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All Journal Keluwih: Jurnal Kesehatan dan Kedokteran Indonesian Journal of Biomedicine and Clinical Sciences
Retnaningtyas, Lucia Pudyastuti
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Agriculture, Biological Sciences & Forestry Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Nursing Public Health

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Henoch-Schonlein Purpura (HSP) Lucia Pudyastuti Retnaningtyas
KELUWIH: Jurnal Kesehatan dan Kedokteran Vol. 1 No. 1 (2019): Keluwih: Jurnal Kesehatan dan Kedokteran (December)
Publisher : Direktorat Penerbitan dan Publikasi Ilmiah, Universitas Surabaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (315.295 KB) | DOI: 10.24123/kesdok.V1i1.2486

Abstract

Abstract—Henoch-Schonlein purpura (HSP) is a systemic vasculitic disease (vascular inflammation) characterized by the deposition of immune complexes consisting of IgA in kidney skin. This disease is called Anaphylactoid purpura, rheumatic Purpura, Schonlein-Henoch purpura. In this case, the patient complained of the appearance of red spots on the legs to the buttocks within three days and did not feel itchy. Ankle pain and can not be moved, and do not feel nausea, fever, heartburn, and others. Examination of the extremities contained red lesions and was more prominent than other skin surfaces. Diagnosis of patients suspected of having Henoch-Schonlien purpura. Treatment of HSP patients with Prednisone at a dose of 2 mg/kg/day which is divided into three doses. On the third-day purpura decreases tend to thin out and enkle pain disappears on the fifth day. Red spots appear, after therapy is stopped for 1 month. HSP sufferers 94% recover in children and 89% in adults. HSP recuration is more common in children over the age of 10 years and a kidney biopsy must be performed to determine subsequent therapy. Abstrak—Henoch-Schonlein purpura (HSP) adalah penyakit vaskulitik sistematik (inflamasi vaskuler) ditandai dengan deposisi komplek imun yang terdiri dari IgA pada kulit ginjal. Penyakit ini disebut Anaphylactoid purpura, Purpura rheumatic, Schonlein-Henoch purpura. Pada kasus ini pasien mengeluh timbulnya bercak merah pada kaki sampai bagian pantat dalam waktu tiga hari dan tidak merasa gatal-gatal. Pergelangan kaki nyeri dan tidak bisa digerakkan, serta tidak merasa mual, demam, nyeri ulu hati dan lain-lain. Pemeriksaan ekstremitas terdapat lesi merah dan lebih menonjol dibandingkan premukaan kulit lain. Diagnosa pasien di duga menderita Henoch-Schonlien purpura. Pengobatan pasien HSP dengan Prednison dengan dosis 2mg/kgBB/hari yang terbagi dalam tiga dosis. Pada hari ketiga purpura berkurang cenderung menipis dan nyeri enkle menghilang pada hari kelima. Bercak merah timbul, setelah terapi dihentikan selama 1 bulan. Penderita HSP 94% sembuh pada anak-anak dan 89% pada dewasa. Rekurnasi HSP lebih sering terjadi pada anak usia diatas 10 tahun dan biopsi ginjal harus dilakukan untuk menentukan terapi selanjutnya.
Tantangan Dalam Diagnosis Atresia Esofagus Tipe C: Sebuah Laporan Kasus Retnaningtyas, Lucia Pudyastuti
Keluwih: Jurnal Kesehatan dan Kedokteran Vol. 5 No. 1 (2023): Keluwih: Jurnal Kesehatan dan Kedokteran (December)
Publisher : Direktorat Penerbitan dan Publikasi Ilmiah, Universitas Surabaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24123/kesdok.V5i1.6036

Abstract

Abstract—Newborn with hypersalivation and vomiting can be caused by various causes, one of which is esophageal atresia. Esophageal atresia is a rare disease, the most life-threatening congenital malformations in newborns, a congenital gastro-intestinal abnormality characterized by loss of esophageal continuity (atresia) with or without tracheo-esophageal fistula. With a thorough history and physical examination, supported by a simple radiological examination, the diagnosis of esophageal atresia can be established. In this case, the 4-day-old baby was referred twice from a mother and child hospital to a fully equipped hospital. Babies experience drooling from birth and vomit immediately after feeding. At referral hospital, an orogastric tube (OGT) is installed to the patient, and it is found that the tip of OGT cannot fit along the predetermined size, and the OGT tip rises again - coiled inside the baby's mouth. From the results of the radiological examination of the babygram, a circular OGT image was obtained in Thoracal IV. The diagnosis of type C esophageal atresia can be established immediately by oesophagography, and patient got esophageal repair and neonatal intensive care with good result. This case report is useful to learn in establishing the diagnosis of esophageal atresia early to get prompt management. Keywords: drooling, hypersalivation, newborn, esophageal atresia Abstrak—Bayi baru lahir dengan hipersalivasi dan muntah dapat disebabkan oleh bermacam penyebab, salah satunya atresia esofagus. Atresia esofagus (AE) adalah penyakit langka, salah satu malformasi kongenital yang paling mengancam jiwa pada bayi yang baru lahir, sebuah kelainan kongenital gastro-intestinal yang ditandai dengan hilangnya kontinuitas esofagus (atresia) dengan atau tanpa adanya fistula trakeo-esofagus. Dengan anamnesis dan pemeriksaan fisik yang teliti, didukung dengan pemeriksaan radiologi sederhana, diagnosis atresia esofagus dapat ditegakkan. Pada kasus ini, bayi usia 4 hari mengalami rujukan dua kali dari rumah sakit ibu dan anak baru kemudian sampai di rumah sakit dengan fasilitas lengkap. Bayi mengalami drooling sejak lahir dan muntah segera tiap kali diberi minum. Di rumah sakit rujukan, bayi dipasang orogastric tube (OGT), dan didapatkan bahwa ujung OGT tidak dapat masuk sepanjang ukuran yang telah ditentukan, dan ujung OGT naik kembali - melingkar di dalam mulut bayi. Dari hasil pemeriksaan radiologi babygram, didapatkan gambaran OGT melingkar di Thoracal IV. Diagnosis atresia esofagus tipe C dapat segera ditegakkan berdasarkan esofagografi, dan pasien mendapatkan penanganan komprehensif berupa tindakan repair esofagus dan perawatan neonatus di Neonatal Intensive Care Unit dengan hasil yang baik. Laporan kasus ini memberi pelajaran untuk dapat menegakkan diagnosis AE secara dini untuk mendapatkan managemen yang tepat. Kata kunci: hipersalivasi, muntah, bayi baru lahir, atresia esofagus
Risk factors for type 2 diabetes mellitus in adolescents: a systematic review and meta-analysis Metta Lestari Utami; Welly Rustanto; Lucia Pudyastuti Retnaningtyas; Maria Goretti Marianti Purwanto
Indonesian Journal of Biomedicine and Clinical Sciences Vol 57 No 1 (2025)
Publisher : Published by Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/inajbcs.v57i1.20298

Abstract

The prevalence of type 2 diabetes mellitus (T2DM) in adolescents worldwide has increased over the last three decades. Several clinical studies concerning risk factors for T2DM in adolescents were reported, however, the results varied and no systematic review of the studies are reported. This study aimed to systematically review the risk factors for T2DM in adolescents. Publications in English about adolescent with T2DM aged 10-19 yr and coexisting risk factors were searched in Medline and Cochrane. This systematic review and meta-analysis were in-line with MOOSE guidelines. Each publication was assessed the titles, abstracts, and full text, and then extracted the data, and assessed the risk of bias and evidence quality were conducted by 2 independent reviewer. Seven studies involving 52,779 adolescents were included in this review. Meta-analysis using a fixed effect model with the inverse variance method was conducted to calculate the odds ratio with 95% confidence intervals. Adolescents who smoke both actively and passively were at risk of 2.88 times (pooled OR 2.88; 95% CI 1.99-4.17; I² = 61%), the male gender was at risk of 1.31 times (pooled OR 1.31; 95% CI 1.09-1.57; I² = 0%), having parents with a history of T2DM was at risk of 2.48 times (pooled OR 2.48; 95% CI 1.83-3.36; I² = 82%), obesity was at risk of 1.28 times (pooled OR 1.28; 95% CI 1.15-1.43; I² = 57%), and hypertension was 1.14 times more likely to get T2DM than those who did not have risk factors. Hypercholesterolemia was not a risk factor for T2DM (pooled OR 1.00; 95% CI 0.95-1.05; I² = 0%). In conclusion, the main risk factor for T2DM in adolescents is smoking, followed by parental T2DM, male gender, obesity, and hypertension.
Congenital Basal Meningocele: An Unusual Cause of Nasal Obstruction in Early Life Retnaningtyas, Lucia Pudyastuti
Keluwih: Jurnal Kesehatan dan Kedokteran Vol. 6 No. 2 (2025): Keluwih: Jurnal Kesehatan dan Kedokteran (June)
Publisher : Direktorat Penerbitan dan Publikasi Ilmiah, Universitas Surabaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24123/kesdok.V6i2.7366

Abstract

Abstract— Basal meningoceles are rare congenital defects that can cause nasal obstruction and often clinically occult until they result in life-threatening complications. Knowing the clues to early diagnosis, management, and complications is essential. Case: A 7-day-old baby girl was referred to our hospital because of high fever and dyspnoea, and the baby was diagnosed with pneumonia, lip tie, cup ears and suspicion of laryngomalacia. The patient got dyspnoea with stridor when drinking, and it decreased when her mouth was open. The suction catheter could not enter through the left choana. The nasal endoscopy showed an elevation of the hard palate. A 3-dimensional facial CT scan demonstrated a transsellar–transsphenoidal meningocele protruding into the left nasal cavity. A diluted liquid came out from the left nose with a yellowish-clear colour, and the baby showed a high-pitched cry. Bacterial meningitis was established from cerebrospinal liquor analyses. After meningitis treatment, surgical repair to meningocele reposition and bone defect repair was done at 40 days. Conclusion: In our case, the nasal obstruction was not detected from the beginning of birth, and it led to delays in finding the cause. Basal meningocele in this case was accidentally diagnosed by a facial CT scan exploring the cause of choana atresia. It’s essential to detect choana atresia since birth, explore the etiology immediately, and manage it well to prevent life-threatening complications. Keywords: nasal obstruction, congenital basal meningocele Abstrak—Meningocele basal merupakan kelainan kongenital langka yang dapat menyebabkan obstruksi hidung yang secara klinis sering tersembunyi sehingga baru diketahui saat sudah terjadi komplikasi. Oleh karena itu sangat penting untuk mengetahui cara menegakkan diagnosis dini agar dapat diberi tata laksana yang tepat untuk mencegah terjadinya komplikasi yang mengancam nyawa. Kasus: Seorang bayi perempuan berusia 7 hari dirujuk ke rumah sakit kami karena demam tinggi dan dispnoea dan bayi itu didiagnosis sebagai pneumonia, ikatan bibir, telinga cangkir dan kecurigaan laringomalesia. Pasien mengalami dispnea dengan stridor saat minum; dan menurun ketika mulutnya terbuka. Kateter hisap tidak bisa masuk melalui choana kiri. Endoskopi hidung menunjukkan peningkatan langit-langit keras. CT scan wajah 3 dimensi menunjukkan transsellar – meningocele transsphenoidal yang menonjol ke dalam rongga hidung kiri. Cairan encer keluar dari hidung kiri dengan warna bening kekuningan, dan bayi itu menunjukkan tangisan nada tinggi. Meningitis bakteri ditetapkan dari analisis cairan serebrospinal. Setelah meningitis diobati, perbaikan bedah reposisi meningocele dan perbaikan cacat tulang dilakukan pada usia 40 hari. Kesimpulan: Dalam kasus kami, meningocele basal secara tidak sengaja didiagnosis dengan CT scan wajah yang mengeksplorasi penyebab choana atresia. Sangat penting untuk mendeteksi choana atresia sejak lahir, segera mengeksplorasi etiologinya, dan mengelolanya dengan baik untuk mencegah komplikasi yang mengancam jiwa. Kata kunci: obstruksi hidung, meningocele basal kongenital
Co-Authors Maria Goretti Marianti Purwanto Metta Lestari Utami Welly Rustanto