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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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Profil Anafilaksis di RSU Hasanah Graha Afiah, Depok pada Januari 2023 – April 2024 Koesnoe, Sukamto; Wulandari, Risky; Wicaksana, Bramantya
Jurnal Penyakit Dalam Indonesia
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Introduction. Anaphylaxis is a severe hypersensitivity reaction that occurs rapidly and can be life-threatening. This reaction disrupts the respiratory, cardiovascular, digestive, and/or integumentary systems. The global prevalence of anaphylaxis is 1-2%, with a mortality rate of 0.3%. However, data on anaphylaxis in Indonesia is very limited. The aim of this study was to obtain anaphylaxis profile at Hasanah Graha Afiah Hospital, Depok. Methods. This study used a cross-sectional descriptive study from January 2023 to April 2024 at Hasanah Graha Afiah Hospital, Depok, Jawa Barat. Inclusion criteria include patients aged ≥17 years, diagnosed with anaphylaxis in medical records in inpatient and/or emergency units. Data was collected from electronic medical records. Demographic variables include gender, age, marital status, occupation, education, comorbidities, causes of anaphylaxis, diagnostic criteria, severity, initial therapy, and mortality. Results.This study found an anaphylaxis incidence rate of 0.8%, with the highest occurrence in the 26-35 age group (28%). Most anaphylaxis cases were in females (59%). The most common triggers were NSAIDs (34.4%), followed by antibiotics (28.1%), paracetamol (9.4%), anti-bleeding agents (9.4%), and anti-tuberculosis drugs (6.2%). Interestingly, we found food, blood products, and cold as other causes. Anaphylactic shock occurred in 19% of cases. The most used therapies were methylprednisolone (43%), diphenhydramine (28%), epinephrine (17%), and dexamethasone (12%). There were no anaphylaxis-related mortalities. Conclusions. The incidence of anaphylaxis at RSU Hasanah Graha Afiah, Depok, was 0.8%. Most cases occurred in females aged 26–35 years, with medications being the primary trigger. Vigilance in selecting disease treatment, early recognition of anaphylaxis, and prompt and appropriate management are essential instruments in the successful handling of anaphylaxis.
Hubungan Heart Rate Variability dengan Global Longitudinal Strain pada Pasien Diabetes Melitus Tipe 2 di Puskesmas Jakarta Hadi, Dwi Rendra; Rusdi, Lusiani; Tarigan, Tri Juli Edi; Mansjoer, Arif
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Introduction. Diabetes mellitus (DM) remains a major global health issue due to its direct consequences and complications, particularly cardiovascular complications. These complications are influenced by autonomic neuropathy, which can be assessed by Heart Rate Variability (HRV). Autonomic dysfunction is thought to impair heart function, which can potentially be predicted early by observing Global Longitudinal Strain (GLS). The relationship between HRV and GLS has not been extensively studied. Therefore, this study aimed to identify the relationship between HRV and GLS. Methods. A cross-sectional study with a population of adult type 2 DM patients residing in Jakarta in December 2020. HRV parameters included RR interval, Standard Deviation of NN Intervals (SDNN), Root Mean Square of Successive Difference (RMSSD), Low Frequency (LF), High Frequency (HF), and LF/HF ratio. Global longitudinal strain was analyzed using echocardiography. Results. Analysis was conducted on 167 samples. The mean value of GLS was -20.30 (SD 1.57). There were no correlation between RR interval (r = -0.07, p = 0.377), SDNN (r = -0.10, p = 0.189), RMSSD (r = -0.12, p = 0.098), LF (r = -0.003, p = 0.968), HF (r = -0.09, p = 0.21), and LF/HF ratio (r = -0.10, p = 0.189) with GLS. No association was found between hypertension, history of smoking, dyslipidemia, duration of diabetes, and HbA1C with GLS. Conclusion. There is no correlation between heart rate variability and global longitudinal strain in type 2 DM patients.
Infeksi Oportunistik pada Pasien HIV yang Dirawat Inap di RSUP Dr. Hasan Sadikin Bandung Tahun 2019-2022 Salma, Katarina; Hartantri, Yovita; Fauziah, Nisa
Jurnal Penyakit Dalam Indonesia
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Introduction. Human Immunodeficiency Virus (HIV) is a virus that infects and attacks the human immune system. The high morbidity and mortality rates in HIV patients can be attributed to various factors, one of which is the presence of opportunistic infections due to the weakened immune response, making HIV patients highly susceptible to other infections. This study aims to provide an overview of opportunistic infections in HIV patients hospitalized at Dr. Hasan Sadikin General Hospital in Bandung within the period of 2019-2022. Methods. This descriptive observational study was conducted on 255 HIV patients with opportunistic infections who were hospitalized at dr. Hasan Sadikin Hospital (RSHS), Bandung. The study utilized secondary data from medical records from 2019 to 2022. The sampling method employed in this research was total sampling. Data processing and analysis of the relationship between two variables, namely the number of opportunistic infections and length of hospital stay, with HIV stage, were performed using IBM SPSS Statistics software version 26. The statistical methods used in this analysis included the Chi-square test and the Mann-Whitney test. Results. The research findings indicated that the most common opportunistic infection in HIV patients was oral candidiasis (60,0%), followed by pulmonary tuberculosis (453,1%) and toxoplasmosis (45,136,5%). The prevalence of opportunistic infections was higher in males (79,2%) compared to females. The age group most affected was patients aged 24-44 years. There was also a significant association between the HIV stage and the number of opportunistic infections, with a higher number of opportunistic infections occurring in patients with stage 4 HIV. Conclusions. Oral candidiasis and tuberculosis are opportunistic infections with the highest prevalence among HIV patients who were hospitalized at dr. Hasan Sadikin Hospital during the period of 2019-2022.
Efek Hipnoterapi untuk Meningkatkan Kualitas Hidup pada Pasien Penyakit Ginjal Kronik: Suatu Laporan Kasus Berbasis Bukti Chairani, Aisha Putri; Putranto, Rudi; Shatri, Hamzah; Marbun, Maruhum Bonar Hasiholan; Faisal, Edward; Irvianita, Vinandia; Martina, Diah
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Chronic Kidney Disease (CKD) is a condition of kidney damage with a decrease in glomerulus filtration rate of 60 ml/min/1.73 m3 for a duration of more than three months. CKD is closely related to the patient’s quality of life because the patient must carry out various lifestyle restrictions to slow the progression of kidney damage. Lifestyle restrictions often cause problems in the psychosocial field that increase the severity of symptoms and decrease kidney function faster. This evidence-based case review was compiled to determine the effectiveness of hypnotherapy in improving the quality of life of CKD patients. Literature searches were conducted in four databases, namely PubMed, Cochrane, EMBASE, and Scopus. There are three literatures that fit the eligibility criteria. The critical review was conducted using guidelines created by the Centre for Evidence-Based Medicine, University of Oxford. Hypnotherapy consistently shows improved quality of life in the form of decreased symptoms of anxiety, depression, drowsiness, fatigue, and improved social functioning and relationships with family. Hypnotherapy can be considered a complementary therapy in the management of CKD patients with minimal side effects by considering the patient’s accessibility and preferences.
Pencegahan Sindrom Delirium Akut pada Pasien Lansia di Rawat Inap Vera, Vera
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Acute delirium syndrome is often found in hospitalized older patients, requiring longer hospital stay and higher hospital cost. Studies showed that 40% of these delirium cases in older patients may be prevented with multicomponent intervention based on National Institute for Health and Clinical Excellence (NICE) and Hospital Elder Life Program (HELP) guidelines. This article explained multicomponent intervention, which includes protocols for disorientation, dehydration, hypoxia, constipation, malnutrition, pain control, infection control, infection prevention, drugs evaluation, early mobilization, and education for patients’ family / caregiver. Prevention of acute delirium syndrome in hospitalized older patients will reduce the medical cost and distress among patients’ family.
Penghambat Kanal Kalsium sebagai Kontrol Glukosa Darah pada Insulinoma: Sebuah Laporan Kasus Nizam, Nadhira; Putra, Ryan Tresna; Hasibuan, Anshari Saifuddin
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Insulinoma is a rare neuroendocrine tumor of the pancreas arising from β-cells, leading to excessive insulin secretion and resultant hypoglycaemia. Surgical resection is the first-line treatment for insulinoma, but when surgery is not feasible, medical therapy is an important option. Calcium channel blockers (CCBs) such as verapamil can inhibit insulin release from β-cells and have been proposed as an adjunct therapy to help control blood glucose levels in insulinoma. We report a 43-year-old man who presented to the emergency department with decreased consciousness due to hypoglycaemia. His capillary blood glucose at home was 35 mg/dL, about 8 hours after his last meal. He had a history of recurring hypoglycaemic episodes in the past month, with recorded blood glucose ranging from 26–100 mg/dL during a prior hospitalization. On examination, he was hemodynamically stable but had mild epigastric tenderness. Laboratory tests confirmed hyperinsulinemic hypoglycaemia (plasma glucose 58 mg/dL with concurrent serum insulin 47 µIU/mL and C-peptide 13.1 ng/mL), consistent with insulinoma. Abdominal imaging revealed a heterogeneous pancreatic mass suspected as an insulinoma. Initial management included a continuous infusion of 10% dextrose (500 mL/24h) with IV boluses of 40% dextrose as needed for blood glucose <70 mg/dL. Despite this, the patient experienced recurrent hypoglycaemia, so octreotide 50 µg three times daily was added. Octreotide alone did not fully stabilize his blood glucose levels. On the 6th day of hospitalization, oral verapamil 80 mg once daily was initiated – chosen both to treat the patient’s concurrent hypertension and for its potential to suppress insulin release. Following the addition of verapamil, the patient’s blood glucose levels improved and remained above 100 mg/dL with markedly reduced hypoglycemic episodes. The patient subsequently underwent a debulking surgery of the pancreatic tumor. This case highlights the importance of controlling blood glucose in insulinoma patients and demonstrates that the addition of verapamil can stabilize blood glucose when used alongside standard medical therapy (such as octreotide). Verapamil may serve as a useful adjunct in the management of insulinoma-related hypoglycemia, especially in patients awaiting surgery or those who are not surgical candidates.
Advanced HIV Disease: Wajah HIV yang Hampir Terlupakan Yunihastuti, Evy; Wicaksana, Bramantya
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Mortalitas pada Pasien Hemodialisis: Masih Menjadi Tantangan Globa Khumaedi, Anandhara Indriani Indriani; Elita, Dina
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Faktor-Faktor yang Berhubungan dengan Massa Otot, Kekuatan Otot, dan Performa Fisik pada Lansia Riviati, Nur; Indrajaya, Taufik; Chodilawati, Rukiah; Dibyantari, Ridzqie; Indra, Bima
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Introduction. Despite its high prevalence and significant impact on health, comprehensive studies are still needed to explore the factors affecting sarcopenia parameters, such as muscle mass, muscle strength, and physical performance. This study aimed to identify the factors influencing sarcopenia parameters in the elderly, including muscle mass, muscle strength, and physical performance. Methods. A cross-sectional study was conducted from July to December 2022 on elderly individuals (>60 years old) at the Geriatric Polyclinic, Moh. Hoesin General Hospital, Palembang, selected through consecutive sampling. Muscle mass was measured using bioimpedance analysis, expressed in ASMI values; muscle strength was measured using a handheld dynamometer; and physical performance was assessed using the five-time sit-to-stand test. The SARC-F score was classified as normal (<4) and abnormal (≥4). Data on age, gender, serum albumin levels, comorbidities, and Mini Nutritional Assessment Short Form (MNA-SF) scores were collected for correlation analysis and comparison with muscle mass, muscle strength, and physical performance. Results. Of the 41 subjects, the average age was 70.75 (SD 7) years, with 56.1% being female. All subjects had low muscle mass, with an average ASMI of 3.31 (SD 0.59) kg/m² in females and 4.89 (SD 1.06) kg/m² in males. The average muscle strength for females was 16.9 (SD 6.1) kg and for males 27.5 (SD 8.3) kg. The five-time sit-to-stand test result for females was 24.2 (SD 14.2) seconds and for males, 21.8 (SD 11.1) seconds. Based on SARC-F, 8 subjects (19.5%) were categorized as at risk for sarcopenia. Serum albumin levels for all subjects were within the normal range [4.3 (SD 0.3) g/dl]. Malnutrition was found in 14 subjects (34.1%) according to the MNA-SF results. Comorbidities were present in 35 patients. Statistical analysis showed a significant correlation between serum albumin levels and muscle strength (r=0.35; p=0.005) and physical performance (r=-0.5; p<0.001). Nutritional status had no significant effect on the three parameters, but it did significantly affect muscle mass in elderly males (p=0.002). Comorbidities, including cardiovascular disease, non-insulin-dependent diabetes mellitus, and musculoskeletal disorders, were not significantly related to any of the sarcopenia parameters. Conclusions. Serum albumin is significantly associated with muscle strength and physical performance, while nutritional status is significantly associated with muscle mass in elderly males. Comorbidities were not significantly related to muscle mass, muscle strength, or physical performance in the elderly.
Gejala Neuropsikiatri Pasien HIV Setelah Menjalani Transisi Antiretrovirus Nevirapin ke Dolutegravir di Rumah Sakit Cipto Mangunkusumo, Jakarta Pratama, Metra Adi; Putranto, Rudi; Herqutanto, Herqutanto; Syahrani, Aisyah; Hapsari, Aljira Fitya; Natali, Veritea; Pane, Meivina Ramadhani; Yunihastuti, Evy
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Introduction. Dolutegravir (DTG) is one of the effective antiretroviral therapies (ART) for suppressing HIV replication and has a favorable safety profile. However, reports regarding neuropsychiatric side effects, especially in patients transitioning from a nevirapine (NVP) regimen to dolutegravir, have started to emerge. This study aimed to describe the changes in neuropsychiatric symptoms before and after the transition from a NVP-based ARV regimen to DTG in HIV patients at Cipto Mangunkusumo Hospital (RSCM), Jakarta. Methods. This study employed a prospective cohort design involving 292 HIV patients at Cipto Mangunkusumo Hospital who were transitioning from NVP to DTG regimen. Participants were monitored for six months, and neuropsychiatric symptoms were assessed using a modified HIV symptom index (mHSI). Data collection was conducted at the beginning of the transition (baseline) and during follow-up through interviews regarding HIV-related symptoms and ART. Results. At the start of the study, 70.2% of participants reported at least one neuropsychiatric symptom, which increased to 80.1% after 6 months of transitioning to TLD. The most commonly reported symptoms were insomnia, headaches, and anxiety, with women reporting more symptoms than men. Statistical analysis showed a significant increase in symptoms of sadness, headaches, and irritability (p < 0.01) after the transition to dtg. Conclusions. Although DTG shows good viral suppression capabilities, significant neuropsychiatric side effects still arose, especially in patients with a history of mental disorders. Close monitoring of neuropsychiatric symptoms and adjustments to the ART regimen need to be carried out to improve the quality of life for HIV patients undergoing DTG therapy.

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