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All Journal Majalah Anestesia & Critical Care (MACC) Deka in Medicine
Maulidiyah, Novita
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Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Public Health

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Successful resolution of mesenteric tuberculosis and HIV co-infection following 6 months of anti-tuberculosis therapy: a case report Maulidiyah, Novita; Wicaksono, Ramadi; Retnowulan, Aisyah; Santoso, Budi; Subianto, Aries; Mashudi, Latifah; Kurniawan, Fajar
Deka in Medicine Vol. 1 No. 1 (2024): April 2024
Publisher : PT. DEKA RESEARCH INSTITUTE

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.69863/dim.v1i1.2

Abstract

BACKGROUND: Mesenteric tuberculosis (TB), a rare extrapulmonary variant of TB, poses diagnostic and therapeutic challenges in its management. Therefore, discussing a case of mesenteric TB is both intriguing and informative for gaining insights into its clinical presentation and optimal treatment strategies. CASE PRESENTATION: A 50-year-old male presented symptoms of blackish stools three days post-gallstone surgery, accompanied by approximately two months of abdominal discomfort, described as squeezing or stabbing, alleviated temporarily by analgesics, alongside abdominal distension, rigidity, decreased appetite, and afternoon fevers. Physical examination revealed normal vital signs, with pale conjunctiva and asymmetrical chest wall movement, dull percussion, and decreased breath sounds in the lower left hemithorax. Abdominal inspection indicated distension, postsurgical signs, and ascites. Following laboratory investigations, chest and abdominal radiographs, and tissue biopsies, the patient was diagnosed with HIV co-infection along with pulmonary and mesenteric TB. Treatment comprised an intensive phase of four fixed-dose combinations (FDC) of anti-TB drugs, followed by a continuation phase of two FDC tablets, alongside first-line antiretroviral (ARV) therapy and cotrimoxazole prophylaxis. By the sixth month follow-up, clinical improvement was observed, with resolution of symptoms and weight gain to 56 kg. CONCLUSION: This case highlights the effective management of mesenteric TB and HIV co-infection, emphasizing the importance of comprehensive care and collaborative efforts between TB and HIV/AIDS control programs.
Right ventricular strain: Cardiovascular challenges in pulmonary diseases Rahmianti, Nia; Vendarani, Yoni; Maulidiyah, Novita
Deka in Medicine Vol. 1 No. 3 (2024): December 2024
Publisher : PT. DEKA RESEARCH INSTITUTE

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.69863/dim.2024.e359

Abstract

Right heart failure is associated with a poor prognosis, and right ventricular (RV) strain, assessed through echocardiography, is a valuable method for evaluating right heart function. However, discussions on this topic remain limited. This article explores RV strain induced by pulmonary diseases to increase awareness of how these conditions can exacerbate right heart failure. Pulmonary embolism leads to increased RV afterload, resulting in RV dilation and ischemia, which can progress to cardiogenic shock. Echocardiography is effective in detecting RV strain and assessing the severity of pulmonary embolism. In Chronic Obstructive Pulmonary Disease (COPD), increased pulmonary vascular resistance causes RV dysfunction, identifiable through speckle-tracking echocardiography (STE). Pulmonary fibrosis may contribute to right heart failure through pulmonary hypertension. RV Longitudinal Strain (RVLS) is an important prognostic marker in patients with pulmonary hypertension and COVID-19, where low RVLS (≤20.5%) is associated with higher mortality. In conclusion, right heart failure carries a poor prognosis, and RV strain evaluation using STE is a useful tool for early detection. Pulmonary diseases, including COPD, pulmonary embolism, pulmonary fibrosis, pulmonary hypertension, and COVID-19, can induce RV strain, which is critical for assessing prognosis and guiding disease management.
Severe Respiratory Acidosis in Acute Exacerbation COPD, Is that Possible to Treat? Siti Wahdiyati; Limalvin, Nicholas Prathama; Maulidiyah, Novita; Limantara, Ferry; Kurniawan, Fajar
Majalah Anestesia & Critical Care Vol 42 No 3 (2024): Oktober
Publisher : Perhimpunan Dokter Spesialis Anestesiologi dan Terapi Intensif (PERDATIN) / The Indonesian Society of Anesthesiology and Intensive Care (INSAIC)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55497/majanestcricar.v42i3.395

Abstract

Introduction: Chronic obstructive pulmonary disease (COPD), currently the third leading cause of death worldwide, is a common condition characterized by progressive airflow limitation and tissue destruction. Patients with COPD may present to the Emergency Room (ER) with severe acute exacerbations (AECOPD), which can be associated with acute respiratory failure—a life-threatening condition with a mortality rate approaching 50% in Indonesia—requiring rapid intervention and ICU admission. In this report, we present a severe respiratory acidosis in AECOPD case with successful emergency followed by ICU management and the frequent pitfalls. Case Illustration: In this report we present a-67 years old male, pedicab driver and smoker came to the ER with acute onset shortness of breath and decrease of consciousness with history of shortness of breath in last 10 years. In primary survey we found clear wheezing sound, tachypnea, intercostal retraction, decrease of peripheral oxygen saturation, tachycardia and verbal respond of consciousness. Blood gas analysis result interpreted severe respiratory acidosis with pH 6.90 and pCO2 128.5 mmHg. Chest radiograph showed infiltrate that became the cause of exacerbation. Endotracheal intubation was performed due to decreased consciousness, persistent tachypnea and pCO2 over 100 mmHg. This patient was hospitalized for 12 days including 9 days in ICU followed by 3 days in regular ward. Conclusion: The goal for AECOPD management is to minimize and prevent the negative effects of the exacerbation.
Co-Authors Dwi Budi Santoso Fajar Kurniawan Limalvin, Nicholas Prathama Limantara, Ferry Mashudi, Latifah Rahmianti, Nia Retnowulan, Aisyah Siti Wahdiyati Subianto, Aries Vendarani, Yoni Wicaksono, Ramadi