Nikko Darnindro
Department of Internal Medicine, Faculty of Medicine, University of Indonesia Dr. Cipto Mangunkusumo General National Hospital, Jakarta

Published : 14 Documents
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Knowledge Attitude Practice of Married Women Resided in Flat Located at Klender About Pap smear Examination and Associated Factors Jakarta 2006

Journal of the Indonesian Medical Association Vol. 57 No. 7 July 2007
Publisher : Journal of the Indonesian Medical Association

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Abstract

In Indonesia, nowadays cervical cancer still occupies the first place among types of malignancies in women. About 65% of cervical cancer patients are in the terminal stage due to late diagnosis. The design of this research was cross sectional study. The sampling method was random cluster sampling. Data was obtained by guided questionnaire. From 107 respondents, most of them were 45-55 years old (40.2%), first marriage at age 21-30 (71%), with duration of marriage more than 10 years (68.2%). Majority of the group had occupation as housewives (60.7%), had been labored for 1-3 times (61.7%), with moderate education level (56.1%) and low income (65.4%). The most accessed information source was from friend (48.6%). Most respondents had bad knowledge (46.7%), moderate attitude (63.6%), and bad practice (92.5%). Only 33.7% of respondents had undergone Pap smear. There is significant association among duration of marriage (p=0.007), occupation (p=0.01) and knowledge concerning Pap smear. There is significant association between respondents’ age and practice concerning Pap smear (p=0.007). There is significant association between respondents’ knowledge and attitude (p=0.012) concerning Pap smear. There is no significant association between respondents’ attitude and practice concerning Pap smear (p=0.694). Knowledge Attitude Practice (KAP) married women resided in flat located at Klender concerning Pap smear was still bad.Keywords: KAP, cervical cancer, Pap smear, low socioeconomic condition

Treatment of Hypertension in Patient with Nephrotic Syndrome

Journal of the Indonesian Medical Association Vol. 58 No. 2 February 2008
Publisher : Journal of the Indonesian Medical Association

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Abstract

Up to this moment, hypertension is an issue that hard to be dealt with. According to WHO 1996, hypertension have taken its part as contributing factor on morbidity and mortality mainly in modern countries. The prevalence of hypertension in Indonesia is about 6 to 15%, and the estimated number of 1 billion people across the globe are having this problem, also there are 7,1 millions hypertension related death. One of the causes of hypertension is kidney disease. Chronic kidney disease can cause hypertension and also hypertension can cause chronic kidney disorder. Nephrotic Syndrome is the common chronic kidney disease. Management of hypertension in patients with nephrotic syndrome has to consider long term effect of medication, renal condition, and other comorbid condition.Keywords: Hypertension, Chronic Kidney Disease, Nephrotic Syndrome, Treatment of choices.

Retrospective Study of Treatment for Severe Malaria at Serukam Bethesda Hospital West Borneo 2007-2008

Journal of the Indonesian Medical Association Vol. 60 No. 1 January 2010
Publisher : Journal of the Indonesian Medical Association

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Abstract

Malaria is one of the most important infectious disease in tropic areas. Morbidity increases in severe malaria. Choosing the right drug to treat malaria is important because it is related with its the resistance, and decreased of morbidity and mortality. Drug treatment with Artemisinine derivat is the treatment of choice according to WHO. A retrospective study to compare the effectiveness of Artemisine derivatives with Quinine to treat severe malaria had been conducted. Artemisinine derivatives is better than Quinine to decrease length of fever, hospital stay, and mortality, but statistically it is not significant.Keywords: malaria falciparum, artemisinine derivats

The Problematic Therapy in Managing Myasthenia Gravis’s Patient with Health-care Associated Pneumonia

Journal of the Indonesian Medical Association Vol. 62 No. 9 September 2012
Publisher : Journal of the Indonesian Medical Association

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Inroduction: Myathenia gravis is an autoimmune disease with weakness and fatigue of striated muscle as primary symptomps. Comorbid desease like repeated lung infections may worsen myasthenia. Nosocomial pneumonia is comorbid desease with high morbidity and mortality. Antibiotics are precaution in myasthenia gravis as some of them may worsen the clinical symptomps of myasthenia and cause myasthenia crisis. A male, 29 yo with history of myasthenia gravis and hospitalized 4 weeks before, visit RSCM with worsing cough and breathlessness as chief complains. Initial selected empiric therapy was cefotaxim 3x1 g for three days and resulted in worsing clinical symptomps then cefotaxim switched to ceftazidime 3x1 g as it suitable to possible microorganism (mo) in health-care associated pneumonia. In thefifth day culture of sputum grew Pseudomonas aeruginosa and Klebsiella that sensitive to amikacin, tetracycline, meropenem and imipenem. Base on literature the antibiotics selected for myasthenia gravis was meropenem 3x1 g as aminoglycoside, macrolide and quinolon may worsen myasthenia. As meropenem resulted clinical improvement, they were given until eight days then sputum culture was repeated. In day thirteenth the sputum culture grew Pseudomonas that resistant to meropenem, nevertheless sensitive to ceftazidime and levofloxacin. In this case ceftazidime 3x1 gr were given for seven days.In myasthenia gravis with nosocomial pneumonia as comorbid the antibiotic selection was needed in immediate and appropriate manner adjusted to the result of sputum culture and drug susceptible testing and side effect of antibiotic to myasthenia. J Indon Med Assoc. 2012;62:359-68.Keywords: myasthenia gravis, nosocomial, pneumonia, HCAP, antibiotic

Prolonged Cholestatic as a Typical Manifestation of Hepatitis A Infection: Diagnosis and Management

The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 14, NUMBER 2, August 2013
Publisher : The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy

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Abstract

Hepatitis A virus (HAV), a positive-strand RNA virus, is stable at moderate temperature and low pH level. These characteristics allow the virus to survive in the environment and be transmitted through fecal-oral route.Twenty-year-old male came with jaundice and itchy skin since one month before admission. He was diagnosed as hepatitis A cholestasis type according to his history taking, physical examination, and laboratory result. Blood test showed elevated total bilirubin 27.4 g/dL, direct bilirubin 21.2 g/dL, indirect bilirubin 6.2 g/dL, alanin aminotransferase (ALT) 95 U/L, aspartate transaminase (AST) 134 U/L, alkaline phosphatase (ALP) 221 U/L, and gamma-glutamyltransferase (gGT) 17 U/L. His ultrasound results showed mild, non-specific hepatomegaly without common bile duct dilatation. The patient got symptomatic therapy with ursodeoxycholic acid (UDCA) 300 mg twice daily for his itchy skin and steroid therapy 0.5-1 mg/kg per day on the tenth day. He did not vomit or feel nausea anymore. After five days of steroid therapy, his total bilirubin level became 10.83 g/dL. He was discharged home with steroid therapy and steroid was tapered off during follow-up in the clinic.Prolonged cholestasis is one of atypical manifestation of hepatitis A which is rarely found. Cholestasis increases morbidity and prolongs hospitalization. Steroid therapy decreased bilirubin level and gave clinicalimprovement to the patient.Keywords: hepatitis A, prolonged cholestasis, steroid therapy

Current Diagnosis and Management of Helicobacter pylori

The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 14, NUMBER 3, December 2013
Publisher : The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy

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Abstract

Helicobacter pylori (H. pylori) is a microbe which cause chronic infection in human. Currently, the prevalence in developed countries continue to decrease, but the same does not happen in developing countries. Orofecal transmission and its connection with environmental condition is assumed to be its cause.Impact of H. pylori infection in gastric mucosa is influenced by the bacteria pathogenesis which is able to survive in acid condition and causes inflammatory reaction. The diagnosis is differentiated through endoscopy or non-endoscopy depends on the alarm symptoms, local prevalence, pre-test probability, availability, cost and aim of examination.Management of H. pylori depends on the high rate of clarithromycin resistence. In area with resistency prevalence below 20% triple therapy can still be used, while in increasing resistency area, use of four times daily therapy or other antibiotics such as levofloxacin and furazolidone can be considered.Keywords: Helicobacter pylori, diagnosis, alternative therapy

Gastric Mucous Atrophy and Metaplasia in Patient with Helicobacter pylori Infection

The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 16, No 1 (2015): VOLUME 16, NUMBER 1, April 2015
Publisher : The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy

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Abstract

Background: Helicobacter pylori (H. pylori) is one of the most common bacteria found in human and cause chronic infection. Recent study conducted in one of private hospitals in Jakarta shows that there is a trend of declining prevalance of H. pylori from 12.5% in 1998 to 2.9% in 2005. The aim of this study is to obtain` the prevalance of gastric atrophy and metaplasia in patients with H. pylori infection based on histopathology.Method: This was a case control study between June to August 2014 with 69 cases and 71 controls using medical records datas and histopathology results. Control sample was taken consecutively from patient undergone esophagogastroduodenoscopy procedure in 2013.Results: The average age for patient with H. pylori was 51 years slightly higher than patient with negative H. pylori (p > 0.05). Generally, the prevalence rate among males was slightly lower than females (p > 0.05). From Histopathology findings, active chronic gastritis was found in 62.3% patients with positive H. pylori than only 12.7% in patient with negative H. pylori (95% CI = 4.86-26.7; OR = 11.31). Mild and moderate  atrophy was higher among H. pylori positive (p = 0.09). gastric mucous metaplasia was also higher (10% vs. 1.4%) among positive H. pylori patient (p = 0.03).Conclusion: H. pylori infection can cause atrophy and metaplasia in gastric mucosa. Prevalence of gastric metaplasia caused by H. pylori infection is lower in this study compared to the same study abroad.

Prevalensi Ketidakpatuhan Kunjungan Kontrol pada Pasien Hipertensi yang Berobat di Rumah Sakit Rujukan Primer dan Faktor-Faktor yang Memengaruhi

Jurnal Penyakit Dalam Indonesia Vol 4, No 3 (2017)
Publisher : Jurnal Penyakit Dalam Indonesia

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Abstract

Pendahuluan. Berdasarkan WHO, hipertensi berkaitan dengan 7,5 juta kematian diseluruh dunia atau mencapai 12,8% dari total semua kematian. Sedangkan berdasarkan riskesdas 2013 di Indonesia hipertensi masih menjadi masalah kesehatan utama dengan prevalensi mencapai 26,5 %. Ketidakpatuhan merupakan penyebab utama kegagalan pengobatan hipertensi dan  faktor risiko munculnya komorbid kardiovaskular. Belum ditemukan penelitian sebelumnya yang meneliti kepatuhan kontrol pasien di komunitas suburban. Penelitian ini dilakukan untuk menganalisis besarnya prevalensi pasien yang tidak kontrol setelah pengobatan hipertensi.Metode. penelitian ini merupakan studi retrospektif, melalui penelusuran rekam medis pada pasien yang berobat antara bulan Oktober – Desember 2015.Hasil. Dari 80 pasien yang menjadi subyek penelitian, rerata usia pasien 57.5 ± 11 tahun, didominasi oleh pasien wanita (68,8%). Berdasarkan klasifikasi ESC 2013 prevalensi terbesar adalah hipertensi derajat 2 mencapai 40%. Komorbid terbanyak dijumpai adalah diabetes mellitus sebesar 22,5 %. Enam puluh persen pasien mendapatkan 1 jenis obat dan golongan Calcium Channel Blocker merupakan jenis obat yang tersering diberikan. Prevalensi pasien yang tidak kontrol mencapai 63,8 %. Dari analisa bivariate ditemukan hubungan bermakna antara kepatuhan kontrol dengan jumlah obat yang diberikan, makin sedikit obat yang dikonsumsi makin rendah kepatuhan kontrol meskipun dalam analisa multivariate tidak ditemukan kemaknaan.Simpulan. Prevalensi ketidakpatuhan kontrol masih tinggi. Diperlukan penelitian lanjutan untuk mengetahui faktor faktor lain yang menjadi penyebab.Kata Kunci: Faktor berpengaruh, hipertensi, ketidakpatuhan kontrol Prevalence of Noncompliance of Control visits in Hypertensive patients treated at Primary Referral Hospitals and Factors relatedIntroduction. According to WHO, hypertension is associated with 7.5 million deaths worldwide or 12.8% of all deaths. Meanwhile, based on 2013 riskesdas in Indonesia, hypertension is still a major health problem with a prevalence of 26.5%. Noncompliance is a major cause of treatment failure of hypertension and risk factors for cardiovascular comorbidity. No previous research has been found that examines patient control compliance in the suburban community. This study aims to analyse the prevalence of patients who did not control after hypertension treatment in primary referral hospitalsMethods. This study was a retrospective study, by tracking medical records in patients treated between October and December 2015.Results. A total of 80 hypertensive patients participated in the study (55 were females). The mean age was 57.5 ± 11  years, and 22,5% had diabetes mellitus. Mean systolic pressure was 161± 19 mmHg, diastolic pressure was 96 ± 10 mmHg. The majority of the patients had 2nd degree hypertension according to ESC 2013. Sixty percent of patient was given monotherapy and the most frequently prescribed drugs were calcium channel blockers (CCB) (70.0%). The prevalence of loss-to-follow up patient was 63,8%% (51/80). Respondents with mono-therapy, without comorbidities, and admission from emergency department were more often loss-to-follow up than those with combination therapy (OR 10.3; 95%CI 3.5 – 30.1), with comorbidities (OR 4,3; 95%CI 1.6 – 11.4), and admission from outpatient clinic (OR 14.6; 95%CI 4.8 – 44.6). Although the comorbidities variable was not significant in multivariate analysis.Conclusion. The prevalence of noncompliance of control is still high. Further research is needed to determine other factors that cause.

Gastric Mucous Atrophy and Metaplasia in Patient with Helicobacter pylori Infection

The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 16, No 1 (2015): VOLUME 16, NUMBER 1, April 2015
Publisher : The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy

Show Abstract | Original Source | Check in Google Scholar | Full PDF (121.166 KB)

Abstract

Background: Helicobacter pylori (H. pylori) is one of the most common bacteria found in human and cause chronic infection. Recent study conducted in one of private hospitals in Jakarta shows that there is a trend of declining prevalance of H. pylori from 12.5% in 1998 to 2.9% in 2005. The aim of this study is to obtain` the prevalance of gastric atrophy and metaplasia in patients with H. pylori infection based on histopathology.Method: This was a case control study between June to August 2014 with 69 cases and 71 controls using medical records datas and histopathology results. Control sample was taken consecutively from patient undergone esophagogastroduodenoscopy procedure in 2013.Results: The average age for patient with H. pylori was 51 years slightly higher than patient with negative H. pylori (p > 0.05). Generally, the prevalence rate among males was slightly lower than females (p > 0.05). From Histopathology findings, active chronic gastritis was found in 62.3% patients with positive H. pylori than only 12.7% in patient with negative H. pylori (95% CI = 4.86-26.7; OR = 11.31). Mild and moderate  atrophy was higher among H. pylori positive (p = 0.09). gastric mucous metaplasia was also higher (10% vs. 1.4%) among positive H. pylori patient (p = 0.03).Conclusion: H. pylori infection can cause atrophy and metaplasia in gastric mucosa. Prevalence of gastric metaplasia caused by H. pylori infection is lower in this study compared to the same study abroad.

Current Diagnosis and Management of Helicobacter pylori

The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 14, NUMBER 3, December 2013
Publisher : The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy

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Abstract

Helicobacter pylori (H. pylori) is a microbe which cause chronic infection in human. Currently, the prevalence in developed countries continue to decrease, but the same does not happen in developing countries. Orofecal transmission and its connection with environmental condition is assumed to be its cause.Impact of H. pylori infection in gastric mucosa is influenced by the bacteria pathogenesis which is able to survive in acid condition and causes inflammatory reaction. The diagnosis is differentiated through endoscopy or non-endoscopy depends on the alarm symptoms, local prevalence, pre-test probability, availability, cost and aim of examination.Management of H. pylori depends on the high rate of clarithromycin resistence. In area with resistency prevalence below 20% triple therapy can still be used, while in increasing resistency area, use of four times daily therapy or other antibiotics such as levofloxacin and furazolidone can be considered.Keywords: Helicobacter pylori, diagnosis, alternative therapy