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Published By Fakultas Kedokteran Universitas Sriwijaya

2598-0580

2022 ◽  
Vol 6 (3) ◽  
pp. 1460-1464
Author(s):  
Yonis Ismed ◽  
Radiyati Umi Partan ◽  
Ismail Bastomi

Background. Tuberculosis is still a significant health problem, especially in developing countries. Although pulmonary tuberculosis is the most common form of the disease, extrapulmonary tuberculosis also contributes significantly to morbidity and mortality. 10-15% of extrapulmonary cases are due to tuberculous arthritis. The following is a case report of a 36-year-old woman with a diagnosis of genu Sinistra tuberculosis arthritis and drug-induced hepatotoxic injury due to OAT. Case presentation. A woman, 36 years old, Muslim, addresses Banyuasin. The patient is a housewife, treated at Dr. Moh Hoesin General Hospital since October 11, 2021. The main complaint in the form of pain in the left knee has been getting worse since 1 week before being admitted to the hospital. 4 months before admission the hospital, the patient complained of left knee pain, the pain felt like being stabbed, coming and going, especially when walking. In this patient, there was a complaint of nausea that was felt in the pit of the stomach. The results of laboratory examinations showed an increase in the transaminase enzyme and hyperuricemia, so it was suspected that the patient had DILI due to OAT drugs. Hepatocyte death in DILI can occur through two processes, namely processes mediated by apoptosis or necrosis. In apoptosis, cell shrinkage and fragmentation occur into small pieces with the cell membrane intact. These fragments are cleared by phagocytosis and generally do not stimulate the host immune response. Conclusion. A patient diagnosed with arthritis tuberculosis genu Sinistra with Drug-Induced Liver Injury and Confirmed COVID 19.


2022 ◽  
Vol 6 (3) ◽  
pp. 1465-1474
Author(s):  
Annisa Permatasari ◽  
Deny Salverra Yosy ◽  
Achirul Bakri ◽  
Ria Nova

Background. Most of heart defects in children do not show typical clinical symptoms. Ten percent of the cases are late detected. Echocardiography is an examination with high sensitivity and specificity in detecting heart defects in children, but it cannot be performed by all health workers, expensive and not always available in hospitals. Auscultation is an important part of a physical examination that inexpensive, easy examination, and becomes a competency of all doctors. The aim of this study to determine the accuracy of the screening method by listening to murmurs on heart auscultation by various levels of physician competence. Methods. This is a diagnostic test of 250 elementary school children held in the pediatric ward of dr. Mohammad Hoesin Palembang from September to November 2019. The auscultation examination was performed by three pediatrics resident from three stages (i.e. junior, middle and senior), followed by echocardiography examinations by a pediatric cardiologist. Results. The highest sensitivity of auscultation was found in senior resident, 42.4%, while the lowest was found in junior resident, 12.1%. The results of the kappa analysis of the cardiac auscultation examination on the three examiners showed a poor level of agreement on junior stage  compared to senior resident (k = 0.189; CI = 0.033-0.346) and the level of agreement was sufficient in junior stage compared to middle stage resident (k = 0.297; CI = 0.134 -0.461) and middle stage compared to senior resident (k = 0.301; CI = 0.147-0.456). Conclusion. Experience and length of learning will affect the accuracy of the auscultation examination in detecting heart defects in children.


2022 ◽  
Vol 6 (3) ◽  
pp. 1446-1454
Author(s):  
Burhannudin Ichsan ◽  
Nining Lestari ◽  
Sulistyani

Background. Infantile colic, defined as paroxysmal, excessive, and consolable crying without an identifiable cause. It is common in the first 3 months of life. There have been many RCT studies conducted. A systematic synthesis is required to summarize the results of these RCTs. This study was aimed to systematically analyze the benefits of Lactobacillus reuteri DSM 17938 for infantile colic. Methods. This systematic review and meta-analysis used keywords: (“infantile colic” OR “abdominal cramps” OR “abdominal cramp” OR “infant colic”) AND “lactobacillus reuteri” AND (placebo OR placebos) AND (“randomized controlled trial” OR RCT). The databases used were: pubmed, science direct, and google scholar. Meta-analysis was conducted to combine the articles. The eligibility criteria were: patient with infantile colic, intervention with L. reuteri DSM 17938, control was placebo, RCT study design, outcome with dichotomous scale, all races, all ethnicities, all countries, all genders, in English, and not limited by year. Results. The search resulted in 800 articles. After reducing duplication, the number of articles was 747. Screening with titles and abstracts resulted in 13 full teks articles. Six articles fitted the eligibility criteria. The results of the meta-analysis were as follows. The forest plot showed that the combined effect of the six articles showed an RR of 0.47 and was statistically significant (p <0.001). Conclusion. Based on the results of this meta-analysis, L. reuteri DSM 17938 is recommended for infants with infantile colic. There were no significant side effects with the use of L. reuteri DSM 17938 on infantile colic.


2022 ◽  
Vol 6 (3) ◽  
pp. 1455-1459
Author(s):  
Widodo Adi Prasetyo ◽  
Armen Ahmad

Background. Ancylostomiasis is an infection caused by hookworms. It is estimated that hookworms infect 1.2 billion people worldwide and cause higher morbidity than other types, mainly due to iron deficiency anemia. Hookworm infection increases with age. The main clinical manifestations are abdominal pain, features of iron deficiency anemia and hypoproteinemia. Diagnosis is based on the finding of characteristic eggs in the stool. Case presentation. A 67-year-old female patient had been administered into the Internal Medicine Ward of Dr. M. Djamil Padang Hospital with the main complaint of weakness, fatigue, and lethargy which had increased since 3 days before being admitted to the hospital. The patient also had complaints of pale skin, fever, heartburn, decreased appetite and weight loss. The patient was admitted to the hospital with awareness of compost mentis, cooperative, and his general condition appeared to be moderately ill, blood pressure 130/90 mmHg, pulse rate 104 x/minute, regular pulse, adequate filling, respiratory rate 22 x/minute, temperature 37.8 C. On physical examination, the conjunctiva of the pantient’s eyes were anemic. Laboratory examination revealed Hemoglobin 4 g/dl, Hematocrit 16%, MCV/MCH/MCHC 62fl/15pg/25g/dL, Reticulocytes 0.5%, SI/TIBC 22/315 mg/dL, Ferritin 8.5 ng/mL, and peripheral blood smear showing severe hypochromic microcytic anemia and relative eosinofilia. Ancylostoma duodenale worm eggs were found on routine stool examination. Final diagnosis was Severe microcytic hypochromic anemia caused by an iron deficiency and Ancylostomiasis. Severe microcytic hypochromic anemia caused by iron deficiency and ancylostomiasis was established based on the patient’s history, physical examination and laboratory investigations. Conclusions. Hookworms infect many people worldwide and cause high morbidity, mainly due to iron deficiency anemia. The highest prevalence is found in the tropics and subtropics, including Indonesia. The main clinical manifestations are abdominal pain, features of iron deficiency anemia and hypoproteinemia. Diagnosis is based on the finding of characteristic eggs in the stool. Albendazole 400 mg single dose resulted in 80% cure and a dose of 200 mg/day for 3 days gave 100% cure. Treatment of anemia is by administering ferrous sulfate or ferrous gluconate orally 200 mg three times a day and continued for up to 3 months after normal hemoglobin levels are achieved to maintain iron stores.


2022 ◽  
Vol 6 (3) ◽  
pp. 1443-1445
Author(s):  
Vesri Yossy ◽  
Wydya Yenny ◽  
Lilik Norawati

Background: There are various therapeutic modalities for acne and post acne scarring, but the best option is to have a safe, effective with affordable cost such as monotherapy or combination therapy. One of the recommended combination therapy for acne vulgaris with atrophic acne scars is microneedling radiofrequency which can improve skin structure. Case report: A 25 year old male with moderate comedonal acne vulgaris and severe scarring. The patient came with complaints of uneven skin surface on both cheeks, forehead and chin which had been felt to increase since 3 years ago. The appearance of acne on the face has been felt since 12 years ago. The patient's parents and sister also had acne complaints. On dermatological examination, on the forehead, temples, cheeks, nose and chin found blackheads, whiteheads, papules, hyperpigmented macules, multiple atrophic acne scars. The treatment choice for this patient is microneedling radiofrequency in combination with topical therapy. Discussion: The combination of microneedling with radiofrequency is one of the therapeutic modalities for acne vulgaris and also post-acne scarring with minimal side effects. In the evaluation for 2 weeks after the procedure, this patient did not complaint of any adverse events.


2022 ◽  
Vol 6 (3) ◽  
pp. 1435-1442
Author(s):  
Erwin Sukandi ◽  
Yudhie Tanta ◽  
Taufik Indrajaya ◽  
Ali Ghanie ◽  
Muhammad Irsan Saleh ◽  
...  

Coronary Slow Flow Phenomenon (CSFP) is characterized by the slow flow of contrast in one or more epicardial coronary vessels without evidence of coronary artery stenosis during coronary angiography procedures. CSFP is fairly common at the time of elective angiography with an incidence of around 7% and accounts for about 4% of hospitalized unstable angina cases. Coronary angiography is currently still the only effective way to detect CSFP, but this procedure is an invasive procedure with high costs, there is a risk of allergy to contrast. Electrocardiography (ECG), as a widely available, inexpensive, and simple modality is felt to be an attractive alternative in early detection of this abnormality. The ECG parameters on CSFP discussed in this study include; p-wave dispersion, QT interval dispersion, QRS intrinsic (Tpeak-Tenddeflection duration), and QRS fragmentation. Further studies are needed on the ECG image in CSFP so that in the future ECG can be a cheaper and non-invasive diagnostic modality for CSFP compared to coronary angiography.


2022 ◽  
Vol 6 (3) ◽  
pp. 1423-1434
Author(s):  
Denny Satria Utama ◽  
Eriza ◽  
Priscilla Ralahayu ◽  
Erial Bahar

Background. Nasopharyngeal carcinoma is a malignant tumor that grows in the nasopharyngeal area with predilection in the fossa Rossenmuller and the nasopharyngeal roof adjacent to the Eustachian tube, so one of NPC’s early symptoms is ear symptoms. Hearing loss is a common symptom found in people with NPC due to dysfunction of the Eustachian tube, a continuing middle ear disorder that can result in conductive hearing loss.This study aims to find out the relationship between primary tumor of NPC and the degree of conductive hearing loss at dr. Mohammad Hoesin Hospital Palembang. Methods. This is a cross sectional study that obtained 42 samples from the medical records at Dr. Mohammad Hoesin Hospital Palembang that met the inclusion and exclusion criteria. The study subjects collected in total sampling have been conducted audiometry examinations at the ORLHNS clinic of Dr. Mohammad Hoesin Hospital Palembang during the period January 2019 - April 2021. Results. The proportion of hearing loss in NPC patients in this study was 30 subjects (71.4%) with the highest proportion of hearing loss complaints being 33.3%. The proportion of conductive hearing loss of nasopharyngeal carcinoma patients in the study was 33 subjects (78.5%) right ear and 28 subjects (66.7%) left ear. There was a significant association between the degree of the NPC primary tumor and the incidence of conductive deafness of the left ear, but there was no significant association in the right ear. There is a significant correlation between NPC primary tumors and left ear hearing thresholds at frequencies of 500 Hz and 4000 Hz, but there is no significant association between the degree of NPC primary tumor and right ear hearing loss. Conclusions. There is significant correlation between the primary tumor of NPC and the hearing threshold of the left ear but there was no significant association in the right ear.


2022 ◽  
Vol 6 (4) ◽  
Author(s):  
Denny Satria Utama ◽  
Eriza ◽  
Belly Sutopo Wijaya ◽  
Erial Bahar

Background. Nasopharyngeal carcinoma (NPC) is the most common malignancy in head and neck in Indonesia with 19,943 new cases in 2020 resulting 13,399 deaths. Lymphocytes are cells that play a role in the anti-cancer immune response, especially CD-8 T-cells. Neoadjuvant chemotherapy is chemotherapy given before radiotherapy that aims to kill primary tumors and micrometastasis tumors. This study aims to find out the relationship of CD-8 expression to treatment response in NPC undergoing neoadjuvant chemotherapy at Dr. Mohammad Hoesin Hospital Palembang. Methods. This study is an analytical observational research study on a retrospective cohort basis. Data collection from medical records using total sampling in 15 patients pilot study of NPC patients undergoing neoadjuvant chemotherapy and conducted CD-8 examination at ORLHNS polyclinic Dr. Mohammad Hoesin Hospital Palembang from December 2018 to December 2019 that met the criteria of inclusion and exclusion. Results. From 15 samples, the average CD-8 test result before neoadjuvant chemotherapy was 24.54 ng/μL and after neoadjuvant chemotherapy was 193.56 ng/μL. There was a tendency to increase the average CD-8 from before to after completion of neoadjuvan chemotherapy with a statistically significant difference of p =0.001. ROC analysis found CD-8 cut off points is 23.76 ng/μL with an area below the curve is 0.667. There were no significant relationships between CD-8 to performance status and treatment response with p values of 0.289 and 0.219, respectively.  Conclusions. There was a significant change between CD-8 before neoadjuvant chemotherapy and after neoadjuvant chemotherapy with increased CD-8 tendencies and trends from before to after 6 series neoadjuvant chemotherapy with CD-8 cut off points is 23.76 ng/μL. In this study there has not been a significant relationships between CD-8 to performance status and treatment response in NPC patients undergoing neoadjuvant chemotherapy.


2022 ◽  
Vol 6 (2) ◽  
pp. 1411-1415
Author(s):  
Fadel Fikri Suharto ◽  
Alwi Shahab ◽  
Yulianto Kusnadi ◽  
RM Dewi Anggraini

Backgrounds. Latent autoimmune diabetes in adults (LADA) is a slowly progressive form of autoimmune diabetes mellitus characterized by older age at diagnosis, presence of pancreatic autoantibodies, and lack of absolute insulin requirement at diagnosis. Patients with LADA had better β-cell function than patients with classic Type 1 DM (T1DM). Overtime, LADA tends to experience rapid and progressive loss of beta cell function that requires intensive insulin therapy. This case report aims to describe a case of Diabetic Ketoacidosis (DKA) in a patient with latent autoimmune diabetes in adult (LADA) induced by sepsis (urinary tract infection/UTI). Case Presentations. A woman, 28 years-old, came to the Emergency Department (ED) RSMH Palembang with chief complaints of decreased consciousness and shortness of breath. Patient had a history of frequent urination, pain when urinating, and fever. Urinalysis examination were glycosuria, proteinuria, hematuria. Hb-A1c level was 10.7%, C-Peptide 0.11 ng/dL, Anti GAD65 qualitative positive, and Islet cell antibody (ICA) negative. Patient was diagnosed with diabetic ketoacidosis (DKA), LADA, and sepsis due to urinary tract infection (UTI). Patients were managed with DKA and sepsis management algorithm. Conclusion. Diabetic ketoacidosis (DKA) in LADA caused by sepsis is an emergency in the metabolic endocrine and diabetes fields. Prompt and appropriate management can improve outcome prognosis in this case.


2022 ◽  
Vol 6 (2) ◽  
pp. 1405-1410
Author(s):  
Muhammad Reza Azriyantha ◽  
Ambiar Manjas

Background. Cholelithiasis is a condition where there are stones in the gallbladder or the common bile duct or both. This study aims to describe the characteristics of cholelithiasis patients in RSUD Dr. Achmad Mochtar Bukittinggi. Methods. This research is a descriptive observational study on the incidence of cholelithiasis in hospitals. Dr. Achmad Mochtar Bukittinggi period January 2019 – December 2020. A total of 224 research subjects participated in this study. Secondary data was collected from medical records of research subjects, including data on age, gender, body mass index, clinical symptoms, and type of surgery. Data analysis was carried out with the help of SPSS 25 software. Results. Cholelithiasis was most commonly found in the age group over 50 years (47.8%), normal BMI (46%) cases. The most complained symptom in cholelithiasis patients in this study was abdominal pain (61.6%). All cholelithiasis patients (100%) in this study underwent laparoscopic cholecystectomy surgery. Conclusion. Cholelithiasis patients who underwent surgery in hospitals. Dr. Achmad Mochtar Bukittinggi for the period January 2019 – December 2020 were 224 patients. The majority of patients over 50 years of age, women, had a normal BMI. The patient frequently complained of abdominal pain and all had undergone laparoscopic cholecystectomy.


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