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Severe Leptospirosis (Weil’s Disease) Complicated by Septic Shock: A Case Report Andrean, Melvin; Sasongko, Calvin; Nabil Mubtadi Falah
Jurnal Kedokteran Meditek Vol 31 No 5 (2025): SEPTEMBER
Publisher : Fakultas Kedokteran Universitas Kristen Krida Wacana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36452/jkdoktmeditek.v31i5.3908

Abstract

Introduction: Weil’s disease is the severe manifestation of leptospirosis, characterized by multiorgan dysfunction and high mortality risk without timely diagnosis and treatment. Early clinical suspicion and prompt intervention are critical for favorable outcomes. Case Illustration: a 51-year-old male with fever, left leg myalgia, jaundice, hypotension, and tachycardia consistent with septic shock. Laboratory evaluation revealed leukocytosis, acute liver injury, and severe acute kidney injury. Additionally, chest imaging revealed bilateral pulmonary infiltrates. Initial management included fluid resuscitation, vasopressors, and broad-spectrum antibiotics. Leptospira IgM serology confirmed the presence of leptospirosis on day 2. Despite severe acute kidney injury, renal function improved without dialysis, and vasopressors were discontinued by day 3. The patient was discharged on day 11, having made a full recovery. Discussion: Severe leptospirosis can present with nonspecific symptoms and progress to septic shock and multiorgan dysfunction. In this case, the diagnosis was supported by IgM-ELISA and a history of exposure to floodwater. Early treatment with broad-spectrum antibiotics and supportive care led to a full recovery. Conclusion: This case highlights the uncommon presentation of septic shock as the dominant feature of Weil’s disease, together with rapid renal recovery without dialysis, underscoring the reversibility of multiorgan dysfunction when promptly managed.
Rare Malaria Case in Jakarta: Diagnostic Challenges and Treatment Strategies for General Practitioners in Non-Endemic Area Andrean, Melvin; Faizi Assafah, Afif
Asian Journal of Social and Humanities Vol. 3 No. 6 (2025): Asian Journal of Social and Humanities
Publisher : Pelopor Publikasi Akademika

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59888/ajosh.v3i6.539

Abstract

Malaria, a significant global health issue caused by Plasmodium species, is rare in urban areas like Jakarta but remains endemic in regions such as Papua, Indonesia. This case report highlights a mixed Plasmodium infection (P. vivax and P. malariae) in a 27-year-old male presenting with fever, chills, and body aches. Initially misdiagnosed with dengue fever due to overlapping symptoms, further history revealed recent travel to Papua, leading to malaria diagnosis via blood smear examination. The case emphasizes diagnostic challenges in non-endemic regions where general practitioners may lack familiarity with malaria, especially in atypical presentations. Rapid diagnostic tests, hematological markers, and detailed travel histories are critical for improving diagnostic accuracy. Treatment with dihydroartemisinin-piperaquine and primaquine was effective, showcasing the importance of adhering to national malaria guidelines. This report highlights the need for heightened awareness, better training, and improved diagnostic resources to manage malaria in non-endemic urban areas effectively.
Investigating the Prognostic Value of Serum Albumin Levels in Patients Undergoing Hemodialysis: A Systematic Review and Meta-analysis Adrya, Jessica; Sasongko, Calvin; Andrean, Melvin; Kartadinata, Muhammad Faishal; Theis, Aveline Maisie; Putri, Syafira Ayudiah Syah; Mukti, A. Muh. Yasser; Moelyadi, Felly; Varsha, Srigita; Dhika, Veriantara Satya
Medicinus Vol. 15 No. 1 (2025): October
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v15i1.10770

Abstract

Background: Hypoalbuminemia, characterized by low serum albumin levels, is frequently observed in patients undergoing hemodialysis and has been identified as a potential predictor of increased mortality risk. This systematic review aims to evaluate the relationship between hypoalbuminemia and mortality in hemodialysis patients, assessing the prognostic value of serum albumin levels as an indicator for patient outcomes. Methods: A comprehensive search was conducted in databases including PubMed, Europe PMC, and Scopus to identify relevant studies. Studies were included if they investigated the association between serum albumin levels and mortality outcomes in adult patients undergoing hemodialysis. Data extraction was performed independently by two reviewers, focusing on study characteristics, patient demographics, albumin levels, and mortality outcomes. Quality assessment of studies was conducted using the Newcastle-Ottawa Scale (NOS). Result: A total of eight studies, encompassing 45,178 hemodialysis patients with a mean age in the 50s, met the inclusion criteria. The studies had a combined male cohort of 22,501 individuals. The definition of hypoalbuminemia varied across studies, with cutoff values ranging from 3.0 to 3.9 g/dL. Follow-up durations spanned from as early as 3 months to a maximum of 6.1 years. The meta-analysis revealed a pooled hazard ratio (HR) of 1.08 (95% CI: 0.94–1.25), suggesting a non-significant association between hypoalbuminemia and increased mortality risk (P = 0.28). However, substantial heterogeneity was present (I² = 79%), indicating variability across studies. Conclusions: Hypoalbuminemia showed a non-significant association with mortality in hemodialysis patients, though variability across studies suggests further research is needed for clarity.
Pengaruh Lingkungan dan Beban Kerja Terhadap Produktivitas Perawat IGD RSUD Cengkareng Andrean, Melvin; Wahyudi, Bayu; Veranita, Mira
Jurnal Sains Manajemen Vol. 8 No. 1 (2026): Jurnal Sains Manajemen
Publisher : LPPM Universitas Adhirajasa Reswara Sanjaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51977/xy65tk88

Abstract

Produktivitas perawat pada Instalasi Gawat Darurat RSUD Cengkareng menjadi elemen penting dalam menjamin keberlangsungan mutu pelayanan serta keamanan pasien. Tujuan utama dari penelitian ini adalah untuk menelaah sejauh mana lingkungan kerja dan beban kerja memberikan dampak terhadap produktivitas tenaga keperawatan. Pendekatan yang diterapkan ialah metode kuantitatif dengan pola analisis deskriptif serta kausalitas. Populasi meliputi seluruh perawat di Instalasi Gawat Darurat dengan jumlah responden 48 orang yang ditentukan melalui teknik pengambilan sampel menyeluruh. Data diperoleh melalui penyebaran instrumen kuesioner berformat tertutup dengan penilaian berbasis skala Likert, selanjutnya diproses menggunakan analisis regresi linier berganda. Hasil analisis mengindikasikan bahwa lingkungan kerja memiliki pengaruh yang signifikan dan menguntungkan terhadap produktivitas perawat, sementara beban kerja justru menimbulkan dampak signifikan yang menurunkan kinerja. Kedua faktor penelitian tersebut secara bersamaan memberikan pengaruh signifikan terhadap produktivitas tenaga keperawatan. Kondisi lingkungan kerja yang kondusif dan memberikan dukungan emosional dapat meningkatkan semangat serta performa perawat, sedangkan beban kerja berlebih berpotensi menurunkan efektivitas serta mutu pelayanan kepada pasien. Hasil kajian ini memberikan saran kepada pengelola rumah sakit untuk memperkuat aspek lingkungan kerja, mencakup faktor fisik dan sosial-psikologis, serta menyesuaikan beban kerja agar sesuai dengan kapasitas perawat. Penelitian ini dapat dijadikan acuan dalam menentukan kebijakan strategis dan upaya perbaikan kualitas layanan di Instalasi Gawat Darurat.