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"This edition teaches you an evidence-based, step-by-step process for evaluating, diagnosing, and treating patients based on their clinical complaints. By applying this process you will be able to recognize specific diseases and prescribe the most effective therapy. Each chapter addresses a common patient complaint and begins with a case &​ guidance on how to organize the differential diagnosis. As the case progresses, clinical reasoning is explained in detail to either confirm or refute a diagnosis. Filled with algorithms, summary tables, and questions that direct evaluation, this new edition is enhanced by the edition of 5 new chapters, all incorporating the latest research resulting in new &​ refined approaches to common symptoms encountered in clinical medicine."

"Latar Belakang : Prevalensi ansietas dan depresi serta faktor risiko pada penyintas COVID-19 di seluruh dunia dan Indonesia masih tinggi dan berbeda beda dari setiap negara. Di Indonesia faktor risiko ansietas dan depresi belum pernah diteliti. Penelitian ini dilakukan untuk menentukan prevalensi dan faktor risiko gejala ansietas dan depresi pasca rawat inap COVID-19 di rumah sakit Cipto Mangunkusumo.Metode : Desain penelitian ini adalah Kohort retrospektif. Subjek penelitian diambil dari pasien pasca perawatan inap COVID-19 pada periode Januari 2022 sampai Maret 2023. Gejala ansietas dan depresi dinilai menggunakan Hospital Anxiety Depression Scale. Analisa bivariat digunakan menentukan faktor risiko dari variabel kategorik dan dilanjutkan ke analisa multivariat regresi logistik sampai didapatkan nilai P: 0,05.Hasil : Terdapat 209 subjek yang dilibatkan dalam penelitian ini dengan prevalensi gejala ansietas 20,57% dan gejala depresi 13,40%. Faktor risiko gejala ansietas adalah wanita RR (IK95%) 1,805 (1,017 – 3,204), p=0,043, Dukungan sosial sedang dan rendah dengan RR (IK95%) 1,935 (1,028 – 3,643), p=0,041 untuk dukungan sosial sedang dan RR (IK95%) 3,325 (1,314 – 8,411), p=0,011 untuk dukungan sosial rendah, Komorbid dengan RR (IK95%) 1,742 (1,019 – 2,977), p=0,042, Anosmia atau hipogeusia dengan RR (IK95%) 1,894 (1,045 – 3,433), p=0,035, gejala menetap pasca COVID-19 dengan nilai RR (IK95%) 2,885 (1,553 – 5,359), p=0,001. Faktor risiko gejala depresi adalah gejala menetap pasca COVID-19 RR (IK95%) 2,738 (1,300 – 5,770), p=0,008, kedia adalah aktifitas fisik ringan RR (IK95%) 6,556 (1,577 - 27,244), p=0,010.Kesimpulan : Faktor risiko gejala ansietas pasca perawatan COVID-19 yang bermakna adalah wanita, dukungan sosial, komorbid, anosmia atau hipogeusia, gejala menetap sedangkan faktor risiko gejala depresi adalah gejala menetap pasca COVID-19 dan aktifitas fisik ringan.

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Background: The prevalence of anxiety and depression, as well as risk factors for COVID-19 survivors worldwide and in Indonesia, is still high and varies from country to country. In Indonesia, the risk factors for anxiety and depression have not been studied. This study was conducted to determine the prevalence and risk factors for symptoms of anxiety and depression after hospitalization for COVID-19 at Cipto Mangunkusumo hospital.

Methods: The study design was a retrospective cohort. The study subjects were taken from post-hospitalized COVID-19 patients from January 2022 to March 2023. Symptoms of anxiety and depression were assessed using the Hospital Anxiety Depression Scale. Bivariate analysis was used to determine risk factors from categorical variables and proceeded to multivariate logistic regression analysis until a P value of 0.05 was obtained.

Results: There were 209 subjects involved in this study, with a prevalence of 20.57% anxiety symptoms and 13.40% depressive symptoms. Risk factors for anxiety symptoms are women RR (95% CI) 1.805 (1.017 – 3.204), P=0.043, Medium and low social support with RR (95% CI) 1.935 (1.028 – 3.643), P=0.041 for moderate social support, RR (95% CI 3.325 (1.314 – 8.411), P=0.011 for low social support, Comorbid with RR (95% CI) 1.742 (1.019 – 2.977), P=0.042, Anosmia or hypogeusia with RR (95% CI) 1.894 (1.045 – 3.433 ), P=0.035, persistent symptoms after COVID-19 with a RR (95% CI) 2.885 (1.553 – 5.359), P=0.001. Risk factors for depressive symptoms are persistent symptoms after COVID-19, RR (95% CI) 2.738 (1.300 – 5.770), P=0.008, lastly light physical activity RR (95% CI) 6.556 (1.577 - 27.244), P=0.010.

Conclusion: Significant risk factors for anxiety symptoms post hospitalization for COVID-19 are women, social support, comorbidities, anosmia or hypogeusia, and persistent symptoms, while risk factors for depressive symptoms are persistent symptoms after COVID-19 and light physical activity"

"Background: HIV/AIDS is a chronic, lifelong disease with a wide clinical spectrum which could decrease the quality of life. Objective symptoms measurement is important because it is correlated to treatment adherence and progressivity of the disease. Currently, there is no clinical tool available to evaluate symptoms of HIV infection and the treatment’s side effect for the outpatient setting. This study aimed is to assess the reliability of the Indonesian version of HIV Symptom Index for measuring symptoms of HIV/AIDS patients, and use it for assessment of their symptom profile. Methods: this is a cross sectional study in outpatient HIV/AIDS subjects (n=87) recruited in Cipto Mangunkusumo Hospital’s HIV clinic from September-November 2018. The HIV Symptom Index consisted of 20 items evaluating somatic, psychologic, and the combination of both symptoms, and its’ language adaptation to Indonesian was done with Beaton and Guillemin method. Reliability of the Indonesian version of HIV Symptom Index was tested by alpha cronbach’s a coefficient analysis, and the internal validity was tested with multitrait scaling analysis before being used to profile the symptom pattern of HIV/AIDS patients. Results: Indonesian version of HIV Symptom Index is reliable (cronbach alpha 0.76) and valid (multitrait correlation >0.4) for measuring symptoms of HIV/AIDS patients. The most common symptom is fatigue (55.7%), followed by insomnia (43.3%), dizziness and lightheadedness (42.3%), skin problems (42.3%), and pain, numbness, or tingling in the hands or feet (39.2%). Conclusion: Indonesian version of HIV symptom Index is reliable and valid to measure symptoms of HIV/AIDS patiens objectively."

"ABSTRAKPenelitian ini merupakan penelitian pendahuluan untuk melihat kemungkinan pengembangan Skala CES-D Revisi yang telah diadaptasi ke dalam bahasa Indonesia. Skala ini merupakan alat deteksi dini (first screening) gejala depresi. Subyek yang diikutsertakan dalam penelitian adalah subyek dari masyarakat umum berumur 20-40 tahun di Jakarta (N=137). Uji validitas yang dipakai adalah uji validitas kriteria dengan menggunakan SDI. Hasil uji analisis data menunjukkan Skala CES-D Revisi memiliki koefisien alpha Cronbach sebesar 0.779. Koefisien korelasi item-total terkoreksi bergerak antara 0.046-0.546. Beberapa butir pernyataan tampak kurang sensitif mengukur gejala depresi sehingga menyebabkan koefisien alpha dan koefisien korelasi item-total menjadi rendah. Koefisien korelasi antara CES-D Revisi dengan BDI sebesar 0.54 (p<0.01). Selain itu, pengujian dengan t-test menunjukkan ada perbedaan skor CES-D Revisi yang signifikan (p<0.01) antara kelompok individu yang hampir tidak menunjukkan adanya tanda-tanda depresi dengan kelompok individu dengan derajat depresi berat pada BDI. Kelompok individu dengan derajat depresi berat akan memiliki skor CES-D Revisi yang lebih tinggi dibandingkan dengan kelompok individu yang hampir tidak menunjukkan adanya tanda-tanda depresi. Skala CES-D Revisi dapat dikembangkan lebih lanjut untuk digunakan sebagai alat ukur deteksi dini gejala depresi di Indonesia.

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ABSTRACTThis research is a preliminary study to see the possibility of developing the Revised CES-D Scale which has been adapted into Indonesian. This scale is a tool for early detection (first screening) symptoms of depression. Subjects included in the study were subjects from the general public aged 20-40 years in Jakarta (N=137). The validity test used is a criterion validity test using SDI. The results of the data analysis test show the Revised CES-D Scale has a Cronbach alpha coefficient of 0.779. The corrected item-total correlation coefficient moved between 0.046-0.546. Some items appear to be less sensitive in measuring symptoms of depression, causing the alpha coefficient and item-total correlation coefficient to be low. The correlation coefficient between the Revised CES-D and BDI was 0.54 (p<0.01). In addition, the t-test showed that there was a significant difference in the Revised CES-D score (p<0.01) between the group of individuals who showed almost no signs of depression and the group of individuals with a degree of major depression on the BDI. The group of individuals with a degree of major depression will have a higher Revised CES-D score than the group of individuals who show almost no signs of depression. The Revised CES-D scale can be further developed to be used as a measuring tool for early detection of depressive symptoms in Indonesia. "

"Ditinjau dari pendekatan Model kognitif, secara umum orang dengan Gangguan Depresi Mayor mengalami lima buah simtom Depresi yaitu simtom afektif, simtom, simtom kognitif, simtom motivasional, simtom fisik, dan simtom Behavioral. Model kognitif juga mengungkapkan tingginya kemungkinan terjadinya dependency pada orang dengan gangguan depresi sebagai salah satu bentuk nyata simtom behavioral Depresi Tingginya kemungkinan orang dengan gangguan depresi untuk mengalami dependency cenderung meningkatkan kemungkinan seseorang mengalami interpersonal dependency, yaitu sebuah bentuk ketergantungan yang dialami oleh seseorang dengan menjadikan orang lain sebagai objek ketergantungan tersebut.Metode penelitian yang digunakan adalah metode kualitatif dengan pendekatan wawancara yang dilengkapi oleh metode observasi. Populasinya adalah orang-orang yang telah didiagnosis depresi mayor oleh psikolog maupun psikiater. Pemilihan sampel dilakukan dengan menggunakan theory based/operation construct sampling, di mana sampel dipilih dengan kriteria tertentu, berdasarkan teori atau konstruk operasional depresi yang termuat dalam DSM IV TR.Diperoleh beragam gambaran interpersonal dependency pada orang dengan gangguan depresi yang dikelompokan dalam empat dimensi, yaitu kognitif, motivasional, afektif, dan behavioral di mana ditemukan peranan yang lebih dominan pada dimensi kognitif dan afektif. Selain itu diperoleh juga faktor-faktor ekstrinsik pada orang dengan gangguan depresi mayor berupa dalam proses terjadinya interpersonal dependency pada orang dengan gangguan depresi Mayor ,berupa peranan pola asuh orang tua.

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Being analyze from The Cognitive Model approach, people who has major depression disorder are generally deliver through five depression symptoms. Those symptoms are affective symptom, cognitive symptom, motivational symptom, physical symptom and behavioral symptom. The Cognitive Model also elaborates the high possibility of dependency that could happen to people who has depression disorder as a frank appearance of behavioral symptom. This high possibility of dependency experienced by the ones who have major depression disorder tends to risen the possibility of interpersonal dependency, a form of dependency happened to certain people by making someone else as the object of the dependency.

This research process was using qualitative method with interview approach and observation method. The population of this research was those people diagnosed having major depression disorder by psychologist and or psychiatrist. The samples has chosen by using the theory based/operation construct sampling, where those samples picked out with certain criteria, based on the theories or depression operational construct stated in DSM IV TR.

During this research, various interpersonal dependency appearances are found in person who has diagnosed with major depression disorder, which could be classified to four dimensions: cognitive, motivational, affective and behavioral. We can also find the dimensions that have more dominant and stronger influence, which are cognitive dimension and affective dimension. Moreover, external factors could also be found occur to person with major depression disorder along with the forming of the interpersonal dependency, like parenting pattern role."

"Recurrent abdominal pain is one of the most common symptoms found in children. Description of abdominal pain is important in determining the etiologic cause. Organic pain must be ruled out first before suspecting psychogenic cause of pain. However; Children and infant are likely having difficulties in describing abdominal pain. Referred pain may lead to misdiagnosis. Alarm symptoms of abdominal pain are important indices and must be recognized. Careful and complete anamnesis and physical examination play critical role in management approach of recurrent abdominal pain in children and determine whether medical therapy only or combination with surgical intervention is considered necessary."

"AbstrakPURPOSE:Chinese herbal medicine (CHM) has been widely used in China to treat allergic rhinitis (AR). However, several studies have produced conflicting data with regard to the efficacy of the medicine. Our aim was to perform a meta-analysis of randomized clinical trials (RCTs) to evaluate the relative efficacy of CHM.METHODS:We systematically searched the PubMed, Medline, and Springer electronic databases up to March 2017 for RCTs comparing the efficacy of CHM versus placebo for the treatment of patients with AR. Total nasal symptoms and quality of life were assessed through pooling mean difference (MD) with its 95% confidence interval (CI). Moreover, sensitivity and subgroup analyses according to control design and quality of life assessment were performed to evaluate the source of heterogeneity.RESULTS:Eleven RCTs were enrolled in the meta-analysis. Assessment of overall heterogeneity indicated significant heterogeneity among the individual studies (I²=100%, P<0.00001), and thus ransomed effects model was used to pool data. CHM was found to significantly enhance quality of life compared with placebo (MD=-0.88, (95% CI: -1.55, -0.21); P=0.01). The symptom of itchy nose, sneezing or total nasal symptoms scores were not significantly improved after CHM treatment, although the improvement in itchy nose just failed to reach significance (MD=0.09, (95% CI: 0.00, 0.18); P=0.06).CONCLUSIONS:This study suggests that CHM appears to improve the quality of life of AR patients. However, these findings, as well as the findings for the effect of CHM on sneezing, total nasal symptoms, and the symptom of itchy nose, need to be substantiated in larger cohorts of AR patients by further well-designed studies."

"Penelitian ini membandingkan kuesioner Visual Prostate Symptom Score VPSS yang jarang digunakan dengan kuesioner International Prostate Symptom Score IPSS dan parameter uroflowmetri di Indonesia pada pasien laki-laki yang berobat di Rumah Sakit Umum Nasional Cipto Mangunkusumo. Evaluasi menggunakan IPSS dalam bahasa Indonesia, VPSS, uroflowmetri dan ultrasonografi transabdominal dikerjakan pada pasien pria berusia lebih dari 45 tahun yang berobat ke Rumah Sakit Umum Nasional Cipto Mangunkusumo antara Februari 2014 dan Agustus 2015. Dari seluruh subyek, 24,2 dan 11,1 membutuhkan bantuan ketika menjawab kuesioner IPSS dan VPSS. Usia rata-rata, skor total IPSS, skor total VPSS, Q-max, volume berkemih, dan volume residu pasca berkemih masing-masing adalah 67,4 8,9 tahun, 13,4 7,8, 10,8 2,7, 13,6 8,6 mL / detik, 248 136 ml, dan 54,9 68,3 ml. Skor total, IPSS kualitas hidup QoL, IPSS pertanyaan Q 2, IPSS Q7, dan IPSS Q5, secara signifikan berkorelasi dengan skor total VPSS, VPSS QoL, VPSS Q1, VPSS Q2, dan VPSS Q3 koefisien korelasi r, nilai P masing-masing: 0,57.

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This study aims to compare and correlate the novel Visual Prostate Symptom Score VPSS with International Prostate Symptom Score IPSS questionnaire and uroflowmetry parameters in Indonesian men who visited Dr. Cipto Mangunkusumo National General Hospital. Male patients older than 45 years who visited Dr. Cipto Mangunkusumo National General Hospital between February 2014 and August 2015 with LUTS were evaluated with Indonesian version of the IPSS, VPSS, uroflowmetry and transabdominal ultrasound. Appropriate statistical analysis was employed. Of all subjects, 24.2 and 11.1 require assistance when answering IPSS and VPSS questionnaires respectfully. The mean age, IPSS total score, VPSS total score, Q max, voided volume, and post void residual volume were 67.4 8.9 years, 13.4 7.8, 10.8 2.7, 13.6 8.6 mL sec, 248 136 ml, and 54.9 68.3 ml respectively. Total IPSS, IPSS quality of life QoL, IPSS question Q 2, IPSS Q7, and IPSS Q5, were significantly correlated with total VPSS, VPSS QoL, VPSS Q1, VPSS Q2, and VPSS Q3 correlation coefficient r P value 0.57."

"Pengalaman tertekan dengan perubahan-perubahan yang terjadi akibat proses akulturasi didefinisikan sebagai acculturative stress (Berry dalam Organista, Chun, & Marin, 1998). Acculturative stress tergantung pada sejumlah faktor-faktor perantara, termasuk diantaranya adalah karakter kelompok dominan, strategi akulturasi yang dilakukan kelompok minoritas, bentuk-bentuk akulturasi yang dialami, kondisi demografi, sosial, serta karakteristik psikologis dari kelompok maupun anggota kelompok. Masing-masing faktor ini dapat mempengaruhi level acculturative stress (Berry dalam Organista, Chun & Maria, 1998). Faktor-faktor perantara yang lain adalah bagaimana kelompok dominan menggunakan pengaruh-pengaruhnya pada proses akulturasi dan tingkat pluralisme dalam masyarakat (Murphy, 1965 dalam Berry, 1989). Acculturative stress merupakan konsekuensi dari proses akulturasi, tetapi kemungkinan terjadinya dapat berkurang secara signifikan jika partisipasi dalam masyarakat dan pertahanan kultur yang diwariskan didukung oleh kebijakan dan praktek di dalam masyarakat. Acculturative stress juga diketahui berdampak pada tingkat personal, beberapa diantaranya adalah menurunnya kesehatan (fisik, sosial, dan psikologis), menurunnya tingkat motivasi, perasaan terasing, dan meningkatnya penyimpangan sosial.Etnis Cina di Jakarta sebagai etnis minoritas tennasuk salah satu etnis yang mengalami proses akulturasi. Bagaimana accullurative stress terjadi pada etnis Cina di Jakarta merupakan pokok permasalahan yang dibahas dalam penelitian ini. Model konseptual yang diuji didasarkan pada model Liebkind (1996), yaitu `Migration Contigencies and Acculturative Stress'. Model ini merupakan modifikasi dari teori acculturative stress Berry (1992) dan Beyser (1991). Pengujian model konseptual menggunakan teknik Structural Equation Modeling (SEM) dengan bantuan program LISREL.Model ini terdiri dari satu variabel exogeneous (diskriminasi) dan tiga variabel endogeneous (tingkat akulturasi, identitas etnis, dan acculturative stress). Pengumpulan data dilakukan melalui kuesioner self-report yang terdiri dari tujuh instrumen (perceived discrimination, reaksi emosional alas racial discrimination, tingkat akulturasi, identitas etnis, perceived stress, dan Chinese Depressive Symptom). Sebanyak 313 kuesioner yang dapat dianalisis dari 360 kuesioner yang disebar secara proporsional berdasarkan penyebaran populasi etnis Cina di lima wilayah di DKI Jakarta.Dari pengujian diketahui bahwa model konseptual yang diadaptasi dari "Migration Contigencies and Acculturative Stress" Liebkind yang meramalkan acculturative stress pada kelompok etnis minoritas, dalam hal ini kelompok etnis Cina di Jakarta, ternyata terbukti signifikan secara statistik. Goodness of Fit yang diperoleh adalah Chi square (x') =6.62, DF=5, pada p-value=0.23, RMSEA=0.032, GPI=0.99, CF1=1.00, dan NFI=0.99 menunjukkan bahwa data fit dengan model. Dengan demikian acculturative stress dapat diramalkan melalui variabel diskriminasi, akulturasi, dan identitas etnis. Dari pengujian model, didapat hubungan langsung yang positif antara diskriminasi dan acculturative stress. Hal ini berarti semakin individu merasakan diskriminasi semakin tinggi acculturative stress-nya. identitas etnis menjadi variabel tidak langsung dari pengaruh diskriminasi terhadap acculturative stress. Dengan adanya perantara identitas etnis maka pengaruh diskriminasi terhadap acculturative stress menjadi lebih kecil. Terdapat hubungan tidak langsung antara diskriminasi dan acculturative stress melalui perantara akulturasi dan identitas etnis. Variabel identitas etnis memberikan pengaruh yang lebih besar bila dibandingkan variabel akulturasi_ Disamping itu, terbukti signifikan adanya hubungan langsung yang positif antara low self-esteem dengan acculturative stress.Pengujian model juga membuktikan adanya perbedaan model acculturative stress berdasarkan gender. Pada perempuan, acculturative stress dipengaruhi secara langsung oleh diskriminasi dan terdapat pengaruh tidak langsung diskriminasi terhadap acculturative stress melalui identitas etnis. Pada laki-Iaki diskriminasi berpengaruh langsung terhadap acculturative stress, namun tidak terdapat pengaruh tidak langsung dari identitas etnis. Demikian jugs pada pengujian model acculturative stress berdasarkan identifikasi etnis (Tionghoa keturunan, Tionghoa Indonesia, dan Orang Indonesia) terdapat hubungan langsung antara diskriminasi dengan acculturative stress, namun tidak terdapat pengaruh identitas etnis sebagai variabel perantara dari diskriminasi terhadap acculturative stress."