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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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Peripheral Artery Disease Accompanied by IntermittentClaudication in Rural Areas of Sikka Regency – A Cross SectionalStudy with Pulse Palpation Methods and Its Risk Factors Sofian, Naldo; Prasetyo, Garry; Wibisono, Stephanie
Jurnal Penyakit Dalam Indonesia Vol. 4, No. 3
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Abstract

Introduction. There are few studies regarding peripheral artery disease (PAD by intermittent claudication) on adults in Indonesia, including its risk factors. This study aims to determine relationship and comparison of PAD accompanied by intermittent intermittent claudication risk factors in adult, especially in rural areas of Sikka regency, Flores, measured by pulse palpation. Methods. A cross sectional study in 3 primary healthcare working areas in Sikka regency and consecutive sampling had been done. Interview of risk factors was conducted and blood pressure was taken from all four extremities in supine position. Ankle brachial index (ABI) value was defined as systolic blood pressure of foot arteries (dorsalis pedis and posterior tibia) divided by highest systolic blood pressure among brachial artery. PAD was then defined by presence of both intermittent claudication and ABI <0.9. Random blood glucose, total cholesterol, and uric acid had been measured using EasytouchTM while urine examination was done using urine dipsticks. Results. A total of 333 subjects had been participated in which woman (64.9%), farmers (71.2%), working, less-than-5-yearhypertension history (30.3%) and mean age 57.47 years old were our majority subjects’ characteristics. There were 135 subjects had intermittent claudication and 39 (28.89%) of them had PAD. Several independent significant (p<0.05) risk factors include sex (man vs. female; p=0.001; OR 0.167 [0.056–0.497]) and proteinuria (p=.000; OR 6.612 [2.725–16.045]). Conclusion. Proteinuria and sex are independent risk factors and significantly related on PAD accompanied by intermittent claudication in adult of rural areas in Sikka regency.
Diagnosis and Treatment of Conn Syndrome: A Case Study Abdaly, Muhammad Syah; Juliyanti, Juliyanti; Marbun, Maruhum Bonar
Jurnal Penyakit Dalam Indonesia Vol. 4, No. 3
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Acute neuromuscular disorder is a commonly found medical condition, which may prove to be fatal in certain conditions. Hypokalemia is one possible cause of neuromuscular disorder. In patient with hypokalemia accompanied with hypertension, primary hyperaldosteronism might be the primary cause. Primary hyperaldosteronism (Conn syndrome) is clinically known as a triad, which is consists of hypertension, hypokalemia, and metabolic alkalosis. In this article, the case of a patient with neuromuscular disorder is presented, and after evaluation, it was found that the patient was suffered from the Conn syndrome
Diagnosis and Treatment of Celiac Disease Oktadiana, Harini; Abdullah, Murdani; Renaldi, Kaka
Jurnal Penyakit Dalam Indonesia Vol. 4, No. 3
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Celiac disease is a reversible, proximal immune enteropathy resulting from the interaction of dietary gluten with the intestinal immune system. Celiac disease can produce varied manifestations and may develop at any age. New cases have increased substantially, due to increase awareness and better diagnostic tools. Standard diagnosis of celiac disease is based on positive serologic tests and histopathologic examination of duodenal biopsies. Treatment of celiac disease with free gluten diet will improve symptoms, quality of life, reduce risk of malignancy and complication. Nowadays, treatment strategy of celiac disease with non-dietary therapies is still underdevelopment.
Factors Related to 30 day Mortality in Critically Ill Patients withInvasive Candidiasis in Cipto Mangunkusumo Hospital Ardian, Ardi; Pitoyo, Ceva W; Adhitianingsih, Dita; Santoso, Widayat Djoko; Setiati, Siti
Jurnal Penyakit Dalam Indonesia Vol. 4, No. 1
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Introduction. Mortality rate of invasive candidiasis is still high, approximately 30-70%. Every study has a variety mortality rate depend on study design and sample. There is no data in Indonesia about profile and mortality factors analysis in critically ill patients with invasive candidiasis. Methods. The Study design was cross sectional. We studied 102 hospitalized critically ill patients with invasive candidiasis. The demographic, clinical and laboratory data, the risk factors for invasive candidiasis and the outcome of each patient in 30 days were recorded. An analysis bivariate with chi square or Fisher’s test was carried out to analyse some factors such as age > 60 years old, severe sepsis, APACHE score > 20, respiratory failure, renal failure, delayed antifungal treatment > 72 hours after positive culture, Charlson index score, and ICU or non ICU patients. The logistic regression of multivariate analysis was carried out to identify the most influence of all mortality factors. Results. Among 102 identified sample, the majority was male (52.9%), the median age was 53 years old and the mortality rate was 68,6%. Laboratory candida findings came from blood sample (candidemia) (98.03%), liquor cerebrospinal (1.5%) and retina exudate (1.5%). The most common candida species were candida non albicans especially Candida tropicalis (34.3%) and Candida parapsilosis (34.3%). The risk factors for invasive candidiasis from this study related to underlying disease were sepsis (78.9%), malignancy (42.15%), diabetes mellitus (29.4%) and related to therapy or treatment were the usage of broad spectrum antibiotic (99%), central vein catheter (77.5%), and parenteral nutrition (70.6%). The result from multivariate analysis, severe sepsis (p 0.001, OR 7.7, IK95% 2.4 – 24.7), Charlson Index ≥3 (p 0.022, OR 3.5, IK95% 1.2–10.2), and respiratory failure (p 0.066, OR 2.7 IK95% 0.9 – 8.0) were independently associated with mortality. Conclusions. In Cipto Mangunkusumo hospital, most critically ill patients with invasive candidiasis was male, median age was 53 years old, and mortality rate was 68,6%. The most species candida caused infection were Candida tropicalis and Candida parapsilosis. The most risk factors of invasive candidiasis from underlying disease was sepsis and from the treatment was the usage of broad spectrum antibiotic. Severe sepsis, and Charlson index ≥3 were associated with a 30 day mortality in critically ill patients with invasive candidiasis.
Approach to Diagnosis and Treatment of Drug Allergy Pandapotan, Roy Akur; Rengganis, Iris
Jurnal Penyakit Dalam Indonesia Vol. 4, No. 1
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Drug allergy is a serious medical problem. Drug allergy can be defined as an adverse drug reaction involving immunological mechanism. However, it is not easy to decide whether an adverse drug reaction is an allergic reaction, and it requires a systematically diagnostic approach. Beside a thorough history taking and physical examination, there are general and specific laboratory examination to investigate drug allergy which can be done in vivo, in vitro, or biopsy. The management of drug allergy include the avoidance of the precipitating event, and specific methods to reduce the drug reaction which include threating through, dosing test, desensitization, and the administration of premedication for certain drugs.
Cost of Care Saving of Terminal Cancer Adult Patient UsingPalliative Care Consultation in Cipto Mangunkusumo Hospital Putranto, Rudi; Trisnantoro, Laksono; Hendra, Yos
Jurnal Penyakit Dalam Indonesia Vol. 4, No. 1
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Introduction. Terminal cancer patients was increasing in Indonesia, and need attention to approach palliative and end of life care. Terminal cancer management was burden the hospital, because it causes high costly and the length of stay This study aimed to get a general picture of service palliative at Cipto Mangunkusumo, then to evaluate the relationship hospitalization and rates of inpatient services people with terminal cancer adults who received the intervention palliative care and to evaluate the relationship variable rates for accommodation (room), doctor visit, procedure/surgery, medicines and consumables, laboratory and radiology to palliative interventions in patients with terminal cancer in inpatient Dr. Cipto Mangunkusumo Hospital. Methods. This research was descriptive study with case control design and performed in the inpatient unit, Dr Cipto Mangunkusumo Hospital, during the month of January to December 2015. The subjects were medical records and billing of terminal cancer patients were .hospitalized adults in class III in January - December 2015 with National Health Insurance (BPJS). Inclusion criteria are terminal cancer patients, beusia ≥ 18 years, received palliative care consultation team while exclusion criteria are patients receiving palliative consultation on treatment days ≥ 25 days. Results. It is known that there is a significant relationship between palliative interventions to patients with hospital rates (p= 0.041), whereas there was no significant relationship between palliative interventions by the length of stay (p = 0.873). There is a significant relationship between palliative interventions and expenditures room rates, visite, action and medicine and palliative interventions. Conclusions. There is a significant relationship between palliative interventions with hospital rates. There is a significant relationship between palliative interventions and expenditures room rates, visite, action and medicine and palliative interventions. These data showed that palliative care intervention was saving money for hospital.
The Association between Vitamin D 25(OH)D Level andAlbuminuria in Type 2 Diabetes Mellitus Indra, Tities Anggraeni; Lydia, Aida; Purnamasari, Dyah; Setiati, Siti
Jurnal Penyakit Dalam Indonesia Vol. 4, No. 1
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Introduction. Vitamin D 25(OH)D deficiency was reported as a possible risk factor for the development of diabetic nephropathy in several epidemiologic studies. Whether vitamin D 25(OH)D deficiency plays a role in the development of diabetic nephropathy in Indonesia is unknown. This study aims to determinate the association between vitamin D 25(OH)D level with albuminuria in patients with type 2 diabetes mellitus in Indonesia. Methods. A cross-sectional study was conducted in 96 patients with type 2 diabetes mellitus at outpatient clinic of MetabolicEndocrine Cipto Mangunkusumo Hospital. Serum vitamin D level was assessed using Diasorin kit with CLIA method, while albuminuria was assessed using random urine sample. Statistical analysis was conducted using chi square for bivariate analysis and regression logistic method for multivariate analysis. Results.The prevalence of vitamin D 25(OH)D deficiency in patients with type 2 diabetes mellitus was 49% with a median value 16,35 (4,2-41,4) ng/mL. There was no significant correlation between vitamin D deficiency with the severity of albuminuria (OR 0,887; 95% CI 0,335 to 2,296). Confounding factors such as poor blood glucose control and overweight strongly influenced the association between vitamin D deficiency with the incidence of albuminuria in patients with type 2 diabetes mellitus. Conclusion. The results of this study showed that there was no association between vitamin D deficiency with the severity of albuminuria in patients with type 2 diabetes mellitus in Indonesia.
Challenges in Providing Treatment of Severe Malaria Case in aDistrict Hospital of Remote Area in Indonesia Priantono, Dimas; Purnama, Asep; Nelwan, Erni Juwita
Jurnal Penyakit Dalam Indonesia Vol. 4, No. 1
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Severe Malaria is commonly found due to Plasmodium falciparum infection, which is causing high mortality in patient. A Severe case might be difficult to treat optimally in the remote settings area that could be due to lack in awareness of disease manifestation and inadequate diagnostic facilities. We report a case of Severe Malaria Falciparum infection, confirmed by blood smear examination of Plasmodium falciparum (Pf) parasites. Patient had received Artemicinin Based Combination Therapy (ACT), which consisted of dihydroartemisinin (DHA)-piperaquine and primaquine (PQ) with no clear clinical and microscopy improvement. The second line anti malaria consisted of quinine, doxycycline, and PQ was then initiated, showing clinical and microscopy responses.
Risk Factors of Antituberculosis Induced-Hepatotoxicity amongHIV/AIDS Patients Luthariana, Lies; Karjadi, Teguh H.; Hasan, Irsan; Rumende, C. Martin
Jurnal Penyakit Dalam Indonesia Vol. 4, No. 1
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Introduction. Antituberculosis (ATT) induced hepatotoxicity is commonly found among HIV/AIDS patients. Several risk factor related to drug-induced hepatotoxicity such as alcoholism, hepatitis B or hepatitis C infection, abnormal baseline aminotransferase/bilirubin, poor nutritional status and concomitant hepatotoxic drugs consumption, are usually found in these patients. This study was conducted to evaluate risk factor of ATT-induced hepatotoxicity in HIV/AIDS patients. Methods. This is a case control retrospective study with matching of age, sex, antituberculosis regimen, and alcohol consumption. Risk factors evaluated are hepatitis C and hepatitis B coinfection, concomitant hepatotoxic drugs consumption, abnormal baseline aminotransferase and or bilirubin. Results. We collected data of 33 cases and 33 controls We found 82% subjects in case group and 76% subjects in control group have hepatitis C coinfection; 18% subjects in case group and 6% subjects in control group have hepatitis B coinfection. Fifty four point five percent (54.5%) subjects in case group and 42.4% subjects in control group consume other hepatotoxic drugs. Elevated baseline ALT level was found in 51.5% subjects in case group and 12% subject in control group. Bivariate analysis showed that the risk of hepatotoxicity was higher in patients with elevated baseline ALT level (OR=7.5; 95% CI 1,72- 32,80; p < 0,05). Conclusions. Elevated baseline ALT level will increase antituberculosis drug induce hepatotoxicity risk up to 7.5 times. There were no association between hepatitis C, hepatitis B, concomitant hepatotoxic drugs consumption and antituberculosis drug-induced hepatotoxicity in HIV/AIDS patients.
Pemeriksaan Kadar Laktat pada Tata Laksana Sepsis:Apakah Benar Diperlukan? Sinto, Robert
Jurnal Penyakit Dalam Indonesia Vol. 3, No. 1
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