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Successful Steroid Therapy of Henoch Schonlein Purpura in Young Adult Woman with Moderate Symptoms: A Case Report Yafanita Izzati Nurina; Awalia; Fariska Zata Aman; Nanda Aulya Ramadhan
Indian Journal of Forensic Medicine & Toxicology Vol. 15 No. 3 (2021): Indian Journal of Forensic Medicine & Toxicology
Publisher : Institute of Medico-legal Publications Pvt Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37506/ijfmt.v15i3.15987

Abstract

Henoch schonlein purpura is a rare incidence case and almost similar to the clinical symptoms of autoimmunediseases such as systemic lupus erythematus in young adult woman. A 23-year old woman patient presentedwith reddish spots accompanied by a burning sensation and pain in both legs, vomiting profus and abdominalpain. She also complained mild fever, frequent mouth sores, hair loss, joint pain and stiffness, frequentfatigue in the last 1 month. Laboratory tests showed mild anemia, leukocytocis, proteinuria, erythrocytes andleukocytes microscopic in urinalysis, increased of serum IgA and LED. The skin biopsy showed neutrophilcell infiltration in the capillary vessel walls with necrotic debris. Methylprednisolone oral was given since shehospitalized and decreased gradually. This case hada good prognosis because the result of serum creatininewas normal insix months latereven though had moderate symptoms.
Comprehensive Multimodal Rehabilitation for Chronic Musculoskeletal Problems in Geriatric Patient: A Case Study Ramadhan, Nanda Aulya; Nugraheni, Nuniek
Jurnal Medis Islam Internasional Vol 6 No 1 (2024): June
Publisher : UNUSA Press

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33086/iimj.v6i1.6136

Abstract

Introduction: Musculoskeletal problems are a major cause of morbidity in the geriatric population. These issues can decrease independence, increase functional decline and mortality, and negatively affect the psychological well-being and overall quality of life of elderly individuals. Returning to full function in such cases is highly challenging and requires comprehensive management. Case: A 67-year-old married female housewife presented with sharp, localized chronic pain in her left wrist for one year. The pain was non-radiating, without any tingling sensation, and aggravated by movements such as ulnar deviation and lifting objects (pain scale: 8/10). Tenderness was observed in the lateral anatomical snuffbox of the left wrist,  with a positive Finkelstein test. The patient also experienced sharp, localized pain in her left shoulder for seven months following a coronary artery bypass graft (CABG) surgery for coronary artery disease. The shoulder pain worsened with overhead activities (pain scale: 6/10) and improved with rest (pain scale: 3/10). The patient exhibited limited active range of motion (ROM) in flexion, extension, abduction, and external rotation, with positive Neer and Hawkins tests. Her metabolic equivalent of task (METs) score was 3.46, and she scored 5 on the Geriatric Depression Scale. The Barthel Index was 75, and she was diagnosed with several geriatric syndromes: instability (standing balance), impaired vision (cataract), isolation (depression), iatrogenesis (polypharmacy), and impotence (menopause). The patient had difficulties performing daily activities and participating in the community. A multimodal rehabilitation program was implemented, including therapeutic exercise, pharmacotherapy, kinesiotaping, thumb splint, physical modalities, and consultations with an internist and psychiatrist. After several sessions, the patient's pain decreased significantly to 1/10 (wrist) and 0/10 (shoulder). Active ROM improved to near normal, METs increased to 5.27, and she regained full independence in daily activities (Barthel Index 100). Discussion: Chronic musculoskeletal problems, especially when coupled with geriatric syndromes, are particularly challenging to manage. A comprehensive geriatric assessment, combined with a thorough multimodal rehabilitation approach, is key to successful outcomes. Improvements in pain, ROM, depression, and METs can lead to better functional performance, thereby reducing disability and enhancing the patient's quality of life. A supportive caregiver also plays a crucial role in achieving satisfactory results. Conclusions: This case highlights that comprehensive multimodal rehabilitation is crucial for the successful management of chronic musculoskeletal problems in the geriatric population. 
Penguatan Manajemen Laboratorium dalam Menurunkan Morbiditas dan Mortalitas Hepatitis B Putri, Aditea Etawati; Hernaningsih, Yetti; Wardhani, Puspa; Rini, Diah Puspita; Indrasari, Yulia Nadar; Ramadhan, Nanda Aulya
Faletehan Health Journal Vol 12 No 01 (2025): Faletehan Health Journal, Maret 2025
Publisher : Universitas Faletehan

Show Abstract | Download Original | Original Source | Check in Google Scholar

Abstract

Hepatitis B virus (HBV) infection is one of the threats in the medical world and requires guaranteed and valid laboratory analysis procedures, one of which is through the quality control (QC) mechanism. As part of laboratory management, QC has an impact on the validity of laboratory analysis results, especially related to HBV infection. The purpose of this study was to determine the level of knowledge of medical analysts before and after laboratory management training. The research method used comparative paired test analysis to obtain the significance and binary logistic regression to determine the most influential questions on the test. The results showed a significant increase in medical analyst knowledge after being given laboratory management material. Supported by a p value = 1.000 from the Hosmer and Lemeshow test and an overall prediction of 95.5% (positive: 92.0% and negative 97.6%), this training was very good in terms of goodness-of-fit and accurate. Material related to immunochromatography (ICT) method is an influential factor based on the analysis of test results. Medical analyst training, especially related to laboratory management in the context of HBV management, has a significant impact and can be continued and developed.