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Helmizar, Roland
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UNEXPECTED EXTRAPYRAMIDAL REACTION: ACUTE TARDIVE DYSKINESIA FOLLOWING SHORT-TERM METOCLOPRAMIDE USE IN A PATIENT WITH DIABETES AND CHRONIC KIDNEY DISEASE Helmizar, Roland; Yuri Haiga; Vina Tri Septiana; Nana Liana; Ruhsyahadati Ajisman; Rahma Triyana; Muhammad Rizki Saputra
Nusantara Hasana Journal Vol. 5 No. 7 (2025): Nusantara Hasana Journal, December 2025
Publisher : Yayasan Nusantara Hasana Berdikari

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59003/nhj.v5i7.1781

Abstract

Tardive dyskinesia (TD) is a potentially irreversible extrapyramidal movement disorder characterized by involuntary, repetitive movements, predominantly affecting the orofacial region. Although most commonly associated with prolonged exposure to dopamine receptor–blocking agents, TD may also arise following the use of gastrointestinal prokinetics such as metoclopramide. Female sex, diabetes mellitus, advanced age, and renal impairment are recognized risk factors that increase susceptibility, yet TD remains underrecognized outside psychiatric settings. A 49-year-old woman with poorly controlled type 2 diabetes mellitus presented with nausea, vomiting, and generalized weakness. Laboratory findings demonstrated normocytic anemia, uncontrolled hyperglycemia (HbA1c 9.2%), and acute-on-chronic kidney disease (eGFR 22 mL/min/1.73 m²). She received standard supportive therapy, including intravenous metoclopramide. Within 24 hours, she developed repetitive tongue protrusion and orofacial dyskinesia. Neuroimaging and electrolyte evaluation were unremarkable, and there was no history of prior neuroleptic exposure. Metoclopramide was promptly discontinued, leading to gradual improvement and complete resolution of symptoms within two weeks. Antiemetic therapy was switched to ondansetron. This case underscores that acute TD may occur after short-term metoclopramide use, particularly in patients with diabetes and renal dysfunction. Heightened clinical awareness and cautious prescribing are essential to prevent this potentially disabling adverse effect.
COMMUNITY-ACQUIRED PNEUMONIA OLEH KLEBSIELLA PNEUMONIAE DI RSUP DR. M. DJAMIL PADANG TAHUN 2024: GAMBARAN MORTALITAS TINGGI DAN TANTANGAN KLINIS Ruhsyahadati, Ruhsyahadati; Liana, Nana; Triyana, Rahma; Puspita, Dian; Rizki Saputra, Muhammad; Helmizar, Roland; Malik, Rifkind; Akbar, Aulia
Nusantara Hasana Journal Vol. 5 No. 8 (2026): Nusantara Hasana Journal, January 2026
Publisher : Yayasan Nusantara Hasana Berdikari

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59003/nhj.v5i8.1859

Abstract

Community-acquired pneumonia (CAP) caused by Klebsiella pneumoniae is frequently associated with severe clinical courses and high mortality, particularly among elderly patients and those with comorbidities. The increasing rate of antimicrobial resistance has further limited the effectiveness of standard empirical therapy. This was a retrospective descriptive observational study using secondary data from medical records of hospitalized CAP patients at Dr. M. Djamil General Hospital, Padang, from January 2022 to December 2023. Subjects were adults (≥18 years) diagnosed with CAP and with positive cultures for K. pneumoniae. Variables included demographic characteristics, length of hospital stay, clinical outcomes, and antibiotic susceptibility patterns. Data were analyzed using univariate descriptive analysis. A total of 50 patients were included, predominantly male (58%) and aged over 65 years (40%). The most frequent comorbidities were hypertension (60%) and diabetes mellitus (36%). The mean length of hospital stay was 14 days. Mortality was high, reaching 56%. Antibiotic susceptibility testing showed the highest sensitivity to meropenem (96%) and amikacin (92%), while commonly used first-line agents such as ceftriaxone, ampicillin–sulbactam, and ciprofloxacin demonstrated low sensitivity (<15%). CAP due to Klebsiella pneumoniae at Dr. M. Djamil General Hospital is associated with very high mortality and widespread resistance to first-line antibiotics. Empirical therapy should be guided by local antibiogram data and supported by strong antimicrobial stewardship programs.
Status Vitamin D dan Hubungannya dengan Kadar Kolesterol Total Mahasiswa Fakultas Kedokteran Universitas Baiturrahmah Jelmila, Sri Nani; Mutiya Rahmi, Rafiqa; Suharni; Helmizar, Roland; Liana, Nana
Scientific Journal Vol. 5 No. 1 (2026): SCIENA Volume V No 1, January 2026
Publisher : CV. AKBAR PUTRA MANDIRI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.56260/sciena.v5i1.321

Abstract

Pendahuluan: Defisiensi vitamin D dilaporkan tinggi pada populasi dewasa muda termasuk mahasiswa kedokteran, meskipun berada di negara tropis. Vitamin D diduga berperan dalam metabolisme lipid melalui modulasi inflamasi dan regulasi metabolik.Tujuan penelitian: menganalisis status vitamin D dan hubungannya dengan kadar kolesterol total pada mahasiswa Fakultas Kedokteran Universitas Baiturrahmah. Metode: Penelitian analitik observasional dengan desain cross-sectional dilakukan pada 61 sampel. Kadar 25-hidroksivitamin D diperiksa dengan ELISA dan diklasifikasikan menjadi defisiensi, insufisiensi, dan sufisiensi, sedangkan kolesterol total diperiksa dengan metode enzimatik kolorimetrik. Hasil: Hasil menunjukkan status vitamin D terbanyak adalah defisiensi (36,1%), rerata kadar kolesterol total adalah 174,16±28,81 mg/dL. Analisis menunjukkan tidak terdapat hubungan bermakna antara status vitamin D dan kadar kolesterol total (p=0,14). Kesimpulan: defisiensi vitamin D merupakan kondisi yang dominan pada mahasiswa kedokteran, namun tidak berhubungan signifikan dengan kadar kolesterol total.
Co-Authors Adelin, Prima Aditia Permana, Yudhi Ajisman, Ruhsyahadati Aliefia, Desi Anggraini, Debie Aulia Akbar Dhuha, Alief Dian Puspita Eldrian, Febiane Haiga, Yuri Hasni, Dita Jelmila, Sri Nani liana, nana Lismawati Lismawati, Lismawati Malik, Rifkind Melya Susanti Muhammad Rizki Saputra Muhammad Rizki Saputra, Muhammad Rizki Munawaroh, Madina Mutiya Rahmi, Rafiqa Nana Liana Nani Jelmila, Sri Rahma Triyana Rasyid, Lismawati Rizki Saputra, Muhammad Ruhsyahadati Ruhsyahadati Ajisman Ruhsyahadati, Ruhsyahadati Suharni Suharni Suharni Tri Septiana, Vina Tri Yana, Rahma Triyana, Rahma Vina Tri Septiana Yurizali, Bun