
The difference in Nutrition Intake Adequacy AmongInstitutionalized Elderly Residents with and without Sarcopeniaat Nursing Homes in Bandung, West Java Tirtadjaja, Delia Anastasia; Apandi, Muhamad; Dwipa, Lazuardhi
Jurnal Penyakit Dalam Indonesia Vol. 8, No. 4
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Introduction. The changes in the elderly’s daily routine including dietary intake and nutritional pattern may cause them to be more susceptible to malnutrition. The changes also increase the risk of sarcopenia that may lead to poor health outcomes such as fall injury, fracture, hospitalization, disability, or even death. Sarcopenia is more likely to occur in a nursing home compared to community settings. This study aimed to determine the difference in nutrition intake adequacy between institutionalized elderly subjects with and without sarcopenia in Bandung, West Java. Methods. A cross-sectional study was held in Ciparay and Budi Istri Nursing Home, Bandung, West Java, Indonesia. Sarcopenia was determined based on the Asian Working Group of Sarcopenia (AWGS) criteria. Nutritional intake was assessed with two non-consecutive 24-hour food recalls and nutritional adequacy was defined based on the American Geriatric Society (AGS) recommendation, which included a total energy intake of ≥ 25kcal/kg BW/day and protein intake of ≥1g/kg BW/day. Results. The present study included 65 older adults, who were categorized into 2 groups, i.e. sarcopenic (31 subjects) and non-sarcopenic groups (34 subjects). Despite the food served having already met daily dietary reference intakes, the sarcopenic elderly subjects showed inadequate nutritional intake (p=0.001) compared to non-sarcopenic elderly subjects. Conclusion. There are differences in nutrition intake adequacy between sarcopenic and non-sarcopenic institutionalized elderly subjects in Bandung. Elderly subjects with sarcopenia had more inadequate nutrition intake than non-sarcopenic elderly subjects.
Depressive Symptoms as a Predictor Factor of All-Cause Mortality within Six Months in Elderly Hemodialysis Patients Perdhana, Langgeng; Chasan, Shofa; Mupangati, Yudo Murti; Nuraini, Siti
Jurnal Penyakit Dalam Indonesia Vol. 8, No. 4
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Introduction. Depression is a mental disorder that is often found in the elderly and hemodialysis patients, resulting in bad effects on patients. There is no study on the relationship between depression and all-cause mortality risk in elderly hemodialysis patients in Indonesia. This study aimed to determine the role of depression as a predictor factor of all-cause mortality within 6 months in elderly hemodialysis patients. Methods. A prospective cohort study was conducted from February to August 2020 at the hemodialysis unit of Roemani Muhammadiyah Hospital, Semarang. The inclusion criteria were elderly patients (aged ≥60 years), undergoing hemodialysis ≥3 months, hemodialysis frequency twice a week, willing to participate in this study, able to communicate well, and has no history of mental disorders include a history of psychotic disorders and mental disorders due to substance use. Meanwhile, patients whose data were incomplete, transferred to another hemodialysis unit, HBsAg +, hemoglobin level /dl. FRAILTY score >2, and had other stressors not related to hemodialysis or chronic kidney disease (CKD) such as social, family, and work factors were excluded from this study. Depression was assessed using the Beck Depression Inventory-II questionnaire. The collected data was then analyzed using Kaplan Meier and Cox Regression.Results. Of 32 respondents, most of them were male (81.3%). The mean age was 67.2 (SD 7) years. There were 6 (18.7%) respondents categorized into a depression group and 26 (81.3%) respondents into a non-depression group. Cox Regression analysis showed that depression was a predicting factor of all-cause mortality within six months in elderly hemodialysis patients (p value=0.012, and Hazard ratio=10.149). Conclusion. Depression is a predictor factor of all-cause mortality within six months in elderly hemodialysis patients.
Management of Chronic Kidney Disease-Mineral and Bone Disorder (CKD-MBD) Nugroho, Pringgodigdo
Jurnal Penyakit Dalam Indonesia Vol. 8, No. 4
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Chronic kidney disease (CKD) is still a burden on worldwide health issues affecting about 11-13% of the general population. Chronic kidney disease-mineral and bone disorder (CKD-MBD) is a common complication in CKD, which occurs early in the disease, and progresses as kidney function deteriorates. With declining kidney function, mineral homeostasis becomes progressively dysregulated, including alterations in several parameters such as calcium, phosphate, intact parathyroid hormone (iPTH). Changes in these parameters are associated with bone disorders and vascular abnormalities, which are strongly correlated with increased cardiovascular (CV) morbidity and mortality, and overall mortality. Currently, CKD-MBD and its complication management have been focusing on correcting biochemical and hormonal abnormalities to limit their potential effects. All therapeutic decisions are based on circulating levels of calcium, phosphate and PTH considered together. CKD-MBD management should also be individualized since it might differentially benefit the patients.
Comparison of Lipid Profiles in Patients with Type 2 Diabetes Mellitus with Good Glycemic Control and Poor Glycemic Control in RSUD Dr. Saiful Anwar Malang Yudha, Nyoman Satvika Dharma; Arsana, Putu Moda; Rosandi, Rulli
Jurnal Penyakit Dalam Indonesia Vol. 8, No. 4
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Introduction. Diabetes mellitus (DM) is a group of metabolic diseases characterized by hyperglycemia due to insulin resistance, deficiency of insulin action, or both with a prevalence of 8.5% in Indonesia. Evidence regarding the relationship between HbA1c and lipid profile in type 2 DM is currently contradictory, therefore a study was conducted to examine the relationship between glycemic control and lipid profile for DM patients.Methods. This survey research was conducted at the outpatient endocrine clinic Dr. Saiful Anwar Malang Hospital in 2014-2019 with a total of 1,308 patients. Patients were then classified into type 2 DM patients with good (HbA1c < 7%, n = 291) and poor glycemic control (HbA1c > 7%, n = 1017).Results. There were lower levels of total cholesterol (183.9 (SD 38.7) mg/dl vs. 198.6 (SD 44.8) mg/dl; p < 0.001), triglycerides (144.2 (SD 67.5) mg/dl vs. 172.9 (SD 112) mg/dl; p < 0.001), and low-density lipoprotein (LDL-C) (119.2 (SD 32.1) mg/dl vs. 131 (SD 35.4) mg/dl; p < 0.001) in type 2 DM patients with good glycemic control compared to poor glycemic control group. There was no significant difference in high-density lipoprotein (HDL-C) levels between the two groups (47.7 (SD 13.4) mg/dl vs. 47.5 (SD 12.7) mg/dl; p = 0.89). There was a significant correlation between total cholesterol levels (r = 0.232; p < 0.001), triglycerides (r = 0.223; p < 0.001), and LDL-C (r = 0.20; p < 0.001) with HbA1c levels.173Jurnal Penyakit Dalam Indonesia | Vol. 8, No. 4 | Desember 2021|Perbandingan Profil Lipid pada Pasien Diabetes Melitus Tipe 2 dengan Kontrol Glikemik yang Terkendali dan Kontrol Glikemik yang Tidak Terkendali di RSUD Dr. Saiful Anwar Malang Conclusion. Type 2 DM patients with good glycemic control had significantly lower total cholesterol, triglycerides, and LDL-C levels compared to type 2 DM patients with poor glycemic control.
Factors Associated with Length of Stay of COVID-19 Patients at Serui Regional General Hospital Papua Province: Cross-Sectional Study Baihaqi, Fahri Ahmad; Rumaropen, Henny
Jurnal Penyakit Dalam Indonesia Vol. 8, No. 4
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Introduction. Coronavirus Disease 2019 (COVID-19) is a respiratory infectious disease caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2 has become a global health problem. The length of stay of the patient is related to the use of hospital resources. COVID-19 patients are at risk of increasing length of stay due to various factors and the increased length of stay can increase the burden of health services. The purpose of this study was to determine the factors that influence the length of stay of COVID-19 patients.Methods. An observational analytic study with a cross-sectional design was conducted at Serui Regional General Hospital, Papua Province. The subjects were COVID-19 patients hospitalized from September 2020 – August 2021 who met the inclusion and exclusion criteria. Subjects were selected by purposive sampling technique. The Independent variables were gender, age, fever, cough, sore throat, shortness of breath, myalgia, malaise, headache, anosmia, vomiting, diarrhea, comorbidities, diabetes, hypertension, asthma, tuberculosis, malaria, hemoglobin, leukocytes, platelets, and neutrophil-lymphocyte ratio (NLR). The dependent variable was the length of stay. Data were obtained from medical records. Bivariate analysis was done with chi-square test, Fisher’s test is used as an alternative if the requirements were not met. Significant variables were analyzed with a multivariate logistic regression test.Results. From 48 subjects of COVID-19 patients hospitalized from September 2020 – August 2021 at Serui Regional General Hospital, Papua Province there were 26 subjects (54.2%) with a length of stay >11 days. The median length of stay was 11 days. Multivariate analysis showed that the factors associated with the length of stay in COVID-19 patients were fever (p=0.003; OR 10.59; 95% CI 2.22-50.49) and NLR (p=0.034; OR 4, 55; 95% CI 1.12-18.49).Conclusion. Fever and NLR are factors associated with the length of stay of COVID-19 patients at the Serui Regional General Hospital, Papua Province.
The Relationship of Subjective Global Assessment (SGA) with Energy Intake, Protein, Hand Grip Strength and Body Mass Index in Chronic Kidney Disease (CKD) Patients with Continuous Ambulatory Peritoneal Dialysis (CAPD) Adrianto, Yudhi; Hustrini, Ni Made; Kresnawan, Triyani; Amelia, Annisa Eka; Hudayani, Fitri
Jurnal Penyakit Dalam Indonesia Vol. 8, No. 4
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Introduction. Energy and protein intake in chronic kidney disease (CKD) with continuous ambulatory peritoneal dialysis (CAPD) therapy plays an important role in balancing hypercatabolic conditions. Unbalanced intake will result in energy and protein deficits which are increasing the risk of muscle catabolism, decreasing body mass index (BMI), and malnutrition. Subjective global assessment (SGA) as the gold standard in nutritional assessment is needed in assessing nutritional status and determining malnutrition, therefore nutritional intervention can be delivered and improve CAPD patients’ quality of life. This study was conducted to determine the relationship between SGA with energy and protein intake, hand grip strength, and body mass index on CKD patients undergoing CAPD. Methods. A cross-sectional study was conducted among 30 CKD patients undergoing CAPD which were purposively selected using total sampling. Nutritional status was assessed using SGA questionnaire, energy and protein intake was assessed through food records, and hand grip strength was measured by jamar hydraulic hand dynamometer. The normality of the data was tested using the Kolmogorov-Smirnoff test and bivariate analysis was conducted using the Chi-Square test. Results. Of a total of 30 CKD patients, most of them were aged 25-55 years (76.6%), while the age group <25 years was only>6.7%. More than 73% of patients had normal SGA nutritional status and 26% were malnourished. The average energy requirement was 1,942 (SD 277) Kcal, the lowest energy intake was 921 kcal/day and the highest was 1,959 kcal/day with an average dialysate energy intake of 404 (SD 42) kcal. The average protein intake was 54 (SD 9.5) grams, while the average protein requirement was 70.7 (SD 9.7) grams/day. Based on BMI status, 20% of subjects were underweight, 60% normal, and 20% overweight. A total of 53.3% of patients had poor hands grip strength and only 46.7% were normal with an average grip strength was 26.7 (SD 9.3) kg. Analysis showed that SGA was not related to energy intake (p<0.857), grip strength (p<0.307), and BMI (p<0.829). However, there was a relation between protein intake and SGA (p<0.048, OR: 1.233, 95% CI: 1,058 – 2,389). Conclusions. Inadequate protein intake is related to the risk of malnutrition than adequate protein intake. There is no relationship between energy intake, hands grip strength, and BMI on SGA scores.
Correlation between Polypharmacy and Length of Stay Geriatric Patient in Mohammad Hoesin Palembang Hospital Tanzil, Iswadi; Riviati, Nur; Saleh, Irsan
Jurnal Penyakit Dalam Indonesia Vol. 8, No. 4
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Introduction. Geriatric patients have multipathological characteristics, low physiologic reserves, atypical clinical signs and symptoms, decreased functional status, and nutritional disturbances. This situation is a risk factor for polypharmacy. Polypharmacy is closely related to drug side effects, drug interactions, and patient compliance. Polypharmacy is thought to have a relationship with the length of stay in geriatric patients. The purpose of this study was to determine the correlation between polypharmacy and length of stay in geriatric patients at Moehammad Hoesin Hospital Palembang. Methods. This was a cross-sectional study with a correlation test design conducted at Dr. Mohammad Hoesin Hospital (RSMH) Palembang from April 2021 to July 2021. The sample was geriatric patients aged > 60 years. We collected data on the number and types of drugs given and the length of hospitalization. All data processing and analysis in this study were conducted by using SPSS version 22 for Windows. Results. Of 56 geriatric patients, there was 28 female (50%) and 28 male (50%). The median value of the number of drugs was 7 (3-32). Patients without polypharmacy were 7 (12.5%), and patients with polypharmacy were 49 (87%). The median length of hospitalization for geriatric patients at RSMH was 11.5 (range 1-47) days. There was a correlation between polypharmacy and length of stay (r=0.277; p value=0.039). Conclusion. There is a weak correlation between polypharmacy and length of stay (r=0.277; p=0.039).
The Challenges of Diagnosis and Management of SuspectedAutoimmune Hepatitis in a 34-Year-Old Woman with PeriodicParalysis and Graves’ Disease Larasati, Yeni; Wahono, C. Singgih
Jurnal Penyakit Dalam Indonesia Vol. 8, No. 4
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Periodic paralysis hypokalemia is a muscle weakness that can be caused by hyperthyroidism due to Graves’ disease. The prevalence reaches 10% of patients with periodic paralysis hypokalemia with symptoms of thyrotoxicosis. Graves’ disease is an immune system disorder that can cause other organ dysfunction, such as autoimmune hepatitis. Currently, the diagnosis of autoimmune hepatitis is still a challenge for clinicians due to limited supporting examination facilities, such as SMA, AMA, anti-LKM-1. This article discusses a case of a 34-year-old woman with limb weakness for 3 months, losing 4 kg of weight in 1 month, often feeling hungry, restless, having trouble sleeping, unable to stand the heat, and palpitation. Her urine was looked like a tea color for the last 10 days. Laboratory examination results showed an increase in alanine transaminase (ALT) levels 256 U/I and aspartate aminotransferase (AST) 142 U/I, accompanied by an increase in total bilirubin levels of 12.09 mg/dl, direct bilirubin 10.5 mg/ dl. Markers of hepatitis B (HbsAg) and anti-HCV were negative. The potassium level was 2.29 mmol/L and the antinuclear antibody test was 1.3 IU/ml. Thyroid-stimulating hormone (TSH) <0.01 uIU/ml, and FT4 5.46 mg/dl. Abdominal ultrasound showed chronic liver disease. Histopathology of liver tissue showed chronic hepatitis with inflammatory infiltration. The patient had been treated with thiamazole, potassium supplements, propranolol, and prednisone. As a result, the patient’s condition and liver enzyme tests improved
Depresi pada Populasi Lanjut Usia yang Menjalani Hemodialisis Faisal, Edward
Jurnal Penyakit Dalam Indonesia Vol. 8, No. 4
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Menurut laporan tahunan European Renal Association–European Dialysis and Transplant Association (ERA-EDTA), pasien yang menjalani transplantasi ginjal dari tahun 2014 sampai 2018 memiliki kesempatan hidup hanya setengah dari usia dengan sisa fungsi ginjal yang ditransplantasikan, sedangkan untuk pasien yang dilakukan hemodialisis (HD) adalah 70% lebih pendek.

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