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Correlation between Head Computed Tomography Scan Examination and Cranial Index Measurement in Pediatric Hydrocephalus Zulfariska, Nony; Anandasari, Pande Putu Yuli; Margiani, Ni Nyoman; Sitanggang, Firman Parulian; Patriawan, Putu; Widiana, I Gde Raka
Mutiara Medika: Jurnal Kedokteran dan Kesehatan Vol 22, No 1 (2022): January
Publisher : Universitas Muhammadiyah Yogyakarta

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18196/mmjkk.v22i1.12464

Abstract

Hydrocephalus in children can inhibit child growth. However, if treated immediately, the patient will develop normal intelligence. In radiology, the most important problem is to detect hydrocephalus early. Currently, radiology examinations can detect hydrocephalus accurately with a CT scan to identify the presence of blockages and assess the degree. Skull radiography is used to assess the presence of advanced hydrocephalus. A comparison is carried out and assesses the relationship between hydrocephalus measurement on the ventricular and cranial index by scanogram. The study used a cross-sectional analytics design, using Picture Archiving and Communication System (PACS) data. There were 68 samples taken using consecutive sampling, obtaining ventricular index measurement results above 0.30, and patients under 12 years old. Spearman rank test showed a correlation between the ventricular index measurements and cranial index, with Spearman’s Rho (r) = 0.856 and p0.001 with linear equation Y= 2.973 + 0.005X. It revealed that the constant 2.973 indicated that if there is no B coefficient value, the participation value will be 2.973. Furthermore, regression coefficient X of 0.005 indicated that the participation value grows by 0.005 for every 1 addition of the B coefficient value with R2= 0.340.
PROFIL DAN PERBANDINGAN HASIL DIAGNOSIS KLINIS DENGAN DIAGNOSIS RADIOLOGI DEEP VEIN THROMBOSIS DI RSUP SANGLAH, DENPASAR Kadek Diah Febri Yanti; Ni Nyoman Margiani
E-Jurnal Medika Udayana vol 4 no 2 (2015):e-jurnal medika udayana
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (138.384 KB)

Abstract

Deep Vein Thrombosis” (DVT) adalah pembentukan bekuan darah di sistem pembuluh darah vena dalam. Salah satu modalitas diagnosis selain anamnesis dan pemeriksaan fisik adalah pemeriksaan radiologis berupa color flow doppler ultrasonography. Studi ini mencari perbedaan hasil diagnosis yang ditegakkan secara klinis dan hasil diagnosis secara radiologis. Penelitian ini merupakan studi potong lintang deskritif yang dilakukan di Instalasi Radiologi Rumah Sakit Umum Pusat Sanglah. Data pasien dengan klinis DVT positif dicatat umur dan jenis kelaminnya kemudian dianalisa perbedaan presentasi diagnosis radiologi positif dan diagnosis radiologi negatif DVT serta sebaran umur dan jenis kelamin. Terdapat 53 kasus suspek DVT sejak tanggal 1 Oktober 2011 hingga 31 Oktober 2012, hanya 26 kasus yang terbukti terdapat gambaran radiologis DVT dan 27 kasus lainnya tidak ada gambaran DVT pada pemeriksaan color flow doppler ultrasonography. Persentase pasien diagnosis radiologis DVT (+) dengan pasien suspek DVT sebesar 49%. Persentase pasien diagnosis radiologis DVT(-) dengan pasien suspek DVT sebesar 51%. Distribusi umur pasien penderita DVT dibagi menjadi 3 kelompok umur, proporsinya adalah pasien dengan usia dewasa sebesar 30,7%, pasien dewasa tua 46,2% dan pasien tua 23,1%. Distribusi jenis kelamin terhadap kejadian DVT selama satu tahun di Instalasi Radiologi Rumah Sakit Umum Pusat Sanglah menunjukkan proporsi pasien wanita sebesar 61,5% dan pasien laki-laki sebesar 38,5%. Penelitian ini membuktikan bahwa terdapat perbedaan hasil antara pemeriksaan klinis dengan pemeriksaan color flow doppler ultrasonography pada DVT. Distribusi umur pasien terbanyak yang mengalami DVT  di RSUP Sanglah Denpasar adalah usia dewasa tua 40-60 tahun dan jenis kelamin perempuan.  
RERATA UKURAN GINJAL DEWASA NORMAL DENGAN COMPUTED TOMOGRAPHY DI RSUP SANGLAH TAHUN 2017 Gusti Ayu Made Lindya Dewi; Ni Nyoman Margiani; I Made Dwijaputra Ayusta
E-Jurnal Medika Udayana Vol 8 No 11 (2019): Vol 8 No 11 (2019): E-Jurnal Medika Udayana
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (278.226 KB)

Abstract

Ginjal merupakan salah satu organ vital pada tubuh manusia yang sangat penting peranannya dalam metabolisme tubuh. Ukuran ginjal merupakan salah satu parameter dalam menentukan ginjal yang sehat. Bila ada kelainan, yang kemungkinan terjadi pada kelainan kronis atau akut ditandai dengan pembesaran ukuran ginjal. Sehingga sangat penting untuk mengetahui ukuran ginjal yang sesungguhnya karena akan sangat membantu dalam menegakkan diagnosis dan salah satu metode yang dapat dilakukan untuk mengetahui ukuran ginjal yaitu melalui pemeriksaan CT Scan. Penelitian ini merupakan penelitian yang bersifat deskriptif dengan rancangan penelitian cross sectional. Subjek penelitian ini adalah semua pasien yang melakukan pemeriksaan radiologi abdominal CT Scan tanpa ada kelainan fungsi ginjal di Rumah Sakit Umum Pusat Sanglah dengan melakukan total sampling dari pasien radiologi yang melakukan abdominal CT Scan. Terdapat 80 orang subjek yang menjadi sampel dalam penelitian ini. Dari 80 orang sampel didapatkan ukuran rerata ginjal kanan dengan panjang 83,61 mm, lebar 55,59 mm dan tinggi 94,18 mm. Ukuran rerata ginjal kiri dengan panjang 87,58 mm, lebar 58,71 mm dan tinggi 95,83 mm. Pada 80 orang subjek didapatkan bahwa rerata ukuran ginjal kanan lebih kecil dibandingkan rerata ukuran ginjal kiri. Berdasarkan jenis kelamin, laki – laki memiliki rerata ukuran ginjal yang lebih besar dibandingkan perempuan. Kata kunci : Ginjal, CT- Scan, Jenis Kelamin.
Proven Cases of Duodenal Atresia on Plain Abdominal Radiography in Correlation With Surgical Findings : a Cases Series Fiona Fiona; Ni Nyoman Margiani; Firman Parulian Sitanggang
Jurnal Profesi Medika : Jurnal Kedokteran dan Kesehatan Vol 14, No 2 (2020): Jurnal Profesi Medika : Jurnal Kedokteran dan Kesehatan
Publisher : Fakultas Kedokteran UPN Veteran Jakarta Kerja Sama KNPT

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33533/jpm.v14i2.1814

Abstract

Duodenal atresia is an emergency congenital abnormality and the most common cause of proximal bowel obstruction in neonates, where the duodenum has not developed properly in embryogenesis with a blind end that cannot be seen through gastric contents. The incidence of duodenal atresia is 1/10,000 live births that commonly affecting boys than girls. In cases of neonatal bilious vomiting, the first choice imaging modality is plain abdominal radiography. The purpose of this case report is to increase radiologist and pediatrician awareness in duodenal atresia diagnosis through plain abdominal radiography and to minimize radiation in the neonates. We report 3 cases of duodenal atresia that were found in Sanglah Hospital, Denpasar in 1 year for the period 2018 - 2019. Case 1: A 4-day-old baby girl presented with bilious vomiting in the first 24 hours after birth. Case 2: A 4-day-old baby boy presented with lethargic, weak crying and groaning after birth. There is no history of passed meconium in the first 24 hours of birth. Case 3: A newborn boy presented with bilious emesis after breastfeeding and non projectile. From the 3 cases, a plain abdominal radiograph was examined and a double bubble sign with no intestinal gas distal was found.
Diagnostic Value of Gynecologic Ultrasonography as A Malignancy Predictor in Children's Ovarian Tumor Ni Made Putri Suastari; Pande Putu Yuli Anandasari; Putu Patriawan; Ni Nyoman Margiani; Firman Parulian Sitanggang; I Gde Raka Widiana
Mutiara Medika: Jurnal Kedokteran dan Kesehatan Vol 22, No 2 (2022): July
Publisher : Universitas Muhammadiyah Yogyakarta

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18196/mmjkk.v22i2.14389

Abstract

The incidence of ovarian malignancy is rare in children, with proportions between 16-55%. A gynecologic ultrasonography score is expected to increase accuracy and be able to diagnose malignancy earlier. By using a retrospective cross-sectional study design, this study is a diagnostic test to assess ultrasonography examination as a predictor of malignancy with histopathological examination as the gold standard. The study subjects were 45 children admitted from July 2017 to December 2020. Characteristics of the subjects were obtained from medical records, gynecologic ultrasonography images were accessed from PACS, and histopathological results were obtained from SIMARS. The gynecologic ultrasonography images were scored by two observers using a scoring table. Variables assessed consisted of inner wall structure, wall thickness, septa, morphology, tumor vascularization and ascites. The data will then be analyzed, determining the optimal cut-off score, sensitivity, specificity, accuracy, and positive and negative predictive value. AUC value of 0.92 using a cut-off ≥14 obtained 15 malignant subjects and 1 benign subject and resulted in a sensitivity of 78.9%, specificity of 96.2%, a positive predictive value of 93.8%, a negative predictive value of 86.2%, and accuracy of 88.89%. It can be concluded that the diagnostic value of gynecologic ultrasonography examination as a predictor of malignant ovarian tumors in children was remarkable.
Foto polos abdomen megaureter kongenital pada kecurigaan cystoma ovari maligna: Laporan kasus Rein Matondang; Ni Nyoman Margiani
Intisari Sains Medis Vol. 11 No. 1 (2020): (Available online: 1 April 2020)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1257.23 KB) | DOI: 10.15562/ism.v11i1.722

Abstract

Background: Megaureter defined as dilated ureter with or without dilatation of the renal pelvis and calyces.  Megaureter is a common diagnosis in children, representing 23% of children with urinary tract obstruction. The diagnosis is more common in boys than girls, and more often is on the left side.Case description: A 17-year-old female was referred with a suspicion of malignant ovarian cystoma. On examination, the abdomen was distended.  Plain radiograph of the abdomen revealed ground glass appearance in abdominal-pelvic cavity suspected of abdominal mass. An ultrasound of the abdomen revealed moderate right hydronephrosis and severe left hydronephrosis. Abdominal CT Scan with contrast demonstrated grade II right hydronephrosis with proximal hydroureter and grade III-IV left hydronephrosis, no solid mass in abdomen. Gynecologyst suspected this patient with left ovarian cystic mass. During the operation, evaluation to obtained ovarian cystic mass was done, yet no mass was obtained. They found a left mega ureter from proximal to distal suspected of a congenital giant mega ureter, followed by left nefrectomy and ureterectomy.Conclusion: A ground glass appearance in plain x-ray may mimicking as hydronephrosis or gynecological mass, particularly in young female patients with suspicion of abdominal mass. Latar belakang: Megaureter didefinisikan sebagai ureter yang melebar dengan atau tanpa dilatasi pelvis renalis dan calix ginjal. Megaureter adalah diagnosis yang umum pada anak-anak, mewakili 23% diagnosis pada anak-anak dengan obstruksi saluran kemih. Diagnosis ini lebih sering terjadi pada anak laki-laki daripada anak perempuan, dan lebih sering di sisi kiri.Deskripsi kasus: Seorang wanita berusia 17 tahun dirujuk dengan kecurigaan sistoma ovarium maligna. Pada pemeriksaan, perut tampak distensi. Foto polos abdomen menunjukkan ground glass appearence di rongga perut-panggul yang diduga massa abdomen. Ultrasonografi abdomen menunjukkan hidronefrosis kanan sedang dan hidronefrosis kiri berat. CT-Scan abdomen dengan kontras menunjukkan hidronefrosis kanan derajat II dengan hidroureter proksimal dan hidronefrosis kiri derajat III-IV, tidak tampak massa padat di perut. Dicurigai suatu massa kistik ovarium kiri. Selama operasi, dilakukan evaluasi untuk menemukan massa kistik ovarium, namun tidak didapatkan. Ditemukan megaureter kiri dari proksimal ke distal yang diduga sebagai giant megaureter kongenital, dilanjutkan nefrektomi kiri dan ureterektomi.Kesimpulan: Suatu gambaran ground glass appearance pada foto polos dapat menyerupai hidronefrosis atau masa ginekologi terutama pada wanita muda yang dicurigai massa abdomen.
Constipation that needs attention: late Hirschsprung disease Kristin Agustina; Ni Nyoman Margiani; Pande Putu Yuli Anandasari; Ni Made Mahastuti
Intisari Sains Medis Vol. 12 No. 1 (2021): (Available online : 1 April 2021)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (920.816 KB) | DOI: 10.15562/ism.v12i1.845

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Background: Hirschprung disease (HD) or congenital aganglionic megacolon is an intestinal motor disorder that occurs in approximately 1 in 5000 live births. It makes colon fail to relax, mainly producing the symptoms of constipation. Approximately 90% of cases are diagnosed in the first year of life. Most of the remaining 10% are made in early childhood, with less than 1% being made in teenagers or adulthood.Case report: A 13 years old girl reported to the pediatric surgical outpatient department complaining constipation since birth. There was no history of delayed passage of meconium. A contrast enema study with water-soluble contrast showed high probability of ultrashort segment HD. Histopathological examination revealed neither nerve fibers with ganglion cells nor hypertrophy of nerve fibers were seen confirming the aganglionosis. Surgical treatment was performed with good clinical progression. Conclusion: Despite of its rarity, the possibility of HD should be considered in teenagers with chronic refractory constipation, especially when there was a history of delayed or non-passage of meconium after birth. An accurate diagnosis is mainly based on collective assessment of medical history, clinical examination, contrast enema study, and rectal biopsy as a gold standard. 
Atipikal intraoseus hemangioma: laporan kasus Pande Putu Bagus Premana; Elysanti Dwi Martadiani; Ni Nyoman Margiani; I Wayan Juli Sumadi
Intisari Sains Medis Vol. 12 No. 1 (2021): (Available online : 1 April 2021)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (878.937 KB) | DOI: 10.15562/ism.v12i1.942

Abstract

Introduction: Atypical hemangioma is rarely found benign neoplasm which frequently involves the vertebrae and craniofacial bones. Meanwhile, soft tissue hemangioma is a benign vascular neoplasm commonly encountered. When it occurs in long bones, it is usually found at diaphysis and meta-diaphysis. Intraosseous hemangioma can occur at any age and is usually asymptomatic, whereas soft tissue hemangioma is more frequent in women compared to men.Case report: A 26-year-old woman had a complained about pain on the left thigh over the past 10 years, that worsened for the past few months. Her growth and development was normal. Five years before admission, she had fallen while walked, but no history of having surgery. Femur radiograph showed expansile lytic lesion with narrow transitional zone accompanied by sclerotic and ground glass apperance on left femoral diaphysis and soft tissue swelling that contain calcification. CT scan revealed well defined lobulated solid soft tissue mass with calcification within the mass. it contain dilated and turtous vascular component, causing expansile lytic lesion and cortical destruction.Conclusion: Soft tissue Hemangioma is often found to have a higher occurrence in women compared to men. Unlike hemangioma in the axial bone, the diagnosis of hemangioma in the appendicular bone is more challenging due to rare cases and non-specific radiological features. Intraosseous hemangioma can provide varied radiological features and must be included in comparative diagnosis of osteolytic and expansile lesions.  Pendahuluan: Hemangioma atipikal jarang merupakan neoplasma jinak yang jarang ditemukan danering melibatkan tulang vertebra dan kraniofasial. Sedangkan hemangioma jaringan lunak merupakan neoplasma vaskuler jinak yang biasa dijumpai. Ketika terjadi pada tulang panjang, biasanya ditemukan di diafisis dan meta-diafisis. Hemangioma intraoseus dapat terjadi pada semua usia dan biasanya asimtomatik, sedangkan hemangioma jaringan lunak lebih sering terjadi pada wanita dibandingkan pria. Laporan kasus ini akan mendeskripsikan gambaran hemangioma intraoseus atipikal pada seorang laki-laki dewasaLaporan Kasus: Seorang wanita berusia 26 tahun memiliki keluhan tentang nyeri pada paha kiri selama 10 tahun terakhir, yang memburuk selama beberapa bulan terakhir. Pertumbuhan dan perkembangannya normal. Lima tahun sebelum masuk rumah sakit, pernah mengalami kondisi jatuh berjalan, tapi tidak ada riwayat menjalani operasi. Radiografi femur menunjukkan lesi litik yang meluas dengan zona transisi yang sempit disertai dengan munculnya sklerotik dan ground glass pada diafisis femoralis kiri dan pembengkakan jaringan lunak yang mengandung kalsifikasi. CT-scan menunjukkan massa jaringan lunak padat berlobus yang terdefinisi dengan baik dengan kalsifikasi di dalam massa. itu mengandung komponen pembuluh darah melebar dan kura-kura, menyebabkan lesi litik yang meluas dan kerusakan kortikal.Simpulan: Hemangioma jaringan lunak sering ditemukan memiliki kejadian yang lebih tinggi pada wanita dibandingkan pria. Tidak seperti hemangioma pada tulang aksial, diagnosis hemangioma pada tulang apendikuler lebih menantang karena kasus yang jarang terjadi dan gambaran radiologis yang tidak spesifik. Hemangioma intraoseus dapat memberikan gambaran radiologis yang bervariasi dan harus dimasukkan dalam diagnosis komparatif lesi osteolitik dan lesi ekspansil.
Karakteristik gambaran Tuberkulosis (TB) paru pada foto toraks pasien Human Immunodeficiency Virus (HIV) tahun 2017-2021 di RSUP Sanglah, Bali, Indonesia Tiffany Rebecca; Dewa Gde Mahiswara Suadiatmika; Ni Nyoman Margiani
Intisari Sains Medis Vol. 12 No. 3 (2021): (Available online: 1 December 2021)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (336.074 KB) | DOI: 10.15562/ism.v12i3.1194

Abstract

Background: Tuberculosis is a disease caused by Mycobacterium tuberculosis that mostly attacks the lungs. HIV is a virus that causes damage to the immune system. HIV infection increases the risk of developing pulmonary TB because TB is an opportunistic disease; vice versa TB infection increases HIV progression. This study is about researching the characteristics of TB in HIV patients radiologically at Sanglah Hospital Denpasar.Methods: This study is a cross-sectional descriptive study conducted retrospectively. The data in this study used medical records of HIV-infected pulmonary TB patients from Sanglah Hospital, especially the characteristics of chest radiographs in the medical records and chest X-rays of patients. For the data collecting technique, a total sample is used to analyze all 47 cases. Data were analyzed using SPSS version 25 for Windows.Results: Most HIV patients with pulmonary TB coinfection at Sanglah Hospital, Denpasar, were obtained from as many as 47 people. It was found that the age between 30 - 39 recorded to be the highest at 31.3%, men were the most dominant with 81.3%, most of the patients diagnosed with HIV stage 4 were 72.9%, and the most dominant characteristics of the chest radiograph are 41.7% consolidation.Conclusion: Most cases of pulmonary TB with HIV coinfection at Sanglah Hospital Denpasar in 2017 - 2021 are male around 30 - 39 years. In addition, most of them were diagnosed with HIV stage 4 and finally almost all the patients had consolidation characteristics on chest radiographs.  Latar Belakang: Tuberkulosis adalah penyakit yang disebabkan oleh Mycobacterium tuberculosis yang paling banyak menyerang paru-paru. HIV adalah virus yang menyebabkan kerusakan pada sistem kekebalan tubuh. Infeksi HIV meningkatkan risiko berkembangnya TB paru karena TB adalah penyakit oportunistik sebaliknya infeksi TB meningkatkan perkembangan HIV. Penelitian ini bertujuan untuk mengetahui karakteristik TB pada pasien HIV secara radiologis di RSUP Sanglah Denpasar.Metode: Penelitian ini merupakan penelitian deskriptif potong lintang yang dilakukan secara retrospektif. Data dalam penelitian ini menggunakan rekam medis pasien TB paru terinfeksi HIV dari RSUP Sanglah, terutama karakteristik foto toraks pada rekam medis dan foto rontgen dada pasien. Untuk teknik pengumpulan data, sampel total digunakan untuk menganalisis semua 47 kasus. Data dianalisis dengan SPSS versi 25 untuk Windows.Hasil: Pasien HIV koinfeksi TB paru terbanyak di RS Sanglah Denpasar didapatkan sebanyak 47 orang. Didapatkan usia antara 30-39 tahun tercatat paling tinggi 31,3%, laki-laki paling dominan dengan 81,3%, sebagian besar pasien terdiagnosis HIV stadium 4 sebanyak 72,9%, dan karakteristik foto toraks yang paling dominan adalah konsolidasi 41,7%.Kesimpulan: Kasus TB paru koinfeksi HIV terbanyak di RSUP Sanglah Denpasar tahun 2017 – 2021 adalah laki-laki berusia sekitar 30–39 tahun. Selain itu, sebagian besar terdiagnosis HIV stadium 4 serta hampir semua pasien memiliki karakteristik konsolidasi pada radiografi dada.
Correlation of Abdominal CT scan Score and Alpha-fetoprotein Levels in Hepatocellular Carcinoma Indira Prawita Martani; Firman Sitanggang; Ni Margiani; I Gde Widiana; Made Asih; I Made Ayusta
International Journal of Integrated Health Sciences Vol 10, No 2 (2022)
Publisher : Faculty of Medicine Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15850/ijihs.v10n2.2768

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Objective: To assess the correlation between the Alpha-fetoprotein (AFP) level and characteristics of liver lesions listed in the abdominal computed tomography (CT) scan scores in hepatocellular carcinoma.Methods: This was a retrospective analytic observational study with a cross-sectional design conducted at Sanglah Hospital in January 2017–January 2021. Subjects were patients diagnosed with hepatocellular carcinoma based on clinical and laboratory features. Samples were taken by consecutive sampling. The results of the abdominal CT scan were read by two radiologists with a predetermined abdominal CT scan scoring system. The AFP level data were taken at a maximum of 5 days before an abdominal CT scan was performed.Results: A total of 64 subjects were included in this study. The mean serum AFP level was 1,000 IU/mL (range 0.54–61830 IU/mL). The mean abdominal CT scan score by examiner one was 10.093±5.59, while the examiner two provided a score of 10.281±5.45. The difference in mean CT scan scores between the two examiners was very low and insignificant (mean difference score -0.188; 95% CI -1.894–1.519). The rho Spearman value was 0.918 (p<0.001) between serum AFP levels and abdominal CT scan scores. In the partial correlation, the value of r=0.678 (p<0.001) was obtained after controlling for body mass index (BMI), age, and sex variables.Conclusions: There is a strong positive correlation between serum AFP levels and abdominal CT scan scores in hepatocellular carcinoma patients. Further research is needed with a prospective design to reduce research bias.