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Ivanna Sarahfebi
Faculty of Medicine, Maranatha Christian University, Bandung, West Java, Indonesia
Health Professions Medicine & Pharmacology Public Health

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Journal : Medical Clinical Update Journal

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Precocious Puberty: A Case Report Anna Felita; Ivanna Sarahfebi; Anastasia Nadya; Parbati Anjali; Chandni P. Daryanani
Medical Clinical Update Vol. 1 No. 1 (2022): October
Publisher : Rumah Sakit Unggul Karsa Medika

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1670.743 KB) | DOI: 10.58376/mcu.v1i1.9

Abstract

Background Puberty is a transitional period in children with acceleration of growth and development of secondary sexual characteristics. When this period appears before the age of 8 to 9 years in children, it is called precocious puberty. Depending on the primary source of the hormonal production, precocious puberty may be classified as central (gonadotropin dependent or true) or peripheral (gonadotropin independent or precocious pseudo-puberty). Case presentation We herein report a case of precocious puberty in a 7,5-year-old girl who has shown early sign of secondary sexual development. Patients complained pain on her nipple, her breasts began to grow in size, and changes in her body odour, but had no complaints about her pubic hair growth and any vaginal discharge. Laboratory findings shown high level in fertility hormones and level of bone age is equal to 10-year-old girl. Patient then had begun to receive monthly therapy of Leuprolide. Conclusion Detailed history taking on chronological order of thelarche, pubarche, menarche, and adrenarche, followed by assessment on family history, nutritional history, child developmental history, medication history, and neurological complaints should be done in order to diagnose precocious puberty. Physical examination and other examination of bone age determination, Luteinizing Hormone and Follicle-Stimulating Hormone level, and pelvic ultrasound are essentials in defining the diagnosis and treatment. Leuprolide is indicated for Central Precocious Puberty patient who have advanced bone age at the time of initial evaluation. As a clinician, it is necessary to diagnose precocious puberty as soon as possible to have good prognosis for the patient.
Paralysis Due to Hypokalemia and Hypocalcemia: A Case Report Ivanna Sarahfebi; Anastasia Nadya; Anisya Lisna; Parbati Anjali; Theresia Monica Rahardjo; Valentine Natasya Moenardi
Medical Clinical Update Vol. 1 No. 1 (2022): October
Publisher : Rumah Sakit Unggul Karsa Medika

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (4814.862 KB) | DOI: 10.58376/mcu.v1i1.11

Abstract

Background Hypokalemia is the most frequent electrolyte disorder encountered in clinical practice. It caused by inadequate potassium intake or excessive renal or gastrointestinal potassium loss. Hypokalemia may associate with muscle weakness. Hypocalcemia can result from disorders of vitamin D metabolism and action, hypoparathyroidism, resistance to parathyroid hormone (PTH), or other conditions such as nutritional deficiency. Numbness and tingling sensation may occur on hypocalcemia. Case presentation A 36-year-old woman came with complaints of weakness of upper and lower limbs three days before admission. At first, the weakness felt suddenly on the left arm and left foot after waking up in the morning, making her not being able to walk. Patient felt tingling sensation on her face, upper limbs, and lower limbs. Her hands felt stiff as well as her mouth. Patient had a decreasing serum level (3 mEq/l) and decreasing total calcium level (4,8 mg/dL). Conclusion In young adult patients with limbs weakness, it is necessary to consider electrolyte imbalance, such as hypokalemia and hypocalcemia. Hypokalemia can be caused by decreased potassium intake, excessive vomiting, drug consumption, kidney disease, and endocrine disease. To diagnose hypokalemia, it is necessary to carry out further examinations such as basic biochemical laboratories (magnesium, calcium, phosphorus), blood gas analysis, TSHs, urine analysis (urine calcium, potassium excretion in 24-hour urine collection), drug screening.
Co-Authors Anastasia Nadya Anisya Lisna Anna Felita Chandni P. Daryanani Parbati Anjali Theresia Monica Rahardjo Valentine Natasya Moenardi