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Kasus Tuberkulosis Paru dengan Stunting pada An.Sw dengan Pendekatan Kedokteran Keluarga di Wilayah Kerja Puskesmas Sindang Jaya Eunike Alicia Valentina; Rayhan Al-ghifari Iridansyah Siregar; Hania Angelia; Tom Surjadi
Malahayati Nursing Journal Vol 5, No 8 (2023): Volume 5 Nomor 8 2023
Publisher : Universitas Malahayati Lampung

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/mnj.v5i8.9535

Abstract

ABSTRACT Tuberculosis (TB) is a disease caused by Mycobacterium tuberculosis.The highest mortality occurs in children aged under five years old, particularly those who are malnourished. In 2021, Indonesia is ranked second for country with the highest TB incidence, with a total of 42.187 TB cases in children. Stunting is a chronic nutritional problem caused by malnutrition and recurrent infection, especially in the first thousand days of life. Stunting inhibits physical growth, increasing susceptibility to disease, and interferes with child cognitive development, thereby reducing child’s intelligence and productivity in the future. Studi Status Gizi Indonesia (SSGI) 2021 showed that the prevalence of stunting in Indonesia is 24,4%, which is still considered high. Family medicine approach to increase growth and development, treat and prevent infection, prevent cognitive impairment of An. SW in the future. This research utilized a qualitative approach with a case study research design. The case in this study is a 14-month-old female toddler with the initials SW who presented with recurrent acute respiratory infections. An. SW was born prematurely with low birth weight and her mother was a 16-year-old teenager. Upon conducting an anthropometric examination, An. SW was found to be severely stunted. Holistic and comprehensive treatment has been done to An. SW, so that her complaints are reduced, her weight is increasing, and now she has received adequate treatment for pulmonary tuberculosis with her mom as supervisor. The family of An. SW has understood about stunting and lung tuberculosis and also has improved their parenting style, especially in terms of feeding practices. It was found that the stunting in An. SW was caused by infectious factor such as, lung tuberculosis and non-infectious factors such as inadequate nutrition intake and the parents’ lack of knowledge. After the family medicine approach, the weight of An. SW is increasing and she finally gets the antituberculosis drugs. Keywords: Pulmonary Tuberculosis, Stunting, Family Medicine  ABSTRAK Tuberkulosis (TB) adalah penyakit yang disebabkan oleh infeksi bakteri Mycobacterium tuberculosis. Mortalitas tertinggi terjadi pada anak di bawah usia 5 tahun, terutama pada anak-anak dengan malnutrisi. Pada tahun 2021, Indonesia menduduki peringkat kedua angka kejadian TB tertinggi dengan jumlah kasus TB anak sebanyak 42.187 kasus. Stunting adalah masalah gizi kronis yang terjadi akibat malnutrisi dan infeksi berulang pada 1.000 Hari Pertama Kehidupan. Stunting menghambat pertumbuhan fisik, menyebabkan anak rentan terhadap penyakit dan mengganggu perkembangan kognitif anak sehingga menurunkan tingkat kecerdasan dan produktivitas anak di masa depan. Studi Status Gizi Indonesia (SSGI) 2021 menunjukkan bahwa prevalensi stunting di Indonesia masih tergolong tinggi, yaitu 24,4%. Kunjungan kedokteran keluarga untuk meningkatkan tumbuh kembang, mengatasi dan mencegah infeksi, serta mencegah gangguan kognitif di masa depan pada An. SW. Penelitian ini menggunakan pendekatan kualitatif dengan jenis penelitian studi kasus. Adapun kasus dalam penlitian ini yaitu Seorang balita perempuan beinisial SW dan berusia 14 bulan datang dengan keluhan ISPA berulang. An. SW terlahir prematur dengan BBLSR dan ibunya adalah remaja berusia 16 tahun. Saat dilakukan pemeriksaan antropometri, An. SW tergolong severely stunted. Tata laksana holistik dan komprehensif telah dilakukan sehingga keluhan An. SW berkurang, berat badannya meningkat, dan saat ini telah mendapatkan pengobatan TB paru yang adekuat dengan ibunya sebagai PMO. Keluarga telah memahami tentang stunting dan TB paru, serta memperbaiki pola asuh terutama dalam hal praktik pemberian makanan. Ditemukan bahwa kondisi stunting pada pasien disebabkan oleh faktor infeksi yaitu TB paru serta faktor non-infeksi kurangnya asupan gizi dan pengetahuan orang tua. Setelah dilakukan pendekatan kedokteran keluarga, berat badan An. SW meningkat dan telah mendapatkan OAT. Kata Kunci: Tuberkulosis Paru, Stunting, Kedokteran Keluarga.
Case Report: Chronic Embolic Stroke With Bronchopneumonia In Geriatric Patients Johanes Andrew; Dana Profit Sampurno; Rayhan Al-ghifari Iridansyah Siregar; Eric Eric
Cerdika: Jurnal Ilmiah Indonesia Vol. 5 No. 3 (2025): Cerdika: Jurnal Ilmiah Indonesia
Publisher : Publikasi Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59141/cerdika.v5i3.2457

Abstract

Stroke is a neurological deficit of the central nervous system caused by vascular issues, affecting around 800,000 individuals annually. According to Riskesdas 2018, the prevalence of stroke is approximately 10.9%, with the highest rates in East Kalimantan and the lowest in Papua. In this study, we present a case of a 79-year-old male diagnosed with embolic stroke at Royal Taruma Hospital. The patient was admitted with a fever that persisted for four days prior to hospitalization. Comprehensive anamnesis, physical examination, and diagnostic tests confirmed a diagnosis of febris e.c. bronchopneumonia and hemiparesis duplex e.c. chronic CVDNH. Embolic strokes occur when a cerebral artery is occluded by a clot originating from the heart, aortic arch, or a major cerebral artery, often leading to maximal neurological deficits at the onset. This case underscores several risk factors for embolic stroke, including hypertension, dyslipidemia, and advanced age. The patient was treated with rivaroxaban (10 mg once daily) for anticoagulation and meropenem (1 g three times daily) to manage the infection. Post-treatment, a comprehensive geriatric assessment revealed no signs of urinary or fecal incontinence, and the patient did not exhibit polypharmacy. Following intervention, there was a notable improvement in neurological function and resolution of infectious symptoms. This case highlights effective management strategies for a 79-year-old male with complex medical conditions and emphasizes the necessity of timely interventions in elderly patients for better prognostic outcomes.
A 41-Year-Old-Man With Diffuse Axonal Injury: A Case Report Rayhan Al-ghifari Iridansyah Siregar
Cerdika: Jurnal Ilmiah Indonesia Vol. 5 No. 3 (2025): Cerdika: Jurnal Ilmiah Indonesia
Publisher : Publikasi Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59141/cerdika.v5i3.2460

Abstract

Diffuse axonal injury (DAI) is a significant pathological feature of traumatic brain injury (TBI) and poses a considerable challenge in clinical neurology. This injury is characterized by microscopic damage to axons in neuronal tracts, especially within the corpus callosum and brainstem, leading to severe outcomes, including high morbidity and mortality. We report a case involving a 41-year-old male who presented to the emergency room of RT Hospital after a motorcycle accident, resulting in a prolonged loss of consciousness lasting over 12 days. The diagnosis of DAI was confirmed through detailed history taking, thorough physical and neurological examinations, and MRI brain imaging, which revealed characteristic axonal damage. This case underscores the prevalence of DAI among motorcycle accident victims, regardless of age, and the typical presentation of prolonged unconsciousness. The patient was treated with an intensive regimen aimed at reducing injury effects and promoting neurological recovery. This included mannitol to lower intracranial pressure, nimodipine for neuroprotection, and phenytoin to prevent seizures. Additionally, amantadine and alinamin F were used to enhance cognitive recovery. Supportive therapies comprised paracetamol for fever, ceftriaxone and levofloxacin as antibiotics, and pantoprazole for gastrointestinal protection. Despite these comprehensive efforts, the prognosis remains poor, with a high risk of lasting neurological deficits. This case highlights the critical implications of DAI in TBI management and underscores the need for early diagnosis and ongoing research to better understand and treat this severe condition.