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All Journal Jurnal Ilmiah Kedokteran Wijaya Kusuma Folia Medica Indonesiana
Tjan, Anastasia
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Biochemistry, Genetics & Molecular Biology Health Professions Medicine & Pharmacology Neuroscience Public Health

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Penyengatan Meningeal Sisterna Basalis Meningitis TB pada Computed Tomography Scanning: Sebuah Ulasan Bergambar Tjan, Anastasia; Asih, Made Widhi; Martadiani, Elysanti Dwi
Jurnal Ilmiah Kedokteran Wijaya Kusuma Vol 8, No 2 (2019): EDISI SEPTEMBER 2019 (available online since Oktober 2019)
Publisher : Universitas Wijaya Kusuma Surabaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1233.025 KB) | DOI: 10.30742/jikw.v8i2.623

Abstract

Tuberculosis (TB) is one of the major worldwide threat and global burden in Indonesia. CNS tuberculosis is the most severe form of TB infection. CT evaluation on diagnosing tuberculosis meningitis (TBM) with triad of hydrocephalus, basal meningeal enhancement and infarction was reported to be sensitive. PCR cerebrospinal fluid (CSF) is known to be specific, however negative results have been reported due to presence of PCR?s inhibitors, poor lysis of mycobacteria, and the uneven distribution in specimens. CT Scan plays the vital role in diagnosing TBM patient with the presence of TBM CT triad, especially basal cistern enhancement (BME) which is the specific enhancement pattern in MTB patient. There are 9 must know BME pattern, such as contrast filling the cistern, double and triple line, linear enhancement at MCA cistern, Y sign, posterior infundibular recess enhancement, ill defined border, join the dots sign, nodular enhancement, and asymmetry off all pattern. Familiarizing BME criteria is essential to provide confident diagnosis and reduce morbidity and mortality
Radiology Perspective One-Year Study of Hirschsprung Disease Tjan, Anastasia
Folia Medica Indonesiana Vol. 57, No. 1
Publisher : Folia Medica Indonesiana

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Abstract

Hirschsprung disease is a rare developmental disorder of the enteric nervous system. This researched purpose to give an epidemiological database and current trend analysis from radiological perspective of Hirschsprung disease at our center. A prospective descriptive study was conducted for a year in 2017 at Sanglah Public General Hospital Bali. Colon in loop examination using either water-soluble or barium was conducted. All baseline characteristics, contras media used, and HD type were the parameter being evaluated in this study. Hirschsprung accounted for 2.16% from all 1018 newborn. Male is 3.4 times more prone to Hirschsprung disease. Age distribution predominant during 0 – 4 weeks after birth (36.4%). Ultrashort, short, long segments were 45.5%, 45.5%, and 9% respectively. Contras media used was mainly barium rather than water soluble 8:3, due to standard operating procedure adapted by some pediatric surgeon. Ultrashort and short segment HD has the same contribution. Barium is dominated at our center although water soluble is chosen in most literature for infant, due to its ability as diagnostic as well as therapeutic. Hence further research should be done to support and change the perspective in making the diagnosis.
Semilunar Sign of Trans-Mediastinal Herniation of Giant Bullae with Tension Hydropneumothrax Tjan, Anastasia; Ayusta, I Made Dwija Putra; Mahiswara, Dewa Gde
Folia Medica Indonesiana Vol. 56, No. 4
Publisher : Folia Medica Indonesiana

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Herniation of bulla across mediastinum is rare, while transmediastinal giant bulla herniation accompanied with hydropneumothorax is even rarer. We report a case of an 18 years old male with dyspnea came to emergency department with trans-mediastinal giant bulla herniation, which appears as semilunar sign on chest x-ray, and righthydropneumothoraks. It appeared that the giant bulla also infected by the presence of air fluid level within. Semilunar sign was seen on the contralateral left mediastinum as the hallmark finding for trans-mediastinal herniation of bulla. Chest CT further confirms the diagnosis. Subsequently chest tube insertion and symptomatic relives were given, however the patient end up dead after 2 days of observation. Heart and lung compression by the lesions were the cause of this patient poor outcome. Bullous lung disease should be evaluated thoroughly and not underestimated since it could cause severe disease progression.
Co-Authors Ayusta, I Made Dwija Putra Dwija Putra Ayusta, I Made Elysanti Dwi Martadiani Made Widhi Asih Mahiswara, Dewa Gde Narasiang, Benefit Sherwin R.U.A. Sompie