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INDONESIA
journal of internal medicine
Published by Universitas Udayana
ISSN : -     EISSN : -     DOI : -
Core Subject : Health,
Medicine & Pharmacology
Arjuna Subject : -
Articles 162 Documents
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KORELASI ANTARA DERAJAT BERATNYA OSTEOARTHRITIS LUTUT DAN CARTILAGE OLIGOMERIC MATRIX PROTEIN SERUM Andriyasa, Ketut; Raka Putra, Tjokorda
journal of internal medicine Vol. 13, No. 1 Januari 2012
Publisher : journal of internal medicine

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Abstract

Prevalence of knee Osteoarthritis (OA) in the community is quite high. Diagnosis and assessment of severity of knee OAbased on X-ray examination is not so sensitive yet. Various attempts have been made to nd markers of cartilage damage.One potential marker is Cartilage Oligomeric Matrix Protein (COMP). Based on animal studies, the more severity damageof joint cartilage, the more COMP is released. Based on this, researchers want to know whether there is a correlationbetween the severities of knee OA with serum concentration of COMP in human.This study is a cross sectional analyticstudy, whose performed in Outpatient clinic RSUP Sanglah Denpasar. The diagnosis of knee OA based on ACR criteriaand the degree of knee OA severity is determined based on the Kellgren and Lawrance criteria. COMP patients arechecked by using ELISA method. The correlation between the severities of knee OA and serum COMP was analyzed bySpearman correlation test. Level of statistical signicance used was p < 0.05. Sixty-six patients who meet the inclusioncriteria are examined, male was 28 (42.4%), women was 38 (57.6%). The mean age is 63.9 ± 7.0 years. The severity ofknee OA are: 4.5% for grade one, 35.8% grade two, 38.8% grade three and 20.9% at grade 4. The mean serum COMPconcentration is 1084.0 ng/ml. There is a trend of increasingly grade of severity of knee OA, the higher the concentrationof serum COMP, but not statistically signicant (r = 0.127, p = 0.31). In conclusion, there is no positif correlation thatstatistically signicant between severity of knee OA and serum COMP concentration.
OSTEOSARKOMA DIAGNOSIS DAN PENANGANANNYA Kawiyana, Siki
journal of internal medicine Vol. 10, No. 1 Januari 2009
Publisher : journal of internal medicine

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Abstract

Osteosarcoma is the second most common bone malignant neoplasm. Occurs between 5 Ð 30 years old, most oftenbetween 10 Ð 20 years old. It is located at long bone metaphyses which has rapid growth rate, therefore it is most often found inthe knee. Its diagnosis is established based on clinical findings, laboratory examination, radiographic examination such as plain xrayphoto, CT-scan, MRI, bone scan, angiography and biopsy histopathologic examination. The osteosarcoma prognosis dependson its stage and treatment effectivity. The osteosarcoma currently is managed by giving chemotherapy at pre-operative(induction=neoadjuvant chemotherapy) and post-operative (adjuvant chemotherapy). ÓLimb salvageÓ is the expected objective insurgical treatment for osteosarcoma. Post-operative follow up is very crucial in managing patient with osteosarcoma.
SARIPATIPenelitian ini bertujuan untuk mengetahui efek dari monitoring gula darah sendiri pada glycaemic control dan indikator psikologis pada pasien yang baru terdiagnosis diabetes mellitus (DM) tipe 2. Rancangan penelitian ini adalah prospective randomi Study, Esmon
journal of internal medicine Vol. 9, No. 1 Januari 2008
Publisher : journal of internal medicine

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Abstract

Penelitian ini bertujuan untuk mengetahui efek dari monitoring gula darah sendiri pada glycaemic control dan indikator psikologis pada pasien yang baru terdiagnosis diabetes mellitus (DM) tipe 2. Rancangan penelitian ini adalah prospective randomised controlled trial dari monitoring gula darah sendiri. Penelitian ini mengikutsertakan 184 orang pasien (111 lakilaki) yang berusia <70 yang baru terdiagnosis DM tipe 2. Kriteria eksklusi mayor meliputi diabetes sekunder, pengobatan dengan insulin dan adanya pemantauan gula darah sendiri sebelumnya. Intervensi dilakukan dengan melakukan randomisasi terhadap subjek menjadi kelompok yang melakukan monitoring gula darah dan yang tidak melakukan monitoring gula darah (kontrol). Penelitian dilakukan selama 1 tahun dengan follow up dilakukan selama 3 bulan. Hasil akhir yang dinilai adalah kadar HbA1c, indikator psikologis, penggunaan obat hipoglikemik oral, indeks massa tubuh (IMT), dan jumlah insiden hipoglikemia yang dilaporkan. Hasil penelitian: 96 pasien (55 laki-laki) dirandomisasi menjadi kelompok monitoring dan 88 (56 kali-laki) sebagai kontrol. Pada awal penelitian tidak terdapat perbedaan antara mean (SD) umur (57,7 (11,0) pada kelompok monitoring dengan 60,9 (11,5) pada kelompok kontrol) atau HbA1c masing-masing(8,8 (2,1)% dan 8,6 (2,3)%). Pada kelompok monitoring terdapat IMT yang lebih besar pada awal penelitian (34 (7) dengan 32 (6,2)). Tidak terdapat perbedaan yang bermakna antara kedua kelompok pada waktu yang ditentukan (12 bulan) pada HbA1c (6,9 (0,8)% dengan 6,9 (1,2)%, P=0,69; 95% dengan konfiden interval untuk perbedaan -0,25% to 0,38%), IMT (33,1 (6,4) dengan 31,8 (6,0); penambahan untuk IMT awal, P=0,32), penggunaan obat hipoglikemik oral, atau insiden hipoglikemia. Monitoring berhubungan dengan skor untuk depresi yang 6% lebih besar pada well-being questionnaire (P=0,01). Kesimpulan: pada pasien yang baru terdiagnosis dm tipe 2, monitoring gula darah sendiri tidak memiliki efek terhadap glycaemic control tapi berhubungan dengan skor depresi yang lebih besar. Maurice JK et al. Efficacy of self monitoring of blood glucose in patients with newly diagnosed type 2 diabetes (ESMON study): randomised controlled trial. BMJ 2008;336;1174-7.
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.
PENDEKATAN DIAGNOSTIK DAN TERAPI DIARE KRONIS Wiryan, NGP Cilik; Wibawa, I Dewa Nyoman
journal of internal medicine Vol. 8, No. 1 Januari 2007
Publisher : journal of internal medicine

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Abstract

Diarrhea is defined as a change in bowel habit, with an increase in stool frequency or fluidity or both, more than 3 timesdaily or stool weight > 200 g/day. Acute diarrhoe if it is less than 2 weeks of duration, persistent if between 2-4 weeks in duration,and Chronic if it is more than 4 weeks in duration. Diarhoea is a common problem around the world. Chronic diarrhea morecompleksabout diagnosis and treatment than acute one. The pathophysiiological mechanisms chronic diarhoea divided into major grouposmotic, secretory and imflamtory. A carefull history will often suggest the diagnosis and direct investigations. Physical examinationmore usefull to measure the severity of diarhoe rather than suggest the cause of chronic diarhoea. Iinitial investigation includeblood test, serology for celiac ds, stool examinations. Small intestinal and colon ds need for enteroscopy, capsul endoscopy,sigmoidoscopy, colonoscopy, many test for non invasive for malabsorption. In specific clinical conditions need specific examinationtoo. Small Intestinal Bacterial Overgrowth can be diagnosed directly by culture from aspiration of duodenal fluid or indirectly byusing breath test. Bile acid malabsorption can be diagnosed by by measured bile acid radioactif labelled measured of metaboliteserum, and bile acid excretion. Lactose malabsorption can be diagnosed by lactose assay, breath test (hydrogen 14C Lactose and 13C lactose). Increasing orocaecal transit time diagnosed by using barium study, radionucleide scintygraphy, lactose hydrogenbreath test. Chronic diarrhoea due to increasing hormones producing tumours diagnosed by measured increasing level of hormonesin to serum. Investigations patients with chronic diarrhoea available in the ambulatory or hospitalised patients. Treatment ofchronic diarrhoea depends on the specific aetiology and may be curative, suppressive or empirical.
STROKE NON HEMORAGIK DENGAN FIBROMA VENTRIKEL KIRI William, Yosef; Putra Gunadhi, I Gusti Ngurah
journal of internal medicine Vol. 11, No. 1 Januari 2010
Publisher : journal of internal medicine

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Abstract

Cardiac ! broma is a rare case. It?s incidents about 3.2% from all incident of cardiac and pericardia tumor, that most oftenfound in infancy and adolescence, and less frequently in adults. Cardiac ! broma is a benign solitary tumor of the heart which isconsist of ! brous tissue that most commonly in the left ventricle or the interventricular septum. This case was a male 51 yearsold with chief complaint of decrease of consciousness about 3 days prior admitted to hospital. He was consulted from neurologistwith stroke non hemorrhagic. He was used to be a smoker since young adult. At ! rst time, we found weakness both of extremity,and cardiomegaly without abnormality in heart?s sound. ECG shown inferior old myocardial infarction. The head CT Scan shownthere was a infarct in capsulla interna of left sub cortex hemisphere. And from echocardiography, we found there?s a mass onleft ventricular with its size was 2 x 2.5 cm. We diagnosed with observation of left ventricular mass caused by probable cardiacmyxoma, coronary arterial disease/OMI inferior/FC II, and stroke non hemorrhagic. After two months he had stroke, patient hada total resection of his cardiac tumor. It was done with open heart technique. From histologic ! ndings, we found a white solidmass in macroscopic, and in microscopic, there was ! brous tissue with focal calci! cation at the edge of tissue, which surroundednecrosis coagulated area. One week after surgery, he was went home in well condition and had some medications, i.e. vitamin Bcomplex, acetosal 100 mg od , and captopril 6.25 mg tid. A cardiac ! broma was a rare cardiac tumour. Until now, pathogenesisof cardiac ! broma still unknown. Diagnostic of cardiac ! broma can get from echocardiography and histologic examination.Treatment of cardiac ! broma are symptomatic for its complication, and invasive procedure, i.e. total or subtotal resection, andcardiac transplantation
KORELASI LAJU FILTRASI GLOMERULUS, HEMOGLOBIN, SATURASI OKSIGEN DAN KOMORBID DENGAN KADAR LAKTAT PASIEN PENYAKIT GINJAL KRONIS STADIUM TERMINAL Tantri, Ni Luh; Lahmadi, Iqbal; W Soeatmadji, Djoko; -, Nursamsu
journal of internal medicine Vol. 12, No. 3 September 2011
Publisher : journal of internal medicine

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Abstract

Hyperlactatemia usually happen in Chronic Kidney Disease (CKD) patients and it can used as indicator how bad theoxygen perfusion to organs. Therapy for hyperlactatemia is Hemodialysis (HD). Some studies assume few factors thatcorrelate to the level of lactate post HD, such as improving of Glomerulus Filtration Rate (GFR), level of hemoglobin(Hb), oxygen saturation and accompany diseases. An analytic cross sectional study was carried out in Saiful AnwarHospital to deÞ ne correlation between GFR, level of Hb, oxygen saturation and accompany diseases with level of lactatepost HD. Forty three samples were included. There were signiÞ cant correlation between level of lactate post HD withlevel of Hb (p = 0.000) and GFR (p = 0.006). With multivariate models, there were signiÞ cant correlation between levelof lactate post HD with those factors (p = 0.000). Using linier regression entering those variables into model, it foundformula level of lactate = 3.719 ! 0.196 (Hb) ! 0.053 (GFR). There was signiÞ cant correlation between between level oflactate post HD with GFR, Hb, oxygen saturation and accompany diseases.
ANEMIA PADA PENDERITA HIV-AIDS DI POLIKLINIK TERATAI RS HASAN SADIKIN- BANDUNG Sumantri, Rachmat; Wicaksana, Rudi; Ariantan, Agnes R; Supandiman, Iman; Idjradinata, Ponpon; Creven, Reinout van-; der Ven, Andre van
journal of internal medicine Vol. 10, No. 3 September 2009
Publisher : journal of internal medicine

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Abstract

The prevalence of anemia in HIV-infection ranging between 1.3 ? 95% depend on the stadium of infection. Anemiamakes bad impact on morbidity and mortality, and anemia is an independent risk factor for death in HIV-infected patients. Across-sectional study has been done in Teratai Clinic Hasan Sadikin Hospital to evaluate the prevalence and the etiology ofanemia between 1 January to 30 June 2008. Inclusion criteria were all patients who signed the informed consent. There were534 patients, 222 were anemic, prevalence of anemia was 41.6% (95% CI: 37.4 ? 45.8%), men 167 (72.2%). 188 were mildanemia (Hb 10 ?12/14 g/dl), 26 moderate anemia (Hb 8 ? 10 g/dl), and severe anemia in 6 patients (Hb < 8 g/dl). Anemia ofchronic disease or anemia of in! ammation were found in 142 (64.5%) cases, zidovudine related anemia 32 (14.5%) cases, ironde" ciency 14 (6.4%), hemolytic anemia 15 (6.8%) cases, thallassemia 8 (3.6%) cases, and megaloblasic 9 (4.1%) cases. All ofanemic patients showed low (< 2) reticulocyt index, high ferritin, low sTfR, and high hs-CRP.
PERAN SISTEM FlBRINOL1S1S PADA BERBAGAI PROSES FISIOLOGIS DAN PATOLOGIS Gde Budhiarta, Anak Agung
journal of internal medicine Vol. 7, No. 3 September 2006
Publisher : journal of internal medicine

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Abstract

Plasminogen can be converted to plasmin either by t-PA or u-PA. A dual role for these pathways isnow well established where t-PA is involved in fibrin homeostasis and u-PA is primarily involved in cellmigration and tissue remodelling. Using this mechanism thrombolytic terapy of myocardial infarction andsome other thromboembolic diseases have been introduced. Thrombolytic therapy could be improved byearlier and accelerated treatment, the used of plasminogen activator with increased thrombolytic potencysuch as reteplase, tenetecplase and staphylokinase and the use of more specific and potent anticoagulant andantiplatelet agents. Increased activity of matrix metalloproteinases (MMPs) has been implicated innumerous disease processes, including tumor growth and metastases, arthritis, and periodontal disease. It isnow becoming increasingly clear that extracelluler matrix degradation by M M Ps is also involved in thepathogenesis of cardiovascular disease, including atherosclerosis, restenosis, dilated cardiomyapathi,andmyocardial infarction. Administration of synthetic MMP inhibitor in experimental animal models of; thesecardiovascular disease significantly inhibits the progression of respectivelyatherosclerotic lesion formation,neointima formation, left ventricular remodeling, pump dysfunction, and infarc healing.
PENALAKSANAAN SINDROMA RENJATAN DENGUE DENGAN EDEMA PARU Somia, Agus; Parwati, Tuti
journal of internal medicine Vol. 11, No. 3 September 2010
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Abstract

Dengue Hemorrhagic Fever (DHF) is a systemic disease caused by one of the four types Dengue Viruses. DHF transmittedby a mosquito called Aedes aegyptii. Clinical spectrums of dengue infection widely vary from asymptomatic, undifferentiatedfever, dengue fever, dengue hemorrhagic fever, and dengue shock syndrome grade III and IV. Dengue infections remain on thetop list of infectious disease found in our country and several South-East Asia Nations. Pathognomonic clue differing denguehemorrhagic fever with dengue fever is the presence of plasma leakage due to the increasing of vascular permeability. Dengueshock syndrome is a medical emergency needing direct and correct ß uid resuscitation to deal with hemodynamic disturbance andplasma leakages without causing ß uid overload or further complication. We report an 18 years old male with chief complain offever for 6 days and newly lung edema after 12 hours of admission. Patient diagnosed with 3rd grade of dengue hemorrhagic feverwith lung edema. Patient then undergone ß uid resuscitation with crystalloid and colloid ß uid and given furosemide as diureticagent simultaneously. Finally getting better after Þ ve days of treatment in hospital

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