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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. 9, No. 4" : 9 Documents clear
Value of Heart Rate Variability, Neutrophil-Lymphocyte Ratio and Quality of Life of Patients with Depressive Symptoms in Acute Myocardial Infarction Shatri, Hamzah; Adli, Mizanul; Muhadi, Muhadi; Abdullah, Murdani; Irawan, Cosphiadi; Putranto, Rudi; Koesnoe, Sukamto; Wijaya, Ika Prasetya
Jurnal Penyakit Dalam Indonesia Vol. 9, No. 4
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Introduction. Major depression criteria can be found in more than 20% of coronary heart patients and more than 30% acute coronary syndrome patients have significant depressive symptoms. Several studies have shown that reduction of hearth rate variability (HRV) and enhancement of neutrophil lymphocyte ratio (NLR) can cause enhancement of morbidity and mortality in myocardial infarction patients. On the other hand, depression can cause reduction of HRV, enhancement of NLR and reduction of quality of life. This study aimed to determine differences in HRV, NLR and quality of life between acute myocardial infarction (AMI) patients with depressive symptoms and AMI patients without depressive symptoms. Methods. A cross-sectional study was conducted among AMI patients who were treated during the period of March to July 2021 at the Intensive Cardiac Care Unit (ICCU) Cipto Mangunkusumo Hospital Jakarta. Samples were taken consecutively until the amount of sample is met. Data were analyzed using unp aired T test. Results. There was a total of 46 subjects AMI patients in this study, ten subjects with depressive symptoms and 36 subjects without depressive symptoms. From the analysis, it was found that AMI patients with depressive symptoms had lower standard deviation normal to normal (SDNN) average (p=0.447), lower low frequency/high frequency (LF/HF) (p=0.323), and higher NLR average (p=0.438) than AMI patients without depressive symptom, although it was not statistically significant. Analysis showed that the mean value of SF36 total scores (p<0.001), physical function domain scores (p<0.001), energy domain scores (p<0.001), mental health domain scores (p<0.001), social function domain scores (p=0.028), bodily pain domain scores (p=0.002), and general health domain scores (p=0.002) were lower in AMI patients with depressive symptoms. Conclusion. AMI patients with depressive symptoms had lower SDNN, lower LF/HF, and higher NLR than AMI patients without depressive symptoms, although it was not statistically significant. AMI patients with depressive symptoms significantly have lower quality of life than AMI patients without depressive symptoms.
Cutaneous Adverse Drug Reaction Among HIV-Infected Patients Starting Antituberculosis Treatment Widhani, Alvina; Karjadi, Teguh Harjono; Yunihastuti, Evy; Salwani, Desi; Pramudita, Angga; Nababan, Saut Horas; Praptini, Mirna Nurasri; Mondrowinduro, Prionggo
Jurnal Penyakit Dalam Indonesia Vol. 9, No. 4
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Introduction. Treatment of tuberculosis (TB) in HIV patients is complicated due to numerous comorbidities and possible adverse effects. One of which is cutaneous adverse drug reaction (CADR). This adverse event is often difficult to manage because of multiple medications the patients get. The objective of this study was to know the prevalence and risk factors of CADR among HIV-infected patients starting anti-TB treatment. Methods. This retrospective study reviewed data from medical records of new patients at Working Group on AIDS outpatient clinic at Cipto Mangunkusumo Hospital, Indonesia in January 2008-December 2010 that had started anti-TB treatment. Risk factors of CADR among HIV patients treated with antituberculosis drugs evaluated were sex, age, route of HIV transmission, TB manifestation, and baseline CD4+ cell count. Numeric data were analyzed using independent T-test if normally distributed, otherwise Mann Whitney U test were used. Chi-square or Fisher’s exact test were used for categorical data. p-value was considered significant if below 0.05. Results. Of 454 HIV-infected patients that started anti-TB treatment, median age was 30 years. Most patients were male and intravenous drug users/IDU. Median baseline CD4+ cell count was 61 cells/ μL. There were 10.6% subjects that developed CADR. Most common manifestations were maculopapular rashes (66.7%), followed by erythema multiforme (14.6%), and Stevens Johnson Syndrome (8.3%). Anti-TB drugs were stopped and then re-challenge was conducted in 54.2% patients. Anti-TB drugs were continued and only the suspected drug was stopped in 29.2% patients. The offending drugs were cotrimoxazole (41.7%), rifampicine (41.7%), ethambutol (16.7%), pyrazinamide (14.6%), pyrimethamine (12.5%), isoniazide (10.4%), streptomycin (8.3%), efavirenz (8.3%), fixed dose combination of antituberculosis drugs (8.3%), and nevirapine (4.2%). The proportion of CADR was higher in woman than man (12% vs. 10.3%, p=0.66), non-IDU than IDU (13% vs. 9.2%, p=0.20), without extrapulmonary TB than extrapulmonary TB (11.1% vs. 9.4%, p=0.29), but the associations weren’t statistically significant. Median age was higher (31 vs. 30 years, p=0.32) and CD4 cell count (59.5 vs. 62 sel/μL, p=0.96) was lower in CADR group than non CADR group. Conclusion. The prevalence of CADR among HIV-infected patients starting anti-TB treatment was 10.6%. Sex, age, route of HIV transmission, TB manifestation, and baseline CD4+ did not have statistically significant association with CADR.
Effect of Advance Care Planning on Heart Failure Patients: An Evidence Based Case Report Shatri, Hamzah; Nurfitria, Nandika; Sinulingga, Dika; Irvianita, Vinandia; Faisal, Edward; Putranto, Rudi; Martina, Diah
Jurnal Penyakit Dalam Indonesia Vol. 9, No. 4
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Despite the advances in medical therapy, heart failure remains a disease that requires attention due to the course of the illness; it can lead to unpredictable, progressive, and fatal conditions. Existing therapy aims to improve the condition and prevent disease progression, with a balanced secondary therapy for various conditions that can trigger acute decompensated heart failure. Advances in technology and therapy may increase the prevalence of patients with heart failure, including prolonging the refractory phase of the disease. There are recommendations for advance care planning to support patient therapy and improve the quality of life of patients with heart failure. This evidence-based case report aims to investigate the benefits of advance care planning in heart failure patients. A heart failure patient is referred to the palliative care team for advance care planning. Literature searches were conducted on ProQuest, PubMed, Scopus, and Cochrane according to the clinical questions. The studies were selected based on the inclusion and exclusion criteria, then a critical review was conducted. One study showed significant results regarding the effectiveness of advance care planning on the quality of life of heart failure patients. Another study showed a significant improvement in depression among patients engaged in advance care planning. However, it showed no difference in the quality of life compared to usual care because the sample size was relatively small, and the quality of evidence was low. Therefore, it can be concluded that advance care planning can improve heart failure patients’ psychological symptoms and quality of life.
Pemberian Antibiotik Dini Berpengaruh terhadap Mortalitas COVID-19? Sofro, Muchlis Achsan Udji
Jurnal Penyakit Dalam Indonesia Vol. 9, No. 4
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Coronavirus disease 2019 (COVID-19) merupakan infeksi saluran napas yang diakibatkan oleh severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Data di seluruh dunia sampai akhir Juni 2022 menunjukkan bahwa COVID-19 telah menyebabkan 6,2 juta kematian dengan jumlah 530 juta kasus.
Association between Early Antibiotic Administration and In-Hospital Mortality in Moderate and Severe COVID-19 Patients Chen, Lie Khie; Nathanael, Jason; Shakinah, Sharifah; Pasaribu, Adeline; Sinto, Robert; Nainggolan, Leonard; Susilo, Adityo
Jurnal Penyakit Dalam Indonesia Vol. 9, No. 4
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Introduction. Patients with moderate and severe COVID-19 generally receive antibiotic therapy with consideration of the possibility of co-infection or secondary bacterial infection which clinically is difficult to distinguish from COVID-19 symptoms. Overuse of antibiotics can lead to an increased risk of bacterial resistance to antibiotics which is associated with poor outcomes in COVID-19 patients. This study aimed to assess the effect of early antibiotic administration on mortality in moderate and severe COVID-19 patients. Methods. An observational study with a retrospective cohort design was conducted at Dr. Cipto Mangunkusumo Hospital. Data were obtained from medical records of patients admitted from March to September 2020. Patients who received early antibiotics were defined as patients who received antibiotics hospital, 108 subjects were included in this study, 74 (68.5%) with moderate degrees and 34 (31.5%) with severe degrees. Early antibiotics were administered to 79 (73.1%) subjects with a median start time of one day. The results of the bivariate analysis did not find a significant effect of early antibiotic administration on mortality in moderate or severe COVID-19 patients (p=0.42). Subgroup analysis based on the degree of disease also found no significant results. Conclusion. There is no relationship between early antibiotic administration and mortality of moderate and severe COVID-19 patients.
Determinant Factors of Cognitive Frailty in Elderly Patients Santoso, Valencia; Rensa, Rensa
Jurnal Penyakit Dalam Indonesia Vol. 9, No. 4
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Introduction. Physical frailty and cognitive impairment have a strong relationship and there are differences in factors associated with cognitive frailty. This research aimed to determine the prevalence of cognitive frailty and identify factors associated with cognitive frailty in the elderly population in hospital polyclinic. Methods. A cross-sectional study with secondary data on patients aged ≥60 years in the Internal Medicine Polyclinic of Atma Jaya Hospital, Jakarta, from May 2020 to May 2021. The independent variables of this study were age, cardiovascular disease, type 2 diabetes mellitus, dyslipidemia, risk of malnutrition, risk of depression, and functional status. The alternative criteria by Won et al. were used to classify cognitive frailt. Bivariate analysis (chi-square test) and multivariate analysis (logistic regression) were performed using SPSS program. Results. There were 343 subjects with a median age of 66 years, 35% had cardiovascular disease, 5.2% had a high risk of malnutrition, 9.3% had depressive symptoms, 20.4% had a low functional status (ADL-Barthel index), 55.7% were diagnosed with type 2 diabetes mellitus, and 36.4% were diagnosed with dyslipidemia. The prevalence of subjects with cognitive frailty is 1.2% and 98.8% without cognitive frailty. The determinant factor of cognitive frailty is the presence of cardiovascular disease [OR 10.17 (95% CI 0.97-106.54); p=0.05]. Conclusions. Prevalence of cognitive frailty in elderly outpatients is 1.2%. The determinant factor of cognitive frailty is cardiovascular disease.
Effectiveness of Garlic Extract (Allium sativum) to Reduce Level of Malondialdehyde Serum and Improve Quality of Life in Patients with Chronic Hemodialysis: A Randomized Double-Blind Placebo-Controlled Trial Istiqomah, Amelia; Ali, Zulkhair; Saleh, Irsan
Jurnal Penyakit Dalam Indonesia Vol. 9, No. 4
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Introduction. Study reported that malondialdehyde (MDA) levels as an in vivo marker of oxidative stress were increased in patients undergoing hemodialysis. Antioxidants allicin compounds contained in garlic (Allium sativum) are known to have antioxidant activity by inducing antioxidant enzymes such as superoxide dismutase (SOD), catalase (CAT) and inhibiting prooxidant enzymes (nitric oxide synthase, xanthine, NADPH oxidase, and cyclooxygenase). This study aimed to investigate the effectiveness of Allium sativum to reduce level of MDA serum and improve quality of life in patients with chronic hemodialysis. Methods. This study was a crossover randomized double-blind placebo-controlled trial. The subjects were 40 chronic kidney disease (CKD) stage 5 patients with chronic hemodialysis (HD). Subjects were randomly divided into 2 groups, namely the group that received 1,000 mg of garlic extract per day (2 x 500 mg) for 6 weeks and the group that received a placebo, which was then carried out during a washing period for 2 weeks and then the two groups were crossover. Each group measured the levels of serum MDA before and after treatment, also fill in kidney disease quality of life (KDQOL) SF-36 questionnaire. Results. Out of 40 subjects, most of them were male (57.5%) with median of age of 48.6 (range 26-59) years. It was found that serum MDA levels before and after garlic extract administration were 2.423 (SD 0.236) nmol/l and 1.649 (SD 0.26) nmol/l (p<0,001) with a mean change of -0.782 (SD 0.735) nmol/l. Statistical analysis showed a significance difference of MDA serum between the two groups. There was significant improvement in quality of life before and after garlic extract administration from 57.81 (SD 16.95) to 67.62 (SD 13.61) with a mean change of 9.81 (SD 3.34). But there was no significant difference between quality of life and MDA serum. Conclusion. There is effectiveness of garlic extract to decrease serum MDA and improve the quality of life in patients with CKD stage 5 using chronic HD at Mohammad Hoesin Hospital, Palembang.
Kecubung Intoxication: A Case Report on A 16-Year-Old Male at Kuningan District Saputera, Monica Djaja; Saputera, Jessica Djaja
Jurnal Penyakit Dalam Indonesia Vol. 9, No. 4
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Kecubung (angel’s trumpet) is a plant with hallucinogen effect which contain a tropane alkaloid, which are widely grown in Indonesia and is widely abused by several groups of adolescents aged 18 years in East Nusa Tenggara. Kecubung intoxication is a common case in Indonesia, but rarely reported and hard to make a definitive diagnosis due to lack of the toxicology screening assessment. Besides, an antidote of this case also not available in this country. We present a case of 16-years old male who visited the emergency room with fluctuating level of consciousness accompanied by anxiety, anger, and a visual hallucination. He was given an IV Diazepam 10 mg and Alprazolam 0.5 mg oral in the first day, and continue with Risperidone 2 mg oral – twice a day, Trihexyphenidyl Hydrochloride 2 mg and Clozapine 12.5 mg oral – once a day, and resulting in significant improvement of symptoms and behavior.
Second-Line Therapy Tyrosine Kinase Inhibitor for Chronic Phase Chronic Myeloid Leukemia Resistant to Imatinib Pratiwi, Chici; Rajabto, Wulyo
Jurnal Penyakit Dalam Indonesia Vol. 9, No. 4
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Since the era of tyrosine kinase inhibitor (TKI) therapy, there has been an increase in the median survival of chronic myeloid leukemia. Nevertheless, nowadays there were several cases of chronic myeloid leukemia that are resistant to the first-line TKIs, so that several second-line TKIs were introduced. Assessment of the therapeutic response was performed using a complete peripheral blood examination, bone marrow aspiration cytogenetic examination, and quantitative BCR-ABL examination. The treatment failure criteria were applied based on the ELN criteria. In selecting the second line TKI should be based on the results of mutation analysis and consider the safety profile of the second line therapy. This paper will discuss the recommendations for second-line therapy TKI, adjusted to the resources in Indonesia.

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