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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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Program Multidisiplin Pasien Gagal Jantung Kronik untuk Menurunkan Angka Perawatan Ulang Rumah Sakit Lusiani, Lusiani; Adnan, Nurhayati
Jurnal Penyakit Dalam Indonesia Vol. 11, No. 1
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Heart failure is a complex disease caused by abnormalities in the structure or function of the heart resulting in decreased cardiac output. The complexity of heart failure causes an increasing burden of mortality and morbidity. This has further exacerbated the burden of treatment costs as well as the high rate of hospital readmissions. Readmission rate in patients with heart failure within 30 days post-hospitalization can reach 17.5%. In order to reduce re-hospitalization rates, multidisciplinary programs were introduced. The program involves collaboration of cardiologists, specialty nurses, pharmacists, nutritionists, and social workers using home or clinic-based models. Studies show that special management programs with a multidisciplinary approach can reduce re-hospitalization, mortality, and morbidity in heart failure patients. Multidisciplinary programs can also increase the level of medication adherence in heart failure patients. Therefore, multidisciplinary programs can be considered as one of the main lines in the management of heart failure.
“To Operate or Not to Operate”: Peran Internis dalam Prediksi Risiko Perioperatif Pada Lansia Fitriana, Ika
Jurnal Penyakit Dalam Indonesia Vol. 11, No. 2
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Faktor-faktor yang Berhubungan dengan Kualitas Tidur Pasien dengan Lupus Eritematosus Sistemik Andru, Gestana; Widhani, Alvina; Putranto, Rudi; Mansjoer, Arif; Shatri, Hamzah
Jurnal Penyakit Dalam Indonesia Vol. 11, No. 2
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Introduction. Sleep disturbances are often found among Systemic Lupus Erythematosus (SLE) patients. Poor sleep may cause low quality of life. Study about sleep quality among SLE patients and related factors in Indonesia is scarce. This study aimed to know factors related to poor sleep quality among SLE patients. Methods. This cross-sectional study was conducted among SLE patients at Cipto Mangunkusumo Hospital Jakarta Indonesia. Sleep quality was assessed by Pittsburgh Sleep Quality Index (PSQI), with global PSQI score >5 indicates poor sleep quality. Factors evaluated were symptoms of depression and anxiety by Hospital Anxiety Depression Scale (HADS), pain by Visual Analogue Scale (VAS), Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K), autonomic dysfunction by Low Frequency/High Frequency (LF/HF) ratio from Heart Rate Variability (HRV), and high sensitivity C-Reactive Protein (hs-CRP) level. Bivariate analysis was done by Chi Square or Fisher’s test. Multivariate analysis was done by logistic regression, p value <0.05 was considered statistically significant. Results. Total of 166 SLE patients were included. Mean age was 32.7 years old with the majority in age group of 21-30 years old and female. Poor sleep quality in SLE patients was found in 82.5% of subjects. Symptoms of depression were significantly associated with poor sleep quality in SLE patients, especially sleep efficiency. Anxiety was associated with subjective month- and week-long sleep quality, sleep disturbances, and sleep medication usage. Musculoskeletal component of the SLEDAI-2K was associated with month- and week-long sleep quality, sleep latency, and daytime dysfunction. Hematologic involvement was associated with daytime dysfunction, whereas mucocutaneous involvement was associated with sleep disturbances. Conclusions. Symptoms of depression were significantly associated with poor sleep quality in SLE patients, especially sleep efficiency. Anxiety was associated with subjective month- and week-long sleep quality, sleep disturbances, and sleep medication usage.
Manifestasi Klinis Infeksi Mpox pada Penderita HIV: Sebuah Telaah Sistematik dan Meta-Analisis Mardaningrat, Gede Ari Mahendra; Nugraha, Putu Arya; Putri, Isabella Soerjanto; Aryadi, Putu Hendri
Jurnal Penyakit Dalam Indonesia Vol. 11, No. 2
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Introduction. Mpox is a zoonotic disease caused by the mpox virus. Sexual intercourse is the biggest cause of mpox transmission. Human immunodeficiency virus (HIV) is a viral infection that is also transmitted mostly through sexual routes. This systematic review and meta-analysis was conducted to understand the clinical picture of mpox in relation to HIV infection. Methods. This meta-analysis followed MOOSE (Meta-analysis of Observational Studies in Epidemiology) guidelines. A systematic search for relevant studies was carried out using the PubMed, EMBASE and Cochrane Library databases covering the period 1 January 2022 to 31 May 2024. The keywords used were “Clinical feature” or “Clinical Manifestation” and “MPOX” or Monkey pox and “HIV”. Results. There were 8 studies that met the inclusion and exclusion criteria for meta-analysis. Eight studies were identified with a total of 2,392 patients with and without HIV. In this meta-analysis, an analysis of each clinical manifestation appearing in patients was conducted, resulting in statistically significant findings, including lymphadenopathy (RR: 0.89; 95% CI: 0.82-0.96), perianal lesions (RR: 1.17; 95% CI: 1.01-1.37), proctitis (RR: 1.79; 95% CI: 1.37-2.35), rectal pain (RR: 1.33; 95% CI: 1.16-1.52), rectal bleeding (RR: 1.33; 95% CI: 1.16-1.52), and tenesmus (RR: 1.63; 95% CI: 1.34-1.99). Conclusions. Enlarged lymph nodes, perianal lesions, proctitis, rectal pain, rectal bleeding, and tenesmus are the dominant clinical manifestations in mpox patients accompanied by HIV infection.
Model Prediksi Mortalitas Pembedahan Pasien Usia Lanjut yang Menjalani Pembedahan Elektif di Rumah Sakit Cipto Mangunkusumo Djafar, Fitria; Dwimartutie, Noto; Chandra, Susilo; Harimurti, Kuntjoro
Jurnal Penyakit Dalam Indonesia Vol. 11, No. 2
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Introduction. Elderly patients are at high risk of mortality after elective surgery. The aim of this study was to obtain and evaluate the performance of a mortality prediction model for elderly patients undergoing elective surgery. Methods. The design of this study was a retrospective cohort using medical record data from 747 elderly subjects who underwent elective surgery in the period January 2015–December 2017 at Cipto Mangunkusumo Hospital (RSCM), Jakarta. This study used multivariate analysis with logistic regression to determine significant predictors that were included in the prediction model. The performance of the prediction model was assessed using the Hosmer-Lameshow test, and its discrimination ability was determined by calculating the Area Under the Curve (AUC). Results. Of the total 747 elderly subjects, the elective surgery mortality rate was 14.5%. The predictor variables were functional status [ADL 9-11, OR 1.808 (95% CI 0.848-3.854); ADL 0-8, OR 3.382 (95% CI 1.724-6.634)], comorbidities [CCI 3-4, OR 12.206 (95% CI 5.317-28.018); CCI >5, OR 15.820 (95% CI 6.701-37.347)], albumin level <3 g/dL [OR 3.777 (95% CI 2.105-6.779)], type of surgery [grade II, OR 3.827 (95% CI 1.849- 7.923); grade III, OR 6.560 (95% CI 3.378-12.739)], and ASA status with an ASA score > 3 [OR 5.106 (95% CI 1.841-14.159)] were further included in the components of the surgical mortality predictor scoring system. The mortality prediction model was categorized into low risk (score < 7; probability of mortality 2.33%), medium risk (score 7-10; probability of mortality 25.22%), and high risk (score > 10; probability of mortality 74.67%). The prediction model showed good discrimination [AUC score 0.900 (95% CI: 0.873-0.927)] and good calibration (p=0.718 on Hosmer-Lameshow test). Conclusion. The prediction model of mortality among elderly patients undergoing elective surgery, incorporating factors like functional capacity, comorbidities, preoperative serum albumin concentrations, surgical procedure type, and ASA classification, showed good performance.
Karakteristik Pasien Rinitis Alergi dengan Hasil Uji Cukit Kulit Positif yang Berobat di Poliklinik THT-KL Rumah Sakit Umum Daerah Zainoel Abidin Banda Aceh T.R, T. Husni; Murzalina, Cut; Elvia, Elvia; Alia, Dina; Razali, Rezania; Annisa, Siti Nur; Putra, Teuku Romi Imansyah; Farhana, Rika
Jurnal Penyakit Dalam Indonesia Vol. 11, No. 2
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Introduction. Allergic rhinitis is an inflammatory disease mediated by IgE in the nasal mucosa, resulting from allergen sensitization and causing various clinical symptoms. The skin prick test is the primary diagnostic technique used to detect specific IgE antibodies against allergenic proteins and peptides. The incidence of allergic rhinitis in Indonesia ranges from approximately 1.5% to 12.4% and increases every year. This study aims to determine the characteristics of allergic rhinitis sufferers with positive skin prick test results who received treatment at the ENT outpatient service of Zainoel Abidin Regional General Hospital (RSUDZA) Banda Aceh from January 2019 to March 2020. Methods. This was a retrospective descriptive study with a cross-sectional design that utilized secondary data from patient medical records. The samples were collected using the total sampling technique, encompassing a total of 62 patients in this study. Results. This study revealed that allergic rhinitis sufferers with positive skin prick test results were predominantly in the age group 17-25 years (27.4%), female (69.4%), and from Banda Aceh (56.5%). Most of the rhinitis patients were students (41.9%), with the highest level of education being high school (43.5%). Allergic rhinitis is frequently caused by house dust mites (24.2%) as inhalant allergens and shrimp (26.3%) as ingested allergens. Most allergic rhinitis patients who visited complained most frequently of sneezing more than five times (26.3%). Conclusions. This study concluded that the characteristics of allergic rhinitis sufferers with positive skin prick test results in RSUDZA are predominantly in the late adolescent age group (17-25 years), female, with house dust mites and shrimp as the main allergens, and the most common clinical symptom is sneezing more than 5 times.
Prevalensi dan Karakteristik Pasien Tuberkulosis Paru Resisten Obat (TB-RO) dengan Diabetes Melitus Tipe 2 di Klinik TB-RO Rumah Sakit Umum Pusat Dr. Hasan Sadikin, Bandung Maulida, Diva Harnum; Dewi, Intan Mauli Warma; Santoso, Prayudi; Cahyadi, Adi Imam; Kusumawati, Maya; Kulsum, Iceu Dimas
Jurnal Penyakit Dalam Indonesia
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Introduction. Diabetes mellitus (DM) patients have a higher risk of tuberculosis (TB) infection, including the risk of drug- resistant (DR)-TB infection, compared to those without DM. Data on the characteristics of pulmonary DR-TB with DM in Indonesia are still very limited. The management of pulmonary DR-TB with DM should consider multiple factors, such as drug interactions between DM medication and anti-TB drugs, as well as potential exacerbation of DM complications by anti-TB drugs side effects. Effective management of pulmonary DR-TB patients with DM will improve treatment outcomes. This study aimed to determine the prevalence and characteristics of pulmonary DR-TB patients with type 2 DM at the DR-TB clinic of Dr. Hasan Sadikin Central General Hospital, Bandung. Methods. This cross-sectional study was conducted at the Drug Resistant Tuberculosis (DR-TB) Clinic of Dr. Hasan Sadikin Central General Hospital, Bandung, during the period of January 2020 to May 2023. Data were obtained from the medical records of patients with drug resistant pulmonary tuberculosis and type 2 DM. The study included patients diagnosed with drug resistant pulmonary tuberculosis and type 2 DM who were aged 18 years or older. Data analysis was performed using descriptive statistical methods, and normality test was conducted using the Kolmogorov-Smirnov test. Results. The prevalence of pulmonary DR-TB cases with Type 2 DM was 11.17%. Out of a total of 82 samples, more than half had normal BMI (61.04%), diagnosed with MDR-TB (74.39%). The duration of Type 2 DM were in average between 1-5 years (53.16%), with an HbA1c value ≥7% in 94.20% of the patients. Infiltrates were found in 46.27% of radiological findings. Anemia was present in 54,88% of participants, with an average and standar deviation hemoglobin level of 12.15 (± 1.75) g/dL. Conclusions. The prevalence of pulmonary drug-resistant tuberculosis with type 2 DM at Dr. Hasan Sadikin Central General Hospital, Bandung, is 11,17%. The majority of patients had uncontrolled type 2 DM (HbA1c ≥7%), normal BMI, positive sputum mycobacteriology, and the primary chest X-ray finding is infiltrate. Future studies are necessary to determine the clinical and treatment outcome of these patients.
Two-point Compression POCUS sebagai Metode Diagnosis Dini Trombosis Vena Dalam Proksimal Ramadan, Edwin Ti; Maharani, Sausan Hana; Cahyanur, Rahmat; Priantono, Dimas; Rajabto, Wulyo
Jurnal Penyakit Dalam Indonesia Vol. 11, No. 2
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Deep vein thrombosis (DVT), especially in the proximal part of the lower extremity, might progress to pulmonary embolism and be fatal. Therefore, it is crucial to prompt the diagnosis of DVT in the emergency room (ER). Due to its efficiency and patient convenience, duplex ultrasound has become the preferred diagnostic method for DVT. Point-of-care ultrasonography (POCUS) was known as a simpler and faster way to use ultrasonography at the bedside. The two-point compression method has become frequently used due to its ability to take less time for examination, yet there are still concerns about its accuracy. This study was conducted to find out whether two-point compression POCUS can be used as an early diagnostic method for proximal DVT. The literature search was carried out in the databases PUBMED, EMBASE, and SCOPUS on March 29, 2023, using keywords “Deep Vein Thrombosis”, “two-point compression POCUS”, and “diagnosis”. Four publications were chosen from the search results. One cross-sectional study was found to have a low validity value because POCUS and Doppler ultrasound operators were not blinded, and the reference test was only performed on positive DVT results on POCUS. All studies had high sensitivity and specificity (>90%) compared to the reference test, except for one cross-sectional study in critical patients in ICU, which had a 63% sensitivity value. In conclusion, the two-point compression POCUS method can be utilized as an early diagnostic method for proximal DVT, with the disclaimer that POCUS operators should get curriculum-based training before doing the examination.
Peningkatan Leukosit, Neutrofil, dan Prokalsitonin Persisten Tanpa Bukti Infeksi pada Kanker Stadium Akhir: Sebuah Laporan Kasus Yanuar, Santosa; Ahani, Ardhi Rahman; Setiabakti, Andrian; Rizka, Aulia; Sinto, Robert
Jurnal Penyakit Dalam Indonesia Vol. 11, No. 2
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Elevation of leukocyte, neutrophil, and procalcitonin (PCT) has been known as a marker of bacterial infection independent of the underlying disease. This article will describe a case of end-stage cancer with persistent elevation of leukocyte, neutrophil, and procalcitonin with no evidence of infection. A 45-year-old female presented with abdominal distension for three months prior to hospital admission. The patient was suspected to have breast cancer with hepatic metastasis based on diagnostic tests. Throughout treatment, the patient experienced persistent elevation of leukocytes, neutrophils, and PCT despite no signs or symptoms of infection from history, physical examination, and diagnostic tests. The patient received antibiotic therapy including ciprofloxacin escalated to meropenem, but leukocytes, neutrophils, and PCT did not decrease. A breast tumor biopsy was performed. The result of biopsy revealed after the patient had passed away. The histopathology was invasive carcinoma, No Special Type (NST) of right breast. The immunohistochemistry showed luminal B type, HER2 positive. The persistent increase in leukocytes and neutrophils in this patient indicates poor prognosis, disease progression, metastasis, and pro-cancer activity of neutrophils. The elevated PCT in this patient may be due to systemic inflammation and/or aberrant secretion from the cancer itself.
Sindrom Kardiovaskular-Ginjal-Metabolik: Konsep Terkini untuk Klinisi Yamin, Muhammad; Putra, Harits Adi
Jurnal Penyakit Dalam Indonesia Vol. 11, No. 2
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Cardiovascular-kidney-metabolic (CKM) syndrome is a systemic abnormality resulting from complex pathophysiological interactions among cardiovascular disease, chronic kidney disease, and metabolic risk factors, particularly diabetes mellitus and obesity. In clinical practice, the management of CKM syndrome encounters some significant challenges, including the lack of clinicians’ knowledge regarding the most up-to-date therapy, limited drug availability, and restrictions on health insurance. Those issues potentially lead to a rise in morbidity and mortality rates of patients with CKM syndrome. This article elucidates the most updated concept of CKM syndrome regarding its pathophysiology, diagnostic approach, and treatment based on clinical stages ranging from stage 0 to stage 4. Some emerging medications have proven to improve the prognosis of patients with CKM syndrome by targeting any of the pathophysiological interactions, namely sodium-glucose cotransporter-2 inhibitors, glucagon-like peptide-1 receptor agonists, angiotensin-enzyme converting inhibitors, and angiotensin receptor blockers. Recent studies have proven their efficacy in reducing hospitalisation rates and cardiovascular-related mortality. Not only by applying current clinical guidelines in practice, CKM syndrome should also be managed holistically in a multidiscipline manner starting from health promotion to curative treatment. Hence, the current concept of CKM syndrome pointing to holistic and multidiscipline management hopefully could prevent the progressivity of the disease and reduce the morbidity and mortality rates.

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