Current Internal Medicine Research and Practice Surabaya Journal 2023-08-31T15:17:57+07:00 Prof. Dr. Usman Hadi, dr., Sp.PD, K-PTI., FINASIM Open Journal Systems <p><strong>Current Internal Medicine Research and Practice Surabaya Journal</strong> (CIMRJ) <a href="">e-ISSN: 2721-544X</a> is published by the Faculty of Medicine, Universitas Airlangga in collaboration with <a href="" target="_blank" rel="noopener">The Indonesian Society of Internal Medicine (PAPDI) branch of Surabaya</a>.</p> <p><strong>Current Internal Medicine Research and Practice Surabaya Journal</strong> classify the articles into Original Articles, Case Report, and Review Articles. It is published two times a year in January and August. The scope of this journal includes allergy, endocrinology, gastroenterology, geriatrics, hematology, hepatology, nephrology, rheumatology, and tropical infection.</p> Correlation between Serum High-Sensitivity C-Reactive Protein Level and Severity of Albuminuria Measured by Urine Albumin-to-Creatinine Ratio in Type 2 Diabetic Patients 2023-08-29T14:54:21+07:00 Dicky Febrianto Soebagijo Adi Soelistijo Artaria Tjempakasari <p>Introduction: One of complications in type 2 diabetes mellitus (DM) that require high treatment cost is diabetic kidney disease (DKD), which is characterized by the presence of albuminuria, decrease in glomerular filtration rate, or both. Researches show a positive correlation between type 2 DM and serum high-sensitivity C-reactive protein (hs-CRP) level, a sensitive marker of subclinical inflammation. This study aimed to analyze the correlation between serum hs-CRP level and severity of albuminuria measured by urine albumin-to-creatinine ratio (ACR).<br />Methods: The study was conducted at the Endocrinology Outpatient Clinic of Dr. Soetomo General Academic Hospital, Surabaya, on June-July 2020.<br />Results: The study included 50 patients with type 2 DM, consisting of 25 (50%) men and 25 (50%) women, with median age of 58.0 (42-68) years and mean body mass index (BMI) of 21.91 ± 1.310 kg/m2. Median duration of DM was 12.0 (6-22) years, median HbA1c level was 7.20% (5.7%-12.3%), mean serum crEatinine level was 0.83 ± 0.180 mg/dL, and median estimated glomerular filtration rate (eGFR) value was 92.85 (61.6-121.2) mL/minute/1.73 m2. Median serum hs-CRP level was 1.20 (0.1-4.0) mg/L and median urine ACR value was 49.570 (7.78-426.00) mg/g. Normoalbuminuria was detected in 28% of subjects, microalbuminuria in 66% of subjects, and macroalbuminuria in 6% of subjects. This study showed positive and significant correlation between serum hs-CRP level and severity of albuminuria (r = 0.701; p = &lt;0.001).<br />Conclusion: There was positive and significant correlation betweeen serum hs-CRP level and severity of albuminuria in type 2 diabetic patients. </p> 2023-08-31T00:00:00+07:00 Copyright (c) 2023 Dicky Febrianto Association between Albuminuria and Serum Phosphate Levels in Non-Dialysis Stage 3-5 Chronic Kidney Disease Patients 2023-08-30T15:01:51+07:00 Ernesto Everald Baibelino Harfonso Nunuk Mardiana Atika <p>Introduction: Chronic kidney disease (CKD) remains a global burden and catastrophic disease as about 697.5 million people suffering from it in 2017. About 42% of CKD mortality in Indonesia is related to cardiovascular complications. Hyperphosphatemia, a manifestation of chronic kidney disease-mineral bone disorder, could increase the risk of cardiovascular mortality. Albuminuria has been proven to inhibit the compensatory mechanisms for hyperphosphatemia, thereby aggravating this condition. This study was conducted to analyze the association between albuminuria and serum phosphate levels among CKD patients in Dr. Soetomo General Academic Hospital, Surabaya, Indonesia.<br />Methods: This cross-sectional study used medical records of 129 non-dialysis stage 3-5 CKD patients at the outpatient clinic of Dr. Soetomo General Academic Hospital from March-November 2021. Descriptive analysis was performed on albuminuria, serum phosphate, age, sex, body mass index, comorbid, blood chemistry tests, and CKD stages data. Correlational analysis was conducted using the Spearman Rank test on albuminuria and serum phosphate levels.<br />Results: The majority of the subjects in this study were male (55.81%); mean age was 55.21±11.99 years; mean BMI was 22.39±2.27 kg/m2; hypertension was found in 65.89% of the patients; mean eGFR was 25.01±16.1 ml/min/1.73 m2 and dominated by CKD stage 3-5. The distribution of albuminuria grade was dominated by heavy albuminuria (&gt;300 mg/g) and the mean serum phosphate level was 4.81±1.9 mg/dl. Spearman Rank analysis found a significant positive correlation with weak association strength (p&lt;0.001; rs=0.277) between albuminuria and serum phosphate levels.<br />Conclusion: There was a significant positive correlation with weak association strength between albuminuria and serum phosphate levels.</p> <p> </p> 2023-08-31T00:00:00+07:00 Copyright (c) 2023 Ernesto Everald Baibelino Harfonso, Nunuk Mardiana, Atika N-Acetylcysteine Improves Renal Function and Reduces Tissue Malondialdehyde Levels in Glycerol-Induced Acute Kidney Injury 2023-08-29T15:00:38+07:00 Nurina Hasanatuludhhiyah Arifian Hardi Putri Ratnani Suhartati <p>Introduction: The etiology of myoglobinuric acute kidney injury involves oxidative injury brought on by the Fenton reaction and myoglobin redox cycle. Renal tubules may be harmed, and lipid peroxidation compounds with vasoconstrictor characteristics may be produced. N-acetylcysteine (NAC) is an antioxidant shown to improve renal microcirculation and have protective effects in various models of renal damage. The aim of the study was to demonstrate the protective impact of NAC in glycerol-induced rats by measuring tissue malondialdehyde (MDA) level and renal function test (RFT), and to determine the correlation between the protective effect and NAC dose.<br />Methods: This study measured tissue malondialdehyde (MDA) and renal function to examine any protective effect of NAC in a glycerol-induced rat model and to determine whether the effect was dose-related. Five groups of male Wistar rats were used: 1) saline control group, (2) glycerol (50%, 8mL/kg, i.m) plus saline i.v group, 3) glycerol plus NAC (100 mg/kg)-treated group, 4) glycerol plus NAC (200 mg/kg)-treated group, 5) glycerol plus NAC (400 mg/kg)-treated group. At 24 hrs, after glycerol injection, rats were sacrificed, cardiac blood was taken for renal function measurement, and renal tissues were removed for thiobarbituric acid MDA level assessment.<br />Results: Our study revealed that glycerol administration significantly amplified renal tissue MDA, serum creatinine, and BUN (blood urea nitrogen) levels. However, NAC administration dampened the MDA increment and renal function deterioration (p&lt;0.05). Moreover, tissue MDA, BUN, and serum creatinine levels were significantly correlated to NAC dose (r=0.485; r=0.491; rs=0.544, respectively; all p&lt;0.05), indicating that NAC protection declines by dose increments.<br />Conclusion: In this glycerol-induced acute kidney injury rat model, the administration of intravenous NAC 100 mg/kg reduced lipid peroxidation and improved renal function. Nevertheless, the protective effect was diminished in higher doses.</p> 2023-08-31T00:00:00+07:00 Copyright (c) 2023 Nurina Hasanatuludhhiyah, Arifian Hardi Putri Ratnani, Suhartati Correlation between Skinfold Thickness and Total Daily Dose of Insulin in Patient with Type 2 Diabetes Mellitus in Dr Soetomo General Hospital 2023-08-29T15:04:26+07:00 Amilia Putri Larasati Jongky Hendro Prajitno Bambang Purwanto <p>Introduction: Type 2 diabetes mellitus (T2DM) is a non-communicable disease with a high prevalence in Indonesia. T2DM is caused by insulin resistance and relative insulin deficiency. One of the therapy for T2DM is insulin administration which is injected into the subcutaneous tissue. The absorption of insulin in the subcutaneous tissue is influenced by many factors, one of which is the thickness of subcutaneous fat. This study aimed to determine the correlation between the skinfold thickness of T2DM patients with the total daily dose of insulin needed every day. <br />Methods: This was an observational analytic study using a cross-sectional design to analyze the correlation between subcutaneous fat thickness represented by skinfold thickness and the total daily dose of insulin of T2DM patients. Measurement of skinfold thickness was carried out on the triceps using a skinfold caliper. Data on the patient's total daily dose of insulin were obtained from medical records.<br />Results: A total of 53 patients were included in this study. The patient's mean triceps skinfold thickness was 26.29±8.72 mm. The mean total daily dose of insulin was 40.96±18.01 IU. The results of the Spearman Rank correlation test showed a significant correlation between skinfold thickness on the triceps and the patient's total daily dose of insulin (p&lt;0.05). <br />Conclusion: The higher the skinfold thickness, the greater the dose of insulin needed by the patient.</p> 2023-08-31T00:00:00+07:00 Copyright (c) 2023 Amilia Putri Larasati, Jongky Hendro Prajitno, Bambang Purwanto Association Between Hemoglobin Levels and Quality of Life in Patients Undergoing Chronic Hemodialysis 2023-08-31T15:17:57+07:00 Naufal Daffa Uzzuhdi <p>Introduction: Anemia is a global problem that can be found almost all over the world. Anemia is the most common complication in patients undergoing chronic hemodialysis which can affect quality of life. Health-related quality of life is a factor that correlates with morbidity, mortality, and patient care costs. This study aimed to assess the correlation between hemoglobin levels and quality of life in patients undergoing chronic hemodialysis. <br />Methods: This study was a cross-sectional study with consecutive sampling of 92 research subjects conducted in November-December 2022 at the hemodialysis installation at Dr. Soetomo General Academic Hospital. This study used the SF-36 questionnaire instrument which was divided into 8 quality of life domains.<br />Results: Of the 92 samples that have been collected, 54 were male patients (58.7%) while 42 were female (41.3%). The average age of the subjects in this study was 47.55 years old. The highest level of education was senior high school graduates with a total of 40 people (43.5%). Hemoglobin levels in 92 research subjects were in the range of 7–3.9 g/dl with an average of 9.70±1.63. Fifty subjects (54.4%) had a poor quality of life and 42 subjects (45.6%) had a good quality of life. The range of total quality of life values was 22.98–89.75 with an average of 59.87±14.16. <br />Conclusion: There was a significant relationship between hemoglobin levels with quality of life of the patients at Dr. Soetomo General Academic Hospital. The higher the hemoglobin level, the higher the total quality of life of the patients. It is recommended to the hemodialysis unit at Dr. Soetomo General Academic Hospital to increase hemoglobin level in hemodialysis patients.</p> 2023-08-31T00:00:00+07:00 Copyright (c) 2023 Naufal Daffa Uzzuhdi Omega-3 Polyunsaturate Fatty Acid Supplementation Potential to Improve Activity Components of Rheumatoid Arthritis: A Systematic Review 2023-08-29T14:45:39+07:00 Nadia Hidayat Awalia Awalia Betty Agustina Tambunan Hermina Novida <p>Introduction: Rheumatoid arthritis (RA) is a chronic disease that causes deformity in most productive age and can lead to death as disease activity increases. Omega-3 polyunsaturated fatty acids have the potential to complement available therapies in reducing disease activity. Currently, the effect of omega-3 PUFAs on disease activity components is still unclear. The current systematic reviews determine the effect of omega-3 PUFAs’ supplementation on the components of RA disease activity. <br />Methods: This research is guided by the PRISMA guidelines systematically. Literature was searched in the databases: PubMed, MDPI, and The inclusion criteria used were: giving omega-3 PUFAs, free full-text, RCT, in English or Indonesian, assessing disease activity and its components; while the exclusion criteria were: unpublished, comparisons were inappropriate. Assessment of literature quality with the Cochrane Collaboration's tool. The study included six studies from 1994 to 2017. <br />Results: The effect of omega-3 PUFAs is diversity in changes of disease activity in 4 of 5 studies. There are significant reductions in the number of joint pains in the literature by daily doses above 2.9 grams or at lower doses taking longer; and swollen joints in 2 studies that were only affected in doses above 2.9 grams. There are significant reductions in pain severity in the studies. Change increases with higher doses. There are variable LED and CRP changes. <br />Conclusion: Depending on their dose and administration duration, omega-3 PUFAs can directly and indirectly affect disease activity through the influence of most of its components, namely: the number of joints affected and the degree of pain.</p> 2023-08-31T00:00:00+07:00 Copyright (c) 2023 Current Internal Medicine Research and Practice Surabaya Journal Lung Abnormalities in Liver Cirrhosis 2023-08-29T15:05:40+07:00 Muli Yaman <p>Regardless of preexisting lung illness, patients suffering from liver cirrhosis, especially decompensated liver cirrhosis, can develop distinct pulmonary complications. Liver cirrhosis patients should be assessed for hepatopulmonary syndrome (HPS), portopulmonary hypertension (PoPH), hepatic hydrothorax (HH) and spontaneous bacterial empyema (SBEM) which are the most clinically significant pulmonary consequences, in particular when dyspnea develops in conjunction with hepatic cirrhosis. These entities differ in terms of pathophysiology, clinical characteristics, diagnosis and suitable treatment options. This emphasize the need of specific diagnostic algorithm in liver cirrhosis patients presenting with dyspnea or other pulmonary symptoms. These pulmonary complications might be rare in patients with liver cirrhosis and portal hypertension, but these complications might carry significant morbidity and mortality risks and, therefore, strong clinical suspicion is required to make an early accurate diagnosis. There are several medical therapies available for each condition in the multiple studies but most of the treatments and procedures does not have significant benefit or have short lived benefit. The only treatment that changes the clinical prognosis of decompensated cirrhosis effectively in long term is liver transplantation. However, liver transplantation also needs careful considerations as on some cases it might increase the risk of morbidity and mortality.</p> 2023-08-31T00:00:00+07:00 Copyright (c) 2023 Muli Yaman