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All Journal Ina Kidney Cermin Dunia Kedokteran Kesmas: Jurnal Kesehatan Masyarakat Nasional (National Public Health Journal)
Mokoagow, Muhammad Ikhsan
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Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

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Successful Management of Thyroid Storm with Continuous Renal Replacement Therapy without Plasma Exchange Mulyadi, Calvin Kurnia; Wardoyo, Elizabeth Yasmine; Sari, Anggraini Permata; Yohanes, Aryan; Sarwono, Johanes; Allisha, Fidkya; Epriliawati, Marina; Mokoagow, Muhammad Ikhsan
Indonesian Journal of Kidney and Hypertension Vol 2 No 2 (2025): Volume 2 No. 2, August 2025
Publisher : PERNEFRI (PERHIMPUNAN NEFROLOGI INDONESIA)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32867/inakidney.v2i2.195

Abstract

Background: Thyroid storm is a life-threatening endocrine emergency that needs urgent management. Conventional therapies, however, may not always yield satisfactory outcome. Hereby, we report a case of refractory thyroid storm with hemodynamic and cardiac instability that showed significant improvement following continuous renal replacement therapy (CRRT) instead of therapeutic apheresis. Case Illustration: A 46-year-old woman presented to the emergency department with severe thyrotoxicosis and pneumonia. On arrival, she was alert and hemodynamically stable. Physical examination revealed rapid irregular heart rate, fever, exophthalmos, diffuse goitre, and bilateral pulmonary rales. Laboratory findings indicated primary thyrotoxicosis, remarkable leukocytosis, and high procalcitonin that was consistent with sepsis. The Burch-Wartofsky score was 65, indicating thyroid storm. Clinical deterioration including loss of consciousness occurred on the next few days with electrocardiography changing into unstable supraventricular tachycardia despite optimal medical treatment administered to manage thyrotoxicosis and infection. Due to a suboptimal response, continuous veno-venous hemofiltration (CVVH) was initiated for 33 hours. This resulted in marked clinical improvement, including a reduction in free thyroxine (fT4), hemodynamic stabilization and recovery of consciousness. Discussion: While therapeutic plasma exchange (TPE) is the recommended adjunctive therapy for refractory thyroid storm according to the ASFA 2016 guidelines, it is often unavailable in many centers, particularly in low-resource settings. CRRT may serve as an alternative, offering hemodynamic stabilization through mechanisms not yet fully understood. Conclusion: CRRT may be considered a safe and effective alternative treatment for thyroid storm in patients who are refractory to standard medical therapy and particularly for those presenting with hemodynamic instability.
Factors Associated with Depression among Type 2 Diabetes Mellitus Patients at a Tertiary Hospital during the COVID-19 Pandemic Mokoagow, Muhammad Ikhsan; Pitawati, Dian; Arisandy, Ditya Nona; Magfira, Nadya; Palupi, Pratiwi Indah; Nasarudin, Jerry; Epriliawati, Marina; Kshanti, Ida Ayu
Kesmas Vol. 17, No. 4
Publisher : UI Scholars Hub

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Diabetes mellitus is a metabolic disorder characterized by chronic hyperglycemia that can cause various complications, economic burdens, and psychosocial issues that eventually lead to depression. This study aimed to describe the prevalence of depression among type 2 diabetes mellitus patients in the Internal Medicine Outpatient Clinic of a South Jakarta tertiary hospital during the COVID-19 pandemic. This cross-sectional study was conducted from May to July 2021. The data were collected consecutively from 100 patients aged 18 years or older who came for regular consultation. The instrument used for determining depression is Beck Depression Inventory-II. The prevalence of depression, a correlation between depression and participants' characteristics, and multivariate analysis for risk factors were determined. The results showed that the prevalence of mild to severe depression based on the BDI-II classification was 17%. Screening showed mild to severe depression predominantly in females above 60 years old, with higher levels of education, obesity grade I, individuals with one or more comorbidities, and those who had diabetes for more than ten years. In this study, having one or more comorbidities was associated with an increased risk of depression in people with diabetes.
Inisiasi Fixed Ratio Combination (FRC) Insulin Glargine/Lixisenatide untuk Orang Dewasa dengan Diabetes Melitus Tipe 2 Mokoagow, Muhammad Ikhsan
Cermin Dunia Kedokteran Vol 50 No 12 (2023): Penyakit Dalam
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v50i12.1014

Abstract

Hyperglycaemia is a medical condition of increased blood glucose levels, which is characteristic of several diseases, especially diabetes mellitus. Diabetes mellitus is currently a global threat to health. A fixed-ratio combination a insulin glargine and lixisenatide (iGlarLixi) is a productcontaining glargine insulin (a long-acting insulin) and lixisenatide (a glucagon-like peptide-1 receptor agonist) in one single injection. Fixed ratio combination offers many clinical benefits for adults with type 2 diabetes mellitus.
Co-Authors Allisha, Fidkya Arisandy, Ditya Nona Epriliawati, Marina Ida Ayu Kshanti Magfira, Nadya Mulyadi, Calvin Kurnia Nasarudin, Jerry Palupi, Pratiwi Indah Pitawati, Dian Sari, Anggraini Permata Sarwono, Johanes Wardoyo, Elizabeth Yasmine Yohanes, Aryan