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CRANIAL ULTRASOUND: EFFICIENT SCREENING TOOL FOR EARLY DETECTION OF BRAIN INJURY IN PRETERM INFANTS Erawati, Dini Rachma; Yueniwati, Yuyun
MNJ (Malang Neurology Journal) Vol. 7 No. 1 (2021): January
Publisher : PERDOSSI (Perhimpunan Dokter Spesialis Saraf Indonesia Cabang Malang) - Indonesian Neurological Association Branch of Malang cooperated with Neurology Residency Program, Faculty of Medicine Brawijaya University, Malang, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mnj.2021.007.01.2

Abstract

Background: Cranial ultrasound becomes an important diagnostic tool to evaluate brain injury in infants. Brain injury is a major complication for preterm birth. The brain injury of preterm infants differs from that of a term infant. Brain injury has correlation with gestational age and mode of delivery.Objective: To analyze the correlation between cranial ultrasound findings with gestational age and mode of delivery and to reveal if cranial ultrasound can be used to detect brain injury in premature infants.Methods: An observational analytic study using cross-sectional design took place in Saiful Anwar Hospital Malang, Indonesia. 38 healthy preterm infants underwent cranial ultrasound examination within the first four day of life. Fisher Exact test was used to analyze the correlation between cranial ultrasound findings with gestational age and mode of delivery.Results:  Most of  the healthy preterm infants (89.5%) were  ≥ 32 weeks gestational age, and 52.6% of samples had caesarean section as their mode of delivery. There were three abnormal findings in cranial ultrasound; increased periventricular echogenic (5.3%), increased parenchym echogenic (5.3%), and indistinguishable of gray-white matter differentiation (5.3%). There was no significant correlation between abnormal cranial ultrasound findings with gestational age and mode of delivery (p= 0.202; p= 0.218).Conclusion: There were abnormal cranial ultrasound findings in some healthy preterm infants despite no significant correlation between ultrasound findings with gestational age and mode of delivery. Cranial ultrasound in preterm infants could become a screening tool for early detection of brain injury.
Bone metastases tend to increase in non-small cell lung cancer with epidermal growth factor receptor mutation Maleachi, Reginald; Erawati, Dini Rachma; Pratiwi, Suryanti Dwi; Andarini, Sri
Universa Medicina Vol. 41 No. 1 (2022)
Publisher : Faculty of Medicine, Universitas Trisakti

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2022.v41.4-10

Abstract

BackgroundIncreased understanding in molecular pathology of advanced non-small cell lung cancer (NSCLC) over the past decades has led to personalized treatment approaches being advocated. Epidermal growth factor receptor (EGFR) mutation that often occurs in NSCLC can be identified using immunohistochemical examinations. Moreover, clarifying the relationship between computed tomography (CT) and EGFR mutation of NSCLC might inform therapeutic decision-making. The purpose of this study was to determine the relationship between metastatic sites on primary chest CT-scan and EGFR mutation in NSCLC lung cancer patients. MethodsAn cross-sectional design using secondary data was conducted, involving 76 NSCLC patients. EGFR mutations were determined by immunohistochemical examination and metastatic sites by chest CT-scan with contrast. The collected metastatic sites comprised hilar and mediastinal lymphadenopathy, pulmonary nodules, and bone, liver, spleen and suprarenal metastases. A Chi square test was used to analyze the data. ResultsThis study revealed that the highest NSCLC stage was IVb, found in 39 samples (51.3%), while 34 (44.7%) subjects had EGFR mutation. There was no statistically significant difference between metastatic site and positive EGFR mutation, although positive bone metastases (54.8%) tend to have more numerous positive EGFR mutations compared to negative bone metastases (37.7%) (p=0.142). ConclusionsPatients with positive bone metastases tend to have higher positive EGFR mutation compared to negative bone metastases in NSCLC lung cancer patients. Prospective studies evaluating patients with EGFR mutation for bone metastases should be considered. This can provide information on therapeutic decision-making to obtain good clinical outcomes.
Myocardial Infiltration in Primary Mediastinal B-Cell Lymphoma Detected by Cardiac Magnetic Resonance Imaging Sutedjo, Verawati; Soewondo, Widiastuti; Yuniarti, Mira; Tenggara, Jeffry Beta; Erawati, Dini Rachma
Indonesian Journal of Cancer Vol 17, No 4 (2023): December
Publisher : http://dharmais.co.id/

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v17i4.966

Abstract

Introduction: Cardiac involvement, particularly myocardial infiltration in primary mediastinal lymphoma, is a rare occurrence with an incidence of only 9% in known cases of primary malignancy. Neoplasm infiltration into the myocardium manifests through direct invasion, hematogenous spread, transvenous invasion through the great veins, or lymphangitic spreading in the mediastinal. Myocardial infiltration in lymphoma presents a grim prognosis and its treatment may be associated with specific risks, such as myocardial rupture. Various imaging modalities may detect cardiac involvement, with cardiac magnetic resonance (CMR) imaging considered the gold standard. CMR enables clear delineation of myocardial infiltration, making it valuable for local staging, pretreatment planning, and evaluating treatment response. Case Presentation: : A 37-year-old woman patient was diagnosed with primary mediastinal large B-cell lymphoma. Mild chest discomfort and shortness of breath were observed 3 months before hospital admission. A thorax CT scan showed a heterogeneous contrast-enhancing mass with a central necrotic area in the anterior mediastinum. Following thoracotomy and tumor debulking, the patient complained of severe crushing chest pain radiating to her back, accompanied by new T wave inversion on ECG and elevated cardiac troponin levels a week after surgery. Coronary angiogram results showed a normal coronary artery. Subsequent cardiac MRI showed tumor infiltration into the anterior pericardial space, as well as the myocardium of the left and right ventricles. Chemotherapy was promptly initiated, resulting in a gradual improvement of symptoms. Conclusions: In this study, we discuss the use of 3D-CRT in the re-irradiation of NPC with its limitation on obtaining optimum dose sculpture compared to more sophisticated and widely spread modalities like IMRT. However, with careful planning, we can still obtain optimum tumor dose, minimize OAR dose, and subsequently late toxicities that come after. We hope that this study can bring hope to centers with limited facilities, and we suggest further studies on reirradiation, especially in OAR dose tolerance guidelines. 
Strengthening Moral and Material Support for Lupus Patients and Their Families at the Kupu Parahita Indonesia Foundation Through Cinematherapy Handono, Kusworini; Dewi, Elvira Sari; Desfryda, Elynca Putri; Dwinadella, Sephia; Putri, Choirinnisa Meilia Ayu; Kalim, Handono; Wahono, Cesarius Singgih; Barlianto, Wisnu; Erawati, Dini Rachma; Pratama, Mirza Zaka; Sari, Tita Luthfia; Nurdiana, Nurdiana; Kusuma, Zaenal
Journal of Innovation and Applied Technology Vol 9, No 2 (2023)
Publisher : Lembaga Penelitian dan Pengabdian Kepada Masyarakat Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jiat.2023.9.2.13

Abstract

Lupus patients and their families require adequate support to manage the disease's progression. This community service aims to help the Kupu Parahita Indonesia Foundation provide strengthened moral and material support for lupus patients and their families at the Kupu Parahita Indonesia Foundation. Results: The cinematherapy planned by the PKNM and Community Service Team received much positive feedback from patients and families. The sharing session expressed that patients and their families are grateful for the opportunity to enjoy free recreation together. Enthusiasm comes with enthusiasm to meet people with fellow lupus. . In conclusion, cinematherapy can help the Kupu Parahita Indonesia Foundation provide lupus patients and their families with more substantial moral and material support.
Correlation Between Changes in NLR Value and RECIST among Lung Cancer Patients at Saiful Anwar Malang Hospital Kristianto, Fransiskus; Setyawan, Ungky Agus; Erawati, Dini Rachma
Respiratory Science Vol. 5 No. 1 (2024): Respiratory Science
Publisher : Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497/respirsci.v5i1.141

Abstract

Background: In practice, clinicians use Response Evaluation Criteria in Solid Tumors (RECIST) to decide the progressivity of lung tumors. Besides RECIST, there is an inflammatory marker called Neutrophil to Lymphocyte Ratio (NLR), which has prognostic value in cancer patients. Many previous studies have shown that NLR can predict the prognosis because inflammation in cancer patients is part of the tumor progressivity.  Therefore, the changes in NLR value have the potency to be one of the ways to decide the progressivity of tumors in lung cancer patients. Method: This cross-sectional study was conducted to see whether there is a correlation between RECIST and NLR in 95 lung cancer patients at Saiful Anwar Hospital whose data were taken from January 2022 to May 2023. The variable will be tested using the chi-square test to see the correlation and the logistic regression method to obtain the odds ratio. Results: There is a significant correlation between changes in NLR and RECIST with P=0.041.  Through Logistic Regression Analysis, the value of the odds ratio is 2.46 (CI 95%=1.03-5.94).  In the group with progressive RECIST, the average NLR value after therapy was higher than the average NLR value after therapy in the non-progressive group. Conclusion: This study concludes that changes in NLR value have the potency to help the determination process of lung cancer progressivity as RECIST does.
Correlation of Brixia Score Changes with Length of Stay in Patient with COVID-19 Sutedjo, Verawati; Soewondo, Widiastuti; Erawati, Dini Rachma
Indonesian Journal of Medicine Vol. 7 No. 3 (2022)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (31.13 KB)

Abstract

Background: The increase in Covid-19 cases in Indonesia as well as the hospital length of stay is unpredictable. The degree of lung damage in Covid-19 largely determines the severity of the disease, a serial chest X-ray using Brixia score can be used to assess changes in pulmonary parenchymal damage and could predict the length of hospitalization. This study aims to analyze the correlation of Brixia score with the length of hospitalization in Covid-19 patients.Subjects and Method: This cross-sectional study was conducted at Sumber Waras Hospital from November 2021 until January 2022. The samples are Covid-19 confirmed patients who were treated at Sumber Waras hospital. Independent variable is Brixia score and dependent variable is length of hospitalization. Brixia's score assessment from two serial chest X-rays was divided into 4 categories: low to low, low to high, high to low, and high to high. All the categories were analyzed using Kruskall-Wallis method then continued with Mann-Whitney U test. The multivariate variable was analyzed using linear regression.Results: There are 190 samples, the median score of Brixia at the beginning of treatment is 4 (range 0-18), and the median score of Brixia on serial examination is 6 (range 0-18). Patients in low to low category had median 10 days length of hospitalization, low to high category and high to low category had median 11 days, and high to high category had median 8 days. There was no statistically significant correlation between Brixia score and length of hospitalization (p= 0.377).Conclusion: There is no significant relationship between the median Brixia score changes with the length of hospitalization of covid-19 patients.Keywords: Covid-19, hospitalized, Brixia score changes, length of stayCorrespondence: Widiastuti Soewondo. Faculty of Medicine Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta, Central Java, Indonesia. Mobile: +6282134368592. Email: widiastuti.sprad56@staff.uns.ac.id.Indonesian Journal of Medicine (2022), 07(03): 262-268https://doi.org/10.26911/theijmed.2022.07.03.02
Cohort Patient Evaluation of Lung Condition 9 Months after Severe Covid 19 Mahendra, Reza Aditya; Rakhma , Sastia; Sugiri, Yani Jane Rosihaningsih; Djajalaksana, Susanthy; Erawati, Dini Rachma
Malang Respiratory Journal Vol. 7 No. 1 (2025): March 2025 Edition
Publisher : Universitaas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mrj.2025.007.01.02

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Introduction: COVID-19 is an infection caused by novel coronavirus Serious Acute Respiratory Syndrome (SARS)-CoV-2. About 20% patients with severe symptoms could become critically ill. In this case report, we present a case with severe COVID-19 infection. Case report: Mr. SA, a 54-year-old patient came to the hospital with chief complaint of dry cough. Patient had fever for 2 days and myalgia. Patient had a history of well-controlled hypertension. X-ray examination showed worsening consolidation and CT-scan showed pleural effusion. Patient was treated with convalescent plasma therapy, IVIG, and symptomatic drugs. The patient was diagnosed with confirmed case of severe COVID-19, stage I hypertension, hypercoagulable state, CCS, and grade I obesity. The Evaluation of this patient consist of CT Scan, Lung Function using a Body Plethysmograph that will followed for 9 month after the patient discharged. Conclusion: There had been a few therapeutic options for COVID-19 but no definitive treatment yet. IVIG and convalescent plasma had been used for the treatment of SARS-CoV and MERS-CoV. As such, these treatments were also used in COVID-19 treatment with promising results. Keywords: COVID-19, IVIG, convalescent plasma
Hydrocarbon Pneumonitis After Repeated Exposure and Gasoline Aspiration with Differential Diagnosis Lung Tuberculosis Setiadi, Satya; Rakhma, Sastia; Chozin, Iin Noor; Astuti, Tri Wahyu; Sugiri, Yani Jane R.; Yudhanto, Hendy Setyo; Erawati, Dini Rachma
Malang Respiratory Journal Vol. 7 No. 1 (2025): March 2025 Edition
Publisher : Universitaas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mrj.2025.007.01.05

Abstract

Introduction: Chemical pneumonitis is an uncommon condition. Hydrocarbon pneumonitis is a kind of chemical pneumonitis. The features of this disease are atypical and may manifest either abruptly or persistently. Lung tuberculosis is an endemic illness in Indonesia, with an estimated 969,000 patients exhibiting diverse characteristics that may resemble chemical pneumonitis. Case Report: A 29-year-old gas station attendant with a history of recurrent exposure to gasoline vapours and episodes of asphyxiation while syphoning gasoline. A thoracic CT scan with contrast reveals several bilateral nodules with a tree-in-bud pattern, suggestive of pulmonary tuberculosis, with chemical pneumonitis as a differential diagnosis. Utilising clinical data, including occupational history, body plethysmography and spirometry results (moderate restrictive), laboratory findings, CT scan pictures, and Volatile Organic Compound analysis (elevated hydrocarbon levels), the patient is diagnosed with hydrocarbon pneumonitis. Discussion: The differential diagnosis was excluded through the analysis of sputum using molecular rapid test, IGRA test, LJ culture, and AFB of bronchial washing fluid. The administration of inhaled corticosteroids is a viable therapeutic option for this situation. Following six months of medication and exposure avoidance, the patient's condition has been improving. The patient was initially diagnosed with suspected lung tuberculosis based on a thoracic CT scan with contrast revealing bilateral multiple nodules exhibiting a tree-in-bud pattern. However, considering the patient's occupational history involving exposure to gasoline vapour and a history of choking on gasoline, the radiological findings ultimately confirmed a diagnosis of hydrocarbon pneumonitis. Case management may be determined by the severity level; however, due to its rarity, no primary treatment option exists. Conclusion: Hydrocarbon pneumonitis is infrequently encountered in comparison to pulmonary tuberculosis. Inhaled corticosteroids are a treatment alternative that yields clinical improvement. This example illustrates those rare diseases, such as hydrocarbon pneumonitis, can mimic pulmonary tuberculosis.
Aspergilloma: Clinical Manifestation After Tuberculosis Infection Winarni, Tika Wahyu; Erawati, Dini Rachma
International Journal of Radiology and Imaging Vol. 1 No. 01 (2022): International Journal of Radiology and Imaging
Publisher : Department of Radiology, Medical Faculty, University of Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (346.004 KB) | DOI: 10.21776/ub.ijri.2022.001.01.2

Abstract

Aspergilloma is a mass-like fungus ball consisting of Aspergillus fumigatus. Aspergilloma occurs in patients with pulmonary structural abnormalities in which the presence of a previous cavity is the predisposing factor that most often results in Aspergillus colonization, especially in tuberculosis endemic countries. 28 y.o and  33 y.o female , complained of hemoptysis, chest pain, weight loss, and a history of TB treatment. The chest X-ray and CT scan revealed a solid lesion with an “Air-crescent sign” indicating Aspergilloma lesion. Patients were given symptomatic, anti-fungal drugs, and supported  by embolization procedure to reduce hemoptysis. The patient's condition began to improve after treatment. Imaging findings in x-rays and CT scans that point to Aspergilloma will help doctors in further management to provide a better prognosis for the patient.
ABNORMAL FREE GAS COLLECTION IN RADIOGRAPHY: A PICTORIAL REVIEW Tjakraatmadja, Ricardo; Erawati, Dini Rachma
International Journal of Radiology and Imaging Vol. 1 No. 01 (2022): International Journal of Radiology and Imaging
Publisher : Department of Radiology, Medical Faculty, University of Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (424.62 KB) | DOI: 10.21776/ub.ijri.2022.001.01.3

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An abnormal free gas collection in the thorax and abdomen is a condition which is present of abnormal air in the thorax and abdominal cavity that normally not found. Radiological examination plays very important role to detect the presence of abnormal gas, the volume, the location, and the complication. Some of these conditions can represent classic radiological appearance that we can find in everyday practice.