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All Journal Majalah Kedokteran Bandung Journal of Biomedicine and Translational Research Universa Medicina Medica Hospitalia
Priambada, Dody
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Biochemistry, Genetics & Molecular Biology Dentistry Health Professions Immunology & microbiology Medicine & Pharmacology Nursing Public Health

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Glioblastoma dengan Deep Vein Thrombosis pada pasien COVID-19: Sebuah Laporan Kasus Tugasworo, Dodik; Kurnianto, Aditya; Retnaningsih, Retnaningsih; Andhitara, Yovita; Ardhini, Rahmi; Priambada, Dody; Daynuri, Daynuri
Medica Hospitalia : Journal of Clinical Medicine Vol. 7 No. 1A (2020): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (695.084 KB) | DOI: 10.36408/mhjcm.v7i1A.468

Abstract

Latar belakang: Glioblastoma (GBM) berhubungan dengan peningkatan hiperkoagulabilitas dan peningkatan risiko dari venous thromboembolism (VTE) (termasuk Deep Vein Thrombosis (DVT)). VTE merupakan komplikasi kardiovaskular atau respirasi yang sering ditemukan pada pasien-pasien yang dirawat inap karena COVID-19. Hubungan mengenai VTE pada kasus GBM dan COVID-19 belum pernah dibahas sebelumnya. Laporan kasus ini akan membahas tentang seorang wanita usia 55 tahun dengan GBM dan DVT dengan hasil PCR SARS-CoV-2 positif yang dirawat di RSUP Dr. Kariadi. Laporan kasus: Wanita 55 tahun datang ke rumah sakit dengan nyeri kepala dan nyeri serta bengkak pada tungkai kanan. Pada pemeriksaan laboratorium didapatkan INR 0.92, D-Dimer kuantitatif 46540 ug/L, dan titer fibrinogen kuantitatif 234 mg/dL. Dari USG vena doppler tungkai kanan didapatkan gambaran DVT sepanjang vena tungkai kanan, pada pemeriksaan MRI kepala dan biopsi tumor sesuai dengan gambaran GBM, hasil pemeriksaan foto rontgen thoraks terjadi perburukan gambaran paru, serta pemeriksaan PCR SARS-CoV-2 positif. Pembahasan: Pada pasien ini, kondisi GBM dapat menyebabkan adanya kondisi hiperkoagulabilitas akibat neoangiogenesis, mutase onkogenik, dan aktivitas kronik kaskade koagulasi. Selain itu, infeksi dan inflamasi yang berat berkontribusi dalam berkembangnya DVT, seperti yang ditemukan pada pasien dengan COVID-19 yang parah. Pada pasien rawat inap dengan COVID-19, prevalensi DVT tinggi dan biasanya memiliki outcome yang buruk. Istilah COVID-19 associated coagulopathy (CAC) digunakan untuk menggambarkan perubahan koagulasi pada pasien yang terinfeksi COVID. Simpulan: Peningkatan risiko DVT pada pasien dengan glioblastoma dan infeksi COVID-19 disebabkan hiperkoagulabilitas dan koagulopati akibat sel tumor dan virus SARS-CoV-2. Kata Kunci: glioblastoma, DVT, COVID-19 Introduction: GBM is associated with increased of hypercoagulability and the risk of venous thromboembolism (VTE) (include Deep Vein Thrombosis (DVT)). VTE is a cardiovascular or respiratory complication that is often found in patients with COVID-19. The relationship of VTE in GBM and COVID-19 has not been discussed before. This case report will discuss a 55-year-old woman with GBM and DVT with a positive SARS-CoV-2 treated at Dr. Kariadi Hospital. Case presentation: A 55-year-old woman came to the hospital with cephalgia, pain and redness in the right leg. On laboratory examination, it was obtained INR 0.92, quantitative D-Dimer 46540 ug/L, and quantitative fibrinogen titer 234 mg/dL. Venous doppler USG of right leg showed the imaging of DVT along the venous system in right leg. Head MRI and tumor biopsy showed the imaging of GBM, on the chest X-ray examination showed the deterioration of the lung damage, and positive SARS-CoV-2 with PCR examination. Discusssion: GBM can cause hypercoagulability due to neoangiogenesis, oncogenic mutation, and chronic coagulation cascade activity. In addition, severe infection and inflammation contribute to the development of DVT, as found in patients with severe COVID-19. In hospitalized patients with COVID-19, the prevalence of DVT is high and usually has a poor outcome. The term COVID-19 associated coagulopathy (CAC) is used to describe changes in coagulation in patients infected with COVID-19. Conclusion: Increased risk of DVT in GBM and COVID-19 is because of hypercoagulability and coagulopathy due to tumor cells and SARS-CoV-2 virus. Keywords: glioblastoma, DVT, COVID-19
Penatalaksanaan Wanita Dengan Rinore Lcs Dan Meningoensefalokel Akibat Patensi Sternberg’s Canal Iriani, Desy; Dewi, Anna Mailasari Kusuma; Priambada, Dody
Medica Hospitalia : Journal of Clinical Medicine Vol. 8 No. 1 (2021): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (609.649 KB) | DOI: 10.36408/mhjcm.v8i1.574

Abstract

Latar belakang : Rinore liquor cerebro spinal (LCS) adalah kebocoran LCS yang terjadi karena adanya defek pada basis kranii sehingga terdapat hubungan antara intrakranial dengan cavum nasal. Sternberg’s canal merupakan defek kongenital di dinding lateral sphenoid. Kasus ini menjelaskan etiologi serta penatalaksanaan pasien rinore LCS dan meningoensefalokel. Laporan kasus : Dilaporkan wanita usia 32 tahun dengan keluhan keluar cairan hidung kiri terkadang mengalir deras, hilang timbul selama 1 tahun disertai pusing. Pemeriksaan CT scan menunjukkan defek tulang di lateral sfenoid kiri disertai lesi isodens di sinus sfenoid, hal ini diperjelas dengan hasil MRI yang menggambarkan meningoensefalokel. Pasien dilakukan operasi sfenoidektomi dengan endoskopi kerjasama dokter THT dan Bedah Saraf, dilakukan pemasangan lumbar drain, identifikasi lokasi kebocoran LCS dan pemasangan graft lemak. Evaluasi 6 minggu pasca operasi, keluhan keluar cairan hidung dan pusing sudah tidak ada. Pasien mengalami perbaikan dan peningkatan kualitas hidup. Pembahasan : Kasus rinore LCS mempunyai beberapa etiologi, setelah melalui anamnesis, pemeriksaan fisik dan pemeriksaan penunjang, didapatkan etiologi pada kasus ini yaitu akibat patensi Sternberg’s canal. Pada kasus ini dilakukan penanganan operatif karena keluhan sudah lama dan etiologi sudah jelas. Kerjasama multidisiplin diperlukan, untuk pemasangan lumbar drain dan pemasangan graft lemak dengan kerjasama yang baik. Kesimpulan : Penatalaksanaan rinore LCS dibagi menjadi konservatif dan operatif. Keberhasilan penanganan rinore LCS bergantung pada tajamnya penilaian dokter dalam memutuskan tatalaksana yang tepat agar pasien dapat tertangani dengan cepat sebelum terjadi komplikasi.
Functional Outcome of Biportal Endoscopy Spine Surgery for Lumbar Disc Herniation Diseases Risdianto, Ajid; Andar, Erie; Brotoarianto, Happy Kurnia; Priambada, Dody; Muttaqin, Zainal; Prihastomo, Krisna Tsaniadi; Bakthiar, Yuriz; Arifin, Muhammad Thohar
Majalah Kedokteran Bandung Vol 57, No 3 (2025)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15395/mkb.v57.4128

Abstract

Biportal endoscopic spine surgery (BESS) is an innovative, minimally invasive technique to treat lumbar disc herniation (LDH). BESS provides superior surgical visualization with minimal tissue dissection. However, its application requires a thorough understanding of endoscopic anatomy and adaptation of endoscopy equipment, which are key factors in achieving optimal functional outcomes post-surgery. This study aimed to evaluate the functional outcomes and complications of BESS performed on 49 patients between 2020 and 2022 at Dr. Kariadi Hospital, Semarang, Indonesia. The majority of patients (53%) had herniation at the L4-5 level, followed by L5-S1. Pain assessment using the Visual Analog Scale (VAS) demonstrated a significant reduction in pain, from 4.26 to 1.5, post-surgery. Functional outcomes, as evaluated using MacNab’s Criteria, revealed that 93.8% of patients achieved a satisfactory condition, with 36.7% reporting no pain and 57.1% experiencing occasional pain that did not affect their daily activities. Complications were minimal, with two cases of dural tears and intraoperative bleeding. The study concludes that BESS is a safe and effective procedure for LDH, resulting in significant pain relief and functional improvement, although certain technical challenges persist.
Cushing’s syndrome manifesting as chronic insomnia caused by adrenal cortical adenoma with incidental pituitary microadenoma: a case report Rakhmayanti, Rizky; Minuljo, Tania Tedjo; Suryawati, Herlina; Fitrikasari, Alifiati; Soedarso, Mohamad Adi; Priambada, Dody
Journal of Biomedicine and Translational Research Vol 7, No 1 (2021): April 2021
Publisher : Faculty of Medicine, Universitas Diponegoro

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14710/jbtr.v7i1.9247

Abstract

Background: Cushing’s syndrome is condition caused by excessive glucocorticoid with insomnia as one of its neuropsychiatric manifestation. Cushing’s syndrome may be caused by excessive adrenocorticotropin hormone (ACTH-dependent), for example from ACTH producing pituitary tumors, or by overproduction of cortisol by adrenocortical tumors. In this report, we presented a case with Cushing’s syndrome manifesting as chronic insomnia with adrenal cortical adenoma and pituitary microadenoma.Case presentation: A 30-year-old woman was consulted from the Neurologic Department to the Internal Medicine Department with the chief complaint of insomnia and worsening headache since 6 months prior to the admission. She had undergone head MRI and abdominal CT scan previously and was found to have both pituitary microadenoma and left adrenal mass. From the physical examination she had clinical signs of Cushing’s syndrome like Cushingoid face and purplish striae on her stomach. Midnight cortisol serum examination was done initially and showed high level of cortisol. High dose dexamethasone suppression test or DST (8 mg overnight) was later performed to help determine the main cause of Cushing’s syndrome. The result failed to reach 50% suppression of cortisol serum, suggestive that the Cushing’s syndrome was not ACTH-dependent from the pituitary but potentially from overproduction of cortisol by the left adrenal mass. Therefore, left adrenalectomy was performed and the histopathological study supported the diagnosis of adrenal cortical adenoma.Conclusion: Chronic insomnia is a very important symptoms of Cushing’s syndrome that should not be neglected. The patient had both microadenoma pituitary and left adrenal mass thus high dose DST test (8 mg overnight) needed to be performed to differentiate the source of Cushing’s syndrome. The result showed only little suppression therefore the pituitary microadenoma was not the source of Cushing’s syndrome and more suggestive from the adrenal etiology.
The survival benefits of adjuvant radiotherapy for malignant meningioma: a retrospective cohort study Bakhtiar, Yuriz; Eka Setiawan, Fariz; Ilmansyah, Rafi; Prihastomo, Krisna Tsaniadi; Priambada, Dody; Rizky Aryani Septarina, Faiza; Arifin, Muhamad Thohar; Muttaqin, Zainal
Universa Medicina Vol. 44 No. 3 (2025)
Publisher : Faculty of Medicine, Universitas Trisakti

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2025.v44.318-327

Abstract

BackgroundMalignant meningiomas (MM) are rare aggressive tumors associated with poor survival outcomes. Due to their rarity, there is limited data on the outcomes and prognostic factors of MM patients, particularly on adjuvant radiotherapy roles in this tumor population. This study aims to investigate the clinical characteristics, prognostic factors, and survival outcomes of MM with focus on survival benefits of adjuvant radiotherapy. MethodsThis retrospective cohort study analyzed 19 MM patients, who were initially subjected to postoperative radiotherapy, at Dr. Kariadi General Hospital, Semarang, from 2013 to 2023. Kaplan-Meier analysis was used to estimate survival rates at 1, 2, and 5 years. Univariate and multivariate Cox regression analyses were performed to identify factors associated with overall survival (OS). Variables with a p-value ≤ 0.25 in univariate analysis were included in the multivariate models. ResultsThe median OS was 16 months (95% CI 0.0–40.2), with estimated 1-year, 2-year, and 5-year survival rates of 52.6%, 42.1%, and 15.8%, respectively. Adjuvant radiotherapy (RDT) was associated with a significantly improved OS (p<0.001). However, sex, age, tumor location, and extent of resection did not show a significant association with OS. Cox regression showed that RDT had no statistically significant effect on OS in the multivariate model (HR = 0, 95% CI 0–1.8, p=0.923). ConclusionAdjuvant radiotherapy is critical for improving OS in MM patients, and gross-total resection (GTR) alone does not guarantee better long-term outcomes. Further studies with larger cohorts and molecular analysis are necessary to refine treatment strategies for MM.
Co-Authors Ajid Risdianto Alifiati Fitrikasari Andar, Erie Andhitara, Yovita Ardhini, Rahmi Bakhtiar, Yuriz Bakthiar, Yuriz Brotoarianto, Happy Kurnia Daynuri, Daynuri Dewi, Anna Mailasari Kusuma Dodik Tugasworo Eka Setiawan, Fariz Ilmansyah, Rafi Iriani, Desy Kurnianto, Aditya Minuljo, Tania Tedjo Muhamad Thohar Arifin Muhammad Thohar Arifin Prihastomo, Krisna Tsaniadi Rakhmayanti, Rizky Retnaningsih Retnaningsih Rizky Aryani Septarina, Faiza Soedarso, Mohamad Adi Suryawati, Herlina Zainal Muttaqin