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INDONESIA
journal of internal medicine
Published by Universitas Udayana
ISSN : -     EISSN : -     DOI : -
Core Subject : Health,
Medicine & Pharmacology
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Articles 9 Documents
 1 
Search results for , issue "Vol. 12, No. 1 Januari 2011" : 9 Documents clear
HUBUNGAN ANTARA ACTIVITIES SPECIFIC BALANCE CONFIDENCE SCALE DENGAN UMUR DAN FALLS PADA LANSIA DI POLIKLINIK GERIATRI RSUP SANGLAH DENPASAR Yuna Ariawan, IW; Kuswardhani, RA Tuty; Astika, IN; Suka Aryana, IGP
journal of internal medicine Vol. 12, No. 1 Januari 2011
Publisher : journal of internal medicine

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Abstract

Falls are a major health problem for elderly. Apart from the direct injuries resulting from falls, other long-term consequencesmay include disability, fear of falling, and loss of independence, which can have serious effects on people?s health and qualityof life. These risk factors are categorized into two distinct groups: intrinsic and extrinsic factors. Psychological factors, morecommonly referred to the ?fear of falling syndrome?, have been linked to signi! cant reductions of daily activities in fallersresulting in a loss of independence. The Activities-Speci! c Balance Con! dence (ABC) scale was used to measure con! dence incarrying out speci! c activities without falling or becoming unsteady. We conduct an analytic cross-sectional study to determineassociation between ABC scale with age and falls in elderly. Fifty two elderly outpatient, age over 60 years at Geriatric ClinicSanglah Hospital Denpasar on January 2010 recruited for this study. All subjects were asked questionnaire of ABC scale andhistory of falls. Health status was taken from physical examination and medical records. Data were analyzed using SPSSsoftware 17 version.There were 52 elderly outpatient consisted of 26 (50%) men, 26 (50%) women, age range 61 ? 87 years, mean 70.6 ±6.5 years, and 17.3% of them have history of falls. Total ABC scale mean were signi! cantly difference between women andmen (81.2 ± 14.1 vs 90 ± 12.8 p < 0.05); OA and without OA (80.5 ± 18.1 vs 88.6 ± 10.3 p < 0.05); and between faller and nonfaller(73.5 ± 13.6 vs 88.2 ± 12.9 p = 0.01). There was no signi! cant correlation between ABC scale and age. The ABC scalewith cut off 82.9 has signi! cantly association with falls p = 0.01; prevalence ratio = 7.0 95%CI 1.6 ? 49.8; 74.4% sensitivity,78% speci! city. As a conclusion we found lower total ABC scale has signi! cantly association with falls in elderly and has goodsensitivity and speci! city on scale below 82.9%.
PARANEOPLASTIC SYNDROMES Suega, Ketut
journal of internal medicine Vol. 12, No. 1 Januari 2011
Publisher : journal of internal medicine

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Abstract

The term Paraneoplastic Syndromes (PNS) refers to symptoms or signs resulting from damage to organs or tissuesthat are remote from the site of a malignant neoplasm or its metastases. Widely known examples include cancer cachexia,hypercalcemia,Cushing!s syndrome,and Trousseau!s syndrome . A particularly devastating form of paraneoplastic syndromes ia agroup of disorders classiÞ ed as Paraneoplastic Neurological Disorders (PND).The incidence of PNS varies with the neurologicalsyndrome and with the tumor. PNS can occurs in 7 to 10% of all patients with cancer. A paraneoplastic syndrome may resultfrom production and release of antibodies and physiologically active substances, or it may be idiopathic. However, not allparaneoplastic syndromes are associated with these antibodies. Symptoms can be atypical, psychiatric, or even ß uctuating,and PNS should often be in the differential diagnosis of otherwise unexplained neurological syndromes. An internationalpanel of neurologists has established diagnostic criteria that divide patients with a suspected PNS into deÞ nite and probablecategories. These criteria are based on the presence or absence of cancer, the presence of well-characterized antibodies, and thetype of clinical syndrome. Detection of a "well-characterized# paraneoplastic antibody is extremely helpful because it provesthe paraneoplastic etiology of the neurological syndrome. Usually, the paraneoplastic syndromes are divided into the followingcategories: (1) miscellaneous (nonspeciÞ c), (2) rheumatologic, (3) renal, (4) gastrointestinal, (5) hematologic, (6) cutaneous, (7)endocrine, and (8) neuromuscular. Treatment varies with the type and location of the paraneoplastic disorder, consist of treatmentof the underlying tumor, as well as the treatment of the presumptive immune-mediated disorder is based on immunosuppression.Because paraneoplastic syndromes differ widely from individual to individual, prognosis may vary greatly.
HUBUNGAN ANTARA DERAJAT BERAT INFEKSI VIRUS DENGUE DAN KADAR NATRIUM SERUM Agung Budiyasa, Dewa Gde; Parwati Merati, K Tuti
journal of internal medicine Vol. 12, No. 1 Januari 2011
Publisher : journal of internal medicine

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Abstract

Dengue Viral (DV) infection has been a big problem on the world (WHO, 2005). One of the factors that can inß uencesuccesfull of the DV infection treatment was correction for hyponatremia as one of the factors caused dengue encephalopathy.Hyponatremia cause by plasma leakage, the more severe plasma leakage the more severe hyponatremia. The aim of this study toknow association between degree of severity of DV infection and natrium serum concentration, correlation between two signsof plasma leakage (albumin concentration and hematocrit) with serum natrium concentration. Analytic cross sectional designbe applied for DV infection patients who admitted at Internal Medicine Department of Sanglah General Hospital on November! December 2010. Pearson correlation test showed signiÞ cant correlation between albumin and serum natrium (p = 0.018, r =0.254), no signiÞ cant correlation between hematocrit and natrium serum (p = 0.861, r = 0.019). Linear regression showed pvalue for albumin 0.495 and degree of severity of DV infection 0.000, so variable that can predict natrium serum concentrationwas degree of severity of DV infection, stated with formula y = 134,515 - 2,664x. The conclusion we found there was negativeassociation between degree of severity of DV infection and natrium serum concentration which signiÞ cant between DF and DHF.But among degree of DHF there were just tendention that the more severe degree of severity of DHF the lower serum natriumconcentration. There was signiÞ cant correlation between albumin and natrium serum concentration, but albumin can"t predictnatrium serum concentration. No signiÞ cant correlation between natrium serum concentration and hematocrit. We suggest tomeasure natrium serum concentration to antisipate worsening of DV infection, and better be performed for serial examination.
PERUBAHAN GOLONGAN DARAH PADA PENDERITA LEUKEMIA MIELOBLASTIK AKUT Losen Adnyana, IW; Suega, K
journal of internal medicine Vol. 12, No. 1 Januari 2011
Publisher : journal of internal medicine

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Abstract

We reported a case of acute leucemia (AML-M6) that experienced change of blood group. Leukemia is hematologicmalignancy with differentiation abnormality at grades haematopoetic stem cell that can make progressive expansión frommalignant clone cell in bone marrow and than spread to systemic circulation. In ABO blood system, group A with A antigenand anti B antibody, group B with B antigen and A antibody, O group without AB antigen and antibody. In this case, acuteleukemia be con! rmed with blood smear and bone marrow puncture. Changes of blood group known after remission inductionchemotherapy accordng to AML-M6 regiment. Post chemotherapy, there was changes O to A blood group according to ABOsystem. On family examination showed result of subgroup A of blood group previously. On acute leucemia or other hematopoiticdisease, there are two mechanism for explanation change of ABO blood system. The ! rst hematologic malignancy induced lossof ABO antigen due to inactivity of transferae A and B as the result was loss or decreased of antigen A and or B with simultantincrease of H antigen. Second, loss of ABH antigen in certain type of leucemia preceeding by loss of heterogenicity. ABO antigenwill reversed after proper treatment of leucemiaitself.
PERBANDINGAN ANTARA PEMBERIAN ANTIBIOTIKA MONOTERAPI DENGAN DUALTERAPI TERHADAP OUTCOME PADA PASIEN COMMUNITY ACQUIRED PNEUMONIA (CAP) DI RUMAH SAKIT SANGLAH DENPASAR Sajinadiyasa, I GK; Ngurah Rai, IB; Sriyeni, LG
journal of internal medicine Vol. 12, No. 1 Januari 2011
Publisher : journal of internal medicine

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Abstract

Among CAP patient, there are still some controversies about eÞ cacy of various approach management for the patient.There are important issues about using the dual therapy improving the better outcome compared to monotherapy of CAP patient.A retrospective study was held on CAP patients, who were hospitalized in Sanglah Hospital in 2008-2009 to compare betweendual versus monotherapy antibiotic with the outcome.Seventy Þ ve subjects were included in this study. About 73.3% subjects received dual therapy (cefotaxim and azitromicyn)and 26.7% received monotherapy (levoß oxacin). There were no signiÞ cant correlation between dual vs monotherapy antibioticwith length of stay (LOS) (p = 0.075) or with mortality (p = 0.367). Also there were no correlation between PSI score and LOS(p = 0.303) and mortality (p = 1.000). In age group, there was signiÞ cant correlation between age and mortality (p = 0.025), butthere were no signiÞ cant correlation with LOS (p = 0.265). As our conclusions, we Þ nd there were no signiÞ cant correlationbetween dual vs monotherapy antibiotic with outcome patient CAP. But there was signiÞ cant correlation about patient in olderage had higher mortality compare with younger age.
SEORANG PENDERITA CALCIPHYLAXIS PADA GAGAL GINJAL KRONIK -, Arvanita; SL, Jodi
journal of internal medicine Vol. 12, No. 1 Januari 2011
Publisher : journal of internal medicine

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Abstract

Calciphylaxis, also called calciÞ c uremic arteriolopathy, is a rare abnormality which characterized by medial calciÞ cation of the small arteries and ischemia of the subcutaneous tissue, often leading to necrosis of subcutaneous fat and skin. It affects mainly woman with ESRD.  A 48 year old woman with ESRD had a history of long standing ESRD which was being treated by hemodialysis for 13 years and peritoneal dialysis for 12 months. Two weeks prior to admission, she complained of a constant dull aching pain accompanied by multiple cutaneous ulcers on both distal extremities. The symptoms did not resolve with antibiotic and analgesic treatment. The skin of the leg had multiple violaceous lesions which were tender on palpation. There was multiple painful lesions with diameter 6 ! 8 cm, necrotic ulcerated lesions surround by erythema. Laboratory data revealed serum calcium was 10.4 mg/dl, phosphate was 8.5 mg/dl and parathyroid hormone level 2,164. Plain Photo of abdomen and both extremity revealed calciÞ cation soft tissue. Skin biopsy was consistent of CalciÞ c Uremic Arteriolopathy (CUA). Histopathology studies showed metastatic calciÞ cation sub cutis (cutaneous calciphylaxis) and arteriolosclerosis within superÞ cial dermis. The patients was treated with local wound care, fosrenol 3 x 500 mg and usual treatment for CKD were continued.  Response calciphylaxis after the treatment was getting bette
HUBUNGAN ANTARA HIPERURIKEMIA DENGAN MICROALBUMINURIA PADA MASYARAKAT DESA LEGIAN KUTA BALI Halim, Abd.; -, Kambayana; Raka Putra, Tjokorda
journal of internal medicine Vol. 12, No. 1 Januari 2011
Publisher : journal of internal medicine

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Abstract

Microalbuminuria has been linking to cardiovascular (CV) risk in patients with diabetes or hypertension in unselectedgeneral population. Serum Uric Acid (UA) is an emerging novel risk factor for CV disease. The aim of our study was to evaluatethe correlations between hyperucemia and microalbuminuria in the adult Legian Kuta Village population. We selected eligible136 participants of adult (>18 years old) in Legian Kuta village who agreed to participate. We excluded diabetes mellitus,hypertension, urinary tract infection, and fever. We measured total cholesterol, HDL, LDL-cholesterol, triglyseride, fasting and2-hour post prandial blood sugar, serum creatinine, serum uric acid, systolc-diastolic blood pressure and microalbuminuria(Urinary Albumin/Creatinine Ratio, ACR).The prevalence of hyperuricemia in our study was 16.9 % while microalbuminuria was 5.1 % (ACR 30 ! 299  g/mgcreatinine) and macroalbuminuria 1.5% (ACR > 300  g/mg creatinine). Hyperuricemia and obesity signiÞ cantly correlated withmicroalbuminuria by Bivariate Analysis Spearmanrho correlation r = 0.274, p = 0.001; r = 0.178, p = 0.038 (p < 0.05) respectively.Age, sex, smoking, total cholesterol, LDL, HDL and triglyseride were not signiÞ cantly correlated with microalbuminuria (p >0.05). In a stepwise multiple logistic regression model, hyperuricemia to microalbuminuria remained signiÞ cantly correlatedwith R Square 0.280 and prevalence ratio 7.90; p = 0.013; 95% CI 1.54 ! 40.60. Obesity was not signiÞ cantly correlated withmicroalbuminuria p = 0.161; 95% CI 0.59 ! 23.03. Our study showed hyperuricemia was signiÞ cantly correlated, as independentpredictors to microalbuminuria.
HUBUNGAN C-REACTIVE PROTEIN DENGAN PEMANJANGAN PROTHROMBIN TIME PADA PASIEN SIROSIS HATI YANG MENGALAMI PERDARAHAN SALURAN MAKANAN BAGIAN ATAS Mariadi, IK; Wibawa, IDN; Purwadi, N; Suryadarma, IGA
journal of internal medicine Vol. 12, No. 1 Januari 2011
Publisher : journal of internal medicine

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Abstract

Bacterial infections are common complications in cirrhosis, and cause the systemic in! ammation process. The natureof the relationship between gastrointestinal bleeding and infection in cirrhosis has not been clari" ed. Infection is associatedwith failure to control variceal bleeding and early variceal rebleeding in these patients. Bacterial infections, and particularlyendotoxemia, have been shown to activate the coagulation system and generally to interfere with hemostasis. We performedcross-sectional analytic study in cirrhosis patients with upper gastrointestinal bleeding to assess whether there are any associationbetween in! ammation process (CRP) with defect in haemostatic system (prolongation in prothrombin time). Forty-nine patientswere evaluated, 37 (75.5%) out of these were male and the rest were female. Ninteen out of this with in! ammation process and30 without in! ammation process. Fourteen out of 19 patients (73.7%) in in! ammation group have prolongation on prothrombintime and 12 out of 30 patients (40%) in non in! ammation group have prolongation on prothrombin time. The difference of thisproportion statistically signi" cant (Chi-square test X2: 5.29; p = 0.021). The CRP also have positive correlation with prolongationin prothrombin time (Spearman correlation R = 0.390; p = 0.006). In conclusion there is signi" cant association between CRP andprothrombin time in cirrhosis patients with upper gastrointestinal bleeding.
PREVALENSI SINDROMA METABOLIK PADA POPULASI PENDUDUK BALI, INDONESIA Dwipayana, M Pande; Suastika, K; Saraswati, IMR; Gotera, W; Budhiarta, AAG; -, Sutanegara; Gunadi, IGN; Badjra Nadha, K; Wita, W; Rina, K; Santoso, A; Kajiwara, N; Taniguchi, H
journal of internal medicine Vol. 12, No. 1 Januari 2011
Publisher : journal of internal medicine

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Abstract

An epidemiological study on metabolic syndrome (MS) in seven villages population of Bali (6 villages and 1 suburban),Indonesia have been conducted. One thousand eight hundred fourty (age, 13 " 100 year; M/F, 972/868) subjects were recruitedin the study. Criteria for obesity was based on WHO for Asia PaciÞ c population (2000) and for MS based on a joint statement ofIDF, NHLBI, AHA, WHF, and IAS (2009). The prevalence of central obesity based on waist circumference (WC) was 35% (M,27.5%; F, 43.4%) and MS was 18.2% (M, 16.6%; F, 20.0%).Waist circumference, as a central role in metabolic syndrome, hassigniÞ cant correlation with other components of metabolic syndrome, i.e. diastolic blood pressure (R = 0.129; p &lt; 0.001), fastingblood glucose (R = 0.088; p &lt; 0.001), HDL cholesterol (R = -0.066; p = 0.006), triglyceride (R = 0.349; p &lt; 0.001), and totalcholesterol (R = 0.179; p &lt; 0.001).Of the study could be concluded as follow: the prevalence of obesityand MS were relativelyhigh; Waist circumference was correlated with other components of metabolic syndrome and the best parameter for predictingmetabolic syndrome.

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