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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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Saatnya Memberikan Vaksin Influenza untuk Tenaga Kesehatan Hasibuan, Anshari Saifuddin
Jurnal Penyakit Dalam Indonesia
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Gastric Outlet Obstruction sebagai Keluhan Awal Limfoma Gaster: Sebuah Laporan Kasus Chen, Lie Khie; Mohammad, Nurhidayat; Rumondor, Bayu B; Muzellina, Virly Nanda
Jurnal Penyakit Dalam Indonesia
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Gastric lymphoma often presents with non-specific symptoms, contributing to delayed diagnosis. Gastric Outlet Obstruction (GOO) is a potential complication that may occur in patients with gastric lymphoma. A 62-year-old male patient presented with persistent weakness, nausea, and vomiting. His symptoms began with long-standing abdominal discomfort, which had not been further evaluated. Esophagogastroduodenoscopy (EGD) revealed GOO secondary to a mass, which, after pathological and immunohistochemical evaluation, was diagnosed as diffuse large B-cell lymphoma (DLBCL). The patient was subsequently given a nasojejunal feeding tube and treated with R-CHOP chemotherapy (rituximab, cyclophosphamide, doxorubicin, vincristine, and oral prednisone). The non-specific nature of gastric lymphoma symptoms often results in diagnostic delays, resulting in diagnoses at more advanced stages. Gastric lymphoma complicated by GOO poses distinct challenges, particularly in managing nutritional support, which can impair the patient’s performance status and, in turn, influence treatment response and overall survival. Due to the non-specific nature of initial symptoms, many patients with gastric lymphoma are diagnosed at later stages. Therefore, early screening for patients with atypical dyspepsia symptoms is essential to rule out malignancies, including gastric lymphoma.
Pengetahuan dan Persepsi Keluarga Penderita Penyakit Ginjal Tahap Akhir (PGTA) terhadap Transplantasi Ginjal di RS Hasan Sadikin Bandung Syakira, Rizqa Adinda; Mariani, Helni; Andhika, Rizky
Jurnal Penyakit Dalam Indonesia
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Introduction. Kidney transplantation is the best kidney replacement therapy for End Stage Renal Disease (ESRD) patients. The gap between the number of donors and recipients remains a problem contributing to the low rate of kidney transplantation in Indonesia. The families of ESRD patients are the most recommended donor candidates. Knowledge and perception have a crucial role in the decision to donate organs, making it important to know the knowledge and perception of ESRD patients’ families towards kidney transplantation. This study aimed to describe the knowledge and perception of families of ESRD patients undergoing dialysis at Dr. Hasan Sadikin General Hospital Bandung. Methods. A descriptive quantitative study with a cross-sectional approach was conducted on the families of patients in the Dialysis Unit of Dr. Hasan Sadikin General Hospital, Bandung, aged ≥26 years, selected through consecutive sampling. Respondents were chosen if they had a blood relationship or emotional connection with patients undergoing hemodialysis or Continuous Ambulatory Peritoneal Dialysis (CAPD). Data collection was carried out from December 2023 to February 2024 using a validated questionnaire. The questionnaire items were developed based on several research studies on similar topics. Knowledge levels were measured through three variables: concepts, selection, and factual events. Meanwhile, the perception aspect assessed prosocial personality, post-transplant risk, and confidence in the procedure. Descriptive data analysis was performed using SPSS version 25. Results. A total of 107 respondents met the inclusion criteria, with the majority aged 26–35 years (34.6%) and predominantly female (69.2%). The majority of respondents were characterized by good knowledge (53.3%) and positive perceptions (65.4%). Within the knowledge domain, the highest proportion of correct responses was observed for items related to donor requirements (98.1%), whereas the lowest was noted for items addressing the conceptual understanding of kidney transplantation procedures (25.2%). In terms of perception, the most favorable responses were associated with the concept of severance of family ties, while the most negative responses were linked to concerns regarding the risks of post-transplant complications. Conclusions. Most respondents have a good level of knowledge and positive perceptions towards kidney transplantation. The greatest fear among respondents was related to the transplant procedure and the risks of post-transplant complications. This study highlights the need for educational interventions to improve the knowledge and perceptions of ESRD patients’ families concerning aspects of kidney transplantation that remain insufficiently understood.
Pengaruh Durasi Pengobatan dan Preferensi Pasien Kanker Stadium Akhir terhadap Layanan Homecare di Rumah Sakit Medistra pada Tahun 2021-2023 Putra, Peter Brian Sutanto, Dr; Suwangto, Erfen Gustiawan, Dr; Djuartina, Tena, Dr; Budianto, Iskandar Rahardjo, Dr; Lesmana, C. Rinaldi A.
Jurnal Penyakit Dalam Indonesia
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Introduction. Cancer is still an enormous health problem in the world and rank second as the most common cause of mortality. End-stage cancer requires end-of-life or palliative care to improve the patient’s quality of life before death. Homecare services have become an option for providing palliative care to avoid long-term hospital stays. The study aimed to provide an overview of the treatment duration and other factors in end-stage cancer patients regarding the selection of homecare services at Medistra Hospital during the period of 2021-2023. Methods. This study with a cross-sectional design analyzed medical records of end-stage cancer patients who received palliative homecare services at Medistra Hospital from 2021 to 2023. Chi-square analysis was used to describe the association between gender, treatment duration, and cancer type with the decision to choose homecare services. The Mann-Whitney test was conducted to describe the relationship between age and the decision to choose homecare. Results. Out of 595 end-stage cancer patients, 429 chose to undergo palliative homecare. Males represented the majority in both the homecare group (53.1%) and the non-homecare group (56.6%). Patients who chose homecare were generally older (median age 65 years) compared to those who did not (median age 61 years, p = 0.002). Hematologic cancers were most common in the non-homecare group (25.3%), while gastrointestinal cancers were the most prevalent in the homecare group (39.9%). Patients with a treatment duration of less than 8 weeks from diagnosis were more likely to choose homecare, while those with a duration of 8 weeks or more were more likely to decline homecare (98.6% vs. 3.6%, p <0.001). Conclusion. Treatment duration and age are significant factors that related to the decision of end-stage cancer patients to choose homecare services.
Analisis Prediktif Mutasi EGFR pada Adenokarsinoma Paru Menggunakan Pendekatan Pembelajaran Mesin Njoto, Edwin Nugroho; Pamungkas, Yuri; Putri, Atina I.W.; Haykal, Muhammad. Najib; Eljatin, Dwinka Syafira; Djaputra, Edith Maria
Jurnal Penyakit Dalam Indonesia
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Introduction. Lung adenocarcinoma is a prevalent form of lung cancer, and mutations in the epidermal growth factor receptor (EGFR) gene are known to play a crucial role in its pathogenesis. This study aimed to develop a machine-learning model to predict EGFR mutations in lung adenocarcinoma patients using clinical and radiological features. Methods. A case-control study was conducted using a dataset comprising 160 patients with lung adenocarcinoma. Several machine learning algorithms, including decision tree, linear regression, Naive Bayes, support vector machine, K-nearest neighbor, and random forest, were employed to predict EGFR mutations based on variables such as smoking status, tumor diameter, tumor location, bubble-like appearance on CT-scan, air-bronchogram on CT-scan, and tumor distribution. Results. Most study subjects were over 50 years old (83.75%) and female (53.13%). The analysis results indicated that the random forest model demonstrated the best performance, achieving an accuracy of 83.33%, precision of 86.96%, recall of 80.00%, and an Area Under the Curve (AUC) of 90.0. The Naive Bayes model also performed well, with an accuracy of 85.42%, precision of 82.61%, recall of 86.36%, and an AUC of 91.0. Conclusions. The study highlights the potential of machine learning techniques, particularly random forest and Naive Bayes, in accurately predicting EGFR mutations in lung adenocarcinoma patients based on readily available clinical and radiological features. These findings could contribute to the development of non-invasive, cost-effective, and efficient tools for EGFR mutation detection, ultimately facilitating personalized treatment approaches for lung adenocarcinoma patients.
Efektivitas Vaksin COVID-19 mRNA Booster Kedua pada Tenaga Kesehatan di Rumah Sakit Umum Pusat Nasional Dr. Cipto Mangunkusumo dan Faktor yang Memengaruhinya Lubis, Siti Taqwa Fitria; Koesnoe, Sukamto; Yunihastuti, Evy; Shatri, Hamzah; Karjadi, Teguh Harjono; Harimurti, Kuntjoro; Pitoyo, Ceva Wicaksono; Yunir, Em
Jurnal Penyakit Dalam Indonesia
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Introduction. The emergence of the Omicron variant during the pandemic had an impact on the effectiveness of the COVID-19 vaccine. The spread of Omicron increased rapidly even in populations that had been vaccinated with booster doses, causing a high incidence of infection. This study aimed to determine the effectiveness and factors related to the effectiveness of the second mRNA booster vaccine as well as antibody levels after the second mRNA booster vaccine in healthcare workers at Cipto Mangunkusumo National General Hospital. Methods. This study used a cohort design. Total sampling of 271 healthcare workers were obtained from previous research and continued with consecutive sampling. Selected subjects were interviewed, and blood samples were taken to measure IgG sRBD antibody levels. The effectiveness of the vaccine was calculated, and bivariate and multivariate analysis was carried out to assess the factors that influenced the effectiveness of the second mRNA booster vaccine. Results. A total of 9 subjects (5.6%) were infected with COVID-19 in the second booster vaccine group and 11 subjects (9.7%) in the first vaccine group. The effectiveness of the vaccine against COVID-19 infection was 42% (CI 95% -37 – 75%), p = 0,215. Age, gender, hypertension, type 2 DM, obesity, smoking, and COVID-19 infection before booster have no relationship to the effectiveness of the second booster mRNA vaccine. In 48 subjects who had their antibody levels checked during the first and second boosters, there was an increase from 4,743 AU/ml (IQR 6,053.3) to 8,532 AU/ml (IQR 8,040.3). Conclusions. The effectiveness of the second mRNA booster vaccine against COVID-19 infection in healthcare workers was 42%. There were no factors related to the effectiveness of the second mRNA booster vaccine. The sRBD antibody levels after the second booster vaccine were higher than the first booster vaccine.
Efek Terapeutik Analog Somatostatin dalam Menghambat Perkembangan Autosomal Dominant Polycystic Kidney Disease Sitompul, Irvin Rembrant Holleritz; Putri, Grasella Angelika; Laksmi, Purwita Wijaya
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Autosomal Dominant Polycystic Kidney Disease (ADPKD) is a hereditary disorder characterized by formation and progressive growth of cysts in the kidneys and other organs such as liver, spleen, and pancreas. Recent advances have led to possibilities to target the main cause of cyst growth, cAMP. Somatostatin targets cAMP and inhibits its production directly and indirectly in kidney and liver, which might potentially prevent renal and liver cyst progression in ADPKD. This report aims to evaluate the effectiveness of somatostatin analogue therapy in slowing disease progression in ADPKD patients, according to the latest evidence. A literature search was conducted on five databases, namely the Cochrane Library, EBSCO, Embase, ProQuest, and PubMed/MEDLINE. Selected articles are screened for duplication, title and abstract, as well as based on eligibility criteria. The selected articles were then critically appraised using the Oxford Center for Evidence Based Medicine (CEBM) critical appraisal tools for therapeutic study and systematic review as a guide. The systematic search resulted in one meta-analysis assessing the effectiveness of somatostatin analogues in ADPKD patients in terms of Total Kidney Volume (TKV), Total Liver Volume (TLV), and eGFR. This article analyzed 10 RCTs with a total sample size of 854 subjects. This study showed that somatostatin analogue is associated with lower TLV (%TLV) growth (MD -6.37%; 95% CI -7.90 to -4.84; p<0.001; I2 = 14%), and lower TKV (%TKV) growth rate (MD -3.66%; 95% CI -5.35 to -1.97; p<0.001; I2 = 56%). However, it was not associated with eGFR decline (MD -0.96 mL/min/1.73m2; 95% CI -2.38 to 0.46; p = 0.19; I2 = 74%). Adverse effects were mainly gastrointestinal tract symptoms, and approximately 15% of test subjects administered with somatostatin analogue permanently discontinued the drug. Somatostatin analogue therapy has benefit in slowing TLV and TKV growth which outweigh the cost and risk of therapy. In conclusion, somatostatin can be recommended as therapy in ADPKD patients presenting with both kidney and liver cyst.
Long COVID dan Sistem Kardiovaskular Muhadi, Muhadi; Laksmana, Ivan Mardhi
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Even after nasopharyngeal Polymerase Chain Reaction (PCR) swab investigation revealed no COVID-19 infection, some individuals continue to have long COVID symptoms. According to a research published in 2022, 4.5 – 36.6% of patients had symptoms following a COVID-19 infection more than three months. Long COVID symptoms may impact multiple organ systems, including the cardiovascular system. Chest pain, palpitations, arrhythmia, postural orthostatic tachycardia syndrome, and other symptoms are possible appeared in long COVID. D-Dimer, echocardiography, CT scan, cMRI and other supportive test showed meaningful results. Pharmacological treatment can be given based on the concurrent diagnosis found in patients with long COVID. While non-pharmacological treatment can be given in the form of pulmonary rehabilitation, breathing exercises, acupuncture, and COVID-19 vaccination. The state and quality of life of individuals experiencing cardiovascular symptoms following a long COVID infection may deteriorate due to delayed treatment and inadequate early detection.
Profil Kadar Vitamin D dan Hubungannya dengan Derajat Keparahan Klinis serta Parameter Inflamasi pada Pasien Terkonfirmasi COVID-19 Hasudungan, Wicensius Parulian; Rachman, Andhika; Widhani, Alvina; Mansjoer, Arif
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Introduction. The available data currently is not adequate to show the differences in vitamin D levels across various clinical stages of COVID-19 in Indonesia. Therefore, this study was conducted to determine the profile of vitamin D levels and its relationship with the clinical severity and inflammatory parameters in confirmed COVID-19 patients. Methods. The study was conducted at Cipto Mangunkusumo Hospital and Wisma Atlet COVID-19 Emergency Hospital from January to December 2021. Subjects who were 18 years old and above and had confirmed COVID-19 status through COVID-19 Polymerase Chain Reaction (PCR) from oropharyngeal swab were included. Those who refused to participate in the study were excluded. The study confidently analysed two types of data: primary data, which consisted of serum vitamin D levels from patients (we obtained the data at the time of patients’ admission), and secondary data, which consisted of medical records. Results. It is worth noting that of the 96 subjects, 77.08% had a vitamin D deficiency. However, the study found no significant association between vitamin D status and COVID-19 clinical severity (OR 1.16 (0.61 – 2.23); p = 0.641). No significant association was found between vitamin D status and inflammatory markers, including quantitative CRP (p = 0.691), D-dimer (p = 0.956), and neutrophil-lymphocyte ratio (p = 0.883). Conclusions. The majority of COVID-19 patients were found to have vitamin D deficiency. Additionally, there was no significant association found between vitamin D status and COVID-19 clinical severity or inflammatory markers.
Status Gizi sebagai Faktor Risiko Mortalitas di Rumah Sakit pada Pasien Lanjut Usia Pasca Reseksi Tumor Kolorektal Wulandari, Ayu Fitri Sekar; Budiono, Parish; Mupangati, Yudo Murti
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Introduction. Malnutrition in elderly patients, particularly those with colorectal cancer, increases morbidity, mortality, and length of hospital stay due to metabolic dysregulation and hypermetabolic perioperative response, affecting wound healing, infection risk, postoperative complications, and nutritional deficits. This study aimed to analyze whether nutritional status is a risk factor for in-hospital mortality in elderly patients after colorectal tumor resection. Methods. A case-control matching study was conducted on elderly patients who underwent colorectal tumor resection, using secondary data from elderly inpatients at Dr. Kariadi General Hospital from January 2020 to April 2024. The collected data were analyzed using bivariate analysis with the Chi-square test and multivariate analysis with logistic regression. Results. The study involved 48 elderly patients who died during treatment and 48 elderly patients who survived until the end of treatment. Nutritional screening assessed with Skrining Gizi Kariadi (SGK) was not associated with in-hospital mortality after colorectal tumor resection [p=0.306; OR 1.952 (95% CI 0.694-5.491)]. However, nutritional assessment based on American Society for Parenteral and Enteral Nutrition (ASPEN) criteria was associated with in-hospital mortality after colorectal tumor resection [p<0.001; OR 5.800 (95% CI 2.345-14.344)]. The results of the multivariate analysis also revealed a significant link between nutritional status based on the ASPEN criteria (p=0.028) and a higher risk of in-hospital mortality in elderly patients after colorectal tumor resection. Conclusion. Nutritional status, based on ASPEN criteria, is a risk factor for in-hospital mortality in elderly patients after colorectal tumor resection.

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