eJournal Kedokteran Indonesia
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Epidemiological Profile of Twice per Week Hemodialysis Patients of Top Referral National Hospital in Indonesia
No full textData regarding the epidemiology and laboratory test results of end-stage renal disease (ESRD) patients on twice per week hemodialysis in Indonesia remain limited. This study was conducted to describe the epidemiological and laboratory profiles of ESRD patients undergoing hemodialysis twice a week. This was a cross-sectional study in which the medical records data of all ESRD patients on hemodialysis at Cipto Mangunkusumo Hospital in 2017. Of 145 subjects, 51% were male. The mean age was 50.1 (SD 13.5) years and the mean body mass index (BMI) was 23.1 kg/m2 (SD 4.8). The aetiology of ESRD in these patients was primarily hypertension (40.7%). There was a significant difference in systolic blood pressure (SBP) and diastolic blood pressure (DBP) before and after hemodialysis (p=0.001 and p<0.001) The mean estimated glomerular filtration rate (eGFR) was 4.3 mL/min/1.73 m2 (SD 2.2) and significantly different between those <60 years old and ≥60 years old (p=0.004). In addition, there was an association between uric acid and post-hemodialysis SBP (p = 0.02). It is concluded that age and sex distribution played a significant role in determining epidemiological profile patients undergoing twice per week hemodialysis.  
Prognosis of Peritoneal Dialysis Compared to Hemodialysis in Patient with End-Stage Renal Disease
No full textEnd-stage Renal Disease (ESRD) is the terminal stage of Chronic Kidney Disease, where the function of the failing kidney must be substituted with Renal Replacement Therapy (RRT). There are two forms of RRT; Peritoneal Dialysis (PD) and Hemodialysis (HD. However, the issue of which method provide a better survival for patient remains an interesting topic to date. This paper aims to provide evidence on whether PD provides better survival compared to HD in a patient with ESRD. Systematic search was done using two databases; Pubmed® and Scopus®. Cohort studies were selected as appropriate study design to answer a prognosis question. Two restrospective cohorts and one prospective cohort study are relevant for this report. Two studies demonstrated survival advantage of PD over HD described by Relative Risk of Mortality of 0.398 and 0.49. The last study showed worse survival of PD patients compared to HD (RR=1.82). The difference in survival in the last study may be attributed to the fact that patients undergoing PD has worse baselinecharacteristics. PDand HD bring about comparable survival in ESRD patients
Left Ventricular Myocardial Intrinsic Function in Mitral Stenosis: Evaluation of Pre and Post Balloon Mitral Valvotomy
No full textOne of the treatment options in mitral stenosis (MS) is balloon mitral valvulotomy (BMV) which may improve myocardial intrinsic function. This study was aimed to observe myocardial systolic function with intrinsic parameter by using STDS- focusing on global longitudinal strain (GLS) - in MS pre and post BMV. This descriptive analytic study which included MS patients who underwent BMV from 2009-2011, were examined by routine echocardiography examination, one day pre BMV and maximal 5 days post BMV. STDS of 4 Left ventricle chambers were taken. Exclusion criteria were: post BMV gradient more than 10 mmHg and post BMV significant mitral regurgitation. Paired t-test analysis was used to compare variables pre and post BMV procedure. There were 45 MS patients with mean age of 39 years old (± 10.7), pre BMV: mean MVA 0.68 cm2 (SD 0.57), mean MVG 14.02 mmHg (SD 5.06), mean EF 58.26% (SD 8.82) and mean GLS -11.81 (SD 3.50). Post BMV: mean MVA 1.4 cm2 (p : 0.000), mean MVG 5.82 (p<0.001), mean EF 61.28% (p=0.001) and GLS also significantly improved to 13.18 (p=0.02). Improvement of LVMIF after BMV procedure, may explain beneficial effect of BMV in regional myocardial deformation and systolic function in MS patients
Subclinical Thyroid Dysfunction: Diagnosis and Management
No full text Thyroid glands play a critical role in fetal brain development during pregnancy and in the regulation of growth and metabolic function after development. Thyroid dysfunction has become a common clinical problem nowadays and the incidence is increasing each year. However, the ideal approach for adequate diagnosis and management of thyroid dysfunction still becomes a debate among endocrinologists. Several guidelines for thyroid dysfunction management have been established by various group of experts, mostly focused on thyroid nodules. Subclinical hyperthyroidism (SH) and subclinical hypothyroidism is considered as a laboratory than a clinical diagnosis. In order to achieve compliance with accepted protocols, an appropriate interpretive reports should be an integral part of the investigation of both SH and subclinical hypothyroidism. The medications of anthytiroid drugs, radioactive iodine, and surgery are considered as treatments for SH. Whereas oral levothyroxine treatment is chosen as a therapy for subclinical hypothyroidism. Taken together, diagnosis and management of both SH and hypothyroidism need regular monitoring of thyroid function. Even though expert panels already released various guidelines for the diagnosis and management of thyroid dysfunction, each patient should be assessed individually to determine the most suitable treatment. Until adequate data are available, clinical judgment was combined with patient’s preferences to improve best practice. 
Influence of Mesenchymal Stem Cell Transplantation in Retaining Ganglion Cell of End Stage Glaucoma Patients
No full textMesenchymal stem cells transplantation enhances nerve growth factor synthesis, brain derived nerve factor, glial cell line-derived neurotropic factor, and neurotrophin-3.. We report four end-stage primary open angle glaucoma patients, consisting of three males and one female with a median age of 68 years old, treated at RSCM on September 2017. Visual acuity ranged between 1/300 to 2/60 and intraocular pressure (IOP) between 10-14 mmHg. All patients underwent allogeneic mesenchymal stem cells transplantation derived from umbilical cord by subtenon injection and evaluated the results of the potential evoked retinograph and average thickness of ganglion cell-inner plexiform layer (GC-IPL). Three months later, two patients admitted their vision was improved. with, no significant anatomical structure changes were observed. While two other patients did not report any significant effects
PERANAN ENDOSKOPI TERAPEUTIK DALAM MENINGKATKAN KUALITAS HIDUP PASIEN KANKER GASTROINTESTINAL STADIUM LANJUT
No full textNeurological Complication in Nasopharyngeal Carcinoma
No full text Nasopharyngeal Carcinoma (NPC) frequently cause neurological complication such as local ivasion, intracranial infiltration, radicular pain, metastatic spread to brain and spine, And stroke like syndrome due to hypercoagulation. This study was conducted to describe neurological complication in NPC and the factors that may influence. This was a cross sectional study used the data from medical records of patients were referred to neurology department for further assestement on neurological complication and stagging purpose from January until December 2014. Statistical analysis was done with SPSS for windows version 20.0. From 86 samples, mean of age was 49.23+11.28 years old, majority of men (73.3%), tumor size of T3 and T4 (68.6 %), and histopathologically non-keratinized (96.5%, Type II and III of WHO). Clinical onset of NPC were found in 11.89 months, and clinical onset of neurological complication were found in 14.32 months. Local invasion of NPC was noted in all samples (100%) with fifth cranial nerve involvement (26.1 %) of samples. The only factor that significantly influence neurological complication due to local invasion and intracranial infiltration was the size of tumor (p=0.032 ; p=0.02). It was concluded that the main neurological complications were cranial nerve lesions due to local invasion. There is a relationship between tumor size and local invasion and intracranial infiltration
Association of Knee Pain and Working on Squatting Position and Other Risk Factors Among Dairy Farmers
No full textDairy farmers have been identified having high risk for knee pain. Squatting position when milking cows create awkward knee posture and high compression on knee joint that could lead to knee injury and degenerative diseases on knee joint. This study aims to identify the prevalence of knee pain among dairy farmers and the association of squatting position and other factors with knee pain among dairy farmers in West Java. A cross sectional study on 117 respondents was conducted at Unit Pelaksana Teknis Daerah (UPTD) Balai Pengembangan Ternak Sapi Perah dan Hijauan Makanan Ternak (BPT-SP HPT) Cikole, Lembang from May through June 2017 (total population). Instruments used were standardized interview form and Knee Injury and Osteoarthritis Outcome Score (KOOS) questionnaire. Working position was observed. Chi Square and Logistic Regression was conducted with SPSS Statistics 20.0 program. In this study, 88% dairy farmers had knee pain, mostly with mild knee pain. Association was found between knee pain and squatting (ORc=7.36). Determinants for knee pain are working period 6-10 years with ORA=7.35 (95% CI 1.25-42.95, p=0.027) and working period >10 tahun with ORA= 26,09 (95% CI 1.24-547.59, p=0.036). Prevalence of knee pain among dairy farmers was 88%. The study suggests that knee pain among dairy farmers had association with squatting position. Working period >5 years was identified as determinant factor. It is necesary to improve dairy farmers working condition to reduce exposure of risk factors during working period.  
Mental Disorders in Children and Adolescents with HIV and Various Factors Related
No full textHIV/AIDS may affect all ages, including children and adolescent. HIV may lead to various physical and mental problems. This study aims to measure the prevalence of mental disorder in children and adolescent infected with HIV and various other factors related. This cross sectional study was done during August until November 2014, included 92 patients in Allergic-Immunology outpatient clinic in Pediatric Department of Cipto Mangunkusumo Hospital. Samples were interviewed to collect personal data, examined using SDQ and MINI KID questionnaires.The results showed 18.5% and 25% of the samples have emotional and behavioral problem. Approximately 23.9% have mental disorders, with separation anxiety (7.6%), ADHD/ attention deficit and hyperactive disorder (7.6%), adjustment disorder (1.1%), major depression (4.3%), and oppositional defiant disorder (3.3%). Analysis suggest that samples who are currently attending school, and samples that have not disclosed to their condition as being HIV+, are more protected from mental problems, though not statistically significant. The prevalence of mental disorders in children and adolescent with HIV are higher than the general population. Emotional, hyperactivity and behavioral problems are related to mental disorder
Graves Ophthalmopathy: Comparison of Clinical Appearance, Thyroid Hormones, and TSH Receptor Antibody Profiles
No full textGraves ophthalmopathy (GO) is the most common extrathyroid manifestation of Graves’ disease (GD). This study aims to evaluate characteristic difference in terms of clinical appearance, thyroid hormones (TSHs, FT4 and FT3) and TSH receptor antibody profiles (TRAb and TSAb) in GD patients with and without clinical GO. This study using consecutive sampling methode on endocrine clinic dr. Cipto Mangunkusumo National Hospital in December 2009 to Januari 2011. This was cross sectional study involving 75 GD patients. Subjects were divided into two groups, those with and without clinical OG. Graves ophthalmopathy were diagnosed clinically by Bartley’s criteria. Thyroid hormones (TSHs, FT4 and FT3) and TRAb were measured by ELISA technique while TSAb were measured by RIA technique. There was no statistically significant difference in smoking history, blood pressure, age, and duration of illness between two groups. In terms of laboratory parameters, there were also no significant difference of TSHs, FT4, FT3, TRAb and TSAb between groupswith and without clinical GO. The clinical OG group however, showed increasing trend of TSAb than those of without clinical OG (615.4 (295-1120.9) vs 972.4 (450-1648), p=0.06). If lower lid retraction were included as diagnosis of OG, there was significant difference of TSAb between two groups (596 [291-1120] vs 941 [454-1642], p=0.03). There were no significant difference in clinical appearances, thyroid hormones and anti-TSH receptor antibody profiles between GD patients with and without clinical GO. But there was incraesing tren of TSAB in GD patients with clinical GO