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An Indonesian Pregnant Woman with Lung Cancer and Liver Metastasis : A Case Report Jayalie, Vito Filbert; Priantono, Dimas; Amin, Zulkifli
Indonesian Journal of Cancer Vol 12, No 2 (2018): April-June
Publisher : National Cancer Center - Dharmais Cancer Hospital

Background: Lung cancer in pregnancy is a rare disease compared to other types of cancer. However, special issue should be applied in order to maximize benefit for mother without harming the fetus.Methods: We present a case of 37-year-old, five months pregnant woman who came to the hospital with chief complain of shortness of breath. Later on, she was found to have a stage IV Non-Small Cell Lung Cancer (NSCLC) with adenocarcinoma subtype.Result: This may be the first lung cancer in pregnancy reported in Indonesia. Being a developing country, several challenges emerged before diagnosing patient of having lung cancer.Conclusion: Careful considerations along with multidisciplinary approach are necessary to provide the best care for the patient.

Challenges in Providing Treatment of Severe Malaria Case in aDistrict Hospital of Remote Area in Indonesia Priantono, Dimas; Purnama, Asep; Nelwan, Erni Juwita
Jurnal Penyakit Dalam Indonesia Vol. 4, No. 1
Publisher : UI Scholars Hub

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Severe Malaria is commonly found due to Plasmodium falciparum infection, which is causing high mortality in patient. A Severe case might be difficult to treat optimally in the remote settings area that could be due to lack in awareness of disease manifestation and inadequate diagnostic facilities. We report a case of Severe Malaria Falciparum infection, confirmed by blood smear examination of Plasmodium falciparum (Pf) parasites. Patient had received Artemicinin Based Combination Therapy (ACT), which consisted of dihydroartemisinin (DHA)-piperaquine and primaquine (PQ) with no clear clinical and microscopy improvement. The second line anti malaria consisted of quinine, doxycycline, and PQ was then initiated, showing clinical and microscopy responses.

Two-point Compression POCUS sebagai Metode Diagnosis Dini Trombosis Vena Dalam Proksimal Ramadan, Edwin Ti; Maharani, Sausan Hana; Cahyanur, Rahmat; Priantono, Dimas; Rajabto, Wulyo
Jurnal Penyakit Dalam Indonesia Vol. 11, No. 2
Publisher : UI Scholars Hub

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Deep vein thrombosis (DVT), especially in the proximal part of the lower extremity, might progress to pulmonary embolism and be fatal. Therefore, it is crucial to prompt the diagnosis of DVT in the emergency room (ER). Due to its efficiency and patient convenience, duplex ultrasound has become the preferred diagnostic method for DVT. Point-of-care ultrasonography (POCUS) was known as a simpler and faster way to use ultrasonography at the bedside. The two-point compression method has become frequently used due to its ability to take less time for examination, yet there are still concerns about its accuracy. This study was conducted to find out whether two-point compression POCUS can be used as an early diagnostic method for proximal DVT. The literature search was carried out in the databases PUBMED, EMBASE, and SCOPUS on March 29, 2023, using keywords “Deep Vein Thrombosis”, “two-point compression POCUS”, and “diagnosis”. Four publications were chosen from the search results. One cross-sectional study was found to have a low validity value because POCUS and Doppler ultrasound operators were not blinded, and the reference test was only performed on positive DVT results on POCUS. All studies had high sensitivity and specificity (>90%) compared to the reference test, except for one cross-sectional study in critical patients in ICU, which had a 63% sensitivity value. In conclusion, the two-point compression POCUS method can be utilized as an early diagnostic method for proximal DVT, with the disclaimer that POCUS operators should get curriculum-based training before doing the examination.

Non-Severe COVID-19 Complicated by Deep Vein Thrombosis (DVT) Rajabto, Wulyo; Priantono, Dimas
Jurnal Respirologi Indonesia Vol 44, No 2 (2024)
Publisher : Perhimpunan Dokter Paru Indonesia (PDPI)/The Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497/jri.v44i2.263

Background: Coronavirus Disease 2019 (COVID-19) displays various symptoms ranging from asymptomatic to life-threatening. Patients may present with typical respiratory infections or atypical symptoms. Non-severe COVID-19 encompasses mild and moderate cases, characterized by the absence of criteria for severe or critical illness, with mild cases not showing evidence of viral pneumonia or hypoxia and moderate cases maintaining SpO2 levels of at least 90% on room air.Case: We presented a COVID-19 case with the chief complaint of unilateral leg swelling. A 48-year-old male was admitted with the chief complaint of cramps and swelling of the left leg. He had a history of fever, cough, nausea, and vomiting. Laboratory studies showed elevated D-dimer. Doppler ultrasound shows signs of both proximal and distal deep vein thrombosis. CT pulmonary angiography excluded pulmonary embolism while the lung window image supported the diagnosis of COVID-19 pneumonia. Polymerase chain reaction (PCR) obtained from nasopharyngeal and oropharyngeal swabs confirmed COVID-19 infection.Discussion: We treated the patient with parenteral anticoagulation followed by direct oral anticoagulant upon discharge. The swelling improved as well as the patient’s clinical status. Thromboembolic complications have been credited as the culprit of high mortality in COVID-19. Systemic activation of coagulation in pulmonary and peripheral circulation contributed to life-threatening thrombotic complications. Our patient presented with COVID-19-associated proximal and distal DVT without pulmonary embolism.Conclusion: Prompt diagnosis of COVID-19 infection and acute DVT improves patient care. The hallmark of the management of VTE in COVID-19 patients is treatment with therapeutic dose parenteral anticoagulation followed by oral anticoagulant.

Non-Severe COVID-19 Complicated by Deep Vein Thrombosis (DVT) Rajabto, Wulyo; Priantono, Dimas
Jurnal Respirologi Indonesia Vol 44 No 2 (2024)
Publisher : Perhimpunan Dokter Paru Indonesia (PDPI)/The Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497/jri.v44i2.263

Background: Coronavirus Disease 2019 (COVID-19) displays various symptoms ranging from asymptomatic to life-threatening. Patients may present with typical respiratory infections or atypical symptoms. Non-severe COVID-19 encompasses mild and moderate cases, characterized by the absence of criteria for severe or critical illness, with mild cases not showing evidence of viral pneumonia or hypoxia and moderate cases maintaining SpO2 levels of at least 90% on room air.Case: We presented a COVID-19 case with the chief complaint of unilateral leg swelling. A 48-year-old male was admitted with the chief complaint of cramps and swelling of the left leg. He had a history of fever, cough, nausea, and vomiting. Laboratory studies showed elevated D-dimer. Doppler ultrasound shows signs of both proximal and distal deep vein thrombosis. CT pulmonary angiography excluded pulmonary embolism while the lung window image supported the diagnosis of COVID-19 pneumonia. Polymerase chain reaction (PCR) obtained from nasopharyngeal and oropharyngeal swabs confirmed COVID-19 infection.Discussion: We treated the patient with parenteral anticoagulation followed by direct oral anticoagulant upon discharge. The swelling improved as well as the patient’s clinical status. Thromboembolic complications have been credited as the culprit of high mortality in COVID-19. Systemic activation of coagulation in pulmonary and peripheral circulation contributed to life-threatening thrombotic complications. Our patient presented with COVID-19-associated proximal and distal DVT without pulmonary embolism.Conclusion: Prompt diagnosis of COVID-19 infection and acute DVT improves patient care. The hallmark of the management of VTE in COVID-19 patients is treatment with therapeutic dose parenteral anticoagulation followed by oral anticoagulant.

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