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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 360 Documents
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Level of Disability and Limitation of Shoulder Motion in Post Mastectomy at Hasan Sadikin Hospital Bandung in 2019 Rachmawati, Nadya; Prabowo, Tertianto; Fathurrachman, Fathurrachman
Jurnal Penyakit Dalam Indonesia Vol. 7, No. 4
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Introduction. Post-mastectomy complications in breast cancer patients can be a long-term disabilities such as limitation of shoulder function that only appears after several months to years after surgery and may remain for the rest of the patient’s life. This study aims to describe the level of disability and limitation of the shoulder joint’s range of motion in breast cancer patients following mastectomy at Hasan Sadikin Hospital, Bandung 2019. Methods. This research was conducted by using descriptive method with cross-sectional study design. Sampling technique using consecutive sampling method during one-month study period. Samples were post-mastectomy breast cancer patients who came to the Surgical Oncology Department of Hasan Sadikin Hospital Bandung on October-November 2019. Upper limb disability level obtained based on the results of quickDASH score filled by the patient while the range of motion of the shoulder joint measured by the researcher itself using a goniometer. Results. The QuickDASH scores from 84 patients studied, showed a median of 4.6 (range 0 - 59.1) with the majority falling in the category of minimum disability (score 1-20). The measurement of shoulder joint’s range of motion using goniometer showed a decrease in abduction on 52% of patients, decrease in flexion on 44% of patients, and decrease in external rotation on 20% of patients. Conclusions. The level of disability of the shoulder joint in the department of post-mastectomy Dr. Hasan Sadikin Bandung October-November 2019 showed the majority of minimum disability and limitation of motion of the shoulder joint occurs dominant abduction motion. Keywords: Breast cancer, mastectomy, quickDASH score, range of motion
The Impact of “CODE STEMI” Program Implementation on Door to Balloon Time and Major Adverse Cardiac Events of Patients with ST Elevation Myocardial Infarction Funay, Prijander L B; Wijaya, Ika Prasetya; Ginanjar, Eka; Shatri, Hamzah
Jurnal Penyakit Dalam Indonesia Vol. 7, No. 4
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Introduction. Delay in the management of ST Elevation Myocardial Infarction (STEMI) patients is a cause of high mortality and the incidence of major adverse cardiac events (MACE). Efforts that can be made in health facilities with primary percutaneous coronary intervention (PCI) capability are achieving timely reperfusion of STEMI patients. Various strategies were carried out to achieve timely reperfusion including implementation the CODE STEMI program. This study aimed to determine the effect of the implementation of the CODE STEMI program on Door to Balloon Time (D2BT) and MACE of STEMI patients undergoing primary PCI. Methods. This was a retrospective cohort study conducted among STEMI patients undergoing primary PCI before the application of the CODE STEMI program (2015-2016) and after the application of the CODE STEMI program (2017-2018). Data were obtained from patients’ medical record. Analysis was performed quantitatively by Mann Whitney test for D2BT and chi square for MACE. Results. There were 111 patients in the non-CODE STEMI group and 144 patients in the CODE STEMI group. D2BT decreased significantly 110 minutes from 275 (99-2356) minutes in the non-CODE STEMI group to 165 (67-1165) minutes in the CODE STEMI group (p < 0.001). Analysis in both group (CODE STEMI vs. non-CODE STEMI) showed as follows: MACE events (48.4% vs 51.6%; p = 0.120), heart failure (46.6% vs 42%; p = 0.288), cardiogenic shock (27% vs 19.4%; p = 0.152), arrhythmia (12.6% vs 6.2%; p = 0.079), stroke (4.5% vs 5.6%; p = 0.705), and mortality rate (7.2% vs 3.5%; p = 0.179) which were similar between the two groups. The incidence of reinfarction (4.5% vs 0.7%; p = 0.047) and repeated PCI (2.7% vs 0.0%; p = 0.047) were significantly reduced in the CODE STEMI group. Conclusions. The CODE STEMI program reduces D2BT. The CODE STEMI program did not reduce the overall MACE incidence but reduced the incidence of reinfarction and repeated PCI of STEMI patients undergoing primary PCI
Profile of Patients Neutropenia Fever Unrelated to Chemotherapy in Dr. Cipto Mangunkusumo General Hospital Danasasmita, Gantira; Chen, Lie Khie; Sinto, Robert; Nugroho, Pringgodigdo
Jurnal Penyakit Dalam Indonesia Vol. 7, No. 4
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Introduction. The condition of neutropenia increases the risk of infection. The causes of neutropenia are widely discussed as side effects of chemotherapy, but patients with neutropenia who are not due to side effects of chemotherapy are increasing in number. This study aims to provide an overview of the characteristics of neutropenic fever population unrelated to chemotherapy. Method. The study was conducted retrospectively on the medical records of neutropenic fever patients who were not chemotherapy-related in the National Hospital Dr. Cipto Mangunkusumo in January 2018-November 2019. Variables studied included demographic, clinical characteristics, classification of multinational association of supportive care in cancer (MASCC) scores and their etiology, and mortality outcomes within 5 days of treatment. Results. Total of 68 subjects were included in this study, consist of 50% female and 50% male with median age was 38.5 years (interquartile range 27). Diagnosis data showed that 86.8% subjects were patients with hematological abnormalities, 3 patients had solid tumors (lymphoma, colon cancer and lung cancer), and the rest were non-malignant diseases. Analysis showed that 72.1% onset of fever was found in outpatient care, the rest was inpatient care. The mean value of absolute neutrophil count was 201.50 (SD 173.18), meanwhile the mean MASCC score was 21 (SD 4.54) in the low-risk category. A total of 35 subjects (51.5%) had a MASCC low risk score and 33 subjects (48.5%) had a high risk. The median procalcitonin subject was 1.99 ng / mL (range 0.11 - 178.30). The 5-days mortality incidence was 54.4%. Chi-square analysis of the two groups found significant differences in care mortality (p <0.05). Analysis with Independent T-test also showed a significant differences in the parameters of age and systolic blood pressure values between the high risk and low risk groups. Conclusions. The majority etiologies among subjects were haematological disorders. Based on the MASCC score, most of the subjects were in the high-risk group. Total of mortality incidence was 54.4%.
Fever-Induced Brugada Syndrome in an Acute Gastroenteritis Patient: A Case Report Cikutra, Rio Yansen; Irwin, Irwin
Jurnal Penyakit Dalam Indonesia Vol. 7, No. 4
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Brugada syndrome (BS) is a disease caused by autosomal dominant sodium channel mutation in the heart. The prevalence of BS worldwide is estimated to be 1-5/10,000 population and the highest prevalence is in Southeast Asia which is >5/10,000 population. Brugada syndrome is a dangerous condition because it predisposes to malignant arrhythmias (ventricular tachycardia/VT and ventricular fibrillation/VS) and sudden cardiac death (SCD). Fever is a trigger for malignant arrhythmias, syncope, or SCD in BS. This article discusses about a case of 64-year-od man patient with complaint of syncope, preceded by chest pain and palpitation. The patient also had a fever and enteritis for two days. Electrocardiographic (ECG) examination was performed on the patient and a coved-type ST-segment elevation of ≥2 mm was obtained followed by a negative T wave in the right precordial leads (V1 and V2). Based on these results, the patient was diagnosed with type 1 BS. To date, the implantation of implantable cardioverter defibrillator (ICD) is the only therapy that has proven effective in preventing SCD in BS.
Prognosic Factors Related to The Complete Hematologic Response (CHR) in 3 Months in Leukemia Granulositic Patients Administered with Imatinib Mesylate Rinaldi, Ikhwan; Reksodiputro, Arry H.
Jurnal Penyakit Dalam Indonesia Vol. 7, No. 3
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Introduction. The complete hematologic response is an integral part to achieve the complete cytogenetic response target and the major molecular response of imatinib mesylate therapy, although it does not determine the prognosis. The complete hematologic response in Indonesia is lower than in the world (74% vs. 95%). Sixty percent of chronic myeloid leukemia patients in Indonesia were administered hydroxyurea before imatinib mesylate. Chronic myeloid leukaemia (CML) patients in Indonesia are younger than in other countries. This study aimed to determine what prognostic factors which affect the complete hematological response of chronic phase CML patients who received imatinib mesylate in Indonesia. Methods. The study was done by retrospective cohort design using the medical records data of chronic myeloid leukemia patients who were treated at Teratai Clinic and hematology clinic RSCM and received imatinib mesylate therapy from January 2004-December 2011. Results. Most of the study subjects were male (61.5%), aged 26-40 years (47.4%), duration of diagnosis <12 months>(69.2%), duration of hydroxyurea therapy <6 months>(64.1%), hemoglobin concentration <12 g>/dl (69.2%), leukocyte count ≥50,000 (48.7%), platelet count 0 – <450,000 (42.3%), spleen size ≥10 cm (55.1%), low Sokal score (42.3%), and achieve a complete hematologic response within 3 months (57.7%). Duration of hydroxyurea therapy <6 months is prognostic factor higher CHR achievement. Conclusions. Clinical and laboratory characteristics CML patients in Indonesia are different than CML patients in the world. Duration of diagnosis until imatinib mesylate administration <12 months, duration of hydroxyurea administration <6 months, and hemoglobin concentration ≤12 g/dl were associated with the achievement of complete hematological response of chronic CML patients in Indonesia. Duration of hydroxyurea administration <6 months was identified as independent factor of achievement of complete hematological response of chronic CML patients in Indonesia.
Exogenous Cushing Syndrome: When do We Get the Benefit of Glucocorticoid Stress Dose? Soelistijo, Soebagijo Adi; Gunawan, Hendra; Primasatya, Chandra Adi Irawan; Ariana, Audy Meutia; Mudjanarko, Sony Wibisono; Pranoto, Agung
Jurnal Penyakit Dalam Indonesia Vol. 7, No. 3
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Exogenous cushing syndrome is the most common cushing syndrome found in clinical practice. Its most frequent etiology is the adverse effect of glucocorticoid therapy found in clinical practice or in the form of traditional medicine. The clinical manifestations of exogenous cushing syndrome are similar to the spontaneous counterpart, albeit with the presence of glucocorticoid consumption. We present a case series of exogenous cushing syndrome due to traditional medicine and glucocorticoid consumption with opportunistic infection as its initial manifestation. The first case did not need glucocorticoid supplementation while it was initiated in the second case. Comprehensive management of exogenous cushing syndrome should involve the decision of giving glucocorticoid stress dose, treatment to the underlying disease and education in order to prevent self-glucocorticoid consumption.
The Role of Continous Ambulatory Peritoneal Dialysis in Equity of Kidney Replacement Therapy in Indonesia Lydia, Aida
Jurnal Penyakit Dalam Indonesia Vol. 7, No. 3
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With the increasing incidence of chronic kidney disease in Indonesia, an effective, sustainable and widely available kidney replacement therapy (KRT) is needed. PD is one of the available modalities that can meet those criteria. To date, out of the two existing types of PD, only continuous ambulatory peritoneal dialysis (CAPD) is available in our country. Studies showed that residual kidney function is preserved better in CAPD patients compared to HD patients. With the use of CAPD as KRT, patients can do dialysis independently. Hence, it can be solution to the limitations and the difficulty of reaching HD units especially in remote areas. However, due to lack of knowledge or experience of clinicians regarding CAPD, the use of CAPD is scarce in Indonesia. Clinicians can increase their role in kidney services by increasing CAPD utilization. The key to improve CAPD utilization is a good understanding and optimal education about CAPD to patients and their families. This review aims to introduce and remind clinicians of the availability of CAPD besides HD and kidney transplant as one of the available modalities of KRT for patients with ESKD in Indonesia.
The Correlation between Transforming Growth Factor-Beta (TGF- β) Serum Level and Beck Depression Inventory (BDI) Score in Colorectal Cancer Patients at RSMH Palembang Apriansyah, Muhammad Ali; Syahrir, Mediarty; Rosyidi, Muhammad, Kgs; Faisyar, Ahmad
Jurnal Penyakit Dalam Indonesia Vol. 7, No. 2
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Introduction. Depression not only increase the mortality rate, but also can interfere the quality of life of colorectal cancer patients during treatment. Low levels of systemic inflammation may contribute to the development of depression. The inflammatory process can be seen by measuring serum transforming growth factor-β (TGF-β) levels and depressive symptoms using the beck depression inventory (BDI) score. This study aimed to determine the correlation between TGF-β serum levels with depression in colorectal cancer patients. Methods. Analytical observational research with cross sectional design was conducted among colorectal cancer patients who underwent chemotherapy with a BDI score ≥10 (depression) in the RSMH Palembang from June 2018 to June 2019. Serum TGF-β levels were measured by the enzyme-linked immunosorbent assay (ELISA) quantitative method. Spearman analysis was used to assess the correlation of TGF-β levels and BDI score. Results. A total of 40 subjects were included in this study with mean value of TGF-β serum was 108.14 pg/mL (SD 39.97 pg/mL). Median beck depression inventory (BDI) score was 14 (range 10-28). There was a moderate positive correlation between serum TGF-β levels and BDI score (r = 0.485; p = 0.002). Conclusion. There was a moderate positive correlation between serum TGF-β levels and BDI score in colorectal cancer patients at RSMH Palembang
The Proportion of Acute Transfusion Reaction at Outpatient Blood Transfusion Unit in Tertiary Hospital in Indonesia Zein, Ahmad Fariz Malvi Zamzam; Sukrisman, Lugyanti
Jurnal Penyakit Dalam Indonesia Vol. 7, No. 2
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Introduction. Acute transfusion reaction (ATR) is an important issue related to patient safety. The prevalence of ATR at tertiary hospital in Indonesia is 0.5%. This study was aimed to determine the proportion of ATR in outpatient blood transfusion unit at tertiary hospital. Method. This retrospective study implemented data from medical records of adult patients who underwent blood transfusion in outpatient blood transfusion unit, Cipto Mangunkusumo Hospital between August – October 2014. The blood components included packed red cells (PRC), thrombocyte concentrate (TC), fresh frozen plasma (FFP), and cryoprecipitate. We recorded the administration of premedication and ATR-related symptoms/signs. The ATR report was based on WHO classification. Results. There were 1,010 blood transfusions during the study period. The distribution of blood components were PRC (n=802, 79.4%), PC (n=74, 7.3%), FFP (n=43, 4.3%), and cryoprecipitate (n=91, 9.0%). The premedication was administered in 21 transfusions (2.1%). There were 11 ATRs with WHO category 1 (1.1%), no other categories were reported. Based on blood component, the ATR occurred predominantly in PRC transfusion (0.6%), followed by FFP (0.3%), cryoprecipitate (0.1%), and TC (0.1%), respectively. Conclusion. The proportion of ATR in outpatients blood transfusion unit at Cipto Mangunkusumo Hospital was 1.1%. All reported ATR were category 1 in this study. The ATR was predominantly in PRC transfusion.
Prediction Model of 30-Day Mortality in Elderly Patients Admitted to Geriatric Acute Ward Using Comprehensive Geriatric Assessment Domain Dwimartutie, Noto; Setiati, Slti; Wahyudi, Edy Rizal; Harimurti, Kuntjoro
Jurnal Penyakit Dalam Indonesia Vol. 7, No. 2
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