Ummi Ulfah Madina, Ummi Ulfah
Department of Internal Medicine, Faculty of Medicine University of Indonesia/Dr. Cipto Mangunkusumo General Hospital, Jakarta

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Blood Transfusion Strategy in Gastrointestinal Tract Bleeding: Liberal or Restrictive Madina, Ummi Ulfah; Abdullah, Murdani
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 15, No 3 (2014): VOLUME 15, NUMBER 3, December 2014
Publisher : The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (0.036 KB) | DOI: 10.24871/1532014177-181

Abstract

Gastrointestinal tract bleeding is an emergency problem, which is frequently found. The manifestations of gastrointestinal tract bleeding vary, ranging from massive bleeding which is life threatening until occult bleeding that is not sensed by the patient. One of the main objectives in the management of gastrointestinal tract bleeding is stabilizing patient’s hemodynamic, either by using infusion of crystalloid, colloid, or even with the administration of blood transfusion. In massive gastrointestinal tract bleeding, administration of red blood cells transfusion may be life saving. However, in cases where bleeding is not profuse, the safest and most effective blood transfusion strategy is still controversial. Until now, there is no trial that gives information regarding safety and effectiveness of liberal or restrictive transfusion strategy in lower gastrointestinal tract bleeding. However, for most patients with gastrointestinal bleeding, with or without portal hypertension, it is better to postpone blood transfusion until the hemoglobin level decrease to less than 7 g/dL.Keywords: gastrointestinal tract bleeding, blood transfusion, liberal, restrictive
Predictors of Handgrip Strength Changes in Elderly Patients Madina, Ummi Ulfah; Setiati, Siti; Laksmi, Purwita Wijaya; Mansjoer, Arif
Jurnal Penyakit Dalam Indonesia Vol. 8, No. 3
Publisher : UI Scholars Hub

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Abstract

Introduction. The increasing elderly population throughout the world has been related to the increased prevalence of sarcopenia and frailty. Handgrip strength is a component of sarcopenia, one of frailty syndrome phenotypes. Previous studies have assessed the association of age, sex, nutritional status, functional status, mental status, and comorbidity, but varied results. No longitudinal study has been done to determine the correlation of handgrip strength changes with age, sex, nutritional status, functional status, mental status, and comorbidity in Indonesia. The aim of this study was to determine the correlation between age, sex, nutritional status, functional status, depressive symptoms, comorbidity, and handgrip strength changes in elderly patients. Methods. A prospective cohort study using secondary data of elderly patients who were routinely visiting Geriatric OutPatients Clinic at Cipto Mangunkusumo Hospital, Jakarta, from the INA-FRAGILE register observed for one year (2013- 2014). The multivariate logistic regression analysis was used to assess the correlation between sex, age, nutritional status (MNA score), functional status (ADL score), depressive symptoms (GDS-SF score), comorbidities (CIRS score), and handgrip strength changes. Results. From 162 subjects which were included in the study, the mean age was 72.9 (SD 5.9) years, predominantly female (57.41%), with good nutrition (83.9%), independent (median 9- 20), not depressed (median 0-11), has average comorbidity index 11.8 (SD 3.7), and 53.1% experienced decreased handgrip strength. Nutritional status (OR = 2.7, p = 0.033) and comorbidity (OR 0.3, p <0.002) correlated with handgrip strength changes
Elderly Mistreatment: Risk Factors and Therapy Madina, Ummi Ulfah; Dwimartutie, Noto
Jurnal Penyakit Dalam Indonesia Vol. 3, No. 1
Publisher : UI Scholars Hub

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Abstract

Elderly mistreatment is a preventable serious health problem that lowering older adults quality of life. Elderly mistreatment can be done by the caregiver or even the patient himself, regardless the intention. Meanwhile, defining an elderly mistreatment is still a challenge due to varied risk factors and cultural differences in each country. Those conditions result in challenges in identifying and managing elderly mistreatment. This review will also discuss screening modalities to identify elderly who is at risk or currently abused to prevent and manage elderly mistreatment properly.