Trias Nugrahadi, Trias
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Streptococcus pneumoniae Drugs Resistance in Acute Rhinosinusitis Hao, Chong Jie; Chrysanti, Chrysanti; Nugrahadi, Trias
Althea Medical Journal Vol 3, No 1 (2016)
Publisher : Althea Medical Journal

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Abstract

Background: Acute rhinosinusitis that usually caused by Streptococcus pneumoniae becomes the reason why patients seek for medical care. Drugs resistance in Streptococcus pneumoniae is increasing worldwide. This study was conducted to determine drugs resistance of Streptococcus pneumonia from acute rhinosinusitis in Dr. Hasan Sadikin General Hospital.Methods: A descriptive laboratory study was conducted in June–October 2014 at the Laboratory of Microbiology Faculty of Medicine Universitas Padjadjaran. The sample was taken using nasopharyngeal swabbing from 100 acute rhinosinusitis patients in Dr. Hasan Sadikin General Hospital and planted on tryptic soy agar containing 5% sheep blood and 5 μg/ml of gentamicin sulphate and then incubated in 5% CO2 incubator at 37°C for 24 hours. The identification of Streptococcus pneumonia was performed by optochin test. The susceptibility test against Streptococcus pneumoniae was done using disk diffusion method.The antibiotic disks were trimethoprim-sulfamethoxazole, oxacillin, levofloxacin, azithromycin, and doxycycline.Results: Out of 100 samples, 8 of them were tested positive for Streptococcus pneumoniae. Three of Streptococcus pneumoniae isolates died with unknown reason after it were stored at -80 .The drugs resistance test showed the resistance of Streptococcus pneumonia to oxacillin, azithromycin and trimethoprim were 6, whereas levofloxacin and doxycycline are 4.Conclusions: Streptococcus pneumonia drugs resistance in acute rhinosinusitis shows the resistance of Streptococcus pneumoniae to oxacillin, azithromycin and trimethoprim are 6, whereas the resistance to levofloxacin and doxycycline are 4. [AMJ.2016;3(1):64–8]DOI: 10.15850/amj.v3n1.722
Visualization of bleeding site on 24-hour imaging in lower gastrointestinal bleeding with 99mTc-nanocolloid: A case report Alyani, Hilmi; Budiawan, Hendra; Nugrahadi, Trias
JKKI : Jurnal Kedokteran dan Kesehatan Indonesia JKKI, Vol 15, No 3, (2024)
Publisher : Faculty of Medicine, Universitas Islam Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20885/JKKI.Vol15.Iss3.art14

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Gastrointestinal bleeding can be diagnosed by history taking, physical examination, and diagnostic examinations. However, localization of gastrointestinal bleeding via a nuclear medicine examination can indicate an accurate examination to detect the location of bleeding. Radiopharmaceuticals can be selected according to a patient’s condition. Good image results are needed so that the results are conclusive and lead to further examination and management. A 2-years-old girl patient was hospitalized in a paediatric ward due to a large number of loose stools mixed with fresh blood for months after experiencing diarrhoea. The patient was active, absence any decreased appetite, pain, activity disturbances, or significant weight loss . Her parents took her for treatment to several hospitals but no improvement. The patient was referred to the Nuclear Medicine Department to undergo localization of gastrointestinal bleeding study. 99mTc-nanocolloid was injected as radiopharmaceuticals, followed by a dynamic and serial static imaging after 30 minutes. No focus of radioactivity extravasation was found. Examination was continued at 1, 2, and 24 hours. Diffuse radioactivity extravasation was found in the descending colon 24 hours after injection of the radiopharmaceutical, and she was confirmed by colonoscopy and biopsy a week later. 99mTc-labeled colloid had not been used after a few studies showed that 99mTc-red blood cell (RBC) in vitro was better at localizing gastrointestinal bleeding. Usually, 99mTc-labeled colloid remains in circulation for only 30 minutes due to rapid distribution to the reticuloendothelial system. The visualization of the bleeding site on 24-hour imaging was unusual. However, these findings suggest that 99mTc-labeled colloid can still be used with due regard to the patient's clinical active bleeding and imaging techniques.