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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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Factor Related to The Incidence of Ascites in Chronic Kidney Disease Patients Undergoing Hemodialysis at RSUD Dr Moewardi Surakarta: A Cross Sectional Study Yusman, Felizia Alika; Dewi, Ratih Tri Kusuma; Mashuri, Yusuf Ari; Nurhayatun, Evi; Giani, Maia Thalia
Jurnal Penyakit Dalam Indonesia Vol. 7, No. 3
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Introduction. Chronic kidney disease (CKD) is a global health issue with continuously rising prevalence. Fluid overload is a frequent systemic complication which occurs in CKD patients undergoing hemodialysis (HD). One of clinical manifestation of fluid overload in HD patients is ascites. This study aimed to determine the factors related to the incidence of ascites in CKD patients undergoing hemodialysis. Methods. An observational analytic study with a cross-sectional approach was conducted at Dr. Moewardi Hospital, Surakarta from September until October 2019. The subjects were end-stage CKD patients undergoing HD. Subjects were selected by total sampling technique. Data were obtained from medical records tracking. Furthermore, each variable was analyzed using Chi Square and Independent T-test analysis. P value less than 0.05 is considered statistically significant. Results. A total of 116 subjects were recruited in this study. Incidence of ascites was documented in 24 (20.7%) patients. The comorbid of chronic heart failure (CHF) was found in 23 (19.8%) subjects, where this condition was associated with the incidence of ascites [p = 0.003; PR 2.888 (95% CI=1.476–5.650)]. In the subjects with hypoalbuminemia was also related to higher incidence of ascites [p < 0.001; PR 7.800 (95% CI=3.153 – 19.293)]. Meanwhile gender, age, diabetes mellitus, the levels of hemoglobin, ureum, creatinine serum, albumin, hematocrit, and leukocyte were not associated with ascites in CKD patients undergoing HD (p > 0.05). Conclusions. Factors related to the incidence of ascites in patients with chronic kidney disease who have undergone hemodialysis is chronic heart failure and hypoalbuminemia.
Five Year Survival of Active Multiple Myeloma Patients Based on Durie-Salmon and International Myeloma Working Group 2003 Diagnostic Criteria Kurniawati, Sri Agustini; Reksodiputro, Ary Harryanto; Atmakusuma, Tubagus Djumhana
Jurnal Penyakit Dalam Indonesia Vol. 7, No. 3
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Introduction. Survival of active multiple myeloma (MM) patients is determined by early diagnosis and various prognostic factors. The development of MM diagnostic criteria from Durie-Salmon (DS) criteria to International Myeloma Working Group (IMWG) 2003 is an attempt to diagnose active MM earlier. However, due to limited resources, these diagnostic criteria cannot be fulfilled consistently in Indonesia. Based on this reason, it is necessary to know the proportion of MM based on DS and IMWG 2003 diagnostic criteria and also their impact on the survival of MM patients in Indonesia. Methods. This was a retrospective cohort study with survival analysis. Subjects were active MM patients in Cipto Mangunkusumo Hospital and Dharmais Cancer Hospital during 2005-2015. Data were presented in Kaplan-Meier survival curve and table with 95% confidence interval (CI). Results. This study involved 102 active MM patients with complete diagnostic data and survival for more than 1 month. As much as 56.9% of patients met DS diagnostic criteria and 72.5% met IMWG 2003 criteria. Median of overall survival (OS) based on DS criteria (77.8 months) was similar with IMWG 2003 criteria. Overall survival in the first, third, and fifth year of MM patients who met DS criteria were 89.9%, 77.5%, and 54.8%, respectively. Meanwhile overall survival in the first, third, and fifth year of MM patients who met IMWG 2003 criteria were 87.5%, 75.6% and 55.9%, respectively. Conclusions. The proportion of active MM patients who met IMWG 2003 diagnostic criteria was higher than those who met DS criteria. Overall survival of active MM patients who meet DS diagnostic criteria is similar with those who met IMWG 2003 criteria.
The Association between D-dimer Concentration and Laboratory Parameters for Plasma Leakage in Dengue Infection Suwarto, Suhendro; Diahtantri, Riyanti Astrid; Hudiya, Elian
Jurnal Penyakit Dalam Indonesia Vol. 5, No. 3
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Introduction. Plasma leakage and activation of the coagulation system are the pathological hallmark of dengue hemorrhagic fever (DHF) that causes an increase in D-dimer concentration due to the degradation of fibrin clots. This study was conducted to determine the association between of D-dimer and laboratory parameters of plasma leakage, namely: thrombocytopenia, hypoalbuminemia, hemoconcentration and concentration serum glutamic oxaloacetic transaminase (SGOT) in dengue infected patients. Methods. A retrospective study was conducted at private hospitals in Jakarta, from December 2016 to March 2018. Patients >14 years with dengue infection and positive NS-1 were included in this study, and were classified into dengue fever (DF) group or DHF group. The Mann Whitney test was used for non-parametric variables and the Spearman test was used for the correlation for non-normally distributed numeric variables. Results. Seventy-three dengue infected patients included in this study consists of 29 (39.7%) female and 44 (60.3%) male. Total of 43 (58.9%) were classified as DD group, 30 (41.1%) were classified as DHF group. The D-dimer concentration of the DHF group in the fever phase was higher compared to the DD group (p = 0.004). There was a weak correlation in the fever phase between D-dimer concentration and the degree of thrombocytopenia (r = 0.35; p = 0.003) and weak inverse correlation in the fever phase between D-dimer concentration and albumin concentration (r = -0.34; p = 0.049). We found a weak correlation in the critical phase between D-dimer concentration and the degree of thrombocytopenia (r = 0.39; p = 0.034) and the moderate inverse correlation in the critical phase between the D-dimer concentration and albumin concentration (r = -0.43; p = 0.032). Conclusions. D-dimer concentrations in DHF patients in the fever phase are higher compare to DD patients. D-dimer concentration correlates with the degree of thrombocytopenia and hypoalbuminemia.
Validation of A2DS2 Score as Predictor of Pneumonia among Patients Hospitalized for Acute Ischemic Stroke Nababan, Toman; Pitoyo, Ceva Wicaksono; Harris, Salim; Rumende, Cleopas Martin
Jurnal Penyakit Dalam Indonesia Vol. 5, No. 3
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Introduction. Pneumonia is the leading cause of morbidity and mortality in acute ischemic stroke patients admitted to hospital. Thus required a valid scoring system which is easy to apply, to predict and stratify the risk of pneumonia in patients with acute ischemic stroke. This study aimed to assess the performance of calibration and discrimination of A2 DS2 score in predicting the incidence of pneumonia in patients with acute ischemic stroke. Methods. A retrospective cohort study was conducted among adult acute ischemic stroke patients who are hospitalized in Cipto Mangunkusumo Hospital, Jakarta. Age, atrial fibrillation, dysphagia, sex (male), and stroke severity (rated with National Institute of Health Stroke Scale/NIHSS) were obtained at the beginning of admission. The subjects were followed up for up to seven days after the onset of ischemic stroke to assess the outcome (pneumonia). Calibration properties of the A2 DS2 score were assessed by Hosmer-Lemeshow test and calibration plot. Discrimination properties of the A2 DS2 score were assessed by the area under the curve (AUC). Results. A total of 281 subjects were followed up. The incidence of pneumonia in acute ischemic stroke patients was observed in 118 patients (42%). Hosmer Lemeshow test of A2 DS2 score showed p = 0,222 and calibration plot showed r = 0,982. Discrimination of A2 DS2 score was shown by the AUC value of 0,885 (95% CI 0,845-0,924). Conclusion. The A2 DS2 score has a good calibration and discrimination performance in predicting the incidence of pneumonia in patients with acute ischemic stroke.
Comparison of Renal Safety of Tenofovir and Telbivudine in Chronic Hepatitis B Patients: A Real World Study in Indonesia Gani, Rino Alvani
Jurnal Penyakit Dalam Indonesia Vol. 5, No. 3
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Introduction. Tenofovir disoproxil fumarate (tenofovir) and telbivudine are two available nucleos(t)ide analogue (NA) for the treatment of chronic hepatitis B (CHB) patients. Tenofovir has been known as a nephrotoxic agent in HIV patients, but still controversy in CHB patients. On the other hand, telbivudine had a renal protective effect and increased estimated glomerular filtration rate (eGFR). This studi aimed to address the renal safety of tenofovir and telbivudine in Indonesian patients. Method. A retrospective cohort study design was conducted in CHB patients who prescribed with tenofovir or telbivudine from January 2013 to December 2016. Patients who hade baseline eGFR
The Differences of Marital Satisfaction of ODHA Couples with and without Depression Symptoms Salahudin, Muhammad Ismail; Fitrikasari, Alifiati; Sofro, Muchlis Achsan Udji; Julianti, Hari Peni
Jurnal Penyakit Dalam Indonesia Vol. 5, No. 3
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Introduction. HIV/AIDS disease has caused physical, social, and emotional problems to infected individuals and their spouses. ODHA couples have a prevalence of depression symptoms with physical complaints, which amounted to 12.7%. There is a relationship between love, communication, and physical intimacy to satisfaction in marriage. Depression in ODHA couples is correlated with marital satisfaction. This study aimed to analyze the differences of marital satisfaction of ODHA HIV negative couples who experience depression symptoms with ODHA who do not experience depression symptoms Methods. The research design was cross-sectional. The samples were 52 official couples of ODHA aged 18-60 years who had outpatient treatment in Poly of Infection Tropical RSUP. Dr. Kariadi Semarang and met the criteria of research inclusion. Sampling technique was conducted with consecutive sampling method. Depression status was measured by the beck depression inventory (BDI) instrument and marital satisfaction was measured by ENRICH marital satisfaction scale (EMS). Processing and data analysis using SPSS program. The relationship analysis test using chi-square test. Results. Subjects who did not experience depression 78.8% and those with depression 21.2% consisted of mild 9.6%, moderate 11.6%, and severe 0%. No subjects were found to be unsatisfied with their marriage, 55.8% were very satisfied and 44.2% were satisfied. There was no significant difference between marital satisfaction of ODHA HIV negative couples with depression symptoms and without depression symptoms (p = 0,595). There was a significant difference between the marital satisfaction of ODHA HIV negative couples with depression symptoms and without depression symptoms in communication (p = 0.021), conflict resolution (p = 0.025), use of leisure activities (p = 0.025), and sexual activities (p = 0.007) Conclusion. There was no difference between the marital satisfaction of ODHA HIV negative couples with depression symptoms and without depression symptoms. There was a significant difference between the marital satisfaction of ODHA HIV negative couples with depression symptoms and without depression symptoms in communication, conflict resolution, the use of leisure activities, and sex activities.
Antibiotic Treatment based on Guidelines for Reducing Length of Stay (LOS) in Patients with Community Acquired Pneumonia (CAP) Munarsih, Fetri Charya; Natadidjadja, Ronald Irwanto; Syamsudin, Syamsudin
Jurnal Penyakit Dalam Indonesia Vol. 5, No. 3
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Introduction. Community acquired pneumonia (CAP) now is known as the most common infection presented. Empiric antibiotic administered followed by observing parameters. This study aimed to know how far the American Thoracic Society/ Infectious Disease Society of America (ATS/IDSA) antibiotic guidelines 2007 based treatment influenced the length of stay (LOS) of CAP subject in a private hospital ward between January 2014-August 2015 Methods. A retrospective cohort was conducted with bivariate analysis and multivariate analysis for reducing the confounding factor. Sample taken with proportional sampling formula at ward in a hospital in Jakarta. Results. The result showed that subjects with unproper empiric antibiotic based on ATS/IDSA 2007 guidelines tent to have hospital prolong stay 10.25 times (p <0.001) than others with proper on ATS/IDSA empiric antibiotic guidelines. Conclusion. By this result, we observed a very significant statistic result difference in LOS between a group with proper empiric antibiotic based on ATS/IDSA 2007 guidelines and other who unproper.
Efficacy and Safety of Oral Antidiabetic Drugs in Type 2 Diabetes Mellitus with Chronic Kidney Disease Sihotang, Retta C.; Ramadhani, Rizka; Tahapary, Dicky L.
Jurnal Penyakit Dalam Indonesia Vol. 5, No. 3
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Depresi, Ansietas, dan Komplikasi Pasca Sindrom Koroner Akut Indrajaya, Taufik
Jurnal Penyakit Dalam Indonesia Vol. 5, No. 4
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Comparison of Absolute Neutrophil Count between Hospital and Community Acquired Methicillin-Resistant Staphylococcus aureus Infection Kurniyanto, Kurniyanto; Santoso, Widayat Djoko; Nainggolan, Leonard; Kurniawan, Juferdy
Jurnal Penyakit Dalam Indonesia Vol. 5, No. 4
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Introduction. The virulence factors from community acquired-methicillin resistant Staphylococcus aureus (CA-MRSA) mainly due to toxins like Panton Valentin Leukocidin (PVL) and Phenol Soluble Modulin (PSM). Both of toxins cause decrease of value through neutrophil lysis. This study aimed to identify different value of absolute neutrophil count between hospital and community acquired MRSA. Methods. A cross sectional was conducted which included subjects who were infected by MRSA and hospitalized during 2012-2017. Classification of MRSA were divided due to its sensitivity and resistance to non-beta lactam antibiotics. Isolate that resistance to ≤ 2 antibiotics were classified as CA-MRSA. The others with resistance to ≥ 3 antibiotics were classified as hospital acquired MRSA. Absolute neutrophils count (ANC) were collected 24 hours from the positive MRSA culture. Data were analyzed by using independent T test and Mann-Whitney test. Results. We collected 62 subjects infected by MRSA which 35 subjects were HA-MRSA and 27 subjects were CA-MRSA. The median of ANC from CA-MRSA was 7,410.7 (1,147.3-26,560.2) and HA-MRSA was 16,198.0 (3,921.6-28,794.1) with p value < 0.001. Conclusion. There was a different value of absolute neutrophil count in infections due to community and hospital acquired MRSA.

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