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All Journal Jurnal Kedokteran dan Kesehatan : Publikasi Ilmiah Fakultas Kedokteran Universitas Sriwijaya IJCNP (INDONESIAN JOURNAL OF CLINICAL NUTRITION PHYSICIAN) Archives of The Medicine and Case Reports
Diyah Eka Andayani
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Biochemistry, Genetics & Molecular Biology Health Professions Medicine & Pharmacology Neuroscience Nursing Public Health

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The Effect of Vitamin D Supplementation on Autoimmune Bullous Skin Disorder Intensity Score on Bullous Pemphigoid and Acute Kidney Injury: A Case Report Rahmita, Kartika Soka; Diyah Eka Andayani; Diana Sunardi
Archives of The Medicine and Case Reports Vol. 5 No. 3 (2024): Archives of The Medicine and Case Reports
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/amcr.v5i3.529

Abstract

Introduction: Bullous pemphigoid is the most common bullous-type autoimmune disease. Hypovitaminosis D is often associated with autoimmune disease and found in 86,7% bullous pemphigoid patients. Vitamin D supplementation in bullous pemphigoid patients ought to ameliorate its clinical symptoms. Case presentation: A-58 years old male patient with bullous pemphigoid and acute kidney injury admitted with a chief complaint of infected blisters all over the body. The patient had been treated for 1 week with worsening swallowing pain and low intake. On the 12th day of hospitalization, the patient was given calcitriol supplementation of 0,25 mcg per day. There was an improvement in clinical symptoms shown on autoimmune bullous skin disorder intensity score (ABSIS) from 57 on inpatient day 7 to 17.5 on inpatient day 20. Patient discharged on the 20th day of hospitalization with no emerging blisters and the ability to swallow minced food by mouth. Conclusion: Calcitriol supplementation of 0,25 mcg per day for 10 days helps to improve the ABSIS score in bullous pemphigoid patient with acute kidney injury. Administration of calcitriol is considered safe and well tolerated.
The Role Of Synbiotic Supplementation In Improving Bowel Movement Frequency In A Burn Patient With 32% Total Body Surface Area And Constipation: A Case Report Cindy Herno Chrysela; Wina Sinaga; Aditya Wardhana; Diyah Eka Andayani
IJCNP : INDONESIAN JOURNAL OF CLINICAL NUTRITION PHYSICIAN Vol 7 No 1 (2026): IJCNP
Publisher : Perhimpunan Dokter Gizi Klinik Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.54773/ijcnp.v7i1.260

Abstract

Background: Severe burns cause microbiota dysbiosis, impaired intestinal motility, and constipation, worsening patient conditions and prolonging hospitalization. Research Objective: To evaluate the effectiveness of synbiotic supplementation in improving bowel movement frequency in burn patients. Case Illustration: A study conducted in the Burn High Care Unit at RSUPN Cipto Mangunkusumo involved a 42-year-old male patient with 32% TBSA burns and a history of kidney transplantation. Treatments included debridement, skin grafts, electrolyte correction, and synbiotic supplementation starting on day 6. During 29 days, energy intake, fiber intake, bowel movement frequency, and clinical status were monitored, showing significant improvements until discharge. Discussion: The 42-year-old male patient with 32% TBSA burns experienced impaired intestinal motility and constipation consistent with microbiota dysbiosis and decreased SCFA due to severe burns. The patient received enteral nutrition and Rillus® synbiotic supplementation from day 6, theoretically enhancing beneficial bacterial colonization and intestinal motility. Bowel movement frequency improved from day 7, indicating synbiotic-related benefits. Micronutrient supplementation according to ESPEN supported wound healing and immunity. Clinical condition and nutritional status improved with significant wound healing until discharge on day 30. Conclusion: Synbiotic supplementation effectively increased bowel movement frequency and improved intestinal function in severe burn patients with constipation. Keywords: Severe burn, microbiota dysbiosis, synbiotic, constipation, intestinal motility, bowel movement frequency.
THE ROLE OF VITAMIN D3 SUPPLEMENTATION ON MYASTHENIA GRAVIS COMPOSITE SCALE: A CASE REPORT Mardhiani, Meidistya Ayu; Wina Sinaga; Diyah Eka Andayani
Jurnal Kedokteran dan Kesehatan : Publikasi Ilmiah Fakultas Kedokteran Universitas Sriwijaya Vol. 13 No. 2 (2026): Jurnal Kedokteran dan Kesehatan : Publikasi Ilmiah Fakultas Kedokteran Univers
Publisher : Fakultas Kedokteran Universitas Sriwijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32539/jkk.v13i2.931

Abstract

Myasthenia Gravis (MG) is a rare chronic autoimmune disorder triggered by pathogenic IgG autoantibodies and complement activation. Common clinical manifestations include ocular muscle weakness, dysphagia, dysarthria, dysphonia, limb muscle weakness, generalized skeletal muscle weakness, and respiratory muscle involvement. A 47-year-old female presented with unilateral ptosis, bilateral diplopia, dysphagia, dysphonia, dysarthria, and paresis of both upper and lower extremities. The Myasthenia Gravis Composite Scale (MGCS) score was 31. Electromyography confirmed the diagnosis of myasthenia gravis, and laboratory evaluation revealed 25-hydroxyvitamin D deficiency. During hospitalization, the patient received cholinesterase inhibitors, corticosteroids, and vitamin D3 supplementation at 5,000 IU once daily for 9 days. The MGCS score decreased to 19, indicating improved functional capacity. Conclusion: Vitamin D3 supplementation at a dose of 5,000 IU/day may provide potential clinical benefits, as reflected by a reduction in MGCS score, and may also reduce the future risk of osteoporosis secondary to 25-hydroxyvitamin D deficiency. However, the clinical improvement observed in this patient was likely also influenced by the concurrent administration of cholinesterase inhibitors and corticosteroids.
Co-Authors Cindy Herno Chrysela Diana Sunardi Mardhiani, Meidistya Ayu Rahmita, Kartika Soka Wardhana, Aditya Wina Sinaga