Current Internal Medicine Research and Practice Surabaya Journal https://e-journal.unair.ac.id/CIMRJ <p><strong>Current Internal Medicine Research and Practice Surabaya Journal</strong> (CIMRJ) <a href="https://issn.lipi.go.id/terbit/detail/1581561902">e-ISSN: 2721-544X</a> is published by the Faculty of Medicine, Universitas Airlangga in collaboration with <a href="https://papdisurabaya.or.id/" 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. Each issue publishes 7 articles. The scope of this journal includes allergy, endocrinology, gastroenterology, geriatrics, hematology, hepatology, nephrology, rheumatology, and tropical infection.</p> Universitas Airlangga en-US Current Internal Medicine Research and Practice Surabaya Journal 2721-544X <div id="custom-2"> <p>Copyright (c) Author</p> <p>CIMRJ provides immediate open access to its content and is licensed under Creative Commons attribution CC-BY-SA (<a href="https://creativecommons.org/licenses/by-sa/4.0/">https://creativecommons.org/licenses/by-sa/4.0/</a>). The license allows re-distribution and re-use of a licensed work on the conditions that the creator is appropriately credited and that any derivative work is made available under “the same, similar or a compatible license”. Other than the conditions mentioned above, the editorial board is not responsible for copyright violations. his license allows reusers to distribute, remix, adapt, and build upon the material in any medium or format, so long as attribution is given to the creator. The license allows for commercial use. If you remix, adapt or build upon the material, you must license the modified material under identical terms.</p> <p> </p> <p> </p> </div> ASSOCIATION BETWEEN EXCLUSIVE BREASTFEEDING AND CHILDHOOD ALLERGY INN PEDIATRICS OUTPATIENT UNIT RSUD DR SOETOMO SURABAYA https://e-journal.unair.ac.id/CIMRJ/article/view/38217 <p><strong>Introduction:</strong> Allergy is one of the most common diseases for children in the world. The incidence of allergy has increased sharply in Indonesia in the last 20 years. At any time, 30% of people develop allergy manifestations, more than 40% of school-aged children have experienced an allergy manifestation, 20% have experienced asthma, and 6 million people have suffered atopic dermatitis. Considering the incidence number has kept increasing, a prevention effort has become a crucial aspect. One of the easiest methods is exclusively giving breast feeding. Experts have supported that exclusive breastfeeding can reduce children's allergy risk.</p> <p><strong>Methods: </strong>This study was analytical-observational research with a case-control study design. The subject of this research is patients in the pediatrics outpatient unit of Dr. Soetomo General Academic Hospital. They are suspected of suffering from allergies and have a familial atopic history. Data were collected by reviewing the patient's medical records as secondary data. After matching the subject, the data were analyzed using the chi-square test.</p> <p><strong>Results: </strong>From the total of 118 samples, it was found that in the case group, 13 children had been given exclusive breastfeeding, and 46 children had not been given exclusive breastfeeding. Meanwhile, in the control group, it was found that 31 children had been given exclusive breastfeeding, and 28 children had not been granted exclusive breastfeeding. A bivariate analysis found that exclusive breastfeeding can reduce the risk of allergy (p-value = 0.001; OR= 0.255 CI = 0.115 – 0.468).</p> <p><strong>Conclusion: </strong>This research concludes that children breastfed exclusively will have a risk of allergy 0.255 times more than those who had not been breastfed exclusively.</p> RM Aditya Wisnu Wardhana Azwin Mengindra Putra Lubis Djohar Nuswantoro Copyright (c) 2022 RM Aditya Wisnu Wardhana, Azwin Mengindra Putra Lubis, Djohar Nuswantoro http://creativecommons.org/licenses/by-sa/4.0 2022-08-30 2022-08-30 3 2 33 35 10.20473/cimrj.v3i2.38217 THE CORRELATION BETWEEN THE SEVERITY OF LIVER CIRRHOSIS WITH ESOPHAGEAL VARICES IN RSUD DR SOETOMO SURABAYA https://e-journal.unair.ac.id/CIMRJ/article/view/38065 <p><strong>Introduction: </strong>Liver cirrhosis is the end stage of chronic liver disease. The morbidity and mortality associated with complications of liver cirrhosis are very high. In cases of death caused by cirrhosis of the liver, it tends to increase from around 676,000 in 1980 to more than one million in 2010, globally equivalent to 2% of all mortality in the world (Mokdad et al., 2014). The mortality rate increases if there are complications such as ascites, hepatic encephalopathy, esophageal varices, and liver cancer, with success rates of 20-60%, 50%, 70-90% (D'Amico, 2014). In liver cirrhosis with esophageal varices, it is reported that patients with mild and severe liver cirrhosis risk 40% and 85% for varicose veins. So, this research is to determine the correlation between the severity of liver cirrhosis with esophageal varices in Dr. Soetomo General Hospital Surabaya.</p> <p><strong>Methods:</strong> This study was an analytic observational with a cross-sectional study design. The research subjects used in this study were patients diagnosed with liver cirrhosis with esophageal varices from January 2015 - December 2016. Data were collected from medical records and analyzed using the spearman correlation test. Sampling was carried out in total sampling.</p> <p><strong>Results:</strong> Of 26 subjects, most of the subjects were men (69.32%), the highest severity of liver cirrhosis from the Child B group (53.85%), and the highest esophageal varices were grade II and III (46,15%). The most results from each group based on the severity of liver cirrhosis were Child A with grade II esophageal varices (66.7%), and Child B with grade II esophageal varices (64.3%), and Child C with esophageal varices grade III esophagus (88.9%). A correlation coefficient was obtained at 0.659 (p &lt;0.005).</p> <p><strong>Conclusion:</strong> This research concludes a significant correlation between the severity of liver cirrhosis and esophageal varices.</p> Deva Medisika Hertiti Poernomo Boedi Setiawan Gwenny Ichsan Prabowo Copyright (c) 2022 Deva Medisika Hertiti, Poernomo Boedi Setiawan, Gwenny Ichsan Prabowo http://creativecommons.org/licenses/by-sa/4.0 2022-08-30 2022-08-30 3 2 36 39 10.20473/cimrj.v3i2.38065 CORRELATION BETWEEN PHYSICAL ACTIVITY AND FASTING BLOOD GLUCOSE IN PATIENT WITH TYPE 2 DIABETES MELLITUS https://e-journal.unair.ac.id/CIMRJ/article/view/38067 <p><strong>Introduction:</strong> Diabetes Mellitus is a disease caused by an increase in blood glucose levels, which is an increase in levels at an abnormal level, or called hyperglycemia. Diabetes is a metabolic disease related to various factors such as physical activity, lifestyle, habits, diet, etc. Diabetes mellitus is classified as type 1 diabetes mellitus, type 2 diabetes mellitus, and gestational diabetes. Type 2 Diabetes Mellitus (T2DM) is caused by the body's inability to use insulin effectively (insulin resistance). This study aims to determine the relationship between physical activity and fasting blood glucose levels of T2DM patients to provide social change by increasing physical activity to control fasting blood glucose in patients with T2DM.</p> <p><strong>Methods:</strong> This study is quantitative research of analytic observation with a cross-sectional design. The sample in this study was the outpatient T2DM at Endocrine Unit RSUD Dr Soetomo Surabaya from June until September 2018 consecutive sampling. The independent variable was physical activity, and the dependent variable was fasting blood glucose (FBG). Methods of collecting primary data by interview using IPAQ (International Physical Activity Questionnaire) and secondary data by looking at the results of FBG from the patient's medical records of laboratory tests. Collected data were entered into Microsoft excel and then statistically analyzed using IBM SPSS 22. Spearman’s Rho Correlation Test analyzed the data.</p> <p><strong>Results:</strong> Sixty three respondents became in inclusion criteria. Most patients have a moderate physical activity of 28 people, or around 44.4%. Thirty-two people had poor fasting blood glucose levels of about 50.8%. The analysis result was there is a significant correlation between physical activity and fasting blood glucose levels of T2DM patients and a low correlation coefficient in the opposite direction (not in the same order).</p> <p><strong>Conclusion:</strong> Physical activity impacts fasting blood glucose levels and has a negatively correlated direction. The increase in physical activity showed by the value of the IPAQ score, followed by a decrease in fasting blood glucose level.</p> Rani Nurvita Djohar Nuswantoro Jongky Hendro Prajitno Copyright (c) 2022 Rani Nurvita, Djohar Nuswantoro, Jongky Hendro Prajitno http://creativecommons.org/licenses/by-sa/4.0 2022-08-30 2022-08-30 3 2 40 42 10.20473/cimrj.v3i2.38067 MORTALITY INCIDENCE OF SYSTEMIC LUPUS ERYTHEMATOSUS IN DR. SOETOMO GENERAL HOSPITAL SURABAYA https://e-journal.unair.ac.id/CIMRJ/article/view/38064 <p><strong>Introduction: </strong>Systemic Lupus Erythematosus (SLE) is a chronic systemic autoimmune disorder involving a multi-organ system. Fatal autoimmune causes usually characterize SLE with a high mortality rate. In 2012 the mortality rate of SLE in Dr. Soetomo General Hospital Surabaya was 22.9%. Recently covered data hasn’t been published.</p> <p><strong>Methods:</strong> This study is a descriptive retrospective. The aim is to evaluate the mortality rate using the medical records of SLE patients. All SLE patients were admitted to Dr. Soetomo General Hospital Surabaya from May 2016 to May 2017. Patients’ characteristics, disease activity, and causes of death are collected.</p> <p><strong>Results:</strong> There are a total of 176 patients, with 93.2 % female, with a mean age of 29.5 and a mean duration of illness of 20 months. There were 39 deaths (22.2%), with the leading causes being a respiratory failure (33.3%), septic shock (28.2%), and undetermined (23.1%). Low levels of C3 (69.2%)andC4(69.2%)are the most common immunology profile in deed patients. The therapy used the most is the corticosteroid pulse dose(46.2%).</p> <p><strong>Conclusion: </strong>It concludes that the decrease in the mortality rate of SLE in Dr. Soetomo General Hospital, Surabaya is 0.7% from 2012 to 2017.</p> Bulan Ghafirah Yuliasih Yuliasih Bendrong Moediarso Copyright (c) 2022 Bulan Ghafirah, Yuliasih Yuliasih, Bendrong Moediarso http://creativecommons.org/licenses/by-sa/4.0 2022-08-30 2022-08-30 3 2 43 46 10.20473/cimrj.v3i2.38064 A CASE OF THYROTOXIC PERIODIC PARALYSIS AND MODERATE TO SE- VERE GRAVE’S OPHTHALMOPATHY REQUIRING INTRAVENOUS STEROID THERAPY WITH A COMORBIDITY OF CHRONIC HEPATITIS B INFECTION https://e-journal.unair.ac.id/CIMRJ/article/view/32528 <p>Grave’s disease is an autoimmune thyroid disease with several characteristic symptoms and signs. Grave’s ophthalmopathy, an inflammatory disease in the orbital area, is the primary extrathyroid manifestation of Grave’s disease. About 5% of Grave’s ophthalmopathy patients have moderate to severe severity requiring high doses of systemic corticosteroid therapy. Grave’s disease also has a few complications, one of which is thyrotoxic periodic paralysis characterized by hypokalemia and muscle paralysis. Chronic hepatitis B virus infection has the potential to be co-incidence with other diseases (e.g., Grave’s ophthalmopathy). The need for a high dose of corticosteroid therapy in treating Grave’s ophthalmopathy is a risk of reactivation in hepatitis B-infected patients. This paper presented a Grave’s disease patient complicated with Grave’s ophthalmopathy who developed limb muscle weakness. The patient will receive high doses of corticosteroids and prophylactic lamivudine therapy to prevent hepatitis B virus reactivation.</p> Heri Krisnata Ginting Soebagijo Adi Copyright (c) 2022 Heri Krisnata Ginting, Soebagijo Adi http://creativecommons.org/licenses/by-sa/4.0 2022-08-30 2022-08-30 3 2 47 53 10.20473/cimrj.v3i2.32528 UNPROVOKED UPPER EXTREMITY DEEP VEIN THROMBOSIS IN PATIENT WITH PRIMARY ANTIPHOSPHOLIPID SYNDROME: A CASE REPORT https://e-journal.unair.ac.id/CIMRJ/article/view/38144 <p>Upper extremity deep vein thrombosis is less common than in the lower extremity site. Such conditions can appear primarily or secondary to other conditions such as thrombophilia. One of the unique forms of acquired autoimmune thrombophilia is antiphospholipid syndrome (APS). We describe a 25 years old female admitted with sudden swelling, redness, and pain in her left arm. Venous ultrasound confirmed the diagnosis of thrombosis in the left subclavian vein, left axillary vein, left proximal brachial vein, and left proximal basilic vein. The patient was known to have a spontaneous miscarriage in the second pregnancy at eight weeks of gestation. Screening for autoimmune and antibody phospholipid was done, and primary APS was confirmed. She has been treated with a subcutaneous injection of fondaparinux 2.5 mg for five days and oral rivaroxaban 15 mg twice daily for 21 days. But four months later, the patient came with a thrombus in the subclavian vein due to inadequate treatment, then long-term treatment with vitamin K antagonist warfarin proceeded.</p> Hermifa Dwi Aninnaimah Awalia Copyright (c) 2022 Hermifa Dwi Aninnaimah, Awalia http://creativecommons.org/licenses/by-sa/4.0 2022-08-30 2022-08-30 3 2 54 58 10.20473/cimrj.v3i2.38144 DELIVERY OF ANTI-PD-1 GENE WITH RECOMBINANT ADENO-ASSOCIATED VIRUS (RAAV) AS PREVENTIVE AND CURATIVE THERAPY OF INFECTIOUS DISEASES IN CHILDHOOD : LITERATURE REVIEW https://e-journal.unair.ac.id/CIMRJ/article/view/38001 <p>Infections in children are common and are the highest cause of hospitalization in children, especially in children aged 0-4 years. The binding of PD-1 (Programmed Cell Death-1) glycoprotein on its ligand in CD4+ and CD8+ T cells activates a pathway that results in T cell dysfunction. Inserting the anti-PD1 gene into rAAV opens opportunities for preventing and treating infections in children. This literature review aims to determine the potential of anti-PD1 gene rAAV as a new modality for preventing and treating pathogen infections in children. The procedure of searching for literature to answer questions was carried out through online searching of journals in the last ten years. The use of anti-PD-1 has shown to increase the immune response against certain viral, bacterial and parasitic infections. Using rAAV as an anti-PD-1 gene vector has great potential to be a preventive or curative therapy for various infections in children. Further research and development are needed to determine the viral model, dose, indications, and contraindications to the use of the rAAV-transmitted anti-PD-1 gene for the treatment of infectious diseases in children.</p> Farros Yuftariq Izzad Afla Arifa Mustika Muhammad Arsy Reza Suyudi Zumara Ma'rifah Azzahra Copyright (c) 2022 Farros Yuftariq Izzad Afla, Arifa Mustika, MD, PhD, Muhammad Arsy Reza Suyudi, Zumara Ma'rifah Azzahra http://creativecommons.org/licenses/by-sa/4.0 2022-08-30 2022-08-30 3 2 59 62 10.20473/cimrj.v3i2.38001