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M Agung Yudistira Permana
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Graves Disease dengan Gangguan Irama Jantung M Agung Yudistira Permana; Widyanto P Adhy; Nurmalinda Kurniasih Mappapa; Iriyanti Aderina Patola
Medula Vol 10 No 2 (2020): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v10i2.69

Abstract

Hyperthyroidism is an endocrine disorder with the second highest incidence after diabetes, the most common hyperthyroidism (60% -80% of cases) is caused by Graves’ disease. Graves' disease is an autoimmune disorder, the presence of thyroid stimulating immunoglobulin (TSI), or can be called a thyroid stimulating antibody (TSAb) which is secreted in the thyroid gland binding to thyroid stimulating hormone (TSH) receptors in the thyroid gland to stimulate the thyroid gland to produce hormones . In this case, Ms. FF 47th came with thumping chest since one week before came to hospital, accompanied by excessive sweating and trembling hands. There is enlargement of the skin-colored, painless thyroid gland with no firm boundary. From TSH laboratory results <0.1 µU/mL, total T4 and T3 are 157 µg/dL and 8.9ng/dL accompanied by atrial fibrillation on the ECG. Given 3x100mg PTU therapy and oral 3x30mg propanolol obtained good results on the third day of treatment. A long evaluation and monitoring is needed to ensure that the patient has healing.
Emfisema Subkutis dan Simple Pneumothoraks Akibat Tenggelam; Case Report dari Rumah Sakit Tipe D M Agung Yudistira Permana; Ni Ketut Agustiani Sudiar; AA Istri A WIda Purnama Dewi
Medula Vol 10 No 3 (2020): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v10i3.84

Abstract

Drowning is defined as a condition in which acute respiratory disturbances result from immersion of the respiratory tract in a liquid, the third highest cause of death in the world. The process of holding breath can increase the pressure in the alveoli, water entering the respiratory tract will disrupt the surfactant layer, severe multi-organ complications occur, such as cardiac arrest, acute respiratory failure, lactic acidosis even a death. Early resuscitation and management are very important to support the patient's prognosis. This case report will discuss the journey and therapy of post-drowned patients in remote hospitals with limited equipment. An GS 6 years old was taken to the emergency room with a decrease in consciousness after drowning in the sea 1 hour before entering the hospital. The child had drowned for 10 minutes then helped without resuscitation and taken to the emergency room. GCS E2V1M4, HR 170x/min, RR 48x/min, temperature 38.7C and oxygen saturation 45%. During treatment, complications such as pneumothorax and massive subcutaneous emphysema occured . The treatment was done with a minimal invasive infraclavicular incisions method and obtained good results and minimal complications. Evaluation of pulmonary function and post surgical complications are needed during the healing process.
Co-Authors AA Istri A WIda Purnama Dewi Iriyanti Aderina Patola Ni Ketut Agustiani Sudiar Nurmalinda Kurniasih Mappapa Widyanto P Adhy