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Cermin Dunia Kedokteran
Published by PT. Kalbe Farma Tbk.
ISSN : 0125913X     EISSN : 25032720     DOI : 10.55175
Core Subject : Health,
Health Professions
Cermin Dunia Kedokteran (CDK) is a Medical Journal published since 1974 and affiliated with PT Kalbe Farma Tbk. CDK is intended to help accommodate scientific publications and help increase and disseminate knowledge related to the development of medical science, pharmacy, and public health. CDK covers the disciplines of medicine, pharmacy, and health with several types of articles, namely: 1. Research 2. Literature review 3. Case report 4. Evidence-based case report (EBCR), systematic review 5. Other scientific articles Based on the SK Kemendikbudristek Nomor 152/E/KPT/2023, CDK has obtained Rank 4 (SINTA 4) for Scientific Journals.
Arjuna Subject : Kedokteran - Kedokteran (Lain-Lain)
Articles 13 Documents
 1   2 
Search results for , issue "Vol 46 No 2 (2019): Interna" : 13 Documents clear
Efek Segera Jamu X terhadap Kadar Asam Urat Darah Relawan Hiperurisemia Ning Harmanto; Aryaprana Nando; Vivi Kurniati Tjahjadi
Cermin Dunia Kedokteran Vol 46 No 2 (2019): Interna
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v46i2.504

Abstract

Tujuan: Mengetahui efek segera jamu X terhadap kadar asam urat darah subjek hiperurisemia. Metode: Subjek pasien klinik pengobatan tradisional di Jakarta. Kadar asam urat darah sewaktu diperiksa sebelum dan satu jam sesudah pemberian jamu X per oral. Perbedaan kadar asam urat darah diuji dengan Wilcoxon Rank Sum Test. Hasil: Subjek sejumlah 9 orang, 7 pria dan 2 wanita, usia rata-rata 28,78±14,27 tahun. Kadar asam urat darah sewaktu sebelum pemberian 7,42±0,90 mg/dL, dan sesudahnya 6,03±0,96 mg/dL (p<0,05). Simpulan: Jamu X menurunkan kadar asam urat darah subjek dengan kadar asam urat darah di atas normal. Aim: To observe the immediate effect of Indonesian herbal liquid X on blood uric acid level among high blood uric acid subjects. Methods: Subjects were patients in a traditional medicine clinic in Jakarta who agreed to be tested. Their random blood uric acid level were measured before and one hour post ingestion of two spoonful of herbal liquid X. Data was analyzed with Wilcoxon Rank Sum Test. Results: The test was done on 9 subjects, 7 males and 2 females, with average 28,78±14,27 years old. The average random blood uric acid level before treatment was 7,42±0,90 mg/dL, and after treatment was 6,03±0,96 mg/dL. (P<0.05). Conclusion: The herbal liquid X was significantly lowered random blood uric acid levels among those with raised blood uric acid level.
Evaluasi Pemeriksaan Imunoglobulin E Spesifik Menggunakan Immunoblot Assay dengan Baku Emas Skin Prick Test Yudhistira; Ninik Sukartini; Suzanna Immanuel; Iris Rengganis
Cermin Dunia Kedokteran Vol 46 No 2 (2019): Interna
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v46i2.505

Abstract

Pendahuluan. Skin Prick Test (SPT) merupakan baku emas diagnosis alergi, tetapi tidak dapat dilakukan pada kondisi tertentu seperti dermatografisme, hamil, tidak dapat lepas obat antialergi, sehingga pemeriksaan IgE spesifik menjadi pilihan. Di Indonesia belum ada data perbandingan pemeriksaan IgE spesifik dengan SPT. Penelitian ini dilakukan untuk menentukan sensitivitas, spesifisitas, PPV, NPV, LR+ dan LR- pemeriksaan IgE spesifik menggunakan analisis immunoblot. Metode. Penelitian menggunakan desain potong lintang. Subjek penelitian adalah pasien poliklinik alergi imunologi. Pengambilan sampel dengan metode non-probability sampling dengan teknik consecutive sampling. Analisis dilakukan terhadap alergen tungau debu rumah (Dermatophagoides pteronyssinus, Dermatophagoides farinae, Blomia tropicalis) dan kecoa. Hasil. Seratus subjek yang memenuhi kiteria masukan dan tolakan (76% perempuan, rerata usia 38.9 tahun) ikut serta dalam penelitian ini. Sensitivitas empat alergen bervariasi dengan rentang 32.4%-76.8%, spesifisitas 68.0%-85.7%, PPV 54.5%-94.5%, NPV 46.2%-65.3%, LR+ 1.8-5.0, dan LR- 0.3-0.8.Sensitivitas pemeriksaan IgE spesifik cukup baik pada tiga tungau debu rumah tetapi rendah pada kecoa; spesifisitas dan PPV bervariasi cukup sampai baik; NPV cukup baik. Simpulan dan Saran. Uji diagnostik IgE spesifik tungau debu rumah menunjukkan hasil cukup baik. Pemeriksaan IgE spesifik tidak dapat digunakan untuk skrining alergi kecoa. Background. Skin Prick Test (SPT) is considered as gold standard for diagnosis of allergy, but cannot be performed in some conditions such as dermatographism, pregnancy, and unable to abstain from antiallergy drugs. In these conditions, specific-IgE test is a test of choice. But there is no comparison data on specific IgE test with SPT in Indonesia. This study was to investigate sensitivity, specificity, PPV, NPV, LR+, and LR- of specific-IgE test of immunoblot assay kit. Method. The study was cross-sectional. Subjects were patients from allergy-immunology clinic who fulfilled inclusion and exclusion criteria. Sampling was performed using non-probability sampling method with consecutive technique. Analysis was performed for house dust mite allergen (Dermatophagoides pteronyssinus, Dermatophagoides farinae, Blomia tropicalis) and cockroach. Result. Hundred subjects (76% was female, average age of 38.9 years) were involved. Sensitivity of four allergens were varied with range 32.4%-76.8%, specificity 68.0%-85.7%, PPV 54.5%-94.5%, NPV 46.2%-65.3%, LR+ 1.8-5.0, and LR- 0.3-0.8. Sensitivities of specific-IgE for three species of house dust mite were moderate, but low for cockroach; specificities and PPVs were moderate to high; NPVs were moderate. Conclusion. Diagnostic test of specific-IgE with house dust mite allergen shows adequate result. Specific IgE test cannot be utilized for screening of cockroach allergy.
Diagnosis dan Tata Laksana Difteri Ricky Saunders; I Kadek Suarca
Cermin Dunia Kedokteran Vol 46 No 2 (2019): Interna
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v46i2.506

Abstract

Sejak tahun 2011-2015, Indonesia menjadi negara dengan insiden difteri tertinggi kedua di dunia. Penyakit difteri juga menjadi kejadian luar biasa (KLB) di 30 provinsi di Indonesia selama tahun 2017. Difteri adalah penyakit infeksi akut yang disebabkan oleh Corynebacterium diphteriae. Strain toksigenik C. diphteriae dapat menghasilkan toksin dan mengakibatkan berbagai komplikasi berat. Transmisi difteri melalui kontak droplet maupun kontak fisik langsung. Terapi untuk menetralisir toksin bebas dan eradikasi penyebab. Selain imunisasi dasar, pemerintah melaksanakan program outbreak response immunization sebagai upaya pengendalian kejadian luar biasa difteri di Indonesia. During 2011-2015, Indonesia has the world’s second highest incidence of diphteria; an outbreak occured in 30 provinces during 2017. Diphteria is an acute infectious disease caused by Corynebacterium diphteriae. Toxigenic strain can produce toxin and caused many severe complications. The disease spread through droplet or physical contact. Therapy is to neutralize free toxin and eradicate the etiology. In addition to primary immunization, Indonesia performs outbreak response immunization to control outbreak.
Hipokalemia – Diagnosis dan Tatalaksana Maggie Nathania
Cermin Dunia Kedokteran Vol 46 No 2 (2019): Interna
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v46i2.507

Abstract

Kalium adalah kation intraseluler paling melimpah dalam tubuh, 98% intraseluler dan hanya 2% ekstraseluler. Tubuh menggunakan kalium untuk berbagai fungsi, termasuk pengaturan aksi potensial listrik membran sel (terutama di jantung), metabolisme sel, dan sintesis glikogen dan protein. Perubahan homeostasis kalium dapat menyebabkan disfungsi jantung berat sehingga memerlukan pemantauan intensif. Tinjauan ini menyajikan informasi mengenai: (1) definisi hipokalemia, (2) homeostasis kalium, (3) berbagai penyebab hipokalemia, (4) langkah diagnostik hipokalemia, dan (5) tatalaksana hipokalemia. Potassium is the most abundant intracellular cation in the body, 98% found in intracellular fluid and only 2% in extracellular space. The body uses potassium for various functions, including the regulation of cell membrane action potentials (especially in the heart), cell metabolism, and glycogen synthesis and protein. Changes in potassium homeostasis can cause severe cardiac dysfunction requiring intensive monitoring. This review provides information on: (1) definition of hypokalemia, (2) potassium homeostasis, (3) causes, (4) diagnostic steps, and (5) management of hypokalemia.
Survai Model Sistem Tele-expertise untuk Kasus Dermatologi Penggalih M Herlambang; Izzati Muhimmah
Cermin Dunia Kedokteran Vol 46 No 2 (2019): Interna
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v46i2.508

Abstract

Background: Tele-expertise as part of telemedicine can be developed to overcome the problem of uneven distribution of specialist services, especially in dermatology. A technical framework is needed to guide the development of a tele-expertise system to suit the conditions and needs in Indonesia. Methods: The research was carried out in stages, the first stage was needs analysis by survey on general practitioners and dermato-venereologists. The second stage is a literature study and the third stage is the preparation of a tele-expertise framework model. Results and Discussion: In the first phase, 10 general practitioners and 2 skin specialists were willing to fill out the survey. In the second stage, various technical factors were found in telemedicine implementation. A framework model was compiled consisting of 4 main components including workflow, clinical content, infrastructure and interface. Conclusion: A tele-expertise framework model was prepared, especially in the field of dermatology. Further research is needed in the form of prototype testing based on the model for evaluation and development of the framework. In addition, the non-technical approach framework includes ethics, law and draft regulations need to be developed. Latar belakang: Tele-expertise sebagai bagian dari telemedisin dapat dikembangkan untuk mengatasi permasalahan penyebaran layanan dokter spesialis yang belum merata. Untuk itu dibutuhkan kerangka kerja (framework) teknis sebagai panduan pengembangan agar sesuai dengan kondisi dan kebutuhan di Indonesia. Metode: Penelitian bertahap, tahap pertama adalah analisis kebutuhan dengan survei Tahap kedua studi literatur kerangka kerja untuk telemedisin dan tahap ketiga penyusunan model kerangka kerja tele-expertise. Hasil dan Pembahasan: sebuah model framework disusun berdasarkan survei dan literatur yang terdiri dari 4 komponen utama meliputi alur kerja, konten klinis, infrastruktur dan antarmuka. Simpulan: Model kerangka kerja tele-expertise disusun khususnya untuk dermatologi. Diperlukan penelitian lanjut berupa pengujian purwarupa berdasarkan model tersebut untuk evaluasi dan pengembangan kerangka kerja. Selain itu kerangka-kerja pendekatan non-teknis meliputi etika, hukum dan rancangan regulasi perlu dikembangkan.
Diseksi Aorta Akut Stanford Tipe B dengan Gejala Akut Abdomen Ni Luh Putu Rustiari Dewi; IGM Ardika Aryasa; Kadek Susila Surya Dharma
Cermin Dunia Kedokteran Vol 46 No 2 (2019): Interna
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v46i2.509

Abstract

Diseksi aorta akut merupakan kegawatdaruratan aorta dengan presentasi klinis tidak spesifik dan mortalitas tinggi, terutama bila tidak dikenali dini menyebabkan penanganan terlambat di unit gawat darurat. Sebuah kasus pada laki-laki usia 71 tahun dengan diseksi aorta Stanford tipe B dengan presentasi atipik, yaitu gejala nyeri abdomen akut. Pasien memiliki riwayat hipertensi tidak terkontrol sejak satu tahun. CT Angiography menunjukkan gambaran diseksi aorta Stanford tipe B dari arteri subclavia menurun hingga setinggi percabangan aorta. Terapi awal berupa kontrol tekanan darah. Selanjutnya pasien dirujuk untuk terapi thoracic endovascular aortic repair (TEVAR). Gejala akut abdomen perlu dipertimbangkan sebagai salah satu gejala klinis diseksi aorta. Acute aortic dissection is an emergency aortic disease with unspecific clinical presentations and high mortality especially if not early recognized. Its unspecific clinical presentations contribute to lack of proper initial emergency treatment. A case of 71 year-old male with Stanford type B aortic dissection with atypical presentation of acute abdomen was reported. Patient had uncontrolled hypertension since one year ago. CT Angiography described Stanford type B aortic dissection with dissection flap seen just beyond the origin of left subclavian artery extending downwards to terminate just above aortic bifurcation. Initial treatment was pain management and blood pressure control. Tha patient was referred for thoracic endovascular aortic repair (TEVAR). Acute abdomen must be considered as one of clinical presentations of acute aortic dissection.
Juvenile-type Chronic Myeloid Leukemia pada Bayi Usia 3 Bulan Arfandhy Sanda; Agus Alim Abdullah; Mansyur Arif; Nadirah Rasyid Ridha
Cermin Dunia Kedokteran Vol 46 No 2 (2019): Interna
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v46i2.510

Abstract

Leukemia Mieloid Kronik (LMK) pada anak mencakup 2-5% kasus mieloproliferatif pada anak. LMK pada anak dibagi dalam 2 tipe yaitu tipe dewasa dan tipe remaja berdasarkan ada tidaknya kromosom Philadelphia beserta fusi gen BCR-ABL dalam kromosom tersebut. Kasus Seorang bayi laki-laki usia 3 bulan dengan keluhan utama perut membesar. Diagnosis berdasarkan gejala klinis and pemeriksaan laboratorium : leukosit 41.700/µl, hemoglobin 8,6 g/dl, trombosit 46.000/µl. Pada apusan darah tepi ditemukan semua tahapan maturasi sel seri mieloid dan mieloblast 5%. Aspirasi sumsum tulang mendapatkan peningkatan leukopoietik dengan semua tahapan maturasi mieloid. Malaria mikroskopik negatif. Hasil pemeriksaan molekular tidak ditemukan fusi gen BCR-ABL. Chronic myeloid leukemia (CML ) consist of 2-5% of myeloproliferative cases in children. CML in children are divided into two types: adult and juvenile type based on presence of Philadelphia chromosome with fusion gene BCR-ABL in chromosome. Case A baby boy aged 3 months with chief complaint of enlarged abdomen. Diagnosis was based on clinical symptoms and laboratory tests : leukocytes 41.700/µl, hemoglobin 8.6 gr/dl, platelets 46,000/µl. Peripheral blood smear shows all stages of cell myeloid series maturation and 5% myeloblast. Bone marrow aspiration shows increased leukopoietic activity and all stages of myeloid cell series. Malaria microscopy was negative. Molecular test results found no BCR- ABL fusion gene.
Senolytics : A Potential Fountain of Youth. Khing S. Ong; Zack ST. Lim; Boenjamin Setiawan
Cermin Dunia Kedokteran Vol 46 No 2 (2019): Interna
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v46i2.511

Abstract

Senolytics are groups of natural compounds, small molecules drugs and methods that eliminate senescent cells in the body of an organism. This review illustrate the pathogenesis or factors that lead to cellular senescence. As cellular senescence is the main culprit for age-associated diseases, the development of various classes of senolytics is of paramount importance in maintaining or even extending our health-span. Different classes of senolytics with some perspective of its potential for clinical applications will also be discussed. Senolyitcs merupakan kelompok senyawa alami, obat dan metode yang melenyapkan sel-sel tua dari tubuh. Tinjauan ini membahas patogenesis dan faktor-faktor yang menyebabkan proses penuaan sel. Mengingat penuaan sel merupakan penyebab utama penyakit-penyakit akibat penuaan, pengembangan berbagai jenis senolytics sangat penting dalam upaya mempertahankan dan memperpanjang harapan hidup. Akan dibicarakan pula beberapa kelas senolytics beserta potensi klinisnya
Antifungal Echinocandin Johan Indra Lukito
Cermin Dunia Kedokteran Vol 46 No 2 (2019): Interna
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v46i2.512

Abstract

Infeksi fungal invasif (IFI) masih menjadi penyebab utama morbiditas dan mortalitas pasien immunocompromised. Pilihan antifungal yang tersedia untuk IFI terbatas pada polyene, triazole, dan echinocandin. Echinocandin, yang terdiri dari caspofungin, micafungin, dan anidulafungin, merupakan golongan antifungal terbaru yang saat ini banyak digunakan untuk pengobatan IFI. Echinocandin memiliki beberapa keunggulan seperti aktivitas fungisidal yang poten terhadap sebagian besar spesies Candida, rendahnya resistensi, profil keamanan yang lebih baik serta interaksi dengan obat lain yang lebih sedikit. Invasive fungal infection (IFI) is still a major cause of morbidity and mortality in immunocompromised patients. The antifungal choices available for IFI are limited to polyene, triazole, and echinocandin. Echinocandin, which consists of caspofungin, micafungin, and anidulafungin, is the newest class of antifungal which is currently widely used for the treatment of IFI. Echinocandin has several advantages such as potent fungicidal activity against most Candida species, low resistance, better safety profile and fewer drug interaction.
Teknologi Pencampuran Otomatis Nutrisi Parenteral Dedyanto Henky Saputra
Cermin Dunia Kedokteran Vol 46 No 2 (2019): Interna
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v46i2.513

Abstract

Teknologi pencampuran nutrisi parenteral secara otomatis (automated compounding device/ACD) saat ini makin banyak digunakan, terutama di negara maju. Metode ini selain memiliki teknik aseptik yang lebih baik dibandingkan metode pencampuran konvensional, juga memiliki presisi yang lebih tinggi dan dapat memenuhi kebutuhan nutrisi individual secara lebih spesifik. Kendala metode ini adalah investasi awal yang membutuhkan biaya yang relatif tinggi. Automatic compounding device (ACD) technology is increasingly being used, especially in developed countries. This method has better aseptic techniques compared to conventional mixing methods, and also has a higher precision and can meet specific individual nutritional needs. The drawback of this method is relatively high cost initial investment.

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