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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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Association between Thyroid Status and Glucose Intolerance inHyperthyroid Patients Wisnu, Wismandari; Soewondo, Pradana; Subekti, Imam
Jurnal Penyakit Dalam Indonesia Vol. 5, No. 1
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Introduction. The most common endocrinopathy in adults are diabetes mellitus (DM) and thyroid disease. Hyperthyroidism decreases blood glucose control and increased the need of insulin. However, the mechanism of abnormal glucose metabolism in hyperthyroidism is not fully understood. This study aims to determine the relationship of thyroid status with incidence of glucose intolerance in hyperthyroid patients compared to hyperthyroid patients who have achieved clinical status of eutyroid and normal population. Methods. This study was cross sectional design in outpatients with hyperthyroidism in hyperthyroid and euthyroid/subclinical hyperthyroid status, and healthy volunteers who had matching age and sex. An oral glucose test and Homeostatic Model Assesment Insulin Resistance was performed after the diagnosis of hyperthyroidism by FT4 and TSH measurement. Data analysis was performed using SPSS for Windows version 20.0. Results. There were 114 eligible patients (40 case hyperthyroid, 40 case euthyroidism/subclinical hyperthyroidism and 34 healthy subjects). Proportion of glucose intolerance in hyperthyroidism is 52,5% (10% DM, 32,5% impaired glucose tolerance (IGT), and 10% impaired fasting glucose (IFG)), in euthyroidism/subclinical hyperthyroidism was 20% (5% DM, 15% IGT, and 0% IFG), and in healthy subjects was 11,8% (0% DM, 8,8% IGT, and 2,9% IFG). Glucose intolerance in hyperthyroidism was significantly different than euthyroidism/subclinical hyperthyroidism (p=0.002). We also found that the association between thyroid status and glucose intolerance in the group without insulin resistance was significantly different (p=0.004). Conclusions. Our study conclude that there is association between hyperthyroidism and glucose intolerance. Hyperthyroid patients in euthyroidism/subclinical hyperthyroidism status have the same risk as the healthy subject to became glucose intolerance.
Rino-orbital-cerebral Mucormicosys in A Patient Type 1Diabetic: A Case Report Marpaung, Hamka Gunawan; Baso, Gery Dala Prima; Rizka, Aulia; Nelwan, Erni Juwita; Wardani, Retno S; Wahyuningsih, Retno
Jurnal Penyakit Dalam Indonesia Vol. 5, No. 1
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Mucormycosis is an opportunistic andfrequently fulminating fungal infection causedby members of the family Mucoraceae, orderMucorales and class Zygomycetes which highly invasive and high mortality. Mucormycosis occurs in diabetic patients with poor blood glucose control. We reported a case of rhinocerebral mucormycosis in 20-year-old female patient with type 1 diabetes. The patient was treated for diabetic ketoacidosis and swollen symptoms in the left eye and out secretions from the left nose containing blackish spots. The probable diagnosis of rhinocerebral mucormycosis is made based on the results of direct examination and culture of nasal and palate tissue biopcywhich result suitable for Mucor sp. She was given systemic antifungal therapy with amphotericin B and symptoms of swelling of the left eye and secretions of the left nose with patches of blackness improved.
Invasive Candidiasis Prevalence Among Patients in IntensiveCare Unit, Hasan Sadikin Hospital Maulana, Hafizh Ridwan; Sumardi, Uun; Koesoemadinata, Raspati C.
Jurnal Penyakit Dalam Indonesia Vol. 6, No. 1
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Introduction. Intensive care unit (ICU) patients have a high risk of invasive candidiasis (IC), which increase mortality and prolong length of stay in hospitals, resulting greater costs. This study aimed to determine the prevalence of IC and associated risk factors in ICU patients. Methods. A cross-sectional study was conducted including medical records of patients treated in ICU Hasan Sadikin Hospital Bandung admitted in June 2016-June 2017 whose blood sample were sent for culture. The prevalence of IC and corresponding 95% confidence interval (95% CI) was determined. A case-control study was done comparing the characteristics of patients with positive culture for Candida (cases) with those who have a negative culture admitted to ICU in the same week as the cases (control), with ratio 1 to 4. Multivariate analysis was performed to determine the adjusted odds ratio (AOR), 95% CI, and p value. Results. Blood cultures were performed on 313 ICU patients. The prevalence of IC was 3.5% (95%CI: 1.8-6.2), and 9 patients died. There were 8 cases and 33 controls with complete data to be compared. Characteristics associated with invasive candidiasis were: use of ventilator more than 6 days (AOR=15.52; 95%CI: 1.51-159.15; p=0.021); use of urine catheter more than 8 days (AOR=10.77; 95%CI: 1.05-110.86; p=0.046); and positive sputum culture for Candida (AOR=9.54; 95%CI: 1.44- 63.44; p=0.020). Conclusions. Invasive candidiasis has a high mortality rate. Long-term use of ventilator and urine cathether, and positive sputum culture result were important risk factors for IC among adult patients in ICU.
A Case Series Hemichorea-Hemiballism Syndrome Related toNonketotic Hyperglycemia: A Challenge to Diagnostic Process Sasiarini, Laksmi; Budianto, Rahmad; Tarigan, Ricky C.
Jurnal Penyakit Dalam Indonesia Vol. 6, No. 1
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Diabetes mellitus is quite familiar to health-care personnel but occasionally presents with unusual manifestations. One of them is hemichorea-hemiballismus syndrome, a spectrum of involuntary, continuous non-patterned movement involving one side of the body which is related to nonketotic hyperglycemia in uncontrolled diabetes. Here we present two cases of nonketotic hyperglycemic diabetic patients who presented with the hemichorea-hemiballismus syndrome. First – a 57 years old woman was presented with involuntary, arrhythmic, and repetitive movement on the right arm and leg, accompanied by twitching on the right face for two weeks. She had an uncontrolled history of diabetes mellitus. The second- a 60 years old man was presented with recurrent general tonic-clonic seizure for about four days. The history of diabetes was unknown. Initial diagnosis on admission was general tonic-clonic seizure due to thrombotic cerebrovascular accident (CVA). Intravenous diazepam did not give any response to the seizures. Their brain CT scan imaging showed non-enhancing hyperdensities in the basal ganglia due to non-ketotic hyperglycemia, but the lesion was more extensive on the second patient. An involuntary movement was resolved after achieving blood glucose target by rehydration and continuous intravenous insulin therapy. Clinical response in these cases were reversible while the hyperdensities lesion will be persistent for a few months.
Profil of Implementation of Post Exposure Prophylaxis of Hepatitis B, Hepatitis C and Human Immunodeficiency Virus to Health Care Worker in Cipto Mangunkusomo Hospital 2014-2016 Ratih, Dewi Mira; Yunihastuti, Evy; Lestari, Regina; Sulaiman, Andri Andri; Rinaldi, Ikhwan
Jurnal Penyakit Dalam Indonesia Vol. 6, No. 1
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Introduction. Health care workers (HCW) have a high risk of infectious substance exposure. Hepatitis B, hepatitis C, or human immunodeficiency virus (HIV) are some diseases transmitted by body fluid or body tissue. Cipto Mangunkusumo Hospital Jakarta has been implementing post-exposure prophylaxis (PEP)s towards HIV, hepatitis B, and hepatitis C. This study aimed to identify the implementation of post-exposure prophylaxis of HIV, Hepatitis B, and Hepatitis C among HCW in Cipto Mangunkusumo Hospital Jakarta. Methods. A cross-sectional study was conducted to exposed workers in Cipto Mangunkusumo Hospital Jakarta between 2014-2016 who had been recorded by report. Demographic data were collected through medical record and interview was conducted to gather additional data. Statistical analysis was conducted with SPSS 20. Results. Among 196 reports, most HCW were female (69.9%), worked as nurse (38.3%), medical doctor (49.5%), and exposed percutaneously (93.4%). There were 183 risky exposures, with 19 (10.4%) reactive anti-HIV, 11 (6.0%) positive HBsAg, and 12 (6.6%) reactive anti-HCV in source of exposure. Almost all of the HCW has no HIV, hepatitis B, nor hepatitis C at the moment of exposure. Recommendation for antiretroviral (ARV) was given to 81 HCW, but only 49.4% completed the course. Anti-HIV follow up was done only by 21.3% workers. Recommendation of PEP for hepatitis B was given to 37 HCW. But, only 13.5% and 13.3% receive hepatitis B vaccination and hepatitis B immunoglobulin, respectively. Follow-up of HBsAg and anti-HBs on 3rd and 6th months were done by 41 (31.1%), 38 (28.8%), and 2 (1.5%) workers who were recommended to receive prophylaxis. In 182 workers recommended to do the follow-up of anti-HCV, 39 (21.4%), and 37 (20.3%) workers did the follow-up on 3rd and 6th month. Majority of exposed workers were not re-evaluated for HBsAg (64.9%) and anti-HCV (69.9%). Conclusions. The implementation of post-exposure prophylaxis for HIV, Hepatitis B, and Hepatitis C was still low especially in re-evaluation serologic marker. Comprehensive management is recommended including improving knowledge of health care workers, re-evaluation of operational procedure standard, and effective communication.
Anti-DFS70 as Nonsystemic Autoimmune (Primary Billiar Cholangitis) Concomitant Disease Marker in Systemic Lupus Erythematosus Putra, Yasjudan Rastrama; Mulya, Deshinta Putri; Indrarti, Fahmi
Jurnal Penyakit Dalam Indonesia Vol. 7, No. 2
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Anti-dense fine speckled 70 (DFS70) is known as a non-systemic autoimmune marker. It is only found in 1% of systemic autoimmune patients and 2–22% in healthy population. To the best of our knowledge, no anti-DFS70 positive has been reported in systemic lupus erythematosus (SLE) patients with primary billiary cholangitis (PBC) comorbidities. We reported a 40-year-old woman that was diagnosed with SLE 1-month before, came to the hospital due to seven days of fatigue, loss of appetite, icteric, arthralgia, hair loss, and unexplained fever. Total bilirubin was 9.46 mg/dl, direct bilirubin 7.73 mg/dl, gamma-glutamyl transferase (GGT) 503 U/L, alkaline phosphatase (ALP) 520 U/L, ANA-IF 1:1000, ANA-profile measurement borderline on the anti-centromere B, and three positives on the DFS70. Magnetic resonance cholangiopancreatography (MRCP) shown the PBC feature. After ursodeoxycholic acid (UDCA) therapy 250 mg twice daily, ALP and GGT backed to normal limits within two months. This case reminds the doctor that anti-DFS70 finding in SLE needs further evaluation, whether other nonsystemic autoimmune exist or not. Concomitant PBC with SLE well responded with UDCA standard therapy.
Dapatkah D-dimer Digunakan sebagai Penanda Koagulasi pada Kanker? Sukrisman, Lugyanti
Jurnal Penyakit Dalam Indonesia Vol. 7, No. 1
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Pasien kanker mempunyai risiko tinggi untuk mengalami trombosis, terutama tromboemboli vena (TEV). Pasien kanker yang mengalami TEV mempunyai risiko mortalitas yang lebih tinggi dibandingkan dengan pasien kanker tanpa TEV.
Dispersi Gelombang QT Salim, Simon
Jurnal Penyakit Dalam Indonesia Vol. 8, No. 2
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Sejak elektrokardiografi (EKG) dibawa ke perhatian klinisi oleh Einthoven1 sampai dengan saat ini, EKG masih merupakan modalitas yang tidak dapat dipisahkan dalam penilaian sistem kardiovaskular. Namun, pemeriksaan yang sederhana dan tidak invasif ini, tidak selalu mudah untuk diintepretasikan. Hasil yang tergambar di kertas EKG tidak murni dipengaruhi jaringan otot jantung saja, namun dipengaruhi juga oleh jaringan tubuh lain yang terdapat di antara jantung dan lokasi dimana elektroda diletakkan. Dengan demikian, hal ini juga harus dipertimbangkan dalam menginterpretasikan hasil EKG.
Association of Proprotein Convertase Kexin/Type 9 with Atherosclerosis in People with Type 2 Diabetes Mellitus: a Systematic Review Luthfia, Farissa; Wisnu, Wismandari; Tahapary, Dicky Levenus; Nugroho, Pringgodigdo
Jurnal Penyakit Dalam Indonesia Vol. 8, No. 2
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Introduction. Type 2 diabetes melitus is the leading cause of cardiovascular event with high level of low-density lipoprotein as the main predictor marker of atherosclerosis. PCSK9 plays a role in LDL-receptor regulation, its association with atherosclerosis had been investigated but the result is inconsistent. This study aimed to examine the association between PCSK9 level and atherosclerosis in people with type 2 diabetes. Methods. A systematic review was done in July 18 – September 02, 2020 and registered in PROSPERO. Risk of bias of each study was analyzed with Newcastle Ottawa scale tools. Studies involved in this systematic review then narratively analyzed by two independent reviewers. Results. There are 430 subjects involved from 4 studies. Guo, et al. reported that there was a significant association between PCSK9 level with atherosclerosis in type 2 diabetes melitus (OR: 1.12 (CI 95% 1.041 – 1.204), p: 0.002), those association was also reported by Ma, et al. with p value Conclusions. There is still insufficient evidence that show the association between PCSK9 level and atherosclerosis in type 2 DM. Therefore, longitudinal primary research is needed.
Controlled Blood Pressure Factors in Hypertension Patients atArifin Achmad Hospital, Riau Province: Cross Sectional Study Nugraha, Dimas Pramita; Bebasari, Eka
Jurnal Penyakit Dalam Indonesia Vol. 8, No. 2
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Introduction. Hypertension is a chronic disease that causes 1 in every 7 deaths. Controlled blood pressure will reduce the complication of hypertension. The aim of this study was to determine the factors that influence controlled blood pressure. Methods.This research was conduct by using an observational method with a cross-sectional study design to analyze factors for controlled blood pressure. The population of this research was all of the hypertension patients at the internal medicine polyclinic in Arifin Achmad Hospital Riau Province. The sample was selected using accidental sampling method. Patient adherence level factor was measured using the Morisky medication adherence scale-8 (MMAS-8) questionnaire. The stress level factor was measured using the DASS-42 questionnaire. The family support factor was assessed using a family support questionnaire that refers to Friedman and House, while the level of knowledge was measured with the Guttman adoption questionnaire. Data analysis was performed by using chi-square and logistic regression tests. Results. From the analysis, it showed that only 16.7% of 96 respondents had controlled blood pressure. In patients with controlled blood pressure, the most common antihypertensive group factor used was calcium channel blocker (18.6%, RP=0.73, p=0.51), antihypertensive monotherapy factor (21.7%, RP=2.17, p=0.15), high knowledge level factor (21.3%, RP=2.11, p=0.16), good adherence factor (22.1%, RP=6.18, p=0.14), normal stress factor (16.2%, RP=3.78, p=1.00), and high family support (23.2%, RP=10.8, p=0.053). Conclusion. In this study, there were no factors that could be predictors of controlled blood pressure at Arifin Achmad Hospital Riau Province.

Page 27 of 42 | Total Record : 414

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