CURRENT INTERNAL MEDICINE RESEARCH AND PRACTICE SURABAYA JOURNAL
The scope for CIMRJ includes: Allergy, Endocrinology, Gastroenterology, Geriatrics, Hematology, Hepatology, Nephology, Rheumatology, Tropic.
Articles
50 Documents
<![CDATA[Tuberculous Lymphadenitis coexists with Non-Hodgkin Lymphoma ]]>
<![CDATA[Nenci Siagian]]>;
<![CDATA[Bramantono Bramantono]]>;
<![CDATA[Usman Hadi]]>
<![CDATA[ Current Internal Medicine Research and Practice Surabaya Journal Vol. 1 No. 2 (2020): CURRENT INTERNAL MEDICINE RESEARCH AND PRACTICE JOURNAL SURABAYA ]]>
Publisher : <![CDATA[Universitas Airlangga ]]>
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DOI: 10.20473/cimrj.v1i2.21458
<![CDATA[Tuberculous Lymphadenitis (TBLN) is most common extrapulmonary tuberculosis. The common symptom of TBLN is cervical lymphadenopathy which is known to mimic numerous pathological conditions like NHL. Coexistency TBLN and lymphoma is a rare. A woman, 56 years old, had chief complaint of cervical masses since 2 months ago. She had history of weight loss, fever and night sweats but no history of chronic cough. From physical examination and supporting examination, the patient was diagnosed with TBLN coexists with NHL. She got antituberculosis drug (ATD) for 2 weeks before chemotherapy. The patient died of septic shock 9 days later after chemotherapy. From HPE examination, TBLN and NHL may show simillar feature so Zhiel-Neelsen staining and Immunohistochemical are important to confirm each disease. ATD was given to supress the mycobacterium activity before chemotherapy. However the patient had febrile neutropenia after chemotherapy and died of septic shock. Both TBLN and NHL may occur with simillar sign and symptom and HPE. Further examinations have to be done to confirm the diagnosis of both disesases. Although ATD had given to prevent Tb infection progresivity. On 7 days after chemotherapy she had febrile neutropenia and lead to death due to septic shock.]]>
<![CDATA[A Female Patient With Clinical Symptoms as Recurrent Urinary Tract Infection Caused By Urinary Tract Tuberculosis ]]>
<![CDATA[Rastita Widyasari]]>;
<![CDATA[Artaria Tjempakasari]]>;
<![CDATA[Chandra Irwanadi Mohani]]>
<![CDATA[ Current Internal Medicine Research and Practice Surabaya Journal Vol. 1 No. 1 (2020): CURRENT INTERNAL MEDICINE RESEARCH AND PRACTICE JOURNAL SURABAYA ]]>
Publisher : <![CDATA[Universitas Airlangga ]]>
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DOI: 10.20473/cimrj.v1i1.16829
<![CDATA[Background : Urinary tract tuberculosis (TB) is one type of extrapulmonary TB. The prevalence in developed countries is around 15-20% of all cases of extrapulmonary TB.1 The insidious onset and non-specific constitutional symptoms of urinary tuberculosis often lead to delayed diagnosis and rapid progression to a non-functioning kidney.2-3 The only way to limit renal function loss and destruction is by early diagnosis and therapy.4Case: 34-year-old woman, came with complaints of urinary pain accompanied by right flank pain 10 months prior. Patient also had complaint of weight loss but ignoring complaints of night sweats. Patient repeatedly diagnosed as a urinary tract infection and received many kinds of antibiotic therapy but her complaints were not getting better. Urine production was about 1700 cc/24 hours. From general physical examination, there was a lack of nutritional status with BMI 17.1 kg/m2. Vesicular lung sound without rhonchi heard in both lung fields. From the urinalysis examination there were pyuria and haematuria without bacteriuri. Laboratory examination showed value of BUN was 17 mg/dl and creatinine 0.9 mg/dl. From aerob urine culture we found sterile urine. But we found positive result of Mycobacterium tuberculosis (MTB) urine cultures which was sensitive to isoniazid, rifampicin, pyrazinamide, and ethambutol. Abdominal ultrasound showed severe ecstasis of right pelviocalyceal system without stones,mass, nor cyst. We had additional data from intravenous pyelogram (IVP) which showed a non-visualized dextra pelviocalyceal system and delayed bladder emptying function at 120th minutes. From computed tomography stonographic, we found severe right hydronephrosis, proximal to distal right hydroureter, and thickening of bladder wall (± 1.61 cm) on the right antero-lateral side. To find out the cause of thickening of bladder wall, we did bladder biopsy which showed the mononuclear inflammatory cell stroma. Patients were diagnosed with urinary tract TB and received category 1 of oral anti tuberculosis therapy (Rifampicin, Isoniazid, Pyrazinamid, and Ethambutol) for 12 months and underwent right DJ stent implantation to manage the ectasys.Conclusion : Urinary tract TB often showed unspecified complaints and can be suggested as recurrent urinary tract infections. Early diagnosis and optimal management were needed to prevent anatomical and functional complications.]]>
<![CDATA[Medical Perioperative Management In Patient with Acute Kidney Disease ]]>
<![CDATA[Caesar Ayudi]]>;
<![CDATA[Nunuk Mardiana]]>
<![CDATA[ Current Internal Medicine Research and Practice Surabaya Journal Vol. 1 No. 2 (2020): CURRENT INTERNAL MEDICINE RESEARCH AND PRACTICE JOURNAL SURABAYA ]]>
Publisher : <![CDATA[Universitas Airlangga ]]>
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DOI: 10.20473/cimrj.v1i2.21459
<![CDATA[Bartter syndrome is inherited tubulopathy caused by mutations in several genes causing hypokalemia, hypomagnesemia, hypocalcemia with hypercalciuria, and metabolic alkalosis. Beside from inherited disorder, Bartter syndrome can be caused by the use of aminoglycosides, so it is called Bartter-like syndrome. Hypokalemia has been reported as a side effect of aminoglycosides in many studies, but Bartter-like syndrome due to aminoglycosides has only been reported in a few case reports. We report a 43 years old female patient who developed muscle weakness due to hypokalemia. We found the patient’s laboratory results was consistent with Bartter syndrome. The patient had MDR-TB and received combination therapy with capreomycin for two months. We diagnosed a patient with Bartter-like syndrome due to capreomycin. Following diagnosis, we discontinued capreomycin and started potassium, magnesium and calcium therapy. After electrolyte imbalances improved, capreomycin was given three times per week and the patient was no longer experiencing the same condition.]]>
<![CDATA[Calculation of Drug Dosage In Chronic Kidney Disease ]]>
<![CDATA[Tenta Hartian Hendyatama]]>;
<![CDATA[Nunuk Mardiana]]>
<![CDATA[ Current Internal Medicine Research and Practice Surabaya Journal Vol. 1 No. 1 (2020): CURRENT INTERNAL MEDICINE RESEARCH AND PRACTICE JOURNAL SURABAYA ]]>
Publisher : <![CDATA[Universitas Airlangga ]]>
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DOI: 10.20473/cimrj.v1i1.16894
<![CDATA[Kidneys are the main organ in fluid and electrolyte homeostasis. It also have an important role in eliminating various types of drugs. Drug elimination in the kidney is affected by plasma drug concentrations, plasma protein binding, and kidney function. Glomerular filtration rate (GFR) represents the kidney function. Thus by knowing it, drug dosage can be determined.Chronic kidney disease alter the effect of drug, some decrease drug effect but more often increase drug toxicity. Chronic kidney disease affect the pharmacodynamic and pharmacokinetic of drug. Therefore, providing an optimal treatment for CKD patient, knowledge of the pharmacokinetic and pharmacodynamic changing in CKD is needed.Exploring the patient's history and carrying out complete physical examination is important before giving the drug to patients with impaired kidney function. In addition, identifying drugs that have the potential to cause nephrotoxicity and drug interactions is also important.The body response to drugs in patient with CKD is very varied, complex, and individual. Dosage must be based on several factors, not only glomerular filtration rates but also other comorbid diseases, interactions with other drugs and clinical condition of the patient.]]>
<![CDATA[Critical Limb Ischemia In a Diabetes Mellitus Patient with Atrial Fibrilation ]]>
<![CDATA[Caesar Lagaliggo Givani]]>;
<![CDATA[Hermina Novida]]>
<![CDATA[ Current Internal Medicine Research and Practice Surabaya Journal Vol. 1 No. 2 (2020): CURRENT INTERNAL MEDICINE RESEARCH AND PRACTICE JOURNAL SURABAYA ]]>
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DOI: 10.20473/cimrj.v1i2.21472
<![CDATA[Critical Limb Ischemia (CLI) is a clinical syndrome in the form of ischemic pain, especially at rest or a tissue loss condition, such as an ulcer or gangrene that does not heal, associated with Peripheral Arterial Disease (PAD). Diabetes mellitus (DM) accelerates atherosclerosis and becomes one of the risks of PAD. It is also known to accelerate the worsening of PAD with a 4x greater risk of developing CLI compared to patients without DM. At the other side, 60-95% of patients who are operated on as a result of limb ischemia are diagnosed with atrial fibrillation (AF). This paper is a case report regarding a patient with CLI as a complication of DM and AF.]]>
<![CDATA[The Association between The Degree of Liver Cirrhosis Severity and Zinc Serum Level ]]>
<![CDATA[Budi Yuwono]]>;
<![CDATA[Ummi Maimunah]]>;
<![CDATA[Budi Widodo]]>
<![CDATA[ Current Internal Medicine Research and Practice Surabaya Journal Vol. 1 No. 1 (2020): CURRENT INTERNAL MEDICINE RESEARCH AND PRACTICE JOURNAL SURABAYA ]]>
Publisher : <![CDATA[Universitas Airlangga ]]>
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DOI: 10.20473/cimrj.v1i1.16996
<![CDATA[Background: Impaired liver function in LC (Liver Cirrhosis) can cause Zinc deficiency (Zn). One of the causes of Zn deficiency in LC is decreased albumin synthesis, whereas albumin is required as the main Zn binding protein in plasma. However, some studies of the severity of LC with Zn serum levels still provide controversial results.Objective: To determine the association between the degree of LC severity and Zn serum level.Methods: The subjects of this study were LC patients in Gastroentero-Hepatology Unit and Internal medicine wards in of Dr. Soetomo General Hospital Surabaya for three months. Diagnosis of LC was based on clinical examination according to Soehardjno-Soebandiri criteria and other findings (ultrasound or endoscopy). The degree of LC severity was determined based on the CTP score (Child-Turcotte-Pugh). Serum Zn concentration was measured by atomic absorption spectrophotometry method. The research design used the cross-sectional method. The statistical test used was Spearman correlation.Results: Forty-three patients fulfilled the study criteria. The subjects consisted of 27 males (62.8%) and 16 females (37.2%) with the mean age of 53.81 ± 8.67 years. Based on the CTP scores, we obtained CTP A of 4 patients (9.3%), CTP B of 19 patients (44.2%) and CTP C of 20 patients (46.5%). The mean of Zn serum level in CTP A, CTP B, and CTP C score was 58.3 ± 19.6 μg/dl, 43.4 ± 14.5 μg/dl and 31.6 ± 10 μg/dl respectively. The result of the statistical test showed a significant correlation between LC severity and Zn serum level (p <0.05 and r = -0.583).Conclusion: The heavier the severity of LC, the lower Zn serum levels.]]>
<![CDATA[Bartter-like Syndrome In a Patient Receiving Capreomycin For The Treatment Of Multidrug-Resistant Tuberculosis ]]>
<![CDATA[Rusdi Zakki Aminy]]>;
<![CDATA[Nunuk Mardiana]]>
<![CDATA[ Current Internal Medicine Research and Practice Surabaya Journal Vol. 1 No. 2 (2020): CURRENT INTERNAL MEDICINE RESEARCH AND PRACTICE JOURNAL SURABAYA ]]>
Publisher : <![CDATA[Universitas Airlangga ]]>
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DOI: 10.20473/cimrj.v1i2.21555
<![CDATA[Bartter syndrome is inherited tubulopathy caused by mutations in several genes causing hypokalemia, hypomagnesemia, hypocalcemia with hypercalciuria, and metabolic alkalosis. Beside from inherited disorder, Bartter syndrome can be caused by the use of aminoglycosides, so it is called Bartter-like syndrome. Hypokalemia has been reported as a side effect of aminoglycosides in many studies, but Bartter-like syndrome due to aminoglycosides has only been reported in a few case reports. We report a 43 years old female patient who developed muscle weakness due to hypokalemia. We found the patient’s laboratory results was consistent with Bartter syndrome. The patient had MDR-TB and received combination therapy with capreomycin for two months. We diagnosed a patient with Bartter-like syndrome due to capreomycin. Following diagnosis, we discontinued capreomycin and started potassium, magnesium and calcium therapy. After electrolyte imbalances improved, capreomycin was given three times per week and the patient was no longer experiencing the same condition.]]>
<![CDATA[Comparison Of The Function Of Neutrophil Cells Oxidative Burst Among Various Group Ages ]]>
<![CDATA[Dwi Setyawan]]>;
<![CDATA[Gatot Sugiarto]]>;
<![CDATA[Novira Widajanti]]>
<![CDATA[ Current Internal Medicine Research and Practice Surabaya Journal Vol. 1 No. 1 (2020): CURRENT INTERNAL MEDICINE RESEARCH AND PRACTICE JOURNAL SURABAYA ]]>
Publisher : <![CDATA[Universitas Airlangga ]]>
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DOI: 10.20473/cimrj.v1i1.17091
<![CDATA[Background: In old ages there is a change in the immune system along with the aging process called the term immunosenescence. Neutrophil cells play an important role in natural immunity because they are the first immune cells to be deployed in the body's defenses.Objective: To prove that there is a difference in the function of neutrophil cell oxidative burst in older age group compared with the younger age group as well as the tendency of decreased oxidative burst function of neutrophil cells with increasing age.Method: This is a cross-sectional observational analytic study involving 48 healthy subjects. The subjects were divided into 3 age groups: young age (18-40 years old), middle age (41-59 years old), and old age ≥60 years old). Each of them were examined for the function of neutrophil cells oxidative burst. The data were then analyzed using one-way ANOVA test. The result was considered significant if p<0.05.Results: The obtained mean age 59.26±8.03 years old. The mean age for young age group was 28.75±6.66 years old. The mean of middle age group was 50.19±5.46 years old. The mean age of old group was 66.38±3.83 years old. The mean of netrofil oxidative burst cell function was 96.83±2.7% with mean of young age being 98.57±0.98%, middle age 97.71±1.64%, and old age 94.20±3.56%. One way ANOVA comparison analysis showed a significant difference with p = 0.000 (significant when p <0.05). The result of Rank Spearman test showed significant result with r=-0.590 (p=0.000).Conclusion: There are differences in the function of neutrophil cells oxidative burst between young and old age groups. There is a negative trend between the age group and the function of neutrophil cell oxidative burst. The increase of age causes decrease in the function of neutrophil cells oxidative burst.]]>
<![CDATA[Adrenal Incidentaloma In Patient with Bilateral Nephrolithiasis and Infectef Right Kidney Cyst ]]>
<![CDATA[kholidatul husna]]>;
<![CDATA[Hermina Novida]]>
<![CDATA[ Current Internal Medicine Research and Practice Surabaya Journal Vol. 1 No. 2 (2020): CURRENT INTERNAL MEDICINE RESEARCH AND PRACTICE JOURNAL SURABAYA ]]>
Publisher : <![CDATA[Universitas Airlangga ]]>
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DOI: 10.20473/cimrj.v1i2.21557
<![CDATA[Adrenal incidentaloma (AI) is a rare case, with a prevalence of 3-7% in the general population. We report a case of a 66 year old female, presented with the history of bilateral flank pain. The patient was performed urologic evaluation due to suspicion of right perirenal abscess and left kidney tumor, and from abdominal CT scan it was found suprarenal mass. There were no signs and symptoms of hormonal hyperfunction. Radiological evaluation in the patient showed the present of malignant lesion. Therefore, adrenalectomy was planned. Before undergoing adrenalectomy, the patient had passed away 6 days after first surgery (right pyelolitotomy and unroofing cyst), with septic shock suspected as cause of death due to hospital-acquired pneumonia.]]>
<![CDATA[Several Factors Associated With Nitrogen Balance In Elderly Patients ]]>
<![CDATA[Zurriyani Zurriyani]]>;
<![CDATA[Jusri Ichwani]]>;
<![CDATA[Novira Widajanti]]>
<![CDATA[ Current Internal Medicine Research and Practice Surabaya Journal Vol. 1 No. 1 (2020): CURRENT INTERNAL MEDICINE RESEARCH AND PRACTICE JOURNAL SURABAYA ]]>
Publisher : <![CDATA[Universitas Airlangga ]]>
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DOI: 10.20473/cimrj.v1i1.16828
<![CDATA[BackgroundNitrogen balance is the method used to assess the protein adequacy. A negative nitrogen balance means that the body suffers from protein energy malnutrition.ObjectiveTo determine the risk factors that associated with nitrogen balance in the elderly patients who were inpatient in IRNA Internal Medicine Dr.Soetomo Hospital.MethodsThe experimental design of the research used was analytic observational with the cross-sectional design. The study was conducted of 50 elderly patients. Risk factors measured were protein intake using food recall and nitrogen excretion that expressed in Urea Nitrogen Urine (gr / 24 h). The nitrogen balance was derived from the difference between nitrogen intake and nitrogen excretion in 24 hours. Bivariate data analysis using Chi square or exact fisher test, while multivariate data analysis using logistic regression test.ResultsIn bivariate analysis, risk factors significantly associated with negative nitrogen balance were decreased renal function (LFG <90 ml / min / 1.73 m2), prolonged bed rest> 7 days and malnutrition. Other risk factors not significantly associated with negative nitrogen balance were diabetes mellitus, random blood sugar> 180 mg / dl, hypoalbumin and CRP> 6 mg / dl. In multivariate analysis showed the decrease of renal function and duration of bed rest > 7 days was significant.ConclusionThe decreased renal function and bed rest for more than 7 days was a risk factor for protein malnutrition in elderly patients.]]>
