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INDONESIA
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
 1 
Search results for , issue "Vol. 4, No. 4" : 9 Documents clear
Validity of Simple Risk Index and Evaluation of Methods andManagement of Acute Coronary Events to Predict Mortality inAcute Coronary Syndrome Patients in Intensive Coronary CareUnit Cipto Mangunkusumo Hospital Meutia, Rahmah Safitri; Nasution, Sally Aman; Makmun, Lukman H
Jurnal Penyakit Dalam Indonesia Vol. 4, No. 4
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Introduction. Risk stratification is an important part in the management of patients with an Acute Coronary Syndrome (ACS) to avoid overtreatment or undertreatment. Although Simple Risk Index (SRI) and Evaluation of Methods and Management of Acute Coronary Events (EMMACE) have been validated in other countries, no study of its applicability has been performed in Indonesia with different patients’ characteristics. This study aims to obtain the calibration and discrimination performance of SRI and EMMACE to predict 30 days mortality in ACS patients in ICCU of Cipto Mangunkusumo Hospital. Methods. A retrospective cohort study with consecutive sampling was conducted in ACS patients hospitalized in the ICCU Cipto Mangunkusumo hospital between the period of 2003 up to 2010. Data analyzed performed by SPPS program for Windows Version 17. The discrimination performance was explained using a value of area under the receiver-operator curve (AUC) while calibration performance was evaluated using hosmer lemeshow and plot calibration. Results. A total of 922 patients were included in this study consisted of 453 STEMI patients, 234 NSTEMI patients and 235 UAP patients. Simple Risk Index (SRI) score for STEMI had presentable discrimination and calibration performance (AUC= 0,92; R2 = 0,98; and p value= 0,01). Simple Risk Index (SRI) score for overall ACS also showed sufficient performance and calibration discrimination (AUC= 0,87; R2 = 0,99; and p value= 0,52). Meanwhile, EMMACE score in ACS patients showed satisfactory performance discrimination (AUC= 0,87), but the calibration perfomance was not as satisfactory as the SRI score with the calibration plot (R2 )= 0,54 (p value= 0,52). Conclusions. Simple Risk Index (SRI) score shows a satisfactory discrimination and calibration performance both in STEMI and overall ACS patients in predicting mortality of ACS patients in ICCU Cipto Mangunkusumo Hospital. Evaluation of Methods and Management of Acute Coronary Events (EMMACE) score, nonetheless, displays sufficient discrimination performance, but poor performance of calibration.
The Relationship between Age and Activity of Daily Living withthe Fall Risk of Patients in Geriatric Outpatient Installation Deniro, Agustin Junior Nanda; Sulistiawati, Nuniek Nugraheni; Widajanti, Novira
Jurnal Penyakit Dalam Indonesia Vol. 4, No. 4
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Introduction. Fall is one of the physical problems that happened quite frequently and resulted in morbidity and mortality of old people. There are several factors related to fall risk, among others are age and independence in activity of daily living. Methods. This research is an observational analytical study with cross sectional approach, by collecting free variable data (age and activity of daily living) through interview and Barthel index score, dependent variable (fall risk) by direct observation using Timed Up and Go test that analyzed by Rank Spearman correlation test. The number of samples with incidental sampling technique was 55 patients in Geriatric Outpatient Installation RSUD Dr Soetomo Surabaya for the period of August – October 2017. Results. Bivariate analysis showed that there was a correlation between age and fall risk (r = 0.334, p <0.05) and there was a relationship between activity of daily living with fall risk (r = - 0.460, p <0.05 ) of patient in Geriatric Outpatient Installation RSUD Dr Soetomo Surabaya period August - October 2017. Conclusion. There is a significantly low and equivalent relationship between age and fall risk and significantly low and unequal relationship between activity of daily living and fall risk of patients in Geriatric Outpatient Installation RSUD Dr Soetomo Surabaya for the period of August – October 2017.
Predictor Factors Affecting Seroconversion Post-InfluenzaVaccination in the Elderly Nursyirwan, Saskia Aziza; Koesnoe, Sukamto; Wahyudi, Edy Rizal
Jurnal Penyakit Dalam Indonesia Vol. 4, No. 4
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Introduction. The influenza vaccine as the most effective method for preventing influenza virus infection currently has lower efficacy in the elderly than younger adults due to change of immune response as well as other risk factors. This study aims to identify predictor factors affecting seroconversion post-influenza vaccination in elderly. Methods. retrospective cohort study in the elderly population in East Jakarta Posyandu who got the influenza vaccine. A total of 277 subjects with antibody titre pre and one month post-vaccination influenza were examined. Risk factors such as age, gender, exercise status, smoking status, type 2 diabetes, pulmonary, and cardiovascular disease, nutritional status of MNA (Mini Nutritional Assessment), GDS (Geriatric Depression Scale), and pre-vaccination antibodi titre were assessed in each subject. Results. The proportion of elderly people who seroconverted (fourfold rise or more in antibody titer post-vaccination) was 50.9% (141/277). On multivariate analysis, the predictor factors that affect seroconversion of one month post- influenza vaccination in the elderly on the community is a no depression state (p = 0.048, OR = 2.1, CI = 1.01 to 4.30), exercise status ≥5 times per week minimal 30 minutes (p = 0.013, OR 4.0, CI 1.34 to 11.76), and not seroprotective pre-vaccination (p=0.000, OR 6.4, CI 3.40 to 11.99). Conclusion. Predictor factors affecting seroconversion post-influenza vaccination in the elderly on the community is depression status, exercise status and pre-vaccination antibody titre.
Vaksinasi pada Lansia Rengganis, Iris
Jurnal Penyakit Dalam Indonesia Vol. 4, No. 4
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The Patterns of Primary Cotrimoxazole Prophylaxis in Adult HIVPatients in HIV Integrated Clinic Cipto Mangunkusumo HospitalJakarta in 2004-2013 Mastini, Ken Ayu; Djoerban, Zubair; Yunihastuti, Evy
Jurnal Penyakit Dalam Indonesia Vol. 4, No. 4
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Introduction. Low rate use of cotrimoxazole which is a standard of primary prevention against toxoplasmosis infection and Pneumocystis jirovecii pneumonia (PCP) in patients with CD4 <200 cell>/mm3 was found. This study aims to describe prescription pattern of cotrimoxazole primary prophylaxis in adult HIV patients in RSCM. Methods. A cohort retrospective study was conducted in HIV Integrated Clinic Cipto Mangunkusumo Hospital patients from 2004 to 2013. Individuals were eligible for this study if they were ≥18 years old and had indication of primary cotrimoxazole prophylaxis. Variable analyzed in this study were initiation, discontinuation, dosage, duration, duration percentage, and adverse events of primary cotrimoxazole prophylaxis. Results. A total of 3.818 patients had indication of primary cotrimoxazole prophylaxis. Initiation of primary cotrimoxazole prophylaxis was performed in 83% patients who met indication. Total od 99,8% patients used appropriate dose of cotrimoxazole. Frequent adverse events were increasing hepatic transaminase (38,1%), leucopenia (16,9%), anemia (16,5%), nausea (15,4%), vomiting (7,8%), thrombocytopenia (7,4%), and hypersensitivity (5,3%). Adverse event causing discontinuation were hypersensitivity (100%), anemia (2,4%), increasing hepatic transaminase (2,1%), vomiting (0,8%), and leucopenia (0,6%). Inappropriate discontinuation of cotrimoxazole was 61,6% with median duration percentage was 87,5% (IQR 39) and median of duration was 20 months (IQR 20). Duration in patients with CD4 ≤100 cell/mm3 and >100 cell/mm3 was 21 months (IQR 22) and 12,5 months (IQR 14,75) p <0,001. Conclusion. Although initiation of primary cotrimoxazole prophylaxis was done in 83% adult HIV patients with appropriate dosage, it was found that 61,6% discontinuation was inappropriate according with guideline.
Antiphospholipid Antibody Profile in HIV/AIDS Patients Pandjaitan, Inolyn; Sukmana, Nanang; Effendy, Shufrie
Jurnal Penyakit Dalam Indonesia Vol. 4, No. 4
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Introduction. Through the process of molecular mimicry, human immunodeficiency virus (HIV) infection can increase the concentration of antiphospholipid antibody (APA) which has possible association with thrombosis. The molecular mimicry in this HIV/AIDS patients is influenced by several factors, such as immunocompromised condition, the use of antitretroviral (ARV) therapy, hepatitis B and C coinfection, use of other drugs, and history of intravenous drug user (IDU). We conducted this study to determine the profile and prevalence of antiphospholipid antibody in patients with HIV/ AIDS in Dr. Cipto Mangunkusumo General Hospital. Further, we explored the relationship between APA in HIV/AIDS patients with the factors mentioned before. Methods. This cross sectional study was done on HIV/AIDS outpatient at AIDS Working Group Clinic at Dr. Cipto Mangunkusumo General Hospital. We assessed the patients by history taking and measured their level of antibody anticardiolipin (ACA) dan Anti β2 glycoprotein I (anti-β2 GP1). Subjects were selected using simple random sampling. Descriptive data regarding the characteristics of the subjects and the proportions of APA were presented in numbers and percentages. The bivariate analysis between APA with the history of injecting drug use, the absolute CD4 lymphocyte count, antiretroviral therapy, and chronic hepatitis coinfection was performed using Chi-Square test and Fisher test. Results. APA examination results showed 27 (29,3%) patients were positive for ACA IgM, 77 (83,7%) patients were positive for ACA IgG, 61 (66,3%) patients were positive for anti β2 GP1 IgM, and 7 (7,6%) pateints were positive for anti β2 GP1 IgG. There is significant association between APA and the history of intravenous drug user (IDU) and ARV therapy. No association was observed between CD4 lymphocyte count and hepatitis coinfection with prevalence of APA in patients with HIV/AIDS patient. Conclusion. Proportion of anticardiolipin antibody IgG is higher than IgM (83,7% vs 29,3%), while the proportion of anti-β2 GP1 IgM is higher than IgG (66,3% vs 7,6%).
Association between Disease Activity and Depression inRheumatoid Arthritis Patients Mudjaddid, E; Puspitasari, Myra; Setyohadi, Bambang
Jurnal Penyakit Dalam Indonesia Vol. 4, No. 4
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Introduction. Rheumatoid Arthritis (RA) is a chronic, systemic disease that cause synovialinflammation and progressive destruction to cartilages and deformities. Prevalence of depressionin RA patients is 20 to 30%. Disease activity is considered to have association with depression. This study aims to identify the prevalence of depression in RA patients and the associationbetween disease activity index and depression in RA patients. Methods. A cross-sectional study of 145 RA patients that fulfilled the inclusion criteria was conducted in Rheumatology Outpatient Clinic at Cipto Mangunkusumo Hospital Jakarta from January to March 2017.Evaluation of Disease Activity Score - 28 (DAS 28) and Back Depression Inventory (BDI) was done to the patients. Statistical analysis was performed using SPSS version 20. Categorical variables were compared using chi-square test. Results. A total of 145 subjects were included in this study and most of them were female (90.3%). Median age of subjects was 55 years (range 19-83 years). Forty five subject (31%) were identified having psychosocial stressor. The proportion of depression in RA patients was 35.9% (95% CI 30-42%). Based on Disease Severity Score, it was found that subject with mild, moderate, and severe score were 24 (82.8%), 52 (66.7%), and 4 (23.5%), respectively. There was significant association between disease activity with depressionin rheumatoid arthritis patient (p= 0.001).
Diagnosis and Treatment of Pneumocystis Carinii Pneumonia (PCP)/Pneumocystis Jirovecii Pneumonia in HIV patient: A Case Report Agustina, Dewi Rizki; Efiyanti, Christy; Yunihastuti, Evy
Jurnal Penyakit Dalam Indonesia Vol. 4, No. 4
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Pneumocystis carinii pneumonia (PCP) or pneumocystis jirovecii pneumonia is an opportunistic infection that can occur in immunocompromised patients. In patients with HIV, PCP is the most common opportunistic infection especially in patients with CD4 cell counts less than 200 cell /ul. To diagnose a PCP is very difficult because symptoms, blood tests, and thoracic radiography are not pathognomonic for PCP. However, untreated PCP is almost always fatal. Trimethroprimsulfamethoxazole (TMX-SMX) orally or intravenously for 21 days is the drug of choice for managing PCP with or without HIV. This article discusses a case with patients with symptoms of dyspneu, unproductive cough, diagnosed with PCP and finally improvement with TMX-SMX therapy
Cardiotoxicity Complication of Radiotherapy Wisman, Beta Agustia; Nasution, Sally Aman; Panggabean, Marulam M
Jurnal Penyakit Dalam Indonesia Vol. 4, No. 4
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Radiation is an important modality in the management of malignancy. Some cases of malignancy requiring radiotherapy in the chest include breast cancer, Hodgkin's lymphoma, or lung cancer.Cardiotoxicity due to radiotherapy can occur within 3 to 29 years after radiotherapy, mostly in the second or third decade after therapy. Some cardiovascular complications resulting from radiotherapy may affect pericardial, myocardial, vascular, heart valves and conduction disturbances. Symptomatic cardiotoxicity may occurs 10% in patients undergoing radiotherapy in the chest area. It is important for clinicians to understand the cardiotoxicity of radiotherapy for educational purposes, therapeutic and dosing considerations, treatment monitoring and early detection. Early detection and post-radiation monitoring have an important role to reduce morbidity and mortality due to cardiovascular disease after radiotherapy and comprehensive management is necessary

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