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Evy Yunihastuti
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redaksi.jurnalpenyakitdalam@ui.ac.id
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redaksi.jurnalpenyakitdalam@ui.ac.id
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Departemen Ilmu Penyakit Dalam, FKUI/RSCM Jln Diponegoro No.71, Jakarta. 10430
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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,
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.
Articles 414 Documents
Pengaruh Ivabradin terhadap Variabilitas Detak Jantung pada Gagal Jantung dengan Fraksi Ejeksi Rendah Akibat Penyakit Jantung Koroner Kurnia, Handy; Limantoro, Charles; Silitonga, Friska Anggraini Helena; Setiawan, Andreas Arie
Jurnal Penyakit Dalam Indonesia
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Abstract

Introduction. Heart failure is one of the major challenges in global health due to its significant contribution to morbidity and mortality. One of the pathophysiological aspects is autonomic nervous system dysfunction which can be monitored through heart rate variability (HRV) parameters. Ivabradine is a pharmacological agent that potentially improves the balance of sympathetic and parasympathetic tone. This study was designed to evaluate the impact of ivabradine administration on HRV parameters in heart failure with reduced ejection fraction (≤40%) due to coronary heart disease in Indonesian population. Methods. This study used a quasi-experimental research type with a pretest and posttest method without control which was conducted at Dr. Kariadi Hospital from October 2024 to February 2025. Sixteen patients diagnosed with heart failure with reduced ejection fraction due to coronary heart disease underwent intervention in the form of ivabradine administration at a fixed dose of 5 mg twice a day for 30 days. Evaluation of HRV was carried out through 24 hours holter recording before and after therapy. The HRV parameters analyzed included SDNN, SDANN, RMSSD, pNN50, and LF/HF ratio. Data processing was carried out using a paired t-test for normal distribution and the Wilcoxon Signed-Rank test for non-normal data. P value <0.05 was considered statistically significant. Results. A total of 16 subjects participated in this study, consisting of 14 men (87.5%) and 2 women (12.5%), with a mean age of 57 years. There was a significant increase in SDNN of 14.71 (SD 24.15) milliseconds (p = 0.028), SDANN of 56.99 (SD 26.94) milliseconds (p < 0.001), RMSSD of 18.39 (SD 27.05) milliseconds (p = 0.007), and pNN50 of 6.96% (SD 7.87) (p < 0.001), as well as a decrease in the LF/HF ratio of 1.42 (SD 0.85) (p < 0.001) after 30 days of ivabradine therapy. Conclusions. The administration of ivabradine had a significant effect on improving heart rate variability parameters in both the time and frequency domains in patients with heart failure with reduced ejection fraction due to coronary heart disease. These findings indicate enhanced parasympathetic dominance and reduced sympathetic nervous system activity.
Perbandingan Ablasi Radiofrekuensi dengan Transplantasi Hati sebagai Terapi Kuratif pada Karsinoma Hepatoseluler Stadium Awal: Laporan Kasus Berbasis Bukti Gunawan, Mikhael Fabian; Safira, Ranindita Amaida; Singh, Gurmeet; Kalista, Kemal Fariz
Jurnal Penyakit Dalam Indonesia
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Hepatocellular carcinoma (HCC) is the most common type of liver cancer and the second leading cause of cancer-related mortality worldwide. Liver transplantation is considered the definitive treatment for HCC; however, in Indonesia, adult liver transplantation is still rarely performed due to donor limitations and high costs. Radiofrequency ablation (RFA) has therefore become a preferred therapeutic option in the management of HCC. This report discuss about the survival and recurrence rates of HCC in patients treated with RFA compared with those undergoing liver transplantation. A literature search was conducted using the PubMed, Cochrane, Embase, and Scopus databases. Selected articles were screened according to the predefined clinical question as well as inclusion and exclusion criteria. Critical appraisal was performed based on the 2011 Oxford Centre for Evidence-Based Medicine framework, assessing validity, importance, and applicability. Critical appraisal was conducted on two selected articles. One study reported comparable survival rates between the two groups. However, overall, both articles demonstrated that liver transplantation was associated with higher survival rates and lower recurrence rates compared with RFA. In conclusion, survival outcomes are superior with liver transplantation compared with RFA. Nevertheless, RFA may be considered in the management of hepatocellular carcinoma as a bridging therapy to liver transplantation or in situations where liver transplantation is not available.
Polisitemia Sekunder pada Pasien Laki-Laki Muda dengan Sindrom Nefrotik Wardhani, Ariani Intan; Nugroho, Pringgodigdo; Rinaldi, Ikhwan; Sarasawati, Meilania; Miranda, Monik Ediana; Harahap, Agnes Stephanie
Jurnal Penyakit Dalam Indonesia
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Polycythemia is a condition characterized by an abnormal increase in the total red blood cell mass and is classified into primary and secondary polycythemia. Secondary polycythemia occurs as a physiological response to tissue hypoxia or increased erythropoietin production, without intrinsic abnormalities in erythroid progenitor cells. This condition is rare, particularly when associated with nephrotic syndrome. This report aims to describe a case of secondary polycythemia associated with focal segmental glomerulosclerosis (FSGS). A 20-year-old man presented with generalized edema for five months prior to admission, accompanied by foamy urine. Physical examination revealed peripheral edema and minimal ascites. Laboratory investigations demonstrated massive proteinuria and elevated hemoglobin levels. Renal biopsy confirmed the diagnosis of FSGS, while bone marrow biopsy showed normocellular findings without evidence of malignancy or fibrosis. The patient was treated with methylprednisolone, ramipril, and simvastatin, and underwent four sessions of phlebotomy along with antiplatelet therapy. Following treatment, there was improvement in hemoglobin levels, proteinuria, and blood pressure control. Secondary polycythemia has been reported to be associated with various parenchymal kidney diseases, including FSGS. The proposed mechanisms include increased erythropoietin production due to renal ischemia or dysregulation of erythropoiesis feedback mechanisms. Phlebotomy is an important therapeutic intervention to prevent complications related to hyperviscosity and thromboembolism and has been shown to result in clinical improvement. This case illustrates a rare occurrence of secondary polycythemia in a patient with nephrotic syndrome due to FSGS. Accurate diagnosis and comprehensive management, including phlebotomy, can lead to meaningful clinical improvement. This report is expected to contribute to the literature on the diagnosis and management of secondary polycythemia in kidney disease.
Optimalisasi Rekam Medis Elektronik Berbasis Artificial Intelligence Rinaldi, Ikhwan; Sulistiadi, Wahyu
Jurnal Penyakit Dalam Indonesia
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Electronic medical records (EMRs) are essential to modern healthcare systems, yet their implementation continues to face challenges such as disruption of doctor–patient communication, administrative burden, and documentation structures misaligned with clinicians’ clinical reasoning processes. This narrative review aims to assess the limitations of conventional EMRs and examine the potential of artificial intelligence (AI) to improve documentation efficiency, accuracy, and overall clinical performance. The literature indicates that AI technologies, including machine learning, deep learning, and natural language processing, can automate documentation, streamline workflows, enhance decision support, and reduce physician burnout, thereby allowing clinicians to devote more attention to patient care. Nevertheless, the integration of AI into EMRs must address ethical concerns such as algorithmic bias, data privacy, and accountability for AI-assisted decisions. In conclusion, AI-driven EMR optimization has the potential to create a more human-centered, efficient, and data-driven documentation ecosystem when supported by strong regulatory and ethical frameworks.