HUBUNGAN EDEMA DENGAN PROTEIN URINE PADA IBU HAMIL DI RSU PRIMA HUSADA SIDOARJO

Author(s):  
Andreas Putro Ragil Santoso ◽  
Nur Masruroh

Ibu hamil memiliki resiko yang tinggi dengan adanya penyakit komplikasi berupa sindroma HELLP (hemolysis, elevated, liver enzyme, low platelet) edema, gangguan ginjal, perdarahan, infeksi, tekanan darah tinggi saat kehamilan, komplikasi persalinan, aborsi hingga kematian. Preeklamsi terjadi akibat peningkatan hipertensi dimana sebelumnya tidak pernah mengalami hipertensi sebelum kehamilan. Preeklamsi menimbulkan proteinuria dan edema. Penelitian ditujukan untuk mengetahui hubungan kadar protein urine dengan edema pada Ibu Hamil. Desan penelitian menggunakan pendekatan cross sectional. Populasi penelitain merupakan pasien dari RSU Prima Husada, dengan jumlah sampel minilam sebanyak 30 sampel. Hasil penelitian yang dilakukan uji berdasarkan uji spearman menunjukkan bahwa signifikansi p> 0,05 yaitu 0,456 hal tersebut menunjukkan bahwa tidak ada hubungan antara edema dengan protein urine pada Ibu hamil.

2021 ◽  
Vol 62 (5) ◽  
Author(s):  
Hoang Duc Thai ◽  
Trinh Nhut Minh ◽  
Bui Dang Phuong Chi

Objective: Describing characteristics of using 3rd and 4th generation Cephalosporin antibiotics at Thong Nhat Hospital in the period of 2019 - 2020.Subjects and methods: cross-sectional descriptive study on 158 medical records of patients discharged from hospital from February 20th, 2020 to February 24th, 2020 (5 days) was kept at themedical records store, Department of general planning, Thong Nhat hospital.Results: The majority of patients had no diagnosis of infection but had signs of infection, accounting for 69.92%. Duration of C3G/C4G antibiotic treatment of group with signs of infection was 9.22± 2.79 days. Cefotaxim was used the most, accounting for 26.58%. The majority of indications for the use of antibiotics C3G/C4G for patients were appropriate or partly appropriate, accounting for 74.05%. Efficiency of using appropriate or partially appropriate antibiotics had achieved high results, accounting for 39.24%. Most of the cases diagnosed or showed signs of infection after using antibiotics C3G/C4G obtained treatment efficacy, accounting for 75%. The majority of patients using C3G/C4G antibiotics achieved effectiveness in preventing wound infection in the patient with no signs of infection, accounting for 77.78%. The rate of elevated liver enzyme was 7.59%, the rate of thrombocytopenia was 3.16%.Conclusion: Duration of C3G/C4G antibiotic treatment of group with signs of infection was 9.22 ± 2.79 days. Cefotaxim were used the most. Most of indications to use antibiotics C3G/C4G were appropriate or partially appropriate. Efficiency of using appropriate or partially appropriate antibiotics had achieved high results. The rate of elevated liver enzyme was 7.59%, the rate of thrombocytopenia was 3.16%.


2021 ◽  
Vol 9 ◽  
Author(s):  
Suhua Xu ◽  
Peng Zhang ◽  
Liyuan Hu ◽  
Wenhao Zhou ◽  
Guoqiang Cheng

Objective: The aim of this single-center retrospective study was to analyze the clinical characteristics, treatment options, and course of neonatal-onset congenital portosystemic shunts (CPSS).Methods: We included all patients with CPSS who presented with clinical symptoms within the neonatal period in our institution between 2015 and 2020.Results: Sixteen patients were identified, including 13 patients with intrahepatic portosystemic shunts (IPSS) and three patients with extrahepatic portosystemic shunts (EPSS). The median age of diagnosis was 16 days (range prenatal 24 weeks−12 months). Hyperammonemia (60%), neonatal cholestasis (44%), elevated liver enzyme (40%), hypoglycemia (40%), thrombocytopenia (38%), and coagulation abnormalities (23%) appeared in neonatal CPSS. Twelve patients (75%) presented with congenital anomalies, of which congenital heart disease (CHD) (44%) was the most common. Thirteen patients with IPSS initially underwent conservative treatment, but two of them were recommended for the catheter interventional therapy and liver transplantation, respectively, due to progressive deterioration of liver function. Spontaneous closure occurred in nine patients with IPSS. The shunt was closed using transcatheter embolization in one patient with EPSS type II. Another patient with EPSS type II underwent surgical treatment of CHD firstly. The remaining patient with EPSS type Ib received medical therapy and refused liver transplantation.Conclusion: Hyperammonemia, neonatal cholestasis, elevated liver enzyme, hypoglycemia, and thrombocytopenia are the main complications of neonatal CPSS. Moreover, CPSS is associated with multiple congenital abnormalities, especially CHD. Intrahepatic portosystemic shunts may close spontaneously, and conservative treatment can be taken first. Extrahepatic portosystemic shunts should be closed to prevent complications.


2005 ◽  
Vol preprint (2007) ◽  
pp. 1
Author(s):  
Monica Emanuelli ◽  
Davide Sartini ◽  
Valentina Rossi ◽  
Alessandra Corradetti ◽  
Beatrice Landi ◽  
...  

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Melashu Balew Shiferaw ◽  
Ketema Tafess Tulu ◽  
Amtatachew Moges Zegeye ◽  
Amarech Asratie Wubante

Liver disease has emerged as the most common non-AIDS-related cause of death in HIV patients. However, there is limited data regarding this condition including our setting in Ethiopia. Hence, liver enzyme abnormalities among highly active antiretroviral therapy (HAART) experienced and HAART naïve patients were assessed in this study. A total of 164 HAART experienced and 164 HAART naïve patients were studied. Blood specimen was collected to determine alanine aminotransferase (ALT) and aspartate aminotransferase (AST), CD4 count, and viral hepatitis. The prevalence of liver enzyme abnormality was 20.1% and 22.0% among HAART experienced and HAART naïve patients, respectively. The HAART experienced patients had higher mean ALT than HAART naïve patients (P=0.002). Viral hepatitis (AOR = 6.02; 95% CI = 1.87–19.39), opportunistic infections (AOR = 2.91; 95% CI = 1.04–8.19), current CD4 count <200 cells/mm3(AOR = 2.16; 95% CI = 1.06–4.39), and male sex (AOR = 1.83; 95% CI = 1.001–3.33) were associated with elevated ALT and/or AST. In conclusion, liver enzyme abnormalities were high in both HAART experienced and HAART naïve HIV-1 infected patients. Hence, monitoring and management of liver enzyme abnormalities in HIV-1 infected patients are important in our setting.


Diagnostics ◽  
2021 ◽  
Vol 11 (9) ◽  
pp. 1605
Author(s):  
Su Hyun Park ◽  
Jong Hyun Lee ◽  
Dae Won Jun ◽  
Kyung A Kang ◽  
Ji Na Kim ◽  
...  

Due to its high prevalence, screening for hepatic fibrosis in the low-risk population is called for action in the primary care clinic. However, current guidelines provide conflicting recommendations on populations to be screened. We aimed to identify the target populations that would most benefit from screening for hepatic fibrosis in clinical practice. This study examined 1288 subjects who underwent magnetic resonance elastography. The diagnostic performance of the Fibrosis-4 (FIB-4) index and NAFLD fibrosis score was compared in the following groups: (1) ultrasonography (USG)-diagnosed NAFLD, (2) elevated liver enzyme, (3) metabolic syndrome, (4) impaired fasting glucose, and (5) type 2 diabetes regardless of fatty liver. Decision curve analysis was performed to express the net benefit of groups over a range of probability thresholds (Pts). The diabetes group showed a better area under the receiver operating characteristic curve (AUROC: 0.69) compared with subjects in the USG-diagnosed NAFLD (AUROC: 0.57) and elevated liver enzyme (AUROC: 0.55) groups based on the FIB-4 index. In decision curve analysis, the diabetes group showed the highest net benefit for the detection of significant fibrosis across a wide range of Pts. Patients with diabetes, even in the absence of fatty liver, would be preferable for hepatic fibrosis screening in low-risk populations.


2020 ◽  
Vol 1 (1) ◽  
pp. 40-6
Author(s):  
Fahmi Agnesha ◽  
Sri Rahardjo

Preeklampsia merupakan salah satu penyebab morbiditas dan mortalitas ibu hingga saat ini. Penyakit ini memiliki beberapa bentuk manifestasi klinis yang merupakan gambaran dari perburukan dari preeklampsia diantaranya adalah eklampsia dan sindroma HELLP (hemolysis, elevated liver enzyme dan low platelet). Kedua perburukan preeklampsia tersebut biasa terjadi pada usia kehamilan 27 hingga 37 minggu, namun semakin dini onset penyakit ini muncul prognosis bagi ibu akan semakin buruk. Seorang perempuan usia 34 tahun, gravida 3 paritas 1 abortus 1 hamil 24 minggu, janin intra uterine fetal death. Pasien datang dikarenakan kejang seluruh badan selama 5 menit sekitar 30 menit yang lalu sebelum masuk rumah sakit. Berdasarkan pemeriksaan fisik didapatkan hipertensi dengan tekanan darah 180/110 mmHg. Selain itu dari pemeriksaan penunjang didapatkan trombositopenia 94.000, SGOT 350 IU/L and SGPT 285 IU/L. Pasien didiagnosis dengan eklampsia dan sindroma HELLP, kemudian dilakukan terminasi kehamilan melalui seksio sesarea darurat dengan anestesia umum. Pembahasan: manajemen anestesia pada ibu hamil dengan eklampsia dan sindroma HELLP memiliki beberapa pertimbangan khusus antara lain adanya kesulitan intubasi, kemungkinan terjadinya peningkatan tekanan intrakranial dan juga efek pemberian anti kejang terhadap kontraksi rahim. Melalui penegakan diagnosis dan pengenalan risiko yang mungkin dapat terjadi pada pasien dengan eklampsia dan sindroma HELLP dapat direncanakan tindakan dan manajemen anestesia yang lebih baik sehingga morbiditas dan mortalitas ibu dengan eklampsia dan sindroma HELLP dapat diturunkan.   Eclampsia and HELLP Syndrome in Early Pregnancy: Diagnosis and Management of Anesthesia Abstract Preeclampsia is one of the leading cause maternal morbidity and mortality. It has various clinical manifestations that describe the severity of the disease include eclampsia and HELLP syndrome (hemolysis, elevated liver enzyme dan low platelet). Those worsening of preeclampsia usually happen during 27 to 37 weeks of gestation. Even though the earlier the onset showed the worse the prognosis is. A pregnant woman 34 years old, gravidy 3 parity 1 abortus 1, 24 weeks gestational age with intra uterine fetal death. Patient had chief complain for seizure before admission. From the physical examination found that patient has severe hypertension with blood pressure 180/110 mmHg. The laboratory result showed trombositopenia 94.000, SGOT 350 IU/L and SGPT 285 IU/L. Patient diagnosed with eclampsia and HELLP syndrome and then did emergency caesarean section with general anesthesia. Discussion: The anesthesia management in this case should be specifics due to the patient condition circumstances with eclampsia and HELLP syndrome. We should prepare for difficult airway, intracranial pressure increase and effect of anticonvulsant agent to the uterine tone. By diagnose and identify the risk of eclamptic and HELLP syndrome patient carefully we can plan the better procedure and anesthesia management that maternal morbidity and mortality can be reduced.


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