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All Journal E-Jurnal Medika Udayana Jurnal Kesehatan Andalas Mutiara Medika: Jurnal Kedokteran dan Kesehatan JBN (Jurnal Bedah Nasional) ISM (Intisari Sains Medis) : Jurnal Kedokteran Journal of the Indonesian Medical Association : Majalah Kedokteran Indonesia Bali Anatomy Journal Essential: Essence of Scientific Medical Journal Pediatric Sciences Journal
Pande Putu Yuli Anandasari
Departement Of Radiology, Faculty Of Medicine, Universitas Udayana
Biochemistry, Genetics & Molecular Biology Education Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

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Challenging diagnostic of juvenile systemic sclerosis in limited sources: a case report Ronaldi, Melissa; Wati, Ketut Dewi Kumara; Gunawijaya, Eka; Yantie, Ni Putu Veny Kartika; Anandasari, Pande Putu Yuli
Pediatric Sciences Journal Vol. 5 No. 1 (2024): (Available online: 1 June 2024)
Publisher : Medical Faculty of Brawijaya University, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51559/pedscij.v5i1.88

Abstract

Background: Juvenile Systemic Sclerosis (JSSc) is a rare chronic-autoimmune rheumatic disease leading to potential delay in diagnosis, especially in limited sources due to lack of knowledge and facility. This case report aimed to present a rare case of JSSc in limited sources of medical facilities. Case presentation: A 15-year-old girl was earlier suspected of having congenital heart disease due to the presentation of bluish fingers without any detectable clinical heart disease manifestation, including normal electrocardiography as well as echocardiography. The patient experienced pain and difficulty executing wrist endorotation, representing limited joint movement action. Further physical examinations showed pale, cold fingers and toes, bluish color in the peripheral represented sclerodactyly and arthritis. Skin showed multiple erythema-hypopigmentation papuls, in accordance with gottorn papule, gottorn sign. The antinuclear antibody titer was 1:320. Chest CT-Scan result was a fibrotic line at the inferior lobe of the left lung with the left diaphragm tenting due to a chronic inflammatory process. Skin biopsy shows an acanthotic epidermis, dermafibrocollagenous tissue with extensive fibrosis, and sclerosis with vascular proliferation. These findings meet JSSc PRES, ACR, and EULAR standard classification criteria, including 1 major and 4 minors. The treatment regimen was started with methylprednisolone 2 mg/kg/day, then tapering off once clinical manifestation alleviated, methotrexate 10 mg/BSA, and folic acid 1 mg a day. Long-term monitoring plans are also scheduled. Conclusion: Recognizing early symptoms of JSSc would provide a better outcome.
Nilai Diagnostik Ultrasonografi Hepatobilier sebagai Prediktor Atresiabilier pada Kolestasis Bayi di RSUP Sanglah Denpasar Tahun 2017 - 2021 Agustina, Kristin; Anandasari, Pande Putu Yuli; Sitanggang, Firman Parulian; Putra, I Wayan Gede Artawan Eka; Asih, Made Widhi; Patriawan, Putu
Jurnal Kesehatan Andalas Vol. 12 No. 1 (2023): Online March 2023
Publisher : Faculty of Medicine, Universitas Andalas

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25077/jka.v12i1.2156

Abstract

Hepatobiliary ultrasound is the most common initial diagnostic modality in the early detection of biliary atresia. It is not the gold standard, but the hepatobiliary ultrasound examination can be used to determine the appropriate further management. Objective: To determined the diagnostic value of ultrasound examination as a predictor of biliary atresia in cholestasis of infants. Methods: This was an observational study with a diagnostic test to determine the validity of hepatobiliary ultrasound as a predictor of biliary atresia with cholangiography as the gold standard. The research subjects were 40 infants taken by total sampling from January 2017 until December 2021. Data were obtained from medical records, hepatobiliary ultrasound images were accessed from PACS, and cholangiography results from SIMARS. The hepatobiliary ultrasound images were scored by two observers using a scoring table. The variables assessed included: gallbladder morphology, absence of common bile duct, triangular cord sign, gallbladder contraction index and liver morphology. Data analysis consisted of interobserver reliability test, and relationship assessment analysis. Diagnostic tests to determine the optimal cut-off score, sensitivity, specificity, positive predictive value, negative predictive value and accuracy. Results: At cut-off≥ 5, the number of patients with radiologically impressive biliary atresia was 26 and not biliary atresia was 14. The validity analysis showed a sensitivity 87.5%, specificity 68.8%, positive predictive  80.8%, negative predictive 78.6%, and accuracy 80%. Conclusion: The diagnostic value of hepatobiliary ultrasound as a predictor of biliary atresia in cholestasis of infants is good.Keywords:  biliary atresia, hepatobiliary ultrasound, neonatal cholestasis
Peran Skor Brixia sebagai Prediktor Kejadian Coronavirus Disease-19 (COVID-19)-associated Hemostatic Abnormalities (CAHA) Berdasarkan Kadar D-dimer Fiona, Fiona; Margiani, Ni Nyoman; Sitanggang, Firman Parulian; Eka Putra, I Wayan Gede Artawan; Anandasari, Pande Putu Yuli; Ayusta, I Made Dwijaputra
Majalah Kedokteran Indonesia Vol 73 No 3 (2023): Journal of The Indonesian Medical Association - Majalah Kedokteran Indonesia, Vo
Publisher : PENGURUS BESAR IKATAN DOKTER INDONESIA (PB IDI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47830/jinma-vol.73.3-2023-954

Abstract

Introduction: Coronavirus Disease-19 (COVID-19) is a systemic disease that causes complications in respiratory system and coagulopathy, which is called COVID-19-associated hemostatic abnormalities (CAHA). The Brixia chest X-ray scoring system may benefit in detecting CAHA. This study aims to investigate the role of the Brixia score as a predictor of CAHA based on D-dimer levels. Methods: This was a cross-sectional study that used medical records from Radiology Installation, Sanglah General Hospital, Bali, during August 2020 until August 2021. Subjects were confirmed and hospitalized COVID-19 patients with mild to critical degree and aged 18-59 years old. Any other pulmonary diseases than COVID-19 in X-ray was excluded. Brixia score was determined independently and blindly determined by two radiologists. The incidence of CAHA was defined as an elevation of D-dimer in pulmonary COVID-19. We conducted interobserver Bland-Altman, followed by correlation test, receiver operating characteristic (ROC) analysis, and multiple logistic regression test to control for confounding factors. Result: This study included 70 subjects selected through random sampling. We found a positive correlation between the Brixia score and D-dimer levels (r=0.329, p less than 0.05). The ROC analysis indicated that a Brixia score cut-off ≥10 is the best predictor of CAHA, with a positive predictive value of 95.8% and a negative predictive value of 40.9%. Subjects with a Brixia score ≥10 were found to have a higher risk of developing CAHA (aOR 14.78, p less than 0.05) after controlling for age, gender, nutritional status, and comorbidities. Conclusion: There was a statistically significant association between Brixia score and CAHA in COVID-19 patients based on D-dimer levels. The Brixia score could be used as a predictor of CAHA with the cut-off value ≥10.
Co-Authors Agustina, Kristin Angelina, Vioreli Ayusta, I Made Dwijaputra Dewa Gde Mahiswara Suadiatmika Dewa Gede Mahiswara Suadiatmika Eka Gunawijaya Eka Putra, I Wayan Gede Artawan Elysanti Dwi Martadiani Eveline, Ency Fiona Fiona, Fiona Firman Parulian Sitanggang Gede Wirya Kusuma Duarsa Gusti Ayu Putu Nilawati I Gde Raka Widiana I Gede Agus Pradana I Wayan Gede Artawan Eka Putra, I Wayan Gede Artawan Eka Indira Prawita Martani Inez Kartika Ketut Dewi Kumara Wati Kristin Agustina Listyani Gunawan Made Widhi Asih Ni Made Mahastuti Ni Made Putri Suastari Ni Nyoman Margiani Ni Putu Veny Kartika Yantie, Ni Putu Veny Kartika Patriawan, Putu Putu Kurnia Darma Pratama Ronaldi, Melissa Sitanggang, Firman Parulian Zulfariska, Nony