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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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INTERLEUKIN-6 YANG TINGGI SEBAGAI FAKTOR RISIKO TERHADAP KEJADIAN OSTEOPOROSIS PADA WANITA PASCAMENOPAUSE DEFISIENSI ESTROGEN Kawiyana, Siki
journal of internal medicine Vol. 10, No. 1 Januari 2009
Publisher : journal of internal medicine

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Abstract

In estrogen deficient post-menopausal women, the decrease of estrogen level in blood is not the sole cause for osteoporosis.Osteoporosis occurs due to the increase of osteoclastic bone resorption activity. OsteoclastÕs number and activity depend onits activating factors such as interleukine-6 (IL-6). The aim of the study was to prove that high IL-6 serum concentration is a riskfactor for osteoporosis. The study was an analytic-observational study in case-control design, which was done at Sanglah GeneralHospital, Denpasar. The sample size was 41 case subjects (osteoporosis) and 41 control subjects (non-osteoporosis) using pairedcase-control sample size formula. The t-paired and McNemartestsresults were: (1). IL-6 concentration was higher significantlyin case compared than control (3.47 ± 1.75 pg/mL vs 2.51 ± 1.13 pg/mL, p=0.001). (2). As risk factor for osteoporosis, using 2.17pg/ml as the cut off point, the IL-6 has significant OR as high as 4 (CI 95%: 1.23 Ð 14.24, p=0.032). From this study we mayderive conclusions as follows: (1). In estrogen deficient post-menopausal women, IL-6 concentration was higher in osteoporosisthan non-osteoporosis. (2). The high IL-6 serum concentration was a risk factor for osteoporosis in estrogen deficient postmenopausalwomen. (3). High IL-6 serum concentration can be used as predictor for osteoporosis in estrogen deficient postmenopausalwomen
HUBUNGAN KADAR INTERLEUKIN 6 DENGAN KADAR BESI SERUM PENDERITA ANEMIA PADA PENYAKIT KRONIK Wibawa, I Putu Budi; Bakta, I Made
journal of internal medicine Vol. 9, No. 1 Januari 2008
Publisher : journal of internal medicine

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Abstract

Anaemia of chronic disease is the second most prevalence after iron deficiency anaemia. It is a commonproblem faced because it decreasing the life quality. The pathofisiology of anaemia of chronic disease is same inmalignancy, chronic infection and chronic inflammation. There is immune driven pathway. Releasedproinflammation cytokine cause hypoferemia and hyperferitinaemia which the result is anaemia. The Objectiveis to determine the correlation of IL-6 with serum iron and haemoglobin in anaemia of chronic disease patien atSanglah General Hospital, Denpasar – Bali. The Cross sectional analytic study performed to search thecorrelation of IL-6 with serum iron and haemoglobin. Descriptive statistical test performed to descript thesample characteristic and the distribution frequency of many variable. Spearman correlation used with p < 0.05is significant. From 25 samples, there are 12 man (48%) and 13 woman (52%). The mean of samples age is49.20 ± 17.95 years old. The most prevalence diagnosis is lung TB, 8 samples (32%). The mean of IL-6 is 39.32± 48.66 pg/mL. The mean of serum iron is 42.48 ± 22.09 ug/mL. The mean of hemoglobin is 10.49 ± 1.47 g/dL.The mean of feritin is 607.62 ± 841,01 ng/mL. The mean of monocyte count is 0,91 ± 0,95 cell/mm3. Thecorrelation of IL-6 with serum iron is not significant (r -0.05, p 0325). The correlation of IL-6 withhaemoglobin is not significant too (r -0.027, p=0.898). There are possibility cause, first, the gradation ofmalignancy, chronic infection, chronic inflammation is not performed. Second, other inflammation cytokine isnot checked. Comorbid disease also may take a place. We conclude the correlation of IL-6 with serum iron andhaemoglobin is not significant.
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 BEBERAPA METODE DIAGNOSIS ANEMIA DEFISIENSI BESI: usaha mencari cara diagnosis yang tepat untuk penggunaan klinik Suega, Ketu; Bakta, I Made; Adnyan, Losen; Darmayuda, Tjok
journal of internal medicine Vol. 8, No. 1 Januari 2007
Publisher : journal of internal medicine

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Abstract

Iron deficiency anemia (IDA) is the most widespread public health problems. In 1989 WHO report more than one third ofworlds population suffered from anemia and half of them with iron deficiency anemia. Iron deficiency anemia can cause reducedwork capacity in adults and impact motor and metal devolepment in children and adolescents. It also can increase risk of infection,mother mortality rate, affects cognition in adulescents girls and causes fatique in adult women. IDA may affect visual andauditory functioning and is weakly associated with poor cognitive development in children. The diagnosis of IDA requires properclinical manifestation, laboratory evidence and also others diagnostic test that support iron deficiency. There are some diagnostictests frequently use in clinical practice to diagnose IDA, such as the morphology of erytrosite, examination of serum iron andtotal iron binding capacity, examination of feritin serum, and bone marrow staining. Knowing the best of diagnostic methods canuse in clinical practice and also knowing the profile of IDA, can leads into better management of IDA in population. A diagnostictest was done in order to know the sensitivity and spesifity of erytrosite index, serum iron, TIBC, and feritin serum in dignosticIDA. The study was done at Internal Departement, Sanglah Hospital for 6 months, start from March 2003 until October 2003.The result is Feritin has the best sensitivity (90.6%) and specificity (90.6%) , with cut off point 35.4 µg/l. MCH as erytrosite indexhas sensitivity (84.4%) and specificity (75%) to diagnose IDA, the cut off point is 21.8 pg . Sensitivity and specificity of TIBC is81.3% and 83.8% with cutt off point 282 µg/l. Sensitivity and specificity saturation of transferin is 84.4% and 79.7% with cuttoff point 6%. Serum iron has sensitivity 75.0% and specificity 68.7% with cut off point 17 µg/l.
FAKTOR-FAKTOR YANG MEMPENGARUHI TINGKAT KETIDAKPATUHAN PENDERITA TUBERKULOSIS DALAM BEROBAT DI POLIKLINIK DOTS RSUP SANGLAH DENPASAR Bagiada, I Made; Putri Primasari, Ni Luh
journal of internal medicine Vol. 11, No. 3 September 2010
Publisher : journal of internal medicine

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Abstract

Tuberculosis (TB) is a major public health problem in the world, especially in developing countries such as Indonesia. Itremains a major contributor to the global burden of disease and has received considerable attention in recent years, particularlyin developing countries. In our country, there is a little information about factors that can predict the adherence of TB patients.The objective of this study was to know factors contributing in non-adherence TB patients in polyclinic DOTS RSUP SanglahDenpasar. This study was a cross-sectional descriptive study of 15 adult newly diagnosed TB patients. Patients interviewed withquestionnaires consist of demographic and reasons of their non-adherence for TB treatment. About 12 (80%) of TB patients weremale. We didn?t ! nd much different in knowledge, work, educational status, and home distance among TB patients to in" uencethe adherence of the patients. The most important factor in" uencing the adherence of TB patients were drug side effects. Thedrug side effects were gastritis and skin itch (found in 10 and 3 patient respectively). Another reason for non-adherence in TBtreatment were over estimated and cost.Adherence was one of the potential factors to increase cure rate in TB patients. Non- adherence not only decreasing curerate in TB patients, but also as a risk for MDR TB. By determining inhibition factors in the treatment of TB patients, we canimprove the effectiveness of TB treatment.
HUBUNGAN JUMLAH FOLIKEL ANTRAL DENGAN RESPONS OVARIUM TERHADAP STIMULASI OVULASI Adnyana, IB Putra
journal of internal medicine Vol. 7, No. 3 September 2006
Publisher : journal of internal medicine

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Abstract

Recent studies show there is possibility to predict ovarian response to ovulation stimulation. Several possiblepredictor factors are age, ovarian volume, antral follicle count (AFC), ovarian stroma blood flow, and hormonalmarkers like Follicle Stimulating Hormone (FSH), Estradiol (E2) and Inhibin B. AFC is a simple examination forovarian reserve. Compared with hormonal markers, AFC more simply, relatively less costly and only using ultrasoundmachine, which widely available and the result could be obtained in timely manner. To understand relationshipbetween AFC and ovulation stimulation response. All women who joined IVF program with short protocol stimulationfrom January 2005 until May 2006 were enrolled into the study. Data collected were AFC day two, mature folliclecount, total oocyte count, mature oocyte count, and total gonadotrophin dose. Data were analyzed with Kendall’scorrelation test to show relationship. This study shows statistically significant correlations between AFC with maturefollicle count (r=0,329; p=0,037), total oocyte count (r=0,506; p=0,001), mature oocyte count (r=0,492; p=0,002), andtotal gonadotrophin dose (r=-0,477; p=0,002). This study shows there are statistically significant correlations betweenAFC with ovarian response to ovulation stimulation and the cutoff point of AFC is 4,5.
PATOFISIOLOGI DAN PENATALAKSANAAN NEFROPATI RADIOKONTRAS Sanjaya, Surya; Suwitra, Ketut
journal of internal medicine Vol. 10, No. 2 Mei 2009
Publisher : journal of internal medicine

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Abstract

Contrast induced nephropaty (CIN) was recognized as one of the leading causes of acute renal failure in patient withrenal insufficiency, diabetes mellitus, volume depletion and low cardiac out put. The incidence of CIN is estimated to be 1 Ð 2%in the general population, but the relative risk is greatly increased in diabetics, the elderly, and those with intrinsic renal disease,congestive heart failure, and dehydration. CIN is defined by an increase in creatinine 0.5 mg/dL or 25% from baseline that occurs2 Ð 3 days after contrast administration. A reduction in renal perfusion caused by a direct effect ofcontrastmedia on the kidneyand toxic effects on the tubularcells are generally accepted as the main factors in the pathophysiologyof contrastmedium inducednephropathy. Pathological changes induced by contrastmedium are epithelialcell vacuolization, interstitial inflammation andcellular necrosissuggest a direct toxic effect of contrastmedia on renal tubularepithelial cells. Several measures have beenrecommended to prevent contrastinduced nephropathy,which include: volume expansion, hydrationwith intravenous administrationof normal saline, infusion of mannitol, theophylline, dopamine,acetylcysteine, use of iso-osmolar non-ionic contrastmediainsteadof low-osmolarnon-ionic or high-osmolar ionic contrast,haemofiltration rapidly after contrast administration, injectionofsmall volume of contrast medium, gadolinium based contrastmedia
HUBUNGAN ADIPONEKTIN DENGAN GAGAL JANTUNG KONGESTIF Agung Budiyasa, Dewa Gde; Santoso, Anwar
journal of internal medicine Vol. 9, No. 3 September 2008
Publisher : journal of internal medicine

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Abstract

Adipose tissue synthesis several protein involved in the regulation of insulin action and lipid metabolism. Among theprotein adipocytokines, adiponectin is the most abundant and exerts profound anti-diabetic, anti-atherogenic, and anti-inflammatoryroles. Adiponectin may contribute to the regulation of vascular hemostasis by its ability to affect several signaling pathwaysin the vessel wall and modulate excess inflammatory responses. In the heart, adiponectin serve as a regulator of cardiacinjury through modulation of pro-survival reaction, cardiac energy metabolism, and inhibition of hypertropic remodelling. Manyeffect of adiponectin in the cardiovascular system correlate with the activation of both AMPK and Cox-2.Adiponectin levels may influence the development of CHF, but the epidemiological data are somewhat complex. This isdue in part to the fact that while higher body mass indices are a risk factor for heart failure, obesity is a predictor of improveprognosis in patients with establish CHF because wasting is strongly associated with the increased risk of death in the final stageof this disease. In this regard, high adiponectin levels are a predictor of mortality in patients with heart failure. Presumably, thisparadoxical relationship exist because high body mass, hence low protein, favors survival in endstage heart failure. Therefore,further studies should examine adiponectin levels in patients with stable heart failure
KORELASI ANTARA KADAR MAGNESIUM DENGAN RESISTENSI INSULIN PADA PENDUDUK SUKU BALI DI DESA PEDAWA KABUPATEN BULELENG Sri Yenny, Luh Gede; Suastika, Ketut
journal of internal medicine Vol. 12, No. 3 September 2011
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Abstract

Magnesium is one of microminerals playing pivotal role in glucose homeostasis and insulin activities. Magnesium playsa very important role in phosphorylation of insulin receptor. This is an analytical cross-sectional study to determinethe prevalence of hypomagnesium and correlation between magnesium level with insulin resistance, performed inPedawa Village Bali at February 2010. Subjects for this study were comprised of 111 people, 45 males (40.5%) and 66females (59.5%). Prevalence of hypomagnesium is 17.12%. The prevalence of hypomagnesium is higher in geriatricsubjects compare with non geriatric subjects (38.48% vs 10.98%, p = 0.004), is higher in diabetes subjects compare withnon diabetes (60% vs 15.1%, p = 0.035), and higher in subject with metabolic syndrome compare with non metabolicsyndrome (34.78% vs 12.5%, p = 0.025). Because lack on sensitivity of insulin measurement, 87 subjects (78.38%) thathave insulin level < 2  IU/ml can not measured by machine so the level of HOMA-IR of this subjects can not calculated,and just 24 subjects (21.62%) have insulin level > 2  IU/ml which can measured. From this 24 subjects, there is nosigniÞ cant correlation between magnesium level and insulin resistance (HOMA-IR) (r = -0.1, p = 0.642). In this study,we found a high prevalence of hypomagnesium in residents of Pedawa Village. The prevalence of hypomagnesium ishigher in geriatrics, diabetes mellitus, and metabolic syndrome subjects. There is no signiÞ cant correlation betweenmagnesium and insulin resistance (HOMA-IR), may be because lack of subject in this study. Thus further studies withhigher sensitivity of insulin measurement and enough sample of diabetic or metabolic syndrome patients in hospitalsettingare needed to determine correlation between magnesium level and insulin resistance.
HUBUNGAN KADAR ESTROGEN DENGAN KADAR DEOXYPIRIDINOLIN URIN PADA WANITA MENOPAUSE Wardhiana, I Putu Gede
journal of internal medicine Vol. 8, No. 3 September 2007
Publisher : journal of internal medicine

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Abstract

Women in her life will get two land marks, menarche and menopause. Menopause is that point in timewhen permanent cessation of menstruation occurs following the loss of ovarian activity. Women will loss theprotective effect of estrogen, accelerate bone remodeling and get osteoporotic. This study was conducted toevaluate relationship between estrogen level and bone resorption by deoxypyridinoline ekskretion in urine ofmenopausal women. Cross sectional study was done at Obgyn Department, RS Sanglah Denpasar. Population inthis study were women who got cessation their menstruation for 12 months or more, including our inclusioncriteria and the worked in this hospital. We performed deoxypyridinoline urine by high performance liquidchromatography (HPLC) method at Klinik Prodia and basal estradiol level (E2) at Laboratorium Graha TunjungRS Sanglah Denpasar. 52 menopausal women were evaluated, 21.1% with normal estradiol level, and 78.9%low (< 30 pg/ml). We collected 75% normal deoxyyridinoline urine and 25% with high deoxypyridinoline urinelevel (> 7.5 nmol/L), 1 sample with normal estradiol got high deoxypyridinoline urine level. From 41 sample(78.9%) with low estradiol level, twelve (23.1%) with high deoxypyridinoline have the highest osteoporotic riskin their life. Conclusion: 23,1% sample with low estradiol level and high deoxypyridinoline have the highestosteoporotic risk in their life

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