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Rochmah, Izzah
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Biochemistry, Genetics & Molecular Biology Health Professions Medicine & Pharmacology Nursing Public Health

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SEBUAH LAPORAN KASUS Sindrom Nefrotik pada Pasien Pengguna Obat Antiinflamasi Non Steroid (OAINS) pada Dewasa: sebuah Laporan Kasus Mumtaza, Hilya Itsnain; Rochmah, Izzah
Jurnal Klinik dan Riset Kesehatan Vol 2 No 2 (2023): Februari 2023
Publisher : RSUD Dr. Saiful Anwar Province of East Java

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.11594/jk-risk.02.2.8

Abstract

Background: Non-steroidal antiinflammatory drugs (NSAID) is a common drug with an antiinflammation and an analgesic effect which consumed widely among people. On the other hand, NSAID also have some adverse effects including nefrotic syndrome (NS). Case Presentation: A man, 20 years old, came with general body swelling. The swelling appeared gradually accompanied by shortness of breath as the body swelling was spread. The patient has a history of frequently consuming pain reliver medications which he bought over the counter, 3-4 times/week since 1 year ago. The patient was diagnosed with nephrotic syndrome. We stop the OAINS and administer some medications, such as, intravenous steroid, oral ARBs, and oral anticoagulant therapy. Patients responded well to the therapy given marked by reduced edema and improved kidney function. Discussion: NS is glomerular syndrome consists of massive proteinuria, hypoalbuminemia, peripheral oedema, and/or hyperlipidemia. The etiology of NS divided into 2 group : primary NS and secondary NS. The primary NS such as minimal change disease glomerulonephritis, membranous nephropathy, focal segmental glomerulonephritis, and IgA nephropathy. In the other hand, secondary SN can be caused by NSAID toxicity, infection, metabolic dysfunction, and autoimmune disease. Conclusion: In this case report, a male, 20 years old is diagnosed with NS and had medical history of being long term NSAID’s user who responded well after given steroid therapy. In order to find the definite etiology of SN, it need adjunct examination such as renal biopsy. Moreover, medical practitioner should do the holistic and comprehensive anamnesis and physical examination associated with the risk of NS.
Tantangan Untuk Mengobati Hipoglikemia Bagi Pasien Lanjut Usia Diabetes Dalam Praktek Klinis Sehari-hari Rochmah, Izzah; Erwan, Nabila; Mumtaza, Hilya
Jurnal Klinik dan Riset Kesehatan Vol 2 No 3 (2023): Edisi Juni
Publisher : RSUD Dr. Saiful Anwar Province of East Java

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.11594/jk-risk.02.3.7

Abstract

Background: Hypoglycemia is an acute complication that often occurs in daily clinical practice. The incidence of hypoglycemia is increased, one of which is by age factors and the use of insulin. Case Presentation: A 66-years old Indonesian woman with obesity (BMI=35.2 kg/m2) came to Emergency Department (ED) with decreased of consciousness due to a skipped meal after a prandial insulin injection with errors in calculating insulin dose. She had Diabetes Mellitus type 2 since 10 years ago and got insulin prescription since last year. The random blood sugar (RBG) was 27 mg/dl. Patient was administered intravenous D40% 75ml and the symptoms was improved. Patient was diagnosed this patient with severe hypoglycemia. During hospitalization, patient’s blood sugar had fluctuation in 2 days consecutive mornings and began to stable in day 3 on ward. When the patient discharged, we prescribed 24U basal insulin given before bed if the RBG level >200mg/dl. Discussion: In older population, the neuroglycopenic symptoms, such as lethargy, dizziness, and delirium appear in higher BG level than the autonomic symptoms. The disproportion of demand and supply of blood glucose in the brain causes the neuroglycopenic symptoms. In addition, those signs are also likely to be misinterpreted as signs of stroke, dementia, or vision problems. This cycle of misidiagnosed and the tendency of neuroglypenic symptoms lead the older population into hypoglycemia unawareness. Conclusion: Hypoglycemia unawareness is one of the warning signs of the severity of Diabetes Mellitus type 2 caused by multiple factors which has high prevalence in the elderly. Therefore, particular management is needed in this population by selecting the suitable glucose-lowering agent considering individualized patient preferences rather than focusing on the glycemic target.
SEBUAH LAPORAN KASUS Sindrom Nefrotik pada Pasien Pengguna Obat Antiinflamasi Non Steroid (OAINS) pada Dewasa: sebuah Laporan Kasus Mumtaza, Hilya Itsnain; Rochmah, Izzah
Jurnal Klinik dan Riset Kesehatan Vol 2 No 2 (2023): Februari 2023
Publisher : RSUD Dr. Saiful Anwar Province of East Java

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.11594/jk-risk.02.2.8

Abstract

Background: Non-steroidal antiinflammatory drugs (NSAID) is a common drug with an antiinflammation and an analgesic effect which consumed widely among people. On the other hand, NSAID also have some adverse effects including nefrotic syndrome (NS). Case Presentation: A man, 20 years old, came with general body swelling. The swelling appeared gradually accompanied by shortness of breath as the body swelling was spread. The patient has a history of frequently consuming pain reliver medications which he bought over the counter, 3-4 times/week since 1 year ago. The patient was diagnosed with nephrotic syndrome. We stop the OAINS and administer some medications, such as, intravenous steroid, oral ARBs, and oral anticoagulant therapy. Patients responded well to the therapy given marked by reduced edema and improved kidney function. Discussion: NS is glomerular syndrome consists of massive proteinuria, hypoalbuminemia, peripheral oedema, and/or hyperlipidemia. The etiology of NS divided into 2 group : primary NS and secondary NS. The primary NS such as minimal change disease glomerulonephritis, membranous nephropathy, focal segmental glomerulonephritis, and IgA nephropathy. In the other hand, secondary SN can be caused by NSAID toxicity, infection, metabolic dysfunction, and autoimmune disease. Conclusion: In this case report, a male, 20 years old is diagnosed with NS and had medical history of being long term NSAID’s user who responded well after given steroid therapy. In order to find the definite etiology of SN, it need adjunct examination such as renal biopsy. Moreover, medical practitioner should do the holistic and comprehensive anamnesis and physical examination associated with the risk of NS.
Tantangan Untuk Mengobati Hipoglikemia Bagi Pasien Lanjut Usia Diabetes Dalam Praktek Klinis Sehari-hari Rochmah, Izzah; Erwan, Nabila; Mumtaza, Hilya
Jurnal Klinik dan Riset Kesehatan Vol 2 No 3 (2023): Edisi Juni
Publisher : RSUD Dr. Saiful Anwar Province of East Java

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.11594/jk-risk.02.3.7

Abstract

Background: Hypoglycemia is an acute complication that often occurs in daily clinical practice. The incidence of hypoglycemia is increased, one of which is by age factors and the use of insulin. Case Presentation: A 66-years old Indonesian woman with obesity (BMI=35.2 kg/m2) came to Emergency Department (ED) with decreased of consciousness due to a skipped meal after a prandial insulin injection with errors in calculating insulin dose. She had Diabetes Mellitus type 2 since 10 years ago and got insulin prescription since last year. The random blood sugar (RBG) was 27 mg/dl. Patient was administered intravenous D40% 75ml and the symptoms was improved. Patient was diagnosed this patient with severe hypoglycemia. During hospitalization, patient’s blood sugar had fluctuation in 2 days consecutive mornings and began to stable in day 3 on ward. When the patient discharged, we prescribed 24U basal insulin given before bed if the RBG level >200mg/dl. Discussion: In older population, the neuroglycopenic symptoms, such as lethargy, dizziness, and delirium appear in higher BG level than the autonomic symptoms. The disproportion of demand and supply of blood glucose in the brain causes the neuroglycopenic symptoms. In addition, those signs are also likely to be misinterpreted as signs of stroke, dementia, or vision problems. This cycle of misidiagnosed and the tendency of neuroglypenic symptoms lead the older population into hypoglycemia unawareness. Conclusion: Hypoglycemia unawareness is one of the warning signs of the severity of Diabetes Mellitus type 2 caused by multiple factors which has high prevalence in the elderly. Therefore, particular management is needed in this population by selecting the suitable glucose-lowering agent considering individualized patient preferences rather than focusing on the glycemic target.
Co-Authors Erwan, Nabila Mumtaza, Hilya Mumtaza, Hilya Itsnain