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Jurnal Penyakit Dalam Indonesia
Published by Universitas Indonesia
ISSN : 24068969     EISSN : 25490621     DOI : https://doi.org/10.7454/
Core Subject : Health,
Medicine & Pharmacology
Jurnal Penyakit Dalam Indonesia contains the publication of scientific papers that can fulfill the purpose of publishing this journal, which is to disseminate original articles, case reports, evidence-based case reports, and literature reviews in the field of internal medicine for internal medicine and general practitioners throughout Indonesia. Articles should provide new information, attract interest and be able to broaden practitioners insights in the field of internal medicine, as well as provide alternative solutions to problems, diagnosis, therapy, and prevention.
Arjuna Subject : Kedokteran - Kedokteran Internal
Articles 9 Documents
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Search results for , issue "Vol. 11, No. 1" : 9 Documents clear
Infark Ventrikel Kanan dengan Blok Atrioventrikular: Laporan Kasus dengan Tinjauan Pustaka Dalimunthe, Naomi Niari; Hasan, Refli; Ahmad, Herwindo; Isnanta, Rahmad; Realsyah, T; Safri, Zainal
Jurnal Penyakit Dalam Indonesia Vol. 11, No. 1
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Inferior myocardial infarction is frequently accompanied by right ventricular infarction. This report presents two cases of right ventricular infarction accompanied by hemodynamic disorder and atrioventricular block complications. These patients were diagnosed with right ventricular infarction based on history, clinical presentations, and electrocardiography findings. The management approach for these patients involved optimizing volume and fluid status, using temporary pacemakers, and urgent percutaneous coronary intervention. This report highlights the need to promptly identify right ventricular involvement in inferior myocardial infarction, as the treatment strategies for right ventricular infarction are different from left ventricular infarction.
Hubungan Rasio Neutrofil Limfosit terhadap Komplikasi Kardiovaskular pada Pasien Penyakit Ginjal Kronik Hemodialisis Akmal, Thariq Hikmatul; Susanto, Agung; Dewi, Ratih Tri Kusuma; Sunggoro, Agus Jati
Jurnal Penyakit Dalam Indonesia Vol. 11, No. 1
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Introduction. The neutrophil-to-lymphocyte ratio (NLR) is a simple parameter to assess the inflammatory status, especially in chronic kidney disease (CKD) patients experiencing capillary damage due to increased glomerular capillary pressure. In a state of vascular endothelial inflammation, there is a higher tendency to form atherosclerotic plaques and calcification that can induce cardiovascular events such as heart failure, coronary heart disease, and stroke. This study aimed to determine the relationship between the NLR and cardiovascular complications in CKD patients undergoing hemodialysis. Methods. An analytical observational study with cross-sectional approach was conducted among 119 CKD patients undergoing hemodialysis at Dr Moewardi Regional Hospital who met the inclusion and exclusion criteria. The relationship between the two variables was analyzed using Fisher exact test. Results. The majority of subjects in this study were male (51.3%) and were aged over 50 years old (63.9%). Most subjects experienced complications of heart failure (54.6%), followed by coronary heart disease (19.3%), and stroke (17.7%). Analysis of complete blood count data showed a mean neutrophil count of 77.20% (SD 11.49), lymphocytes 13.64% (SD 8.23), and NLR 10.7 (SD 10.3). Notably, a majority of participants exhibited an NLR value ≥3.5, observed in 95 individuals (79.8%). Fisher exact test results indicated a significant relationship between elevated NLR and cardiovascular complications in hemodialysis CKD patients (p-value= 0.028). Conclusion. There is a significant relationship between NLR and cardiovascular complications in CKD patients undergoing hemodialysis.
Hubungan Tingkat Stres, Kecemasan, dan Depresi dengan Konstipasi Fungsional pada Mahasiswa Kedokteran Z, Khafifah; Wilson, Wilson; Tejoyuwono, Agustina Arundina Triharja
Jurnal Penyakit Dalam Indonesia Vol. 11, No. 1
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Introduction. Stress, anxiety, and depression are factors associated with functional constipation that affect students’ quality of life. Stress, anxiety, and depression are often experienced by first-year medical students, but studies assessing these three variables with functional constipation are still limited. Methods. This study used a cross-sectional analytical design. Study was carried out in July 2023 involving 88 first-year medical students from the Tanjungpura University Medical Study Program. Analysis of relationship tests was carried out using Kendall’s Tau-B tests. Results. Most students were in the normal category of stress, anxiety and depression levels, however 21 students were in mild to severe stress levels, 46 students were in mild to very severe anxiety levels, and 19 students were in mild to severe depression levels. Based on the assessment of functional constipation according to ROME IV, 20 students (22.73%) experienced functional constipation. There was a significant association between stress level (p=0.001), anxiety level (p=0.041), and depression (p=0.006) with functional constipation. Conclusion. There is a correlation between stress, anxiety and depression that influence functional constipation. Among first-year medical students at Tanjungpura University.
Efektivitas Terapi Antituberkulosis Empirik pada Pasien dengan Penyakit HIV Stadium Lanjut: Sebuah Laporan Kasus Berbasis Bukti Chandra, Natasha; Elita, Dina; Yunihastuti, Evy
Jurnal Penyakit Dalam Indonesia Vol. 11, No. 1
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Patients with advanced human immunodeficiency virus (HIV) disease have a high risk of mortality, with tuberculosis (TB) being one of the leading causes. Empiric antituberculosis therapy could be considered as a strategy to reduced mortality although there is no strong evidence. This study aims to review the efficacy of empiric antituberculosis therapy in patient with advanced HIV disease compared to isoniazid prophylaxis therapy and assessed with mortality as outcome. A 46- year old male patient with advanced HIV disease on antiretroviral therapy (ARV) and liver cirrhosis was admitted to hospital due to difficulties in sleeping and walking. During hospitalization he had seizure followed by decreased consciousness hence TB meningitis was suspected. Latest laboratory results showed CD4 count of 132 cells/mm3 and negative TB examinations. He was given empiric antituberculosis therapy but later died during hospitalization. A systematic literature searching was conducted in PubMed, ScienceDirect, Scopus, Cochrane, and EMBASE using keywords according to clinical question resulting in 69 studies. Study selection was conducted according to eligibility criteria and two studies with open-label randomized trial design were selected. Eligible studies were critically appraised using the Oxford Center for Evidence-Based Medicine Critical Appraisal Worksheet. Both studies had good validity. In patients with advanced HIV disease, mortality at week 24 was 5.2% (95%CI 3.5-7.8%) in empiric antituberculosis therapy group and 5.2% (95%CI 3.4-7.8%) in isoniazid prophylaxis therapy group, with an absolute risk difference of -0.06% (95%CI −3.05-2.94%; p=0.97). Meanwhile, mortality at week 96 was 10.1% (95%CI: 7.5- 13.6%) in empiric antituberculosis therapy group and 10.5% (95%CI 7.9-13.9%) in isoniazid prophylaxis therapy group, with absolute risk difference of 0.4% (95%CI −3.8-4.6%; p=0.86). Based on critical appraisal on both studies, it can be concluded that empiric antituberculosis therapy is not effective in significantly reducing mortality compared to isoniazid prophylaxis therapy in patients with advanced HIV disease.
Gambaran Klinis Pasien Terduga Tuberkulosis Paru Resisten Obat (TB-RO) dengan Kolonisasi Candida sp. di Rumah Sakit Hasan Sadikin Bandung Zalfa, Hasna Rafifah Zahira; Kulsum, Iceu Dimas; Suryadinata, Hendarsyah; Chrysanti, Chrysanti; Dewi, Intan Mauli Warma
Jurnal Penyakit Dalam Indonesia Vol. 11, No. 1
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Introduction. Candida sp. is a fungus that lives as a commensal in human body, but may cause infection upon immune suppression. The decrease in immunity due to TB infection and long-term use of antibiotics in TB patients may increase the risk of the Candida sp. colonization in patient. Data regarding the prevalence of Candida sp. colonization in TB patients and its impact has not been widely reported. This study was conducted to determine the prevalence and clinical characteristics of presumptive drug-resistance TB patients with Candida sp. colonization. Methods. A cross-sectional study was conducted using secondary data from a previous study in 2018 at the DR-TB clinic in Hasan Sadikin General Hospital Bandung, Indonesia. Patients who were included in the study were aged 18 years or above, presented with pulmonary TB symptoms, and had minimum 5 months of TB treatment history. Candida sp. growth on sputum was examined by culture on CHROMagar® media. Results. One hundred and twenty-two patients met the inclusion and exclusion criteria. The prevalence of Candida sp. colonization in presumptive drug-resistance TB patients was 54.9%. The species found were mostly Candida albicans (71.6%), Candida glabrata and Candida parapsilosis (14.9%), and Candida tropicalis (5.9%). The predominant symptoms of pulmonary tuberculosis included a persistent cough lasting two weeks or longer and productive cough (100%), while the most frequently observed abnormalities on radiological scans were nodules and patchy lesions (98.5%). There were no significant differences between patients with positive and negative Candida sp. colonization. Conclusions. More than 50% of presumptive drug-resistant TB patients at the MDR-TB clinic in Hasan Sadikin General Hospital had positive results of Candida sp. culture on their sputum. The most common clinical manifestations were coughing for 2 weeks or more, productive cough, hemoptysis, fever, chest pain, shortness of breath, night sweats, weight loss, and reduced appetite. Future studies should be conducted to determine the long-term outcome of fungal colonization in these patients.
Etika Publikasi di Bidang Kedokteran Jasirwan, Chyntia Olivia Murine; Faisal, Edward; Yunihastuti, Evy
Jurnal Penyakit Dalam Indonesia Vol. 11, No. 1
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Publikasi ilmiah merupakan penjelasan sistematis mengenai hipotesis, bukti, dan kesimpulan dari sebuah penelitian yang dimaksudkan untuk mengedukasi masyarakat. Publikasi merupakan tujuan utama dari penelitian, dan peer-review dilakukan untuk memverifikasi temuan dan meningkatkan kepercayaan penulis untuk evaluasi penelitian yang dipublikasi. Publikasi merupakan salah satu persyaratan khusus dalam suatu institusi akademik dan dapat mendukung promosi ke jabatan akademis. Publikasi (nasional dan internasional) telah menjadi norma yang dapat dikatakan wajib dalam dunia pendidikan. Berbagai pelanggaran etika banyak terjadi dan kita temukan, seperti plagiarisme, tata bahasa yang tidak pantas, dan praktik pengelolaan data yang meragukan. Kurangnya pemahaman tentang etika penelitian seringkali menjadi akar dari masalah ini.
Faktor-Faktor yang Memengaruhi Kualitas Hidup Pasien Gagal Jantung Kronik Fraksi Ejeksi Terjaga (HFpEF) Rawat Jalan di RSUPN Dr. Cipto Mangunkusumo Pratama, Derin Anugrah; Nasution, Sally Aman; Muhadi, Muhadi; Mansjoer, Arif; Alwi, Idrus; Purnamasari, Dyah; Lydia, Aida; Tahapary, Dicky Levenus
Jurnal Penyakit Dalam Indonesia Vol. 11, No. 1
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Introduction. The prevalence of heart failure in Indonesian adults is 1.5%, at least half of which categorized as heart failure with preserved ejection fraction (HFpEF). Quality of life assessment plays an important role in the management of heart failure, one of the tools widely used is the Minnesota Living with Heart Failure (MLHF) questionnaire. In Indonesia, there is still no data regarding risk factors that affect the quality of life of HFpEF patients. This study aimed to determine the quality of life profile of HFpEF patients and the relationship between the risk factors (age, hypertension, DM, smoking, and obesity) on the quality of life of HFpEF patients. Methods. A cross-sectional study was conducted. Data was collected from adult HFpEF (based on echocardiography in the last 6 months) patients (>18 years old) who visited the Cardiology Clinic at Cipto Mangunkusumo Hospital from January 2022 to December 2023. Quality of life was measured using the MLHF questionnaire. Bivariate analysis was performed to find the relationship between risk factors (age, gender, hypertension, DM, smoking, and obesity) and patients’ quality of life. Multivariate analysis was performed for hypertension, DM, gender, and age variables. Results. Out of 206 subjects, 72.33% of patients were dominant in the physical domain items, and 27.67% of patients were dominant in the emotional domain items. The majority of patients dominant in physical items had overall good quality of life. The majority of patients dominant in emotional items also had good quality of life. No significant relationship was found between the dominant domain item and the quality of life in HFpEF patients. We also found that there was no significant relationship between socio-demographic factors and risk factors for dominant domain items. However, there was a significant relationship between age (p=0.005), gender (p=0.001), and smoking history (p=0.001) with the quality of life in HFpEF patients. Adult patients had a poorer quality of life compared to elderly patients (OR= 0.33 [95% CI 0.17-0.66]). No significant relationship was found between hypertension, diabetes mellitus, dyslipidemia, and obesity with the quality of life in HFpEF patients. Conclusions. There is a statistically significant relationship between age, gender, and smoking history with the quality of life in HFpEF patients. Meanwhile, there is no significant relationship between hypertension, diabetes mellitus, and obesity with the quality of life in HFpEF patients.
Evaluasi Pengukuran Kekakuan Limpa dalam Memprediksi Perdarahan Varises Esofagus Berulang pada Pasien Sirosis Hati Tahir, Andi Cahaya; Kurniawan, Juferdy; Simadibrata, Marcellus; Rizka, Aulia; Shatri, Hamzah; Lesmana, Cosmas Rinaldi A.; Mulansari, Nadia Ayu
Jurnal Penyakit Dalam Indonesia Vol. 11, No. 1
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Introduction. Esophageal variceal bleeding is one of the complications caused by an increase in pressure within the portal vein blood vessels. The gold standard examination for portal pressure is the hepatic venous pressure gradient (HVPG), but HVPG examination is invasive, involving transjugular catheterization of the hepatic vein. Currently, non-invasive methods for measuring portal hypertension are being developed to predict esophageal varices and esophageal variceal bleeding using spleen stiffness measurements. This study aimed to evaluate the accuracy of spleen stiffness measurement in predicting recurrent esophageal variceal bleeding in patients with liver cirrhosis. Methods. This study used a retrospective cohort design with secondary data sourced from medical records at Cipto Mangunkusumo Hospital. Spleen stiffness assessment was conducted using the vibration controlled transient elastography (VCTE) spleen-dedicated stiffness measurement (FibroScan®, Echosens, France) with a frequency of 100Hz. After six weeks post-first esophageal variceal bleeding in liver cirrhosis patients, an evaluation of recurrent esophageal variceal bleeding was performed. The collected data were analyzed using SPSS 26. The ability of spleen stiffness measurement to predict recurrent esophageal variceal bleeding was assessed by evaluating the AUROC (area under the curve of receiver operating characteristic) curve. Results. A total of 102 liver cirrhosis patients who experienced first-time esophageal variceal bleeding were included in the study. Recurrent esophageal variceal bleeding was found in 23/102 (22.5%) liver cirrhosis patients. There was a significant difference in spleen stiffness values between the two groups, with higher values in the group of patients with recurrent esophageal variceal bleeding (90.9 kPa (IQR: 86.5 – 96.2) vs. 59.3 kPa (IQR: 45.2 – 74.3), p < 0.001). The AUC value of spleen stiffness for predicting recurrent esophageal variceal bleeding provided good predictability, with an AUC value of 0.898 (95% CI 0.808 – 0.988), p < 0.001. The cut-off value of spleen stiffness at 70 kPa yielded a sensitivity of 87% and specificity of 65% in predicting recurrent esophageal variceal bleeding. Conclusion. Spleen stiffness measurement can be beneficial as an evaluation method to assess the likelihood of recurrent esophageal variceal bleeding in patients with liver cirrhosis at the 6th week after the first bleeding episode.
Program Multidisiplin Pasien Gagal Jantung Kronik untuk Menurunkan Angka Perawatan Ulang Rumah Sakit Lusiani, Lusiani; Adnan, Nurhayati
Jurnal Penyakit Dalam Indonesia Vol. 11, No. 1
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Heart failure is a complex disease caused by abnormalities in the structure or function of the heart resulting in decreased cardiac output. The complexity of heart failure causes an increasing burden of mortality and morbidity. This has further exacerbated the burden of treatment costs as well as the high rate of hospital readmissions. Readmission rate in patients with heart failure within 30 days post-hospitalization can reach 17.5%. In order to reduce re-hospitalization rates, multidisciplinary programs were introduced. The program involves collaboration of cardiologists, specialty nurses, pharmacists, nutritionists, and social workers using home or clinic-based models. Studies show that special management programs with a multidisciplinary approach can reduce re-hospitalization, mortality, and morbidity in heart failure patients. Multidisciplinary programs can also increase the level of medication adherence in heart failure patients. Therefore, multidisciplinary programs can be considered as one of the main lines in the management of heart failure.

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