Priska Widiastuti, Priska
Bagian Neurologi, Fakultas Kedokteran Universitas Udayana/Rumah Sakit Sanglah Denpasar Bali

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THORACIC OUTLET SYNDROME Widiastuti, Priska; Purwata, Thomas Eko
Medicina Vol 46 No 3 (2015): September 2015
Publisher : Medicina

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (167.794 KB)

Abstract

Thoracic outlet syndrome (TOS) adalah kumpulan gejala yang disebabkan oleh penekanan strukturneurovaskular ekstremitas atas saat berjalan di antara kosta pertama dan klavikula menuju keaksila. Penekanan dapat disebabkan oleh kelainan tulang atau jaringan lunak di sekitarnya. GejalaTOS dapat berupa gejala neurologi seperti nyeri lengan atas dan bawah, kesemutan, hilangnya rasaraba, kelemahan motorik, dan gejala vaskular seperti klaudikasio ekstremitas atas selama aktifitas,pucat, dingin, kelainan suplai darah perifer, mikroemboli, dan perubahan warna kulit. Pemeriksaanfoto rontgen, elektromiografi dan arteriografi/venografi dapat digunakan untuk mendukung diagnosisTOS. Terapi TOS berupa terapi konservatif dengan mengontrol nyeri dan udem, memperbaiki posturtubuh, modifikasi gaya hidup, dan terapi pembedahan melalui pendekatan supraklavikular anterior,transaksila, dan subskapular posterior. [MEDICINA 2015;46:174-7].Thoracic outlet syndrome (TOS) is a constellation of symptoms caused by compression ofneurovascular structure of the upper limb as they pass between first rib and clavicle en route to theaxilla. Compression can be caused by bony or soft tissue abnormalities. The symptoms can beneurological symptoms including arm and forearm pain, paresthesia, sensation loss, motor weakness,and vascular symptoms including upper limb claudication during exercise, pallor, coldness, impairedperipheral blood supply, microembolization, and skin colour changes. Rontgen photo, electromyographyand arteriography/venography can be used to diagnose TOS. Thoracic outlet syndrome can be treatedconservatively with pain and edema control, proper posture, life style modification, and surgical therapywith anterior supraclavicular, transaxillary, and posterior subscapular approaches. [MEDICINA2015;46:174-7].
Sistem Skoring Diagnostik untuk Stroke: Skor Siriraj Widiastuti, Priska; Ngurah Nuartha, Anak Agung Bagus
Cermin Dunia Kedokteran Vol 42, No 10 (2015): Neurologi
Publisher : PT. Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (176.514 KB) | DOI: 10.55175/cdk.v42i10.959

Abstract

Penegakan diagnosis stroke perdarahan atau stroke iskemik memerlukan alat penunjang seperti CT scan kepala sebagai pemeriksaan baku emas yang tidak dipunyai oleh semua daerah. Skor Siriraj telah dikembangkan sekitar tahun 1984-1985 di Rumah Sakit Siriraj, Thailand, untuk membedakan stroke perdarahan atau stroke iskemik. Banyak penelitian menunjukkan hasil bervariasi, karena perbedaan kondisi daerah, prevalensi stroke, jumlah sampel, dan metode penelitian. Skor Siriraj dikatakan tidak cukup sensitif pada penelitian di Jakarta. Namun, penelitian terakhir di India menyimpulkan skor Siriraj masih dapat digunakan untuk membedakan stroke perdarahan dan stroke iskemik, terutama di daerah yang belum memiliki fasilitas CT scan kepala.Diagnosis of haemorrhagic stroke or ischemic stroke require supporting examination such as CT scan of the head as the gold standard examination but not all regions have such facilities. Siriraj scores have been developed in 1984-1985 in Siriraj Hospital, Thailand, to differentiate haemorrhagic stroke or ischemic stroke. Many researches show variable results, explained by regional difference, stroke prevalence, sample size and also different research methods. Siriraj score is not sensitive enough to distinguish ischemic and haemorrhagic stroke in Jakarta. But recent study in India concluded that Siriraj scores can still be used to distinguish haemorrhagic from ischemic stroke, especially in areas where head CT scan is not available.
Case Report: Re-Emergence of Rabies Cases in Denpasar Praptikaningtyas, Anak Agung Istri; Widiastuti, Priska
COMSERVA : Jurnal Penelitian dan Pengabdian Masyarakat Vol. 5 No. 3 (2025): COMSERVA: Jurnal Penelitian dan Pengabdian Masyarakat
Publisher : Publikasi Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59141/comserva.v5i3.3245

Abstract

Rabies is a fatal zoonotic disease caused by Lyssavirus from the Rhabdoviridae family, which primarily affects the central nervous system. Once symptoms manifest, the case fatality rate exceeds 99%, making it one of the deadliest viral infections. The high mortality rate emphasizes the urgency of preventive measures. This case report aims to highlight the clinical features, diagnostic challenges, and management of symptomatic rabies in humans and reinforce the importance of Post-Exposure Prophylaxis (PEP). A descriptive clinical case report is presented of a 41-year-old male who developed rabies symptoms three months after a dog bite, having not received PEP. Clinical presentation included hydrophobia, vomiting, restlessness, and paresthesia. The patient was treated symptomatically with intravenous antibiotics, antipyretics, gastric protection, and psychiatric support, alongside monitoring in a special care unit. The results show that despite comprehensive symptomatic management—including ceftriaxone, paracetamol, omeprazole, and haloperidol rabies remained untreatable at the symptomatic stage. This case underscores the critical window for prevention before the onset of symptoms. Rabies remains incurable once neurological symptoms appear. Thus, in any suspected exposure to potentially rabid animals, prompt and complete post-exposure prophylaxis  comprising wound care, anti-rabies vaccine, and rabies immunoglobulin is essential. This case reinforces the public health importance of early intervention to prevent fatal outcomes.
Case Report: Re-Emergence of Rabies Cases in Denpasar Praptikaningtyas, Anak Agung Istri; Widiastuti, Priska
COMSERVA : Jurnal Penelitian dan Pengabdian Masyarakat Vol. 5 No. 2 (2025): COMSERVA: Jurnal Penelitian dan Pengabdian Masyarakat
Publisher : Publikasi Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59141/comserva.v5i3.3245

Abstract

Rabies is a fatal zoonotic disease caused by Lyssavirus from the Rhabdoviridae family, which primarily affects the central nervous system. Once symptoms manifest, the case fatality rate exceeds 99%, making it one of the deadliest viral infections. The high mortality rate emphasizes the urgency of preventive measures. This case report aims to highlight the clinical features, diagnostic challenges, and management of symptomatic rabies in humans and reinforce the importance of Post-Exposure Prophylaxis (PEP). A descriptive clinical case report is presented of a 41-year-old male who developed rabies symptoms three months after a dog bite, having not received PEP. Clinical presentation included hydrophobia, vomiting, restlessness, and paresthesia. The patient was treated symptomatically with intravenous antibiotics, antipyretics, gastric protection, and psychiatric support, alongside monitoring in a special care unit. The results show that despite comprehensive symptomatic management—including ceftriaxone, paracetamol, omeprazole, and haloperidol rabies remained untreatable at the symptomatic stage. This case underscores the critical window for prevention before the onset of symptoms. Rabies remains incurable once neurological symptoms appear. Thus, in any suspected exposure to potentially rabid animals, prompt and complete post-exposure prophylaxis  comprising wound care, anti-rabies vaccine, and rabies immunoglobulin is essential. This case reinforces the public health importance of early intervention to prevent fatal outcomes.