Current Internal Medicine Research and Practice Surabaya Journal

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EISSN : 2721-544X
Published by: Universitas Airlangga (10.20473)
Total articles ≅ 29
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Diaz Syafrie Abdillah, Ardyarini Dyah Savitri
Current Internal Medicine Research and Practice Surabaya Journal, Volume 3, pp 1-4; https://doi.org/10.20473/cimrj.v3i1.28169

Abstract:
Introduction: Osteoarthitisgenu is a joint disorder of the genu section due to a gradual decrease in cartilage bone cohesiveness. A metabolic syndrome is a group of both lipid and non-lipid abnormalities in an individual. This study aims to determine the relationship between metabolic syndrome and the incidence of osteoarthritis genu in type 2 DM patients at RSI Jemursari Surabaya. Methods: This study uses an analytic observational method with a cross-sectional design. The population of type 2 DM patients and samples were obtained according to the inclusion and exclusion criteria. The sample size is 98 samples with a simple random sampling technique. Result: In this study, the frequency of the metabolic syndrome in this study (31.6%), age 55-65 years (38.7%), male gender (51.6%), and components of the metabolic syndrome include hypertension, type 2 diabetes, hypertriglyceridemia (83.9%). On the frequency of Genu Osteoarthritis (28.6%) with the age of 46-55 years (43%), female gender (61%). Osteoarthritis genu location distribution is mostly bilateral (60.7%). Conclusion: Based on the results of the Chi-Square Test statistical test using the SPSS statistical application, it shows a p significance value of 0.080 (> 0,05).  Keywords:  Metabolic syndrome, Osteoarthritis genu, DM type 2
Corina Ong
Current Internal Medicine Research and Practice Surabaya Journal, Volume 3, pp 13-15; https://doi.org/10.20473/cimrj.v3i1.31412

Abstract:
Introduction: Indonesia is in the 6th place with the most diabetes mellitus cases in the world. Long term exposure of hyperglycemia that can be seen in chronic type 2 diabetes mellitus patient can cause macrovascular and microvascular complications. This complication contributes to increase mortality rate in Indonesia.Methods: This study uses cross sectional study by studying the medical record of type 2 diabetes mellitus patients, such as age, duration of diabetes mellitus, HbA1C levels, blood pressure, lipid profile, macrovascular and microvascular complication. The data obtained is reviewed descriptively. Results: Most of type 2 diabetes mellitus patient is between 55-64 years (39.4%), mean 55.75 (SD=9.7). Most of the patients suffers type 2 diabetes mellitus for ≥5 years (61%). Meanwhile, the number of type 2 diabetes mellitus patients with uncontrolled HbA1C levels (≥7.0%) is 79%, mean 8.4 (SD= 1.8). Most of type 2 diabetes mellitus patients do not experience hypertension (77.8%) and experience dyslipidemia (94.3%), with the most prevalent lipid abnormality is high LDL (30.9%). Besides, most of type 2 diabetic patients have microvascular complications (57%), with the most common complication is diabetic neuropathy (45.6%), and the other microvascular complications are diabetic nephropathy (33.7%) and diabetic retinopathy (20.7%). While macrovascular complications is 43%, with the most common complication is diabetic foot (29.9%), and the other macrovascular complications are coronary heart disease (27.8%), peripheral arterial occlusive disease (22.9%), and stroke (19.4%).
Dicky Febrianto, Hermina Novida
Current Internal Medicine Research and Practice Surabaya Journal, Volume 3, pp 16-21; https://doi.org/10.20473/cimrj.v3i1.29969

Abstract:
Patients with thyroid dysfunction are well represented in the general population. Hyperthyroidism can develop as a paraneoplastic syndrome in germ cell tumors. Testicular seminoma as a form of germ cell tumors, can express human chorionic gonadotropin (hCG). Beta-hCG strongly resembles TSH. A 26-year-old male with a history of cryptorchidism, came to Dr. Soetomo Hospital with the complaints of palpitation, diarrhea, weight loss, fatigue, nervousness, excessive sweating, and heat intolerance. He also complained of enlarged breast and a palpable mass in lower abdomen for 4 months. From the TSH and FT4 examinations, patient’s symptoms were in accordance with thyrotoxicosis. Anti-TPO and thyroid USG examination were within normal limits. Patient was treated with beta-blocker and thiamazole. Histopathology of abdominal mass showed a testicular seminoma. After surgery and chemoterapy, the clinical symptoms of hyperthyroidism gradually improved. Administration of beta-blocker and thiamazole was stopped in 4 months after surgery. Many of germ cell tumors in male are associated with cryptorchidism, half of them being testicular seminoma. Seminoma expresses hCG. At very high levels, hCG can stimulate the TSH receptors, causing hyperthyroidism or thyrotoxicosis. TSH and FT4 measurement were needed in patient with suspected hyperthyroidism. Anti-TPO test is performed to exclude autoimmune cause of thyroid disease. Symptomatic management of beta-hCG induced hyperthyroidism is not different from hyperthyroidism in general, namely administration of beta-blocker and anti-thyroid drugs. However, the definitive treatments are surgery and chemotherapy. Hyperthyroidism in germ cell tumors almost all responds well to surgery and chemotherapy.Patients with thyroid dysfunction are well represented in the general population. Hyperthyroidismcandevelopasaparaneoplasticsyndromeingermcelltumors.Testicularseminomaasaformofgermcelltumors,canexpresshumanchorionicgonadotropin(hCG). Beta-hCGstronglyresemblesTSH.A26-year-oldmalewithahistoryofcryptorchidism,cametoDr.SoetomoHospitalwiththecomplaintsofpalpitation,diarrhea,weightloss, fatigue, nervousness, excessive sweating, and heat intolerance. He also complained ofenlargedbreastandapalpablemassinlowerabdomenfor4months.FromtheTSHandFT4examinations,patient’ssymptomswereinaccordancewiththyrotoxicosis.Anti-TPOandthyroidUSGexaminationwerewithinnormallimits.Patientwastreatedwithbeta-blocker andthiamazole.Histopathology ofabdominal massshowedatesticularseminoma.After surgery andchemoterapy,theclinicalsymptomsofhyperthyroidismgraduallyimproved. Administration ofbeta-blockerand thiamazolewasstoppedin 4monthsaftersurgery.Many ofgermcelltumorsin maleareassociatedwith cryptorchidism,halfofthembeing testicular seminoma.SeminomaexpresseshCG. At veryhighlevels,hCGcanstimulatetheTSH receptors, causing hyperthyroidism or thyrotoxicosis. TSH and FT4 measurement were neededin patientwithsuspectedhyperthyroidism.Anti-TPOtestisperformedtoexclude autoimmunecauseof thyroiddisease. Symptomaticmanagementof beta-hCGinduced hyperthyroidismisnotdifferentfromhyperthyroidismingeneral,namely administrationof beta-blocker and anti-thyroid drugs. However, the definitive treatments are surgeryand chemotherapy.Hyperthyroidismingermcell tumorsalmostall respondswelltosurgery and chemotherapy.
Jihan Kalishah, Dominicus Husada, M Vitanata Arfijanto, Agung Dwi Wahyu Widodo
Current Internal Medicine Research and Practice Surabaya Journal, Volume 3, pp 5-8; https://doi.org/10.20473/cimrj.v3i1.32549

Abstract:
Introduction:Escherichia coliis a Gram-negative bacteria and a most cause of nosocomial infections. Bacteria has the ability to form biofilm that may cause antimicrobe resistance. This biofilm protects the microbes from environmental conditions which make it the most cause of nosocomial infections including urinary tract infection and the infections resulted from the use of medical instruments. The aim of this experiment is to observe the presence of cefotaxime and ceftriaxone antimicrobial resistance in E. coli as a cause of biofilm formation.Method: This study conducted three experimentsof E. coli sensitivity test on cefotaxime and ceftriaxone, E. coli resistance test after a 48 hours incubation, and optical density measurement using iMark™ ELISA Microplate Reader. Result: The results of sensitivity experiment with antibiotic cefotaxime and ceftriaxone disk showed sensitive result in wild-type E. coli and E. coli ATCC while after 48 hours incubation E. coli ATCC remains sensitive and in wild-type E. coli result are three intermediates, one sensitive and other than that it’s all change to resistance. The third experiment results were obtained from ELISA then classified into three categories. In E. coli ATCC 1 and 2, the results are mostly in high category (OD >0.240). The OD in E. coli 1 is mostly high, while results from E. coli 2 consists of one bacterium in weak category (OD <0.120), four in moderate category (OD 1.20 – 0.240), and three in high category. Conclusion: It can be concluded that E. coli resistance test in cefotaxime andceftriaxone after 48 hours’ incubation are mostly resistant in wild-type E. coli but sensitive in E. coli ATCC.
Arinda Agung Katritama, Pudji Lestari, Muhammad Vitanata Arifijanto
Current Internal Medicine Research and Practice Surabaya Journal, Volume 3, pp 9-12; https://doi.org/10.20473/cimrj.v3i1.32586

Abstract:
Introduction: Service quality of primary healthcare centre especially at HIV testing services must be improved. When the service quality is improved there will be a positive feedback such as patient’s satisfaction. Within the high patient satisfaction rate, People Living with HIV (PLWH) are expected to be more active, productive and also invited friends to check themselves, so the iceberg phenomenon will be revealed and prevention will be easier to control. Methods: This research used observational analytic design with purposive sampling method. The total research sample was 189 respondent, assess the questionnaire that consisted of five dimensions of service quality which were tangible, reliability, responsiveness, empathy and assurance, and also three indicators of patient satisfaction which were overall satisfaction, expectation and experience. Results: Among 189 respondents, mostly male with 129 responses or 68.3%, according to age group, mostly from 20-25 years old age group with 88 responses or 46.6% and according to time visit, mostly first visit patient with 162 responses or 85.8%. According to service quality, mostly categorized in a good group with 173 respondents or 91.5%. In patient satisfaction, mostly were categorized in a satisfy group with 157 respondents or 81.5%, There was a positive correlation between service quality and patient satisfaction with p value <0.01 and correlation coefficient 0.632. Conclusion: There is a correlation between every dimension of service quality which are tangible, reliability, responsiveness, empathy and assurance with patient satisfaction of HIV testing services patient in Kedungdoro Primary Health Care Surabaya
Yhan Batista, Novira Widajanti, Agustina Konginan
Current Internal Medicine Research and Practice Surabaya Journal, Volume 3, pp 22-25; https://doi.org/10.20473/cimrj.v3i1.32537

Abstract:
Suicide attempt in the elderly is underestimated and underreported due to cultural reference. Triggering factors may be the results of stressful life events or acquired late-life depression. An elderly woman, 69-year-old, was rushed to the emergency room due to household cleaning liquid ingestion. There was a history of previous suicide attempts and severe depressive episodes before. Since there was no sign of severe intoxication, then, the patient was treated symptomatically. Comprehensive geriatric and psychiatric assessments concluded that the patient was in a depressive state. The patient was discharged with symptomatic treatment and antidepressants but two weeks later she completed the course by drowning herself in a river.
Agustinus Vincent, Bramantono -, Usman Hadi, Muhammad Vitanata Arifijanto
Current Internal Medicine Research and Practice Surabaya Journal, Volume 3, pp 26-32; https://doi.org/10.20473/cimrj.v3i1.32536

Abstract:
Dengue viral infection (DVI) is a debilitating arthropod-borne disease that has been rapidly spread in several regions of the world in recent years. The spectrum of disease varies from mild self-limiting illness to dengue fever (DF) to more severe and fulminating forms, i.e., dengue hemorrhagic fever (DHF), dengue shock syndrome (DSS),and expanded dengue syndrome (EDS). The pathogenesis of EDS is not clear amid lack of studies on animal models. In the absence of in vitro experiments, disease spectrum is difficult to be elucidated and mimicked for humans.Recent advances on research on atypical complications of EDS demonstrate the involvement of other major organs such as the kidney, lung, heart, and central nervous system. Histopathological findings demonstrate the presence of hemorrhage, edema, and inflammatory infiltrates in these organs.The spectrum of Dengue viral infection varies from mild self-limiting illness to dengue fever to more severe and fulminating forms, i.e., dengue hemorrhagic fever, dengue shock syndrome, and expanded dengue syndrome. Apart from the classical presentation, dengue infection can result in a myriad of unusual clinical manifestations, which are grouped under the title expanded dengue syndrome. These findings urge more focused and comprehensive investigations to explore such relationships so that high-risk patients could be identified immediately during their presentation to the hospitals. Keywords: Expanded dengue syndrome, Pathogenesis, Organ-specific manifestation
Khoirotul Ummah, Soebagijo Adi
Current Internal Medicine Research and Practice Surabaya Journal, Volume 2, pp 49-55; https://doi.org/10.20473/cimrj.v2i2.26284

Abstract:
Pituitary adenoma is one of intracranial tumors that grows and develops in the pituitary gland which plays a role in regulating the hormonal balance in the body. Most pituitary adenomas are benign and do not spread to other organs. Pituitary adenoma can be classified based on radiological features, tumor size and the type of hormone produced. There are several ways to establish of diagnosis of pituitary adenoma, in addition to recognizing the symptoms and clinical signs are hormonal function tests and imaging. The surgery is the first medical actions. The postoperative recovery rate reached 90% in relatively benign cases and tumor recurrence rate is 5-10% depending on the size of the tumor, the stage of the tumor during surgery, experience of neurosurgical. A woman, 46 years old referred to Soetomo Hospital from Soebandi Jember Hospital for treatment the recurrent adenoma pituitary with complains of headache, double-vision and changing shape of his face, his enlarged lips and nose. Patient was diagnosed based on head CT scan and already had surgery on January, 2015. The head MRI evaluated post surgery was still a residual mass from the previous tumor. 3 monts after surgery no complains any more. The complains reappear at the end of 2017. The head CT scan on January, 8, 2017, size tumor: 1.2 cm x 1.8 cm. The head MRI results on December, 20, 2017 size tumor : size 1.6cm x 2.1cm and abnormal hormonal result, high prolactine, low cortisol and high IGF1. In Soetomo Hospital was diagnosed as pituitary macroadenoma with acromegaly and hyperprolactinemia and received bromocriptine 3x5 mg evaluated for 2 weeks then lowered to 3x 2.5 mg after obtaining a decrease in prolactin levels and methyl prednisolone 3x1 / day until cortisol level was normal. Patients will also plan for surgery of EETH (Endoscopic Endonasal Transphenoidal).
Kurnia Alisaputri, Sony Wibisono
Current Internal Medicine Research and Practice Surabaya Journal, Volume 2, pp 56-59; https://doi.org/10.20473/cimrj.v2i2.26243

Abstract:
Managing crisis thyroid in toxic multi nodular thyroid in pregnancy is challenging. This case objective is to highlight comprehensive treatment going to safe mother & baby’s life. A woman, 43 years old in 13th week of her third pregnancy, admitted in emergency room with palpitating and vomiting as her chief complaints. Her complaints had started since she stopped taking propylthiouracyl. She used to take it since diagnosed hyperthyroid. She was diagnosed crisis hyperthyroid in pregnancy. The first main goal was to stabilize the patient, curing the precipitate factors, and assist her to have a healthy baby. She was discharged from hospital day 7th. She was routinely checked FT4 for evaluation and switch on Thyrozol during 25-26th weeks and continued it until postpartum. Her baby was delivered vaginally with normal APGAR score and growing well. Based on her experience, she agreed to have IUD to prevent unplanned pregnancy.
Usman Hadi, Bramantono Bramantono, M Vitanata, Musofa Rusli, Brian Eka Rahman, Tripudi Asmarawati, Erika Marfiani, Erwin Astha Triyono
Current Internal Medicine Research and Practice Surabaya Journal, Volume 2, pp 25-28; https://doi.org/10.20473/cimrj.v2i2.28956

Abstract:
Objective: To find out the diagnostic pattern of COVID-19 using RT-PCR or a rapid antibody test in the suspected group patients.Method: The study was conducted in Dr. Soetomo General Hospital (referal hospital for covid-19, 1500 beds). The study used data on patients with suspected covid-19 who were hospitalized at the Dr. Soetomo General Hospital in Surabaya.Result: There were 200 suspected COVID-19 patients enrolled in this study, the main complaints of cough, fever, dyspnoea, around 69.5%, 75%, and 76.5%, respectively. Although not a common symptom, it seems that anosmia (14%) is typical for COVID-19. Based on this scoring system, a total of 196 patients had a high risk of being infected with COVID-19, and 125 (64%) of them finally showed a positive PCR test. PCR test mostly positive (62.5%), while serological test (rapid imunoglobulin test) mostly non reactive, but there were nonsignificant different between PCR and Serological test (p=0.16 OR: 1.5(0.84-71). Furthermore, if we compare the various existing variables, namely the covid-19 score, immunoglobulin rapid test, and radiological examination, only the radiological examination results can be used as a strong predictor of positive PCR results (p=0.005, OR: 1.68 (0.17-16.43).In this study, we found that abnormal chest radiographs are a good parameter for diagnosing COVID-19, (OR: 2.92; 95% CI, 1.34 -6.34).Conclussion: The initial radiological examination combined with the clinical symptoms of Covid-19 is the most important thing to predict the presence of this disease.
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