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Seorang penderita hipopituitarisme akibat kraniofaringioma Nugraha, Ida Bagus Aditya; Winarka, Made Arie Dwi; Budiartha, Anak Agung Gede
Jurnal Penyakit Dalam Udayana Vol 1 No 2 (2017): Vol. 1 No. 2 (2017) June-December 2017
Publisher : PAPDI BALI

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Hipopituitarisme merupakan suatu kelainan di bidang endokrinologi yang ditandai dengan kurangnya sekresi baik secara total atau sebagian dari hormone pituitari anterior atau posterior atau keduanya. Kraniofaringioma merupakan tumor intrakranial tersering pada anak-anak dan merupakan tumor tersering pada region hipotalamus dan hipopituitari. Berikut ini akan dilaporkan satu kasus hipopituitarisme yang terjadi pada seorang penderita perempuan usia 15 tahun dengan kraniofaringioma yang juga telah dilakukan tindakan pembedahan.Diagnosis kraniofaringioma ditegakkan berdasarkan manifestasi klinis yaitu adanya gangguan pertumbuhan baik dari tinggi badan, pertubuhan tulang, rambut pada pubis, ketiak, atau ekstremitas, pasien tampak lemas, nafsu makan berkurang sedikit, dan saat kontrol pasien belum haid. Dari pemeriksaan MRI kepala + kontras menunjukan adanya massa di intersella sampai supra sella. Diagnosa hipopituitari didapatkan dari beberapa pemeriksaan hormonal yang terjadi. Penatalaksanaan yang telah dilakukan yaitu terapi pengganti hormonal GH, glukokortikoid, tiroksin, dan estradiol. Monitoring dilakukan tiap 3 bulan awal yang kemudian nantinya dapat diulang tiap 6 bulan.

Keganasan Kolorektal dengan Fenomena Raynaud Sekunder Adnyani, Ni Made Dwi; Nugraha, Ida Bagus Aditya; Kambayana, Gede
Cermin Dunia Kedokteran Vol 46, No 12 (2019): Kardiovaskular
Publisher : PT. Kalbe Farma Tbk.

Penyakit Raynaud adalah penyakit vaskular primer yang ditandai dengan spasme temporer arteri kecil dan arteriol, biasanya di jari tangan atau, yang lebih jarang, jari kaki. Penyebab penyakit Raynaud dapat primer atau sekunder; salah satu penyebab sekunder adalah proses malignansi. Dilaporkan kasus Fenomena Raynaud Sekunder diduga akibat kanker kororektal pada laki-laki, 46 tahun, suku Jawa.Raynaud's disease is a primary vascular disease characterized by temporary spasm of small arteries and arterioles, usually in fingers or, rarely, in toes. The cause of Raynaud's disease can be primary and secondary; one of the secondary causes is malignancy. This is a case of a 46 year-old Javanese male with secondary Raynaud's phenomenon associated with colorectal cancer.Â Â

Manajemen Alopecia Areata pada Anak Nugraha, Ida Bagus Aditya; Sumapta, I Gusti Made
Cermin Dunia Kedokteran Vol 41, No 7 (2014): Kardiologi
Publisher : PT. Kalbe Farma Tbk.

Rambut merupakan salah satu bagian tubuh yang berharga. Masalah yang sering dijumpai di masyarakat adalah kerontokan rambut; penyebabnya meliputi berbagai hal meliputi faktor eksternal dan faktor internal. Meskipun jarang, kerontokan rambut yang lebih dikenal dengan alopecia areata pada anak perlu diketahui dan ditangani dengan tepat.Hair loss is one of the many hair problems; caused by two main factors: internal and external. Although the incidence of hair loss in children is rare, it is important to be diagnosed and managed properly.Â

Diagnostic problems of right-sided heart failure patient with cardiomyopathy cirrhosis Ida Bagus Aditya Nugraha
Neurologico Spinale Medico Chirurgico Vol 4 No 2 (2021)
Publisher : Indoscholar

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36444/nsmc.v4i2.129

Heart failure may cause liver damage, known as cardiomyopathy cirrhosis. Conversely, liver disease could also lead to heart failure and cardiovascular abnormalities. Cirrhotic cardiomyopathy is a relatively rare disease. Diagnosis should be found out as early as possible to prevent complications. Unfortunately, epidemiology data of cirrhotic cardiomyopathy is still limited, and the prevalence is still not precisely known. Hence, we reported a case of a young man with the main problem of right-sided heart failure and suspected cardiac cirrhosis with unclear manifestation. This case has a good outcome so that we hope this report could give a great reference on treating cardiomyopathy cirrhosis.

A LITERATURE REVIEW ( Imunodefisiensi Primer): Imunodefisiensi Primer IDA BAGUS ADITYA NUGRAHA; I WAYAN WAWAN; KETUT SUARDAMANA
Jurnal Medika Hutama Vol. 3 No. 03 April (2022): Jurnal Medika Hutama
Publisher : Yayasan Pendidikan Medika Indonesia

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Primary immunodeficiency disorder (PID) refers to a heterogeneous group of over 130 disorders that result from defects in immune system development and/or function. PIDs are broadly classified as disorders of adaptive immunity (i.e., T-cell, B-cell or combined immunodeficiencies) or of innate immunity (e.g., phagocyte and complement disorders). Although the clinical manifestations of PIDs are highly variable, most disorders involve at least an increased susceptibility to infection. Early diagnosis and treatment are imperative for preventing significant disease-associated morbidity and, therefore, consultation with a clinical immunologist is essential. PIDs should be suspected in patients with: recurrent sinus or ear infections or pneumonias within a 1 year period; failure to thrive; poor response to prolonged use of antibiotics; persistent thrush or skin abscesses; or a family history of PID. Patients with multiple autoimmune diseases should also be evaluated. Diagnostic testing often involves lymphocyte proliferation assays, flow cytometry, measurement of serum immunoglobulin (Ig) levels, assessment of serum specific antibody titers in response to vaccine antigens, neutrophil function assays, stimulation assays for cytokine responses, and complement studies. The treatment of PIDs is complex and generally requires both supportive and definitive strategies. Ig replacement therapy is the mainstay of therapy for B-cell disorders, and is also an important supportive treatment for many patients with combined immunodeficiency disorders. The heterogeneous group of disorders involving the T-cell arm of the adaptive system, such as severe combined immunodeficiency (SCID), require immune reconstitution as soon as possible. The treatment of innate immunodeficiency disorders varies depending on the type of defect, but may involve antifungal and antibiotic prophylaxis, cytokine replacement, vaccinations and bone marrow transplantation.

A CASE REPORT : Komplikasi dan Tatalaksana Snakebite: Komplikasi dan Tatalaksana Snakebite IDA BAGUS ADITYA NUGRAHA
Jurnal Medika Hutama Vol. 3 No. 03 April (2022): Jurnal Medika Hutama
Publisher : Yayasan Pendidikan Medika Indonesia

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Indonesia as one of the largest tropical and agricultural countries in the world shared the particularly high burden cases of snakebite. The clinical manifestations of snakebite could vary according to the type of venoms. This case reported a 75 years old male patient with snakebite in Pedis Sinistra come with bleeding and anuria. Bleeding caused by snake venom is presenting with blood clotting disturbances as the result of venom-induced consumption coagulopathy (VICC). VICC, a disseminated intravascular coagulation (DIC)-like syndrome, is characterised by low levels or undetectable of fibrinogen, resulting in incoagulable blood. Renal manifestations vary from urinary sediment changes with mild proteinuria to renal failure. Nephropathy in snakebite is the result of several mechanisms including the inflammatory process, direct nephrotoxicity, and immunologic reaction. Appropriate first aid treatment and comprehensive management of snakebite cases are warranted to reduce mortality and morbidity rates. The patient was diagnosed with VICC and acute kidney injury (AKI) related snakebite. The patient was applied pressure immobilization bandage, given antivenom, fresh frozen plasma (FFP), thrombocyte concentrate (TC), antibiotic, and renal replacement theraphy. After the treatment, bleeding was improved, but after iatrogenic pnemothorax and pneumonia occured, the patient's condition deteriorated. Unfortunately, the patient has died on 13rd day of treatment with causa mortis multiple organ failure.

Manajemen Alopecia Areata pada Anak Ida Bagus Aditya Nugraha; I Gusti Made Sumapta
Cermin Dunia Kedokteran Vol 41, No 7 (2014): Kardiologi
Publisher : PT. Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v41i7.1124

Rambut merupakan salah satu bagian tubuh yang berharga. Masalah yang sering dijumpai di masyarakat adalah kerontokan rambut; penyebabnya meliputi berbagai hal meliputi faktor eksternal dan faktor internal. Meskipun jarang, kerontokan rambut yang lebih dikenal dengan alopecia areata pada anak perlu diketahui dan ditangani dengan tepat.Hair loss is one of the many hair problems; caused by two main factors: internal and external. Although the incidence of hair loss in children is rare, it is important to be diagnosed and managed properly.

Keganasan Kolorektal dengan Fenomena Raynaud Sekunder Ni Made Dwi Adnyani; Ida Bagus Aditya Nugraha; Gede Kambayana
Cermin Dunia Kedokteran Vol 46, No 12 (2019): Kardiovaskular
Publisher : PT. Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v46i12.399

Penyakit Raynaud adalah penyakit vaskular primer yang ditandai dengan spasme temporer arteri kecil dan arteriol, biasanya di jari tangan atau, yang lebih jarang, jari kaki. Penyebab penyakit Raynaud dapat primer atau sekunder; salah satu penyebab sekunder adalah proses malignansi. Dilaporkan kasus Fenomena Raynaud Sekunder diduga akibat kanker kororektal pada laki-laki, 46 tahun, suku Jawa.Raynaud's disease is a primary vascular disease characterized by temporary spasm of small arteries and arterioles, usually in fingers or, rarely, in toes. The cause of Raynaud's disease can be primary and secondary; one of the secondary causes is malignancy. This is a case of a 46 year-old Javanese male with secondary Raynaud's phenomenon associated with colorectal cancer.

A/Seorang SEORANG PENDERITA EVANS SYNDROME RESPON CEPAT TERHADAP TERAPI STEROID FRANKY SIMARMATA; IDA BAGUS ADITYA NUGRAHA
Jurnal Medika Hutama Vol. 2 No. 03 April (2021): Jurnal Medika Hutama
Publisher : Yayasan Pendidikan Medika Indonesia

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Evans Syndrome (ES) adalah penyakit autoimun yang ditandai dengan terdapatnya Autoimmune Hemolytic Anemia (AIHA) dan Immune Thrombocytopenia Purpura (ITP) secara bersamaan dengan penyebab yang tidak diketahui (1,2). Walaupun ES umumnya disebabkan oleh kondisi idiopatik, namun kelainan ini juga dapat disebabkan oleh penyakit autoimun seperti lupus eritematosus sistemik (LES), kelainan limfoproliferatif, atau imunodefisiensi primer (3).

Problem diagnostik seorang penderita endokarditis infektif dengan komplikasi perdarahan intrakranial: Sebuah laporan kasus Franky Simarmata; Ida Bagus Aditya Nugraha; I Wayan Wita; Dwijo Anargha Sindhughosa
Intisari Sains Medis Vol. 12 No. 2 (2021): (Available Online: 1 August 2021)
Publisher : DiscoverSys Inc.

Introduction: Infective Endocarditis (IE) is a disease frequently affecting heart valves. The diagnosis is relatively simple, however it could be difficult in unspecific symptoms. Intracranial complications of patients with IE rarely happen.Case: The case was a 64 years-old male with sudden decrease of consciousness 12 hours prior to admission and diagnosed as a hemorrhagic stroke. He had a history of heavy smoking for about 10 years. Infective Endocarditis (IE) was diagnosed by Duke Criteria, and from this patient we found the vegetation at mitral valve with diameter 1.09 x 0.73 cm. Treatment for the patient is antibiotic according to sensitivity test of blood culture. The patient was discharged with improvement of condition. However, in approximately three months after discharge, the patient got hospitalized again due to the same condition and passed away.Conclusion: Infective endocarditis is a relatively rare disease. In our case we had a definite IE patient with a spectrum of neurological events complicating this disease. The presence of cerebral hemorrhage complications makes the patient's prognosis worse. Pendahuluan: Endokarditis Infektif (IE) merupakan penyakit yang umumnya menyerang katup jantung. Diagnosis pada umumnya relatif sederhana, namun dapat menjadi sulit gejala yang ditemukan tidak spesifik. Komplikasi intrakranial pasien dengan IE jarang terjadi.Laporan Kasus: Seorang laki-laki 64 tahun dengan penurunan kesadaran mendadak 12 jam sebelum masuk rumah sakit (MRS) dan didiagnosis sebagai stroke hemoragik. Pasien memiliki riwayat perokok berat selama kurang lebih 10 tahun. Endokarditis infektif (IE) di diagnosis dengan kriteria Duke, dan dari pasien ini ditemukan vegetasi pada katup mitral dengan diameter 1,09 x 0,73 cm. Pengobatan untuk pasien adalah antibiotik berdasarkan uji sensitivitas kultur darah. Pasien dipulangkan dengan kondisi perbaikan. Namun, sekitar tiga bulan setelah keluar, pasien kembali dirawat di rumah sakit karena kondisi yang sama dan meninggal dunia.Simpulan: Endokarditis infektif merupakan penyakit yang relatif jarang. Dalam laporan kasus ini, pasien dengan spektrum kejadian neurologis yang menyulitkan penyakit IE. Adanya komplikasi perdarahan otak membuat prognosis pasien semakin buruk.

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