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Emfisema Subkutis Derajat 5 pada Pasien Rekuren Pneumotoraks Spontan Sekunder : Sebuah Laporan Kasus Dwikarlina, Intan; Wijaya, Rendy; Antariksa, Genta; Sari, Fitri; Putra, Christian
Jurnal Klinik dan Riset Kesehatan Vol 3 No 1 (2023): Edisi Oktober
Publisher : RSUD Dr. Saiful Anwar Province of East Java

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.11594/jk-risk.03.1.8

Pendahuluan: Emfisema subkutis merupakan kondisi terdapatnya udara di lapisan subkutan kulit. Emfisema subkutis terjadi melalui berbagai etiologi, salah satunya yakni akibat pecahnya alveoli yang menyebabkan infiltrasi udara diantara jaringan ikat pada kasus pasien dengan pneumotoraks spontan. Laporan Kasus: Pria usia 53 tahun datang dengan keluhan sesak nafas yang muncul tiba-tiba setelah pasien BAB. Keluhan sesak disertai pembengkakan luas pada seluruh tubuh dimulai dari area genitalia hingga seluruh wajah pasien. Pasien memiliki riwayat pneumotoraks spontan sekunder dan memiliki riwayat menderita tuberkulosis yang kambuh pada tahun 2021. Diskusi: Emfisema subkutis terjadi ketika udara masuk ke jaringan di bawah kulit dan jaringan lunak. Emfisema subkutis dapat diklasifikasikan menjadi lima tingkatan berdasarkan tingkat keparahannya. Pada laporan kasus ini, emfisema subkutis derajat 5 terjadi karena riwayat pneumotoraks pada paru kanan pasien. Pneumotoraks bisa bersifat traumatik atau spontan. Pneumotoraks spontan bisa dibagi menjadi primer (tanpa penyebab yang jelas) atau sekunder (terkait dengan penyakit paru). Pasien juga memiliki riwayat penyakit tuberkulosis dan sindrom obstruksi pasca tuberkulosis (SOPT). Penanganan pasien meliputi pemasangan chest tube, terapi oksigen, dan tindakan dekompresi udara subkutan. Kesimpulan: Pada laporan kasus ini, emfisema subkutis derajat 5 dengan riwayat infeksi tuberkulosis berespon baik terhadap pemasangan chest tube tergambar dengan penurunan derajat emfisema secara bertahap. Tenaga medis diperlukan untuk melakukan anamnesis dan pemeriksaan medis secara holistik dan komprehensif terkait faktor resiko penyebab emfisema subkutis derajat 5.

THE IMPACT OF NURSING CARE ENVIRONMENT ON BEHAVIOURAL DISTURBANCES IN DEMENTIA: A LITERATURE REVIEW Dwikarlina, Intan
Indonesian Journal for Health Sciences Vol 8, No 2 (2024): September
Publisher : Universitas Muhammadiyah Ponorogo

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24269/ijhs.v8i2.8883

Most of the dementia population will suffer from behavioural and psychological symptoms of dementia (BPSD), causing them to undergo progressive disturbances such as agitation, depression, elation, delusions, and hallucinations. Most evidence favours non-pharmacological intervention, including managing the physical environment settings, to tackle this issue. Adjusting the physical environment care will massively support people with dementia to continue their daily living. Providing a better nursing care environment has a significant impact on their orientation. Giving them a home-like and social opportunity allows them to regain their sense of normal life. Access to sensory stimulation will aid them to feel comfortable and promote better sleep. The green neighbourhood creates reciprocity feelings among people with dementia toward their environment. Tailoring the physical environment design can help lessen the behavioural symptoms of people with dementia, including their agitation, apathy, and depressive complaints. More high-quality trials and interventions with bigger sample sizes are required

Diagnosis dan Manajemen Obstruksi Jalan Napas Atas (Jackson 1) Akibat Infeksi Difteri pada Wanita Hamil Dwikarlina, Intan; Wijaya, Rendy; Yulia Rusmayanti, Mega; Antariksa, Genta; Candradikusuma, Didi
Jurnal Klinik dan Riset Kesehatan Vol 4 No 2 (2025): Edisi Februari
Publisher : RSUD Dr. Saiful Anwar Province of East Java

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.11594/jk-risk.04.2.9

Diphtheria is an infectious disease caused by Corynebacterium diphtheria, which generally causes inflammation of the airways, leading to severe symptoms that can be life-threatening. Indonesia is listed as one of the ten countries with the highest cases of diphtheria worldwide. However, studies on cases of diphtheria infection, especially in the pregnant women population, have rarely been reported. A 28-year-old woman presented with shortness of breath. Complaints accompanied by difficulty swallowing and speaking. The patient had a child who died due to similar symptoms. Signs of airway obstruction are found as inspiratory stridor and suprasternal retraction, pseudomembranes in the pharynx, and subcutaneous crepitation in the colli. Diphtheria infection was confirmed through a throat swab examination with Neisser staining and culture. In addition to isolation, the patients were administered oxygen therapy, anti-diphtheria toxin, penicillin procaine, dexamethasone, and additional supportive therapy. Diphtheria infection is transmitted through direct contact, droplets or contaminated items. Manifestations of laryngeal diphtheria generally come from the extension of tonsillar-pharyngeal diphtheria symptoms, including sore throat, hoarseness, and advanced respiratory obstruction. A definite diagnosis is made by isolating the bacteria or finding an increase in serum antibodies. Therapies targeting infectious conditions and supporting obstetrics help improve the overall patient condition. Diphtheria is a highly contagious and potentially fatal disease, especially for pregnant women; thus, immediate diagnosis is needed. Isolation and appropriate management alleviate upper airway obstruction. Diphtheria management should include both curative therapy and preventive to protect the community further and prevent outbreaks from emerging.

Catamenial Pneumothorax due to Suspected Thoracic Endometriosis Syndrome in a Woman with Adenomyosis and Cystoma Ovarii Antariksa, Genta; Dwikarlina, Intan; Sutrisno, Sutrisno; Yudhanto, Hendy Setyo
Jurnal Kedokteran Brawijaya Vol. 33 No. 3 (2025)
Publisher : Fakultas Kedokteran Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jkb.2025.033.03.10

Catamenial pneumothorax (CP) is a recurrent spontaneous pneumothorax during the menstruation period and is often associated with thoracic-pelvic endometriosis. This case study reported a 39-year-old woman who presented with recurrent shortness of breath, particularly during menstruation. The patient also experienced severe dysmenorrhea and difficulty getting pregnant. Despite a negative sputum test, a history of chest tube insertion and tuberculosis treatment were identified. Elevated levels of the CA-125 marker were observed in a previous examination. Physical examination revealed decreased fremitus sounds on the mediobasal side, chest expansion, and right lung breath sounds. The plain radiograph displayed a visceral pleural line, air-fluid level appearance, and the collapse of the right hemithorax accompanied by fibrosis. The patient underwent inpatient treatment and had a chest tube inserted. A decortication thoracotomy procedure was performed, and anatomical pathology microscopic examination of the right lung tissue revealed a non-specific chronic inflammatory process accompanied by fibrosis.

Emfisema Subkutis Derajat 5 pada Pasien Rekuren Pneumotoraks Spontan Sekunder : Sebuah Laporan Kasus Sari, Fitri; Dwikarlina, Intan; Wijaya, Rendy; Antariksa, Genta; Sarti, Fitri; Putra, Christian
Jurnal Klinik dan Riset Kesehatan Vol 3 No 1 (2023): Edisi Oktober
Publisher : RSUD Dr. Saiful Anwar Province of East Java

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.11594/jk-risk.03.1.8

Background: Subcutaneous emphysema is a condition where persistent air exists in the subcutaneous layer of the skin. Subcutaneous emphysema occurs through various etiologies, one of which is due to the rupture of the alveoli that cause air infiltration between the connective tissues in patients with spontaneous pneumothorax. Case Presentation: A 53-year-old man complained of shortness of breath that appeared suddenly after the patient defecated. Complaints of chest tightness accompanied by extensive swelling throughout the body starting from the patient’s genital to the entire patient's face. The patient had a history of secondary spontaneous pneumothorax and a history of suffering from tuberculosis recurrence in 2021. Discussion: Subcutaneous emphysema occurs when air enters the tissues under the skin and soft tissues. Subcutaneous emphysema can be classified into five grades based on its severity. In this case report, grade 5 subcutaneous emphysema occurred because of a patient's right lung history of pneumothorax. Pneumothorax can be traumatic or spontaneous. Spontaneous pneumothorax can be divided into primary (without a clear cause) or secondary (associated with lung disease). The patient also has a history of tuberculosis and post-tuberculosis obstructive syndrome (SOPT). Patient management includes chest tube placement, oxygen therapy, and subcutaneous air decompression measures. Conclusion: In this case report, a grade 5 subcutaneous emphysema with a history of tuberculosis infection responded well to chest tube insertion as illustrated by the gradual reduction in emphysema degrees. Medical personnel is needed to carry out a holistic and comprehensive history and medical examination regarding the risk factors for grade 5 subcutaneous emphysema.

Diagnosis dan Manajemen Obstruksi Jalan Napas Atas (Jackson 1) Akibat Infeksi Difteri pada Wanita Hamil Dwikarlina, Intan; Wijaya, Rendy; Yulia Rusmayanti, Mega; Antariksa, Genta; Candradikusuma, Didi
Jurnal Klinik dan Riset Kesehatan Vol 4 No 2 (2025): Edisi Februari
Publisher : RSUD Dr. Saiful Anwar Province of East Java

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.11594/jk-risk.04.2.9

Diphtheria is an infectious disease caused by Corynebacterium diphtheria, which generally causes inflammation of the airways, leading to severe symptoms that can be life-threatening. Indonesia is listed as one of the ten countries with the highest cases of diphtheria worldwide. However, studies on cases of diphtheria infection, especially in the pregnant women population, have rarely been reported. A 28-year-old woman presented with shortness of breath. Complaints accompanied by difficulty swallowing and speaking. The patient had a child who died due to similar symptoms. Signs of airway obstruction are found as inspiratory stridor and suprasternal retraction, pseudomembranes in the pharynx, and subcutaneous crepitation in the colli. Diphtheria infection was confirmed through a throat swab examination with Neisser staining and culture. In addition to isolation, the patients were administered oxygen therapy, anti-diphtheria toxin, penicillin procaine, dexamethasone, and additional supportive therapy. Diphtheria infection is transmitted through direct contact, droplets or contaminated items. Manifestations of laryngeal diphtheria generally come from the extension of tonsillar-pharyngeal diphtheria symptoms, including sore throat, hoarseness, and advanced respiratory obstruction. A definite diagnosis is made by isolating the bacteria or finding an increase in serum antibodies. Therapies targeting infectious conditions and supporting obstetrics help improve the overall patient condition. Diphtheria is a highly contagious and potentially fatal disease, especially for pregnant women; thus, immediate diagnosis is needed. Isolation and appropriate management alleviate upper airway obstruction. Diphtheria management should include both curative therapy and preventive to protect the community further and prevent outbreaks from emerging.

THE IMPACT OF NURSING CARE ENVIRONMENT ON BEHAVIOURAL DISTURBANCES IN DEMENTIA: A LITERATURE REVIEW Dwikarlina, Intan
Indonesian Journal of Health Science Vol 8 No 2 (2024): September
Publisher : Universitas Muhammadiyah Ponorogo

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24269/ijhs.v8i2.8883

Most of the dementia population will suffer from behavioural and psychological symptoms of dementia (BPSD), causing them to undergo progressive disturbances such as agitation, depression, elation, delusions, and hallucinations. Most evidence favours non-pharmacological intervention, including managing the physical environment settings, to tackle this issue. Adjusting the physical environment care will massively support people with dementia to continue their daily living. Providing a better nursing care environment has a significant impact on their orientation. Giving them a home-like and social opportunity allows them to regain their sense of normal life. Access to sensory stimulation will aid them to feel comfortable and promote better sleep. The green neighbourhood creates reciprocity feelings among people with dementia toward their environment. Tailoring the physical environment design can help lessen the behavioural symptoms of people with dementia, including their agitation, apathy, and depressive complaints. More high-quality trials and interventions with bigger sample sizes are required

Gangguan Kognitif Pasca-Stroke – Tinjauan Sistematik: Analisis Pradhea, Tifani Antonia; Dwikarlina, Intan; Putra, Aulia Wiratama; Agustina, Lisa; Nardian, Derajat Fauzan
Cermin Dunia Kedokteran Vol 51 No 12 (2024): Kedokteran Umum
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v51i12.1239

Introduction: The increasing number of stroke survivors was accompanied by an increase of cognitive impairment incidence as one of the post-stroke long-term consequences. Post-stroke cognitive impairment needs to be highlighted because of impact on reducing the quality of life, especially in the elderly. Methods: Literature was extensively searched across ScienceDirect, PubMed, Google Scholar, and Cochrane databases, using several predetermined keywords. Results and Discussion: Nine articles were analyzed. MMSE and MoCA assessments were used as parameters of post-stroke cognitive impairment. Most patients experience post-stroke cognitive impairment ranging from mild cognitive impairment to vascular dementia or other types of dementia. Risk factors include older age, female, lower and shorter education, location of lesions in the left hemisphere with involvement of certain brain structures, uncontrolled and fluctuating blood pressure, family history of stroke, comorbid diseases, as well as an individualistic social life. Conclusion: Stroke significantly increases the risk of cognitive impairment anddementia.

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