Prasetyaning Estu Pratiwi
Faculty Of Medicine, UPN “Veteran” Jawa Timur, Indonesia

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Journal : Medicosphere

LITERATURE REVIEW OF NEPHROTIC EDEMA MANAGEMENT: A Literature Review Pramuti, Agysza Ulfiantika; Estu Pratiwi, Prasetyaning
Journal of Diverse Medical Research: Medicosphere Vol. 2 No. 4 (2025): J Divers Med Res 2025
Publisher : Faculty of Medical - UPN Veteran Jawa Timur

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33005/jdiversemedres.v2i4.111

Abstract

Abstract Background. Nephrotic syndrome (NS) is a renal disorder characterized by proteinuria, hypoalbuminemia, hyperlipidemia, and edema. Among these, edema remains a prominent clinical manifestation affecting patient quality of life and signaling disease progression. Understanding its multifactorial pathophysiology is essential for optimizing treatment strategies. Methods. A systematic review of peer-reviewed literature from 2020 to 2024 was conducted using PubMed, ScienceDirect, and Elsevier. Search terms included "Edema," "Nephrotic Syndrome," "Proteinuria," and "Nephrotic Edema." Relevant articles, including case reports, reviews, and clinical studies, were critically analyzed to identify advances in understanding and managing edema in NS. Discussion. Edema in NS arises from a combination of hypoalbuminemia-induced oncotic pressure reductions, increased sodium retention, and altered vascular permeability. Standard therapies, such as diuretics and dietary sodium restriction, address these mechanisms but may be insufficient for resistant cases. Emerging strategies include combination diuretics, targeted immunomodulators, and personalized approaches based on genetic predispositions and hormonal influences. Advanced outcome measures now enable improved assessment of treatment effectiveness and patient outcomes experiences . Conclusion. Effective management of nephrotic edema requires a holistic approach, integrating conventional therapies with emerging innovations. Advances in molecular research and diagnostic precision are paving the way for personalized interventions, emphasizing the need for multidisciplinary care to improve outcomes and enhance patient quality of life.
The Bronchiectasis in Geriatric Patients: Adaptation of Diagnosis and Management in the Context of Advanced Age: A Case Report Aulia, Khansa Tsabitah; Pratiwi, Prasetyaning Estu
Journal of Diverse Medical Research: Medicosphere Vol. 2 No. 7 (2025): J Divers Med Res 2025
Publisher : Faculty of Medical - UPN Veteran Jawa Timur

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Introduction: Bronchiectasis is an abnormal and permanent dilation of the bronchi caused by chronic inflammatory processes or recurrent infections. This condition can aggravate the patient's respiratory status, especially if it is accompanied by complications. Case Description: A 70-year-old man came in with complaints of chronic cough with phlegm and increasingly severe shortness of breath. No history of tuberculosis or other systemic diseases was found. Thoracic photos and CT scans show a picture of bronchiectasis with honeycombing leading to pulmonary fibrosis. Laboratory tests showed leukocytosis, increased urea and creatinine, and impaired liver function. The patient received injectable moxifloxacin antibiotic therapy followed by oral ciprofloxacin, as well as other supportive therapies. Clinical improvement begins to be seen after a few days of treatment. Discussion: Bronchiectasis in the elderly is often a challenge due to symptoms that overlap with other lung diseases as well as the presence of comorbidities. The absence of a definitive cause in these patients led to the diagnosis of idiopathic bronchiectasis. The honeycombing findings on imaging indicate the possibility of pulmonary fibrosis aggravating the condition. Prompt and appropriate management is essential to prevent disease progression. Conclusions: Idiopathic bronchiectasis with complications of pulmonary fibrosis is a rare and challenging case in diagnosis and management. A thorough radiological and laboratory examination is helpful in establishing the diagnosis and determining the optimal therapy.
The Role of Risk Factors in the Early Manifestation of Gout in Young Women: A Case Report BASHOR, FURQON ABDULLAH; pratiwi, Prasetyaning Estu
Journal of Diverse Medical Research: Medicosphere Vol. 2 No. 8 (2025): J Divers Med Res 2025
Publisher : Faculty of Medical - UPN Veteran Jawa Timur

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ABSTRACT Introduction: Gout is an inflammatory form of arthritis caused by the deposition of monosodium urate crystals in tissues and joints due to hyperuricemia. Although it is more common in middle-aged men, the increasing incidence in young women with genetic predisposition and certain lifestyle factors has become a clinical concern. Early identification and management of risk factors are crucial to prevent disease progression. Case Illustration: A 33-year-old woman with a family history of gout and dyslipidaemia presented with intermittent joint pain in the lower extremities exacerbated by consumption of high-purine foods. The patient was diagnosed with hyperuricaemia in 2017 but did not undergo regular follow-up. Use of allopurinol and corticosteroids was effective in alleviating symptoms, but the complaints persisted. Discussion: This case illustrates the significant role of hereditary risk factors, high-purine dietary patterns, and inadequate medical supervision in the onset of early gout. Pathophysiologically, gout begins with chronic hyperuricemia, which then triggers an inflammatory process through uric acid crystallisation. Genetic factors such as the T allele at SNP rs2231142 of the ABCG2 gene are known to impair uric acid excretion through the intestines, increasing the risk of hyperuricemia and early-onset gout. Epidemiological evidence shows a 3.64-fold increased risk of gout in individuals with high genetic risk and unhealthy lifestyles. Conclusion: The manifestation of gout in young women is the result of a complex interaction between genetic predisposition, environmental factors, and lifestyle. Early detection of risk factors and lifestyle-based interventions particularly a low-purine diet and monitoring of uric acid levels are key approaches in the prevention and management of gout in the productive age population.