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Hubungan Derajat Lesi Radiografi Toraks pada Pasien TBC Paru Dewasa disertai DM Tipe II Terkontrol dengan Kadar Hemoglobin di Rumah Sakit Royal Prima Kota Medan Nazara, Niscaya Aprian; Soekardi, Adi; Lubis, Yolanda Eliza Putri
GALENICAL : Jurnal Kedokteran dan Kesehatan Mahasiswa Malikussaleh Vol 3, No 4 (2024): GALENICAL : Jurnal Kedokteran dan Kesehatan Mahasiswa Malikussaleh - Agustus 202
Publisher : Program Studi Kedokteran Fakultas Kedokteran Universitas Malikussaleh

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.29103/jkkmm.v3i4.18774

Abstract

Tuberkulosis (TBC) disebabkan oleh bakteri mycobacterium tuberculosis dan menyebabkan radang parenkim paru. Diabetes Melitus (DM) merupakan salah satu penyakit komorbid yang memengaruhi gambaran klinis tuberkulosis. Hemoglobin (Hb) merupakan protein yang memberi warna merah pada darah, yang berfungsi membawa oksigen dan terdiri atas besi. Tujuan penelitian ini adalah untuk melihat hubungan derajat lesi radiografi toraks pada pasien TBC paru dewasa disertai DM tipe II terkontrol dengan kadar hemoglobin di Rumah Sakit Prima Kota Medan. Jenis penelitian yang dilakukan adalah penelitian observasional analitik deskiptif pendekatan desain cross sectional dan bersifat retrospektif. Teknik pengambilan sampel adalah purposive sampling serta menggunakan data sekunder. Diperoleh sebanyak 70 data pasien yang memenuhi kriteria inklusi objek penelitian. Hasil penelitian menunjukkan jenis kelamin paling banyak ditemukan adalah laki-laki. Kadar hemoglobin pada laki-laki dan perempuan banyak ditemukan kurang dari normal. Berdasarkan kelompok umur mayoritas 56-65 tahun. Gambaran radiografi foto toraks paling sering ditemukan adalah konsolidasi dengan derajat lesi far advanced. Pada penelitian ini menunjukkan tidak adanya hubungan derajat pada pasien tuberkulosis paru dewasa disertai DM tipe II terkontrol dengan kadar hemoglobin. Dan tidak adanya hubungan radiografi toraks pada pasien tuberkulosis paru dewasa disertai DM tipe II terkontrol dengan kadar hemoglobin.
The role of Chest HRCT in diagnosis active tuberculosis & lung destruction Soekardi, Adi; Icksan, Aziza Ghanie; Ernes, Audrina
Jurnal Prima Medika Sains Vol. 5 No. 2 (2023): December
Publisher : Program Studi Magister Kesehatan Masyarakat Universitas Prima Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.34012/jpms.v5i2.4466

Abstract

Tuberculosis is a public health problem caused by Mycobacterium tuberculosis. In 2021 there will be 10.6 million cases in the world, and Indonesia ranks 2nd with 700,000 cases. In 2022, there will be 17,303 cases in North Sumatra Province and 2,430 cases in Medan City. In current practice, evaluation and diagnosis of active tuberculosis relies on bacteriological examination and Chest Radiographs. However, Chest Radiographs have limited specificity and high intraobserver and interobserver variability. HRCT is also not widely used as a routine option for patients suspected of suffering from tuberculosis, even though HRCT has high accuracy in detecting tuberculosis. We present a case of a patient with active pulmonary tuberculosis and lung destruction e.c. advanced pulmonary tuberculosis (MDR-Tuberculosis) (declared cured in 2018 after 2 years of treatment). This patient was evaluated with chest radiograph and chest HRCT. In this case, the initial findings on the Chest Radiograph, showed the impression of inactive tuberculosis but on further examination with chest HRCT, there was a tree in bud image which indicated active tuberculosis. This shows that there are limitations in diagnosing tuberculosis activity using Chest Radiographs. Due to the significant role of HRCT in the diagnosis of tuberculosis activity, it is necessary to consider the use of HRCT in the evaluation of patients with tuberculosis.
Diagnosis and imaging of diaphragmatic eventration: A case report Nasution, Ikhwanul Hakim; Soekardi, Adi; Mahatvavirya, Redo Widhio
Jurnal Prima Medika Sains Vol. 6 No. 1 (2024): June
Publisher : Program Studi Magister Kesehatan Masyarakat Universitas Prima Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.34012/jpms.v6i1.5116

Abstract

Background: Diaphragmatic eventration is a rare disorder that is typically found by accident in asymptomatic patients with a raised hemidiaphragm on chest X-rays. Both acquired and developmental defects can cause diaphragmatic eventration. The imaging methods for diaphragmatic eventration are numerous. Chest radiography should be done when there is clinical suspicion; this can be further confirmed with a chest computed tomography (CT). Case presentation: We present a case of a 37 years old woman with a left sided diaphragm eventration presenting as dyspnea and epigastrical discomfort. The diagnosis was made with chest x-ray and then confirmed with a chest CT scans. Discussion: There are several modalities to choose in diaphragmatic imaging. Chest x-ray is the main imaging method for diagnosing diaphragm eventration, in rare cases, a eventration needs to be differentiated using CT or MRI. Other imaging methods such as fluoroscopy and ultrasonography may be used in some instances to assess diaphragm function. Conclusions: There are various methods available in the field of diaphragmatic imaging. Certain methods, like CT and plain chest radiographs, concentrate on the anatomic anomalies of the diaphragm that may indicate dysfunction. Some instruments, including fluoroscopy and ultrasonography, are more appropriate for functional imaging.
CT evaluation of pediatric airway foreign bodies: Emphasis on the role of CT scanning in foreign body removal with bronchoscopy Siregar, Indra Riris Delima; Soekardi, Adi; Icksan, Aziza Ghanie
Jurnal Prima Medika Sains Vol. 6 No. 2 (2024): December
Publisher : Program Studi Magister Kesehatan Masyarakat Universitas Prima Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.34012/jpms.v6i2.6257

Abstract

A foreign body that enters the airway through aspiration may become lodged in the trachea, bronchi, or larynx. The size, shape, and type of the foreign body determine where it should be lodged. Children are more frequently impacted. Unexpected inspiration during play or fighting while holding something in their mouths can result in accidents. The first study of choice for any child being evaluated for foreign body aspiration is still a plain film chest X-ray. Computerized tomographic examinations have a slightly higher sensitivity. We report a case of aspiration foreign body in a 12-year-old boy with the main complaint of choking. On physical examination, there were decreased breath sounds and wheezing in the upper left lung area. Chest x-ray revealed a radioopaque needle pin-like foreign body and no abnormalities in both lung. The results of a chest computed tomography (CT) scan showed a needle was abaout 4cm long and located in left bronchus. Once the diagnosis is made, removal of the foreign body with bronchoscopy is performed in these cases. Chest CT scans may need less time for evaluation and provide finer image resolution, making it easier to identify the position, size, and form of AFBs. As a result, chest CT scans offer great potential usefulness in the investigation of suspected AFBs.
Hubungan Derajat Lesi Radiografi Toraks pada Pasien TBC Paru Dewasa disertai DM Tipe II Terkontrol dengan Status Gizi Menggunakan Parameter Indeks Massa Tubuh di Rumah Sakit Umum Royal Prima Kota Medan Cahyadi, Muhamad Ridwan; Soekardi, Adi; Pratama, Irza Haicha
GALENICAL : Jurnal Kedokteran dan Kesehatan Mahasiswa Malikussaleh Vol 3, No 4 (2024): GALENICAL : Jurnal Kedokteran dan Kesehatan Mahasiswa Malikussaleh - Agustus 202
Publisher : Program Studi Kedokteran Fakultas Kedokteran Universitas Malikussaleh

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.29103/jkkmm.v3i4.18773

Abstract

Tuberkulosis paru (TBC) adalah penyakit infeksi menyerang paru yang disebabkan oleh Mycobacterium Tuberculosis. Pada seorang dengan komorbiditas seperti Diabetes Melitus Tipe 2 (DMT2), penyakit ini bisa saja menjadi kompleks sehingga dapat mempengaruhi pada gambaran radiografi toraks. Status gizi, yang diukur dengan indeks masa tubuh (IMT), juga dapat berperan dalam kondisi klinis pasien TBC paru. Penelitian ini bertujuan untuk mengetahui hubungan derajat lesi radiografi toraks dengan status gizi pada pasien TBC paru dewasa dengan DMT2 terkontrol. Jenis penelitian menggunakan observasional analitik deskriptif bersifat retrospektif dengan pendekatan Cross sectional. Dari 70 sampel mayoritas adalah laki-laki 47 atau 67,1%. Usia rata-rata diatas 45 tahun, dan berdasarkan status gizi sebanyak 26 atau 37,1% normal. Derajat lesi paling mendominasi Far-Advanced sebanyak 34 atau 48,6%, dan radiogarfi yaitu konsolidasi 27 atau 38,6%. Hasil anlisis pada status gizi terhadap derajat lesi menunjukan p-value 0,05. Pada status gizi terhadap radiografi menunjukan p-value 0,05. Kesimpulan dari penelitian ini terdapat hubungan status gizi terhadap derajat lesi pada pasien TBC-DMT2 terkontrol. Namun tidak ditemukan hubungan status gizi rehadap radiografi, dari hasil melainkan adanya efek pengaruh dari TBC paru komorbiditas DM itu sendiri.
The impact of white turmeric rhizome extract on the histopathological characteristics of the pancreas in male wistar rats with diabetes Lubis, Zahra Khairunnisa; Ongko, Nicolas Xavier; Soekardi, Adi; Razoki, Razoki
Buletin Kedokteran & Kesehatan Prima Vol. 4 No. 1 (2025): March
Publisher : Fakultas Kedokteran, Kedokteran Gigi, dan Ilmu Kesehatan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.34012/bkkp.v4i1.6407

Abstract

This study investigates the potential of white turmeric (Curcuma zedoaria Rosc.) rhizome extract as a cost-effective treatment for managing diabetes, focusing on its impact on pancreatic histopathology and blood glucose levels in diabetic Wistar rats. The research employed a randomized pre-test and post-test control group design, with rats induced with alloxan to simulate diabetes. The treatment groups received varying doses of white turmeric extract (250 mg/kg BW, 500 mg/kg BW, and 750 mg/kg BW) for 14 days. Histopathological analysis of the pancreas revealed that the white turmeric extract groups showed no signs of edema, inflammation, or necrosis, indicating a protective effect. Blood glucose level measurements demonstrated that the 500 mg/kg BW dose exhibited the most optimal results in lowering blood glucose levels. Statistical analysis using ANOVA and Kruskal-Wallis tests indicated significant differences between groups. These findings suggest that white turmeric extract, particularly at a dosage of 500 mg/kg BW, holds promise as a complementary treatment for managing diabetes by improving pancreatic health and reducing blood glucose levels. Further research is warranted to explore the underlying mechanisms and optimize its application.
POST-COVID-19 SYNDROME IMAGING FINDINGS IN SEVERE COVID-19 WITH PULMONARY CAVITATION: A CASE REPORT Soekardi, Adi; Suryamin, Ricky
Ibnu Sina: Jurnal Kedokteran dan Kesehatan - Fakultas Kedokteran Universitas Islam Sumatera Utara Vol. 23 No. 2 (2024): Juli 2024
Publisher : Faculty of Medicine Universitas Islam Sumatera Utara

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30743/ibnusina.v23i2.654

Abstract

In the fourth year of the SARS-CoV-2 pandemic, there is corresponding increase in the proportion exhibiting long-term symptoms and chronic respiratory complication associated with the disease. The British Medical Journal consider post-COVID syndrome as to symptoms continuing for more than 12 weeks. The most prevalent findings were "ground glass opacity" and "fibrotic-like changes”. The term "fibrotic-like changes" exhibited variations across studies, encompassing architectural distortion with traction bronchiectasis, honeycombing, or both, as well as traction bronchiectasis/bronchiolectasis, volume loss, or both. Other descriptions included evidence of stripe-like fibrosis without reticular opacity and the presence of honeycombing, reticulation, and traction bronchiectasis. Bronchial abnormalities, such as wall thickening and dilation, are frequently observed in patients during the acute and early convalescent phases of COVID-19 pneumonia, but their frequency and severity tend to decrease over time.1 However, in a subset of patients, bronchial dilation continues to persist even after recovery from COVID-19 pneumonia. Pulmonary cavitary lesions are uncommon occurrences in cases of COVID-19 pneumonia. Based on a case series, it has been found that approximately 3% of patients who develop COVID-19 pneumonia experience this complication. Despite ongoing research, the exact mechanisms behind the development of pulmonary cavitary lesions in COVID-19 remain unknown. At present, there is no single effective treatment for long COVID. However, low-dose naltrexone, β-blockers, and intravenous immunoglobulin can be considered for treating different symptoms and conditions.
Incidental detection of Tietze syndrome with costochondritis: A case report Lister, Gilbert; Soekardi, Adi; Icksan, Aziza Ghanie
Jurnal Prima Medika Sains Vol. 7 No. 1 (2025): June
Publisher : Program Studi Magister Kesehatan Masyarakat Universitas Prima Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.34012/jpms.v7i1.6815

Abstract

Background: Tietze syndrome represents a rare and atypical source of anterior chest discomfort, distinguished by localized tenderness and non-suppurative swelling, typically centered around the 2nd or 3rd costal cartilages. Despite diligent investigation, the precise underlying causes of Tietze syndrome remain elusive. Case Report: We present a case of a 35 year old male patient with suspected Tietze syndrome with costochondritis. He came in with complaints of abdominal pain and frequent coughs. He has a history of ADPKD and thalassemia since age 12. Tietze syndrome was an incidental finding in this patient. A thorax scan showed multiple nodular and lobulated lesions in the medial mediastinum; additionally, an abnormal widening and flattening of the costochondral junction of the ribs bilaterally. The CT scan findings reveal notable deformities characterized by widened and irregularly shaped anterior rib masses spanning the 1st to the 4th ribs bilaterally. The USG scan of the thorax showed a hypogenic thickening of the costochondral junction with vascularization. Discussion: Tietze's syndrome presents a diagnostic challenge necessitating comprehensive imaging modalities for accurate diagnosis. Ultrasound imaging stands out as the primary approach, showcasing conspicuous soft tissue swelling indicative of the ongoing inflammatory process. While computed tomography often reveals subtle focal swellings or mild sclerosis in the affected joint. Conclusion: The clinical manifestations frequently encompass an abrupt onset of chest discomfort devoid of antecedent trauma, predominantly observed among younger cohorts with an otherwise clean bill of health. Ultrasound is an accurate and effective modality to diagnose Tietze syndrome. This disease is frequently associated with other comorbidities such as rheumetic and autoimmune disorders.
Incidental detection of achalasia in a patient with dyspnea Leslie, William; Soekardi, Adi; Icksan, Aziza Ghanie
Jurnal Prima Medika Sains Vol. 7 No. 1 (2025): June
Publisher : Program Studi Magister Kesehatan Masyarakat Universitas Prima Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.34012/jpms.v7i1.6816

Abstract

Background: The absence of progressive peristalsis in the esophageal body and aberrant relaxation of the LES are two characteristics of achalasia, which is a main motility disease of the esophageal body and lower esophageal sphincter (LES). The most typical signs of achalasia are dysphagia and recurrent regurgitation. Case report: We report a case of achalasia in a 54-year-old woman with the main complaint of dyspnea. Physical examination did not reveal any abnormalities. Chest x-ray results showed an enlarged upper mediastinal with air fluid level and superposition with the right border of the heart. The results of a chest computed tomography (CT) scan showed a dilated esophagus containing food material with air fluid levels. The patient then underwent an esophagostomy thoracotomy. Discussion: Primary achalasia is associated with inflammatory degeneration of the inhibitory ganglion cells of the esophageal myenteric plexus and LES. Dysphagia, regurgitation, problems swallowing food, chest pain, heartburn, and weight loss are the most common symptoms. Barium esophagram is the best diagnostic test for achalasia with "Rat Tail" or “bird’s beak” appearance. CT scan examination is not only less invasive and painful, but also has high sensitivity for achalasia. In addition, CT scan are useful for differentiating primary and secondary achalasia and for diagnosing complications of achalasia. Conclusion: Most cases of achalasia come with dysphagia, but some patients can come with respiratory problems or without complaints. CT scans can help identify achalasia in patients without complaints. Radiological examination plays an important role in detecting achalasia and reducing complications.