Irsan Hasan, A. Sulaiman, Cosmas Juferdy Kurniawan, Rinaldi A. Lesmana, M. ChyntiaOlivia, Saut Horas H Jasirwan, Kemal Nababan, Gita Fariz Kalista, Maria Aprilicia, Rino Alvani Teressa, Gani, Divisi Hepatobilier
Introduction. Hepatocellular carcinoma (HCC) is the most common primary liver cancer in the world and Indonesia. This study aimed to describe the clinical presentation and survival rate of HCC patients in Dr. Cipto Mangunkusumo Hospital (RSCM) as the Indonesian tertiary referral hospital in year 2015-2021 Methods. Cohort study was performed in year 2015-2021. Clinical presentations at the time of diagnosis were recorded from electronical health record. All HCC patients were followed up until death. One-year survival based on staging was assessed using log rank test and presented with Kaplan Meier curve. Results. A total of 799 HCC patients were included. Majority of HCC patients were male, 619 patients (77.5%), and aged 55 (SD 11.9) years. Hepatitis B was the major etiology, found in 500 patients (62.6%). Median of alfa feto-protein (AFP) was 1,109 (0.8-3,462,499) ng/ml. At the time of diagnosis, Barcelona Clinic Liver Cancer (BCLC) stage C (37.7%) was the most commonly found. Portal vein thrombosis was found in 205 patients (25.7%). There were 271 (33.9%) HCC patients received curative and palliative treatment, and others had supportive care. One year survival rate of HCC was 61.2%. One year survival rate of HCC based on staging for BCLC A, BCLC B, BCLC C, and BCLC D were 91.1%, 68.6%, 47.6%, and 13.3%, respectively (log-rank test: p<0.001). Conclusion. The majority of patients diagnosed with HCC were at an advanced stage so that the one-year survival is poor.
{"title":"Profil Klinis dan Kesintasan Pasien Karsinoma Sel Hati di Rumah Sakit Rujukan Tersier Indonesia Tahun 2015-2021","authors":"Irsan Hasan, A. Sulaiman, Cosmas Juferdy Kurniawan, Rinaldi A. Lesmana, M. ChyntiaOlivia, Saut Horas H Jasirwan, Kemal Nababan, Gita Fariz Kalista, Maria Aprilicia, Rino Alvani Teressa, Gani, Divisi Hepatobilier","doi":"10.7454/jpdi.v10i2.1455","DOIUrl":"https://doi.org/10.7454/jpdi.v10i2.1455","url":null,"abstract":"Introduction. Hepatocellular carcinoma (HCC) is the most common primary liver cancer in the world and Indonesia. This study aimed to describe the clinical presentation and survival rate of HCC patients in Dr. Cipto Mangunkusumo Hospital (RSCM) as the Indonesian tertiary referral hospital in year 2015-2021 Methods. Cohort study was performed in year 2015-2021. Clinical presentations at the time of diagnosis were recorded from electronical health record. All HCC patients were followed up until death. One-year survival based on staging was assessed using log rank test and presented with Kaplan Meier curve. Results. A total of 799 HCC patients were included. Majority of HCC patients were male, 619 patients (77.5%), and aged 55 (SD 11.9) years. Hepatitis B was the major etiology, found in 500 patients (62.6%). Median of alfa feto-protein (AFP) was 1,109 (0.8-3,462,499) ng/ml. At the time of diagnosis, Barcelona Clinic Liver Cancer (BCLC) stage C (37.7%) was the most commonly found. Portal vein thrombosis was found in 205 patients (25.7%). There were 271 (33.9%) HCC patients received curative and palliative treatment, and others had supportive care. One year survival rate of HCC was 61.2%. One year survival rate of HCC based on staging for BCLC A, BCLC B, BCLC C, and BCLC D were 91.1%, 68.6%, 47.6%, and 13.3%, respectively (log-rank test: p<0.001). Conclusion. The majority of patients diagnosed with HCC were at an advanced stage so that the one-year survival is poor.","PeriodicalId":32700,"journal":{"name":"Jurnal Penyakit Dalam Indonesia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44782568","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction. Doctors have greater risk of acquiring COVID-19 due to occupational exposure. Personal protective equipment (PPE) is an essential factor in reducing COVID-19 transmission. We aimed to evaluate the behavior changes of PPE usage among doctors in Indonesia before and after getting COVID-19 infection in early pandemic. Methods. This was a descriptive online survey with cross-sectional design. This survey was conducted from October-December 2020 among Indonesian doctors who were COVID-19 survivors. Results. A total of 389 doctors who survived COVID-19 infection across Indonesia were included in the final analysis. Most participants were general practitioners and residents (69.2%) with a median age of 40 (22-28) years. After being infected, there was an improvement in the use of N95 respirator masks in isolation rooms (always: 80.9% from 70.2%; sometimes: 13.2% from 15.8%). An improvement in the use of other PPE before and after being infected with COVID-19 was also shown by the use of other PPE such as headcap (93.9% from 83.3%), face shield (90.4% from 83.3%), goggles (70.2% from 62.3%), gown (61.4% from 53.6%), hazmat suit (88.6% from 81.6%), boots (82.5% from 71.1%), and gloves (91.3% from 86.8%). Similar results were also shown in the use of PPE in other non-isolation rooms. Conclusion. After recovering from COVID-19 infection, these doctors showed an increase usage of adequate PPE both while on duty in isolation and non-isolation rooms.
{"title":"Introduction. Rheumatoid arthritis (RA) is a systemic and chronic autoimmune disease involving the joints disorder as the main manifestations. Methotrexate (MTX) is currently still the drug of choice for RA treatment due to the good clinical response. However, there was a case reported by the American Geriatric Society in 2015 regarding the presence of reversible dementia after treatment with low-dose oral methotrexate. This study aimed to identify the effect of MTX treatment on cognitive …","authors":"","doi":"10.7454/jpdi.v10i2.1446","DOIUrl":"https://doi.org/10.7454/jpdi.v10i2.1446","url":null,"abstract":"Introduction. Doctors have greater risk of acquiring COVID-19 due to occupational exposure. Personal protective equipment (PPE) is an essential factor in reducing COVID-19 transmission. We aimed to evaluate the behavior changes of PPE usage among doctors in Indonesia before and after getting COVID-19 infection in early pandemic. Methods. This was a descriptive online survey with cross-sectional design. This survey was conducted from October-December 2020 among Indonesian doctors who were COVID-19 survivors. Results. A total of 389 doctors who survived COVID-19 infection across Indonesia were included in the final analysis. Most participants were general practitioners and residents (69.2%) with a median age of 40 (22-28) years. After being infected, there was an improvement in the use of N95 respirator masks in isolation rooms (always: 80.9% from 70.2%; sometimes: 13.2% from 15.8%). An improvement in the use of other PPE before and after being infected with COVID-19 was also shown by the use of other PPE such as headcap (93.9% from 83.3%), face shield (90.4% from 83.3%), goggles (70.2% from 62.3%), gown (61.4% from 53.6%), hazmat suit (88.6% from 81.6%), boots (82.5% from 71.1%), and gloves (91.3% from 86.8%). Similar results were also shown in the use of PPE in other non-isolation rooms. Conclusion. After recovering from COVID-19 infection, these doctors showed an increase usage of adequate PPE both while on duty in isolation and non-isolation rooms.","PeriodicalId":32700,"journal":{"name":"Jurnal Penyakit Dalam Indonesia","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136254776","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Setelah Pandemi Covid, Peran Penggunaan, Alat Pelindung, Diri bagi Tenaga, Medis di Indonesia, Sukamto Koesnoe, Muhammad Ikrar Hermanadi
{"title":"Setelah Pandemi COVID-19: Peran Penggunaan Alat Pelindung Diri bagi Tenaga Medis di Indonesia","authors":"Setelah Pandemi Covid, Peran Penggunaan, Alat Pelindung, Diri bagi Tenaga, Medis di Indonesia, Sukamto Koesnoe, Muhammad Ikrar Hermanadi","doi":"10.7454/jpdi.v10i2.1473","DOIUrl":"https://doi.org/10.7454/jpdi.v10i2.1473","url":null,"abstract":"","PeriodicalId":32700,"journal":{"name":"Jurnal Penyakit Dalam Indonesia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42724186","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cardiovascular diseases (CVDs) still contribute as the main cause of mortality and premature mortality worldwide. In Indonesia, CVDs contribute to 35% of the main cause of death in non-communicable diseases followed by diabetes at 6%. The ischemic heart disease and acute ischemic stroke is the main cause of death in Indonesia due to atherosclerosis. Atherosclerosis is a multifactorial cause, with chronic inflammation which causes myocardial infarction and acute ischemic stroke. Research demonstrated that one of the underlying mechanisms of atherosclerosis is inflammation. The current research suggested that inflammation could activate a complex of cytosol proteins, namely nucleotide-binding oligomerization domain-like receptor family pyrin domain containing 3 (NLRP3) inflammasome. The NLRP3 inflammasome is known as a protein sensor as a response to danger signals known as pathogen-associated molecular patterns (PAMPs) or damage/danger-associated molecular patterns (DAMPs). The NLRP3 inflammasome will convert the pro-IL1β and pro-IL-18 into their mature forms which initiates the cell death (pyroptosis) through the cleavage of Caspase-1. This NLRP3 inflammasome has a central role in the initiation and progression of atherosclerosis by affecting the sequences of its cellular and molecular targets. To date, several small molecules and drugs have been identified as NLRP3 inflammasome inhibitory pathways and potential therapeutic agents for atherosclerosis. In this review, we will discuss further the structure of NLRP3 inflammasome and its roles in atherosclerosis, and the potential candidates of the small molecules and drugs targeted in the inflammasome pathway.
{"title":"Peran Penting Inflamasom NLRP3 pada Aterosklerosis","authors":"","doi":"10.7454/jpdi.v10i2.1417","DOIUrl":"https://doi.org/10.7454/jpdi.v10i2.1417","url":null,"abstract":"Cardiovascular diseases (CVDs) still contribute as the main cause of mortality and premature mortality worldwide. In Indonesia, CVDs contribute to 35% of the main cause of death in non-communicable diseases followed by diabetes at 6%. The ischemic heart disease and acute ischemic stroke is the main cause of death in Indonesia due to atherosclerosis. Atherosclerosis is a multifactorial cause, with chronic inflammation which causes myocardial infarction and acute ischemic stroke. Research demonstrated that one of the underlying mechanisms of atherosclerosis is inflammation. The current research suggested that inflammation could activate a complex of cytosol proteins, namely nucleotide-binding oligomerization domain-like receptor family pyrin domain containing 3 (NLRP3) inflammasome. The NLRP3 inflammasome is known as a protein sensor as a response to danger signals known as pathogen-associated molecular patterns (PAMPs) or damage/danger-associated molecular patterns (DAMPs). The NLRP3 inflammasome will convert the pro-IL1β and pro-IL-18 into their mature forms which initiates the cell death (pyroptosis) through the cleavage of Caspase-1. This NLRP3 inflammasome has a central role in the initiation and progression of atherosclerosis by affecting the sequences of its cellular and molecular targets. To date, several small molecules and drugs have been identified as NLRP3 inflammasome inhibitory pathways and potential therapeutic agents for atherosclerosis. In this review, we will discuss further the structure of NLRP3 inflammasome and its roles in atherosclerosis, and the potential candidates of the small molecules and drugs targeted in the inflammasome pathway.","PeriodicalId":32700,"journal":{"name":"Jurnal Penyakit Dalam Indonesia","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41509331","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hanifa Zahra Besri, Yusri Dianne Jurnalis, A. Putra, D. Fitrina, Husni
Introduction. Coronavirus Disease 2019 (COVID-19) is caused by Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) which in 2020 was declared a global pandemic. In the management of COVID-19, patients are classified according to the severity. Identifying prognostic factors at an early stage helps assess severity risks. Abnormal hematological parameters were present in COVID-19 patients such as the elevation of neutrophil lymphocyte ratio (NLR) and D-dimer patients. This study aimed to determine the NLR and D-dimer levels based on the severity of COVID-19 patients. Methods. This study was an observational analytical study that used a case-control approach using 100 medical records of COVID-19 patients who were treated at Semen Padang Hospital in 2021. Consecutive sampling was used in this study. ANOVA test and the Kruskal-Wallis test were used for bivariate analysis. The results were considered significant if the p-value <0.05. Results. Characteristics of patients treated for COVID-19 were: 51% male and 49% female, mean age 57.79 (SD 13.5) years. NLR values based on the severity (mild, moderate, severe, and critical) were 3.12 (SD 2.04), 3.51 (SD 2.87), 6.89 (SD 3.6), 12.57 (SD 10.34) respectively; p<0.05. The median value of D-dimer (ng/mL) based on the severity (mild, moderate, severe, and critical) were 444, 791, 1,610, 2,135; p<0.05. The results of this study showed that there were significant differences in the NLR values and D-dimer levels based on severity. Conclusion. RNL value and D-dimer levels increase the most in the critical degree group and shows a significant relationship in COVID-19 patients.
{"title":"Rasio Neutrofil Limfosit dan Kadar D-Dimer berdasarkan Derajat Keparahan Pasien COVID-19 di Rumah Sakit Semen Padang : Studi Kasus Kontrol","authors":"Hanifa Zahra Besri, Yusri Dianne Jurnalis, A. Putra, D. Fitrina, Husni","doi":"10.7454/jpdi.v10i2.1451","DOIUrl":"https://doi.org/10.7454/jpdi.v10i2.1451","url":null,"abstract":"Introduction. Coronavirus Disease 2019 (COVID-19) is caused by Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) which in 2020 was declared a global pandemic. In the management of COVID-19, patients are classified according to the severity. Identifying prognostic factors at an early stage helps assess severity risks. Abnormal hematological parameters were present in COVID-19 patients such as the elevation of neutrophil lymphocyte ratio (NLR) and D-dimer patients. This study aimed to determine the NLR and D-dimer levels based on the severity of COVID-19 patients. Methods. This study was an observational analytical study that used a case-control approach using 100 medical records of COVID-19 patients who were treated at Semen Padang Hospital in 2021. Consecutive sampling was used in this study. ANOVA test and the Kruskal-Wallis test were used for bivariate analysis. The results were considered significant if the p-value <0.05. Results. Characteristics of patients treated for COVID-19 were: 51% male and 49% female, mean age 57.79 (SD 13.5) years. NLR values based on the severity (mild, moderate, severe, and critical) were 3.12 (SD 2.04), 3.51 (SD 2.87), 6.89 (SD 3.6), 12.57 (SD 10.34) respectively; p<0.05. The median value of D-dimer (ng/mL) based on the severity (mild, moderate, severe, and critical) were 444, 791, 1,610, 2,135; p<0.05. The results of this study showed that there were significant differences in the NLR values and D-dimer levels based on severity. Conclusion. RNL value and D-dimer levels increase the most in the critical degree group and shows a significant relationship in COVID-19 patients.","PeriodicalId":32700,"journal":{"name":"Jurnal Penyakit Dalam Indonesia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42212975","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Critical limb threatening ischemia (CLTI) is the most advanced stage of peripheral arterial diseases. Alternative treatment for claudication in CLTI patients is beraprost. We aim to review effectiveness and safety beraprost for relieve symptoms in CLTI. We conducted systematic literature searching using PubMed/MEDLINE, Embase, ProQuest, and Cochrane databases. Selected articles were examined for duplication and screened by abstract and title. Then, we appraised the articles based on the critical appraisal sheet from Centre for Evidence-Based Medicine (CEBM) University of Oxford. We found one systematic review-meta analysis (SR-MA) which involved 4,477 randomized participants. The results from this study are moderate quality evidence that prostanoids reduced rest pain (RR 1.30; 95%CI 1.06 – 1.59) and promoted ulcer healing (RR 1.24; 95%CI 1.04 – 1.48). In adult patients with CLTI and intermittent claudication as the primary complaint, vasodilator agents such as beraprost have a beneficial effect and a favorable therapeutic response. Numerous effects, including cardiovascular benefit, adverse events, resting pain relief, ulcer healing, outcome maximum walking distance (MWD), and pain-free walking distance, demonstrate the benefit (PFWD). The benefits of beraprost differ depending on the mechanism of action and pharmacokinetics of the drugs.
{"title":"Efektivitas dan Keamanan Beraprost untuk Pengobatan Klaudikasio Intermiten pada Critical Limb Threatening Ischemia (CLTI)","authors":"","doi":"10.7454/jpdi.v10i2.1415","DOIUrl":"https://doi.org/10.7454/jpdi.v10i2.1415","url":null,"abstract":"Critical limb threatening ischemia (CLTI) is the most advanced stage of peripheral arterial diseases. Alternative treatment for claudication in CLTI patients is beraprost. We aim to review effectiveness and safety beraprost for relieve symptoms in CLTI. We conducted systematic literature searching using PubMed/MEDLINE, Embase, ProQuest, and Cochrane databases. Selected articles were examined for duplication and screened by abstract and title. Then, we appraised the articles based on the critical appraisal sheet from Centre for Evidence-Based Medicine (CEBM) University of Oxford. We found one systematic review-meta analysis (SR-MA) which involved 4,477 randomized participants. The results from this study are moderate quality evidence that prostanoids reduced rest pain (RR 1.30; 95%CI 1.06 – 1.59) and promoted ulcer healing (RR 1.24; 95%CI 1.04 – 1.48). In adult patients with CLTI and intermittent claudication as the primary complaint, vasodilator agents such as beraprost have a beneficial effect and a favorable therapeutic response. Numerous effects, including cardiovascular benefit, adverse events, resting pain relief, ulcer healing, outcome maximum walking distance (MWD), and pain-free walking distance, demonstrate the benefit (PFWD). The benefits of beraprost differ depending on the mechanism of action and pharmacokinetics of the drugs.","PeriodicalId":32700,"journal":{"name":"Jurnal Penyakit Dalam Indonesia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49348552","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Artati Murwaningrum, Ikhwan Rinaldi, Inna Intani Mustopa, R. Cipto, Jakarta Mangunkusumo, Divisi Hematologi Onkologi, Kelompok Medik, Staf Medis, Ilmu Penyakit, Dalam
Prevalence of anemia in Indonesia based on Basic Health Research (2018) was 23.7%. Symptoms of iron deficiency anemia were pallor, malaise, palpitation, shortness of breath, headache, sore tongue. But sometimes can be found abnormal behavior in the form of PICA. This article reports on a-52-year-old man who sought medical treatment and was diagnosed with iron deficiency anemia with pica manifestation. The pica manifestation was characterized by a repeated desire to consume raw rice due to bleeding from hemorrhoids. Patient was given oral iron replacement therapy contain 100 mg of Fe (III) hydroxide polymaltose complex and folic acid 0.35 mg alternating with vitamin C 500 mg daily. Total iron daily dose given were 200 mg, divided in two doses. The patient received dietary education and was advised to consult a Gastroenterohepatology Subspecialist for the management of hemorrhoids, but it has not been done yet. The desire for raw rice consumption disappeared and the hemoglobin level increased to 12.4 g/dL after six weeks of therapy. The patient continued to take iron supplements until January 2023 but did not have follow-up visits to the clinic. In January 2023, the patient underwent hemorrhoid surgery due to bleeding accompanied by and a non-reducible lump that had been present for three days. Iron supplements continued for one month post-operation and then discontinued. The latest hemoglobin level was 15.3 g/dL without iron supplements. The symptoms of pica in this patient disappeared along with an increased hemoglobin level, and the management of severe anemia in this patient showed an adequate response. Bleeding has never occurred again after the surgery. Curative measures for hemorrhoidal bleeding are crucial, while iron supplementation is only a supportive therapy.
{"title":"Pica sebagai Manifestasi Anemia Defisiensi Besi: Suatu Laporan Kasus","authors":"Artati Murwaningrum, Ikhwan Rinaldi, Inna Intani Mustopa, R. Cipto, Jakarta Mangunkusumo, Divisi Hematologi Onkologi, Kelompok Medik, Staf Medis, Ilmu Penyakit, Dalam","doi":"10.7454/jpdi.v10i2.1101","DOIUrl":"https://doi.org/10.7454/jpdi.v10i2.1101","url":null,"abstract":"Prevalence of anemia in Indonesia based on Basic Health Research (2018) was 23.7%. Symptoms of iron deficiency anemia were pallor, malaise, palpitation, shortness of breath, headache, sore tongue. But sometimes can be found abnormal behavior in the form of PICA. This article reports on a-52-year-old man who sought medical treatment and was diagnosed with iron deficiency anemia with pica manifestation. The pica manifestation was characterized by a repeated desire to consume raw rice due to bleeding from hemorrhoids. Patient was given oral iron replacement therapy contain 100 mg of Fe (III) hydroxide polymaltose complex and folic acid 0.35 mg alternating with vitamin C 500 mg daily. Total iron daily dose given were 200 mg, divided in two doses. The patient received dietary education and was advised to consult a Gastroenterohepatology Subspecialist for the management of hemorrhoids, but it has not been done yet. The desire for raw rice consumption disappeared and the hemoglobin level increased to 12.4 g/dL after six weeks of therapy. The patient continued to take iron supplements until January 2023 but did not have follow-up visits to the clinic. In January 2023, the patient underwent hemorrhoid surgery due to bleeding accompanied by and a non-reducible lump that had been present for three days. Iron supplements continued for one month post-operation and then discontinued. The latest hemoglobin level was 15.3 g/dL without iron supplements. The symptoms of pica in this patient disappeared along with an increased hemoglobin level, and the management of severe anemia in this patient showed an adequate response. Bleeding has never occurred again after the surgery. Curative measures for hemorrhoidal bleeding are crucial, while iron supplementation is only a supportive therapy.","PeriodicalId":32700,"journal":{"name":"Jurnal Penyakit Dalam Indonesia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44180157","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Farah Fauzia, N. Prihartono, Rudy Hidayat, Abirianti P. Araminta
Introduction. Rheumatoid arthritis (RA) is a systemic and chronic autoimmune disease involving the joints disorder as the main manifestations. Methotrexate (MTX) is currently still the drug of choice for RA treatment due to the good clinical response. However, there was a case reported by the American Geriatric Society in 2015 regarding the presence of reversible dementia after treatment with low-dose oral methotrexate. This study aimed to identify the effect of MTX treatment on cognitive disorder in RA patients. Methods. The study protocol was registered with PROSPERO (CRD42023414937). A systematic literature search was conducted in Medline Embase database, Scopus, CENTRAL to identify cohort observational studies, case controls, and randomized control trial (RCT) studies, evaluating the effect of methotrexate therapy on cognitive function disorder in RA patients. The Newcastle-Ottawa Scale (NOS Scale) was used to analyze the quality of existing observational studies and The COCHRANE was used to analyze the RCT studies which included in the journals reviewed. Results. There were 4 observational studies that met the criteria, including 2 case control studies and 2 cohort studies. Pooling was carried out in two different types of studies. The OR was 0.81 (95%CI 0.4 – 1.68) in the case control studies group, whereas the RR was 0.88 (95% CI 0 .6 – 1.3) in the cohort studies group. The heterogeneity of each type of case-control studies and cohort studies were I2 92% (p-value277% (p-value Conclusion. Methotrexate therapy has not been proven to have an effect on cognitive disorder in RA patients either as a protective factor or as a risk factor.
{"title":"Pengaruh Terapi Metotreksat pada Pasien Artritis Reumatoid terhadap Penurunan Fungsi Kognitif: Meta-Analisis Berdasarkan Telaah Sistematik","authors":"Farah Fauzia, N. Prihartono, Rudy Hidayat, Abirianti P. Araminta","doi":"10.7454/jpdi.v10i2.1442","DOIUrl":"https://doi.org/10.7454/jpdi.v10i2.1442","url":null,"abstract":"Introduction. Rheumatoid arthritis (RA) is a systemic and chronic autoimmune disease involving the joints disorder as the main manifestations. Methotrexate (MTX) is currently still the drug of choice for RA treatment due to the good clinical response. However, there was a case reported by the American Geriatric Society in 2015 regarding the presence of reversible dementia after treatment with low-dose oral methotrexate. This study aimed to identify the effect of MTX treatment on cognitive disorder in RA patients. Methods. The study protocol was registered with PROSPERO (CRD42023414937). A systematic literature search was conducted in Medline Embase database, Scopus, CENTRAL to identify cohort observational studies, case controls, and randomized control trial (RCT) studies, evaluating the effect of methotrexate therapy on cognitive function disorder in RA patients. The Newcastle-Ottawa Scale (NOS Scale) was used to analyze the quality of existing observational studies and The COCHRANE was used to analyze the RCT studies which included in the journals reviewed. Results. There were 4 observational studies that met the criteria, including 2 case control studies and 2 cohort studies. Pooling was carried out in two different types of studies. The OR was 0.81 (95%CI 0.4 – 1.68) in the case control studies group, whereas the RR was 0.88 (95% CI 0 .6 – 1.3) in the cohort studies group. The heterogeneity of each type of case-control studies and cohort studies were I2 92% (p-value277% (p-value Conclusion. Methotrexate therapy has not been proven to have an effect on cognitive disorder in RA patients either as a protective factor or as a risk factor.","PeriodicalId":32700,"journal":{"name":"Jurnal Penyakit Dalam Indonesia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44635173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction. The 2018 Riskesdas data shows that the prevalence of diabetes mellitus is increasing each year. Strobilanthes crispus leaves are known for lowering blood glucose levels. This study aimed to determine the difference in the effectiveness of S. crispus leaves ethanolic extract on fasting blood glucose (FBG) and post-oral glucose tolerance test (OGTT). Methods. True experimental study using post-test only control group design and Rattus norvegicus as experimental animals. Rattus norvegicus were selected by random sampling which were then divided into 4 groups (K, P1, P2, P3), each group consisted of 5 animals. The animals were subsequently induced with diabetes mellitus via a single injection of 160 mg/kgBW/IP alloxan. Group K was given 0.5% NaCMC solution at a dose of 1 ml/200 g BW/day/oral/day. Group P1, P2, and P3 received extract at a dose of 100, 400, 600 mg/kg BW/oral/day for 21 days using oral gavage. Statistical analysis was performed using ANOVA, Tukey, Brown-Forsythe, and Kruskal-Wallis tests. Results. Mean FBG level in group K, P1, P2, P3 were 338.40 mg/dL, 270.80 mg/dL, 200.00 mg/dL, and 138.60 mg/dL, respectively. Mean value of 60 minutes OGTT blood glucose level in group K, P1, P2, P3 were 355.60 mg/dL, 289.00 mg/dL, 188.00 mg/dL, and 164.40 mg/dL, respectively. Meanwhile, mean value of 120 minutes OGTT blood glucose level in group K, P1, P2, P3 were 346.60 mg/dL, 236.20 mg/dL, 175.40 mg/dL, and 117.20 mg/dL, respectively. The hypothesis test results showed a significant difference in 120 minutes OGTT blood glucose level (p= 0.031). Conclusion. The use of ethanol extract from S. crispus leaves is more beneficial in reducing blood glucose levels in 120 minutes OGTT compared to FBG level and 60 minutes OGTT level, with the highest reduction observed in the group given a dose of 600 mg/kgBW/oral/day compared to control.
{"title":"Efektivitas Ekstrak Strobilanthes crispus terhadap Kadar Glukosa Darah Puasa dan Pasca Tes Toleransi Glukosa Oral pada Rattus norvegicus Diabetes Melitus","authors":"","doi":"10.7454/jpdi.v10i1.1028","DOIUrl":"https://doi.org/10.7454/jpdi.v10i1.1028","url":null,"abstract":"Introduction. The 2018 Riskesdas data shows that the prevalence of diabetes mellitus is increasing each year. Strobilanthes crispus leaves are known for lowering blood glucose levels. This study aimed to determine the difference in the effectiveness of S. crispus leaves ethanolic extract on fasting blood glucose (FBG) and post-oral glucose tolerance test (OGTT). Methods. True experimental study using post-test only control group design and Rattus norvegicus as experimental animals. Rattus norvegicus were selected by random sampling which were then divided into 4 groups (K, P1, P2, P3), each group consisted of 5 animals. The animals were subsequently induced with diabetes mellitus via a single injection of 160 mg/kgBW/IP alloxan. Group K was given 0.5% NaCMC solution at a dose of 1 ml/200 g BW/day/oral/day. Group P1, P2, and P3 received extract at a dose of 100, 400, 600 mg/kg BW/oral/day for 21 days using oral gavage. Statistical analysis was performed using ANOVA, Tukey, Brown-Forsythe, and Kruskal-Wallis tests. Results. Mean FBG level in group K, P1, P2, P3 were 338.40 mg/dL, 270.80 mg/dL, 200.00 mg/dL, and 138.60 mg/dL, respectively. Mean value of 60 minutes OGTT blood glucose level in group K, P1, P2, P3 were 355.60 mg/dL, 289.00 mg/dL, 188.00 mg/dL, and 164.40 mg/dL, respectively. Meanwhile, mean value of 120 minutes OGTT blood glucose level in group K, P1, P2, P3 were 346.60 mg/dL, 236.20 mg/dL, 175.40 mg/dL, and 117.20 mg/dL, respectively. The hypothesis test results showed a significant difference in 120 minutes OGTT blood glucose level (p= 0.031). Conclusion. The use of ethanol extract from S. crispus leaves is more beneficial in reducing blood glucose levels in 120 minutes OGTT compared to FBG level and 60 minutes OGTT level, with the highest reduction observed in the group given a dose of 600 mg/kgBW/oral/day compared to control.","PeriodicalId":32700,"journal":{"name":"Jurnal Penyakit Dalam Indonesia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42421624","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hildebrand Hanoch Victor, E. Wahyudi, C. M. Rumende, C. H. Soejono, A. G. Rooshoeroe, Hamzah Shatri, Leonard Nainggolan, Cosphiadi Irawan
Introduction. Nosocomial pneumonia is a lung infection that occurs after the patient is hospitalized for more than 48 hours, without any signs of pulmonary infection at the time of treatment. When compared with young individuals, elderly individuals are more likely to have community-sourced and nosocomial infections with worse outcomes. Comprehensive Geriatric Assessment (CGA) domains are expected to explain the factors that contribute to nosocomial pneumonia in elderly patients. This study aimed to determine the proportion of elderly treated at Dr. Cipto Mangunkusumo National Central General Hospital who experienced nosocomial pneumonia and whether the CGA domains influence the occurrence of nosocomial pneumonia. Methods. A retrospective cohort study was conducted by analyzing the medical records of patients aged 60 years or older who were hospitalized in the medical ward of Geriatric Internal Medicine at Dr. Cipto Mangunkusomo National Central General Hospital in January – September 2019. We also collected secondary data from the geriatric division’s research. The sample consisted of inpatients aged ≥60 years who were hospitalized for more than 48 hours. Those who died within the first 48 hours of hospitalization and subjects with incomplete CGA domain data were excluded from the study. The criteria for nosocomial pneumonia used in this study followed the CDC’s pneumonia criteria for geriatric patients. Data processing was conducted using the application of Statistical Product and Service Solutions (SPSS) 16. Results. Of 228 subjects, the proportion of nosocomial pneumonia in elderly patients hospitalized was 31,14%. The mean age was 69 years with the subject’s age range between 60-89 years. Nutritional status (OR 2.226; CI95% 1.027-4.827) and functional status (OR 3.578; 95%CI 1.398-9.161) are factors that influence the incidence of nosocomial pneumonia in elderly patients who are hospitalized at Dr. Cipto Mangunkusumo National Central General Hospital. Conclusions. The proportion of elderly patients with nosocomial pneumonia was 31.14%. Nutritional status and functional status are factors that influence the incidence of nosocomial pneumonia in elderly patients who are hospitalized at Dr. Cipto Mangunkusumo National Central General Hospital.
{"title":"Penilaian Domain Pengkajian Paripurna Pasien Geriatri (P3G) sebagai Faktor yang Berpengaruh terhadap Kejadian Pneumonia Nosokomial pada Pasien Usia Lanjut yang Dirawat di Rumah Sakit Umum Pusat Nasional Dr. Cipto Mangunkusumo","authors":"Hildebrand Hanoch Victor, E. Wahyudi, C. M. Rumende, C. H. Soejono, A. G. Rooshoeroe, Hamzah Shatri, Leonard Nainggolan, Cosphiadi Irawan","doi":"10.7454/jpdi.v10i1.1293","DOIUrl":"https://doi.org/10.7454/jpdi.v10i1.1293","url":null,"abstract":"Introduction. Nosocomial pneumonia is a lung infection that occurs after the patient is hospitalized for more than 48 hours, without any signs of pulmonary infection at the time of treatment. When compared with young individuals, elderly individuals are more likely to have community-sourced and nosocomial infections with worse outcomes. Comprehensive Geriatric Assessment (CGA) domains are expected to explain the factors that contribute to nosocomial pneumonia in elderly patients. This study aimed to determine the proportion of elderly treated at Dr. Cipto Mangunkusumo National Central General Hospital who experienced nosocomial pneumonia and whether the CGA domains influence the occurrence of nosocomial pneumonia. Methods. A retrospective cohort study was conducted by analyzing the medical records of patients aged 60 years or older who were hospitalized in the medical ward of Geriatric Internal Medicine at Dr. Cipto Mangunkusomo National Central General Hospital in January – September 2019. We also collected secondary data from the geriatric division’s research. The sample consisted of inpatients aged ≥60 years who were hospitalized for more than 48 hours. Those who died within the first 48 hours of hospitalization and subjects with incomplete CGA domain data were excluded from the study. The criteria for nosocomial pneumonia used in this study followed the CDC’s pneumonia criteria for geriatric patients. Data processing was conducted using the application of Statistical Product and Service Solutions (SPSS) 16. Results. Of 228 subjects, the proportion of nosocomial pneumonia in elderly patients hospitalized was 31,14%. The mean age was 69 years with the subject’s age range between 60-89 years. Nutritional status (OR 2.226; CI95% 1.027-4.827) and functional status (OR 3.578; 95%CI 1.398-9.161) are factors that influence the incidence of nosocomial pneumonia in elderly patients who are hospitalized at Dr. Cipto Mangunkusumo National Central General Hospital. Conclusions. The proportion of elderly patients with nosocomial pneumonia was 31.14%. Nutritional status and functional status are factors that influence the incidence of nosocomial pneumonia in elderly patients who are hospitalized at Dr. Cipto Mangunkusumo National Central General Hospital.","PeriodicalId":32700,"journal":{"name":"Jurnal Penyakit Dalam Indonesia","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44307664","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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