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INDONESIA
journal of internal medicine
Published by Universitas Udayana
ISSN : -     EISSN : -     DOI : -
Core Subject : Health,
Medicine & Pharmacology
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Articles 162 Documents
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MANAJEMEN PERIOPERATIF PADA HIPERTENSI Wiryana, Made
journal of internal medicine Vol. 9, No. 2 Mei 2008
Publisher : journal of internal medicine

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Abstract

Hypertension is a leading cause of death and the most frequent preoperative abnormality in surgical patients, and becomemajor risk factor for cardiac, cerebral, renal and vascular disease during intraoperative or post-operative periode. Agressivecontrolled hypertension will decrease complications due to the damage of end organs. Consequences by taking anti-hypertensiveagents is the interaction with other medications that being used during surgery. Consideration must be taken especially due to thehalf life and adjustment dose of this medications. The National Committee 7 (JNC 7) on prevention, detection, evaluation andtreatment of high blood pressure 2003, degree of hypertension can be classified into pre-hypertension (120-139/80-89), hypertensionstage 1 (140-159/90-99 mmHg) and hypertension stage 2 (systolic pressure 160 mmHg or diastolic pressure 100 mmHg).According to the etiology, hypertension can be classified into primary hypertension (80-95%) and secondary hypertension (10-15%) due to the causes. Usually hypertension always has association with abnormality of sympathetic activity, increasing thepheripheral vascular resistance (SVR) or increasing both of them. But the most common cause of hypertension is increasing thepheripheral vascular resistance. Management perioperative of hypertension includes evaluation and optimalised patients conditionpreoperative, management patients who under influenced of anesthetic agents and treatment post operative. Patient withhypertension incline to have instability haemodinamic and more sensitive to anesthesia and surgery procedures, so carefull mustbe taken at the beginning of anesthesia and surgery until post operatively, especially to control hemodynamic. The best monitoringfor patient with hypertension is by using suitable anesthetic techniques, anesthetic agents and antihypertensive agents. Postoperative hypertension can be happened due to several factors such as, inadequate antihypertensive agents, respiratory disturbance,pain, fluid overload, or distended of the bladder. Excellent perioperative management of hypertension patients beforesurgery will decrease morbidity and mortality rate
GAMBARAN KUALITAS HIDUP PASIEN KANKER LIMFOMA NON HODGKIN YANG DIRAWAT DI RSUP SANGLAH DENPASAR (STUDI PENDAHULUAN) Sutrisno, Heri; Dharmayuda, Tjokorda Gde; Rena, Renny A
journal of internal medicine Vol. 11, No. 2 Mei 2010
Publisher : journal of internal medicine

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Abstract

Quality of life was a target therapy in cancer patients especially on metastatic cancer. Quality of life currently havebecomeone of stadard for therapeutic evaluation. Because quality of life was a subjectif characteristic and can only measure bypatient, so measuring quality of life patients must use multidimensional measure tool that offend aspect from physical, social andemotional, simple, easy to understand and answer by all patients and must to validated.To observe description of quality of life from cancer patient of Non Hodgkin Lymphoma (NHL) which admitted in SanglahHospital Denpasar, we have done analytic descriptive research on NHL patients with used EORTC QLQ-C30 questioner. Fifteenof NHL patients which cared in Internal Department Sanglah Hospital on January ? June 2010, 12 (80%) were male and 3 (20%)were female. Good quality of life was 8 (53.3%), moderate was 5 (33.3%) and poor was 2 (13.2%). From 10 (66.7%) patientsundergone chemotherapy, good quality of life was 5 (50%), moderate was 3 (30%) and poor was 2 (20%). There is correlationbetween quality of life of NHL patients with grading of clinical disease (p = 0.032; r = -0.554), there is no correlation qualityof life with giving chemotherapy in NHL patients (p = 0.560; r = -0.164). Meassuring quality of life NHL patient with EORTCQLQ-C30 was correlated with Karnofsky score (p = 0.031; r = 0.557) and ECOG (p = 0.04; r = -0.699).
KORELASI ANTARA BRACHIAL-ANKLE PULSE WAVE VELOCITY DAN PROFIL LIPID PADA KARYAWAN RUMAH SAKIT SANGLAH DENPASAR Arsana, Gede Putu; -, Kambayana; Santoso, Anwar; Suastika, Ketut
journal of internal medicine Vol. 8, No. 2 Mei 2007
Publisher : journal of internal medicine

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Abstract

Brachial-ankle pulse wave velocity (baPWV) is an indicator of limb arterial stiffness. Dislipidemia is a major risk factorof atherosclerosis and may worsen baPWV by increasing the blood viscosity. This study aims to study the correlations betweenbaPWV and the lipid profile among employees of Sanglah Hospital. Cross sectional analytic study was performed in Sanglahhospital. Pulse wave velocity was measured using an automatic device (Fukuda VS 1000). Lipid profile were taken as well. Datawas expressed in mean + SD, analyzed by t-test compare mean and Pearson correlation by using SPSS 13.0. There were 85patients involved, all subjects were male, age all between 40-56 (mean 47.23 + 5.16) years old. Cholesterol total, LDL-C, HDLC,and triglyceride concentrations varied subject, range (means + SD) as (205.05 + 39.40) mg/dL, (144.26 + 36.85) mg/dL,(45.94 + 8.98) mg/dL, and (151.94 + 64.56) mg/dL, respectively. BaPWV on the right limbs were between (13,31 + 2,14 ) m/sec,on the left limbs were (15,05 + 2,33 ) m/sec. Significant correlations were found between total cholesterol concentration and theleft baPWV (r = 0.222, p = 0.41), while a significant correlation were found on the right side (r = 0.234, p = 0.031). Brachialanklepulse wave velocity is positively correlation with total cholesterol concentration.
SEORANG PENDERITA HAMIL DENGAN LEUKEMIA MIELOID AKUT Sukrawan, Gede; Losen Adnyana, Wayan; Suega, Ketut
journal of internal medicine Vol. 12, No. 2 Mei 2011
Publisher : journal of internal medicine

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Abstract

Leukemia during pregnancy is extremely rare, the estimate one per100,000 pregnancies each year. Intrauterine growthdisorders have been reported in pregnant women with untreated AML. A pregnant female patient, 28 years old, Balinese, privateemploy came with chief complain fever, sweaty, nausea and vomiting, body weekly, Physical examination: anemic, pale, bloodpressure; 120/80mmHg, pulse 88 x/minute, respiration 20 x/minute, axillary temperature of 36.7 degrees Celsius, heart andlungarenormal, Abdoment: fundus uteri-high processusxipoideus, distention and bowel sounds normal. Laboratory January 14th 2011:leukocyte 63,2 103/ul, Hb 11.7 g/dl, hematocrite 33.6%, MCV 30.7 pg, trombocite 40 103/ul, anatomicalpathology on November26th 2009 with increasing blast dysplasia eritroid series, allowing a leukemia acute. January 16th 2010 chemotherapyAra-C150 mg in 500 ml NaCl 0.9% 24 hours for 7 days and daunorubicine 60 mg IV bolus for 3 days. January 18th 2010 laboratoryresultleukosit 46.2 x 103/ul, Hb 9.2 g/dl, hematocrite 26.3%, MCV 87.4 fl, MCH 30.4 pg and thrombocyte 10 x 103/ul. The patienthad complite remission after chemoterapy and laboratory results on February 12th 2010 were leucocyte 7.02 x 103/ul, Hb 8.6g/dl, hematocrite 25.5%, MCV 74.5 fl, MCH 25.5 and thrombocyte 125 x 103/ul. The baby was born with normal condition withoperation. Acute leukemia in pregnancy should be managed together hematologist, obstetrics-gynaecology and neonatologists.
HUBUNGAN ANTARA OBESITAS SENTRAL DENGAN ADIPONEKTIN PADA PASIEN GERITARI DENGAN PENYAKIT JANTUNG KORONER Gotera, Wira; Suastika, Ketut; Santoso, Anwar; Kuswardhani, Tuty
journal of internal medicine Vol. 7, No. 2 Mei 2006
Publisher : journal of internal medicine

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Abstract

Obesity is rapidly becoming a global problem not only in developed countries but also in developing countries such asIndonesia. Visceral obesity (central obesity) is an importance risk for cardiovascular disease and recognition that adipose tissuecan be regarded as a large endocrine organ that secreted inflammatory and anti inflammatory molecules (adiponectin). This studyaims to know the correlation between central obesity and adiponectin in geriatric coronary heart disease (CHD) patients. Thisstudy was cross sectional analytic study of geriatric CHD at out and in patients in Sanglah hospital. Data are presented as groupmean ± SD and analyzed by t-test, chi-square, and Pearson correlation with SPSS 12 software. Forty five patients (35 males and10 females), 23 patient unstable angina pectoris, 14 patient acute myocardial infarction, and 8 patient stable angina pectoris wererecruited and examined. There was high prevalence of central obesity 51.1% (23 patients). Mean of log adiponectin weresignificantly difference between central obese and non central obese (1.80 ± 0.61 vs 1.09 ± 0.41 with p). Central obesity increasedrisk of hypoadiponectinemia 5 times than non central obesity (p=0.011, CI 95% 1.4-17.8). Waist circumference has negativecorrelation with log plasma adiponectin (R=-0.663, p<0.001). There was high prevalence of central obesity in geriatric coronaryheart disease patients. Central obesity increased risk of hypoadiponectinemia 5 times than non central obesity. Waistcircumference has negative correlation with plasma adiponectin. Increased of waist circumference will decrease of adiponectin(cardioprotective protein) and will increase risk of acute coronary syndrome in geriatric patients.
ASOSIASI KADAR YKL-40 SERUM DENGAN PENYEMPITAN CELAH SENDIPADA OSTEOARTRITIS LUTUT SIMPTOMATIS Irawanto, Farid; -, Arianti; -, Yuliasih; Soeroso, Juwono
journal of internal medicine Vol. 13, No. 1 Januari 2012
Publisher : journal of internal medicine

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Abstract

Osteoarthritis (OA) is the leading cause of chronic disability in population. Because individuals with early stages of thedisease are often asymptomatic, a biomarker of early OA may be useful. YKL-40, a major secretory protein of humanchonrocytes and synovial cells, is increased in the serum and synovial uid of individuals with joint or cartilage disease.This study evaluated serum levels YKL-40 in patients with knee OA and its relation with join space narrowing.YKL-40 wereassayed in serum samples from 44 patients (36 women, 8 men, mean age 50 ? 60) with symptomatic OA of the knee joint.YKL-40 assayed by immunoassay and joint space narrowing by ultrasound. OA severity was assessed by the measurementdegree of joint space width with ultrasound. Statistical analysis was perfomed to determine association between serummarker and radiological join space width.The mean (standard error) YKL-40 level was 82.66 ng/ml in patients with knee OA.The serum levels of YKL-40 and joint space narrowing were signi!cantly correlated (Spearman test r = 0.769; p < 0.01).inpatients with symptomatic knee OA. Serum YKL-40 may be a marker of joint inflammation in symptomatic OA.
EUTHYROID SICK SYNDROME Rai Purnami, Ni Ketu; Ratna Saraswati, Made; Sustika, I Ketut
journal of internal medicine Vol. 10, No. 1 Januari 2009
Publisher : journal of internal medicine

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Abstract

Subclinical thyroid dysfunction is a common clinical problem for which there are many controversial issues regardingscreening, evaluation and management. Subclinical hypothyroidism is defined as an elevated serum TSH level associated withnormal total or free T4 and T3 levels. Euthyroid sick syndrome (ESS) identifies abnormalities in thyroid function tests observedin patients with systemic nonthyroidal illnesses (NTIs) and those undergoing surgery or fasting. Abnormalities of thyroid functionin NTIs have been classified as 1). Low T3 syndrome, 2). Low T3-low T4 syndrome, 3). High T4 syndrome, and 4). Otherabnormalities. The condition is not considered to need treatment because there are no symptoms and the tests go back to normalwhen the stressful illness has passed. It has been reported a case of euthyroid sick syndrome of a 49 years old woman, whoÕssuffering from sistemic illness of space occupaying lession in thoracal VII-VIII (with histopathologycal findings: metastaticadeno carcinoma). We found low levels of T3 (0.49 nmol/L) and TSH (<0.05 uI/ml), but normal levels of T4 (96.91nmol/L). Inseverely ill patients, T4 decreases and both T4 and T3 are inversely correlated with mortality rate.
EFEKTIFITAS OBAT PENURUN KOLESTEROL 'STATIN' DALAM MENURUNKAN KEJADIAN KARDIOVASKULER PADA SINDROM KORONER AKUT -, Sajinadiyasa; Santoso, Anwar
journal of internal medicine Vol. 9, No. 1 Januari 2008
Publisher : journal of internal medicine

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Abstract

Acute coronary syndromes (ACS) is usually caused by atherosclerotic process in coronary artery. Clinical manifestation of ACS is unstable angina pectoris, acute miocard infarc ( non-Q-wave and Q-wave) and sudden death. ACS develop have various degrees of coronary artery occlusion. ACS is caused by rupture of plaque with a thin cap. Inflammation is also plays the pathogenesis these syndromes. Stable plaque is imfortance condition in prevent cardiac event and statin drug lowering cholesterol can made stable plaque and as antiimplammation.
HUBUNGAN ANTARA ACTIVITIES SPECIFIC BALANCE CONFIDENCE SCALE DENGAN UMUR DAN FALLS PADA LANSIA DI POLIKLINIK GERIATRI RSUP SANGLAH DENPASAR Yuna Ariawan, IW; Kuswardhani, RA Tuty; Astika, IN; Suka Aryana, IGP
journal of internal medicine Vol. 12, No. 1 Januari 2011
Publisher : journal of internal medicine

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Abstract

Falls are a major health problem for elderly. Apart from the direct injuries resulting from falls, other long-term consequencesmay include disability, fear of falling, and loss of independence, which can have serious effects on people?s health and qualityof life. These risk factors are categorized into two distinct groups: intrinsic and extrinsic factors. Psychological factors, morecommonly referred to the ?fear of falling syndrome?, have been linked to signi! cant reductions of daily activities in fallersresulting in a loss of independence. The Activities-Speci! c Balance Con! dence (ABC) scale was used to measure con! dence incarrying out speci! c activities without falling or becoming unsteady. We conduct an analytic cross-sectional study to determineassociation between ABC scale with age and falls in elderly. Fifty two elderly outpatient, age over 60 years at Geriatric ClinicSanglah Hospital Denpasar on January 2010 recruited for this study. All subjects were asked questionnaire of ABC scale andhistory of falls. Health status was taken from physical examination and medical records. Data were analyzed using SPSSsoftware 17 version.There were 52 elderly outpatient consisted of 26 (50%) men, 26 (50%) women, age range 61 ? 87 years, mean 70.6 ±6.5 years, and 17.3% of them have history of falls. Total ABC scale mean were signi! cantly difference between women andmen (81.2 ± 14.1 vs 90 ± 12.8 p < 0.05); OA and without OA (80.5 ± 18.1 vs 88.6 ± 10.3 p < 0.05); and between faller and nonfaller(73.5 ± 13.6 vs 88.2 ± 12.9 p = 0.01). There was no signi! cant correlation between ABC scale and age. The ABC scalewith cut off 82.9 has signi! cantly association with falls p = 0.01; prevalence ratio = 7.0 95%CI 1.6 ? 49.8; 74.4% sensitivity,78% speci! city. As a conclusion we found lower total ABC scale has signi! cantly association with falls in elderly and has goodsensitivity and speci! city on scale below 82.9%.
HUBUNGAN KONSUMSI PURIN DENGAN HIPERURISEMIA PADA SUKU BALI DI DAERAH PARIW ISATA PEDESAAN -, Hensen; Raka Putra, Tjokorda
journal of internal medicine Vol. 8, No. 1 Januari 2007
Publisher : journal of internal medicine

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Abstract

Hyperuricemia is a condition of high consentration of uric acid in the blood. In most epidemiology study hyperuricemiais defined as level uric acid more than 7.0 mg/dl in men and more than 6.0 mg/dl in women. Hyperuricemia can be caused byseveral factors. Regarding the etiology hyperuricemia can be classified as primary, secondary and idiopathic hyperuricemia.Primary hyperuricemia related to genetic factor while secondary hyperuricemia caused by condition or other factors besidesgenetic factor such as high purin consumption, chronic kidney disease, certain drugs, alcohol and hypertension. To know theassociation between high purine diet and hyperuricemia, a cross sectional analytic study was conducted on Balinese in Ubudregion between Desember 2006 and January 2007. Sample study was Balinese age of 13 year old or above, agree to participateby informed consent. Descriptive statistic analysis on numeric data presented as mean mean ± SD, nominal and ordinal data inproportion. Inferential statistic analysis with bivariate simple logistic regression was performed and multiple logistic regressionwas used to know the independency of its association. Of 301 eligible samples, mean age was 40.85 ± 14.30 y.o, and 161 orang(53.5%) men and 139 (46.3%) women. Youngest age was 13 y.o and oldest was 85 y.o. Mean of purine consumption was 153.37± 77.83 mg/day and mean uric acid consentration was 5.14 ± 1.44 mg/dl with mean body mass index 22.57 ± 3.17 kg/m2.Prevalence of hyperuricemia on this study was 12%. High purine consumption was significantly associated with hyperuricemiaby analysis of prevalent ratio 22,82; CI 95% : 9.19 ? 56.66; p<0.001. On multivariate analysis with multiple logistic regressionhigh purin consumption also has independent association with hyperuricemia with prevalent ratio (PR) 57.30; IK 95% : 16.56 ?198.24; p < 0,001. Other factors that independently associated with hyperuricemia was obesity (PR : 7.21; IK 95% : 2.30 ? 22.60;p = 0.001), and chronic kidney disease stage 4 (PR : 74.73; IK 95% : 8.19 ? 681.60; p < 0.001). Age, alcohol consumption andchronic kidney disease stage 1 ? 3, hypertension not significantly associated with hyperuricemia in this population. Conclusion:high purine consumption was associated to hyperuricemia.

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