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Acta Interna : The Journal of Internal Medicine
Published by Universitas Gadjah Mada
ISSN : 2303131X     EISSN : 25415441     DOI : -
Core Subject : Health,
Health Professions Medicine & Pharmacology
The Journal considers any original research that advocates change in, or illuminates, clinical practice. The journal also publishes interesting and informative reviews and opinions pieces on any topics connected with clinical practice. Manuscripts must be solely the work of the author(s) stated, not have been published previously elsewhere, and not be under consideration by another journal. all papers should be written to be clearly understandable to the journal`s readers in a wide range of specialities and countries. Diagrams, figures, and photographs should be used to supplement and enhance the text.
Arjuna Subject : -
Articles 152 Documents
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The Effect of Pursed-Lip Breathing on Functional Capacity of Stable Chronic Obstructive Pulmonary Disease Patient Assessed by Six Minutes Walk Test Dimas Hudy Ariadie; Sumardi Sumardi; Herni Retnowulan
Acta Interna The Journal of Internal Medicine Vol 10, No 1 (2020): Acta Interna The Journal of Internal Medicine
Publisher : Faculty of Medicine Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/actainterna.61297

Abstract

Background. The number of people with Chronic Obstructive Pulmonary Disease (COPD) in Indonesia isestimated to continue grow and currently has reached 4.8 million sufferers resulting in a large socio-economic burden. Management of COPD requires a comprehensive approach involving rehabilitation activities such as Pursed Lip Breathing (PLB) in order to increase the functional capacity of sufferers. Assessment of physical functional capacity of COPD patients can be evaluated through the Six Minute Walk Test / 6-minutes walk test, which can also assess changes in post-intervention functional capacity such as pulmonary rehabilitationprograms.Aims. This study aimed to determine the effect of pulmonary rehabilitation with PLB technique for 4 weeks on the achievement of distance through a six-minute road test in COPD patients who received standard therapy.Methods. An experimental, Randomized Controlled Trial (RCT) study was conducted on stable COPD patients with classification of Global Initiative for Chronic Obstructive Lung Disease stage II (GOLD 2) and GOLD 3 ( Stage III). The study was conducted at the Rumah Sakit Khusus Paru (RSKP) Respira Bantul, Yogyakarta. Subjects were taken randomly as a treatment Pursed Lips Breathing (PLB) or control group. The treatment group consisted of 38 subjects, doing PLB 8 minutes for 28 days (4 weeks) in a row. The placebo group consisted of 37 subjects only continuing the previous standard therapy. Six-minute walking test measurements were carried out in both groups before and after treatment and compared between the PLB and control groups. The difference in average delta range between groups that received PLB and controls was tested by unpaired t-test.Results. There was a difference increase in the average delta range of the six-minute walk test which was not significant between the two study groups. The increase delta mean range in the six-minute walk test treatment group was greater (22.19 ± 45.54 meters) compared to the control group (18.54 ± 42.57 m), with a P = 0.720.Conclusion. There was an improvement in functional capacity in the form of increased performance distance in the six-minute walk test for COPD patients who received standard therapy and pulmonary rehabilitation by pursed-lip breathing (PLB) technique.
Incorporation of Brentuximab Vedotin in the Treatment of Lymphoma: Current Evidence and Potential Use in Indonesia Ibnu Purwanto
Acta Interna The Journal of Internal Medicine Vol 10, No 1 (2020): Acta Interna The Journal of Internal Medicine
Publisher : Faculty of Medicine Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/actainterna.61344

Abstract

Although scientific advances have resulted in significantly improved survival among lymphoma patients, certain subsets of lymphoma patients still have poor prognosis, which includes relapsed and treatment refractory patients. Brentuximab vedotin, an anti-CD30 targeted therapy has shown remarkable results given in both Hodgkin and non-Hodgkin lymphoma, even in cases without CD30 expression. Unfortunately, evidence of its effectiveness in Indonesian patient is still limited as there is only 1 case report of such subject published.Conclusion: Brentuximab vedotin, an anti-CD30 targeted therapy presents as an effective therapeutic option for relapsed and treatment refractory lymphoma patients.
Persistent Lymphopenia as a Predictor of in-Hospitality in Septic Patients at Dr. Sardjito Hospital Juvita Kurniawan
Acta Interna The Journal of Internal Medicine Vol 10, No 1 (2020): Acta Interna The Journal of Internal Medicine
Publisher : Faculty of Medicine Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/actainterna.61348

Abstract

Background: Sepsis, a life-threatening organ dysfunction caused by deregulation of body response to an infection with a high mortality rate. Pro-inflammatory cytokines are related to early mortality related sepsis, and immune dysfunction and suppression characterized by lymphocyte loss are related to late mortality. Persistent lymphopenia is a good biomarker for immunosuppression and predicts mortality in sepsis patients. Lymphocyte counts are easily measured and cheaper than other inflammation marker for sepsis.Aims: The objective of this study was to determine whether persistent lymphopenia has a predictive value for mortality in septic patients at Dr. Sardjito General Hospital.Methods: This study was a retrospective cohort study, sepsis and lymphogenic patients admitted to Internal Medicine ward between January 1, 2016 and December 31, 2017. Lymphocytes were count at day 1 and 4 following the diagnosis of sepsis. Persistent lymphopenia was defined as an absolute lymphocyte count of 1.62x10/μL or less on day 4. The primary outcome was mortality at the end of hospitalization.Results: 126 adult patients, 101 with persistent lymphopenia, 25 non-persistent lymphopenia, 47 patients died (37.3%). Patients with persistent lymphopenia significantly at risk of death (P=0.003, OR 5.66, 95% CI 1.59-20.13) than non-persistent lymphopenia. Logistic regression was used to account for potential confounding factors, persistent lymphopenia (p = 0.003, OR 8.01, 95% CI 2.04-31.45) and skin and soft tissue infection (p= 0.017, OR 2.94, 95% CI 1.21-7.14) were significantly associated with mortality in sepsis patients at Dr. Sardjito General Hospital.Conclusion: Persistent lymphopenia predicts mortality in adult patients with sepsis at Dr. Sardjito GeneralHospital.
The Combination Effects of Physical Exercise and Dzikr for Anxiety Symptoms Improvement in the Elderly Hajj Pilgrim Candidates in Sragen Arfik Setyanigsih; Probosuseno Probosuseno; Noor Asyiqah Sofia
Acta Interna The Journal of Internal Medicine Vol 10, No 2 (2020): Acta Interna The Journal of Internal Medicine
Publisher : Faculty of Medicine Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/actainterna.62838

Abstract

Background. Anxiety disorders often occur in prospective elderly hajj pilgrims during preparation for departure. Physical exercise and dzikr are recommended as one of the non pharmacological efforts in reducing anxiety disorders.Method. Quasi-experimental one group pretest and post-test with research subjects elderly hajj pilgrim candidates in Sragen in 2019 with symptoms of anxiety that were assessed using the Beck Anxiety Inventory (BAI) score. The intervention was carried out in the form of a combination of forty minutes of physical exercise and thirty minutes of dzikr, 4 times during two weeks and assessed differences in BAI scores before and after the intervention.Aims. To find out the improvement of the BAI score after the combined intervention of physical exercise and remembrance, the Paired t-test was performed if the data distribution was normal and the Wilcoxon test if the data distribution was not normal. Differences were considered significant if p <0.05.Result. There were significant differences in the overall BAI score (p-value <0.001, p <0.05), mild anxiety BAI score (p-value 0.001; p <0.05), systolic blood pressure (p-value 0.002, p<0.05), and pulse frequency (p-value 0.012, p <0.05) before and after the intervention. Obtaining a decrease in systolic blood pressure and a decrease in pulse frequency are parameters for achieving a relaxation response.Conclusions. Significant anxiety symptom improvements were demonstrated as the effect of a combination of physical exercise and dzikr in the elderly hajj pilgrim candidates in Sragen.
The Difference of Depression Score of Patients Failed Ultrafiltration Compared to Successful at Continuous Peritoneal Dialysis Patients in RSUP Dr. Sardjito Yogyakarta Padmi Bekti Lestari; Noor Asyiqah Sofia; Iri Kuswadi
Acta Interna The Journal of Internal Medicine Vol 10, No 2 (2020): Acta Interna The Journal of Internal Medicine
Publisher : Faculty of Medicine Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/actainterna.62840

Abstract

Background. High mortality and morbidity in patients with Chronic Kidney Disease (CKD) are associated with psychological problems and poor quality of life. Depression is a psychological problem most often found in groups of CKD patients undergoing renal replacement therapy. Specific research that links the failure of ultrafiltration in Continuous Ambulatory Peritoneal Dialysis (CAPD) patients with depression does not yet exist today. So that further research is needed regarding this matter so that various depression intervention approaches can be carried out in the group of patients undergoing CAPD.Aims. This study aimed to determine the difference in depressive score of patients who failed ultrafiltration compared to those who did not fail in patients undergoing Continuous Ambulatory Peritoneal Dialysis (CAPD) in RSUP dr. Sardjito Yogyakarta.Method. A cross-sectional analytic study to assess differences in depressive score of CAPD patients with ultrafiltration failure compared to those who did not fail ultrafiltration in CAPD Clinic of RSUP dr. Sardjito Yogyakarta. The research subjects consisted of 41 people who fulfilled the inclusion and exclusion criteria. Depression assessment was carried out by calculating the total score of the BDI-II questionnaire and analyzing it using the Mann-Whitney method.Result. The average value of BDI-II in this study was 12 ± 8. 1. Depression scores based on BDI-II are if the score is equal to or more than 17. In this study 7 research subjects (17.1%) are depression. BDI –II values in the non-ultrafiltration failure group 10.96±7.25 and in the failed group 13.38±9.73 with p= 0.633.Conclusion. There were no significant differences in BDI-II score between groups that failed and those  that did not fail ultrafiltration.
Correlation Between Tp-Te Interval With the Degree of Disfunction in Liver Cirrhosis Based on Child Pugh Turcotte Score in Dr. Sardjito General Hospital RA Aditya Adhi Puruhita; Hasanah Mumpuni; Neneng Ratnasari
Acta Interna The Journal of Internal Medicine Vol 10, No 2 (2020): Acta Interna The Journal of Internal Medicine
Publisher : Faculty of Medicine Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/actainterna.62843

Abstract

Background. Hyperdynamic syndrome due to portal hypertension in cirrhosis of the liver leads to failure ofcontractions and cardiac structures that result in complications of cardiomyopathy cirrhosis. The incidenceof arrhythmias was reported in various non- cardiac diseases including liver cirrhosis. We aim to evaluatethe T peak wave - T end (Tp-Te) as a parameter for suspected arrhythmias that occur in liver cirrhosis.Aims. To  determine the  correlation between the  Tp-Te  interval  with dysfunction in the degree of livercirrhosis, which was assessed using the Child Pugh Turcotte score.Methods. This research is a cross-sectional study. Data taken from liver cirrhosis patients who has been metthe inclusion and exclusion criteria were admitted to the Inpatient and Outpatient Hospital Dr. Sardjito untilMay 2020, an assessment of the degree of dysfunction of liver cirrhosis with Child Pugh score Turcotte, andelectrocardiographic examination to assess Tp-Te wave. The independent variable was the Child Pugh Turcottescore, the dependent variable was the Tp-Te wavelength. Analysis of correlation data using the Spearman test.Results. Subjects included 51 patients with liver cirrhosis, correlation analysis found a strong correlation,the higher the Child Pugh Turcotte score was linearly correlated with the Tp-Te wavelength (r = 0.692; p<0.05). Wavelength Tp-Te at Child Pugh to any group showed a significant (p <0.001) , the wavelengthof Tp-Te Child Pugh A  group   67.94 ± 7.80 ms, the Child Pugh  B group   77.26 ± 8.38 ms, whereas inthe Child Pugh C group 92.31 ± 11.36 ms.Conclusion.  There was a strong positive correlation between the Tp-Te interval with the degree of livercirrhosis dysfunction which was assessed using the Child Pugh Turcotte score.
Association between Serum Vitamin D Level and Clinical Manifestations of Systemic Lupus Erythematous Patients in Dr. Sardjito General Hospital Anggi Wahyu Nugroho; Ayu Paramaiswari; Deddy Nur Wachid Achadiono
Acta Interna The Journal of Internal Medicine Vol 10, No 2 (2020): Acta Interna The Journal of Internal Medicine
Publisher : Faculty of Medicine Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/actainterna.62844

Abstract

Background. Vitamin D played a role in the pathogenesis of systemic lupus erythematosus (SLE). Vitamin D made dendritic cells more tolerogenic to autoantigens and inhibited B cells from producing autoantibodies. Vitamin D deficiency would make dendritic cells intolerant, increased production of interferons, and B cells produce excessive autoantibodies. These excessive autoantibodies and interferons would have caused severe clinical manifestations in SLE patients.Aims. This study was to find out vitamin D deficiency would increase the proportion of severe clinical manifestations in SLE patients in the Dr. Sardjito General Hospital. Methods. We conducted a cross-sectional study. Data was taken from medical records of SLE patients who went to Dr. Sardjito General Hospital in 2018. The independent variable was serum 25(OH) D levels, which were divided into deficiency (≤12 ng/ml) and not deficiency (>12ng/ml). The dependent variable was the clinical manifestations of SLE patients, which were divided into mild-moderate and severe. Association between two variables was analyzed using Chi-Square.Results. Vitamin D deficiency was observed in 19(54%) and not deficiency in 16(46%) subjects. SLE patients who underwent vitamin D deficiency more often experienced severe clinical manifestations than those without (52.6% versus 12.5%), prevalence ratio 4.2 CI 1.1-16.5 p=0.015. SLE patients who underwent vitamin D deficiency were more likely to suffer mucocutan, musculoskeletal, and kidney disorders. Also more likely to suffer more than 2 organ disorders than those without (57.9% versus 12.5%), prevalenceratio 4.6 CI 1.2-17.9 p=0.007.Conclusions. Vitamin D deficiency increased the proportion of severe clinical manifestations in SLE patients at Dr. Sardjito General Hospital. It also increased the proportion of mucocutan disorder, musculoskeletal disorder, and kidney disorder. Also, it increased the proportion of occurrence of more than 2 organ disorders in SLE patients at Dr. Sardjito General Hospital.
Maxillary Reconstruction Timing in Severe Systemic Lupus Erythematous (SLE) Patient with Bone Destruction due to Invasive Aspergillosis: Case Report Yulyani Werdhiningsih; Ayu Paramaiswari; Deddy Nur Wachid Achadiono; Nyoman Kertia
Acta Interna The Journal of Internal Medicine Vol 10, No 2 (2020): Acta Interna The Journal of Internal Medicine
Publisher : Faculty of Medicine Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/actainterna.62845

Abstract

Severe Systemic Lupus Erythematosus patient was in the third of 28-days-cycle cyclophosphamide chemotherapy when the early symptoms of aspergillus infection occurred. This developed into extensive cranial bone damage. It was planned to get a biopsy and debridement for bone and soft tissue to diagnose and therapy palate osteonecrosis, followed by reconstruction surgery. This case report aimed to report the successful management of a severe patient on chemotherapy undergoing several operations so that the SLE aspergillosis is optimally managed.
Impressive Result of Gemcitabine and Cisplatin Combination Therapy in Post-Operative Residual Cholangiocarcinoma Patient Presenting with Hyperbilirubinemia, an Experience in Indonesian Tertiary Hospital Ibnu Purwanto; Agus Barmawi; Bambang Purwanto Utomo; Ahmad Ghozali
Acta Interna The Journal of Internal Medicine Vol 10, No 2 (2020): Acta Interna The Journal of Internal Medicine
Publisher : Faculty of Medicine Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/actainterna.62846

Abstract

Introduction: Cholangiocarcinoma (CCA) often presents at an inoperable or an advanced stage in which complete resection is not possible. In such scenario, chemotherapy often is the only option to improve patient’s survival. Severe hyperbilirubinemia, often associated with higher risk of developing chemotherapy-related adverse event, might complicates one’s decision in choosing chemotherapy regimen. Case Report: We present a case of 63-year-old post-operative CCA patient with residual mass and severe hyperbilirubinemia. The patient completed six cycles of gemcitabine (1000 mg/m2, day 1 and 8) and cisplatin (70 mg/m2, day 1) every 3 weeks with tolerable side effect. No sign of residual tumor was observed on CT-Scan performed one-month post chemotherapy. Conclusion: Combination of cisplatin and gemcitabine may offer safe treatment option for post-operative residual CCA patient presenting with hyperbilirubinemia.
Prognostic Nutritional Index (PNI) as a Prognostic Factor in Stage IV Lung Adenocarcinoma Subroto, Subroto; Budiono, Eko; Sumardi, Sumardi
Acta Interna The Journal of Internal Medicine Vol 11, No 1 (2021): Acta Interna The Journal of Internal Medicine
Publisher : Faculty of Medicine Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/actainterna.94627

Abstract

Background. Based on nutritional and immunological indicators, the Prognostic Nutritional Index (PNI) is one of the prognostic indicators besides the Platelet-to-Lymphocyte Ratio (PLR) and Glasgow Prognostic Score (GPS). PNI can serve as a biomarker to help guide clinical practice and promote clinical outcomes for lung cancer patients. PNI was superior to Neutrophil- to- Lymphocyte Ratio (NLR) in the prediction of progression-free survival (PFS) and overall survival (OS). Objectives. To analyze the association between a low PNI score (PNI <40) and increased risk of mortality among stage IV pulmonary adenocarcinoma patients.Methods. A cohort-retrospective study was performed by extracting PNI data from medical records and the mortality of patients with stage IV pulmonary adenocarcinoma. A total of 265 patients met the inclusion and exclusion criteria, based on the medical records of patients with stage IV pulmonary adenocarcinoma who were hospitalized at Dr. Sardjito hospital Yogyakarta between January 1st, 2016 and July 1st, 2019. PNI score were calculated as follows: 10 x serum albumin (g/dl) + 0.005 x lymphocyte count (per mm3). Mortality was considered six months since the diagnosis. Chi-square tests were used to analyze the proportions of mortality and confounders. Multiple logistic regression tests were used to analyze the association between PNI and mortality.Results. Subjects with PNI score <40 were at risk of mortality three times higher than subjects with PNI score ≥40 (adjustedOR 3.356, 95% CI 1.165 - 9.670, p = 0.025).Conclusion. PNI score significantly affected the mortality in patients with stage IV pulmonary adenocarcinoma.

Page 13 of 16 | Total Record : 152

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