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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,
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.
Articles 414 Documents
The Correlation Between MIR-146A and Platelet to Lymphocyte Ratio to Liver Fibrotic on Hepatitis B S.R, Brillian Van Fito; Budi S, R. Satriyo; Pramana, Triyanta Yuli
Jurnal Penyakit Dalam Indonesia Vol. 9, No. 2
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Introduction. Liver fibrosis is a pathological condition as a recovery tissue respond, characterized by excessive extracellular matrix deposit. MicroRNA (miRNA or miR) has a pivotal role on progression of hepatic cirrhosis. Platelet to lymphocyte ratio (PLR) could be as a good predictor of liver fibrosis. This study aimed to find the correlation between miR-146a and PLR with liver fibrosis in Hepatitis B.Method. The cross sectional study conducted in Gastroenterohepatology Clinic of Internal Medicine Department RSUD Dr. Moewardi Surakarta in Januari – Juli 2020, involving 26 Hepatitis B naïve patients. Complete blood count, serum creatinine, liver enzyme, HBsAg, miR-146a, elastography measurement using FibroScan were performed.Results. The average age of patients was 49 (SD 11) years, mainly men (n : 17, 66%). The results from bivariate analysis demonstrated that miR-146a was significantly associated with liver fibrosis (r = 0,639 dan p < 0,001). PLR was also significantly associated with liver fibrosis (r = -0,455 dan p = 0,020). Conclusion. There was a significant correlation between miR-146a and PLR with liver fibrosis on Hepatitis B.
Clinical Profile of COVID-19 Older Patients Hospitalized in Immanuel Teaching Hospital Bandung Vera, Vera; Suprana, Yossie Guventri Eka
Jurnal Penyakit Dalam Indonesia Vol. 9, No. 2
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Introduction. It was reported that 11.2% out of the 78,572 confirmed cases of COVID-19 in Indonesia was foundinolder people with a high mortality rate. There is no available data regarding functional and frailty status of these COVID-19 older patients. This study aimed to describe clinical profile of older COVID-19 patients in terms of geriatric aspect, in order to design better hospital policy for older patients in the COVID-19 isolation ward.Methods. This was a retrospective cohort study of confirmed COVID-19 patients aged >60 years which were admitted to Immanuel Teaching Hospital Bandung during the period of October 2020 - January 2021. Clinical characteristic data, frailty status, mode of oxygen therapy, functional status (activity of daily living – ADL) during and after hospitalization, as well as patient hospitalization outcomes were recorded from the medical record.Results. There were 100 COVID-19 older patients, more than half were aged 60-70 years, most with not frail status. This study found that 74% of older patients had decreased ADL scores, once they got infected with COVID-19. We also found that 43% of COVID-19 older patients died during hospitalization, dominated by frail patients. Among COVID-19 older survivor, 55%had increased ADL score when discharged. A month later, only 25%patients had better ADL scores.Conclusion. Typical symptoms of COVID-19 are not always found in older patients. Apart from its deadly consequence and prolonged hospitalization, the impact of COVID-19 on older patients is decreased functional status, so special management policy for older COVID-19 patients should be considered.
The Assossiation Between Stress During the COVID-19 Pandemic and the Incidence of Dyspepsia Syndrome in The First Year Medical Students Rahmi, Wahida; Yulistini, Yulistini; Murni, Arina Widya
Jurnal Penyakit Dalam Indonesia Vol. 9, No. 3
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Introduction. Dyspepsia syndrome is a collection of symptoms in the upper digestive tract associated with dysregulation of the hypothalamus-hypophysis axis that is triggered by stress. One of the problems faced in the world today is the COVID-19 pandemic which can be a new stressor, especially for students with many changes in the learning process. This study aimed to examine the relationship between stress during the COVID-19 pandemic and the incidence of dyspepsia syndrome.Methods. An analytic obsevasional with cross-sectional design was conducted in April-June 2021 at the Faculty of Medicine, Andalas University. The subjects of this study were the first batch of medical students which were selected by total sampling. Level of stress was measured using a questionnaire adapted from DASS-42, meanwhile dyspepsia syndrome was examined using ROME IV questionnaire. Bivariate analysis was conducted by using Chi-square and Fisher exact test.Results. 68 of 238 students experienced stress with the most stress levels was mild-moderate stress (85.3%) and severe-very severe stress (14.7%). There were 44 students who experienced dyspepsia syndrome from a total of 68 respondents (64.7%). There was no relationship between stress and the incidence of dyspepsia syndrome (p=1,00). However, child’s status were found to be a risk factor for stress stres [p=0.006; OR=13.46 (95%CI 2.134-84.894)].Conclusions. There is no significant relationship between stress during the COVID-19 pandemic and the incidence of dyspepsia syndrome in first-year medical students. However, the results of this study indicate that first child status is a risk for stress to dyspepsia.
Prevalence of Geriatric Syndromes in Elderly Undergoing Chemotherapy Rizka, Aulia; Helda, Helda; Prasetyawaty, Findy; Hanjani, Arcita
Jurnal Penyakit Dalam Indonesia Vol. 9, No. 3
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Introduction. Geriatric syndromes is associated with poor survival, poor quality of life and increased chemotoxicity risk in elderly receiving chemotherapy. Geriatric syndromes is currently not routinely evaluated in pre-chemotherapy clinical setting. This study aimed to identify the prevalence of some geriatric syndromes in elderly patients undergoing chemotherapy.Methods. This study is part of primary study investigating geriatric syndromes in elderly with cancer. A descriptive cross sectional study during March 2020 – March 2021 was conducted to elderly patients before chemotherapy administration in Cipto Mangunkusumo Hospital, a national referral hospital in Jakarta. Patients were recruited consecutively. Patients underwent Comprehensive Geriatric Assesment (CGA), including nutritional, depression, sarcopenia risk assessment, frailty, cognitive assessment, as well as medication review.Results. Total of140 elderly subjects were recruited with mean age of 66 years old. 52% subjects were women and 67% with solid tumor. As many as 80% subjects were having malnutrition, 40,6% were frailt, 40,3% were at high risk of sarcopenia, 14,1% with depression, and 19,1% were having cognitive impairment. Of all subjects, 24,1% have more than 3 diagnosis of geriatric syndromes.Conclusion. As geriatric syndromes are prevalent among elderly subjects receiving chemotherapy, routine identification would be useful to improve cancer treatment result.
Lactate/Albumin Ratio as a Predictor of Mortality in Patients with Sepsis and Septic Shock: A Meta-Analysis Study Baihaqi, Fahri Ahmad; Delarosa, Dinda Olinda; Ramadhan, Rezki
Jurnal Penyakit Dalam Indonesia Vol. 9, No. 3
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Introduction. The lactate/albumin ratio is an inflammatory biomarker that has been widely used and suggested as a predictor of mortality in patients with sepsis and septic shock. However, the results are inconsistent. This meta-analysis aimed to evaluate the prognostic value of lactate/albumin ratio as a predictor of mortality in patients with sepsis and septic shock.Methods. The study protocol was registered with PROSPERO (CRD42021286242). A literature search was performed using PubMed, Ovid EMBASE, Ovid MEDLINE, SCOPUS, and Web of Sciences to find all studies evaluating the association between lactate/albumin ratio and mortality in patients with sepsis and septic shock. Meta-analysis was performed to synthesize the overall Standardized Mean Difference (SMD) of the lactate/albumin ratio and the pooled Odds Ratio (OR) for mortality with 95% confidence intervals (95% CI). Heterogeneity was assessed using I2. Publication bias was assessed quantitatively with Egger’s test. Analysis was performed using Stata version 16.Results. Seven studies (n=10,264 patients) were included in the meta-analysis. The meta-analysis results showed that non-survivor had a higher lactate/albumin ratio than survivor (random-effects model; SMD 1.47; 95% CI 0,91-2,04; p <0.001). Higher lactate/albumin ratio was associated with an increased mortality in sepsis and septic shock patients (fixed-effects model; OR 1.49 (95% CI 1.37-1.62); p <0.001).Conclusions. High lactate/albumin ratio was associated with mortality in sepsis and septic shock patients. Thus, lactate/albumin ratio can be used as a predictor biomarker in predicting mortality for sepsis and septic shock patients.
Effectivity of Acupuncture Therapy in Reduction of Pain Intensity in Cancer Pain Affadhia, Hanna Lianti; Cahyanur, Rahmat; Wahdini, Sri; Rachman, Andhika
Jurnal Penyakit Dalam Indonesia Vol. 9, No. 3
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Pain is one of the most common complaints and interferes with the quality of life of cancer patients. Several studies recommend multimodal interventions that combine pharmacological and non-pharmacological therapies. Acupuncture therapy is one of the non-pharmacological treatment options that could be considered. This evidence-based case report aimed to examine the effectiveness of acupuncture therapy in reducing pain intensity in patients with cancer pain. Literature searching was performed on three databases (PubMed, Scopus, and Embase). The keywords used are cancer pain, malignant pain, acupuncture, acupuncture therapy, pain intensity, pain assessment, pain scale. The critical review was carried out using guidelines from the University of Oxford Center for Evidence-based Medicine. Four articles relevant to the clinical question were included in the study. Acupuncture therapy has been consistently shown to reduce pain intensity, shorter pain onset time, reduced dose and number of analgesics used, and better quality of life with minimal side effects, compared to drug therapy alone. Acupuncture therapy should be considered as a complementary therapy in the management of cancer pain, but not to replace standard regiment of pain protocols. Clinical decisions in applying acupuncture therapy need to assess patient preferences, accessibility, and cost-effectiveness.
Performa Diagnostik Global Leadership Initiative on Malnutrition (GLIM) dibandingkan dengan Malnutrition Nutritional Assessment (MNA) dalam Pengkajian Malnutrisi pada Pasien Geriatri di Rawat Inap Leoni, Astrine Permata; Amelia, Wita Rizki; Laksmi, Purwita Wijaya; Syauqy, Ahmad
Jurnal Penyakit Dalam Indonesia Vol. 10, No. 1
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Introduction. As many as 76.6% of patients aged 60 years and above (elderly) are malnourished or at risk of malnutrition based on MNA within the first 48 hours of hospital admission. The prevalence of malnutrition varies widely depending on the population studied, the healthcare setting and the tools used for the assessment. To date, SGA is widely used in the diagnosis of malnutrition for adults and MNA for elderly patients. Recently, experts proposed empirical consensus of GLIM criteria for determining the diagnosis of malnutrition in adults. This study aimed to investigate the diagnostic performance of GLIM criteria as a new consensus in determining the diagnosis of malnutrition in comparison to MNA as a semi-gold standard for nutritional assessment in the elderly. Methods. A cross-sectional study was conducted from January to April 2022 on 103 consecutively recruited elderly patients aged ≥60 years in the Internal Medicine Wards at Dr. Cipto Mangunkusumo Hospital (RSCM), Jakarta, Indonesia. Results. There were 91.3%, 57.3% and 54.4% malnourished elderly patients upon admission to the hospital, based on GLIM criteria, MNA-SF and MNA-LF, respectively. GLIM has good accuracy compared to both MNA-SF and MNA-LF, as long as the category of malnourished in MNA is a combination of malnutrition and at risk of malnutrition. GLIM had 97.9% sensitivity, 87.5% specificity, AUC 0.93, 98.9% PPV, 77.8% NPV, 7.83 positive LR and 0.02 negative LR towards MNA-SF, and a sensitivity value of 98.9%, specificity 88.9%, AUC 0.94, PPV 98.9%, NPV 88.9%, positive LR 8.91, and negative LR 0.01 towards MNA-LF. Conclusion. GLIM showed good diagnostic accuracy to determine nutritional status in the elderly, especially upon admission to the hospital, so that appropriate early nutritional interventions can be given. Keywords: diagnostic performance, elderly, GLIM, malnutrition, MNA
Risiko Kardiovaskuler pada Pasien Artritis Reumatoid Hidayat, Rudy
Jurnal Penyakit Dalam Indonesia Vol. 4, No. 2
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Clinical Characteristic and Prevalence of Invasive Candidiasis Patient in Cipto Mangunkusumo Hospital Kalista, Kemal Fariz; Chen, Lie Khie; Wahyuningsih, Retno; Rumende, Cleopas Martin
Jurnal Penyakit Dalam Indonesia Vol. 4, No. 2
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Introduction. Incidence of invasive fungal infections (IFI) are reportedly increasing in many countries. Candida is the most common cause of IFI. This study was conducted to determine the prevalence, clinical characteristics, and etiologic pathogen in adult patients with invasive candidiasis (IC) at Cipto Mangunkusumo Hhospital. Methods. This was a cross sectional study with restropective data collection fromof septic patients that’ medical records hospitalized in January 2012 until June 2014. Subjects were selected based on EORTC/MSG 2008 diagnostic criteria for IC. Demographic data, clinical and supporting data, diagnosis, etiologic pathogens, antibiotics, antifungal, outcome, and length of stay were recorded. Results. The IC prevalence at Cipto Mangunkusumo hospital was 12,3% (91 patients from total of 738 sepsis patients). Subjects consisted of 35 proven, 31 probable, and 25 possible invasive candidiasis patients. Candidemia was the most common form of IC and C. albicans was the most common etiologic pathogen. Mean age were 47,9 years, dominated with medical, non-neutropenic, and septic shock patient. Most patients had malignancy with lung infection. The most common medical intervention was urinary catheter. Most patients were given 3rd generation cephalosporin and the most common antifungal used was fluconazole. Forty four percent of IC patients did not get systemic antifungal treatment. Mortality rate was 64.8% and median length of stay were 27 days. Conclusions. IC prevalence was 12,3%. Mortality due to IC was high and C. albicans was the most common etiologic pathogen.
Validation of Rapid Emergency Medicine Score (REMS) in Predicting30 days Mortality in Elderly Visiting Emergency Department Rizka, Aulia; Harimurti, Kuntjoro; Pitoyo, Ceva W; Koesno, Soekamto
Jurnal Penyakit Dalam Indonesia Vol. 4, No. 2
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Introduction. Rapid Emergency Medicine Score (REMS) has been known as a useful instrument to stratify patients in emergency department (ED) based on its ability to predict short term mortality. As the clinical characteristics of elderly patients visiting ED are frequently aypical, validation of REMS in this specific population is very important. To measure predictive validity of REMS in elderly patients visiting ED Methods. Prospective cohort study in elderly visiting ED of Cipto Mangunkusumo between September to October 2016. Subjects were followed for 30 days after visiting ED. Calibration (Hosmer Lemeshow test), discrimination (Area Under ROC Curve) and REMS predictive value of 30 days mortality were measured. Result. Of 321 elderly subjects visiting ED during study period, 306 subjects were included in the study. Among them, 163 (53,2%) were men. 30 days mortality incidence was 22,8% (95% CI 22,3-23,3). Median age was 68,3 (6,7) year. As many as 83 (27%) subjects were in red triage. There were 154 (50%) patients with REMS 0-7, 140 (46%) with REMS 8-17 and 12(4%) with REMS more than 17. Calibration plot shows r=0,23 with poor calibration (p=0,00) in Hosmer Lemeshow test. AUC of REMS in predicting 30 days mortality in elderly was 0,45 (95% CI 0,23-0,66). Conclusion. REMS shows poor calibration and discrimination in eldery patients visiting ED.