Subjects -> MEDICAL SCIENCES (Total: 8529 journals)
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MEDICAL SCIENCES (2342 journals)            First | 3 4 5 6 7 8 9 10 | Last

Showing 1201 - 1400 of 3562 Journals sorted alphabetically
Journal of Health Research and Reviews     Open Access  
Journal of Health Science and Medical Research     Open Access  
Journal of Health Science Research     Open Access  
Journal of Health Sciences     Open Access   (Followers: 1)
Journal of health sciences     Open Access  
Journal of Health Sciences / Sağlık Bilimleri Dergisi     Open Access  
Journal of Health Sciences and Medicine     Open Access  
Journal of Health Sciences and Surveillance System     Open Access  
Journal of Health Sciences Scholarship     Open Access  
Journal of Health Specialties     Open Access  
Journal of Health Studies     Open Access  
Journal of Healthcare Informatics Research     Hybrid Journal   (Followers: 1)
Journal of Heavy Metal Toxicity and Diseases     Open Access  
Journal of Helminthology     Hybrid Journal   (Followers: 2)
Journal of Herbs Spices & Medicinal Plants     Hybrid Journal  
Journal of HIV for Clinical and Scientific Research     Open Access   (Followers: 1)
Journal of Hospital Medicine     Hybrid Journal   (Followers: 10)
Journal of Huazhong University of Science and Technology [Medical Sciences]     Hybrid Journal  
Journal of Human Hypertension     Hybrid Journal   (Followers: 3)
Journal of Human Rhythm     Open Access  
Journal of Human Transcriptome     Open Access  
Journal of Ideas in Health     Open Access  
Journal of Inflammation     Open Access   (Followers: 2)
Journal of Inflammation Research     Open Access  
Journal of Injury and Violence Research     Open Access   (Followers: 7)
Journal of Innovation in Health Informatics     Open Access   (Followers: 17)
Journal of Institute of Medicine     Open Access  
Journal of Insulin Resistance     Open Access   (Followers: 1)
Journal of Interactional Research in Communication Disorders     Hybrid Journal   (Followers: 5)
Journal of Interferon & Cytokine Research     Hybrid Journal   (Followers: 3)
Journal of International Medical Research     Open Access   (Followers: 4)
Journal of Interventional Medicine     Open Access   (Followers: 1)
Journal of Investigative Medicine     Hybrid Journal   (Followers: 3)
Journal of Islamabad Medical & Dental College     Open Access  
Journal of Istanbul Faculty of Medicine     Open Access  
Journal of Karnali Academy of Health Sciences     Open Access   (Followers: 1)
Journal of Kathmandu Medical College     Open Access   (Followers: 1)
Journal of King Abdulaziz University : Medical Sciences     Open Access   (Followers: 2)
Journal of Laboratory Medicine     Hybrid Journal   (Followers: 27)
Journal of Laryngology and Voice     Open Access   (Followers: 11)
Journal of Lasers in Medical Sciences     Open Access  
Journal of Law, Medicine & Ethics     Hybrid Journal   (Followers: 24)
Journal of Legal Medicine     Hybrid Journal   (Followers: 7)
Journal of Limb Lengthening & Reconstruction     Open Access  
Journal of Lumbini Medical College     Open Access   (Followers: 1)
Journal of Mahatma Gandhi Institute of Medical Sciences     Open Access  
Journal of Manipulative and Physiological Therapeutics     Hybrid Journal   (Followers: 6)
Journal of Manmohan Memorial Institute of Health Sciences     Open Access   (Followers: 1)
Journal of Marine Medical Society     Open Access  
Journal of Materials Science : Materials in Medicine     Hybrid Journal   (Followers: 4)
Journal of Maternal and Child Health     Open Access  
Journal of Mechanics in Medicine and Biology     Hybrid Journal  
Journal of Medical and Biological Engineering     Hybrid Journal   (Followers: 4)
Journal of Medical and Biomedical Sciences     Open Access   (Followers: 2)
Journal of Medical Case Reports     Open Access   (Followers: 1)
Journal of Medical Cases     Open Access   (Followers: 6)
Journal of Medical Colleges of PLA     Full-text available via subscription  
Journal of Medical Disorders     Open Access  
Journal of Medical Economics     Hybrid Journal   (Followers: 8)
Journal of Medical Education and Curricular Development     Open Access   (Followers: 6)
Journal of Medical Ethics     Partially Free   (Followers: 25)
Journal of Medical Ethics and History of Medicine     Open Access   (Followers: 15)
Journal of Medical Humanities     Hybrid Journal   (Followers: 21)
Journal of Medical Hypotheses and Ideas     Open Access  
Journal of Medical Imaging and Health Informatics     Full-text available via subscription   (Followers: 1)
Journal of Medical Investigation and Practice     Open Access  
Journal of Medical Laboratory and Diagnosis     Open Access  
Journal of Medical Law and Ethics     Full-text available via subscription   (Followers: 15)
Journal of Medical Microbiology     Full-text available via subscription   (Followers: 6)
Journal of Medical Sciences     Open Access  
Journal of Medical Sciences     Open Access  
Journal of Medical Screening     Hybrid Journal   (Followers: 6)
Journal of Medical Signals and Sensors     Open Access   (Followers: 3)
Journal of Medical Society     Open Access  
Journal of Medical Systems     Hybrid Journal  
Journal of Medical Toxicology     Hybrid Journal   (Followers: 6)
Journal of Medical Ultrasound     Open Access   (Followers: 2)
Journal of Medicinal Botany     Open Access  
Journal of Medicinal Chemistry     Hybrid Journal   (Followers: 197)
Journal of Medicine     Open Access   (Followers: 1)
Journal of Medicine and Biomedical Research     Open Access   (Followers: 1)
Journal of Medicine and Philosophy     Hybrid Journal   (Followers: 8)
Journal of Medicine and the Person     Hybrid Journal  
Journal of Medicine in Scientific Research     Open Access  
Journal of Medicine in the Tropics     Open Access  
Journal of Medicine Research and Development     Open Access   (Followers: 3)
Journal of Medicine, Physiology and Biophysics     Open Access   (Followers: 5)
Journal of Medicines Development Sciences     Open Access   (Followers: 1)
Journal of Metabolomics & Systems Biology     Open Access  
Journal of Mind and Medical Sciences     Open Access   (Followers: 1)
Journal of Molecular Medicine     Hybrid Journal   (Followers: 11)
Journal of Movement Disorders     Open Access   (Followers: 2)
Journal of Muscle Research and Cell Motility     Hybrid Journal   (Followers: 1)
Journal of Nanotechnology in Engineering and Medicine     Full-text available via subscription   (Followers: 6)
Journal of Natural Medicines     Hybrid Journal  
Journal of Natural Science, Biology and Medicine     Open Access   (Followers: 3)
Journal of Nature and Science of Medicine     Open Access   (Followers: 4)
Journal of Negative and No Positive Results     Open Access  
Journal of Nepalgunj Medical College     Open Access  
Journal of Neurocritical Care     Open Access  
Journal of Neurodegenerative Diseases     Open Access   (Followers: 2)
Journal of Neurorestoratology     Open Access  
Journal of Neuroscience and Neurological Disorders     Open Access  
Journal of Nobel Medical College     Open Access  
Journal of Obesity and Bariatrics     Open Access  
Journal of Occupational Health     Open Access  
Journal of Occupational Therapy Education     Open Access   (Followers: 9)
Journal of Ocular Biology, Diseases, and Informatics     Hybrid Journal  
Journal of Oral Biology and Craniofacial Research     Full-text available via subscription  
Journal of Oral Health and Craniofacial Science     Open Access  
Journal of Orofacial Sciences     Open Access  
Journal of Otorhinolaryngology, Hearing and Balance Medicine     Open Access   (Followers: 1)
Journal of Ovarian Research     Open Access  
Journal of Ozone Therapy     Open Access  
Journal of Palliative Medicine     Hybrid Journal   (Followers: 47)
Journal of Paramedical Sciences & Rehabilitation     Open Access  
Journal of Parkinsonism and Restless Legs Syndrome     Open Access   (Followers: 2)
Journal of Parkinson’s Disease and Alzheimer’s Disease     Open Access  
Journal of Participatory Medicine     Open Access  
Journal of Patan Academy of Health Sciences     Open Access  
Journal of Pathogens     Open Access   (Followers: 1)
Journal of Patient Experience     Open Access  
Journal of Patient Safety and Risk Management     Hybrid Journal   (Followers: 1)
Journal of Patient-Centered Research and Reviews     Open Access  
Journal of Patient-Reported Outcomes     Open Access  
Journal of Periodontal Research     Hybrid Journal  
Journal of Personalized Medicine     Open Access   (Followers: 3)
Journal of Pest Science     Hybrid Journal   (Followers: 1)
Journal of Pharmaceutical Policy and Practice     Open Access   (Followers: 4)
Journal of Physiobiochemical Metabolism     Hybrid Journal   (Followers: 2)
Journal of Physiology-Paris     Hybrid Journal   (Followers: 2)
Journal of Pioneering Medical Sciences     Open Access  
Journal of Postgraduate Medicine     Open Access  
Journal of Pregnancy     Open Access   (Followers: 4)
Journal of Prevention & Intervention Community     Hybrid Journal   (Followers: 6)
Journal of Preventive Medicine and Public Health     Open Access  
Journal of Primary Prevention     Hybrid Journal   (Followers: 7)
Journal of Prosthodontic Research     Full-text available via subscription   (Followers: 1)
Journal of Prosthodontics     Hybrid Journal   (Followers: 2)
Journal of Receptor, Ligand and Channel Research     Open Access  
Journal of Regenerative Medicine     Partially Free   (Followers: 3)
Journal of Research in Medical Sciences     Open Access   (Followers: 2)
Journal of Science and Applications : Biomedicine     Open Access   (Followers: 1)
Journal of Science and Technology (Ghana)     Open Access   (Followers: 3)
Journal of Scientific Innovation in Medicine     Open Access  
Journal of Scientific Perspectives     Open Access   (Followers: 1)
Journal of Sensory Studies     Hybrid Journal   (Followers: 4)
Journal of Shaheed Suhrawardy Medical College     Open Access  
Journal of Shoulder and Elbow Arthroplasty     Open Access  
Journal of Sleep Disorders : Treatment & Care     Hybrid Journal   (Followers: 10)
Journal of South American Earth Sciences     Hybrid Journal   (Followers: 5)
Journal of Spinal Cord Medicine     Hybrid Journal   (Followers: 4)
Journal of Spinal Disorders & Techniques     Hybrid Journal   (Followers: 2)
Journal of Sports Medicine and Allied Health Sciences : Official Journal of the Ohio Athletic Trainers Association     Open Access   (Followers: 1)
Journal of Stem Cell Therapy and Transplantation     Open Access   (Followers: 1)
Journal of Stomal Therapy Australia     Full-text available via subscription  
Journal of Strength and Conditioning Research     Hybrid Journal   (Followers: 73)
Journal of Substance Use     Hybrid Journal   (Followers: 14)
Journal of Surgical Academia     Open Access   (Followers: 1)
Journal of Surgical and Clinical Research     Open Access  
Journal of Surgical Case Reports     Open Access  
Journal of Surgical Education     Full-text available via subscription   (Followers: 3)
Journal of Surgical Technique and Case Report     Open Access  
Journal of Systemic Therapies     Full-text available via subscription   (Followers: 3)
Journal of Taibah University Medical Sciences     Open Access  
Journal of Telemedicine and Telecare     Hybrid Journal   (Followers: 12)
Journal of The Academy of Clinical Microbiologists     Open Access  
Journal of the American Association for Laboratory Animal Science     Full-text available via subscription   (Followers: 7)
Journal of the American College of Certified Wound Specialists     Hybrid Journal   (Followers: 2)
Journal of the American College of Clinical Wound Specialists     Hybrid Journal   (Followers: 2)
Journal of the American Medical Directors Association     Hybrid Journal   (Followers: 6)
Journal of the American Medical Informatics Association : JAMIA     Hybrid Journal   (Followers: 35)
Journal of the American Podiatric Medical Association     Full-text available via subscription   (Followers: 7)
Journal of the Anatomical Society of India     Full-text available via subscription  
Journal of the Anus, Rectum and Colon     Open Access  
Journal of The Arab Society for Medical Research     Open Access  
Journal of the Australasian College of Nutritional and Environmental Medicine     Full-text available via subscription  
Journal of the Australasian Society of Aerospace Medicine     Open Access   (Followers: 1)
Journal of the Ceylon College of Physicians     Open Access  
Journal of the Chinese Medical Association     Open Access   (Followers: 2)
Journal of the College of Community Physicians of Sri Lanka     Open Access  
Journal of The Egyptian Public Health Association     Open Access   (Followers: 1)
Journal of the Formosan Medical Association     Open Access   (Followers: 2)
Journal of the Ghana Science Association     Full-text available via subscription   (Followers: 3)
Journal of the Grodno State Medical University     Open Access   (Followers: 1)
Journal of the History of Medicine and Allied Sciences     Hybrid Journal   (Followers: 17)
Journal of the International Society for Telemedicine and eHealth     Open Access   (Followers: 3)
Journal of the Learning Sciences     Hybrid Journal   (Followers: 17)
Journal of the Medical Library Association     Open Access   (Followers: 284)
Journal of the Medical Sciences (Berkala ilmu Kedokteran)     Open Access   (Followers: 1)
Journal of the National Medical Association     Full-text available via subscription  
Journal of the Peripheral Nervous System     Hybrid Journal   (Followers: 3)
Journal of the Postgraduate Institute of Medicine     Open Access  
Journal of the Renin-Angiotensin-Aldosterone System     Open Access   (Followers: 1)
Journal of the Royal Society of Medicine     Hybrid Journal   (Followers: 2)
Journal of the Ruhunu Clinical Society     Open Access  
Journal of the Scientific Society     Open Access   (Followers: 1)
Journal of the Siena Academy of Sciences     Open Access   (Followers: 1)
Journal of Therapeutic Ultrasound     Open Access  
Journal of Thyroid Research     Open Access   (Followers: 1)

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Similar Journals
Journal Cover
Jurnal Penyakit Dalam Indonesia
Number of Followers: 1  

  This is an Open Access Journal Open Access journal
ISSN (Print) 2406-8969 - ISSN (Online) 2549-0621
Published by Universitas Indonesia Homepage  [20 journals]
  • Cedera Hati Hipoksik pada Infark Miokard Akut

    • Authors: Chyntia Olivia Maurine Jasirwan
      First page: 109
      Abstract: Cedera hati hipoksik atau seringkali disebut juga hepatitis hipoksik terjadi akibat kekurangan oksigen pada hepatosit sentrilobulus yang menyebabkan nekrosis hepatosit. Penyebab utama perfusi hati insufisiensi (iskemik) ini adalah kongesti hati atau penyakit hati kronik. Definisi umum cedera hati hipoksik melibatkan tiga faktor utama: kondisi klinis yang tipikal pada kasus kardiak atau syok sirkulatorik, peningkatan hebat kadar enzim aminotransferase serum dalam waktu cepat dan bersifat reversibel, dan tidak ada penyebab kerusakan hati yang lain.
      PubDate: 2018-09-30
      DOI: 10.7454/jpdi.v5i3.215
      Issue No: Vol. 5, No. 3 (2018)
       
  • Hubungan antara Konsentrasi D-Dimer dengan Parameter Laboratorium
           Kebocoran Plasma pada Infeksi Dengue

    • Authors: Suhendro Suwarto, Riyanti Astrid Diahtantri, Elian Hudiya
      Pages: 110 - 115
      Abstract: Pendahuluan. Salah satu petanda demam berdarah dengue adalah kebocoran plasma dan aktivasi sistem koagulasi yang menyebabkan peningkatan konsentrasi D-dimer akibat degradasi bekuan fibrin. Penelitian ini dilakukan untuk mengetahui hubungan D-dimer dengan parameter laboratorium kebocoran plasma yaitu: trombositopenia, hipoalbuminemia, hemokonsentrasi, dan peningkatan serum glutamic oxaloacetic transaminase (SGOT).  Metode. Penelitian retrospektif dilakukan di rumah sakit swasta di Jakarta pada bulan Desember 2016 sampai dengan Maret 2018. Penderita berusia >14 tahun dengan infeksi dengue dan NS-1 positif diikutsertakan ke dalam penelitian ini dan dibagi menjadi kelompok demam dengue (DD) atau demam berdarah dengue (DBD).  Uji Mann Whitney digunakan untuk variabel non parametrik, sedangkan uji Spearman digunakan untuk korelasi antara variabel numerik yang tidak terdistribusi normal. Hasil. Tujuh puluh tiga penderita infeksi dengue yang terdiri atas 29 (39,7%) wanita dan 44 (60,3%) pria ikut dalam penelitian ini. Sebanyak 43 (58,9%) merupakan kelompok penderita DD, sedangkan 30 (41,1%) kelompok penderita DBD. Konsentrasi D-dimer fase demam kelompok DBD lebih tinggi dibandingkan dengan kelompok DD (p = 0,004). Didapatkan korelasi lemah antara konsentrasi D-dimer fase demam dengan derajat penurunan trombosit (r = 0,35; p = 0,003) dan korelasi terbalik lemah antara konsentrasi D-dimer fase demam dengan konsentrasi albumin (r = -0,34; p = 0,049). Didapatkan korelasi lemah antara konsentrasi D-dimer fase kritis dengan derajat penurunan trombosit (r = 0,39; p = 0,034) dan korelasi terbalik sedang antara konsentrasi D-dimer fase kritis dengan konsentrasi albumin (r = -0,43; p = 0,032).Simpulan. Konsentrasi D-dimer pada penderita DBD pada fase demam lebih tinggi dibandingkan penderita DD. Konsentrasi D-dimer berkorelasi dengan derajat penurunan trombosit dan hipoalbuminemia.Kata Kunci: D-dimer, Hemokonsentrasi, Hipoalbuminemia, Infeksi dengue, SGOT, TrombositThe Association between D-dimer Concentration and Laboratory Parameters for Plasma Leakage in Dengue InfectionIntroduction. Plasma leakage and activation of the coagulation system are the pathological hallmark of dengue hemorrhagic fever (DHF) that causes an increase in D-dimer concentration due to the degradation of fibrin clots. This study was conducted to determine the association between of D-dimer and laboratory parameters of plasma leakage, namely: thrombocytopenia, hypoalbuminemia, hemoconcentration and concentration of serum glutamic oxaloacetic transaminase (SGOT) in dengue infected patients.Methods. A retrospective study was conducted at private hospitals in Jakarta, from December 2016 to March 2018. Patients >14 years with dengue infection and positive NS-1 were included in this study, and were classified into dengue fever (DF) group or DHF group. The Mann Whitney test was used for non-parametric variables and the Spearman test was used for the correlation for non-normally distributed numeric variables.Results. Seventy-three dengue infected patients included in this study consists of 29 (39.7%) female and 44 (60.3%) male. Total of 43 (58.9%) were classified as DD group, 30 (41.1%) were classified as DHF group. The D-dimer concentration of the DHF group in the fever phase was higher compared to the DD group (p = 0.004). There was a weak correlation in the fever phase between D-dimer concentration and the degree of thrombocytopenia (r = 0.35; p = 0.003) and weak inverse correlation in the fever phase between D-dimer concentration and albumin concentration (r = -0.34; p = 0.049). We found a weak correlation in the critical phase between D-dimer concentration and the degree of thrombocytopenia (r = 0.39; p = 0.034) and the moderate inverse correlation in the critical phase between the D-dimer concentration and albumin concentration (r = -0.43; p = 0.032).Conclusions. D-dimer concentrations in DHF patients in the fever phase are higher compare to DD patients. D-dimer concentration correlates with the degree of thrombocytopenia and hypoalbuminemia.

      PubDate: 2018-09-30
      DOI: 10.7454/jpdi.v5i3.197
      Issue No: Vol. 5, No. 3 (2018)
       
  • Cedera Hati Hipoksik Prediktor Komplikasi Akut Utama Pasien Infark Miokard
           di Unit Rawat Intensif Koroner Rumah Sakit Cipto Mangunkusumo

    • Authors: Muhadi Muhadi, Nurhayati Adnan Prihartono
      Pages: 116 - 122
      Abstract: Pendahuluan. Major adverse cardiac event (MACE) adalah komplikasi akut utama yang terjadi pada pasien infark miokard, meliputi gagal jantung akut, syok kardiogenik, dan aritmia fatal. Diperlukan biomarker yang akurat, mudah dilakukan, dan cost-effective untuk memprediksi MACE dan kematian. Cedera hati hipoksik atau HLI (hypoxic liver injury) adalah salah satu biomarker potensial menggunakan kadar enzim hati transaminase (serum glutamic-oxaloacetic transaminase/SGOT) sebagai parameter. Penelitian ini bertujuan untuk mengetahui peran HLI sebagai prediktor MACE pada pasien infark miokard tanpa gambaran EKG elevasi segmen ST (NSTEMI).Metode. Penelitian ini merupakan penelitian potong lintang dengan luaran berupa MACE dan kohort retrospektif dengan keluaran kematian selama masa perawatan. Populasi penelitian adalah semua pasien NSTEMI yang menjalani perawatan di ICCU Rumah Sakit Cipto Mangunkusumo (RSCM). Sampel penelitian adalah pasien NSTEMI yang menjalani perawatan di ICCU RSCM pada tahun 2006-2016 dan memenuhi kriteria penelitian. Penentuan titik potong HLI berdasarkan kadar SGOT yang dapat memprediksi MACE dan kematian dihitung dengan kurva ROC. Analisis multivariat dilakukan menggunakan regresi logistik untuk mendapatkan nilai prevalence odds ratio (POR) terhadap MACE dengan memasukkan kovariat. Analisis bivariat mengenai sintasan pasien terhadap kematian dilakukan dengan menggunakan kurva Kaplan-Meier dan diuji dengan log-rank.Hasil. Sebanyak 277 subjek diikutsertakan pada penelitian ini. Proporsi subjek dengan MACE pada penelitian ini adalah 51,3% (gagal jantung akut 48,4%, aritmia fatal 6,5%, syok kardiogenik 7,2%) dan angka kematian sebesar 6,13%. Median nilai SGOT adalah 35 U/L pada seluruh subjek, 40 (rentang 8-2062) U/L pada subjek dengan MACE dan 31 (rentang 6-1642) U/L pada subjek tanpa MACE (p = 0,003). Nilai titik potong yang diambil untuk memprediksi MACE adalah 101,0 U/L (sensitivitas 21,8%; spesifisitas 89,6%; POR 2,727 (IK 95%: 1,306-5,696), p = 0,006). Pada analisis multivariat tidak didapatkan hubungan yang bermakna antara HLI dengan MACE. Nilai titik potong untuk memprediksi kesintasan terhadap kematian adalah 99,0 U/L (sensitivitas 23,5%; spesifisitas 83,8%; likelihood ratio +1,46). Tidak didapatkan perbedaan kesintasan yang bermakna antara subjek dengan nilai HLI di bawah dan di atas titik potong kadar SGOT.Simpulan. Cedera hati hipoksik (HLI) tidak dapat digunakan untuk memprediksi MACE pada pasien NSTEMI kecuali dikombinasikan dengan variabel lain. Tidak terdapat perbedaan kesintasan yang bermakna antara subjek dengan atau tanpa HLI. Kata Kunci: Cedera hati hipoksik, Infark miokard, Kesintasan, MACE, NSTEMI, SGOT
      Hypoxic Liver Injury as Predictor of Major Adverse Cardiac Events in Acute Myocardial Infarction patients admitted to Intensive Coroner Care Unit of Cipto Mangunkusumo National General HospitalIntroduction. Major adverse cardiac events (MACE) is a complicating myocard infarctwhich consist of acute heart failure, cardiogenic shock, and fatal arrhytmia. An accurate, easy and cost-effective biomarker is needed to predict MACE and mortality in patients with myocard infarct. Hypoxic liver injury (HLI) is a potential biomarker using serum glutamic-oxaloacetic transaminase (SGOT) level as the parameter. This study is aimed to discover HLI’s role in predicting MACE in non ST elevation myocard infarct (NSTEMI).Methods. This study was designed as cross sectional to predict MACE and prospective cohort for survival analysis. Study population was all NSTEMI patients admitted to ICCU of...
      PubDate: 2018-09-30
      DOI: 10.7454/jpdi.v5i3.194
      Issue No: Vol. 5, No. 3 (2018)
       
  • Uji Validasi Skor A2DS2 sebagai Prediktor Insiden Pneumonia pada Pasien
           Stroke Iskemik Akut

    • Authors: Toman Nababan, Ceva Wicaksono Pitoyo, Salim Harris, Cleopas Martin Rumende
      Pages: 123 - 128
      Abstract: Pendahuluan. Pneumonia menjadi penyebab utama morbiditas dan mortalitas pada pasien stroke iskemik akut yang dirawat di rumah sakit. Diperlukan suatu sistem skor yang valid dan mudah diterapkan sebagai alat untuk memprediksi dan menstratifikasi risiko timbulnya pneumonia pada pasien stroke iskemik akut. Penelitian ini dilakukan untuk menilai kemampuan skor A2DS2 dalam memprediksi timbulnya pneumonia pada pasien stroke iskemik akut.Metode. Penelitian ini merupakan studi kohort retrospektif terhadap pasien stroke iskemik akut yang dirawat di Rumah Sakit dr. Cipto Mangunkusumo, Jakarta. Usia, fibrilasi atrium, disfagia, jenis kelamin (laki-laki), dan tingkat keparahan stroke (dinilai dengan National Institute of Health Stroke Scale/NIHSS), dinilai pada awal perawatan di rumah sakit dan kemudian diikuti hingga tujuh hari sejak onset stroke iskemik untuk dilihat outcome-nya (pneumonia atau tidak). Analisis data dilakukan menggunakan program SPSS for windows versi 20.0. Performa kalibrasi skor A2DS2 dinilai dengan uji Hosmer-Lemeshow dan plot kalibrasi. Performa diskriminasi skor A2DS2 dinilai dengan area under the curve (AUC).Hasil. Sebanyak 281 subjek diikutsertakan pada penelitian ini dengan angka kejadian pneumonia dalam tujuh hari sejak onset timbulnya stroke iskemik sebanyak 118 subjek  (42%). Uji Hosmer-Lemeshow menunjukkan p = 0,222 dengan plot kalibrasi menunjukkan koefisien korelasi r = 0,982. Nilai AUC yang didapatkan sebesar 0,885 (IK 95% 0,845-0,924).Simpulan. Skor A2DS2 memiliki performa kalibrasi dan diskriminasi yang baik dalam memprediksi timbulnya pneumonia pada pasien stroke iskemik akut. Kata Kunci: Skor A2DS2, Stroke iskemik akut, Validasi
      Validation of A2DS2 Score as Predictor of Pneumonia among Patients Hospitalized for Acute Ischemic StrokeIntroduction. Pneumonia is the leading cause of morbidity and mortality in acute ischemic stroke patients admitted to hospital. Thus required a valid scoring system which is easy to apply, to predict and stratify the risk of pneumonia in patients with acute ischemic stroke. This study aimed to assess the performance of calibration and discrimination of A2DS2 score in predicting the incidence of pneumonia in patients with acute ischemic stroke.Methods. A retrospective cohort study was conducted among adult acute ischemic stroke patients who are hospitalized in Cipto Mangunkusumo Hospital, Jakarta. Age, atrial fibrillation, dysphagia, sex (male), and stroke severity (rated with National Institute of Health Stroke Scale/NIHSS) were obtained at the beginning of admission. The subjects were followed up for up to seven days after the onset of ischemic stroke to assess the outcome (pneumonia). Calibration properties of the A2DS2 score were assessed by Hosmer-Lemeshow test and calibration plot. Discrimination properties of the A2DS2 score were assessed by the area under the curve (AUC).Results. A total of 281 subjects were followed up. The incidence of pneumonia in acute ischemic stroke patients was observed in 118 patients (42%). Hosmer Lemeshow test of A2DS2 score showed p = 0,222 and calibration plot showed r = 0,982. Discrimination of A2DS2 score was shown by the AUC value of 0,885 (95% CI 0,845-0,924). Conclusion. The A2DS2 score has a good calibration and discrimination performance in predicting the incidence of pneumonia in patients with acute ischemic stroke.


      PubDate: 2018-09-30
      DOI: 10.7454/jpdi.v5i3.201
      Issue No: Vol. 5, No. 3 (2018)
       
  • Perbandingan Profil Keamanan Tenofovir dan Telbivudin terhadap Fungsi
           Ginjal pada Pasien Hepatitis B di Indonesia

    • Authors: Rino Alvani Gani
      Pages: 129 - 134
      Abstract: Pendahuluan. Tenofovir disoproksil fumarat (tenofovir) dan telbivudin merupakan dua analog nukleos(t)ida yang tersedia untuk terapi pasien hepatitis B. Tenofovir telah diketahui sebagai agen nefrotoksik pada pasien HIV, namun masih menjadi kontroversi pada pasien hepatitis B kronik. Di lain sisi, telbivudin memiliki efek proteksi terhadap fungsi ginjal dan bahkan meningkatkan estimasi laju filtrasi glomerulus (eLFG). Penelitian ini bertujuan untuk mengetahui profil keamanan terhadap fungsi ginjal dari tenofovir dan telbivudin pada pasien hepatitis B kronik di Indonesia.Metode. Penelitian ini menggunakan desain studi kohort retrospektif pada pasien hepatitis B kronik yang mendapat terapi tenofovir atau telbivudin dalam rentang waktu Januari 2013–Desember 2016. Pasien yang memenuhi kriteria inklusi dan eksklusi akan diikuti selama 1 tahun. Pemeriksaan serial terhadap kreatinin serum dilakukan pada minggu ke-24 dan 48 setelah pemberian tenofovir atau telbivudin.Hasil. Sebanyak 68 pasien dalam terapi tenofovir dan 62 pasien dalam terapi telbivudin dimasukkan penelitian ini. Kadar kreatinin serum meningkat pada kelompok tenofovir dari 0,88 (simpang baku [SB] 0,17) mg/dL pada awal studi menjadi 0,93 (SB 0,22) mg/dL setelah 24 minggu (p = 0,02) dan cenderung plateau setelah penggunaan selama 48 minggu. Namun, pada kelompok telbivudin, kadar kreatinin serum menurun dari 0,85 (SB 0,21) mg/dL pada awal menjadi 0,80 (SB 0,18) mg/dL pada minggu ke-48 (p=0,003)Simpulan. Tenofovir berhubungan dengan peningkatan kadar kreatinin serum dan penurunan eLFG pada pasien hepatitis B kronik dengan eLFG ≥60 mL/menit/1,73 m2.Kata kunci : Fungsi ginjal, Hepatitis B, Telbivudin, TenofovirComparison of Renal Safety of Tenofovir and Telbivudine in Chronic Hepatitis B Patients: A Real World Study in Indonesia Introduction. Tenofovir disoproxil fumarate (tenofovir) and telbivudine are two available nucleos(t)ide analogue (NA) for the treatment of chronic hepatitis B (CHB) patients. Tenofovir has been known as a nephrotoxic agent in HIV patients, but still controversy in CHB patients. On the other hand, telbivudine had a renal protective effect and increased estimated glomerular filtration rate (eGFR). This studi aimed to address the renal safety of tenofovir and telbivudine in Indonesian patients.Method. A retrospective cohort study design was conducted in CHB patients who prescribed with tenofovir or telbivudine from January 2013 to December 2016. Patients who met the inclusion and exclusion criteria were followed up for one year. The serial evaluation of creatinine serum was collected in week-24 and week-48 after the administration of tenofovir or telbivudine.Results. Among CHB patients, 68 and 62 patients that prescribed with tenofovir or telbivudine, respectively, were enrolled in this study. Serum creatinine level  was increased in tenofovir group from 0.88 (SD 0.17) mg/dL at baseline to 0.93 (SD 0.22) mg/dL after 24 weeks (p = 0.02), but creatinine trend to reach plateau after 48 weeks. However, in telbivudine group, serum creatinine level was decreased from 0.85 (SD 0.21) mg/dL at baseline to 0.80 (SD 0.18) mg/dL after 48 weeks (p = 0.003).Conclusion. Tenofovir is associated with the increased of creatinine serum and decreased of eGFR in CHB patients with eGFR ≥60 mL/menit/1,73 m2.

      PubDate: 2018-09-30
      DOI: 10.7454/jpdi.v5i3.213
      Issue No: Vol. 5, No. 3 (2018)
       
  • Perbedaan Kepuasan Perkawinan pada Pasangan ODHA Disertai dan Tanpa
           Disertai Gejala Depresi

    • Authors: Muhammad Ismail Salahudin, Alifiati Fitrikasari, Muchlis Achsan Udji Sofro, Hari Peni Julianti
      Pages: 135 - 140
      Abstract: Pendahuluan. Penyakit HIV/AIDS telah menimbulkan masalah fisik, sosial, dan emosional terhadap individu yang terinfeksi dan pasangannya. Pasangan ODHA memiliki prevalensi mengalami gejala depresi dengan keluhan fisik, yaitu sebesar 12,7%. Terdapat hubungan antara cinta, komunikasi, dan keintiman fisik terhadap kepuasan dalam perkawinan. Depresi pada pasangan ODHA berhubungan dengan kepuasaan terhadap perkawinan.Penelitian ini dilakukan untuk menganalisis adanya perbedaan kepuasan perkawinan pasangan ODHA HIV negatif yang mengalami gejala depresi dengan pasangan ODHA yang tidak mengalami gejala depresi.Metode. Desain penelitian adalah cross-sectional. Sampel adalah 52 orang pasangan sah ODHA usia 18-60 tahun yang menjalani rawat jalan di Poli Infeksi Tropis RSUP. DR. Kariadi Semarang dan memenuhi kriteria inklusi penelitian. Teknik pemilihan sampel menggunakan metode consecutive sampling.  Status depresi diukur dengan instrumen beck depression inventory (BDI) dan kepuasan perkawinan diukur dengan ENRICH marital satisfaction scale (EMS). Pengolahan dan analisis data menggunakan program SPSS. Uji analisis hubungan menggunakan uji chi-square.                                                           Hasil. Subjek penelitian yang tidak mengalami depresi 78,8% dan  yang mengalami depresi 21,2% terdiri dari ringan 9,6%, sedang 11,6%, dan berat 0%. Tidak didapatkan subjek penelitian yang tidak puas terhadap perkawinannya, 55,8% sangat puas dan 44,2% puas.  Tidak terdapat perbedaan bermakna antara kepuasan perkawinan pasangan ODHA HIV negatif  disertai gejala depresi dan tanpa disertai gejala depresi (p=0,595).  Terdapat perbedaan bermakna antara kepuasan perkawinan pasangan ODHA HIV negatif disertai gejala depresi dan tanpa disertai gejala depresi dalam komunikasi (p = 0,021), resolusi konflik (p = 0,025), penggunaan aktivitas santai/luang (p = 0,025), dan hubungan seks (p = 0,007).Simpulan. Tidak terdapat perbedaan antara kepuasan perkawinan pasangan ODHA HIV negatif disertai gejala depresi dan tanpa disertai gejala depresi. Namun demikian, terdapat perbedaan bermakna antara kepuasan perkawinan pasangan ODHA HIV negatif disertai gejala depresi dan tanpa disertai gejala depresi dalam komunikasi, resolusi konflik, penggunaan aktivitas santai/luang, dan hubungan seks. Kata Kunci: Depresi, Kepuasan perkawinan, Pasangan ODHA The Differences of Marital Satisfaction of ODHA Couples with and without Depression Symptoms Introduction. HIV/AIDS disease has caused physical, social, and emotional problems to infected individuals and their spouses. ODHA couples have a prevalence of depression symptoms with physical complaints, which amounted to 12.7%. There is a relationship between love, communication, and physical intimacy to satisfaction in marriage. Depression in ODHA couples is correlated with marital satisfaction. This study aimed to analyze the differences of marital satisfaction of ODHA HIV negative couples who experience depression symptoms with ODHA who do not experience depression symptoms Methods. The research design was cross-sectional. The samples were 52 official couples of ODHA aged 18-60 years who had outpatient treatment in Poly of Infection Tropical RSUP. Dr. Kariadi Semarang and met the criteria of research inclusion. Sampling technique was conducted with consecutive sampling method. Depression status was measured by the beck depression inventory (BDI) instrument and marital satisfaction was measured by ENRICH marital satisfaction scale (EMS). Processing and data analysis using SPSS program. The relationship analysis test using chi-square test.Results. Subjects who did not experience depression 78.8% and those with depression 21.2% consisted of mild 9.6%, moderate 11.6%, and severe 0%. No subjects were found to be unsatisfied with their marriage, 55.8% were very satisfied and 44.2% were satisfied. There was no significant difference between marital satisfaction of ODHA HIV negative couples with depression symptoms and without depression symptoms (p = 0,595). There was a significant difference between the marital satisfaction of ODHA HIV negative couples with depression symptoms and without depression symptoms in communication (p = 0.021), conflict resolution (p = 0.025), use of leisure activities (p = 0.025), and sexual activities (p = 0.007)Conclusion. There was no difference between the marital satisfaction of ODHA HIV negative couples with depression symptoms and without depression symptoms. There was a significant difference between the marital satisfaction of ODHA HIV negative couples with depression symptoms and without depression symptoms in communication, conflict resolution, the use of leisure activities, and sex activities.
      PubDate: 2018-09-30
      DOI: 10.7454/jpdi.v5i3.181
      Issue No: Vol. 5, No. 3 (2018)
       
  • Pengaruh Pemberian Antibiotik berdasar Panduan terhadap Lama Tinggal pada
           Pasien Pneumonia Komunitas di Rumah Sakit

    • Authors: Fetri Charya Munarsih, Ronald Irwanto Natadidjaja, Syamsudin Syamsudin
      Pages: 141 - 145
      Abstract: Pendahuluan. Saat ini pneumonia komunitas menjadi salah satu infeksi dengan angka tertinggi yang dapat dijumpai di rumah sakit. Terapi antibiotik empirik pada pneumonia komunitas dilakukan dengan mengamati berbagai parameter. Parameter yang dapat diukur sebagai outcome terapi pasien dengan pneumonia komunitas selain angka mortalitas adalah  lama tinggal. Penelitian ini bertujuan untuk mengetahui apakah terdapat pengaruh dari pemberian antibiotik empiris terhadap lama tinggal pada pasien pneumonia komunitas yang diterapi berdasarkan panduan penggunaan antibiotik American Thoracic Society Infectious Disease Society of America (ATS/IDSA) 2007 dengan yang tidak diterapi berdasarkan panduan di ruang rawat inap salah satu rumah sakit di Jakarta dari Januari 2014 sampai dengan Agustus 2015.Metode. Desain penelitian ini adalah kohort retrospektif dan dianalisis berdasarkan uji analisis bivariat serta uji analisis multivariat untuk mereduksi pengaruh variabel perancu. Sampel uji pada penelitian dihitung menggunakan rumus perbedaan dua proporsi. Sampel diambil di ruang rawat inap di sebuah rumah sakit di Jakarta.Hasil. Setelah mengontrol variabel perancu, pemberian antibiotik empiris berdasarkan panduan penggunaan antibiotik ATS 2007 pada pasien pneumonia komunitas dengan keterbatasan aktivitas gerak (imobilisasi) sebagai variabel perancu yang bermakna dalam memengaruhi LOS, memiliki kecenderungan 10,25 kali untuk mengalami normal stay di rumah sakit dibandingkan dengan pasien CAP yang menerima antibiotika empiris tidak berdasarkan panduan penggunaan antibiotik ATS 2007 dengan nilai p <0,001.Simpulan. Secara statistik terdapat pengaruh dari pemberian antibiotika empiris terhadap lama tinggal pada pasien pneumonia komunitas yang diterapi berdasarkan panduan penggunaan antibiotika ATS 2007 dengan yang tidak diterapi berdasarkan panduan penggunaan antibiotika ATS 2007. Kata Kunci: Antibiotik, Lama Tinggal, Pneumonia Komunitas Antibiotic Treatment based on Guidelines for Reducing Length of Stay (LOS) in Patients with Community Acquired Pneumonia (CAP)Introduction. Community acquired pneumonia (CAP) now is known as the most common infection presented. Empiric antibiotic administered followed by observing parameters. This study aimed to know how far the American Thoracic Society/Infectious Disease Society of America (ATS/IDSA) antibiotic guidelines 2007 based treatment influenced the length of stay (LOS) of CAP subject in a private hospital ward between January 2014-August 2015Methods. A retrospective cohort was conducted with bivariate analysis and multivariate analysis for reducing the confounding factor. Sample taken with proportional sampling formula at ward in a hospital in Jakarta. Results. The result showed that subjects with unproper empiric antibiotic based on ATS/IDSA 2007 guidelines tent to have hospital prolong stay 10.25 times (p <0.001) than others with proper on ATS/IDSA empiric antibiotic guidelines. Conclusion. By this result, we observed a very significant statistic result difference in LOS between a group with proper empiric antibiotic based on ATS/IDSA 2007 guidelines and other who unproper.
      PubDate: 2018-09-30
      DOI: 10.7454/jpdi.v5i3.195
      Issue No: Vol. 5, No. 3 (2018)
       
  • Limfoma Komposit: Limfoma Hodgkin dan Limfoma Non-Hodgkin Sebuah Laporan
           Kasus

    • Authors: Noorwati Soetandyo, Ruth Vonky Rebecca, Maria Yunti, Arry Harryanto Reksodiputro
      Pages: 146 - 149
      Abstract: Limfoma komposit merupakan penyakit yang jarang terjadi. Limfoma komposit merupakan dua atau lebih tipe limfoma berbeda yang terjadi pada satu lokasi anatomi, baik secara bersamaan maupun sekuensial. Proses diagnostik limfoma komposit memiliki tantangan tersendiri dan sampai saat ini belum ada panduan khusus mengenai tata laksana limfoma komposit. Tulisan ini melaporkan sebuah kasus, pasien wanita 36 tahun dengan limfoma komposit yang terdiri dari limfoma Hodgkin dan limfoma non-Hodgkin yang terjadi sekuensial.Kata Kunci: Komposit, Laporan kasus, Limfoma
      Composite Lymphoma: Hodgkin and Non-Hodgkin Lymphoma A Case ReportComposite lymphoma (CL) is a rare disease. Composite lymphoma is two or more different type of lymphoma that sequentially or simultaneously occur in one anatomical site.  Making a diagnosis of CL is a challenge and there is still no guidelines about the treatment. This case report is about a 36 y.o female with CL, sequentially consisted of Hodgkin and non-Hodgkin lymphoma.

      PubDate: 2018-09-30
      DOI: 10.7454/jpdi.v5i3.200
      Issue No: Vol. 5, No. 3 (2018)
       
  • Efikasi dan Keamanan Obat Anti Diabetik Oral pada Pasien Diabetes Melitus
           Tipe 2 dengan Penyakit Ginjal Kronik

    • Authors: Retta C Sihotang, Rizka Ramadhani, Dicky L Tahapary
      Pages: 150 - 155
      Abstract: Pemilihan obat antidiabetik oral (OAD) pada pasien diabetes melitus tipe 2 (DMT2) dengan penyakit ginjal kronik (PGK) sangatlah penting karena sebagian besar OAD diekskresikan melalui ginjal sehingga diperlukan penyesuaian dosis. Di Indonesia, sulfonilurea (SU) kerja pendek umum dipakai untuk pengelolaan DMT2 dengan PGK. Tinjauan pustaka ini membahas perbandingan efektivitas dan keamanan beberapa jenis SU dengan OAD lainnya pada pasien DMT2 dengan PGK. Golongan obat yang dievaluasi adalah SU, tiazolidindion (TZD), penghambat DPP-IV, dan penghambat SGLT-2. Sulfonilurea kerja pendek (gliklazid dan glipizid) dan penghambat SGLT-2 (empaglifozin dan canaglifozin) dapat menghambat progresi PGK pada DMT2. Pioglitazon dan sitagliptin dikaitkan dengan progresi PGK yang lebih tinggi, sementara linagliptin berefek netral terhadap perburukan PGK. Namun, sitagliptin dan linagliptin memiliki risiko lebih rendah dalam menyebabkan hipoglikemia dibandingkan SU kerja pendek. Dengan demikian, dapat disimpulkan OAD golongan SU kerja pendek, seperti gliklazid dan glipizid masih dapat menjadi pilihan utama untuk pengelolaan glukosa darah pada pasien DMT2 dengan PGK di Indonesia.Kata Kunci: Antidiabetik oral, Efektivitas, Keamanan, Penyakit ginjal kronik, Sulfonilurea Efficacy and Safety of Oral Antidiabetic Drugs in Type 2 Diabetes Mellitus with Chronic Kidney DiseaseSelection of oral antidiabetic drugs (OAD) in patients with type 2 diabetes mellitus (T2DM) with chronic kidney disease (CKD) is very important because most OAD is secreted through the kidneys so dose adjustment is required. In Indonesia, short acting sulfonylureas (SU) are commonly used for the management of T2DM with CKD. This review article aimed to compare the effectiveness and safety of certain SU types with other OAD in T2DM with CKD. Sulfonylureas, tiazolidindion (TZD), DPP-IV-inhibitor, and SGLT-2-inhibitor were evaluated. Short acting sulfonylureas (glycazides and glipizids) and SGLT-2-inhibitor (empaglifozin and canaglifozin) may inhibit the progression of CKD in T2DM. On the contrary, pioglitazone and sitagliptin are associated with higher progression of CKD, while linagliptin has a neutral effect on deterioration of CKD. However, sitagliptin and linagliptin have lower risk of causing hypoglycemia than short acting SU. In conclusion, short acting SU can still be the primary choice for the blood glucose management in T2DM with CKD in Indonesia.
      PubDate: 2018-09-30
      DOI: 10.7454/jpdi.v5i3.202
      Issue No: Vol. 5, No. 3 (2018)
       
 
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