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All Journal Jurnal Penelitian Pendidikan IPA (JPPIPA) JOURNAL LA MEDIHEALTICO Jurnal Impresi Indonesia Jurnal Kedokteran Meditek
Puspita, Angela
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Malnutrition with Secondary Hypothyroidism in Children: A Case Report and Pathophysiological Review of Patients in One of the Hospitals in Surabaya Puspita, Angela; Setiadi, Alexander Wignyo
Journal La Medihealtico Vol. 6 No. 3 (2025): Journal La Medihealtico
Publisher : Newinera Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37899/journallamedihealtico.v6i3.2115

Abstract

Malnutrition in children remains a global health problem that has a broad impact on growth, development and metabolic balance. One complication that receives less attention is secondary hypothyroidism, a condition that occurs due to metabolic adaptation to prolonged energy deficit. This situation can worsen the patient's prognosis and increase the risk of neurological complications and infections. This case report aims to describe the clinical course of a child with severe malnutrition who experienced secondary hypothyroidism and discuss the pathophysiological mechanisms underlying the link between malnutrition and thyroid dysfunction. Case: A 2 year 1 month old boy with a body weight of 5 kg (< -3 SD) and a height of 69 cm presented with complaints of diarrhea, fever, recurrent cough and episodes of seizures. Laboratory examination showed leukocytosis, increased CRP, and electrolyte disturbances. Evaluation of thyroid function revealed low FT4 levels (0.85 ng/dL) with depressed TSH (0.19 µIU/mL), leading to a diagnosis of secondary hypothyroidism. Metabolic adaptations due to malnutrition lead to decreased production of thyroid binding proteins as well as low TSH secretion in response to metabolic stress. This situation contributes to a slowdown in metabolism and worsens nutritional recovery, as well as increasing the risk of infectious and neurological complications. The literature supports that secondary hypothyroidism in children with malnutrition is reversible with optimal nutritional recovery. A multidisciplinary approach that includes clinical stabilization, electrolyte correction, and monitoring of thyroid function is very important in the management of children with malnutrition and secondary hypothyroidism.
Perbedaan Rasio Trombosit Limfosit Pre dan Post Terapi Kemoradiasi Kanker Serviks di Rumah Sakit Pusat Angkatan Laut dr. Ramelan Surabaya Marbentan, Purwo Diva Nadib; Sudiarta, Ketut Edy; Purwaningsari, Diah; Puspita, Angela
Jurnal Kedokteran Meditek Vol 31 No 1 (2025): JANUARI
Publisher : Fakultas Kedokteran Universitas Kristen Krida Wacana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36452/jkdoktmeditek.v31i1.3105

Abstract

Introduction: Cervical cancer is caused by persistent infection with HPV transmitted through sexual intercourse. Chemoradiation is often used in the treatment of cervical cancer because it can reduce recurrence and further cell growth and can increase survival. Increased Platelet Lymphocyte Ratio (RTL) can be used to track the progression of cervical cancer and the degree of differentiation of cancer cells. High RTL indicates a worse degree of cell differentiation and vice versa. Purpose: The aim of this study was to determine the difference in RTL in cervical cancer patients pre and post chemoradiation therapy. Methods: The research design is cross-sectional with total sampling. Data was taken from medical records of cervical cancer patients at the Department of Obstetrics and Gynaecology, RSPAL dr. Ramelan Surabaya in year 2000 - 2023. Results: The average RTL for cervical cancer patients before chemoradiation was 193.1293; and after chemoradiation 169.5459. The results of the Wilcoxon signed rank test showed a significant decrease (p < 0.001). This research proves that there is a significant difference in the Platelet Lymphocyte Ratio (RTL) of stage ≥ IIB cervical cancer patients pre- and post-chemoradiation therapy. Statistical tests show significant results. Conclusion: Chemoradiation has been proven to significantly reduce RTL, and it can be concluded that giving chemoradiation to cervical cancer stage IIIB and above provides good results.
Characteristics of Stress Levels, Learning Motivation, and the Level of Knowledge Puspita, Angela; Angel, Syalomitha Claudia Stefanie; Adji, Arga Setyo
Jurnal Penelitian Pendidikan IPA Vol 10 No SpecialIssue (2024): Science Education, Ecotourism, Health Science
Publisher : Postgraduate, University of Mataram

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.29303/jppipa.v10iSpecialIssue.7704

Abstract

Medical students face a variety of stressors, such as the rigorous medical curriculum, competition for their desired specialty, and adherence to the school’s moral and ethical standards. This study aimed to describe the characteristics of motivation and stress of preclinical medical students. The study gathered questionnaires from 250 preclinical medical students from December 2023 to January 2024. The collected data were related to motivation, stress level, CBT/Socca score, and Learn strategy. The sample is 250 participants, most participants were female (70.4%), aged < 20 years old (98.4%), and had medical interests by their own wishes (77.6%). Most preclinical students in the MSLQ questionnaire had moderate motivation (76.8%) and moderate learning strategy (73.6%), and the results were good in the DASS-42 questionnaire with normal depression, anxiety, and stress (69.2%, 45.2%, 70.0%). The CBT vs SOCCA test scores had very different results; the SOCCA score was lower than CBT score SOCCA= E (24 %) with an average value of 60.50 ± 21.03 vs. CBT= A- (20.0%) with an average value of 63.10 ± 11.37. The characteristics of medical faculty students are normal stress levels, moderate learning motivation, and the SOCCA score was lower than the CBT score.
Life-Threatening Pneumonia In A Child With Down Syndrome Challenges In A Rapidly Progressive Respiratory Failure: A Case Report Puspita, Angela; Setiadi, Alexander Wignyo; Elizabeth, Maria
Jurnal Impresi Indonesia Vol. 4 No. 11 (2025): Indonesian Impression Journal (JII)
Publisher : Riviera Publishing

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.58344/jii.v4i11.7167

Abstract

Children with Down syndrome (DS) demonstrate increased vulnerability to severe respiratory infections due to anatomical, immunological, and physiological vulnerabilities. This case report examines the rapid progression of pneumonia in an 8-year-old child with DS, highlighting critical challenges in managing respiratory failure in this population. Methods: A retrospective case report analysis was conducted at a secondary hospital in Surabaya, Indonesia, involving comprehensive review of medical records, laboratory findings, radiological examinations, and clinical progression of an 8-year-old boy with DS who presented with severe community-acquired pneumonia. Results: The patient presented with a 10-day history of fever, productive cough, and dyspnea. Initial assessment revealed tachypnea (36 breaths/min), hypoxemia (SpO? 89%), and bilateral infiltrates on chest radiography. Despite normal leukocyte count, elevated CRP (24.3 mg/L) and thrombocytosis (589 × 10³/µL) indicated significant inflammation. Management with high-flow nasal cannula oxygenation, empirical antibiotics (ceftriaxone and azithromycin), bronchodilators, and intravenous fluids resulted in clinical improvement within 72 hours, with discharge on the sixth day. Discussion: This case underscores how common respiratory infections can rapidly deteriorate in children with DS due to airway abnormalities, immune dysfunction, and neuromuscular hypotonia. Early recognition of hypoxemia as a warning sign and timely multidisciplinary intervention are crucial to prevent respiratory failure. Preventive strategies including optimized vaccination and caregiver education are essential components of comprehensive care.
Co-Authors Adji, Arga Setyo Angel, Syalomitha Claudia Stefanie Diah Purwaningsari Elizabeth, Maria Marbentan, Purwo Diva Nadib Setiadi, Alexander Wignyo Sudiarta, Ketut Edy