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Acta Interna : The Journal of Internal Medicine
ISSN : 2303131X     EISSN : 25415441     DOI : -
Core Subject : Health,
The Journal considers any original research that advocates change in, or illuminates, clinical practice. The journal also publishes interesting and informative reviews and opinions pieces on any topics connected with clinical practice. Manuscripts must be solely the work of the author(s) stated, not have been published previously elsewhere, and not be under consideration by another journal. all papers should be written to be clearly understandable to the journal`s readers in a wide range of specialities and countries. Diagrams, figures, and photographs should be used to supplement and enhance the text.
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Articles 6 Documents
Search results for , issue "Vol 4, No 2 (2014): The Journal of Internal Medicine" : 6 Documents clear
Correlation of Ferritin Level to The Quality of Life Ariyanto Nugroho; Iri Kuswadi; Bambang Djarwoto
Acta Interna The Journal of Internal Medicine Vol 4, No 2 (2014): The Journal of Internal Medicine
Publisher : Faculty of Medicine Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (143.139 KB) | DOI: 10.22146/acta interna.16926

Abstract

ABSTRACTBackground: Chronic kidney disease is a worldwide health problem. Circumstances that caused the condition of end-stage renal failure causes a decrease in quality of life with a high mortality rate ranging from 22% per year. Many ways to assess the quality of life, form-36 (SF-36) has undergone several revisions refi nement. Serum ferritin continues to be the focus of attention. Nearly half of all hemodialysis patients had serum ferritin > 500 ng/ml. Serum ferritin is a marker of infl ammation that is a good, low levels correlated with iron defi ciency and high levels correlated with infl ammation.Objective: To determine the correlation of high levels of serum ferritin to decline in the quality of life in patients with CRF who had been undergoing hemodialysisMethods: This study was a cross sectional study to determine whether high levels of serum ferritin may have an impact on the decline in the quality of life in patients with chronic renal failure (CRF) who had undergone regular hemodialysis. The study was conducted at Hospital Hemodialysis Unit Dr. Sardjito,Yogyakarta. Result: A total of 61 patients who met the inclusion criteria to undergo research. Score KDQOL-SF in this study, negative correlations (weak) significant in sleep (sleep disorders) 58.79 ± 1.95 (r = -0.306) and (p = 0.017). On the Role Physical scores (physical activity) 24.59 ± 3.21 obtained a negative correlation (weak) signifi cant (r = -0.268) and (p = 0.037). For Emotional Well Being scores (emotional condition) 70.85 ± 1.39 (r = -0.374) and (p = 0.003). On the score of Energy Fatigue (physical fatigue) 62.29 ± 1.61 (r = -0.261) and (p = 0.043).Conclusion: Overall, this study shows the lack of statistically signifi cant results showed a high correlation ferritin directly on quality of life.Keywords: chronic renal failure, hemodialysis, ferritin, KDQOL-SF
Telomere and telomerase in hematological disorders Focusing on bone marrow failure syndromes and hematological malignancies Mardiah Suci Hardianti; Ibnu Purwanto; Johan Kurnianda
Acta Interna The Journal of Internal Medicine Vol 4, No 2 (2014): The Journal of Internal Medicine
Publisher : Faculty of Medicine Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (404.728 KB) | DOI: 10.22146/acta interna.16928

Abstract

ABSTRACTWe review the present knowledge of telomeres and telomerase with special attention to their role in hematological disorders especially bone marrow failure syndromes including acquired aplastic anemia and myelodysplastic syndromes, as well as acute and chronic myeloid leukemia. The current understanding on the role of telomere and telomeres dysfunctions in hematological disorders leads us to a better understanding on the pathology of the diseases as well as considering some possibilities to employ the measurement of telomere length and telomere activity in disease prognostication. Several treatment options targeting telomere and telomerase being developed are also reviewed.Keywords: telomere- telomerase- bone marrow failure syndromes- hematological malignancies
Evaluating Indications and Diagnostic Yield of Colonoscopy in Sardjito General Hospital Suharjo Broto Cahyono; Putut Bayupurnama; Neneng Ratnasari; Catharina Triwikatmani; Fahmi Indrarti; Sutanto Maduseno; Siti Nurdjanah
Acta Interna The Journal of Internal Medicine Vol 4, No 2 (2014): The Journal of Internal Medicine
Publisher : Faculty of Medicine Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (161.006 KB) | DOI: 10.22146/acta interna.16956

Abstract

ABSTRACTBackground: Colonoscopy is the gold standard procedure which is widely used in the diagnosis and treatment of colonic mucosal disorder. Inappropriate colonoscopy indications increase rate of complications.Aim: The main aims of our study were to evaluate indications, fi ndings and diagnostic yield at colonoscopy.Methods: A retrospective study of all colonoscopy was conducted from January 2012 through August 2013, at Dr. Sardjito General Hospital, Yogyakarta and there were 688 colonoscopy reports. Seven colonoscopy indications were documented and presented: rectal bleeding or hematochezia, chronic diarrhea, abdominal pain, constipation, screening and surveillance for colonic neoplasia, change in bowel habit and anemia. Diagnostic yield was defi ned as the ratio between signifi cant fi ndings detected on colonoscopy and the total number of procedures performed for the indication. In our study, diagnostic yield was established by colonoscopy, not confirmed by biopsy.Results: Overall diagnostic yield was 72.53%. The leading indication for colonoscopies was rectal bleeding or hematochezia (36.19%), followed by chronic diarrhea (23.11%), abdominal pain (14.09%), constipation (13.37%), screening and surveillance (5.66%), change in bowel habit (5.52%) and anemia (2.02%). Diagnostic yields according colonoscopies examination were normal (37.14%), colorectal cancer (19.33%), proctitis (14.24%), infl ammatory bowel disease (12.50%), polyps (11.19%),hemorrhoid (10.03%), and diverticel(3.78%). Colorectal cancers were found in patients with hematochezia (74 patients, 29.71%), chronic diarrhea (34 patients, 21.38%), constipation (13 patients, 14.13%). Of 249 patients presenting with hematochezia were found colorectal cancer (74 patients), hemorrhoid (50 patients), proctitis (30 patients), normal (30 patients). Our study showed that diagnostic yield was far lower in patients below 50 years (38.48%) compared > 50 years (61.52%), especially for colorectal cancer (p < 0.001), polyps (p = 0.004) and diverticular (p < 0.001).Conclusions: Hematochezia was the leading indication for colonoscopy and the diagnostic yield was 72.53%. The leading of colonoscopy fi ndings were normal colonoscopies, followed by colorectal cancer, proctitis,infl ammatory bowel disease, polyps and diverticel. Colonoscopy indications should be based on the available guidelines to minimize as much as possible the number inappropriate procedures and complications.Keywords: Colonoscopy, diagnostic yield, colonic indications, appropriateness of colonoscopy
Correlation of thirst with ejection fraction and plasma sodium level in elderly with chronic heart failure Sri Lestari; I Dewa Putu Pramantara; Hasanah Mumpuni
Acta Interna The Journal of Internal Medicine Vol 4, No 2 (2014): The Journal of Internal Medicine
Publisher : Faculty of Medicine Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/acta interna.16572

Abstract

ABSTRAKLatar Belakang: Haus merupakan simptom yang umum dan mengganggu bagi pasien gagal jantung.Banyak pasien gagal jantung usia lanjut mengeluh rasa haus berlebihan. Perjalanan alamiah gagal jantung,terapi farmakologi dan non farmakologi dapat meningkatkan rasa haus. Cardiac output yang rendah danpeningkatan aktivasi sistem neurohormonal seperti sistem renin-angiotensin aldosteron akan merangsangpusat haus di hipotalamus. Hubungan antara rasa haus dengan fraksi ejeksi dan kadar natrium plasma padapasien gagal jantung kronis usia lanjut belum diketahui.Tujuan: Tujuan dari penelitian ini adalah untuk mengetahui hubungan antara derajat rasa haus denganfraksi ejeksi dan kadar natrium plasma pada gagal jantung kronis usia lanjut.Metode: Penelitian menggunakan metode potong lintang, dilakukan di Bagian Penyakit Dalam dan BagianKardiologi RSUP Dr. Sardjito Yogyakarta. Subyek penelitian adalah pasien usia lanjut penderita gagal jantungkelas fungsional III-IV sesuai dengan kriteria NYHA, usia ≥60 tahun. Pengukuran rasa haus dilakukandengan menggunakan skor VAS. Pemeriksaan fraksi ejeksi dilakukan dengan ekokardiografi . Karakteristiksubyek penelitian disajikan dalam bentuk rerata dan simpangan baku. Hubungan antara derajat rasa hausdengan fraksi ejeksi dan kadar natrim plasma dianalisis dengan menggunakan uji korelasi Pearson. Nilai p<0.05 dianggap signifi kan.Hasil: Didapatkan 30 subyek sebanyak 63.3% laki-laki dengan median usia 69.5 tahun. Diperoleh rerata rasahaus 63.67±17.5 mm dan rerata fraksi ejeksi sebesar 41.93±15.5%. Rerata hasil pemeriksaan kadar natriumadalah 139.7±4.1 mmol/l sedangkan rerata osmolalitas plasma 296.4±10.1 mOsm/kg.Kesimpulan: Pada uji korelasi Pearson didapatkan korelasi antara rasa haus dengan fraksi ejeksi adalahkorelasi negatif lemah namun tidak signifi kan secara statistic (r=-0.314, p=0.091). Tidak didapatkan korelasiantara rasa haus dengan kadar natrium plasma (r=-0.04 p=0.833).Kata kunci: usia lanjut, rasa haus, gagal jantung kronis, fraksi ejeksi, natrium plasmaABSTRACTBackground: Thirst is a common symptom that disturbs patient with heart failure. Many elderly patients withheart failure get severe thirst. Natural history of heart failure, pharmacological and non-pharmacological therapiescould increase the thirst level. Low cardiac output and activation of neuro-hormonal system e.g. renin angiotensinaldosteronesystem, would stimulate the thirst center in hypothalamus. Correlations of thirst with ejection fractionand plasma sodium level in elderly with chronic heart failure have not been known yet.Aims: The aims of this study are to investigate the correlations of thirst with ejection fraction and plasmasodium level in elderly with chronic heart failure. Cross sectional design has been conducted on elderly patients(age of ≥60 years) with heart failure of functional class of III-IV (based on NYHA criteria) in Departmentof Internal Medicine and Department of Cardiology, Dr. Sardjito General Hospital, Yogyakarta.Method: Measurement of thirst was done using VAS score, while the investigation of ejection fraction wasperformed using echocardiography. Characteristics of subjects were presented in the average and standarddeviation values. Correlations between thirst with ejection fraction and plasma sodium level were analyzedby using Pearson correlation test with p < 0.05 considered to be signifi cant.Result: There were 30 subjects, 63.3% male, median of age of 69.5 years. The average of thirst value was63.67} 17.5 mm and the ejection fraction was 41.93} 15.5%. The averages of plasma sodium level andplasma osmolality were respectively 139.7} 4.1 mmole/l and 296.4} 10.1 mOsm/kg.Conclusion: Pearson correlation test has revealed a weak negative correlation of thirst and ejection fraction(r= -0.314, p=0.091). On the other hand, there was no correlation between thirst and plasma sodium level(r=-0.04 p=0.833).Keywords: thirst, elderly, chronic heart failure, ejection fraction, plasma sodium level
Differences in lung function in various degrees of pulmonary tuberculosis sequale Iwandheny Sepmeitutu; Sumardi Sumardi; Eko Budiono
Acta Interna The Journal of Internal Medicine Vol 4, No 2 (2014): The Journal of Internal Medicine
Publisher : Faculty of Medicine Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/acta interna.16575

Abstract

Latar belakang: Tuberkulosis masih menjadi masalah kesehatan global untuk negara berkembang khususnyadi Indonesia yang merupakan urutan kelima tertinggi di dunia. Sekuele tuberkulosis dapat terjadi padasebagaian besar pasien yang mengalami penyembuhan setelah mendapatkan pengobatan. Perubahan sekueletuberkulosis menimbulkan perubahan pada paru sehingga mengalami penurunan fungsi paru.Tujuan: Penelitian ini bertujuan mengetahui perbedaan fungsi paru forced expiratory volume in one second(FEV1) dan forced vital capacity (FVC) pada berbagai derajat sekuele tuberkulosis.Metode: Desain penelitian ini adalah potong lintang pada pasien rawat jalan poliklinik BP4 Yogyakarta dariSeptember 2013 hingga sampel terpenuhi. Perbedaan dianalisis dengan uji t dan analisis normalitas denganuji Shapiro-Wilk. Perbedaan bermakna bila p< 0.05 dengan interval kepercayaan 95%.Hasil: Hasil penelitian didapatkan subyek penelitian sebanyak 44 pasien yang terdiri dari 29 (65,9%)laki-laki dan 15(34,1%) perempuan. Subyek yang memenuhi kriteria dilakukan pemeriksaan foto thorakposteroanterior (PA). Derajat keparahan foto thorak dinilai menurut indeks Willcox. Tes spirometri dilakukanuntuk mendapatkan gambaran fungsi paru berupa FEV1 dan FVC. Karakteristik dasar subyek penelitianmenurut fungsi paru menunjukkan kelainan restriksi yang paling banyak yaitu 28 (60,9%). Perbedaan fungsiparu FEV1 bermakna pada derajat ringan dengan derajat berat (p= 0,024) dan bermakna pada fungsi paruFVC pada derajat ringan dengan derajat berat (p= 0,031).Kesimpulan: terdapat perbedaan bermakna fungsi paru FEV1 dan FVC pada derajat ringan dengan derajatberat.Kata kunci: Sekuele tuberkulosis, fungsi paru, indeks Willcox.ABSTRACTBackground: Tuberculosis remains a global health problem to developing countries, especially in Indonesiawhich is the fi fth highest in the world. Tuberculosis sequelae can occur on most patients who experiencedhealing after treatment. Tuberculosis sequelae changes cause changes in the lungs so that the decline inlung functions.Objective: This study was to determine differences in lung function, forced expiratory volume in one second(FEV1) and forced vital capacity (FVC) at various degrees of sequelae tuberculosis.Method: This is a cross-sectional study in an outpatient BP4 Yogyakarta from September 2013 until thesample met. Differences were analyzed by t-test and analysis of normality with Shapiro-Wilk test. Signifi cantdifference is when P <0.05 with 95% confi dence intervals.Result: The study subjects were 44 patients consisted of 29 (65.8%) males and 15 (34.1%) women. Subjectswho met the criteria examined thoracic images posteroanterior (PA). The degrees of severity of thoracicimages were assessed by Willcox index. Spirometry tests performed to get an overview of lung functionsuch as FEV1 and FVC. Basic characteristics of the study subjects according to pulmonary functionabnormalities restriction showed at most that 28 (63.6%). Signifi cant differences in FEV1 lung function in mild degree with severe degree (p = 0024) and FVC signifi cantly in lung function in mild degree withsevere degree (p= 0.031).Conclusion: There are signifi cant differences in lung function, FEV1 and FVC at mild degree by severedegree.Keywords: Tuberculosis sequelae, pulmonary function, index Willcox
Changes in Anthropometry Measurement among Human Immunodefi ciency Virus/Acquired Immune Defi ciency Syndrome (HIV/AIDS) Patients Received Antiretroviral Treatment Adi Irawan; Doni Priambodo Wijisaksono; Rizka Humardewayanti; Yanri WIjayanti
Acta Interna The Journal of Internal Medicine Vol 4, No 2 (2014): The Journal of Internal Medicine
Publisher : Faculty of Medicine Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (858.417 KB) | DOI: 10.22146/acta interna.16851

Abstract

ABSTRACTBackground: Estimated nearly 38.6 million people infected by HIV and 2.8 million died in 2005. Evidence suggests the existence of a very important relationship between the output and improved nutritional statusin HIV/AIDS patients. Poor nutritional status in HIV/AIDS can be caused by several factors, namely the intake and absorption of inadequate nutrition, metabolic changes, hyper metabolism, or a combination of these, changes in the gastrointestinal tract as well as interactions between drugs and nutrients. Losing weight remains on the HAART (Highly Active Antiretroviral Therapies) era, but the problems are the side effects of HAART and lipodystrophy.Objective: The purpose of this study is to determine the provision of anti- retroviral effect on changes in anthropometric values people with HIV/AIDS. Method: The study is using the one group pre-posttest design (quasi-experimental), by assessing changes in anthropometric values in subjects with HIV before and after the administration of ARVs. Analysis of the data is computerized by a computer program Result: Obtained 30 samples of the study with anthropometric changes pre and post ARVs 6 months. Theweight was 51.4 ± 9.12 to 53.6 ± 8.68 with a p-value 0.001. Body Mass Index (BMI) was 19.98 ± 3.47 into 20.84 ± 3.35 with a p-value 0.001 and upper arm circumference 24.13 ± 3.62 into 24.95±3.48 with a p-value 0.003. The provision of antiretroviral drugs for 6 months infl uences the change in nutritional status of HIV patients are assessed by anthropometric measure. Signifi cant changes in the changes body weight, BMIand upper arm circumference. Changes in anthropometric values ARV Efavirenz group and non-Efavirenz meaningful change signifi cant in skinfold thickness obtained at the value of p 0.010.Conclusion: There were no signifi cant changes in anthropometric values compared to patients with early stage HIV and advanced stage after 6 months of antiretroviral therapy.Keywords: HIV, antiretroviral drugs, anthropometric, nutritional status

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