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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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Correlation between Rheumatoid Factor and Vascular Cell Adhesion Molecule-1 Levels in Rheumatoid Arthritis Patients Without Metabolic Syndrome Yogaswara, Reza; Hidayat, Rudy; Muhadi, Muhadi; Rinaldi, Ikhwan
Jurnal Penyakit Dalam Indonesia Vol. 5, No. 2
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Performance of Combination of Symptoms, Chest x-rays and MGIT 960 Culture for Diagnosis of Pulmonary Tuberculosis in HIV Patients Salwani, Desi; Nasir, Ujainah Zaini; Yunihastuti, Evy; Harimurti, Kuntjro; Andriansjah, Andriansjah
Jurnal Penyakit Dalam Indonesia Vol. 5, No. 2
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Left Ventricular Diastolic Dysfunction in Liver Cirrhotic Patients: Proportion, Correlation, and Relationship of Diastolic Parameters with Stage of Liver Dysfunction Mondrowinduro, Prionggo; Hasan, Irsan; Alwi, Idrus; Abdullah, Murdani
Jurnal Penyakit Dalam Indonesia Vol. 5, No. 1
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Introduction. Cardiovascular complication of liver cirrhosis is relatively obscure. Pathophysiology of liver cirrhosis, involving portal hypertension made the possibility of cirrhosis complication manifested as left ventricular diastolic dysfunction. This study aims to determine proportion of left ventricular diastolic dysfunction among liver cirrhotic patients according to American Society of Echocardiography-European Association of Echocardiography (ASE-EAE) 2009 and conventional approach, to determine any correlation between left ventricular diastolic dysfunction severity stages with severity stages of liver dysfunction in cirrhotic patients represented by Child Turcotte Pugh (CTP ) score, also to asses relationship between severity stages of parameters of diastolic function according to ASE-EAE 2009 with liver cirrhosis severity evaluated by numerical CTP score. Methods. A cross sectional study was conducted among 96 liver cirrhotic patients within age of 18-60 years old consecutively due to any causes who admitted to ambulatory unit of Hepatology and Internal Medicine Cipto Mangunkusumo General Hospital wards into intended sample. The study started in November 2013 until proper sample size was obtained. Echocardiography examination was performed by two operators. Interobserver validity was assesed with level of Kappa aggrement and mean difference. Data were extracted to determine prevalence, normality test, Spearman correlation test, and multivariate linear regression test using SPSS for Windows. Results. Left ventricular diastolic dysfunction proportion among liver cirrhotic patients according to ASE-EAE 2009 was 34,3% and 21,9% of normal diastolic function subgroup has left atrial volume index ≥34 mL/m2. Meanwhile, conventional approach resulted in 68,8% of diastolic dysfuncation. All diastolic parameter showed abnormalities on CTP B 8-10. Spearman’s r values of stage of diastolic dysfunction severity according to ASE-EAE 2009 with severity of numerical CTP score was 0,42 (p<0,001) and 0,54 based on conventional approach. Exclusion of diabetic patients and spironolactone treated patients resulted in r=0,51 (p <0,001) based on ASE-EAE 2009 and 0,63 (p<0,001) based on conventional approach.. Parameters of diastolic function that had relation with liver dysfunction severity in cirrhosis measured by numerical CTP were Ar-A (p=0,004), left atrial volume index (p=0,005), and laterale e’ (p=0,026). Conclusion. Severity of left ventricular diastolic dysfunction with severity of liver cirrhosis is positively correlated. Diastolic parameters relate with severity of liver cirrhosis are diastolic ventricular filling pressure with left ventricular chamber stiffness, left atrial remodelling and regurgitant of pulmonary venous flow velocity to oppose filling pressure. Early detection for diastolic dysfunction can be started on CTP B 8. Keywords: Child Turcotte Pugh Score, diastolic dysfunction, liver cirrhosis, liver dysfunction
Management of Antithrombotic in Endoscopic Procedures Suseno, Dwi; Syam, Ari Fahrial
Jurnal Penyakit Dalam Indonesia Vol. 5, No. 1
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The use of antithrombotic medicine has increased along with the growing number of cardiovascular disease in the world. Endoscopy procedure often done to the patients who use antithrombotic medicine. Eventhough most of endoscopies are safe for those patients, there are some main things related to antithrombotic treatment management that have to be noted such as the kind of antithrombotic that being used, stratification of bleeding risk on the procedure, the risk of future thromboembolic, and the process of antithrombotic treatment re-initiation. So that, patient’s safety in undergoing endoscopy procedure is guaranteed.
Validity of Simple Risk Index and Evaluation of Methods andManagement of Acute Coronary Events to Predict Mortality inAcute Coronary Syndrome Patients in Intensive Coronary CareUnit Cipto Mangunkusumo Hospital Meutia, Rahmah Safitri; Nasution, Sally Aman; Makmun, Lukman H
Jurnal Penyakit Dalam Indonesia Vol. 4, No. 4
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Introduction. Risk stratification is an important part in the management of patients with an Acute Coronary Syndrome (ACS) to avoid overtreatment or undertreatment. Although Simple Risk Index (SRI) and Evaluation of Methods and Management of Acute Coronary Events (EMMACE) have been validated in other countries, no study of its applicability has been performed in Indonesia with different patients’ characteristics. This study aims to obtain the calibration and discrimination performance of SRI and EMMACE to predict 30 days mortality in ACS patients in ICCU of Cipto Mangunkusumo Hospital. Methods. A retrospective cohort study with consecutive sampling was conducted in ACS patients hospitalized in the ICCU Cipto Mangunkusumo hospital between the period of 2003 up to 2010. Data analyzed performed by SPPS program for Windows Version 17. The discrimination performance was explained using a value of area under the receiver-operator curve (AUC) while calibration performance was evaluated using hosmer lemeshow and plot calibration. Results. A total of 922 patients were included in this study consisted of 453 STEMI patients, 234 NSTEMI patients and 235 UAP patients. Simple Risk Index (SRI) score for STEMI had presentable discrimination and calibration performance (AUC= 0,92; R2 = 0,98; and p value= 0,01). Simple Risk Index (SRI) score for overall ACS also showed sufficient performance and calibration discrimination (AUC= 0,87; R2 = 0,99; and p value= 0,52). Meanwhile, EMMACE score in ACS patients showed satisfactory performance discrimination (AUC= 0,87), but the calibration perfomance was not as satisfactory as the SRI score with the calibration plot (R2 )= 0,54 (p value= 0,52). Conclusions. Simple Risk Index (SRI) score shows a satisfactory discrimination and calibration performance both in STEMI and overall ACS patients in predicting mortality of ACS patients in ICCU Cipto Mangunkusumo Hospital. Evaluation of Methods and Management of Acute Coronary Events (EMMACE) score, nonetheless, displays sufficient discrimination performance, but poor performance of calibration.
The Relationship between Age and Activity of Daily Living withthe Fall Risk of Patients in Geriatric Outpatient Installation Deniro, Agustin Junior Nanda; Sulistiawati, Nuniek Nugraheni; Widajanti, Novira
Jurnal Penyakit Dalam Indonesia Vol. 4, No. 4
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Introduction. Fall is one of the physical problems that happened quite frequently and resulted in morbidity and mortality of old people. There are several factors related to fall risk, among others are age and independence in activity of daily living. Methods. This research is an observational analytical study with cross sectional approach, by collecting free variable data (age and activity of daily living) through interview and Barthel index score, dependent variable (fall risk) by direct observation using Timed Up and Go test that analyzed by Rank Spearman correlation test. The number of samples with incidental sampling technique was 55 patients in Geriatric Outpatient Installation RSUD Dr Soetomo Surabaya for the period of August – October 2017. Results. Bivariate analysis showed that there was a correlation between age and fall risk (r = 0.334, p <0.05) and there was a relationship between activity of daily living with fall risk (r = - 0.460, p <0.05 ) of patient in Geriatric Outpatient Installation RSUD Dr Soetomo Surabaya period August - October 2017. Conclusion. There is a significantly low and equivalent relationship between age and fall risk and significantly low and unequal relationship between activity of daily living and fall risk of patients in Geriatric Outpatient Installation RSUD Dr Soetomo Surabaya for the period of August – October 2017.
Predictor Factors Affecting Seroconversion Post-InfluenzaVaccination in the Elderly Nursyirwan, Saskia Aziza; Koesnoe, Sukamto; Wahyudi, Edy Rizal
Jurnal Penyakit Dalam Indonesia Vol. 4, No. 4
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Introduction. The influenza vaccine as the most effective method for preventing influenza virus infection currently has lower efficacy in the elderly than younger adults due to change of immune response as well as other risk factors. This study aims to identify predictor factors affecting seroconversion post-influenza vaccination in elderly. Methods. retrospective cohort study in the elderly population in East Jakarta Posyandu who got the influenza vaccine. A total of 277 subjects with antibody titre pre and one month post-vaccination influenza were examined. Risk factors such as age, gender, exercise status, smoking status, type 2 diabetes, pulmonary, and cardiovascular disease, nutritional status of MNA (Mini Nutritional Assessment), GDS (Geriatric Depression Scale), and pre-vaccination antibodi titre were assessed in each subject. Results. The proportion of elderly people who seroconverted (fourfold rise or more in antibody titer post-vaccination) was 50.9% (141/277). On multivariate analysis, the predictor factors that affect seroconversion of one month post- influenza vaccination in the elderly on the community is a no depression state (p = 0.048, OR = 2.1, CI = 1.01 to 4.30), exercise status ≥5 times per week minimal 30 minutes (p = 0.013, OR 4.0, CI 1.34 to 11.76), and not seroprotective pre-vaccination (p=0.000, OR 6.4, CI 3.40 to 11.99). Conclusion. Predictor factors affecting seroconversion post-influenza vaccination in the elderly on the community is depression status, exercise status and pre-vaccination antibody titre.
Clinical Features and Quality of Life in End Stage Renal DiseasePatients Undergoing Hemodialysis Twice A Week Compared toThrice A Week Imelda, Fitri; Susalit, Endang; Marbun, M Bonar M
Jurnal Penyakit Dalam Indonesia Vol. 4, No. 3
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Introduction. National Kidney Foundation Kidney Disease Outcomes Quality Initiative (NFK-KDOQI) recommends thrice weekly hemodialysis (HD) However, in Indonesia, most patients are given HD twice a week. Therefore it is necessary to investigate the clinical features and quality of life in End Stage Renal Disease (ESRD) patients undergoing twice-weekly HD. This study aimed to identify the clinical features and the quality of life in ESRD patients undergoing hemodialysis twice a week. Methods. A cross-sectional study was conducted in ESRD patients undergoing twice-weekly HD and thrice-weekly HD at Cipto Mangunkusumo Hospital and some private hospitals in Jakarta. Blood samples were obtained for laboratory examination. Meanwhile, quality of life were assessed by using Kidney Disease Quality of Life (KDQOL-SF 36). Results. A total of 80 subjects were included in this study, most of them were male and over 50 years old. Some clinical features were significantly higher in twice-weekly HD patients compared to thrice-weekly HD patients. Those features were Interdialytic Weight Gain (IDWG) (mean 4.91% (SD 1.52) and 3.82% (SD 1.28); p= 0.002); albumin (mean 4.05 mg/dl (SD 0.26) and 3.86 mg/dl (SD 0.48); p= 0.027); transferrin saturation (median 25.5% (range 12.0 to 274.0) and 21.95% (5.8 to 84.2); p= 0.004); phosphate level (mean 5.82 mg/dl (SD 1.68) and 5.82 mg/dl (SD 1.68); p= 0.026. Meanwhile, Total Iron Binding Capacity (TIBC) was significantly higher in thrice-weekly HD patients (mean 235.20 μg/dl (SD 55.72) and 273.73 μg/dl (SD 58.29 SB); p= 0.004). Approximately, 68% of twice-weekly HD reached Kt/V >1.8 and 93.3% of thrice-weekly HD reached Kt/V >1.2. Quality of life between the two groups was not significant either on Physical Componet Score (PCS) (p= 0.227), Mental Component Score (MCS) (p= 0.247), and Kidney Disease Component Score (KDCS) (p= 0.889). Conclusions. There are statistically significant differences between clinical features of twice-weekly HD and thrice-weekly HD on examination of IDWG, albumin, transferrin saturation, and phosphate levels which are higher in twice-weekly HD. Whereas, TIBC is higher in thrice-weekly HD group. Meanwhile, the patients quality of life in both groups showed no statistically significant differences.
Conformance Level of Histopathological Examination in BiopsyPre Colonoscopy Compared to Histopathological Examinationin Surgery with Tumors in the Colon at The Endoscopy andGastrointestinal Centre of RSCM Fuadi, Ifransyah; Makmun, Dadang; Krisnuhoni, Ening
Jurnal Penyakit Dalam Indonesia Vol. 4, No. 3
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Introduction. Level of agreement comparison between biopsy per colonoscopy examination is used to measure of the quality of a colonoscopy examination and needed to be identified. This study aims to identify level of agreement comparison between histopathologic examination of biopsy per colonoscopy and histopathologic examination per surgical. Methods. A cross sectional study was conducted by using medical records from patients with colon tumor who had undergone histopathologic examination with biopsy per colonoscopy and then confirmed by surgical procedure in PESC RSPUN dr. Cipto Mangunkusumo between 1st January, 2006 31st December, 2015. Level of agreement calculated using comparative agreement category test in order to obtain the value of kappa. Results. A total of 48 subjects were included in this study. Analysis result showed that level of real agreement, level of agreement by chance, and level of agreement not by chance was 79%, 77%, and 23%, respectively. The kappa value was 0,134. Conclusion. The level of agreement comparison between histopathologic examination of biopsy per colonoscopy compared with histopathologic examination per surgical at PESC RSCM between 2006-2015 period was not good.
Factors Associated with Retention in Care One Year after Deliveryin Patients Undergoing Prevention of Mother to Child Transmission(PMTCT) at RSCM Yulidar, Yulidar; Yunihastuti, Evy; Djauzi, Samsuridjal; Padmita, Astrid Citra; Koesnoe, Sukamto
Jurnal Penyakit Dalam Indonesia Vol. 4, No. 2
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Introduction. Retention in care is important to the successful of HIV treatment. This study is aimed to analyze factors associated with retention in care one year after delivery in patients undergoing PMTCT at HIV integrated clinic of RSCM. Methods. A retrospective cohort study was conducted among post-partum HIV patients who were given ARV therapy for PMTCT at HIV intergrated clinic of Cipto Mangunkusumo Hospital from January 2004 to May 2014. Evaluation of one year retention in care after PMTCT was performed by observing medical records of the patient. The collected data were factors associated with one year after delivery retention in care including age of patients, level of initial CD4, ARV toxicity, injecting drug user, duration of ARV before delivery, having child with positive HIV status, having spouse with positive HIV status, distance from the residence to the hospital, and indication of ARV. Bivariate analysis was performed by using Chi Square and Mann Whitney test and multivariate anaysis was performed by using logistic regression to assess factors associated with retention in car after PMTCT program. Results. 253 subjects met the inclusion criteria. In One year after delivery, the retention in care rate was 55,3%. Multivariate analysis found that factors significantly associated with one year retention in care were indication of ARV initiation for therapy (OR =3,812 [95% CI: 1,825-7,966]), non-IDU patients (OR=3,055 [95% CI: 1,382-6,752]), duration of ARV before delivery for more than 6 months (OR = 2,657 [95% CI: 1,328-5,316]), and level of initial CD4 less than 200/mm3 (OR = 2,033 [95% CI: 1,061-3,894]). Conclusions. Factors significantly associated with one year after delivery retention in care are indication of ARV for therapy, duration of ARV before delivery, non-IDU patients, and level of initial CD4 less than 200/mm3 . and Mann Whitney test and multivariate anaysis was performed by using logistic regression to assess factors associated with retention in car after PMTCT program. Results. 253 subjects met the inclusion criteria. In One year after delivery, the retention in care rate was 55,3%. Multivariate analysis found that factors significantly associated with one year retention in care were indication of ARV initiation for therapy (OR =3,812 [95% CI: 1,825-7,966]), non-IDU patients (OR=3,055 [95% CI: 1,382-6,752]), duration of ARV before delivery for more than 6 months (OR = 2,657 [95% CI: 1,328-5,316]), and level of initial CD4 less than 200/mm3 (OR = 2,033 [95% CI: 1,061-3,894]). Conclusions. Factors significantly associated with one year after delivery retention in care are indication of ARV for therapy, duration of ARV before delivery, non-IDU patients, and level of initial CD4 less than 200/mm3 .

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