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All Journal Jambi Medical Journal "Jurnal Kedokteran dan Kesehatan" Majalah Kedokteran Sriwijaya Biomedical Journal of Indonesia Bioscientia Medicina : Journal of Biomedicine and Translational Research Ina Kidney Bioscientia Medicina : Journal of Biomedicine and Translational Research Jurnal Penyakit Dalam Indonesia
Zulkhair Ali
Department Of Internal Medicine, Dr. Mohammad Hoesin Hospital, Palembang, Indonesia / Department Of Internal Medicine, Faculty Of Medicine, Universitas Sriwijaya, Palembang, Indonesia
Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Nursing Public Health

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FACTORS AFFECTING THICKENING OF CAROTID INTIMA MEDIA THICKNESS IN PATIENTS WITH CHRONIC KIDNEY DISEASE Yonata, Ade; Ali, Zulkhair; Indrajaya, Taufik; Effendi, Ian; Suhaimi, Novadian
Biomedical Journal of Indonesia Vol 6, No 1 (2020)
Publisher : Fakultas Kedokteran Universitas Sriwijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32539/bji.v6i1.10539

Abstract

Chronic kidney disease (CKD) is associated with high mortality rates related to cardiovascular complications. Atherosclerosis, arteriosclerosis and vascular calcification conditions are often found in CKD patients. Carotid intima media thickness (cIMT) thickening is one of the parameters of vascular disorders. A cross sectional study was conducted on patients with chronic kidney disease in the hospital. Mohammad Hoesin Palembang. Patients' blood samples were examined in the hospital laboratory. CIMT thickening was examined using echocardiography. A total of 55 patients with stage 3-5 chronic kidney disease were examined. The median cIMT is 0.8 (0.6-1.45) mm. Spearman's correlation analysis showed a significant correlation between triglyceride levels and thickening of cIMT (r = 0.303, p = 0.025). A significant correlation was also shown between phosphate levels and cIMT thickening (r = 0.290, p = 0.032). There is a significant correlation of triglyceride levels and phosphate levels to cIMT thickening in patients with chronic kidney disease in Palembang
Hubungan Kepatuhan dan Pola Konsumsi Obat Pengikat Fosfat terhadap Kadar Fosfat pada Penyakit Ginjal Kronik Stadium V Reinanda Marizki R; Zulkhair Ali; RM Suryadi Tjekyan
Majalah Kedokteran Sriwijaya Vol 47, No 2 (2015): Majalah Kedokteran Sriwijaya
Publisher : Fakultas Kedokteran Universitas Sriwijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36706/mks.v47i2.2751

Abstract

Penyakit ginjal kronik adalah suatu proses patofisiologis dengan etiologi yang beragam, mengakibatkan  penurunan  fungsi ginjal yang progresif dan pada umumnya berakhir dengan gagal ginjal.  Salah satu komplikasi  dari penyakit ginjal kronik yaitu ketidakseimbangan pengaturan fosfat yang nantinya dapat menyebabkan Gangguan Mineral dan Tulang pada Penyakit Ginjal Kronik USRDS (United States Renal Data System) (1993), mencatat prevalensi hiperfosfatemia masih 53,6 %, walaupun pengikat fosfat sudah diberikan pada sekitar 80% kasus. Penelitian ini bertujuan untuk mencari hubungan antara kepatuhan dan pola konsumsi obat pengikat fosfat terhadap kadar fosfat pasien Penyakit Ginjal Kronik Stadium V. Penelitian ini  adalah suatu studi observasional  laboratorik analitik dengan rancangan   cross sectional di  bagian  Instalasi  Hemodialisis  RSMH  Palembang. Sampel  yang  diambil adalah  seluruh pasien  PGK  stadium  V atau  gagal  ginjal  terminal  yang  menjalani hemodialisis di Instalasi Hemodialisa RSMH Palembang dalam periode Oktober-November 2012. Seluruh data diolah dengan menggunakan  SPSS versi 20 dan hipotesis akan diuji dengan menggunakan  uji kai kuadrat. Dari 142 responden  diperoleh 72,5% responden  mengalami hiperfosfatemia.  Sebanyak 59,9% responden tidak patuh dalam konsumsi  obat pengikat fosfat dan 71,2% responden salah dalam pola   konsumsi  obat pengikat fosfat. Selanjutnya,   sebanyak  61,6%   responden memiliki motivasi rendah  serta 50,4% responden memiliki pengetahuan yang rendah mengenai obat pengikat fosfat. Sebanyak 57% responden patuh terhadap diet rendah fosfat.  Berdasarkan  uji  chi  square  nilai  p  <  0,05 jadi  terdapat  hubungan  antara kepatuhan  dan  pola  konsumsi  obat  pengikat  fosfat  terhadap kadar fosfat  pasien Penyakit Ginjal Kronik Stadium V. Kesimpulan Terdapat hubungan antara  kepatuhan  dan  pola  konsumsi obat pengikat fosfat terhadap kadar fosfat pasien penyakit ginjal kronik stadium V.
Prevalensi dan Faktor Risiko Hipertensi di Kecamatan Ilir Timur II Palembang Tahun 2012 Abdul Hakim R; Zulkhair Ali; R.M. Suryadi Tjekyan
Majalah Kedokteran Sriwijaya Vol 47, No 1 (2015): Majalah Kedokteran Sriwijaya
Publisher : Fakultas Kedokteran Universitas Sriwijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36706/mks.v47i1.2743

Abstract

Hipertensi adalah suatu keadaan dimana tekanan darah melampaui tekanan darah normal. Tekanan darah disebut normal apabila tekanan sistolik <120 mmHg dan tekanan diastolik <80 mmHg. Hipertensi merupakan faktor risiko yang penting penyebab terjadinya penyakit jantung dan pembuluh darah, dan sering disebut sebagai “the silent disease”. Hipertensi timbul karena berbagai faktor risiko seperti umur lanjut, riwayat keluarga, berat badan berlebih, kebiasaan merokok, kurang aktifitas fisik, asupan natrium berlebih, dislipidemia, diabetes mellitus, dan stres. Penelitian ini bertujuan untuk mengetahui prevalensi dan faktor risiko hipertensi di Kecamatan Ilir Timur II Palembang tahun 2012. Penelitian ini dilakukan pada bulan November-Desember tahun 2012 di Kecamatan Ilir Timur II Palembang dengan metode analitik observasional. Rancangan penelitian yang digunakan adalah Cross Sectional. Populasi penelitian adalah penduduk yang berumur ≥15 tahun. Jumlah sampel adalah 512 unit. Data tekanan darah, berat badan, dan tinggi badan didapatkan dengan pengukuran langsung memakai alat dengan metode yang sudah ditentukan, dan data lainnya didapatkan dengan wawancara. Dari data di Kecamatan Ilir Timur II Palembang diperoleh jumlah total penderita hipertensi adalah sebanyak 182 (35.5%) penderita dari 512 total penduduk yang diambil sebagai sampel penelitian. Kesimpulan penelitian menunjukkan bahwa umur (p= 0,000), Indeks Massa Tubuh (p= 0,002), riwayat keluarga yang menderita hipertensi (p= 0,001), dan lama merokok (p= 0,000) merupakan faktor yang berpengaruh pada prevalensi hipertensi di Kecamatan Ilir Timur II Palembang tahun 2012.
Anemia in Chronic Kidney Disease : Role of Hypoxia Inducible Factor Stabilizer Emilia; Zulkhair Ali
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 5 No. 5 (2021): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32539/bsm.v5i5.234

Abstract

Anemia contributes to increased morbidity and mortality in chronic kidney disease patients. The pathogenesis of anemia in these patients is multifactorial, but the contribution of erythropoietin deficiency becomes greater as glomerular filtration rate declines which related to decreased nephron mass. The current standard of care includes supplemental iron, erythropoiesis-stimulating agents (ESA), and red blood cell transfusions, although each has drawbacks. Lately, concern has arisen following randomized clinical trials showing that higher hemoglobin targets and/or high ESA doses may cause significant harm including increasing cardiovascular and thrombotic events, and even death. Recent experimental and clinical studies show the promising efficacy of hypoxia inducible factor (HIF) stabilizer which stimulates endogenous erythropoietin production and enhance iron availability.
Maternal Death Cause by Antepartum Eclampsia, With HELPP Syndrome and AKI Stage III : A Preventable Recurrent Death Ferry Yusrizal; Fitria Koeshardani; Agustina H; Zulkhair Ali; Junaidi A
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 5 No. 11 (2021): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32539/bsm.v5i11.372

Abstract

Background: Eclampsia and severe preeclampsia is of the most frequent cause of maternal death. We usually find the case like this in our daily practice. The case most likely could be prevented. Eclampsia defined as a generalized seizure following preeclampsia in pregnancy. Eclampsia/Preeclampsia (EPH-Gestosis) cause a multisystem dysfunction such as HELLP syndrome, microangiopathy hemolytic anemia, liver dysfunction, and thrombocytopenia. Eclampsia and HELLP syndrome lead to maternal mortality, which happened mostly during third trimester. Most of the patient came to the hospital in a bad condition where the multi organs failure were exist. EPH-Gestosis are due to maternal death in 43,75%. Even the case usually severe, it’s a preventable death. A proper strategy is needed to reduce or to avoid the maternal death.Objective: To analyse a maternal death with eclampsia and how to prevent this recurrent death.Case Report: A woman, 30 years old, G2P1A0 32 weeks pregnant not in labor with antepartum eclampsia was admitted to Mohammad Hoesin General Hospital (MHGH) Palembang, a referral case. Patient experienced generalized seizure six times before coming to MHGH which every seizure duration is less than five minutes and unconscious. On physical examination, patient was conscious, with blood pressure of 160/100 mmHg, pale, and cold extremities. By ultrasound examination, it showed 34 weeks pregnancy with single life fetus. Laboratory examination showed leukocytosis (25.000/mm3), thrombocytopenia (58.000/mm3), hyperbilirubinemia, elevated SGOT and SGPT (1691 and 861 U/L), elevated creatinine serum (2,46 mg/dl), and elevated LDH (3629 U/L). The patient was treated based on the protocol for stabilization with intramuscular injection of MgSO4 40%, nifedipin 10 mg per oral, intravenous injection of dexamethasone 12 mg, and plan to terminate the pregnancy by caesarean procedure. The male baby was born, 2000 g weight and APGAR score 4/6/8. After the cesarean the consciousness not so well. Collaborating therapy to handle the case, with the anesthesiologist, internist and neurologist. Maternal death occurred in 3 days hospitalized …caused by multi organ failure (MOF). Conclusion: The maternal death caused by antepartum eclampsia and the complication. The diagnosis of antepartum eclampsia and HELLP syndrome was decided based on history taking, physical examination, and supporting examination. Multiple organ failure exist in this case when the patient came to MHGH. Patient already treated and tried to overcome the complication but maternal death still occurred. This maternal death has a likely same story of previous death pattern. It is needed a strategy to prevent or to reduce the maternal death and how to make a good effort to cease the case become severe or worst.
Comparison of Omega-3 Serum Level Between Hiv-Aids Patients Along with Their Clinical Profiles and Healthy Population in Mohammad Hoesin General Hospital Palembang Lidiawati Handayani; Harun Hudari; Eddy Mart Salim; Erial Bahar; Nova Kurniati; Zulkhair Ali; Ferry Usnizar
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 5 No. 12 (2021): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32539/bsm.v5i4.382

Abstract

Introduction. Human Immunodeficiency Virus (HIV) infection has been a concerning health problem worldwide. It causes reduction in body immune system and inflammation that can affect its clinical profile. Undergoing ARV therapy patients causes intestine microbiota dysbiosis and translocation that lead to imperfect absorbtion of fatty acid. One way to control microbiota dysbiosis is by controlling the nutritional factor, especially with omega-3. However, different regions upstands different custom in fish consumption especially those of which are rich in omega-3. The purpose of this research is to compare omega-3 serum level between HIV-AIDS patients and healthy population, as well as analyzing the correlation of omega-3 serum level with of HIV-AIDS patient clinical profile.Methods. The research will be applying observational analytic study using comparative study approach which will be performed in Tropical Infection Internal Medicine polyclinic and Medical Check-Up Polyclinic in RSMH Palembang starting from April 2020 until January 2021. Sample consisted of 32 HIV-AIDS patients from 20-58 years of age and 16 healthy population from 27-35 years of age on whom will be performed physical examination as well as clinical profile and omega-3 serum level examination. All data processing and analysis will be performed using SPSS v.25 for windows.Results. Out of 32 HIV-AIDS patients, we obtained low omega-3 serum level with median value at 3 (2-4) Umol/L, while in healthy population was 4 (3-6) Umol/L. Multivariate analysis inferred that the lower omega-3 serum level correlated with HIV-AIDS stage, duration of ARV therapy, blood pressure, and sex.Conclusion. Omega-3 serum levels in HIV-AIDS patients were lower than the healthy population. There was a correlation between omega-3 serum levels and their clinical profile of HIV-AIDS patients in Mohammad Hoesin General Hospital Palembang.
The Association between Urinary Tissue Inhibitor Metalloproteinase 2 (TIMP-2) and Insulin-like Growth Factor Binding Protein 7 (IGFBP-7) and Renal Recovery in Acute Kidney Injury Emilia; Zulkhair Ali; Ian Effendi; Novadian; Suprapti; Mediarty; Taufik Indrajaya; Mgs. Irsan Saleh
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 5 No. 4 (2021): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32539/bsm.v5i4.386

Abstract

Background. Acute kidney injury (AKI) is a common and serious medical condition associated with significant increases in morbidity, mortality, cost of care and non recovery of kidney function that leads to progression to chronic kidney disease. Cell cycle arrest is implicated in the pathogenesis and repair process following AKI. The urinary cell-cycle arrest markers tissue inhibitor of metalloproteinase-2 (TIMP-2) and insulin-like growth factor binding protein 7 (IGFBP-7) have been utilized to predict the risk of AKI in many studies from specific population with good performance. However, their use in predicting recovery is still lacking. The aim of this study was to determine the association between two novel AKI biomarkers, urinary TIMP2 and IGFBP7 and renal recovery after 7 days of treatment in AKI patients at Dr. Mohammad Hoesin Hospital Palembang. Method. This was a prospective cohort study conducted in dr. Mohammad Hoesin Hospital Palembang from January 2021 until March 2021. Subjects enrolled in this study were patients whom diagnosed AKI based on KDIGO 2012 criteria. Urine samples were collected upon patients’ enrollment within 24 hours of AKI diagnosis. We utilized Sandwich Enzyme Linked Immunosorbant Assay (ELISA) method to detect urinary TIMP-2 and IGFBP-7 levels. The primary outcome is recovery from AKI after 7 days of treatment. Chi square test is used to analyze the association between urinary TIMP-2 and IGFBP-7 levels and renal recovery. Results. There were 70 subjects, only 22 of them were recovered after 7 days (31%). Median of urinary TIMP-2 and IGFBP-7 was 0,0047(0,0001-0,1439) [(ng/ml)2/1000]. There was significant association between urinary TIMP2 and IGFBP7 and renal recovery (p=0,027; OR 3,19; 95% CI 1,116-9,128). Conclusion. There was significant association between urinary TIMP2 and IGFBP7 and renal recovery in AKI patients.
Electrocardiography Predictive Value on Coronary Slow Flow Phenomenon Erwin Sukandi; Yudhie Tanta; Taufik Indrajaya; Ali Ghanie; Muhammad Irsan Saleh; Irfannuddin; Radiyati Umi Partan; Zulkhair Ali
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 6 No. 3 (2022): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v6i3.454

Abstract

Coronary Slow Flow Phenomenon (CSFP) is characterized by the slow flow of contrast in one or more epicardial coronary vessels without evidence of coronary artery stenosis during coronary angiography procedures. CSFP is fairly common at the time of elective angiography with an incidence of around 7% and accounts for about 4% of hospitalized unstable angina cases. Coronary angiography is currently still the only effective way to detect CSFP, but this procedure is an invasive procedure with high costs, there is a risk of allergy to contrast. Electrocardiography (ECG), as a widely available, inexpensive, and simple modality is felt to be an attractive alternative in early detection of this abnormality. The ECG parameters on CSFP discussed in this study include; p-wave dispersion, QT interval dispersion, QRS intrinsic (Tpeak-Tenddeflection duration), and QRS fragmentation. Further studies are needed on the ECG image in CSFP so that in the future ECG can be a cheaper and non-invasive diagnostic modality for CSFP compared to coronary angiography.
Anemia in Chronic Kidney Disease : Role of Hypoxia Inducible Factor Stabilizer Emilia; Zulkhair Ali
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 5 No. 5 (2021): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32539/bsm.v5i5.234

Abstract

Anemia contributes to increased morbidity and mortality in chronic kidney disease patients. The pathogenesis of anemia in these patients is multifactorial, but the contribution of erythropoietin deficiency becomes greater as glomerular filtration rate declines which related to decreased nephron mass. The current standard of care includes supplemental iron, erythropoiesis-stimulating agents (ESA), and red blood cell transfusions, although each has drawbacks. Lately, concern has arisen following randomized clinical trials showing that higher hemoglobin targets and/or high ESA doses may cause significant harm including increasing cardiovascular and thrombotic events, and even death. Recent experimental and clinical studies show the promising efficacy of hypoxia inducible factor (HIF) stabilizer which stimulates endogenous erythropoietin production and enhance iron availability.
Maternal Death Cause by Antepartum Eclampsia, With HELPP Syndrome and AKI Stage III : A Preventable Recurrent Death Ferry Yusrizal; Fitria Koeshardani; Agustina H; Zulkhair Ali; Junaidi A
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 5 No. 11 (2021): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32539/bsm.v5i11.372

Abstract

Background: Eclampsia and severe preeclampsia is of the most frequent cause of maternal death. We usually find the case like this in our daily practice. The case most likely could be prevented. Eclampsia defined as a generalized seizure following preeclampsia in pregnancy. Eclampsia/Preeclampsia (EPH-Gestosis) cause a multisystem dysfunction such as HELLP syndrome, microangiopathy hemolytic anemia, liver dysfunction, and thrombocytopenia. Eclampsia and HELLP syndrome lead to maternal mortality, which happened mostly during third trimester. Most of the patient came to the hospital in a bad condition where the multi organs failure were exist. EPH-Gestosis are due to maternal death in 43,75%. Even the case usually severe, it’s a preventable death. A proper strategy is needed to reduce or to avoid the maternal death.Objective: To analyse a maternal death with eclampsia and how to prevent this recurrent death.Case Report: A woman, 30 years old, G2P1A0 32 weeks pregnant not in labor with antepartum eclampsia was admitted to Mohammad Hoesin General Hospital (MHGH) Palembang, a referral case. Patient experienced generalized seizure six times before coming to MHGH which every seizure duration is less than five minutes and unconscious. On physical examination, patient was conscious, with blood pressure of 160/100 mmHg, pale, and cold extremities. By ultrasound examination, it showed 34 weeks pregnancy with single life fetus. Laboratory examination showed leukocytosis (25.000/mm3), thrombocytopenia (58.000/mm3), hyperbilirubinemia, elevated SGOT and SGPT (1691 and 861 U/L), elevated creatinine serum (2,46 mg/dl), and elevated LDH (3629 U/L). The patient was treated based on the protocol for stabilization with intramuscular injection of MgSO4 40%, nifedipin 10 mg per oral, intravenous injection of dexamethasone 12 mg, and plan to terminate the pregnancy by caesarean procedure. The male baby was born, 2000 g weight and APGAR score 4/6/8. After the cesarean the consciousness not so well. Collaborating therapy to handle the case, with the anesthesiologist, internist and neurologist. Maternal death occurred in 3 days hospitalized …caused by multi organ failure (MOF). Conclusion: The maternal death caused by antepartum eclampsia and the complication. The diagnosis of antepartum eclampsia and HELLP syndrome was decided based on history taking, physical examination, and supporting examination. Multiple organ failure exist in this case when the patient came to MHGH. Patient already treated and tried to overcome the complication but maternal death still occurred. This maternal death has a likely same story of previous death pattern. It is needed a strategy to prevent or to reduce the maternal death and how to make a good effort to cease the case become severe or worst.
Co-Authors Abdul Hakim R Ade Yonata Ade Yonata, Ade Agustina H Akbar, M Yusuf Arief Ali Ghanie Alwi Shahab Devi, SNA Ratnasari Eddy Mart Salim Effendi, Ian Elfiani Elfiani Emilia Emilia Erial Bahar Erial Bahar Erial Bahar, Erial Erwin Sukandi Fadil Pramudya Ferry Usnizar Ferry Yusrizal Fitria Koeshardani Harun Hudari Huntari Harahap Ian Effendi Ian Effendi Indrajaya, Taufik Irfannuddin Irfannuddin Istiqomah, Amelia Junaidi A Kendenan, Margaretha kurniati, nova Kusrini, Ida Lidiawati Handayani M Yusuf Arief Akbar Mediarty Muhammad Irsan Saleh Muhammad Yusri Nova Kurniati Novadian Novadian Suhaimi Novadian Suhaimi R.M. Suryadi Tjekyan Radiyati Umi Partan Reinanda Marizki R RM Suryadi Tjekyan Rostika Dewi Shahab, Alwi SNA Ratnasari Devi Suhaimi, Novadian Suprapti Suprapti Taufik Indrajaya Taufik Indrajaya Yudhie Tanta