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Exogenous Cushing Syndrome: When do We Get the Benefit of Glucocorticoid Stress Dose? Soelistijo, Soebagijo Adi; Gunawan, Hendra; Primasatya, Chandra Adi Irawan; Ariana, Audy Meutia; Mudjanarko, Sony Wibisono; Pranoto, Agung
Jurnal Penyakit Dalam Indonesia Vol. 7, No. 3
Publisher : UI Scholars Hub

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Exogenous cushing syndrome is the most common cushing syndrome found in clinical practice. Its most frequent etiology is the adverse effect of glucocorticoid therapy found in clinical practice or in the form of traditional medicine. The clinical manifestations of exogenous cushing syndrome are similar to the spontaneous counterpart, albeit with the presence of glucocorticoid consumption. We present a case series of exogenous cushing syndrome due to traditional medicine and glucocorticoid consumption with opportunistic infection as its initial manifestation. The first case did not need glucocorticoid supplementation while it was initiated in the second case. Comprehensive management of exogenous cushing syndrome should involve the decision of giving glucocorticoid stress dose, treatment to the underlying disease and education in order to prevent self-glucocorticoid consumption.

Approach to Refractory Hypoglycaemia in a Patient with Hepatocellular Carcinoma: A Case Study and Literature Review Audy Meutia Ariana; Ganjar Adityo Permadi; Hermawan Susanto
Journal of Agromedicine and Medical Sciences Vol 10 No 1 (2024)
Publisher : Faculty of Medicine, Universitas Jember

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19184/ams.v10i1.45924

Symptomatic hypoglycaemia in patients without underlying diabetes is uncommon. Etiology of non-diabetic hypoglycaemia varies from hyperinsulinism, hormone deficiencies, malignancies, to critical illness. This case report illustrates the attempt to determine the cause of refractory hypoglycaemia in a 46 years old male patient with underlying hepatocellular carcinoma (HCC). Anamnesis and examinations have narrowed differential diagnosis to concurrent systemic illness (liver failure due to HCC) or paraneoplastic syndrome from non-beta cell tumors, referred as non-islet cell tumor hypoglycaemia (NICTH). It was noted that the absence of chronic liver disease stigmata has put NICTH as the possible main cause. Deciding what diagnostic modalities needed to perform to establish the diagnosis eventually relies on clinical judgement while taking cost-effectiveness and patients’ preference in consideration, particularly in low-resource settings. Nonetheless, the main goal of treating hypoglycaemia is to immediately achieve and sustain euglycemia which can be achieved conservatively or definitively with surgery despite the etiology. Keywords: Hepatocellular carcinoma, Hypoglycaemia, NICTH.

The Relationship Between HbA1c Levels and Severity of COVID-19 Patients with Diabetes Mellitus at Haji General Hospital, East Java Province Nabil Salim Ambar; Muhimmatul Aaliyah Rahmadina; Mohammad Subkhan; Audy Meutia Ariana
Qanun Medika - Jurnal Kedokteran FK UMSurabaya Vol 9 No 01 (2025): Qanun Medika Vol 09 No 01 January 2025
Publisher : Universitas Muhammadiyah Surabaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30651/jqm.v9i01.23444

One of the factors influencing SARS-CoV-2 infection is comorbidity. Diabetes mellitus is a comorbidity with a high mortality rate. Poor glucose control in patients can affect cellular immune responses and increase morbidity and mortality associated with infections. The severity of COVID-19 is classified into 5 levels: asymptomatic, mild, moderate, severe, and critical. HbA1c is a good test for identifying the diabetes status of COVID-19 patients. According to the American Diabetes Association, HbA1c levels are considered controlled if <7% and uncontrolled if ≥7%. This study aims to analyze HbA1c levels in COVID-19 patients with diabetes mellitus from 2020 to 2022. This study uses the productive age category (15-64 years). To determine the relationship between HbA1c levels and the severity of COVID-19 patients with diabetes mellitus at Haji General Hospital, East Java Province, from 2020 to 2022. This research employs a cross-sectional, analytical observational method with a consecutive sampling technique involving 96 hospitalized COVID-19 patients. Data collection was conducted through medical record observation. The majority of the samples were male, with an average age of 53 years. The Fisher Exact Test yielded a p-value of 0.13, which is greater than the significance level (0.05), indicating no significant relationship between HbA1c levels and the severity of COVID-19 in diabetic patients. There is no significant relationship between HbA1c levels and the severity of COVID-19 in diabetic patients at Haji General Hospital, East Java Province.

CASE REPORT KARSINOMA TIROID PADA PEREMPUAN USIA 56 TAHUN Nugroho, Alifia Mazaya Aliya; Vianto, Denny; Rohman, Abdur; Ariana, Audy Meutia
Jurnal Kesehatan Tambusai Vol. 6 No. 2 (2025): JUNI 2025
Publisher : Universitas Pahlawan Tuanku Tambusai

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.31004/jkt.v6i2.44569

Karsinoma tiroid merupakan tumor ganas yang berkembang pada kelenjar tiroid dan termasuk jenis kanker endokrin yang paling sering ditemukan, meskipun hanya mencakup sekitar 1% dari seluruh kasus kanker di populasi umum. Meski begitu, kasus karsinoma tiroid masih tergolong jarang dijumpai. Berdasarkan karakteristik histologisnya, karsinoma tiroid terbagi menjadi empat tipe utama, yaitu karsinoma papiler,karsinoma folikular, karsinoma meduler, dan karsinoma anaplastik. Penelitian ini ini disusun dalam bentuk studi laporan kasus dengan pendekatan deskriptif, yang bertujuan untuk menggambarkan secara rinci kondisi klinis, hasil pemeriksaan penunjang, serta penatalaksanaan pasien dengan diagnosis karsinoma tiroid. Hasil penelitian laporan kasus seorang perempuan berusia 56 tahun mengeluhkan adanya benjolan di bagian leher yang tidak disertai nyeri selama dua tahun terakhir. Hasil pemeriksaan ultrasonografi leher menunjukkan adanya massa padat sepenuhnya (completely solid), hipoekoik, dengan bentuk lebih tinggi daripada lebar (taller than wider), batas yang tidak teratur, serta terdapat fokus echogenik kecil (punctate echogenic foci). Ukuran massa terbesar sekitar 0,66 x 0,87 x 1,06 cm, dengan kesan adanya makrokalsifikasi di dalamnya. Pemeriksaan CDUS menunjukkan adanya peningkatan aliran darah di dalam lesi tersebut. Kesimpulan dari laporan ini menekankan pentingnya deteksi awal pada karsinoma tiroid, karena identifikasi subtipe karsinoma sangat berperan dalam menentukan langkah penanganan yang tepat. Pasien yang terdiagnosis lebih awal dan menerima terapi yang menyeluruh berpotensi memiliki harapan hidup yang lebih baik.

The Relationship Between HbA1c Levels and Severity of COVID-19 Patients with Diabetes Mellitus at Haji General Hospital, East Java Province Ambar, Nabil Salim; Rahmadina, Muhimmatul Aaliyah; Subkhan, Mohammad; Ariana, Audy Meutia
Qanun Medika - Jurnal Kedokteran FK UMSurabaya Vol 9 No 01 (2025): Qanun Medika Vol 09 No 01 January 2025
Publisher : Universitas Muhammadiyah Surabaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30651/jqm.v9i01.23444

One of the factors influencing SARS-CoV-2 infection is comorbidity. Diabetes mellitus is a comorbidity with a high mortality rate. Poor glucose control in patients can affect cellular immune responses and increase morbidity and mortality associated with infections. The severity of COVID-19 is classified into 5 levels: asymptomatic, mild, moderate, severe, and critical. HbA1c is a good test for identifying the diabetes status of COVID-19 patients. According to the American Diabetes Association, HbA1c levels are considered controlled if <7% and uncontrolled if ≥7%. This study aims to analyze HbA1c levels in COVID-19 patients with diabetes mellitus from 2020 to 2022. This study uses the productive age category (15-64 years). To determine the relationship between HbA1c levels and the severity of COVID-19 patients with diabetes mellitus at Haji General Hospital, East Java Province, from 2020 to 2022. This research employs a cross-sectional, analytical observational method with a consecutive sampling technique involving 96 hospitalized COVID-19 patients. Data collection was conducted through medical record observation. The majority of the samples were male, with an average age of 53 years. The Fisher Exact Test yielded a p-value of 0.13, which is greater than the significance level (0.05), indicating no significant relationship between HbA1c levels and the severity of COVID-19 in diabetic patients. There is no significant relationship between HbA1c levels and the severity of COVID-19 in diabetic patients at Haji General Hospital, East Java Province.

HUBUNGAN KADAR HBA1C PADA PASIEN DIABETES MELITUS TIPE 2 DENGAN JENIS KATARAK DI RSUD DR. WAHIDIN SUDIRO HUSODO KOTA MOJOKERTO Khusniyah , Siti Haniatul Dita; Lutfiana, Nurul Cholifah; Dhani , Rini Kusumawar; Ariana , Audy Meutia
JurnalMU: Jurnal Medis Umum Vol 2 No 1 (2025): Jurnal Medis Umum
Publisher : Universitas Muhammadiyah Surabaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30651/jmu.v2i1.25642

Prevalensi pada penduduk indonesia yang menyandang DM sekitar 10 juta penduduk dan Indonesia termasuk negara di urutan ke 7 dari 10 negara yang jumlah penderitanya terbanyak di dunia. Salah satu komplikasi yang diakibatkan oleh DM tipe 2 pada mata adalah katarak. Menurut The Beaver Dam Eye Study dan Blue Mountain Eye Study menyatakan penderita katarak yang menyandang DM cenderung 5 kali meningkatkan risiko pembentukan katarak pada lensa mata. Oleh karena itu, pada penelitian ini bertujuan mengetahui hubungan kadar HbA1c pada pasien DM tipe 2 dengan komplikasi jenis katarak. Penelitian tersebut merupakan analitik observational menggunakan jenis studi cross sectional. Sampel berjumlah 51 mata yang terdiagnosis DM tipe 2 dengan masing-masing jenis katarak. Pada analisis data di kelompok usia yang sangat mendominasi adalah usia 51-60 tahun (52,94%). Kemudian analisis HbA1c mayoritas >6,5% (64,71%). Lalu jenis katarak yang lebih dominan yaitu pada jenis katarak PSC sejumlah 38 mata (74,51%). Hasil dari penelitian ini menunjukkan adanya hubungan yang signifikan antara kadar HbA1c pada pasien DM tipe 2 dengan jenis katarak yaitu 0,002. Dan didapatkan besarnya korelasi (r) adalah 0,793 yang diartikan adanya korelasi positif dengan kekuatan sedang. Kata Kunci: Jenis Katarak, Diabetes Melitus Tipe 2, Kadar HbA1c

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