Pradana Soewondo
Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia, Jakarta

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The correlation between hs C-reactive protein and left ventricular mass in obese women Alwi, Idrus; Harun, S.; Sukmoko, Satrio; Soewondo, Pradana; Waspadji, Sarwono; Soegondo, Sidartawan
Medical Journal of Indonesia Vol 15, No 2 (2006): April-June
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (120.996 KB) | DOI: 10.13181/mji.v15i2.223

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Plasma C-reactive protein (CRP) concentrations are increased in obese individuals. In this study, we examined the correlation between hsCRP and left ventricular mass (LV mass). Fourty five healthy obese women and fourty five healthy non obese women as the controls group were studied by echocardiography and hsCRP. There was no significant correlation between hsCRP and left ventricular mass in obese women (r = 0.29, p 0.06). There was a significant correlation between hs CRP and body mass index (r = 0.46, p 0,002), and also hsCRP and visceral fat (r= 0.33, p 0.03). (Med J Indones 2006; 15:100-4) Keywords: hs C-reactive protein, LV mass, obese women
Non-psychogenic polydipsia in 45-year-old man with primary hyperparathyroidism and recurrent bilateral nephrolithiasis Cahyanur, Rahmat; Sarwono, Johannes; Armelia, Linda; Marbun, Maruhum B.H.; Soewondo, Pradana
Medical Journal of Indonesia Vol 21, No 4 (2012): November
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (446.727 KB) | DOI: 10.13181/mji.v21i4.506

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Non-psychogenic polydipsia with hyponatremia is a rare clinical presentation. Primary hyperparathyroidism is a disorder of calcium, phosphate, and bone metabolism caused by increased level of parathyroid hormone (PTH). It is estimated the incidence of primary hyperparathyroidism are 21.6 per 100,000 person a year. This case report describe a 45-year-old man presented with non-psychogenic polydipsia. This patient drank a lot of water out of the fear of recurrent kidney stones. He had history of recurrent nephrolithiasis with hypercalcemia. We investigate further the cause of hypercalcemia and we diagnosed primary hyperparathryoidism as the cause. (Med J Indones. 2012;21:230-4)Keywords: Hyponatremia, non-psychogenic polydipsia, primary hyperparathyroidism
The DiabCare Asia 2008 study – Outcomes on control and complications of type 2 diabetic patients in Indonesia Soewondo, Pradana; Soegondo, Sidartawan; Suastika, Ketut; Pranoto, Agung; Soeatmadji, Djoko W.; Tjokroprawiro, Askandar
Medical Journal of Indonesia Vol 19, No 4 (2010): November
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (159.097 KB) | DOI: 10.13181/mji.v19i4.412

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Aim: To collect information on diabetes management, diabetes complications, and awareness of self-control in diabetic population of the country. This study also evaluated the physician perspectives, psychological aspects, and quality of life of diabetic patients.Methods: This was a non-interventional, cross-sectional study, which recruited 1832 patients from secondary and tertiary medical centers across Indonesia. Data on demography, medical history, risk factors and clinical examination reports including laboratory assessments were collected from medical records of patients. Blood samples of all patients were collected for centralized HbA1c measurements.Results: Among 1832 patients, 1785 individuals were eligible for analysis. The mean age of the patients was 58.9+9.6 years. The mean duration of diabetes was 8.5+7.0 years. Majority (97.5%) of the patients had type 2 diabetes. 67.9% had poor control of diabetes (A1c:8.1 ± 2.0%). 47.2% had FPG>130 mg/dL (161.6±14.6 mg/dL). Dyslipidemia was reported in 60%  (834/1390) and 74% (617/834) of those received lipid lowering treatment. Neuropathy was most common  complication (63.5%); other complications were: Diabetic retinopathy 42%, nephropathy 7.3%, severe late complications 16.9%, macrovascular complications 16%, microvascular complications 27.6%. About 81.3% of patients were on OADs (± insulin), 37.7% were on insulin (±OADs). Majority used biguanides followed by sulfonylureas. Human insulin was used by 73.2%, premix regimen 58.5%, analogues usage was 24.9%. Majority of the WHO-5 well being index responses fell in positive territoryConclusion: Poor glycaemic control in majority of patients is a concern. There is a need for a large proportion of patients to be adjusted to more intensive pharmacotherapy and a multi-disciplinary approach for management should be adopted. The study fi ndings should be communicated to policymakers and physicians to help them provide proper healthcare and its facilities in Indonesia. (Med J Indones 2010; 19:235-44)Keywords: DiabCare, DiabCare Indonesia, Diabetes complications, Dyslipidaemia, Glycaemic control, Hypertension.
Prevalence, characteristics, and predictors of pre-diabetes in Indonesia Soewondo, Pradana; Pramono, Laurentius A.
Medical Journal of Indonesia Vol 20, No 4 (2011): November
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1041.548 KB) | DOI: 10.13181/mji.v20i4.465

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Background: Pre-diabetes is a state where glucose level higher than normal, but not satisfy the criteria for diabetes. This condition is very critical, so that if subject don’t do lifestyle modification and pharmacology therapy, they could fall to diabetes. This research objective is to describe the prevalence and predictors of pre-diabetes in Indonesia.Methods: A cross-sectional study was conducted by Metabolic Endocrinology Division, Department of Internal Medicine FMUI/RSCM and Jakarta Diabetes and Lipid Center using secondary data from National Health Survey 2007. Total  respondents are 24417 subjects from 33 provinces in Indonesia. We analyze characteristics, correlation, predictors, and  attributable risks for some predictors of pre-diabetes and diabetes.Results: Prevalence of pre-diabetes (based on impaired glucose tolerance data) in Indonesia is 10%. Predictors of pre-diabetes are male, old-age, high socio-economic status, low education level, hypertension, obesity, central obesity, and smoking. Priority for pre-diabetes and diabetes prevention in Indonesia directed to decrease blood pressure (Attributable Risk/AR  56.5%), reduce waist circumference (AR 47.3%), and stop smoking (AR 44.4%).Conclusion: Prevalence of pre-diabetes in Indonesia is high so that we need a prevention strategy for pre-diabetes and the development from pre-diabetes to diabetes. The implementation of those strategies is compiled in the Indonesian Diabetes Prevention Program.(Med J Indones 2011; 20:283-94)Keywords: diabetes, Indonesian diabetes prevention program, pre-diabetes
Ende Diabetes Study: diabetes and its characteristics in rural area of East Nusa Tenggara Waspadji, Sarwono; Soewondo, Pradana; Subekti, Imam; Soebardi, Suharko; Harbuwono, Dante S.; Pramono, Laurentius A.; Supali, Taniawati
Medical Journal of Indonesia Vol 22, No 1 (2013): February
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (575.721 KB) | DOI: 10.13181/mji.v22i1.517

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Background: There are only few studies about diabetes in rural area in Indonesia. Epidemiological study are needed to formulate health policy of disease management in specific area. The aim of this study was to find the prevalence of diabetes and knowledge of diabetes among the community in Nangapanda Village, Ende District, East Nusa Tenggara.Methods: A cross-sectional study “Ende Diabetes Study” was conducted in Nangapanda Village. This study use cluster random sampling method to a total number of 19756 residents in Nangapanda village. From the sampling frame of 1800 adult subjects who underwent screening with glucometer in 2008 and 2009, 125 subjects have been diagnosed as diabetes or impaired fasting glucose (IFG). All of the subjects who were diagnosed as diabetes or IFG from the previous screening and 218 subjects from control (normal subjects in the 2008 and 2009 screening) were included in the present study. Each subject underwent general anamnesis, nutritional interview, complete physical examinations, and laboratory test (blood and urine). The data were analyzed using SPSS 13.0.Ressult: There were 343 subjects in this study. The prevalence of diabetes in Nangapanda using blood glucose criteria (using fasting and post-glucose load values) was 2%; using post glucose load criteria, the prevalence of DM was 1.56%; while with HbA1c criteria, the prevalence was 2.83%. The prevalence of impaired glucose tolerance (IGT) was 2.2%, and IFG was 6.2%. A number of 71.1% Nangapanda residents have sufficient knowledge about diabetes.Conclusion: Prevalence of diabetes in Nangapanda (using fasting and post-glucose load criteria) was 2% and 1.56% (using post-glucose load values). As much as 71.1% of Nangapanda residents have sufficient knowledge about diabetes. (Med J Indones. 2013;22:30-8)Keywords: Diabetes mellitus, Ende Diabetes Study, prevalence, rural Indonesia
Sunlight–derived vitamin D affects interleukin-4 level, T helper 2 serum cytokines, in patients with Graves’ disease: a prospective cohort study Purnamasari, Dyah; Soewondo, Pradana; Djauzi, Samsuridjal
Medical Journal of Indonesia Vol 24, No 4 (2015): December
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (394.046 KB) | DOI: 10.13181/mji.v24i4.1270

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Background: Graves’ disease (GD) is the most common autoimmune disease leading to hyperthyroidism. The role of Th1/Th2 pathways balance in GD is still controversial. Vitamin D is reported to have an effect on those pathways. This study aims to examine the effect of sunlight exposure on vitamin D 25(OH) level and Th1 and Th2 pathway-derived cytokines in GD patients. Methods: A prospective cohort study was conducted on 32 GD patients to compare the effect of sunlight exposure on vitamin D level and cytokines of Th1 and Th2 pathways between exposed and unexposed groups. Exposed group received sunlight exposure three times a week for 30 minutes each between 9–11 a.m for 1 month. Thyroid stimulating hormone (TSH), free thyroxin (fT4), vitamin D 25(OH), interferon-γ (IFN-γ) and interleukin-4 (IL-4) serum levels, were investigated before and after one month of sunlight exposure. Paired t-test or Mann Whitney test were used to analyze the difference between exposed and unexposed GD groups before and after sun exposure.Results: One month of sunlight exposure increased vitamin D 25(OH) level by 27.90% among exposed GD group (15.34 ng/mL to 19.62 ng/mL, p<0.001). Meanwhile, unexposed GD group’s vitamin D 25(OH) level decreased from 20.48 ng/mL to 18.86 ng/mL (p<0.001). Increased vitamin D 25(OH) level in exposed group was not accompanied by the increase of IL-4 level after sunlight exposure.Conclusion: Sunlight exposure increases vitamin D 25(OH) serum level and may affect the level of IL-4, Th2 pathway-derived cytokine, in patients with GD. However, the role of sunlight-derived vitamin D on IFN-γ in GD patients can not be concluded in this study.
Perdarahan Saluran Cerna sebagai Manifestasi Tuberkulosis Intestinum pada Pasien Lepra dengan Reaksi Reversal dan Riwayat Terapi Steroid Jangka Panjang Gebrina, Meutia; Nursyirwan, Saskia Aziza; Soewondo, Pradana; Fauzi, Achmad; Renaldi, Kaka
Jurnal Penyakit Dalam Indonesia Vol 3, No 1 (2016)
Publisher : Jurnal Penyakit Dalam Indonesia

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Abstract

Tuberkulosis usus merupakan suatu kondisi yang cukup sulit ditegakkan diagnosisnya. Gejala penyakit ini tidak khas dan pemeriksaan penunjang yang dilakukan seringkali menunjukkan hasil negatif. Salah satu gejala yang tidak khas dari tuberkulosis usus adalah perdarahan saluran cerna, yang harus menjadi kewaspadaan praktisi klinis.Kata kunci: perdarahan saluran cerna, tuberkulosis Gastrointestinal Bleeding as a Manifestation of Intestinal Tuberculosis in Leprosy Patients with Reversal Reaction and History of Long-Term Steroid TherapyIntestinal tuberculosis is difficult to be diagnosed. Signs and symptoms usually are not specific, and the results of diagnostictools are frequently negative. One of the unusual symptoms of intestinal tuberculosis is gastrointestinal bleeding, whichshould increase the awareness of clinical practitioners.Keywords: gastrointestinal bleeding, tuberculosis
The Correlation between Body Fat Distribution and Medial Tibiofemoral Joint Space Width in Obese Knee Osteoarthritis Patients Herikurniawan, Herikurniawan; Isbagio, Harry; Soewondo, Pradana; Diana, Nyimas; Setiati, Siti
Indonesian Journal of Rheumatology Vol 9, No 1 (2017)
Publisher : Indonesian Rheumatology Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (285.556 KB)

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Background: Obesity is a major risk factor for knee osteoarthritis. The relationship between obesity and OA may not be simply due to a mechanical factor. Evidences suggest that metabolic factors related to body fat play important roles, but the specific type of fat that contributes to OA is unclear. The objective of this study was to examine the possible correlation between body fat distribution with knee OA.Methods: This study was a cross sectional study of OA patients with obesity visiting the Rheumatology and Geriatric-Internal Medicine clinics at Cipto Mangunkusumo Hospital between January-March 2016. Data was collected by consecutive sampling. Knee OA was diagnosed from clinical and radiologic evaluation based on American College of Rheumatology 1986 criteria. Body fat distribution was measured by bioelectrical impedance analysis (BIA). Conventional radiography of the knee was used to evaluate jointspace narrowing (JSN). The correlation between body fat distribution and joint space width was analyzed by bivariate analysisResult: A total of 56 subjects were recruited, majority were women (73.2%). Median visceral fat was 12% (7.5-16.5), median subcutaneous fat was 30.2% (16.5-37.9), and median visceral to subcutaneous fat ratio was 0,40 (0,26-0,80). The mean medial tibiofemoral joint space width was 2.34 mm (SD 0.78). Bivariate analysis revealed a correlation between visceral fat and medial tibiofemoral joint space width (r: -0,474 p: < 0,001). There is no correlation between subcutaneous fat and medial tibiofemoral joint space width (r: -0,187 p:0,169); and visceral to subcutaneous fat ratio and medialtibiofemoral joint space width (r: -0,225 p: 0,09).Conclusion: Visceral fat is correlated with medial tibiofemoral joint space width (r: -0.474 p: < 0.001). There is no correlation between subcutaneous fat, and visceral to subcutaneous fat ratio, with medial tibiofemoral joint space width.Keywords: Osteoarthritis, obesity, visceral fat, subcutaneous fat, visceral to subcutaneous fat ratio, medial tibiofemoral joint space width
Perdarahan Saluran Cerna sebagai Manifestasi Tuberkulosis Intestinum pada Pasien Lepra dengan Reaksi Reversal dan Riwayat Terapi Steroid Jangka Panjang Gebrina, Meutia; Nursyirwan, Saskia Aziza; Soewondo, Pradana; Fauzi, Achmad; Renaldi, Kaka
Jurnal Penyakit Dalam Indonesia Vol 3, No 1 (2016)
Publisher : Internal Medicine Department, Faculty of Medicine Universitas Indonesia-RSCM

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (706.901 KB) | DOI: 10.7454/jpdi.v3i1.7

Abstract

Tuberkulosis usus merupakan suatu kondisi yang cukup sulit ditegakkan diagnosisnya. Gejala penyakit ini tidak khas dan pemeriksaan penunjang yang dilakukan seringkali menunjukkan hasil negatif. Salah satu gejala yang tidak khas dari tuberkulosis usus adalah perdarahan saluran cerna, yang harus menjadi kewaspadaan praktisi klinis.Kata kunci: perdarahan saluran cerna, tuberkulosis Gastrointestinal Bleeding as a Manifestation of Intestinal Tuberculosis in Leprosy Patients with Reversal Reaction and History of Long-Term Steroid TherapyIntestinal tuberculosis is difficult to be diagnosed. Signs and symptoms usually are not specific, and the results of diagnostic tools are frequently negative. One of the unusual symptoms of intestinal tuberculosis is gastrointestinal bleeding, which should increase the awareness of clinical practitioners.
Hubungan Status Tiroid dengan Intoleransi Glukosa pada Pasien Hipertiroid Wisnu, Wismandari; Soewondo, Pradana; Subekti, Imam
Jurnal Penyakit Dalam Indonesia Vol 5, No 1 (2018)
Publisher : Internal Medicine Department, Faculty of Medicine Universitas Indonesia-RSCM

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (449.378 KB) | DOI: 10.7454/jpdi.v5i1.175

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Pendahuluan. Diabetes melitus (DM) dan penyakit tiroid adalah dua kelainan endokrinopati yang paling sering ditemukan pada populasi dewasa. Hipertiroid akan memperburuk kontrol glukosa darah dan meningkatkan kebutuhan insulin. Penelitian ini dilakukan untuk mengetahui hubungan status tiroid dengan kejadian intoleransi glukosa pada pasien hipertiroid dan membandingkannya dengan pasien hipertiroid yang telah mencapai status klinis eutiroid dan populasi normal.Metode. Penelitian ini menggunakan desain potong lintang pada pasien hipertiroid rawat jalan dengan status hormonal hipertiroid, pasien hipertiroid dengan status hormonal eutiroid/hipertiroid subklinis dan subjek sehat dengan matching terhadap jenis kelamin dan  umur. Dilakukan pemeriksaan FT4 dan TSH serta TTGO dengan 75 gram glukosa pada jam ke 0 dan ke 2. Sedangkan resistensi insulin ditentukan berdasarkan perhitungan insulin puasa dan Homeostatis Model Assessment-Insulin Resistance. Analisis dilakukan dengan program SPSS 20.0 for windows.Hasil. Penelitian ini mengumpulkan 114 subjek yang terdiri dari 40 pasien hipertiroid, 40 pasien eutiroid/hipertiroid subklinis, dan 34 sukarelawan sehat. Angka kejadian intoleransi glukosa pada kelompok Hipertiroid adalah 52,5% (10% DM, 32,5% toleransi glukosa terganggu (TGT), dan 10% glukosa darah puasa terganggu (GDPT)). Sedangkan, pada kelompok Eutiroid/Hipertiroid Subklinis adalah 20% (5% DM, 15% TGT, dan 0% GDPT) dan pada kelompok sukarelawan sehat adalah 11,8% (0% DM, 8,8% TGT, dan 2,9% GDPT). Hasil analisis menunjukkan bahwa intoleransi glukosa pada kelompok hipertiroid berbeda bermakna dibandingkan kelompok Eutiroid/Hipertiroid Subklinis (p=0,002). Sementara itu, hubungan antara status klinis tiroid dengan intoleransi glukosa pada kelompok tanpa resistensi insulin juga bermakna secara klinis maupun statistik (p=0,004).Simpulan. Terdapat hubungan bermakna antara status tiroid dengan kejadian intoleransi glukosa pada pasien hipertiroid dan pasien hipertiroid yang status klinisnya sudah eutiroid/hipertiroid subklinis mempunyai risiko yang sama dengan orang sehat untuk terjadinya intoleransi glukosa. Kata Kunci: Hipertiroid, Intoleransi glukosa, Resistensi InsulinAssociation between Thyroid Status and Glucose Intolerance in Hyperthyroid PatientsIntroduction. The most common endocrinopathy in adults are diabetes mellitus (DM) and thyroid disease. Hyperthyroidism decreases blood glucose control and increased the need of insulin. However, the mechanism of abnormal glucose metabolism in hyperthyroidism is not fully understood. This study aims to determine the relationship of thyroid status with incidence of glucose intolerance in hyperthyroid patients compared to hyperthyroid patients who have achieved clinical status of eutyroid and normal population.Methods. This study was cross sectional design in outpatients with hyperthyroidism in hyperthyroid and euthyroid/subclinical hyperthyroid status, and healthy volunteers who had matching age and sex. An oral glucose test and Homeostatic Model Assesment Insulin Resistance was performed after the diagnosis of hyperthyroidism by FT4 and TSH measurement. Data analysis was performed using SPSS for Windows version 20.0.Results. There were 114 eligible patients (40 case hyperthyroid, 40 case euthyroidism/subclinical hyperthyroidism and 34 healthy subjects). Proportion of glucose intolerance in hyperthyroidism is 52,5% (10% DM,  32,5%  impaired glucose tolerance (IGT), and 10% impaired fasting glucose (IFG)), in  euthyroidism/subclinical hyperthyroidism was 20% (5% DM, 15% IGT, and 0% IFG), and in healthy subjects was 11,8% (0% DM, 8,8% IGT, and 2,9% IFG). Glucose intolerance in hyperthyroidism was significantly different than euthyroidism/subclinical hyperthyroidism (p=0.002). We also found that the association between thyroid status and glucose intolerance in the group without insulin resistance was significantly different (p=0.004). Conclusions. Our study conclude that there is association between hyperthyroidism and glucose intolerance. Hyperthyroid patients in euthyroidism/subclinical hyperthyroidism status have the same risk as the healthy subject to became glucose intolerance.