Muchlis Achsan Udji Sofro
2Staf Pengajar Bagian Ilmu Penyakit Dalam FK UNDIP/RSUP Dr. Kariadi Semarang

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ETIOLOGI DAN GAMBARAN KLINIS DIARE AKUT DI RSUP Dr KARIADI SEMARANG Adyanastri, Festy; Sofro, Muchlis Achsan Udji
MEDIA MEDIKA MUDA 2012:MMM VOLUME 1 NUMBER 1 YEAR 2012
Publisher : MEDIA MEDIKA MUDA

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Abstract

Latar Belakang: Diare akut merupakan salah satu masalah kesehatan dunia, jutaan kasus dilaporkan setiap tahun dan diperkirakan sekitar 4-5 juta orang meninggal karena diare akut. Di negara maju walaupun sudah terjadi perbaikan kesehatan dan sosial ekonomi yang tinggi tetapi insidensi penyakit diare akut tetap tinggi dan menjadi masalah kesehatan.Tujuan: Mengetahui etiologi dan gambaran klinis penyakit diare akut.Metode: Metode penelitian menggunakan desain retrospektif. Sampel penelitian pasien diare akut di RSUP Dr Kariadi Semarang dari 1 Januari 2009 – 31 Desember 2011. Data dianalisis dengan uji deskriptif.Hasil: Etiologi diare akut yang tersering secara berurutan : EPEC 29,8%; Vibrio cholerae 24,4%; Shigella dysentriae 21%; tidak ada pertumbuhan kuman 11,8%; Proteus sp 4,6%; Pseudomonas 3,8%. Gambaran klinis tersering dari pasien diare akut adalah berak cair lebih dari empat kali sehari 96,65; muntah 79,4%; nyeri ulu hati 79,8%; demam 72,9%; mual 57,6%; lemas 49,9%; berat badan turun 8%.Kesimpulan: Etiologi tersering dari diare akut E.colli dan gambaran klinis terbanyak dari diare akut adalah berak cair lebih dari empat kali.Kata kunci: Diare akut, etiologi, gambaran klinis.
HUBUNGAN ANTARA HITUNG SEL CD4 DENGAN KEJADIAN RETINITIS PADA PASIEN HIV di RSUP DR. KARIADI SEMARANG Handoko, Alberta Vania; Sofro, Muchlis Achsan Udji
MEDIA MEDIKA MUDA 2012:MMM VOLUME 1 NUMBER 1 YEAR 2012
Publisher : MEDIA MEDIKA MUDA

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Background: HIV / AIDS causes deaths in the world. HIV (Human Immunodeficiency Virus) is a type of RNA retrovirus that attacks human immune system. AIDS (Acquired Immunodeficiency Syndrome)is the late stage of HIV infection where the human immune system is severely damaged and not able to fight diseases like cancer and other infections. One of the infections is retinitis that is caused by Cytomegalovirus or Toxoplasma infection, which can be happened if CD4 counts are decreased. Retinitis can cause blindness, which lower the quality of life.Aim: To know the relation between CD4 counts and retinitis.Methods: Observasional correlation study with retrospective design using medical record files. The samples were 61 medical record files from Internal Medicine Department of Dr. Kariadi Hospital Semarang, period of January 2007 – December 2011.Results: The total of HIV / AIDS patients in Dr. Kariadi Hospital Semarang period of January 2007 – December 2011 were 940 patients. There were 80 patients infected by Cytomegalovirus and/or Toxoplasm, but only 61 could be used as samples. It was found 15 (24.6%) had retinitis, 35 (57.4%) did not have retinitis, 11 (18%) were not known if they had retinitis or not. Based on chi-square statistic testing between CD counts < 50 cell / μL and retinitis in Dr. Kariadi Hospital Semarang, the p = 0.010, which the result had significant meaning if the p < 0.05.Conclusion: There is a relation between CD4 counts <50 cell / μL and retinitis in RSUP Dr. Kariadi Semarang.Key words: HIV/ AIDS, retinitis, CD4. 
FAKTOR RISIKO TERJADINYA KOINFEKSI TUBERKULOSIS PADA PASIEN HIV/AIDS DI RSUP DR KARIADI SEMARANG Permitasari, Desy Ayu; Sofro, Muchlis Achsan Udji
MEDIA MEDIKA MUDA 2012:MMM VOLUME 1 NUMBER 1 YEAR 2012
Publisher : MEDIA MEDIKA MUDA

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Background: Tuberculosis is the most common opportunistic infection disease among HIV/AIDS patient. HIV-TB coinfection is currently the worlds leading cause of mortality due to infectious agent.Objective: To determine the risk factor of Tuberculosis coinfection among HIV/AIDS patient in Dr. Kariadi Hospital Semarang.Methods: This research is an analytical observational research with case control design, using medical records as samples. The samples consisted of 83 HIV/AIDS patients with Tuberculosis coinfection and 83 HIV/AIDS patient without Tuberculosis coinfection period January 2008- June 2012. Analysis data used Chi Square test.Results: On the whole study result showed that, group of man HIV-TB coinfected patient recorded the highest value, 59 respondents (71.1%), 15-35 years category recorded the highest number, 49 respondents (59%). Employed respondents were higher, 37 respondents (68.5%), which the most common type of job were housewife (10.8%) and unemployed (10.8). Ten to twelve g/dL hemoglobin level recorded the highest proportion (50.7%), CD4 count <100 cell/μL was the highest (87.3%). The highest number of tuberculosis site was pulmonary tuberculosis (89.2%), the negative sputum AFB smear examination was the highest (31.3%), and the most common comorbidity was the candidiasis oral (20.8%). Variable related to the TB coinfection among HIV/AIDS patient was the low hemoglobin level (p=0.001). Otherwise, sex, age, marital status, CD4 count, smoking, alcohol, and ARV therapy did not relate to TB coinfection among HIV/AIDS patient.Conclusion: According to the study, variable related to TB coinfection among HIV/AIDS patient was the low hemoglobin level that support the earlier studies. Otherwise, sex, age, marital status, CD4 count, smoking, alcohol, and ARV therapy did not relate to TB coinfection among HIV/AIDS patient.Keywords: TB, HIV, AIDS, risk factor, coinfection
Antiretroviral Side Effects on Adherence in People Living with HIV/AIDS Bagus Arisudhana, Gede Arya; Sofro, Muchlis Achsan Udji; Sujianto, Untung
Nurse Media Journal of Nursing Vol 8, No 2 (2018): (DECEMBER 2018)
Publisher : Department of Nursing, Faculty of Medicine, Diponegoro University

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Background: Antiretroviral therapy is a lifelong treatment in people living with HIV/AIDS (PLWHA). Adherence is the key to the effectiveness of antiretroviral therapy. The administration of antiretroviral has some side effects that may affect patient adherence.Purpose: This study aimed to examine the impacts of antiretroviral side effects on adherence in PLWHA.Methods: This study used a correlational research design. The samples were 78 patients receiving antiretroviral therapy at the tropical disease and infection polyclinic in a hospital in Semarang. Purposive sampling was used to recruit the samples. Data on side effects of antiretroviral were obtained based on the patients’ reports, while data on adherence of pill consumption were obtained through the calculation of pills using pill count adherence rate. The collected data were analyzed using the Fisher’s exact test.Results: Results showed that the side effects of antiretroviral therapy influenced the antiretroviral adherence (p<0.001). Most of the side effects of antiretroviral reported by participants were nausea and dizziness. Some participants also reported weakness, difficult to concentrate, and diarrhea.Conclusion: The side effects of antiretroviral had negative impacts on patients’ antiretroviral therapy adherence. Therefore, nurses and health care providers of PLWHA should be able to recognize and give concern on antiretroviral side effect management.
Faktor Risiko yang Mempengaruhi Kepatuhaan Terapi Antiretroviral (ARV) pada Pasien HIV/AIDS di RSUD Abepura Jayapura Pariaribo, Konstantina; Hadisaputro, Suharyo; Widjanarko, Bagoes; Sofro, Muchlis Achsan Udji
Jurnal Epidemiologi Kesehatan Komunitas Vol 2, No 1: Februari 2017
Publisher : Master of Epidemiology, School of Postgraduate Studies, Diponegoro University, Indonesia

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Background: HIV/AIDS is a major problem in many countries. Antiretroviral (ARV) has become the solution for preventing the pandemic disease. This research aimed to find out risk factors, which affected the HIV/AIDS patients adherence to the antiretroviral (ARV) therapy. The research took place at RSUD Abepura in Jayapura.Method: The research applied an analytical observational design with a case control, which was supported by qualitative data. There were 86 respondents involved, consisting of 43 case and 43 control respondents. Samples collection used a Simple Random Sampling. Instruments used for this study were questioners and indepth interviews. Data analysis included univariate and bivariate analyses using a chi-square test. In addition, it also performed a multivariate analysis using logistic regression test.Results: The research found three risk factors that affected the HIV/AIDS patients adherence to ARV: occupation (p = 0.005; OR = 4.472; 95% CI = 1.633-12.245), inaccessibility to health care center (p = 0.008; OR = 3.675; 95% CI = 1.476-9.146), lacking family supports (p=0.013; OR =3.606; 95% CI = 1.398-9.146). Other factors, sex, age, knowledge, apathetic manner,side-effect history, therapeutic tenure, ethnic background, counseling personnel, health care provider attitude, religious approach, alternative medicine intake, and herbal medicine use, did not have significant affects.Conclusion: Factors that affected the ARV therapy adherence were occupation, inaccessibility to health care center, and lacking family supports.
FAKTOR-FAKTOR YANG MEMPENGARUHI KEJADIAN ANEMIA PADA PEMAKAIAN ZIDOVUDIN PASIEN HIV/AIDS (Studi Kasus di RSUP Dr. Kariadi Semarang) Nurraga, Garda Widhi; Sofro, Muchlis Achsan Udji; Chasani, Shofa; Ngestiningsih, Dwi
JURNAL KEDOKTERAN DIPONEGORO Vol 4, No 4 (2015): MEDIA MEDIKA MUDA
Publisher : Jurusan Kedokteran Umum, Fakultas Kedokteran, Universitas Diponegoro

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Background: The administration of Zidovudine (ZDV) has an important role in decreasing the number of mortality on HIV/AIDS patients. Nevertheless, Zidovudine is known to make a side effect of anaemia. The incidence of anaemia can be influenced by several factors, e.g. age, sex, duration of therapy, CD4 count, and ALT count.Aims: This research aims to determine factors influencing incidence of anaemia on HIV/AIDS patients with Zidovudine treatment in Dr. Kariadi General Hospital Semarang and see the correlation between those determinant factors to the incidence of anaemia.Methods: This research is an analytic observational with cohort-retrospective method used. There were 70 HIV/AIDS patients with Zidovudine, divided into two groups: 35 patients belonged to case group, while the other 35 patients belonged to control group. The data was taken from medical records and analyzed by Chi-square and Fischer test.Results: Age did not have any correlation to incidence of anaemia (p=0.075). Sex was a contributing factor to incidence of anaemia (p=0.027) in which female patients were more susceptible to anaemia. Duration of therapy was a contributing factor to incidence of anaemia (p=0.000) particularly patients with less than 12 months of therapy. CD4 count did not have any correlation to incidence of anaemia (p=0.055). ALT count did not have any correlation to incidence of anaemia (p=1.000).Conclusion: The administration of Zidovudine corresponds to the incidence of anaemia with sex and duration of therapy as the influencing factors on HIV/AIDS patients in Dr. Kariadi General Hospital Semarang.
HUBUNGAN ANTARA KOINFEKSI TUBERKULOSIS DENGAN KEJADIAN TREMOR PADA PASIEN HIV/AIDS Isma, Talita Zata; Retnaningsih, Retnaningsih; Sofro, Muchlis Achsan Udji; Chasani, Shofa; Ngestiningsih, Dwi
JURNAL KEDOKTERAN DIPONEGORO Vol 4, No 4 (2015): MEDIA MEDIKA MUDA
Publisher : Jurusan Kedokteran Umum, Fakultas Kedokteran, Universitas Diponegoro

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Background: Neurons are host cell for Mycobacterium Tuberculosis. M. tuberculosis bacilli live and replicate in neuritis and the soma. CD4 got an important role on its replication. The lower CD4 counts, the highest replication numbers will be. This phenomenon will cause a neurological manifestation as a direct consequence of tuberculosis infection. One of the neurological manifestations is a movement disorder such as tremor.Aim: Determine the association between Tuberculosis co-infection with tremor prevalence among HIV/AIDS patients.Methods: This study was an observational analytic study using cross sectional methods. Twenty four patients were divided into TB-HIV group (15 samples) and control group (9 samples). All respondents had their tremor manifestation observed and examined. Secondary data were collected from patient’s medical records. Obtained data were analyzed using Fischer Exact Test.Results: The prevalence of tremor was 13,3% in TB-HIV group. There was no significant association between tuberculosis infection with tremor incidence (p=0,511). Sex, HAART, anti tuberculosis drugs, and age also has no association with tremor in TB-HIV group.Conclusion: There is no significant association between tuberculosis co-infection with tremor prevalence among HIV/AIDS patients in Dr. Kariadi Hospital and Lung Health Community Centre district Semarang.
HUBUNGAN ANTARA PEMAKAIAN EFAVIRENZ DENGAN EFEK SAMPING NEUROPSIKIATRI PADA PASIEN HIV/AIDS Salsabila, Farah; Sofro, Muchlis Achsan Udji; Chasani, Shofa; Ngestiningsih, Dwi
JURNAL KEDOKTERAN DIPONEGORO Vol 4, No 4 (2015): MEDIA MEDIKA MUDA
Publisher : Jurusan Kedokteran Umum, Fakultas Kedokteran, Universitas Diponegoro

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Background: HIV/AIDS has been a global problem. Antiretroviral therapy is currently an effective therapy for HIV/AIDS. Efavirenz is an antiretroviral agent which commonly cause neuropsychiatric adverse events.Aim: To investigate the association between efavirenz and neuropsychiatric adverse events.Methods: This cross-sectional study included 43 subjects (24 men and 19 women). Twenty subjects used efavirenz and twenty three subjects didn’t use efavirenz. Neuropsychiatric adverse events were assessed with SMMSE for cognitive impairment; DASS 21 for depression disorder, anxiety disorder, and stress disorder; PQ-16 for psychosis; and PSQI for sleep disturbance.Results: Neuropsychiatric adverse events were more common in patients using efavirenz. Fisher’s exact test between efavirenz and cognitive disturbance showed significant association (p= 0,039). The significant result was also showed between efavirenz and anxiety disorder (p= 0,017) as well as between efavirenz and psychosis (p= 0,017). Chi-square test between efavirenz and sleep disturbance showed significant association (p= 0,017). The association test between efavirenz and depression disorder along with association test between efavirenz and stress disorder showed no significant result.Conclusions: Efavirenz was significantly associated with cognitive impairment, anxiety, psychosis, and sleep disturbance. There was no significant association of efavirenz with depression disorder and stress disorder.
HUBUNGAN TINGKAT DEPRESI DENGAN KUALITAS HIDUP PASIEN HIV/AIDS DI RSUP.DR.KARIADI SEMARANG Hapsari, Elyana; Sarjana, Widodo; Sofro, Muchlis Achsan Udji
JURNAL KEDOKTERAN DIPONEGORO Vol 5, No 4 (2016): JURNAL KEDOKTERAN DIPONEGORO
Publisher : Jurusan Kedokteran Umum, Fakultas Kedokteran, Universitas Diponegoro

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Latar Belakang : Epidemi HIV AIDS saat ini telah melanda seluruh negara di dunia. Semarang adalah penyumbang angka HIV/AIDS terbesar di Jawa Tengah. Penyakit HIV AIDS telah menimbulkan masalah yang cukup luas terhadap individu yang terinfeksi yakni meliputi masalah fisik,sosial, dan emosional. Salah satu masalah emosional terbesar yang dihadapi ODHA adalah depresi. Kasus depresi pada ODHA ini diperkirakan mempunyai frekuensi mencapai 60% dari total kasus depresi yang ada. Depresi yang berkelanjutan akan menyebabkan penurunan kondisi secara fisikdan mental, sehinggasangat berpengaruh terhadap kualitas hidup ODHA.Tujuan : Penelitian ini bertujuan untuk mengetahui apakah terdapat hubungan antara depresi dengan kualitas hidup serta mengetahui apakah terdapat hubungan antara faktor demografi dengan kualitas hidup pasien HIV/AIDS di RSUP Dr. Kariadi Semarang.Metode : Penelitian ini merupakan penelitian observasional denganrancangan penelitian Cross sectiona). Tingkat depresi dan kualitas hidup diukur dari skor pada kuesioner BDI dan WHO-QOL. Sampel penelitian berjumlah 92 orang yaitu pasien HIV/AIDS di Poli Penyakit Tropis dan Infeksi RSUP. Dr. Kariadi Semarang yang memenuhi kriteria inklusi. Teknik pengambilan sampel pada penelitian ini dilakukan dengan metode non probability sampling melalui consecutive sampling. Analisis data penelitian menggunakan uji Chi Square.Hasil : Dari hasil analisis menunjukkan adanya hubungan antara depresi dengan kualitas hidup pada domain lingkungan (p =0,037 , α = 0,05), serta didapatkan pula adanya hubungan antara lama menderita dengan kualitas hidup pada domain psikologis (p =0,009 , α = 0,05).Kesimpulan : Terdapat hubungan yang bermakna antara depresi dengan kualitas hidup pada domain lingkungan dan hubungan yang bermakna antara lama menderita dengan kualitas hidup domain psikologis.
Wanita 30 Tahun dengan Sepsis, Infeksi Kulit dan Jaringan Lunak, dan Obesitas Widinartasari, Franzeska Anna Dewi Mursita; Sodiq, Muhammad Ali; Sofro, Muchlis Achsan Udji
Jurnal Penyakit Dalam Indonesia Vol 4, No 2 (2017)
Publisher : Jurnal Penyakit Dalam Indonesia

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Obesitas meningkatkan morbiditas dan mortalitas melalui efeknya terhadap hampir semua sistem kekebalan tubuh manusia. Obesitas memiliki efek terhadap respon imun sehingga meningkatkan kerentanan terhadap infeksi. ß lactamase adalah enzim bakterial yang menginaktivasi antibiotik ß-lactam dengan cara hidrolisis. Salah satu kelompok penghasil ß lactamases, yaitu extended-spectrum ß lactamases (ESBLs), memiliki kemampuan untuk menghidrolisis dan menyebabkan resistensi terhadap berbagai antibiotik terbaru. Manajemen infeksi kulit dan jaringan lunak (skin and soft tissue infection/SSTI) dengan infeksi polimikrobial dan multi drug resistance dapat menjadi suatu masalah yang menantang. Kami melaporkan sebuah kasus mengenai pasien obesitas dengan SSTI polimikrobial. bPasien tersebut menunjukkan tanda dan gejala klinis sepsis dengan gangguan ginjal akut. Dengan resusitasi cairan, pemberian antibiotik dini, dan tindakan bedah, pasien mengalami perbaikan klinis. Kunci untuk manajemen pasien dengan SSTI yang berat memerlukan kewaspadaan awal dan tindakan debridement bedah. Klinisi perlu mempertimbangkan terapi antibiotik empiris kombinasi dini pada SSTI. Kata Kunci: ESBL, infeksi, jaringan lunak, kulit, obesitas, saluran kencing, sepsis  A 30 Years Old Woman with Sepsis, Skin and Soft Tissue Infection, and ObesityObesity increases morbidity and mortality through its multiple efects on nearly every human system. Obesity has efect on the immune response which leads to susceptibility to infections. ß lactamases are bacterial enzymes that inactivate ß-lactam antibiotics by hydrolysis. One group of ß lactamases, extended-spectrum ß lactamases (ESBLs), have the ability to hydrolyse and cause resistance to various types of the newer ß-lactam antibiotics. The management of skin and soft tissue infection with polymicrobial infection and multi drug resistance can be challenging problem. We present a case of an obese patient with polymicrobial SSTI. bPatient showed clinical sign of sepsis with acute kidney injury. With fluid rescucitation, early antibiotic administration and surgical treatment, she gained clinical improvement. The key to successful management of patients with severe skin and soft tissue infection are early recognition and complete surgical debridement. Clinicians need to consider appropriate early empirical antibiotic combination therapy coverage or the use of combination therapy to treat SSTI.