Background Anxiety and depression are psychosomatic disorders that are frequently observed in chr... more Background Anxiety and depression are psychosomatic disorders that are frequently observed in chronic conditions such as systemic lupus erythematosus (SLE). Anxiety and depression can be induced by immunological and neurotransmitter dysregulation, which is characterized by hypothalamic–pituitary–adrenal (HPA) axis dysfunction, production of proinflammatory cytokines, and activation of complement in the blood, such as C3 and C4. The causes of anxiety and depression in SLE are complex, ranging from neuropsychiatric involvement to drug adverse effects. Detecting anxiety and depression symptoms in SLE patients is critical to preventing disability from impacting quality of life. Objective To assess the relationship between anxiety and depression symptomatology, SLE disease activity with levels of C3 and C4 in Cipto Mangunkusumo National Hospital. Methods This study used a cross-sectional design. The study included 120 SLE patients from Cipto Mangunkusumo National Hospital, aged 18 to 60 ...
Background: Helicobacter pylori (H. pylori) infection status in Indonesia might be higher than th... more Background: Helicobacter pylori (H. pylori) infection status in Indonesia might be higher than the actual prevalence. A comprehensive
The American Journal of the Medical Sciences, 2011
Diagnosing spondyloarthritis (SpA) early in young patients with inflammatory back pain and normal... more Diagnosing spondyloarthritis (SpA) early in young patients with inflammatory back pain and normal findings on radiographs of the sacroiliac joints (SIJ) remains a challenge in routine practice. Magnetic resonance imaging (MRI) is regarded as the most sensitive imaging modality for detecting early SpA before the radiographic appearance of structural lesions. The recently published Assessment of SpondyloArthritis International Society classification criteria for axial SpA include for the first time a positive MRI demonstrating sacroiliitis as an imaging criterion indicative of SpA together with at least 1 clinical feature of SpA. A systematic and standardized evaluation of the SIJ in patients with SpA showed that MRI has much greater diagnostic utility than documented previously and allowed a data-driven definition of a positive MRI for SpA. Single MRI lesions suggestive of inflammation can be found in the SIJ and the spine in up to one quarter of healthy controls and young patients with mechanical back pain.
Background In COVID-19, the release of pro-inflammatory mediators in the cytokine storm, primaril... more Background In COVID-19, the release of pro-inflammatory mediators in the cytokine storm, primarily interleukin-6 (IL-6), has been hypothesized to induce pulmonary intravascular coagulation. However, the relationship between IL-6 and coagulopathy remains unclear in COVID-19 progression. We aimed to investigate the correlation of IL-6 with D-dimer, fibrinogen, prothrombin time (PT), and ferritin. Furthermore, we also analyzed the effect of those parameters on the worsening of COVID-19 patients. Methods A prospective cohort study was conducted in moderate and severe COVID-19 patients from June 2020 to January 2021. A serial evaluation of IL-6, D-dimer, fibrinogen, ferritin, and PT was performed and correlated with the patient's condition at admission and on the 14th day. The outcomes (improvement, worsening, or discharged patients) were recorded during the study. Results Of 374 patients, 73 study subjects (61 severe and 12 moderate COVID-19) were included in this study. A total of ...
Fall is one of the geriatric syndromes and a significant public health concern, which causes pote... more Fall is one of the geriatric syndromes and a significant public health concern, which causes potentially severe consequences among the elderly. Geriatric syndromes are common among PLHIV and affect younger age than the general population. This study attempted to identify the risk of falls in PLHIV on antiretroviral therapy (ART) and its related factors among older adults with HIV infection. Methods: This cross-sectional study was conducted from December 2019 to May 2020 among PLHIV aged ≥40 years who received ART for at least 6 months in HIV Integrated Clinic, Cipto Mangunkusumo Hospital, Jakarta. Bivariate and multivariate analyses were performed using Poisson regression with robust estimator using STATA version 12.0. Results: A total of 102 participants mainly consisted of males (83.3%) with a median age of 45 (IQR 5) years. The risk of fall was detected in 52% of these participants. PLHIV who have history of falls, current CD4 below 200 cells/mm 3 , and pre-frail-frail status were associated with an increased risk of falls in the future. An LPV/r-based regimen was found to be a protective factors of risk of falls among PLHIV. Conclusion: History of falls, current CD4 below 200 cells/mm 3 , and pre-frail and frail status were identified as factors associated with a greater risk of fall among PLHIV.
Background Most studies on advance care planning in Asia originate in high-income Asian countries... more Background Most studies on advance care planning in Asia originate in high-income Asian countries. Indonesia is a middle-income Asian country characterized by its religious devoutness and strong family ties. This study aims to explore the perspectives and experiences of Indonesian healthcare professionals on advance care planning for cancer patients. Methods Focus-group discussions were conducted in July and August 2019 and were analysed using thematic content analysis enhanced by dual coding and exploration of divergent views. Purposive sampling of physicians and nurses actively engaged in cancer care in a national cancer centre and a national general hospital. Results We included 16 physicians and 16 nurses. These participants were open to the idea of advance care planning. We further identified four aspects of this planning that the participants considered to be important: 1) the family’s role in medical decision-making; 2) sensitivity to communication norms; 3) patients’ and fam...
Background: The 7+3 regimen is still the main choice of remission induction chemotherapy in acute... more Background: The 7+3 regimen is still the main choice of remission induction chemotherapy in acute myeloid leukemia (AML). Successfully achieving complete remission (CR) and the time required to achieve it determine patient’s survival. Hence, bone marrow examination on 14th day of chemotherapy is recommended to predict CR. However, the examination is invasive and still inaccurate. Methods: A prognostic study with retrospective cohort design was conducted at two central hospitals in Indonesia based on medical record data of AML patients who underwent 7+3 induction chemotherapy from January 1st, 2015, to December 31st, 2019. The association of nadir leukocyte level and the time required to achieve it with CR occurrence was assessed. Results: One hundred and one subjects were recruited with median age 39 years and 55% men. A total of 55.4% subjects achieved CR. Nadir leukocyte level below 200/mcl was the most optimal cut-off point and independently associated with CR (OR 2.45; 95% CI 1....
Karsinoma hepatoselular (KHS) merupakan tumor primer hepar yang paling sering terjadi dari seluru... more Karsinoma hepatoselular (KHS) merupakan tumor primer hepar yang paling sering terjadi dari seluruh tipe kanker hati, serta menduduki peringkat ke-5 kanker tersering di dunia dan ke-3 kanker penyebab kematian terbanyak di dunia. Nyeri merupakan masalah yang seringkali dialami pasien dengan KHS yang mana dapat memberikan pengaruh terhadap penurunan kualitas hidup pasien. Selanjutnya, pasien dengan KHS sering muncul dengan keadaaan sirosis, sehingga penatalaksanaan terkait nyeri menjadi suatu tantangan klinis bagi klinisi. Artikel ini membahas mengenai kasus seorang laki-laki berusia 26 tahun dengan keluhan nyeri perut bagian kanan atas sejak empat bulan lalu disertai dengan penurunan berat badan. Hasil pemeriksaan menunjukkan serologis hepatits B positif dengan peningkatan alfa feto protein (AFP). Computed tomography (CT) scan abdomen dan biopsi hati menyokong karsinoma hepatoseluler, disertai penyebaran ke paru. Pasien kemudian didiagnosis dengan karsinoma hepatoseluler stadium lanjut. Pasien masuk rumah sakit dengan penurunan kesadaran akibat hipoglikemia. Namun, dikarenakan keluhan nyeri perutnya, pasien kemudian mendapatkan terapi analgesik opioid berupa morphine intermediate release (MIR). Dengan pemberian opioid yang hati-hati serta terukur dan terkendali baik, keluhan pasien akibat nyeri keganasan dapat dikontrol dengan memadai, sehingga mampu meningkatkan kualitas hidup pasien.
AimTo determine association between diabetes in confirmed cases of COVID-19 and intensive care ad... more AimTo determine association between diabetes in confirmed cases of COVID-19 and intensive care admission and in-hospital mortality, evaluate several laboratory parameters as mortality predictor, and develop predictors of in-hospital mortality among diabetics with COVID-19.MethodsThis retrospective cohort recruited all cases of COVID-19 hospitalized in Fatmawati General Hospital during March to October 2020. Inclusion criteria was RT-PCR confirmed cases of COVID-19 who aged 18 years and older while exclusion criteria were incomplete medical record or cannot be found and pregnant women.ResultsWe enrolled 506 participants to this study with median age of 51 years (IQR:22), female (56.32%), and diabetes (28.46%). Diabetes increased intensive care admission (adjusted OR:6.07;95%CI:3.52-10,43) and in-hospital mortality (adjusted OR:50;95%CI:1.61-3.89). In predicting in-hospital mortality, ferritin and lactate dehydrogenase offered an acceptable discrimination, AUC:0.71 (95%CI: 0.62-0.79) ...
Pendahuluan . Prevalensi depresi hamper mencapai 50% pada pasien yang berobat di pelayanan tertie... more Pendahuluan . Prevalensi depresi hamper mencapai 50% pada pasien yang berobat di pelayanan tertier klinik asma. Tumor Necrosis Factor-Alpha (TNF-α) telah diketahui sebagai sitokin pro-inflamasi yang berperan penting dalam mekanisme patogenesis sejumlah penyakit inflamasi kronik, termasuk asma bronkial dan depresi. Belum ada data penelitian mengenai hal tersebut di Indonesia. Metode . Penelitian ini merupakan studi cross sectional yang dilakukan pada 40 pasien asma bronkial tidak terkontrol di alergi imunologi klinik unit rawat jalan Rumah Sakit Umum Pusat (RSUP) Moh Hoesin Palembang selama kurun waktu mulai bulan Juni 2014 sampai dengan Agustus 2014. Asma bronkial tidak terkontrol dinilai dengan menggunakan kuesioner Asthma Control Test (ACT), sedangkan gejala depresi dinilai dengan kuisioner Beck Depression Inventory (BDI). Konfirmasi diagnosis depresi dilakukan dengan kriteria dari Diagnostic and Statistical Manual for Psychiatry-IV Text Revision (DSMIV TR)/ International Code Dia...
Nyeri adalah gejala utama pada pasien kanker yang perlu diatasi segera karena dapat menurunkan ku... more Nyeri adalah gejala utama pada pasien kanker yang perlu diatasi segera karena dapat menurunkan kualitas hidup. Kekhawatiran atau tidak efektifnya penggunaan satu jenis opioid membuat klinisi perlu memahami bagaimana rotasi opioid. Untuk itu, studi kasus berbasis bukti ini disusun untuk mengetahui tentang efektivitas rotasi opioid dan kombinasi opioid untuk tata laksana nyeri kanker melalui penelusuran literatur pada tiga database. Pencarian dilakukan di Pubmed, Cochrane library, dan EBSCO sesuai dengan pertanyaan klinis. Dari 24 studi yang didapat, hanya satu yang memenuhi kriteria dan kemudian dinilai secara kritis. Studi tersebut mendapati bahwa pasien baik pada kelompok rotasi (fentanyl transdermal) maupun kombinasi (oral oxycodone dan fentanyl transdermal) masing-masing mengalami penurunan skor nyeri secara berturut dari 2,9 menjadi 2,0 (p=0,22) dan 3,0 menjadi 1,8 (p<0,06). Selain itu, kesuksesan terapi tercapai pada 11 pasien di kelompok rotasi dan 12 pasien di kelompok kombinasi (p=0,98). Berdasarkan studi tersebut, dapat disimpulkan bahwa rotasi opioid sama efektifnya dengan kombinasi opioid dalam mengatasi nyeri pada pasien kanker.
COVID-19 is an infectious disease that is easily widespread and has clinical manifestations as mi... more COVID-19 is an infectious disease that is easily widespread and has clinical manifestations as mild, moderate, or severe disease. COVID-19 patients are required to be isolated during treatment to reduce transmission. This can cause anxiety and depression, which in turn worsens the patient's illness. Providing supportive psychotherapy can help provide a feeling of safety, comfort and calm for patients. The choice of method in providing supportive psychotherapy can be done online/teleconsultation or internet-based. This clinical review aims to determine the effect of online teleconsultation or internet-based psychotherapy on COVID-19 patients. A systematic search was performed using online databases, such as PubMed, Cochrane, EBSCO/CINAHL and ProQuest. The identified articles were screened using eligibility criteria. There were 2 studies (Zhou et al, and Wei et al) which were analyzed critically using the Newcastle Ottawa Scale. Both studies showed that management of psychotherapy...
To identify the correlation between hsCRP and arterial stiffness in type-2 diabetic patients. A c... more To identify the correlation between hsCRP and arterial stiffness in type-2 diabetic patients. A cross-sectional study was conducted to assess the plasma levels of hsCRP and carotid arterial stiffness in 40 patients with type-2 diabetes mellitus. The common carotid artery stiffness was evaluated using radio frequency echo-tracking system to determine the local carotid pulse wave velocity (carotid-PWV). Median value of hsCRP in this study was 4.5 (0.2 to 18.9) mg/L and the average value of local carotid stiffness was 8.8±1.7 m/sec. High sensitive CRP showed a strong correlation with carotid-PWV (r=0.503, P=0.001). hsCRP level was independently associated with carotid-PWV after adjustment for age, body mass index, and mean arterial pressure (r=0.450, P=0.005). Hs-CRP has moderate positive correlation with arterial stiffness in patients with type-2 diabets mellitus.
Coronavirus disease (COVID-19) pandemic occurred abruptly. It is an unexpected disaster. Uncertai... more Coronavirus disease (COVID-19) pandemic occurred abruptly. It is an unexpected disaster. Uncertain treatment for this viral infection increases excessive anxiety, which does not occur only in one person but also in majority of people; therefore, it can create mass panic. Mass panic is a serious problem that must be immediately identified and managed. Mass panic management will reduce COVID-19 incidence.
ABSTRAK Pendahuluan. Kualitas hidup terkait kesehatan selama pasien menderita HIV dapat digunakan... more ABSTRAK Pendahuluan. Kualitas hidup terkait kesehatan selama pasien menderita HIV dapat digunakan sebagai salah satu indikator keberhasilan terapi yang telah diberikan. Salah satu instrumen untuk menilai kualitas hidup pasien adalah kuesioner WHOQOL-HIV BREF yang telah digunakan di berbagai negara, namun belum pernah diuji kesahihan dan keandalannya di Indonesia. Penelitian ini bertujuan untuk menguji kesahihan dan keandalan kuesioner WHOQOL-HIV BREF dalam bahasa Indonesia sebagai alat untuk mengukur kualitas hidup pada pasien HIV/AIDS. Metode. Penelitian potong lintang dilakukan di Poliklinik khusus HIV Rumah Sakit dr. Cipto Mangunkusumo (POKDISUS RSCM) Jakarta pada bulan November 2016. Sampel diambil secara konsekutif. Penelitian dilakukan dalam dua tahap yaitu tahap awal yang merupakan proses adaptasi bahasa dan budaya dan tahap akhir yaitu uji kesahihan dan keandalan dari kuesioner. Hasil. Sebanyak 56 responden ikut serta dalam penelitian ini dan diketahui bahwa 69,6% di antaran...
to examine certain characteristics of patients who suffer from psychosomatic disorders. We called... more to examine certain characteristics of patients who suffer from psychosomatic disorders. We called data through medical report outpatient clinic of the Psychosomatic Division, Department of internal medicine, Cipto Mangunkusumo Central General Hospital/Faculty of Medicine of the University of Indonesia (FKUI/RSUPN-CM), Jakarta, Indonesia, in 1996. The data was processed manually and by computer from which table and graphic were obtained. The descriptive analysis was performed to the objective the study. the FPD patients consisted of those with vegetative imbalance (multiple psychosomatic syndrome) (30.2%), dyspepsia (20.8%), functional heart disease (11.3%) and others 1%-6%. All of SPD consisted of chronic disease, such as hypertension (38.3%), diabetes mellitus (29.8%), bronchial asthma (10.6%), coronary artery disease (6.4%), and others 2%-5%. According to DSM IV, among the psychosomatic patients, 52.7% met the criteria for anxiety, 29.3% for depression, 14.2% for mixed anxiety and...
Background Anxiety and depression are psychosomatic disorders that are frequently observed in chr... more Background Anxiety and depression are psychosomatic disorders that are frequently observed in chronic conditions such as systemic lupus erythematosus (SLE). Anxiety and depression can be induced by immunological and neurotransmitter dysregulation, which is characterized by hypothalamic–pituitary–adrenal (HPA) axis dysfunction, production of proinflammatory cytokines, and activation of complement in the blood, such as C3 and C4. The causes of anxiety and depression in SLE are complex, ranging from neuropsychiatric involvement to drug adverse effects. Detecting anxiety and depression symptoms in SLE patients is critical to preventing disability from impacting quality of life. Objective To assess the relationship between anxiety and depression symptomatology, SLE disease activity with levels of C3 and C4 in Cipto Mangunkusumo National Hospital. Methods This study used a cross-sectional design. The study included 120 SLE patients from Cipto Mangunkusumo National Hospital, aged 18 to 60 ...
Background: Helicobacter pylori (H. pylori) infection status in Indonesia might be higher than th... more Background: Helicobacter pylori (H. pylori) infection status in Indonesia might be higher than the actual prevalence. A comprehensive
The American Journal of the Medical Sciences, 2011
Diagnosing spondyloarthritis (SpA) early in young patients with inflammatory back pain and normal... more Diagnosing spondyloarthritis (SpA) early in young patients with inflammatory back pain and normal findings on radiographs of the sacroiliac joints (SIJ) remains a challenge in routine practice. Magnetic resonance imaging (MRI) is regarded as the most sensitive imaging modality for detecting early SpA before the radiographic appearance of structural lesions. The recently published Assessment of SpondyloArthritis International Society classification criteria for axial SpA include for the first time a positive MRI demonstrating sacroiliitis as an imaging criterion indicative of SpA together with at least 1 clinical feature of SpA. A systematic and standardized evaluation of the SIJ in patients with SpA showed that MRI has much greater diagnostic utility than documented previously and allowed a data-driven definition of a positive MRI for SpA. Single MRI lesions suggestive of inflammation can be found in the SIJ and the spine in up to one quarter of healthy controls and young patients with mechanical back pain.
Background In COVID-19, the release of pro-inflammatory mediators in the cytokine storm, primaril... more Background In COVID-19, the release of pro-inflammatory mediators in the cytokine storm, primarily interleukin-6 (IL-6), has been hypothesized to induce pulmonary intravascular coagulation. However, the relationship between IL-6 and coagulopathy remains unclear in COVID-19 progression. We aimed to investigate the correlation of IL-6 with D-dimer, fibrinogen, prothrombin time (PT), and ferritin. Furthermore, we also analyzed the effect of those parameters on the worsening of COVID-19 patients. Methods A prospective cohort study was conducted in moderate and severe COVID-19 patients from June 2020 to January 2021. A serial evaluation of IL-6, D-dimer, fibrinogen, ferritin, and PT was performed and correlated with the patient's condition at admission and on the 14th day. The outcomes (improvement, worsening, or discharged patients) were recorded during the study. Results Of 374 patients, 73 study subjects (61 severe and 12 moderate COVID-19) were included in this study. A total of ...
Fall is one of the geriatric syndromes and a significant public health concern, which causes pote... more Fall is one of the geriatric syndromes and a significant public health concern, which causes potentially severe consequences among the elderly. Geriatric syndromes are common among PLHIV and affect younger age than the general population. This study attempted to identify the risk of falls in PLHIV on antiretroviral therapy (ART) and its related factors among older adults with HIV infection. Methods: This cross-sectional study was conducted from December 2019 to May 2020 among PLHIV aged ≥40 years who received ART for at least 6 months in HIV Integrated Clinic, Cipto Mangunkusumo Hospital, Jakarta. Bivariate and multivariate analyses were performed using Poisson regression with robust estimator using STATA version 12.0. Results: A total of 102 participants mainly consisted of males (83.3%) with a median age of 45 (IQR 5) years. The risk of fall was detected in 52% of these participants. PLHIV who have history of falls, current CD4 below 200 cells/mm 3 , and pre-frail-frail status were associated with an increased risk of falls in the future. An LPV/r-based regimen was found to be a protective factors of risk of falls among PLHIV. Conclusion: History of falls, current CD4 below 200 cells/mm 3 , and pre-frail and frail status were identified as factors associated with a greater risk of fall among PLHIV.
Background Most studies on advance care planning in Asia originate in high-income Asian countries... more Background Most studies on advance care planning in Asia originate in high-income Asian countries. Indonesia is a middle-income Asian country characterized by its religious devoutness and strong family ties. This study aims to explore the perspectives and experiences of Indonesian healthcare professionals on advance care planning for cancer patients. Methods Focus-group discussions were conducted in July and August 2019 and were analysed using thematic content analysis enhanced by dual coding and exploration of divergent views. Purposive sampling of physicians and nurses actively engaged in cancer care in a national cancer centre and a national general hospital. Results We included 16 physicians and 16 nurses. These participants were open to the idea of advance care planning. We further identified four aspects of this planning that the participants considered to be important: 1) the family’s role in medical decision-making; 2) sensitivity to communication norms; 3) patients’ and fam...
Background: The 7+3 regimen is still the main choice of remission induction chemotherapy in acute... more Background: The 7+3 regimen is still the main choice of remission induction chemotherapy in acute myeloid leukemia (AML). Successfully achieving complete remission (CR) and the time required to achieve it determine patient’s survival. Hence, bone marrow examination on 14th day of chemotherapy is recommended to predict CR. However, the examination is invasive and still inaccurate. Methods: A prognostic study with retrospective cohort design was conducted at two central hospitals in Indonesia based on medical record data of AML patients who underwent 7+3 induction chemotherapy from January 1st, 2015, to December 31st, 2019. The association of nadir leukocyte level and the time required to achieve it with CR occurrence was assessed. Results: One hundred and one subjects were recruited with median age 39 years and 55% men. A total of 55.4% subjects achieved CR. Nadir leukocyte level below 200/mcl was the most optimal cut-off point and independently associated with CR (OR 2.45; 95% CI 1....
Karsinoma hepatoselular (KHS) merupakan tumor primer hepar yang paling sering terjadi dari seluru... more Karsinoma hepatoselular (KHS) merupakan tumor primer hepar yang paling sering terjadi dari seluruh tipe kanker hati, serta menduduki peringkat ke-5 kanker tersering di dunia dan ke-3 kanker penyebab kematian terbanyak di dunia. Nyeri merupakan masalah yang seringkali dialami pasien dengan KHS yang mana dapat memberikan pengaruh terhadap penurunan kualitas hidup pasien. Selanjutnya, pasien dengan KHS sering muncul dengan keadaaan sirosis, sehingga penatalaksanaan terkait nyeri menjadi suatu tantangan klinis bagi klinisi. Artikel ini membahas mengenai kasus seorang laki-laki berusia 26 tahun dengan keluhan nyeri perut bagian kanan atas sejak empat bulan lalu disertai dengan penurunan berat badan. Hasil pemeriksaan menunjukkan serologis hepatits B positif dengan peningkatan alfa feto protein (AFP). Computed tomography (CT) scan abdomen dan biopsi hati menyokong karsinoma hepatoseluler, disertai penyebaran ke paru. Pasien kemudian didiagnosis dengan karsinoma hepatoseluler stadium lanjut. Pasien masuk rumah sakit dengan penurunan kesadaran akibat hipoglikemia. Namun, dikarenakan keluhan nyeri perutnya, pasien kemudian mendapatkan terapi analgesik opioid berupa morphine intermediate release (MIR). Dengan pemberian opioid yang hati-hati serta terukur dan terkendali baik, keluhan pasien akibat nyeri keganasan dapat dikontrol dengan memadai, sehingga mampu meningkatkan kualitas hidup pasien.
AimTo determine association between diabetes in confirmed cases of COVID-19 and intensive care ad... more AimTo determine association between diabetes in confirmed cases of COVID-19 and intensive care admission and in-hospital mortality, evaluate several laboratory parameters as mortality predictor, and develop predictors of in-hospital mortality among diabetics with COVID-19.MethodsThis retrospective cohort recruited all cases of COVID-19 hospitalized in Fatmawati General Hospital during March to October 2020. Inclusion criteria was RT-PCR confirmed cases of COVID-19 who aged 18 years and older while exclusion criteria were incomplete medical record or cannot be found and pregnant women.ResultsWe enrolled 506 participants to this study with median age of 51 years (IQR:22), female (56.32%), and diabetes (28.46%). Diabetes increased intensive care admission (adjusted OR:6.07;95%CI:3.52-10,43) and in-hospital mortality (adjusted OR:50;95%CI:1.61-3.89). In predicting in-hospital mortality, ferritin and lactate dehydrogenase offered an acceptable discrimination, AUC:0.71 (95%CI: 0.62-0.79) ...
Pendahuluan . Prevalensi depresi hamper mencapai 50% pada pasien yang berobat di pelayanan tertie... more Pendahuluan . Prevalensi depresi hamper mencapai 50% pada pasien yang berobat di pelayanan tertier klinik asma. Tumor Necrosis Factor-Alpha (TNF-α) telah diketahui sebagai sitokin pro-inflamasi yang berperan penting dalam mekanisme patogenesis sejumlah penyakit inflamasi kronik, termasuk asma bronkial dan depresi. Belum ada data penelitian mengenai hal tersebut di Indonesia. Metode . Penelitian ini merupakan studi cross sectional yang dilakukan pada 40 pasien asma bronkial tidak terkontrol di alergi imunologi klinik unit rawat jalan Rumah Sakit Umum Pusat (RSUP) Moh Hoesin Palembang selama kurun waktu mulai bulan Juni 2014 sampai dengan Agustus 2014. Asma bronkial tidak terkontrol dinilai dengan menggunakan kuesioner Asthma Control Test (ACT), sedangkan gejala depresi dinilai dengan kuisioner Beck Depression Inventory (BDI). Konfirmasi diagnosis depresi dilakukan dengan kriteria dari Diagnostic and Statistical Manual for Psychiatry-IV Text Revision (DSMIV TR)/ International Code Dia...
Nyeri adalah gejala utama pada pasien kanker yang perlu diatasi segera karena dapat menurunkan ku... more Nyeri adalah gejala utama pada pasien kanker yang perlu diatasi segera karena dapat menurunkan kualitas hidup. Kekhawatiran atau tidak efektifnya penggunaan satu jenis opioid membuat klinisi perlu memahami bagaimana rotasi opioid. Untuk itu, studi kasus berbasis bukti ini disusun untuk mengetahui tentang efektivitas rotasi opioid dan kombinasi opioid untuk tata laksana nyeri kanker melalui penelusuran literatur pada tiga database. Pencarian dilakukan di Pubmed, Cochrane library, dan EBSCO sesuai dengan pertanyaan klinis. Dari 24 studi yang didapat, hanya satu yang memenuhi kriteria dan kemudian dinilai secara kritis. Studi tersebut mendapati bahwa pasien baik pada kelompok rotasi (fentanyl transdermal) maupun kombinasi (oral oxycodone dan fentanyl transdermal) masing-masing mengalami penurunan skor nyeri secara berturut dari 2,9 menjadi 2,0 (p=0,22) dan 3,0 menjadi 1,8 (p<0,06). Selain itu, kesuksesan terapi tercapai pada 11 pasien di kelompok rotasi dan 12 pasien di kelompok kombinasi (p=0,98). Berdasarkan studi tersebut, dapat disimpulkan bahwa rotasi opioid sama efektifnya dengan kombinasi opioid dalam mengatasi nyeri pada pasien kanker.
COVID-19 is an infectious disease that is easily widespread and has clinical manifestations as mi... more COVID-19 is an infectious disease that is easily widespread and has clinical manifestations as mild, moderate, or severe disease. COVID-19 patients are required to be isolated during treatment to reduce transmission. This can cause anxiety and depression, which in turn worsens the patient's illness. Providing supportive psychotherapy can help provide a feeling of safety, comfort and calm for patients. The choice of method in providing supportive psychotherapy can be done online/teleconsultation or internet-based. This clinical review aims to determine the effect of online teleconsultation or internet-based psychotherapy on COVID-19 patients. A systematic search was performed using online databases, such as PubMed, Cochrane, EBSCO/CINAHL and ProQuest. The identified articles were screened using eligibility criteria. There were 2 studies (Zhou et al, and Wei et al) which were analyzed critically using the Newcastle Ottawa Scale. Both studies showed that management of psychotherapy...
To identify the correlation between hsCRP and arterial stiffness in type-2 diabetic patients. A c... more To identify the correlation between hsCRP and arterial stiffness in type-2 diabetic patients. A cross-sectional study was conducted to assess the plasma levels of hsCRP and carotid arterial stiffness in 40 patients with type-2 diabetes mellitus. The common carotid artery stiffness was evaluated using radio frequency echo-tracking system to determine the local carotid pulse wave velocity (carotid-PWV). Median value of hsCRP in this study was 4.5 (0.2 to 18.9) mg/L and the average value of local carotid stiffness was 8.8±1.7 m/sec. High sensitive CRP showed a strong correlation with carotid-PWV (r=0.503, P=0.001). hsCRP level was independently associated with carotid-PWV after adjustment for age, body mass index, and mean arterial pressure (r=0.450, P=0.005). Hs-CRP has moderate positive correlation with arterial stiffness in patients with type-2 diabets mellitus.
Coronavirus disease (COVID-19) pandemic occurred abruptly. It is an unexpected disaster. Uncertai... more Coronavirus disease (COVID-19) pandemic occurred abruptly. It is an unexpected disaster. Uncertain treatment for this viral infection increases excessive anxiety, which does not occur only in one person but also in majority of people; therefore, it can create mass panic. Mass panic is a serious problem that must be immediately identified and managed. Mass panic management will reduce COVID-19 incidence.
ABSTRAK Pendahuluan. Kualitas hidup terkait kesehatan selama pasien menderita HIV dapat digunakan... more ABSTRAK Pendahuluan. Kualitas hidup terkait kesehatan selama pasien menderita HIV dapat digunakan sebagai salah satu indikator keberhasilan terapi yang telah diberikan. Salah satu instrumen untuk menilai kualitas hidup pasien adalah kuesioner WHOQOL-HIV BREF yang telah digunakan di berbagai negara, namun belum pernah diuji kesahihan dan keandalannya di Indonesia. Penelitian ini bertujuan untuk menguji kesahihan dan keandalan kuesioner WHOQOL-HIV BREF dalam bahasa Indonesia sebagai alat untuk mengukur kualitas hidup pada pasien HIV/AIDS. Metode. Penelitian potong lintang dilakukan di Poliklinik khusus HIV Rumah Sakit dr. Cipto Mangunkusumo (POKDISUS RSCM) Jakarta pada bulan November 2016. Sampel diambil secara konsekutif. Penelitian dilakukan dalam dua tahap yaitu tahap awal yang merupakan proses adaptasi bahasa dan budaya dan tahap akhir yaitu uji kesahihan dan keandalan dari kuesioner. Hasil. Sebanyak 56 responden ikut serta dalam penelitian ini dan diketahui bahwa 69,6% di antaran...
to examine certain characteristics of patients who suffer from psychosomatic disorders. We called... more to examine certain characteristics of patients who suffer from psychosomatic disorders. We called data through medical report outpatient clinic of the Psychosomatic Division, Department of internal medicine, Cipto Mangunkusumo Central General Hospital/Faculty of Medicine of the University of Indonesia (FKUI/RSUPN-CM), Jakarta, Indonesia, in 1996. The data was processed manually and by computer from which table and graphic were obtained. The descriptive analysis was performed to the objective the study. the FPD patients consisted of those with vegetative imbalance (multiple psychosomatic syndrome) (30.2%), dyspepsia (20.8%), functional heart disease (11.3%) and others 1%-6%. All of SPD consisted of chronic disease, such as hypertension (38.3%), diabetes mellitus (29.8%), bronchial asthma (10.6%), coronary artery disease (6.4%), and others 2%-5%. According to DSM IV, among the psychosomatic patients, 52.7% met the criteria for anxiety, 29.3% for depression, 14.2% for mixed anxiety and...
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