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I Made Dedy Kusnawan
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Biochemistry, Genetics & Molecular Biology Medicine & Pharmacology Nursing Public Health Veterinary

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Problem Diagnosis dan Tatalaksana Pasien Syok Sepsis dengan Meningitis Suis I Made Dedy Kusnawan
Jurnal Medika Hutama Vol. 5 No. 01 Oktober (2023): Jurnal Medika Hutama
Publisher : Yayasan Pendidikan Medika Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.66940/jmh.v5i01 Oktober.681

Abstract

Sepsis is a condition of clinical syndrome that occurs due to excessive body response to an infection that includes inflammatory, autoimmune, and coagulation processes. Sepsis treatment requires a quick diagnosis and appropriate therapy to reduce mortality caused by this condition. This case report aims to provide an overview of diagnostic and management shock sepsis. A 43-year-old male patient came from refferal from private hospital to emergency ward with diagnostic dengue shock syndrome. Patient came with chief complaint of decrease of consciousness since sunday afternoon. Firstly, the patient can still do communication. however, after some time, the patient cannot be communicated and looks agitated. Physical examination found tightness (respiration rate 26 times/ minute), blood pressure 100/70 mmHg, 89 % saturation via nonoxygen rebreathing mask 15 liters per minute, pulse 106 times per minute, GCS E3V3M5, temperature 38,4 ºC. Both sclerae appear to have icterus, from a physical examination found nuchal rigidity, cold in distal extremity. Through an examination of complete blood count found leukocytosis (36,1 x 103/µL) with predominant neutrofil (33,9 x 103/µL). From liver function examination found an increase in SGOT (224.5 mg/dl) and SGPT (165.2 mg/dl). Renal function examination was found to increase in urea (27,1 mg/dl) and creatinine (3mg/dl). SOFA score this patient is 13 point, criteria to identify sepsis. Treatment of sepsis must be based on rapid diagnosis and appropriate resuscitation treatment to reduce mortality caused by sepsis.
TATALAKSANA SEORANG PASIEN KRISIS TIROID DENGAN COVID 19 I Made Dedy Kusnawan
Jurnal Medika Hutama Vol. 6 No. 01 Oktober (2024): Jurnal Medika Hutama
Publisher : Yayasan Pendidikan Medika Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.66940/jmh.v6i01 Oktober.727

Abstract

Thyrotoxic crisis or thyroid storm is an acute, life threatening complication of hyperthyroidism. It comes with sudden multisystem involvement. Thyroid hormones affects all organ system, can causes increase of metabolic rate, heart rate, ventricle contractility, gastrointestinal motility, muscle, and nervous system excitability. Various factors can trigger thyroid storm in thyrotoxicosis such as trauma, surgery, pulmonary embolism, myocardial infarction, cerebrovascular disorders, infection, diabetic ketoacidosis, and toxemia gravidarum, and nonadherence in taking anti thyroid drugs. Thyroid storm estimated incidence 0.2 per 100.000 per year. The diagnostic strategy for thyroid storms may take consideration from BurchWartofsky scoring system. Thyroid storm need immediate and accurate management including specific therapy with antithyroid, betablocker, iodine, glucucorticoid, and also supportive treatment. A 45 years old female presents with the chief complaint of shortness of breath and palpitation, fever and cough, the patient is diagnosed with thyroid crisis caused by Graves’ disease and also confirm severe covid 19 infection. The patient showed good response with therapy.
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