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All Journal Medula Cermin Dunia Kedokteran
Pramudya, Ricky
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Education Health Professions Medicine & Pharmacology Neuroscience Public Health

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A Kasus Langka: Intususepsi Pada Orang Dewasa Dona, Adma Hayani; Pramudya, Ricky; Parinding, Imanuel Taba
Medula Vol 14 No 11 (2024): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v14i11.1474

Abstract

Intussusception is defined as the invagination of one segment of intestine into the next. Unlike children, intussusception in adults is rare. The incidence of intussusception in adults is around 1%-5% of intestinal obstruction with an average age of 50 years. Compared with intussusception in children, intussusception in adults is different because 90% of cases are complications of pathological starting points, including polyps, carcinoma, strictures, adhesions, and Meckel's diverticulum. Meanwhile, the incidence of idiopathic intussusception is around 10% of cases. A 39-year-old woman with a history of right lower abdominal pain for 3 days came to the emergency department accompanied by vomiting, no bowel movements and a history of abdominal massage. Physical examination found a positive Mc Burney sign, a sausage-like mass was palpable, abdominal ultrasonography showed a doughnut sign and an impression of ileo-caecal intussusception. The patient underwent exploratory laparotomy and appendectomy. During the operation, ileocaecal invagination into the ascending colon was seen, then a milking procedure was performed. The patient was discharged in stable condition on the fifth day of hospitalization. Management of intussusception depends on the part of the intestine involved. Reduction of acute intussusception is an emergency procedure and should be performed immediately after diagnosis in preparation for possible surgery. Management can be done operatively or non-operatively. Resection of the intestine is the final choice if the intestinal viability is compromised or there are pathological points. Early diagnosis and timely intervention greatly affect the patient's prognosis.
Tata Laksana Hipoglikemia pada Pasien Diabetes: Tinjauan Pustaka Pramudya, Ricky; Amiralevi, Siti Haura
Cermin Dunia Kedokteran Vol 52 No 1 (2025): Januari 2025
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v52i1.1254

Abstract

Hypoglycemia is a complication of diabetes mellitus (DM) that may be deleterious. The most frequent cause of hypoglycemia in diabetes patients is inappropriate doses of insulin and/or anti-diabetic drugs. Hypoglycemia occurs more often in type 1 DM patients than in type 2 DM patients. Prompt recognition and treatment is critical because hypoglycemia increased morbidity and mortality.
Pendekatan Klinis Sindrom Takotsubo: Tinjauan Pustaka Pramudya, Ricky
Cermin Dunia Kedokteran Vol 53 No 06 (2026): Juni 2026
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v53i06.1349

Abstract

Takotsubo syndrome (TTS) or cardiomyopathy due to stress is defined as a syndrome of acute systolic and diastolic dysfunction of the left ventricle, usually associated with emotional or profound physical stress. The incidence of Takotsubo syndrome has increased dramatically during the COVID-19 pandemic, which is closely related to psychological stressors such as social isolation, financial problems, and anxiety. Increased sympathetic stimulation with massive catecholamine release plays a major role in the pathogenesis of Takotsubo cardiomyopathy. An accurate history of the emotional and physical events preceding the onset of symptoms is the most important diagnostic tool. In the acute phase, most complaints are typical chest pain similar to myocardial infarction, while others come with symptoms of heart failure, such as dyspnea, orthopnea and/or acute pulmonary edema or syncope. An important clinical marker of Takotsubo cardiomyopathy is an increase in N-terminal prohormone of brain natriuretic peptide (NT proBNP), which has been shown to be directly related to elevated blood catecholamine concentrations, a marker of sympathetic overreaction, and the severity of left ventricular dysfunction with associated systemic complications, such as pulmonary edema. Supportive and symptomatic treatment should be provided in the acute phase. Patients with Takotsubo cardiomyopathy have a good prognosis, with left ventricular function recovering within days and fully recovering within 3–4 weeks.
Co-Authors Amiralevi, Siti Haura Dona, Adma Hayani Parinding, Imanuel Taba