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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 414 Documents
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Kecubung Intoxication: A Case Report on A 16-Year-Old Male at Kuningan District Saputera, Monica Djaja; Saputera, Jessica Djaja
Jurnal Penyakit Dalam Indonesia Vol. 9, No. 4
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Kecubung (angel’s trumpet) is a plant with hallucinogen effect which contain a tropane alkaloid, which are widely grown in Indonesia and is widely abused by several groups of adolescents aged 18 years in East Nusa Tenggara. Kecubung intoxication is a common case in Indonesia, but rarely reported and hard to make a definitive diagnosis due to lack of the toxicology screening assessment. Besides, an antidote of this case also not available in this country. We present a case of 16-years old male who visited the emergency room with fluctuating level of consciousness accompanied by anxiety, anger, and a visual hallucination. He was given an IV Diazepam 10 mg and Alprazolam 0.5 mg oral in the first day, and continue with Risperidone 2 mg oral – twice a day, Trihexyphenidyl Hydrochloride 2 mg and Clozapine 12.5 mg oral – once a day, and resulting in significant improvement of symptoms and behavior.
Second-Line Therapy Tyrosine Kinase Inhibitor for Chronic Phase Chronic Myeloid Leukemia Resistant to Imatinib Pratiwi, Chici; Rajabto, Wulyo
Jurnal Penyakit Dalam Indonesia Vol. 9, No. 4
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Since the era of tyrosine kinase inhibitor (TKI) therapy, there has been an increase in the median survival of chronic myeloid leukemia. Nevertheless, nowadays there were several cases of chronic myeloid leukemia that are resistant to the first-line TKIs, so that several second-line TKIs were introduced. Assessment of the therapeutic response was performed using a complete peripheral blood examination, bone marrow aspiration cytogenetic examination, and quantitative BCR-ABL examination. The treatment failure criteria were applied based on the ELN criteria. In selecting the second line TKI should be based on the results of mutation analysis and consider the safety profile of the second line therapy. This paper will discuss the recommendations for second-line therapy TKI, adjusted to the resources in Indonesia.
Efektivitas Ekstrak Strobilanthes crispus terhadap Kadar Glukosa Darah Puasa dan Pasca Tes Toleransi Glukosa Oral pada Rattus norvegicus Diabetes Melitus Gunawan, Alvin; Wihanto, Laura; Muliono, Ari Christy
Jurnal Penyakit Dalam Indonesia Vol. 10, No. 1
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Introduction. The 2018 Riskesdas data shows that the prevalence of diabetes mellitus is increasing each year. Strobilanthes crispus leaves are known for lowering blood glucose levels. This study aimed to determine the difference in the effectiveness of S. crispus leaves ethanolic extract on fasting blood glucose (FBG) and post-oral glucose tolerance test (OGTT). Methods. True experimental study using post-test only control group design and Rattus norvegicus as experimental animals. Rattus norvegicus were selected by random sampling which were then divided into 4 groups (K, P1, P2, P3), each group consisted of 5 animals. The animals were subsequently induced with diabetes mellitus via a single injection of 160 mg/kgBW/IP alloxan. Group K was given 0.5% NaCMC solution at a dose of 1 ml/200 g BW/day/oral/day. Group P1, P2, and P3 received extract at a dose of 100, 400, 600 mg/kg BW/oral/day for 21 days using oral gavage. Statistical analysis was performed using ANOVA, Tukey, Brown-Forsythe, and Kruskal-Wallis tests. Results. Mean FBG level in group K, P1, P2, P3 were 338.40 mg/dL, 270.80 mg/dL, 200.00 mg/dL, and 138.60 mg/dL, respectively. Mean value of 60 minutes OGTT blood glucose level in group K, P1, P2, P3 were 355.60 mg/dL, 289.00 mg/dL, 188.00 mg/dL, and 164.40 mg/dL, respectively. Meanwhile, mean value of 120 minutes OGTT blood glucose level in group K, P1, P2, P3 were 346.60 mg/dL, 236.20 mg/dL, 175.40 mg/dL, and 117.20 mg/dL, respectively. The hypothesis test results showed a significant difference in 120 minutes OGTT blood glucose level (p= 0.031). Conclusion. The use of ethanol extract from S. crispus leaves is more beneficial in reducing blood glucose levels in 120 minutes OGTT compared to FBG level and 60 minutes OGTT level, with the highest reduction observed in the group given a dose of 600 mg/kgBW/oral/day compared to control. Keywords: DM, fasting blood glucose, OGTT, Rattus norvegicus, Strobilanthes crispus
Gambaran Risiko Post-Traumatic Stress Disorder (PTSD) pada Penyintas COVID-19 di Rumah Sakit Universitas Andalas Wahyuni, Sri; Widya Murni, Arina; Indra, Beni; Gusya Liza, Rini; Koerniati, Isnindiah; Sauma, Eldi
Jurnal Penyakit Dalam Indonesia Vol. 10, No. 1
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Introduction. The COVID-19 pandemic has a negative impact on life where sufferers can experience emotional problems such as despair, deep sadness, helplessness, anxiety, and depressive symptoms. Especially in hospitalized COVID-19 survivors, there are sequelae in the form of anxiety, depression, and Post-traumatic Stress Disorder (PTSD). PTSD experienced by COVID-19 survivors will affect the patient’s quality of life in the future. This study aimed to assess the risk of PTSD in COVID-19 survivors who had been hospitalized at Andalas University Hospital. Methods. A cross-sectional descriptive study was conducted among COVID-19 survivors aged ≥15 years who had been hospitalized at Andalas University Hospital. Samples were selected by using total sampling method with inclusion criteria included experiencing mild, severe, or critical clinical symptoms during COVID-19 infection, being discharged from Andalas University Hospital for six months or more, and willing to participate in the study by signing an informed consent. Samples who have met the inclusion criteria completed the Bahasa Indonesia version of PCL-5 (PTSD Checklist for DSM-5) questionnaire which has been tested for its validity and reliability. Respondents were categorized as having PTSD risk if the questionnaire results showed a score of ≥23. The collected data were subsequently analyzed using univariate analysis. Results. A total of 75 respondents were included in the study, of which 9.3% (7) were found to be potentially or at risk of PTSD. The group of respondents who were at risk of PTSD was mostly comprised of females, and all of them experienced the four PTSD symptoms (intrusion/re-experiencing, avoidance, negative alterations in cognition and mood, and hyperarousal). The most common trigger that causes PTSD among respondents was the experience of a previous life-threatening traumatic event (71.43%). In addition, the most frequent clinical symptoms of COVID-19 in the PTSD risk group were severe clinical symptoms (71.43%). Conclusions. COVID-19 survivors who have the potential to experience PTSD are predominantly female survivors with severe clinical symptoms, experiencing all four PTSD symptoms, and having a traumatic life-threatening experience during COVID-19 hospitalization. Keywords: COVID-19 survivors, hospitalization, risk of PTSD
Modulasi Mikrobiota untuk Memperbaiki Laju Filtrasi Glomerulus, Toksin Uremik, dan Penanda Inflamasi pada Gagal Ginjal Kronik: Telaah Sistematik dan Meta-Analisis Gunawan, Burhan; Purwata, Raymond Sebastian; Hidayat, Syarif; Pandapotan, Roy Akur; Jennifer, Jennifer
Jurnal Penyakit Dalam Indonesia Vol. 10, No. 1
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Introduction. Dysbiosis microbiota is considered as one of the consequences and impacts of high uremic toxins in patients with Chronic Kidney Disease (CKD), which can lead to an increased risk of progression and mortality. The aim of this systematic review and meta-analysis was to perform quantitative effect of microbiota modulation for estimated Glomerular Filtration Rate (eGFR), uremic toxin (total-p cresyl/total pCS), and inflammatory marker (hs-CRP) outcome among CKD patients. Methods. Article searches were conducted from PubMed, ScienceDirect, and Cochrane Library data sources from 2010-2022. Assessment of article quality follows the rules of PRISMA (Preferred Reporting Items in Systematic Review and Meta-Analysis). Only randomized controlled trial (RCT) articles investigating the effect of symbiotic, prebiotic, of probiotic for CKD were included in the analysis. Effect size quantify from Standardized Mean Difference (SMD), using a continuous random effect model and described in the forest plot model. Results. A total of 17 RCT studies with a total 867 CKD stage 1-5 subjects (440 subjects in the intervention group and 427 subjects in the control group). The intervention duration ranging from 1-12 months. The studies included had varied on methodologies, with significant heterogenicity (I296,96%, p Conclusions. The administration of probiotic/prebiotic/symbiotic supplements to CKD patients resulted in significant improvements in e-GFR and reductions in total pCS. These results suggest the potential of symbiotic, prebiotic, and probiotic supplementation to improve CKD outcome. Keywords: Chronic kidney disease, e-GFR, hs-CRP, prebiotic, probiotic, uremic toxin
Cutaneous Anthrax in Gunung Kidul, Yogyakarta: A Case Report Riswanto, Riswanto; Redhono, Dhani; Nurhayatun, Evi
Jurnal Penyakit Dalam Indonesia Vol. 8, No. 3
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Bacillus anthracis is an aerobic, gram-positive, and spore-forming Bacillus species. The most common form of anthrax infection is the cutaneous form. The infection usually develops several days after exposure to products of infected animals and manifest as a black sore with severe swelling on the skin. In this report, a 60-year-old man with a black and swollen lesion on her index finger presented in Gunung Kidul in December 2019. ELISA antibody anthrax serum was performed. The patient was then treated with antibiotics after diagnosis. This patient had a history of contact with the beef of a slaughtered sheep. The patient was treated after making a correct and rapid diagnosis and sufficient antibiotic therapy. We presented this case to update our information about cutaneous anthrax, which are become a current issue again. With appropriate management, cutaneous anthrax can heal with a good result.
Depression in Heart Failure: Psychosomatic Approachv Putranto, Rudi; Shatri, Hamzah; Wijaya, Ika Prasetya; Faisal, Edward
Jurnal Penyakit Dalam Indonesia Vol. 8, No. 3
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Depression is a common condition in heart failure (HF) and is considered a risk factor for cardiovascular disease. Depression disorder in patients with heart disease paradigmatically defines a psychosomatic-somatopsychic challenge to any health delivery. However, despite the devastating effects of depression, it is often underdiagnosed and receives little attention in heart failure patients. This review provides an extensive overview of HF regarding epidemiology, disease pathophysiology, diagnosis, and management from the latest literature. Based on the literature review, the prevalence of depression in heart failure in Indonesian patients was 5.3-42%. Psychological stress experienced by people suffering from depression can cause dysregulation in the sympathetic nervous system and hypothalamic–pituitary–adrenal (HPA) axis. This mechanism, in turn, has some deleterious downstream effects, including the development of hypertension, left ventricular hypertrophy, coronary vasoconstriction, endothelial dysfunction, platelet activation, and the production of pro-inflammatory cytokines. The Diagnostic and Statistical Manual of Mental Disorders-5 (DSM-5), published by the American Psychiatric Association, is used to diagnose depression in patients with HF. Meanwhile, the Patient Health Questionnaire (PHQ)-2 and PHQ-9 are commonly used as screening tools for depression in patients with HF. The Biopsychosocial-spiritual model as a psychosomatic approach have might reduce or prevent depression and thus improve quality of life and other outcomes. Evidence reveals that both psychotherapeutic treatment (e.g., cognitivebehavioral therapy) and pharmacologic treatment (e.g., use of the selective serotonin reuptake inhibitor sertraline) are safe and effective in managing depression in patients with cardiovascular disease. In conclusion, the review of articles in this paper shows that there is a high prevalence of depression in heart failure, but it is often not recognized by doctors, there is a relationship between psychosomatic, and heart failure, non-pharmacological interventions such as psychotherapy and pharmacological therapy have benefits. Future research is needed to create evidence-based evaluations and treatment algorithms tailored to the specific needs of the target population.
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.

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