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INDONESIA
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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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
Correlation of Ramadan Fasting with HbA1C and Lipid ProfileLevel Changes in The Risk Stratification of Complications inDiabetes Mellitus Patients Bramantya, Rinadhi Reza; Arsana, Putu Moda; Sasiarini, Laksmi
Jurnal Penyakit Dalam Indonesia Vol. 8, No. 1
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Introduction. Diabetic patients will still do Ramadan fasting, which could affect the levels of HbA1C and lipid change after Ramadan. This study aimed to identify the correlation between fasting of Ramadan risk stratification with HbA1C and lipid levels diabetic patients who run the fast of Ramadan. Methods. This was a survey research using pre - post test. Study was conducted among diabetes patients who meet the criteria: carry out routine controls before and after Ramadan fasting at dr. Saiful Anwar Malang Hospital, filling in the required data, and underwent examination laboratory. Patients were grouped into moderate, high, and very high-risk stratification. Then we analyzed the HbA1C and fat levels before (pre) and after (post) Ramadan fasting in each risk group. Results. There were 25 subjects included in this study. There was a decrease in HbA1C level in all subjects from 7.93% (SD 2.3) to 7.86% (SD 1.9) after Ramadan fasting (p = 0.563), only the moderate risk group increased by 0,37% (SB 0.27). In all subjects, total cholesterol levels increased from 196.4 (SD 48.7) mg/dl to 205.0 (SB 70.8) mg/dl (p = 0.397), with the highest change found in the very high-risk group with an increase 30,7 (SD 125.0) mg/dl. There was a decrease in HDL levels from 55.6 (SD 31.3) mg/dl to 47.8 (SD 10.5) mg/dl (p = 0.782), and the highest decrease occurred in the very high - risk group (27.7 (SD 66,9) mg / dl). There was an increase in the LDL from 115.9 (SD 45.8) mg/dl to 130.4 (SD 41.9) mg/dl (p = 0.133) which the highest increase found in the very high-risk group (55.0 (SD 74.7) mg/dl). Only triglycerides showed an improvement from 190.7 (SD 105.2) mg/dl to 188.8 (SD 79.6) mg/dl (p = 0.084), increasement only occur in the high risk group (13.2 (SD 213.4) mg/dl). Conclusion. There was a decrease in HbA1C levels, but the value of the statistics was not significant. There was a negative effect of fasting Ramadan against blood-fat levels, except for improvements in the levels of triglycerides though statistically not significant
Retraction: Correlation of Serum Uric Acid Levels with The Severity Of Coronary Artery Stenosis in Patients with Acute CoronarySyndrome: Meta-Analysis Study Prasetyo, Diding Heri; Nasution, Sally Aman; Alwi, Idrus; Abdullah, Murdani
Jurnal Penyakit Dalam Indonesia Vol. 8, No. 1
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Introduction. The relationship between serum uric acid (SUA) level and ischemic heart disease abides controversial and still has not been established as a cardiovascular risk factor. The cooperative interaction between those two factors is not fully understood. Prior epidemiological evidences of the causal relationship is still argumentative. There were various studies using the same methods yet the outcome were different. This study aims to conduct a meta-analysis to synthesize the results of recent studies in order to obtain data quantitatively and also accurately. Methods. This study protocol was registered with PROSPERO (CRD42020210948), and conducted according to PRISMA guidelines, tracing studies published in vulnerable periods from January 2010 to May 2020. The Cochrane Library, EBSCO, Medline/PubMed, ProQuest and Science Direct are sources of published studies. Meta-analysis was conducted to synthesize the associations between SUA level and severity of coronary artery stenosis, using random effect model to account for possible study heterogeneity. Heterogeneity was assessed using I2 , and the meta-analysis was performed using comprehensive meta-analysis version 3 (CMA3) software. Results. Five studies (n = 601 patients) identified a correlation between serum uric acid levels and Gensini scores (r = 0.548; p <0.001) in ACS patients. Heterogeneity bias was found in the analysis, whereas publication bias was not found. There was a moderate positive correlation between serum uric acid levels and the severity of coronary artery stenosis, with a correlation coefficient of 0.548 (p value <0.001).
Correlation between Parathyroid Hormone Serum Levels andAbdominal Aortic Calcification in Chronic Hemodialysis Patientsat Dr. Mohammad Hoesin Center General Hospital Palembang Akbar, M Yusuf Arief; Ali, Zulkhair; Indrajaya, Taufik; Suhaimi, Novadian; Devi, SNA Ratnasari; Bahar, Erial
Jurnal Penyakit Dalam Indonesia Vol. 8, No. 1
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Introduction. Cardiovascular disease is the most common cause of death in patients with chronic kidney disease (CKD). This is evidenced by the finding of vascular calcification in CKD patients. The process of vascular calcification that occurs is often associated with secondary hyperparathyroid conditions that are complications of CKD patients. The aim of this study was to asses the relationship between serum PTH levels and the abdominal aorta calcification (AAC) in CKD patients undergoing hemodialysis (HD) Methods. This observational analytic study with cross-sectional correlation test was conducted in the internal medicine ward of dr. Mohammad Hoesin Palembang from July to December 2019. Subjects were patients who had undergone HD >3 months with age >18 years. All subjects were examined for serum PTH levels and measured the carotid artery wall using doppler ultrasonography and the degree of calcification of the abdominal aorta using a lateral lumbar X-ray which was calculated using the Kauppila score. Results. There were 86 of HD patients studied, 65 subjects (75.6%) had high serum PTH levels and 46 subjects (53.5%) who had AAC. The Spearman correlation analysis showed that serum PTH levels had a relationship with Kauppila score (p=0.014, r=0.264). Multivariate linear regression analysis obtained age (p<0.001, r=0.510), duration of HD (p=0.020, r=0.256), history of hypertension (p=0.031, r=0.239) and serum phosphate levels (p=0.011, r=0.281) had a relationship to the Kauppila score. Conclusions. There is a significant relationship between serum PTH levels and AAC in chronic HD patients. The presence of factors including age, duration of HD, hypertension, and serum phosphate levels also affect the incidence of AAC
Correlation of Haemoglobin Platelet Ratio (HPR) and LeukocytePlatelet Ratio (LPR) with SYNTAX-2 Score in STEMI Patients Ikhsan, Muhammad; Nasution, Sally Aman; Rachman, Andhika; Muhadi, Muhadi
Jurnal Penyakit Dalam Indonesia Vol. 8, No. 1
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Introduction. Various studies have concluded the association between various markers of inflammation with the clinical outcome in STEMI patients. However, most of these markers are quite expensive and not available in healthcare facilities. Hence, we aim to study the correlation between haemoglobin platelet ratio (HPR) and leucocyte platelet ratio (RPL) and the clinical outcomes of STEMI patients. Methods. This is a cross-sectional study performed in adult patients with STEMI who were hospitalized in Intensive Coronary Care Unit Cipto Mangunkusumo Hospital between January 2016 and October 2020. The data was analyzed by testing the correlation between HPR and LPR with SYNTAX-2 score. Results. There were 114 subjects in this study, with a mean age was 53.87 years and dominated by male (86.8%). We found no correlation between HPR and LPR with SYNTAX-2 Score. From the sub-group analysis, there was a moderate positive correlation between HPR and SYNTAX-2 score (r = 0.587; p= 0.005) and a strong positive correlation between LPR and SYNTAX-2 score (r = 0.606; p = 0.004) in subjects with normal body mass index (BMI). Additional results obtained a strong negative correlation between neutrophil lymphocyte ratio (NLR) with SYNTAX-2 score (r = -0.738; p= 0.0037) and a very strong negative correlation between platelet lymphocyte ratio (PLR) with SYNTAX-2 score (r= -0,857; p= 0,007) in subjects with low BMI. Conclusion. There is no correlation between HPR and LPR with SYNTAX-2 Score
Comparative Evaluation of Alpha-Fetoprotein Serum inHepatocellular Carcinoma Patients with Non-Viral Etiology Aprilicia, Gita; Bantas, Krisnawati; Syarif, Syahrizal; Kalista, Kemal Fariz
Jurnal Penyakit Dalam Indonesia Vol. 8, No. 1
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Introduction. Non-viral etiology of hepatocellular carcinoma (HCC) now needs attention. Hepatocellular carcinoma which was caused by hepatitis B and hepatitis C could be controlled in the national program, while HCC from non-B non-C etiology has become a further concern with the with the increased of metabolic syndrome. Serum alpha-fetoprotein is a tumor marker commonly used for screening for HCC in patients with liver cirrhosis (LC). However, in HCC patients with nonviral etiology, AFP serum tends to be normal. This study aimed to evaluate the performance of AFP serum based in HCC and LC patient with non-viral etiology and to evaluate the factors associated with elevated AFP. Methods. Data HCC from registry at Cipto Mangunkusumo Hospital in the period August 2015 to December 2019 were collected. Patients with liver cirrhosis (LC) were taken as the control group. The etiology of liver disease is determined by viral serological examination. Non-viral etiology was defined as a patient who was anti-HCV negative and HBsAg negative. Differences in AFP levels were evaluated by using the Mann Whitney test. Performance of serum AFP in viral and non-viral etiologies were evaluated by receiver operation character (ROC). The factors associated with an increase in AFP by a threshold of 10 ng/ml were evaluated by multivariate analysis using logistic regression. Results. There were 295 HCC patients and 155 LC patients who were included in this study. Non-viral etiology was found in 16.1% of LC group and 14.9% of HCC group. The median serum AFP in HCC patients was higher than in LC patients, 187.50 ng/ml vs. 4.60 ng/ml, p 5 cm was 2.89 (95% CI: 1.56 - 3.67; p value 0.001). Conclusions. AFP Serum is low in HCC patients with non-viral etiology. The increase of serum AFP above 10 ng/ml is associated with etiology of viral hepatitis and tumor size.
EGFR Mutation as a Predictive Factor to Treatment Response ofTKI (Tyrosine Kinase Inhibitor) in Non-Small Cell Lung CancerStage 4: A Case Report Rajabto, Wulyo; Angkasa, Yohana Kusuma
Jurnal Penyakit Dalam Indonesia Vol. 8, No. 1
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Non-small cell lung cancer (NSCLC) typically presents in patients at an advanced stage, with a poor prognosis. The development of epidermal growth factor receptor (EGFR) – tyrosine kinase inhibitors (TKIs) and the systematic identification of EGFR mutations heralded the advent of targeted therapy in lung cancer, transforming the landscape of its treatment and prognosis. This is a case of 37 years-old female patient presented with metastatic bone disease secondary to pulmonary adenocarcinoma EGFR mutation positive which demonstrated a remarkable result to TKI.
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.

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