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All Journal E-Jurnal Medika Udayana ISM (Intisari Sains Medis) : Jurnal Kedokteran MEDICINUS
Putu Andrika
Bagian Ilmu Penyakit Dalam, Fakultas Kedokteran, Universitas Udayana-RSUP Sanglah Denpasar, Bali-Indonesia
Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

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Journal : MEDICINUS

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Comprehensive Approach to Acute Pulmonary Embolism in a Patient with History of Cervical Cancer: Clinical Challenges and Therapeutic Strategies Arya Wiradarma; Putu Andrika
MEDICINUS Vol. 39 No. 3 (2026): MEDICINUS
Publisher : PT Dexa Medica

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.56951/8nxexq93

Abstract

Pulmonary embolism (PE) is a life-threatening medical emergency that requires prompt diagnosis and treatment, particularly in patients with significant risk factors such as a history of cancer. This case report discusses a 45-year-old female with a history of stage IIIA cervical cancer who presented with acute onset dyspnea and hemodynamic instability. The patient’s prior cancer treatments, including chemotherapy and radiotherapy, increased the patient’s risk for venous thromboembolism (VTE), leading to acute pulmonary embolism. The diagnosis was confirmed by computed tomography pulmonary angiography (CTPA), which revealed a substantial thrombus obstructing the left pulmonary artery. Laboratoryfindings showed markedly elevated D-dimer levels. Further assessment with echocardiography (echo) revealed right ventricular (RV) dysfunction, a critical marker of hemodynamic stress caused by the embolism. The echo findings included RV hypokinesis, an increased right ventricle/left ventricle (RV/LV) ratio, and possible tricuspid regurgitation, all of which indicated severe right heart strain. These findings serve as key prognostic indicators in acute PE, correlating with a higher risk of mortality and guiding therapeutic decision-making. The comprehensive management approach for this patient highlights the importance of rapid diagnosis, risk stratification, and aggressive therapeutic interventions in highriskPE. Echocardiographic findings played a crucial role in determining the disease severity and informing the need for potential reperfusion therapies, such as thrombolysis or surgical embolectomy. This case emphasizes the importance of integrating clinical, imaging, and laboratory data to optimize patient outcomes. Echocardiography plays a pivotal role inmonitoring right ventricular function and adjusting treatment strategies in PE, particularly among oncology patients who are at increased risk.
Mortalitas Tuberkulosis Paru di RSUP Prof. dr. I.G.N.G. Ngoerah, Denpasar I Gede Ketut Sajinadiyasa; Gede Dilajaya Robin; Putu Andrika
MEDICINUS Vol. 39 No. 4 (2026): MEDICINUS
Publisher : PT Dexa Medica

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.56951/dw9ejg91

Abstract

Background: Pulmonary tuberculosis (TB) is the second leading cause of death from infectious disease worldwide. According to the World Health Organization (WHO) report in 2022, the global number of deaths due to TB reached 1.3million cases. In Indonesia, the mortality rate due to pulmonary TB in 2021 was 52 cases per 100,000 population. Methods: This is a descriptive study with cross-sectional approach to determine the mortality rate of TB. The subjects were ofpulmonary TB patients recorded at RSUP Prof. dr. I.G.N.G. Ngoerah, Denpasar, in 2023. The sampling technique used was total sampling. Results: Among the 84 subjects, 33 deaths were recorded. Based on sex, death occurred in 8 (9.5%) female subjects and 25 (29.8%) male subjects. Based on age, death occurred in 8 (9.5%) patients aged ≥60 years and 25 (29.8%) patients aged <60 years. Based on HIV status, death occurred in 20 (23.8%) patients with nonreactive HIV status and 13 (15.5%) patients with reactive HIV status. Based on diabetes status, death occurred in 4 (4.8%) diabetic patients and 29 (34.5%) nondiabetic patients. Based on the type of pulmonary TB, death occurred in 13 (15.5%) patients with clinically diagnosed pulmonary TB and 20 (23.8%) patients with bacteriologically confirmed pulmonary TB. Conclusion: Mortality due to pulmonary TB was more commonly observed among males, individuals under 60 years of age, those withnonreactive HIV status, nondiabetes, and those with bacteriologically confirmed pulmonary TB.
Co-Authors Anak Agung Istri Sarastriyani Dewi Arya Wiradarma Ayu Agung Pradnya Paramitha Dwi Sutanega Gede Dilajaya Robin I Gede Ketut Sajinadiyasa I M Bagiada IGN Bagus Artana Ni Nyoman Adi Widyastuti Prima Yogi