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INDONESIA
journal of internal medicine
Published by Universitas Udayana
ISSN : -     EISSN : -     DOI : -
Core Subject : Health,
Medicine & Pharmacology
Arjuna Subject : -
Articles 9 Documents
 1 
Search results for , issue "Vol. 11, No. 2 Mei 2010" : 9 Documents clear
GAMBARAN KUALITAS HIDUP PASIEN KANKER LIMFOMA NON HODGKIN YANG DIRAWAT DI RSUP SANGLAH DENPASAR (STUDI PENDAHULUAN) Sutrisno, Heri; Dharmayuda, Tjokorda Gde; Rena, Renny A
journal of internal medicine Vol. 11, No. 2 Mei 2010
Publisher : journal of internal medicine

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Abstract

Quality of life was a target therapy in cancer patients especially on metastatic cancer. Quality of life currently havebecomeone of stadard for therapeutic evaluation. Because quality of life was a subjectif characteristic and can only measure bypatient, so measuring quality of life patients must use multidimensional measure tool that offend aspect from physical, social andemotional, simple, easy to understand and answer by all patients and must to validated.To observe description of quality of life from cancer patient of Non Hodgkin Lymphoma (NHL) which admitted in SanglahHospital Denpasar, we have done analytic descriptive research on NHL patients with used EORTC QLQ-C30 questioner. Fifteenof NHL patients which cared in Internal Department Sanglah Hospital on January ? June 2010, 12 (80%) were male and 3 (20%)were female. Good quality of life was 8 (53.3%), moderate was 5 (33.3%) and poor was 2 (13.2%). From 10 (66.7%) patientsundergone chemotherapy, good quality of life was 5 (50%), moderate was 3 (30%) and poor was 2 (20%). There is correlationbetween quality of life of NHL patients with grading of clinical disease (p = 0.032; r = -0.554), there is no correlation qualityof life with giving chemotherapy in NHL patients (p = 0.560; r = -0.164). Meassuring quality of life NHL patient with EORTCQLQ-C30 was correlated with Karnofsky score (p = 0.031; r = 0.557) and ECOG (p = 0.04; r = -0.699).
PENATALAKSANAAN KETOASIDOSIS DIABETIK (KAD) Gotera, Wira; Agung Budiyasa, Dewa Gde
journal of internal medicine Vol. 11, No. 2 Mei 2010
Publisher : journal of internal medicine

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Abstract

Diabetic Ketoasidosis (DKA) is metabolic disturbance disorder that be signed by trias hyperglycemia, acidosis, andketosis, which one of very serious acute metabolic complication of diabetes mellitus. In Indonesia the incidence was not sohigh compare than the western countries, but the mortality is still high. In young age the mortality can be prevented by earlydiagnosis, rational and prompt treatment according to it!s pathophysiology. Succesfull of DKA treatment needs correction ofdehidration, hyperglycemia, acidosis, and electrolyte disturbance, identiÞ cation of comorbid precipitation factor, and the mostimportant one was continue monitoring. The treatment were adequate of ß uid therapy, sufÞ cient insulin theraphy, therapy ofpotassium, bicarbonate, phosphat, magnesium, hyperchloremic condition, and antibiotic administration according to indication.The important one was also awarness for therapy complications so that the therapy not to make worsening condition of thepatients.
PREVALENSI DAN RISIKO MEROKOK TERHADAP PENYAKIT PARU DI POLIKLINIK PARU RUMAH SAKIT UMUM PUSAT SANGLAH DENPASAR Sajinadiyasa, I G K; Bagiada, I M; Ngurah Rai, I B
journal of internal medicine Vol. 11, No. 2 Mei 2010
Publisher : journal of internal medicine

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Abstract

Cigarette smoking is the single largest preventable cause of premature death in the world today. Estimates of the numberof yearly deaths from smoking-related causes exceed 400,000 (about one-sixth of all deaths). About 23% of the U.S. populationin the year 2000 smoked, and another 22% used to smoke. United Kingdom reported 12.5 million of adult smokers in 2003 (about26% of UK population). Indonesia also reported very high prevalence of cigarette smoking (about 50 ! 70%). While in Tengananvillage, Bali, smoking prevalence reported about 26.3%. Smoking cessation is the key point in managing patients with tobaccorelated diseases, especially lung diseases.We conducted a cross sectional study to Þ nd out smoking prevalence and smoking contributions to lung diseases amongpatients in pulmonology outpatient clinic of Sanglah hospital, Bali. Among 108 patients, we found 77 patients (71.3%) exposedto cigarette smoking. Among these patients, we found 11 (10.2%) patients still smoking, 55 (50.9%) were ex-smokers, and 11(10.2%) were passive smoker. Among active smokers and ex-smokers, we found 34 patients (31.5%) were light smoker, 25(2.1%) were moderate smoker, and 7 (6.5%) were heavy smoker according to Brinkman index. The most frequent lung problemfound in this study was lung TB (42.6%), while smoking exposure happens in 76.1% patients. As the conclusion, smokingprevalence is high among patients come to pulmonology outpatient clinic of Sanglah hospital.
THROMBOPHILIA KARENA DEFISIENSI PROTEIN C DAN PROTEIN S Rama Putra, I Made; Suega, Ketut
journal of internal medicine Vol. 11, No. 2 Mei 2010
Publisher : journal of internal medicine

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Abstract

Protein C is a natural anticoagulant, inhibits thrombin generation. Protein C de! ciency, is associated with a variablyincreased risk of thrombosis. Incidence of symptomatic protein C de! ciency is approximately 1 in 16,000 to 1 in 32,000 persons,similar in men and women. Morbidity in protein C de! ciency greatly increases with advancing age, when patients are at greaterrisk for thrombotic events such DVT, PE, postphlebitic and blindness secondary to vitreous hemorrhages may occur in patientswith these severe conditions. The etiology can be inherited and acquired in a number of clinical scenarios include meningococcalseptic shock; DIC; liver disease; or chemotherapy. Diagnostic base on personal history of venous thrombosis, thromboembolicevents, abnormal laboratory coagulation tests. The laboratory workup should include haemostatic parameters, coagulationsystem such aPTT, PT, ! brinogen level and D-dimer test. A decreased protein C activity level is required. Imaging studies areappropriate for assessing the presence of thrombotic disease in a particular vessel. The treatment depends largely on a particularpatient?s disease manifestations. Surgical treatment may be appropriate in some circumstances.We reported, a male Balinese 62 years old came with complain red vision and dull feeling since a moth prior toadmission. No historical medical problem found. Physical exam found hypertension and laboratory ! nding showed slightdyslipidemia. Ophthalmologic examination revealed BRVO (Branch Retinal Vein Occlusion) ocular sinistra. Hypercoagulablaestate are suspected. Hematologic exam revealed light hyperagregation and low level of protein C and protein S. Treated withheparin 5000 unit intravenously followed by drip 1000 unit per hour for 3 day continued with warfarin 4 mg OD reach INR 1.5? 2.5. Good resulted base on patient?s good compliance.
KEJADIAN PERITONITIS PADA PASIEN CONTINUOUS AMBULATORY PERITONEAL DIALYSIS: IDENTIFIKASI MIKROORGANISME DAN SENSITIFITAS ANTIBIOTIK Haryanti, Elizabeth; Kandarini, Yenny; Widiana, I Gde Raka; Sudhana, Wayan; Loekman, Jod; Suwitra, Ketut
journal of internal medicine Vol. 11, No. 2 Mei 2010
Publisher : journal of internal medicine

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Abstract

Patients treated with Continuous Ambulatory Peritoneal Dialysis (CAPD) are constantly exposed to microbial invasionof the peritoneal cavity and rapid microbiological diagnosis of peritonitis is essential due to Hospitalization and imposes asignicant burden of morbidity. The aims of this study were to enumerate the association between microorganisms, sensitity,and resistence of antibiotic on CAPD patients with clinical peritonitis.We collected data through medical records by the number of CAPD patients with clinical peritonitis from June 2004 untilJune 2009. The study was analysis with one-way ANOVA. We found 23 patients clinical peritonitis out of 77 CAPD patients,with insidence was 14% per-year, aged 14 ? 65 y (15M; 8F). The chronic pyelonephritic was a leading (16/23) cause of endstages renal disease. Each patients underwent HD prior (5 ? 60 months) to CAPD, with survival time was 2 ? 51 months. Out of23 patients, 4 were returned to hemodialisis, 15 were died, due to cardiogenic shock 46.7%. Aseptic peritonitis was 31.3%, andthe common microorganism was staphylococcus 18.8%. Peritoneal !uid test showed mean score of sensitivity were tetracycline22.93, cipro!oxacin 19.36, piperacillin-tazobactam 17.36, thrimetropin/sulfamethoxazole 16.5, fosfomycin 15.78, consecutivelyand the rest were resistent. Staphylococus was strongly related to insidence peritonitis, and tetracycline was the most highlysensitive antibiotic in CAPD patients.
PENGARUH VIRUS HEPATITIS C PADA RESPON CD4 SETELAH 6 BULAN PEMAKAIAN REGIMEN KOMBINASI ANTIRETROVIRUS LINI PERTAMA PADA PASIEN INFEKSI HIV Somia, Agus; Utama, Susila; Parwati, Tuti; Wibawa, I Dewa Nyoman
journal of internal medicine Vol. 11, No. 2 Mei 2010
Publisher : journal of internal medicine

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Abstract

Hepatitis C Viral (HCV) and Human ImmunodeÞ ciency Virus (HIV) infection are global health problems. Co-infectionHIV-HCV in intravenous drug users about 53 99%. Despite very high prevalence of this co-infection, there were controversiesabout impact of hepatitis C virus in CD4 response of HIV patients receiving anti retroviral therapy. We conduct a retrospectivecohort to Þ nd out the impact of hepatitis C virus in CD4 response after 6 months of Þ rst line ART therapy. We collect data fromVCT-CST clinic patient!s record. Inclusion criteria for this study were HIV patients more than 12 years old, receiving Þ rst lineof ART treatment, and with anti HCV result.Sixty two patients enrolled for this study. Twenty eight patients found positive anti HCV and 34 negative anti HCV result.Mean of age was 29 ± 4.44 years old in anti HCV (+) group and 34 ± 7.335 in anti HCV (-) group, male dominant (92.9% and85.3% respectively). There were no signiÞ cant differences in total lymphocyte count, hemoglobine, and transaminases (AST andALT) between the two groups. The increasing of mean CD4 after 6 months ART treatment higher in anti HCV (-) group than inanti HCV (+) group, but statistically not signiÞ cant.
KARAKTERISTIK PASIEN KO-INFEKSI HIV-HCV DI RSUP SANGLAH DENPASAR Somia, Agus; Utama, Susila; Parwati, Tuti; Wibawa, I Dewa Nyoman
journal of internal medicine Vol. 11, No. 2 Mei 2010
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Abstract

Human Immunode! ciency Virus (HIV) and Hepatitis C Virus (HCV) are similar in many respects. Both viruses have asingle stranded RNA genome, both share similar routes of transmission and both cause chronic infection. However, HIV andHCV are also different in the pathogenesis, clinical manifestation and treatment. The aim of this study is to know characteristicof HIV-HCV coinfection patients in Sanglah Hospital. This study was descriptive study. Data based on patients medical recordduring from 1 januari 2004 sampai 31 Desember 2007 at VCT-CST. There were 48 cases HIV-HCV coinfected. 81.6% was male,mean of age of the ! rst anti HIV positive was 29.19 ± 4.63 years old. The risk factor was 75% IVDU. Baseline data showed71.4% suffered from HIV infection stage IV (WHO). The mean of body mass index was 18.78 ± 2.965 kg/m2, the mean of CD4was median of CD 4 was 222.56 ± 155.4 cell/ul, mean WBC was 4.38 ± 7.06 K/ul, mean of TLC was 1.134 ± 0.689 k/ul, meanof Hb was 12.53 ± 2.29 g/dl, Mean of PLT was 247.9 ± 90.11 k/ul, mean of SGOT 62.29 ± 71.91 IU, mean of SGPT was 77.34 ±109.83 IU. HbsAg positif 8.3% and 79.6% with HAART. The mortality rate was 10.8%. Most of HIV-HCV coinfected was male,productive age and the risk factor were IVDU.
POLA KEPEKAAN BAKTERI PADA PASIEN KEGANASAN HEMATOLOGI DI RSUP SANGLAH DENPASAR Rena, Renny A; Suega, Ketut; Bakta, I Made
journal of internal medicine Vol. 11, No. 2 Mei 2010
Publisher : journal of internal medicine

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Abstract

Hematology malignancies patient are particulary susceptible to infection associated with endogen microorganism whichorigin from body or nosocomial from hospital. The most common etiology of infection is gram-positive oral and gastrointestinaltract. A worsening infection can lead patient to severe septic condition and death. In the last decade, many studies found thatspecies of fungi and virus also has an important etiology of infection in hematology malignancies patient.Empirical antibiotic therapy on the ! rst onset of infection of hematology malignancy are very recomended. It has beenproven to decrease morbidity and mortality rate. Empirical antibiotic therapy suitable with the pattern of the microbial in hospitalis an important way to overcome the infection on hematology malignancies patient.A total of 36 patient with hematology malignancy who done the blood culture in Sanglah hospital were consecutivelyrecruited and studied in order to study the pro! le of blood culture in hematology malignancy patient. Within six months 36patients were included, consist of 26 male (72.2%) and 10 female (27.8%). Characteristic of patient are mean of age 42.78 ± 14.25years. Mean of leukosit 45.76 ± 69.32 x 103/ul, mean of neutrophil dan lymphosit consecutively 27.17 ± 55.80 x 103/ul and 10.29± 19.81 x 103/ul. The mean of hemoglobin 8.48 ± 3.26 g/dl, and mean of trombosit 181.21 ± 230.63 x 103/ul. The most commondiagnosis found is Acute Myeloblastic Leukemia (AML) 33.3% and Non Hodgkin Lymphoma 22.2%. The result of blood culturemostly no growth (56.3%). The most microbial isolated from the culture is Coagulase Negative Staphilococcus / CONS (11.1%).Antibiotic susceptibility testing for Coagulase Negative Staphilococcus / CONS shows linezolid and chloramphenicol are themost sensitive.
PENGARUH VITAMIN C TERHADAP KADAR SERUM FERITIN PADA PASIEN GAGAL GINJAL KRONIK DENGAN HEMODILISIS REGULER Wiryani, Cilik; Suwitra, Ketut
journal of internal medicine Vol. 11, No. 2 Mei 2010
Publisher : journal of internal medicine

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Abstract

Hyperferitinemia in chronic kidney disease patients with regular hemodyalisis may caused by repeated transfusion,excessive iron supplementations, and also inß ammation. Increasing of serum feritin level doesn!t depend on iron reservecapacity. Hemodialysis patients with no supplementations may lead to several antioxidant components deÞ ciency. Qualitative andquantitative of vitamin C deÞ ciency may also occur, thus administration 1 " 1.5 gram/week or 300 mg of vitamin C parenterallyevery dialysis session was recommended in order to compensate subclinical deÞ ciency.This study determine whether administration of vitamin C (500 mg, in NaCl 0.9%, every session of hemodialysis in 8weeks) can decrease serum feritin level in chronic kidney disease patients with regular hemodialysis. Randomized clinical trial,single-blind of 38 chronic kidney disease patients with regular hemodialysis was recruited based on inclusion and exclusioncriteria. Randomization in group with treatment was done with permuted block randomization. Mean of serum feritin before andafter treatment in every group was compared and analysed with Man-Whitney U test. SigniÞ cancy level () was with p less than0.05 (p < 0.05).The result of median and mean for decreasing of serum feritin in group with treatment of 500 mg, vitamin C is 0.00(-227.00 " 218.00) and 77.85 ± 383.25, respectively. While the result of median and mean for decreasing of serum feritincontrol group is 32.00 (-14.00 " 108.00) and 65.85 ± 209.6, respectively. On the analysis indicates median of serum feritinin group with treatment of vitamin C had less 32 points depends with control group (p = 0.84), Thus, there was no signiÞ cantdifference (p > 0.05) between two groups. From Anova analysis for gender, there was signiÞ cant effect in decreasing of serumferitin level (p < 0.05).There was no decreasing of serum feritin level after administration of 500 mg, vitamin C in chronic kidney diseasepatients with regular hemodialysis, and sex had signiÞ cant effect in alteration of serum feritin level.

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