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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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Neutrophil Lymphocyte Ratio as A Predictor of The First Onset Acute Neutropenia After R-CHOP Chemotherapy in Diffuse Large B-cell Lymphoma Patients Christine, Griskalia; Sukrisman, Lugyanti; Sutandyo, Noorwati; Rumende, Cleopas Martin
Jurnal Penyakit Dalam Indonesia Vol. 6, No. 3
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Abstract

Background. Diffuse Large B-cell Lymphoma (DLBCL) is the most common lymphoma in Indonesia. R-CHOP chemotherapy has a moderate risk for neutropenia / febrile neutropenia. Lymphocytes can describe host immunity, while neutrophils and monocytes can describe the inflammatory response. No study has assessed differential count of leukocytes as a predictor of the first onset acute neutropenia after R-CHOP chemotherapy in DLBCL patients. This study aimed to determine the relationship between differential count of leukocytes before chemotherapy as a predictor of the first onset acute neutropenia after R-CHOP chemotherapy in DLBCL patients. Methods. A retrospective cohort study was conducted among 18–60 years old DLBCL patients with ECOG 0–1 and no comorbidity related to chemotherapy 18–60 years old. Subjects were given with the first 3 cycles of R-CHOP chemotherapy without G-CSF prophylaxis. Results. Of the 95 patients, first onset acute neutropenia after chemotherapy occurred in 83 (87.4%) subjects or 83 (55.3%) cycles of 150 chemotherapy cycles. Febrile neutropenia occurs in 50.6% of the onset of neutropenia. Severe neutropenia occurs in 34 (41.0%) cycles of 83 neutropenic episodes. The first onset of acute neutropenia was the most common at 7–15 days after chemotherapy. The AUC of neutrophil lymphocyte ratio was 0.74 (95% CI 0.65–0.82); while absolute lymphocytes, absolute neutrophils, absolute monocytes, and monocyte lymphocyte ratios were 4.1 neutrophil lymphocyte ratio were able to predict the first onset of acute neutropenia after RCHOP chemotherapy in DLBCL patients (sensitivity 71.1%; specificity 64.2%; positive predictive value 71.1%; negative predictive value 64.2%). Conclusion. Neutrophil lymphocyte ratio before chemotherapy > 4.1 is a predictor of the first onset acute neutropenia after R-CHOP chemotherapy in DLBCL patients.
The Additive Effect of Rosmarinic Acid for The Reduction of Glomerular NF-kB Expression in Diabetes Rat that was given Telmisartan Fachrureza, Mochamad; Samsu, Nur; Rudijanto, Achmad
Jurnal Penyakit Dalam Indonesia Vol. 6, No. 3
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Introduction. Diabetic nephropathy is one of the common complications of diabetes, which one of its causes is the increase of free radicals through the activation of NF-kβ and Angiotensin II. Rosmarinic acid has the activity as the anti-oxidant and anti-inflammatory, and the telmisartan is the partial PPAR-γ agonist that has the anti-fibrotic effect. This study aimed to identify the effect of rosmarinic acid and telmisartan in the reduction of subunit p65 NF-kB expression on the glomerular diabetes rat. Methods. An experimental study with a post-test only controlled group was conducted in a group of rats (Rattus norvegicus). Rats were randomly divided into five groups (n=3-4 per group): three treatment groups (group 1: rosmarinic acid 75 mg/kg/ day; group 2: telmisartan 1 mg/kg/day, group 3: combination of rosmarinic acid 75 mg/kg/day and telmisartan 1mg/kg/ day per day), and two control groups (negative and positive control group). After eight weeks, rats were dissected. Blood sugar more than 270 mg/dl confirmed that the rats in diabetes state. The measurement of albuminuria was done using ELISA and the expression of subunit p65 NF-kβ using the immunofluorescence method. Results. The expression of subunit p65 NF-kβ in negative control group was 519.70 (SD 158.12), 702.19 (SD 189.69) in positive control group, 631.19 (SD 119.21) in the rosmarinic acid group, 355.68 (SD 44.71) in the telmisartan group, and 572.37 (SD 98.09) in the combination group (p<0.001). The post hoc test showed that the mean value of subunit p65 NF-kβ expression was significantly different between the positive control group and the telmisartan group (p<0.001). But, there was no significant mean difference of subunit p65 NF-kβ expression between the positive control group and the rosmarinic acid group (p=1.000), as well as between the combination rosmarinic acid and telmisartan group. Conclusion. The addition of telmisartan can reduce expression of the subunit p65 NF-kB. However, adding the rosmarinic acid in diabetes rats given telmisartan did not reduce the expression of subunit p65 NF-kB in the same level with the negative control group.
Meningoensefalitis Manifestation in Wegener’s Granulomatosis with Anca Negative: Case Report Sudibyo, Triyanti Kurniasari Ananta Putri; Mulya, Deshinta Putri; Budiono, Eko; Satiti, Sekar; Rosalia, Levina Prima
Jurnal Penyakit Dalam Indonesia Vol. 6, No. 3
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Wegener’s granulomatosis is a vasculitis that affects small to medium blood vessels, generally occurring at the age of 64- 75 years with an incidence of 8-10 / 1,000,000 people. Meningoencephalitis manifestations are rarely found in Wegener’s granulomatosis with the incidence only in the range of 0-7%. Anti-neutrophil cytoplasmic antibody (ANCA) is often used in diagnosing Wegener’s granulomatosis, but negative ANCA can be found in 10-20% of cases. A 30-year-old man came with a decrease in consciousness. His anamnesis and physical examination showed signs that led to Wegener’s granulomatosis, despite negative ANCA examination results. After getting therapy according to the management of the Wegener’s granulomatosis there is a clinical improvement in the patient. This case is raised because it is a rare case and needs sharpness in establishing a diagnosis. Wegener’s granulomatosis can cause very bad progress, but if handled properly, complete remission can be achieved.
Survival Kidney Transplantation from Related and Emotionally Related Living Donors in Cipto Mangunkusumo Hospital 2010-2015 Susilowati, Utami; Sutrisna, Bambang; Marbun, Maruhum Bonar H; Susalit, Endang
Jurnal Penyakit Dalam Indonesia Vol. 6, No. 2
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Conn’s Syndrome Due to Adrenal Adenoma Rasyid, Haerani; Bakri, Syakib; Kasim, Hasyim; Hidayat, Andi Rahmat; Syarif, Syarif; Azis, Abd
Jurnal Penyakit Dalam Indonesia Vol. 6, No. 2
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Conn’s syndrome is characterized by an increase in aldosterone level causes sodium retention and an increase in urine excretion of potassium. This syndrome is characterized by trias hypokalemia, hypertension, and metabolic alkalosis. This article discussed a case report of a patient with uncontrolled hypertension with neuromuscular symptoms caused by recurrent hypokalemia. After an evaluation of the imaging test, we found a left adrenal tumor then we performed unilateral adrenalectomy surgery. Histopathology examination from the excised tumor revealed the adrenal adenoma. After unilateral adrenalectomy, the patient showed clinical and laboratory improvement.
Peripheral Arterial disease and Cardiovascular Mortality in Type-2 Diabetes Mellitus Esa, Dekta Filantropi; Prahasary, Adelia Nova; Tahapary, Dicky L.; Yunir, Em
Jurnal Penyakit Dalam Indonesia Vol. 6, No. 2
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Peripheral arterial disease (PAD) is one of the macrovascular complications of type 2 diabetes mellitus (T2DM), which increases the risk of cardiovascular mortality. Ankle-brachial index (ABI) is one of the simple and widely available tool to diagnose PAD. The authors aim to find out the cardiovascular mortality in T2DM patient with PAD. Bundo et al. study found HR 2.45 (95% CI: 0.84 to 7.17). Mostaza et al. study reported HR 1.64 (95% CI: 0.64 to 4.49). Aboyans et al. study declared HR 2.21 (95% CI: 1.16 to 4.22). Mohammedi K et al. claimed HR 1.35 (95% CI: 1.15 to 1.60). Quiles et al. found HR 6.61 (95% CI: 2.47 to 17.72). Mueller et al. study reported RR 3,53 (95% CI: 1.80 to 6.91). Mueller et al. study reported RR 4,06 ( 95% CI: 2.67 to 6.18). In conclusion, the mortality risk in T2DM patients with PAD is higher compared to those without PAD. Moreover, an ankle-brachial index can be used as an independent stratification tool to predict the risk of cardiovascular mortality
Profilaksis Pasca Pajanan terhadap Hepatitis B, HepatitisC, dan Human Immunodeficiency Virus pada PetugasKesehatan Widhani, Alvina
Jurnal Penyakit Dalam Indonesia Vol. 6, No. 1
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Validation of ARISCAT Model Score to Predict PostoperativePulmonary Complications in Tertiary Referral Hospital inIndonesia Alkaff, Muhammad; Pitoyo, Ceva Wicaksono; Heriwardito, Aldy; Koesnoe, Sukamto
Jurnal Penyakit Dalam Indonesia Vol. 6, No. 1
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Introduction. There are several prediction model score instruments that can help to assess pulmonary preoperative evaluation and it is believed that ARISCAT model score is very simple to do and have good performance, but not widely used. This score has not been yet validated in Indonesia. This study aimed to assess the performance of discrimination and calibration of ARISCAT score in predicting postoperative pulmonary complication who underwent surgery in a tertiary referral hospital in Indonesia. Methods. A retrospective cohort study was conducted to assess the external validation of ARISCAT scores in the Indonesian population. This study involved patients underwent surgery at Cipto Mangunkusumo Hospital in 2017. Several variables were collected such as age, oxygen saturation, history of pulmonary infection, anemia, type of surgery, duration of operation, emergency surgery, and PPC that observed within 30 days after surgery. Discrimination was assessed by the area under the curve (AUC). Calibration was assessed by the Hosmer-Lemeshow test and calibration plot. Results. Of 428 patients studied, PPC was observed in 32% of patients. Discrimination of ARISCAT score was shown by AUC value of 88.2% (CI 95%; 84.1-92.2%). Hosmer-Lemeshow test showed p=0.052 and calibration plot revealed coefficient Jurnal Penyakit Dalam Indonesia | Vol. 6, No. 1| Maret 2019 | 3 Uji Validasi Skor ARISCAT dalam Memprediksi Komplikasi Paru Pascaoperasi di RS Rujukan Tersier di Indonesia r=0.968. Conclusion. ARISCAT model score has good discrimination and calibration performance and can be applied in the Indonesian population.
Clinical Profile of Cirrhotic Patient with Esophageal Varices WhoUndergone Band Ligation in Cipto Mangunkusumo Hospital Kalista, Kemal Fariz; Lesmana, Cosmas Rinaldi Adithya; Sulaiman, Andri Sanityoso; Gani, Rino Alvani; Hasan, Irsan
Jurnal Penyakit Dalam Indonesia Vol. 6, No. 1
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Introduction. Liver cirrhosis (LC) is the end stage of chronic liver disease. One of the main complication caused by LC is esophageal varices (EV). Bleeding due to EV rupture is the main cause of mortality in patient with LC. EV band ligation can be used for primary or secondary prophylaxis to prevent bleeding. The purpose of this study was to know the clinical profile of LC patient with EV who underwent band ligation and who not underwent band ligation. Methods. A cross-sectional study was conducted in LC patients who underwent esophagogastroduodenoscopy (EGD) in Procedure Room Division of Hepatobiliary, Departement of Internal Medicine, Cipto Mangunkusumo Hospital from 2016 to 2017. Results. During January 2016-December 2017, a total of 313 patients underwent EGD. Most of them ( 73.2%) were male and predominantly > 60 years (34,2%). Most common LC etiology was hepatitis B (51.8%., There were 22% subjects with hepatocellular carcinoma (HCC). EV band ligations were done in 146 (46.7%) patients. In the ligation group, 56.2% patients were from outpatient clinic. The most common EGD indication (39%) was evaluation from previous ligation. Of 41.8% patients had Child-Turcotte-Pugh (CTP) class-A condition, 82.9% patients had MELD score < 15, 61.6% patients had large EV, 22.1% had red color sign (RCS) and 84,9% patients had portal hypertensive gastropathy. There were significant differences in CTP class, ascites, platelet, bilirubin, and albumin between ligation group compare to non-ligation group. Conclussion. Most of LC patients who underwent EV band ligation had CTP class-A, came from the outpatient clinic. The Jurnal Penyakit Dalam Indonesia | Vol. 6, No. 1 | Maret 2019 | 37 Profil Klinis Pasien Sirosis Hati dengan Varises Esofagus yang Menjalani Ligasi Varises Esofagus di Rumah Sakit Dr. Cipto Mangunkusumo main finding in EGD was large EV with portal hypertensive gastropathy. There were significant differences in liver functions between patient in ligation group compared to patient in non-ligation group.
Immunotherapy for Food Allergy: Myth or Reality? Soegiarto, Gatot
Jurnal Penyakit Dalam Indonesia Vol. 6, No. 1
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Allergic reaction to food can have serious consequences. The only treatment option is strict allergen avoidance, but accidental ingestions happen frequently and can lead to severe and potentially life-threatening allergic reactions. Food allergy is one of the most common causes of anaphylactic reactions. Therefore self-injectable epinephrine should always be at hand in case of accidental exposure. Many food allergies may resolve over time, but most patients with persistent food allergies live with fear of anaphylactic reactions. Within the last several years, the usefulness of immunotherapy for food allergies has been investigated. Several food immunotherapies are being developed; which include oral, sublingual, epicutaneous, or subcutaneous administration. The approach follows the same principles as immunotherapy for other allergic disorders, consisted of an induction phase followed by a maintenance phase with regular intake of maximum tolerated amount of food. Although immunotherapy seems promising for food allergic patients, it remains an investigational treatment that need to be studied further before advancing into clinical practice. Hopefully, multicentre and randomizedcontrolled studies can provide answer to multiple questions including optimal dose, ideal duration of immunotherapy, degree of protection, efficacy for different ages, severity and type of food allergy responsive to treatment.

Page 6 of 42 | Total Record : 414

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