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All Journal CRJIM (Clinical and Research Journal in Internal Medicine) Journal of Pain, Vertigo and Headache International Journal of Radiology and Imaging
Pamarta, Trisna Belani
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Biochemistry, Genetics & Molecular Biology Computer Science & IT Dentistry Education Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Nursing Public Health Other

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IMAGING OF SEVERE RENAL AND LIVER INJURY ON A TRAUMA PATIENT: A CASE REPORT Pamarta, Trisna Belani; Nabila, Astrid Hanan; Karliasari, Liana
International Journal of Radiology and Imaging Vol. 3 No. 02 (2024): International Journal of Radiology and Imaging
Publisher : Department of Radiology, Medical Faculty, University of Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.ijri.2024.003.02.5

Abstract

Blunt abdominal trauma accounts for the most abdominal injuries. A quick yet accurate examination must be carried out immediately to identify and promptly address the cause of the internal bleeding. In this case report, we describe A 17-year-old girl who was taken to the emergency room after she lost consciousness following a traffic accident. The patient presented with unstable hemodynamics indicating signs of hemorrhagic shock. The patient then underwent a CT examination with contrast to determine the diagnosis. The patient was diagnosed with internal bleeding with unstable hemodynamics due to liver injury AAST grade IV and renal trauma AAST grade III. In this case, signs of kidney and liver trauma can be recognized, such as fluid accumulation and the severity of injury to each organ. This case report aims to increase awareness of the signs of intra-abdominal bleeding and its severity so that appropriate treatment can be determined immediately. Keywords: renal injury, liver injury, abdominal CT-Scan
A RARE CASE OF ISCHEMIC STROKE IN A YOUNG WOMAN WITH AUTOIMMUNE DISEASE: DIAGNOSIS AND THERAPY CHALLENGES Bulain, Stanley; Atalia, Arila; Lestari, Hotma; Pamarta, Trisna Belani; Rakhmatiar, Rodhiyan
Journal of Pain, Headache and Vertigo Vol. 6 No. 2 (2025): September
Publisher : PERDOSNI (Perhimpunan Dokter Spesialis Neurologi Indonesia Cabang Malang) - Indonesian Neurological Association Branch of Malang cooperated with Neurology Residency Program, Faculty of Medicine Brawijaya University, Malang, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jphv.2025.006.02.02

Abstract

Introduction: Stroke is a leading cause of death and disability worldwide and is considered a disease of the elderly. However, recent trends indicate an increase in stroke cases in young adults due to autoimmune causes. Stroke in young adults directly impacts health, productivity, society, the economy, and the health system. Case: A 30-year-old woman presented with sudden, intermittent weakness of one half of her body for 2 days. Physical examination revealed mild paralysis of the right 7th and 9th nerves, hemiparesis, hemihypesthesia, hemiparesthesia, increased physiological reflexes, and positive Hoffman and Tromner reflexes in the right extremity. A CT scan was normal, and the ANA test was positive. The patient was hospitalized for 7 days and given citicoline 500 mg once, azathioprine 50 mg twice, hydroxychloroquine 1200 mg once, acetylsalicylic acid 200 mg once, and pulse methylprednisolone 125 mg four times. She gradually improved. The patient was referred to the RSSA for MRI and MRA, which revealed a chronic infarction extending from the corona radiata to the left lentiform nucleus and no visible ACA segment A1 structure. The patient experienced a generalized tonic-clonic seizure lasting 2 minutes during the DSA. Diazepam 7.5 mg, Metamizole 1 g, and Nicardipine 3 mg/hour were administered, and the patient subsequently regained consciousness. The DSA results showed total occlusion of the ACA segment A1. The patient was diagnosed with CVA infarction with total occlusion of the ACA segment A1, with suspected autoimmune disorder. The patient was discharged three days later and planned for observation. Conclusion: Ischemic stroke in young adults with autoimmune disorders is a serious condition that requires special attention. Antiphospholipid antibody-related hypercoagulability and vascular complications such as vasculitis are the main mechanisms of stroke in this population. Further evaluation for underlying autoimmune disease is necessary for further treatment decisions.
Circulating Tumor DNA: Unravelling the Treatment Response Uncertainty in Lymphoma: Systematic Review and Meta-Analysis Bulain, Stanley; Setiawan, Aurielle Annalicia; Nestovani, Anggella Christoferisa Ditya; Pamarta, Trisna Belani; Baliulina, Shintya Octaviana; Arifah, Nina Nur
Clinical and Research Journal in Internal Medicine Vol. 7 No. 1: Volume 7 No 1, May 2026
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.crjim.2026.007.01.08

Abstract

Background: Uncertainty in lymphomas treatment response could negatively affect the disease course. Circulating tumor DNA (ctDNA), minimally invasive biomarker, can be useful to monitor treatment response, recurrence, yet minimally invasive. Aim: To evaluate the effectiveness of ctDNA for predicting early relapse (indicated by progression-free survival (PFS) and overall survival (OS)), and for predicting non-complete response (non-CR) in lymphomas. Methods: Comprehensive searches in PubMed, ScienceDirect, Wiley, Springer and Cochrane were conducted. Critical appraisal was conducted using the ROBINS-E tool for cohort and ROB 2.0 randomized controlled trials. hazard ratios (HRs) of pretreatment CtDNA for PFS and OS. The secondary outcome was the risk ratio (RR) of non-CR in detectable posttreatment CtDNA and its diagnostic accuracy analysis. RevMan 5.4 and STATA 17 was used for quantitative analysis. Results: 14 studies (1,144 patients) were included. Higher pretreatment ctDNA significantly increase the risk of worse PFS (HR 2.20, 95% CI 1.41-3.43) and worse OS (2.20, .14-4.26), also with optimal cut-off at 2.5 log10hGE/mL for PFS (2.46, 1.70-3.54) and OS (2.36, 1.30-4.29). The value was also significant in DLBCL, both for PFS (2.46, 1.71-3.55) and OS (2.70, 1.58-4.60), P<0.05 . Detectable posttreatment CtDNA also correlated with non-CR (RR 5.56 95% CI 2.82-10.95), with pooled sensitivities 0.91 (0.71-0.98), specificities 0.76 (0.51-0.90), positive-likelihood ratios 3.74 (1.71-8.19), negative-likelihood ratios 0.12 (0.04-0.39), and area under curve (AUC) 0.91 (0.88 - 0.93). Conclusion: Higher pretreatment CtDNA strongly correlated with the disease progression and survival, specifically at log10hGE/mL. Detectable posttreatment CtDNA were significantly correlated with non-CR.
Co-Authors Arifah, Nina Nur Atalia, Arila Baliulina, Shintya Octaviana Bulain, Stanley Karliasari, Liana Lestari, Hotma Nabila, Astrid Hanan Nestovani, Anggella Christoferisa Ditya Rakhmatiar, Rodhiyan Setiawan, Aurielle Annalicia