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All Journal Jurnal Prima Medika Sains Ibnu Sina: Jurnal Kedokteran dan Kesehatan - Fakultas Kedokteran Universitas Islam Sumatera Utara
Ernes, Audrina
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Humanities Health Professions Medicine & Pharmacology Nursing Public Health

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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.
6-MONTH-OLD INFANT WITH LISSENCEPHALY TYPE I ASSOCIATED WITH MILLER DIEKER SYNDROME: A CASE REPORT Asih, Dewi; Ernes, Audrina
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.v23i2.655

Abstract

Central Nervous System (CNS) malformations occur in 14/10,000 births. Lissencephaly is a rare spectrum of Congenital Brain Malformations (CBM) caused by genetic and non-genetic factors. Lissencephaly consists of type I and type II resulting from disrupted neuronal migration during brain development and is associated with Miller-Dieker syndrome (MDs), Fukuyama Congenital Muscular Dystrophy (FCMD), Muscle-Eye-Brain Disease (MEBD), and Walker-Warburg syndrome (WWs). Type I lissencephaly is associated with MDs, while type II is associated with FCMD, MEBD, and WWs. A 6-month-old infant presented to the emergency department of Royal Prima Medan Hospital with recurrent seizures since 5 days prior to admission, which had been observed since the age of 1.5 months without fever. The patient exhibits facial dysmorphism, growth and developmental delay, with moderate PDA and small ASD (echocardiography), and abnormal EEG and CT findings. Lissencephaly is a rare cortical developmental malformation. MDs is a genetic condition caused by a deletion on chromosome 17p13.3 with characteristics of type I lissencephaly, facial dysmorphism, and severe neurological abnormalities. MDs is a rare chromosomal anomaly and accurately diagnosing based on clinical findings alone can be challenging, thus use of Head CT scan is essential in this case.
Association of perirenal fat thickness, abdominal subcutaneous fat thickness and renal sinus fat diameter with hepatic steatosis Ernes, Audrina; Ginting, Chrismis Novalinda; Pulungan, Ica Yulianti
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.v7i1.6758

Abstract

Hepatic steatosis (HS), characterized by the abnormal accumulation of triglycerides within hepatocytes, is a prevalent pathological condition. However, its detection rate often underestimates its true prevalence, particularly when assessed using abdominal computed tomography (CT) scans. This quantitative cross-sectional study, conducted from September 2024 to February 2025 at Royal Prima Hospital, aimed to investigate the associations of perirenal fat thickness (PrFT), abdominal subcutaneous fat thickness (ASFT), and renal sinus fat diameter (RSFD) with HS. A non-probability sampling method was utilized, and a total of 272 non-contrast abdominal CT scans were analyzed. Statistical analyses were performed using SPSS software. HS was defined as an average hepatic parenchymal Hounsfield Unit (HU) value at least 10 HU lower than that of the spleen, with an absolute hepatic HU attenuation of less than 40. The grading of HS was determined according to the CT liver-spleen (L-S) ratio: mild (0.7 < CT L-S < 1.0), moderate (0.5 < CT L-S < 0.7), and severe (CT L-S < 0.5). The results demonstrated a significant association between the mean right-left PrFT and the presence of HS (p = 0.007), suggesting that perirenal fat may contribute to the development of HS. In contrast, neither the mean right-left RSFD nor the ASFT showed a significant association with HS presence (p = 0.056 and p = 0.904, respectively). Furthermore, none of the fat measurements (PrFT, ASFT, and RSFD) were significantly associated with the grading of hepatic steatosis (p = 0.800, 0.288, and 0.996, respectively). These findings underscore the potential utility of PrFT as a non-invasive indicator for HS diagnosis. The study also highlights the importance of quantitative measurements, such as hepatic and splenic HU values and CT L-S ratios, for the accurate diagnosis of HS, as visual assessment alone may be insufficient.
Co-Authors Dewi Asih Ginting, Chrismis Novalinda Icksan, Aziza Ghanie Pulungan, Ica Yulianti Soekardi, Adi