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All Journal UMI Medical Journal The International Journal of Medical Science and Health Research
Haizah Nurdin
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Biochemistry, Genetics & Molecular Biology Dentistry Education Health Professions Immunology & microbiology Medicine & Pharmacology Nursing Public Health Veterinary

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Renal Replacement Therapy sebagai Intervensi Dini pada Tatalaksana Ketoasidosis Diabetik Gusti Andhika Kusuma; Haizah Nurdin; Syamsu Hilal Salam; Ari Santri Palinrungi
UMI Medical Journal Vol 8 No 1 (2023): UMI Medical Journal
Publisher : Fakultas Kedokteran Universitas Muslim Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33096/umj.v8i1.204

Abstract

Ketoasidosis diabetikum (KAD) adalah gangguan metabolik akut yang secara primer ditandai dengan peningkatan badan keton dalam sirkulasi yang berlanjut menjadi ketoasidosis berat dengan hiperglikemia tidak terkontrol akibat defisiensi insulin. Ketoasidosis diabetik menyebabkan tingkat morbiditas dan mortalitas yang tinggi meskipun terapi diabetes telah berkembang. Aspek krusial dari tata laksana KAD meliputi pemberian cairan dan elektrolit, dalam jumlah adekuat, dan pemberian insulin secara terus menerus. Pasien dengan KAD sering datang dalam keadaan asidosis metabolik berat dan hiperkalemia yang disertai dengan penurunan kesadaran dan gangguan pernapasan sehingga memerlukan tindakan yang tepat dan perawatan intensif. Laporan kasus ini mengenai perempuan umur 20 tahun mengalami penurunan kesadaran. Pada pemeriksaan ditemukan kadar glukosa darah: 742 mg/dL, dan dari analisis gas darah menunjukkan asidosis metabolik berat (pH: 7,13; HCO3: 4,1 pCO2: 10,9) dan keton urine (+). Terapi KAD yang diberikan diruang ICU meliputi koreksi dehidrasi, terapi insulin untuk kontrol glukosa darah, menejemen infeksi dan koreksi ketidakseimbangan elektrolit serta terapi intervensi lain seperti ventilasi mekanik dan CRRT. Setelah perawatan hari kelima kondisi pasien mulai stabil dan dapat pindah ke perawatan ruangan. Penatalaksanaan yang tepat pada pasien KAD dapat memberikan keluaran yang baik pada pasien.
Modified Radical Mastectomy (MRM) in Geriatric Patients with Thoracic Epidural Anesthesia (TEA) Technique : A Case Report Kharisma Saeraya; Faisal Sommeng; Haizah Nurdin
The International Journal of Medical Science and Health Research Vol. 15 No. 6 (2025): The International Journal of Medical Science and Health Research
Publisher : International Medical Journal Corp. Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.70070/vkwqnk93

Abstract

Introduction: Modified Radical Mastectomy (MRM) is one of the main procedures in the management of breast cancer. Thoracic Epidural Anesthesia (TEA) has been known to be an effective technique in delivering superior analgesics and reducing the need for opioids, especially in patients at high risk of general anesthesia. Case: An 80-year-old woman with advanced right breast cancer underwent an MRM procedure using the thoracic epidural anesthesia technique as the primary modality. An epidural catheter is inserted at the T4/T5 interspatial, with the sensory block reaching the clavicle up to three fingers below the mamma line bilaterally. The surgery lasted for 60 minutes without complications, and the patient showed good hemodynamic stability throughout the procedure. Postoperative pain control is obtained with epidural bupivacain infusion and multimodal therapy. The patient was discharged on the fourth postoperative day in a stable condition. Conclusion: TEA is safe and effective for MRM procedures, also in elderly patients. TEA deserves to be considered as an alternative or complementary to general anesthesia in breast surgery, especially in high-risk patient population.
Co-Authors Ari Santri Palinrungi Gusti Andhika Kusuma Kharisma Saeraya Rahmawati Sommeng, Faisal Syamsu Hilal Salam