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All Journal Cermin Dunia Kedokteran Jurnal Penyakit Dalam Indonesia Cermin Dunia Kedokteran
Johan, Michael
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Health Professions Medicine & Pharmacology Public Health

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Evaluasi dan Tatalaksana Hipernatremia Johan, Michael
Cermin Dunia Kedokteran Vol 48, No 6 (2021): Kardiologi
Publisher : PT. Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (152.821 KB) | DOI: 10.55175/cdk.v48i6.1441

Abstract

Hipernatremia didefinisikan sebagai kondisi kadar natrium plasma lebih dari 145 mmol/L. Penyebab hipernatremia bisa dari kehilangan air atau peningkatan kadar natrium. Kehilangan air dapat berupa kehilangan air saja seperti pada keadaan diabetes insipidus atau kehilangan cairan hipotonik seperti pada kehilangan air dari ginjal, gastrointestinal, ataupun kulit. Peningkatan kadar natrium biasanya akibat pemberian cairan hipertonik yang kurang tepat atau iatrogenik. Diagnosis berdasarkan durasi hipernatremia, identifikasi penyebab kehilangan cairan, penilaian status volume, dan osmolaritas urin. Tatalaksana meliputi koreksi penyebab dan koreksi defisit air.Hypernatremia is defined as a condition with a plasma sodium level of more than 145 mmol/L. The cause of hypernatremia can be from water loss or increased sodium level. Loss of water can be in the form of water loss alone, such as in diabetes insipidus or hypotonic fluid loss such as loss of water from the kidneys, gastrointestinal tract, or skin. Increased sodium level is usually the result of improper administration of hypertonic fluids. Diagnostic approach to hypernatremia is based on the duration of hypernatremia, identification of the cause of fluid loss, assessment of volume status, and urine osmolarity. Treatment includes correction of the underlying cause and correction of free water deficits. 
Herpes Zooster Induced Diabetic Ketoacidosis Suwita, Christopher Surya; Johan, Michael; Tahapary, Dicky L.; Darmowidjojo, Budiman
Jurnal Penyakit Dalam Indonesia Vol. 5, No. 4
Publisher : UI Scholars Hub

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Diabetic ketoacidosis (DKA) is an acute, life-threatening complication of diabetes which is common in daily practice. DKA is the result of severe insulin deficiency and often presents as the first symptom of an undiagnosed diabetes even though it may also appear in individuals with diabetes. Some conditions that can trigger DKA include infections, myocardial infarction, stroke, pancreatitis, trauma, or poor treatment compliance. Skin tissue infections such as herpes zoster are rare inciting factor in DKA. This article will discuss a case of DKA that is triggered by herpes zoster.
Pituitary Apoplexy Induced by Anticoagulant Therapy in Patient with Acute Coronary Syndrome: Laporan Kasus Johan, Michael; Pangestu, Handry
Cermin Dunia Kedokteran Vol 51 No 7 (2024): Kedokteran Umum
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v51i7.1023

Abstract

Pituitary apoplexy defined as bleeding or infarct on pituitary gland often occurs in undiagnosed pituitary tumour. Mechanisms thought to trigger pituitary apoplexy are fluctuations in blood pressure, hormonal stimulation of the pituitary gland, coagulation disorders, or vascular disorders. The case is a male, aged 73 years, from India, with complaints of chest pain in the last four hours. Electrocardiography (ECG) and laboratory examination results lead to an acute coronary syndrome (ACS) event. Patients are given fondaparinux, aspirin, and clopidogrel. On the 4th day of hospitalization, the patient experienced a severe headache, projectile vomiting, and double vision. Radiological examination reveals a pituitary tumour with signs of diffuse haemorrhage compressing the optic chiasma, suggesting a pituitary tumour apoplexy. Hormone function tests show a non-functioning pituitary tumour. The blood thinners were discontinued, vitamin K and dexamethasone were given to reduce the patient symptoms. After a few days, the headaches and double vision began to improve. Head MRI showed stable mass of bleeding. Pituitary tumour may be a relative contraindication to dual antiplatelets and anticoagulants in acute coronary syndromes especially in group with renal or liver comorbidities.
Co-Authors Budiman Darmowidjojo, Budiman Pangestu, Handry Suwita, Christopher Surya Tahapary, Dicky L.