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ISM (Intisari Sains Medis) : Jurnal Kedokteran

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Published by Universitas Udayana

ISSN : 25033638 EISSN : - DOI : -

Core Subject : Health, Science,

Biochemistry, Genetics & Molecular Biology Medicine & Pharmacology

Intisari Sains Medis is published by Medical Scientific Community, Indonesia. Intisari Sains Medis is an international, multidisciplinary, peer-reviewed, open access journal accepts papers for publication in all aspects of Science Digest, Medical Research Development, Research Medical Field and Theory. We also publish cases from third world country, that is considered very rare and special cases.

Arjuna Subject : -

Articles 1,063 Documents

86 87 88 89 90

Akurasi otoskopi video digital dalam mendiagnosis otitis media akut pada pasien pediatri: sebuah tinjauan sistematik Anak Agung Wira Ryantama; Ni Luh Parameswari Praptika; Ni Nyoman Astrid Tri Bhuwana
Intisari Sains Medis Vol. 13 No. 1 (2022): (Available Online : 1 April 2022)
Publisher : DiscoverSys Inc.

Introduction: Acute otitis media one of the most prevalent ear and throat infection, mostly affecting children. Diagnosis of this condition was complicated by the perceived invasive procedure and the shortage of qualified otologist. Digital video otoscopy is a new and evolving concept in otology which could be further enhanced with telemedicine. It increases access to specialist otologist care by having the examination performed by less qualified healthcare professional. In this review we would like to assess the newest evidence on digital video otoscopy as diagnostic modality for acute otitis media.Methods: We identified literature published from 2000 to 2020 from MEDLINE and Google Scholar. We included studies which reported diagnosis of acute otitis media using digital video otoscopy devices. We include both descriptive and analytical studies. We exclude literatures that reported secondary results or those that does not have acute otitis media as the diagnosis of interest. Articles that fulfill the criteria was then analyzed qualitatively to identify the themes that emerges.Results: Literature search resulted in 10 included studies which includes descriptive studies, diagnostic studies, and RCTs. Digital video devices used varied from add-ons to smartphones to dedicated digital video otoscopy results. The reported examiners also varied from otologist, general practitioners, to telemedicine facilitators. Most studies concur that digital video otoscopy provided adequate inter-examiner and intra-examiner reliability. At the same time, digital video otoscopy provides adequately accurate diagnosis of acute otitis media. Where comparison was available, the accuracy of digital video otoscopy was not significantly different compared to other modes of otoscopy.Conclusions: Digital video otoscopy provide adequately reliable and accurate diagnostic examination for acute otitis media. Some digital video otoscopy system was simple enough to be operated by nurses or telemedicine facilitators, supporting the utilization of this system for telemedicine.

The efficacy of olmesartan/amlodipine combination in hypertension treatment – a systematic review Ni Luh Parameswari Praptika; Anak Agung Wira Ryantama; Ni Nyoman Astrid Tri Bhuwana
Intisari Sains Medis Vol. 13 No. 1 (2022): (Available Online : 1 April 2022)
Publisher : DiscoverSys Inc.

Introduction: Hypertension is the most common non-communicable disease, which persists as a major risk factor of cardiovascular diseases such as stroke, myocardial infection, and heart failure. Another major problem in clinical practice was the patients' adherence to treatment, directly related to the number of hypertension pills to be taken. Thus, determining the appropriate time duration and action of a hypertensive drug to maintain the blood pressure is needed. Olmesartan is one of the drug compounds frequently used for long-acting anti-hypertensive treatment. It is often combined with amlodipine; however, their combination remains unclear to provide equal efficacy and safety. Thus, in this article, we systematically summarize the combination of Olmesartan with amlodipine.Methods: This systematic literature review was extracted from Science Direct and Pubmed to identify randomized clinical trials (RCT) of the outcome of the Olmesartan/amlodipine effect compared with other hypertension regimens by using PRISMA guideline 2009. The methodological quality of the included studies was assessed independently by two reviewers using The Cochrane Collaboration's RoB 2 tool.Results: We evaluated twelve studies in the last ten years, and there were four studies with an intention-to-treat protocol (25% of articles had some concern, and 75% had a low risk of bias.) and eight studies with per-protocol analysis (37,5% of articles were concerned, and the rest had a low risk of overall bias). We also presented the efficacy and safety outcomes of the study reviewed.Conclusion: Hypertension is a common non-communicable disease, and treatment approaches for hypertension vary widely. Administration of combination drugs is a good approach in reducing the dose of drug administration and reducing the incidence of side effects in monotherapy. Inhibiting the RAA system by olmesartan and reducing vascular smooth muscle tone by amlodipine gives better results and can be a safe and effective option for lowering blood pressure in hypertensive patients. The side effects observed were not severe and only observed in a few cases, making it an option to treat hypertension.

Hubungan nilai Red Cell Distribution Width (RDW) dengan tingkat keparahan pneumonia pada pasien anak di RSUD Wangaya Denpasar, Bali-Indonesia Made Cynthia Mahardika Putri; I Wayan Bikin Suryawan; I Kadek Suarca
Intisari Sains Medis Vol. 12 No. 3 (2021): (Available online: 1 December 2021)
Publisher : DiscoverSys Inc.

Latar Belakang: Pneumonia merupakan penyebab kematian tertinggi pada anak usia kurang dari lima tahun. Berdasarkan Profil Kesehatan Indonesia 2019 terdapat 52,7% kasus pneumonia anak di Indoneisa. Tingginya kasus kematian akibat pneumonia pada anak menandakan beratnya gejala yang timbul dan perburukan klinis yang terjadi, sehingga penting untuk menemukan penanda yang dapat memprediksi anak yang cenderung akan mengalami perburukan klinis. Red cell distribution width (RDW) adalah suatu penanda pada pemeriksaan darah standar namun klinisnya jarang diperhatikan. Tujuan penelitian ini adalah untuk mengetahui hubungan nilai RDW dengan tingkat keparahan pneumonia pada pasien anak. Metode: Jenis penelitian yang digunakan adalah studi analitik observasional dengan pendekatan cross-sectional. Pengambilan sampel menggunakan metode consecutive sampling. Data yang diperoleh dianalisis secara analitik, menggunakan program computer SPSS versi 25.0 dengan uji chi square dan uji independent t-test.Hasil: Rerata RDW didapatkan lebih tinggi pada kelompok subjek dengan pneumonia berat (15,48 ± 1,95) dibandingkan kelompok dengan pneumonia ringan (13,73 ± 1,11) (p=0,000).Simpulan: Terdapat hubungan bermakna antara RDW dengan tingkat keparahan pneumonia. Background: Pneumonia is the highest cause of death in children less than five years old. Based on the 2019 Indonesian Health Profile, there were 52.7% cases of childhood pneumonia in Indonesia. The high number of deaths from pneumonia in children indicates the severity of the symptoms and the clinical deterioration that occurs, so it is essential to find markers that can predict children who are likely to experience clinical deterioration. Red cell distribution width (RDW) is a marker on standard blood tests but is rarely seen clinically. This study aimed to determine the relationship between the RDW value and the severity of pneumonia in pediatric patients.Methods: The type of research used is an observational analytic study with a cross-sectional approach. Sampling used the consecutive sampling method. The data obtained were analyzed analytically, using the computer program SPSS version 25.0 with chi-square test and independent t-test.Results: The mean RDW was higher in person with severe pneumonia (15.48 ± 1.95) than the group with mild pneumonia (13.73 ± 1.11) (p=0.000).Conclusion: There is a significant relationship between RDW and the severity of pneumonia.

Immunopathogenesis of erythema nodosum leprosum Made Sanitca Indah; I Gusti Agung Ayu Dwi Karmila
Intisari Sains Medis Vol. 12 No. 3 (2021): (Available online: 1 December 2021)
Publisher : DiscoverSys Inc.

Leprosy is a chronic granulomatous disease. Its etiology is caused by Mycobacterium leprae (M. leprae). This disease may affect the skin, however it also may affect peripheral nervous system and other organs. The immunologic mechanism of erythema nodosum leprosum (ENL) has not been fully understood. The ENL reaction is the reaction of deposition in immune complex in the blood vessels. Recent studies have reported the association of several immunological markers with leprosy reactions, but inconsistent results have been obtained. Neutrophils are considered a histologic feature of ENL, histologic examination of ENL skin lesions revealed a strong perivascular neutrophil infiltrate throughout the dermis and subcutis. Another thing to note is T lymphocytes. It has been showed that the T-cell counts in peripheral blood of ENL patients is higher. Other immunological processes that play a role in EL immunopathogenesis involve T-helper (Th) cells, T regulatory cells, B cells, and other cytokines.

Correlation between albumin serum and frailty in geriatric inpatient and outpatient clinic at Sanglah Hospital Denpasar Putu Shely Prihastuti Rudy; RA Tuty Kuswardhani; I Gusti Putu Suka Aryana; Nyoman Astika; Ida Bagus Putu Putrawan; Ni Ketut Rai Purnami
Intisari Sains Medis Vol. 12 No. 3 (2021): (Available online: 1 December 2021)
Publisher : DiscoverSys Inc.

Background. Frailty in the elderly has a bad impact on health, especially in the elderly with acute illness. Elderly with frailty has an increase susceptibility to falls, disability and death. Frailty is a common problem in elderly patients, and hypoalbuminemia suggested to increase the risk of death. This study aimed to determine the relationship between albumin and frailty.Method: A Cross-Sectional Study was conducted from February 2018 to January 2019 at Sanglah Hospital with total 60 patients. Patients were divided into two groups, patients with hypoalbuminemia (albumin < 3.5 g/dL) and patients with normal serum albumin levels (albumin ? 3.5 g/dL). The frailty status assessment was measured with Fried's Frailty Phenotype questionnaire. Chi-square test was used to find the relationship between serum albumin and frailty.Result: We evaluated 60 patients, 36 patients (60%) were male and 24 patients (40%) were female. The age of the study subjects ranged from 62 to 92 years. In this study 26 patients (43.3%) with hypoalbuminemia and 34 patients (56.7%) with normal serum albumin. There were 20 patients (76.9%) with frailty in the hypoalbuminemia group, compared to 11 patients (32.4%) in the group of patients with normal serum albumin. Hypoalbuminemia has a risk of 6.97 times greater frailty compared to normal albumin in elderly patients (p = 0.001).Conclusion: This study exhibited a significant relationship between serum albumin and frailty in elderly admitted to inpatient unit and outpatient clinic. The lower the serum albumin level, the higher the probability of the elderly to experience frailty.

Karakteristik pasien fraktur kruris di RSUD Sanjiwani Gianyar tahun 2020 Gede Agastya Pracheta Ewari; Yoga Premana
Intisari Sains Medis Vol. 12 No. 3 (2021): (Available online: 1 December 2021)
Publisher : DiscoverSys Inc.

Background: The location of the most fractures in traffic accident victims is the lower extremity bone. Data from the Basic Health Research (Riskesdas) also shows that fractures in the lower extremities due to traffic accidents have the highest prevalence among other fractures. Cruris fractures generally occur as a result of high-energy trauma such as a traffic accident or low-energy torsional trauma. The increase in cases of trauma, especially traffic accidents cause an increase in the incidence of tibial and fibular fractures. This study aims to determine the prevalence and characteristics of cruris fractures at the Sanjiwani Hospital, Gianyar in 2020.Methods: The design of this study was retrospective descriptive using 30 samples of cruris fractures taken from secondary data from patient medical records at the Sanjiwani Hospital, Gianyar. The variables of this study included gender, age, cause of fracture and type of cruris fracture. Data analysis using SPSS software.Results: The most common fractures of the tibia and fibula occurred in male patients (56%). The age group most frequently experiencing cruris fractures is the adult age (18-59 years). The most common cause of cruris fractures was traffic accidents as many as 19 people (64%). The most common type of cruris fracture found in this study was a fracture of the tibia fibula as many as 21 people (70%).Conclusion: The most common cruris fractures are tibia and fibula fractures in men, with the most common cause of traffic accidents. This study is expected to be able to become a basic data material for conducting a wider study on the prevalence and characteristics of cruris fractures in Bali, so that the public can be more aware of the incidence of fractures that still occur frequently. Latar belakang: Lokasi fraktur terbanyak pada korban meninggal kecelakaan lalu lintas adalah pada tulang bagian ekstremitas bawah. Data dari Riset Kesehatan Dasar (Riskesdas) juga menunjukkan bahwa fraktur pada ekstremitas bawah akibat kecelakaan lalu lintas memiliki prevalensi yang paling tinggi diantara fraktur lainnya. Fraktur kruris pada umumnya terjadi akibat trauma dengan energi tinggi seperti kecelakan lalu lintas atau trauma torsional energi rendah. Peningkatan kasus trauma, terutama kecelakaan lalu lintas menyebabkan peningkatan insidens fraktur tibial dan fibular. Penelitian ini bertujuan untuk mengetahui prevalensi dan karakteristik dari fraktur kruris di RSUD Sanjiwani Gianyar pada tahun 2020.Metode: Rancangan penelitian ini adalah deskriptif retrospektif dengan menggunakan 30 sampel fraktur kruris yang diambil dari data sekunder rekam medis pasien di RSUD Sanjiwani Gianyar. Variabel penelitian ini meliputi jenis kelamin, usia, penyebab fraktur dan jenis fraktur kruris. Analisa data menggunakan perangkat lunak SPSS.Hasil: Fraktur tibia dan fibula paling banyak terjadi pada pasien laki – laki (56%). Kelompok usia yang paling sering mengalami fraktur kruris adalah usia dewasa (18 – 59 tahun). Penyebab terbanyak fraktur kruris adalah kecelakaan lalu lintas sebanyak 19 orang (64%). Jenis fraktur kruris tersering yang ditemukan pada penelitian ini adalah fraktur tibia fibula sebanyak 21 orang (70%).Simpulan: Fraktur kruris paling banyak didapatkan adalah fraktur tibia dan fibula pada laki-laki, dengan penyebab tersering kecelakaan lalu lintas. Penelitian ini diharapkan mampu menjadi bahan data dasar untuk dilakukannya penelitian lebih luas mengenai prevalensi dan karakteristik fraktur kruris di Bali, sehingga masyarakat dapat lebih waspada mengenai kejadian fraktur yang masih sering terjadi.

Anak laki-laki usia 4 tahun dengan paraparesis lower motor neuron, gizi kurang, pendek, dan masalah makan di RS tipe B: sebuah laporan kasus Fitriana Melinda; Made Ratna Dewi
Intisari Sains Medis Vol. 12 No. 3 (2021): (Available online: 1 December 2021)
Publisher : DiscoverSys Inc.

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Background: Paralysis is a symptom of various diseases, disorders, or certain conditions, ranging from mild to severe and can be caused by infectious processes, trauma, malignancies, autoimmune diseases, and other abnormal processes. Eating problems in children is one of the developmental disorders that can occur in healthy infants or children. Eating problems have the potential to cause cognitive and behavioral disorders, and are associated with anxiety disorders and eating disorders in children, adolescents, and young adults. Case description: A 4 years 2 months old male, complained not being able to walk and his legs shrinking since 2 weeks of SMRS. His male cousin has experienced paralysis of the right leg since the 3rd grade of elementary school. There were multiple enlarged right inguinal lymph nodes accompanied by refusal to take meal for the past 3 months. Neurological examination found normal energy in all four extremities but decreased patellar and achilles reflex. Body weight (BW) was 11 kg, body length (BL) 94 cm, BW/BL (-3) - (-2) SD (wasted). Leukocytes 6.4/ul, hemoglobin 11.0 g/dl, hematocrit 33.3%, MCV 69.4 fl, MCH 22.9 pg, MCHC 33.0 g/L, platelets 396.000 /ul, ESR 41 mm / hours, CRP 11 mg/L and CK 1,441 U/L. Radiological examination of lumbosacral photo showed the impression of paraspinal muscle spasm. The patient diagnose with lower motor neuron paraparesis. Conclusion: Handling of patients with eating problems and LMN paraparesis is given non-medical management by meeting fluid needs, nutrition according to patient needs and education about feeding rules to the patient's parents, consultation with psychologists, and medical rehabilitation seek treatment. improvement of eating problems and medical problems in the form of weak legs more optimally. Latar belakang: Kelumpuhan adalah gejala dari berbagai penyakit, kelainan, atau kondisi tertentu, mulai dari yang ringan sampai berat, yang disebabkan oleh proses infeksi, trauma, keganasan, penyakit autoimun, dan proses abnormal lainnya. Masalah makan pada anak merupakan salah satu gangguan perkembangan yang dapat terjadi pada bayi atau anak sehat. Selain itu, masalah makan berpotensi menyebabkan gangguan kognitif dan perilaku, serta dikaitkan dengan gangguan cemas dan kelainan makan pada anak, remaja, dan dewasa muda. Deskripsi kasus: Anak laki-laki berusia 4 tahun 2 bulan, keluhan tidak bisa berjalan dan kaki mengecil sejak 2 minggu SMRS. Kakak sepupu laki-laki dari ibu pasien mengalami kelumpuhan kaki kanan sejak kelas 3 SD. Ditemukan adanya pembesaran kelenjar getah bening inguinal dekstra multipel disertai tidak mau makan sejak 3 bulan lalu. Pemeriksaan neurologis didapatkan tenaga normal pada keempat ekstremitas namun penurunan refleks fisiologis kniepeesreflex (KPR) dan achillespeesreflex (APR). Status antropometri yaitu BB 11 kg, PB 94 cm, BB/PB (-3)-(-2) SD (wasted). Leukosit 6.4 /ul, hemoglobin 11.0 g/dl, hematokrit 33,3%, MCV 69,4 fl, MCH 22,9 pg, MCHC 33,0 g/L, trombosit 396.000/ul, LED 41 mm/jam, CRP 11 mg/L dan CK 1,441 U/L. Radiologi lumbosakral antero-posterior/lateral didapatkan kesan paraspinal muscle spasm. Pasien didiagnosis paraparesis lower motor neuron (LMN). Simpulan: Penanganan pasien dengan anak dengan masalah makan dan paraparesis LMN diberikan penatalaksanaan non-medikamentosa dengan pemenuhan kebutuhan cairan, nutrisi sesuai kebutuhan pasien dan edukasi mengenai feeding rules kepada orang tua pasien, konsultasi dengan psikolog, serta rehabilitasi medik untuk mengupayakan perbaikan masalah makan dan masalah medis berupa kaki lemas dengan lebih maksimal.

Hubungan penyakit komorbiditas terhadap derajat klinis COVID-19 Kadek Wisnu Segara Karya; I Made Suwidnya; Beny Surya Wijaya
Intisari Sains Medis Vol. 12 No. 2 (2021): (Available Online: 1 August 2021)
Publisher : DiscoverSys Inc.

Pendahuluan: Coronavirus Disease 2019 (COVID-19) adalah penyakit infeksi virus yang disebabkan oleh Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). Komorbiditas merupakan faktor risiko keparahan dan mortalitas pada pasien COVID-19. Tingginya prevalensi COVID-19 disertai dengan variasi klinis yang luas mengindikasikan bahwa telaah prediktor derajat klinis COVID-19 sangat diperlukanMetode: Penelitian analitik potong lintang dilakukan di Rumah Sakit Bhayangkara Denpasar. Data demografi dan klinis pasien rawat inap usia usia ?18 tahun dengan COVID-19 dikumpulkan pada periode Agustus 2020-Januari 2021 dengan metode Total Sampling. Kriteria inklusi meliputi pasien usia ?18 tahun yang menjalani rawat inap dengan diagnosis COVID-19 yang terkonfirmasi dengan pemeriksaan RT-PCR SARS-CoV-2. Sampel dikategorikan menjadi derajat berat-kritis dan sedang. Analisis data dilakukan secara deskriptif dan analitikHasil: Terdapat 153 pasien COVID-19 dengan rerata usia 47±15 tahun dan mayoritas laki-laki (60%). Sebagian besar pasien mengalami gejala sedang (77,1%). Gejala utama meliputi demam (71,9%), sesak (16,3%) dan batuk (7,2%). Sebagian pasien memiliki komorbiditas (42,8%). Komorbiditas yang ada paling banyak ditemukan adalah hipertensi (21,6%) dan diabetes melitus (17,6%), diikuti dengan gagal ginjal kronis (5,9%) dan penyakit jantung (4,6%). Sebagian besar pasien (71,9%) menunjukkan hasil bacaan x-ray thorax normal. Mayoritas pasien tidak dirujuk (86,3%) dengan median lama rawat inap 12,5 hari. Hanya 2% pasien yang meninggal. Hasil analisis bivariat menunjukkan pasien dengan usia >50 tahun, adanya komorbid dan gambaran x-ray thorax abnormal berhubungan dengan derajat berat-kritis. Komorbiditas hipertensi, diabetes melitus dan gagal ginjal kronik yang masing-masing berhubungan dengan derajat klinis COVID-19 berat-kritis. Pada analisis multivariat hanya gambaran x-ray thorax abnormal dan adanya penyakit komorbiditas yang berhubungan dengan derajat klinis COVID-19 berat-kritis.Simpulan: Adanya penyakit komorbid hipertensi, diabetes melitus, penyakit ginjal kronis disertai gambaran x-ray thoraks abnormal merupakan faktor prediktor infeksi COVID-19 derajat berat-kritis. Introduction: Coronavirus Disease 2019 (COVID-19) is a viral infection caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). Comorbidity is a risk factor for severity and mortality in COVID-19. The high prevalence of COVID-19 accompanied by a wide clinical variation makes determining the predictors of COVID-19 clinical severity an important endeavor.Methods: A cross-sectional study was conducted at Bhayangkara Hospital Denpasar. Demographic and clinical data of inpatients aged 18 years with COVID-19 were collected from August 2020-January 2021 with the total sampling method. Inclusion criteria included 18 years of age hospitalized with a confirmed COVID-19 diagnosis by SARS-CoV-2 RT-PCR examination. The samples were categorized into severe-critical and moderate infection. Data was analyzed in both descriptive and analytics manner.Results: There were 153 COVID-19 patients with an average age of 47±15 years, and the majority were male (60%). Most experienced moderate symptoms (77.1%). The main symptoms included fever (71.9%), shortness of breath (16.3%) and cough (7.2%). Almost half had comorbidities (42.8%). The most common were hypertension (21.6%) and diabetes mellitus (17.6%), followed by chronic kidney disease (5.9%) and heart disease (4.6%). Most of the patients (71.9%) had a normal chest x-ray. Most patients did not need a referral (86.3%) and were treated with a median length of stay of 12.5 days. The mortality rate was 2%. The results of bivariate analysis showed that patients aged >50 years, comorbidities and abnormal chest x-rays were associated with severe infection. Comorbidities of hypertension, diabetes mellitus and chronic kidney disease were associated with severe-critical infection. In the multivariate analysis, only abnormal chest x-ray images and the presence of comorbid diseases were associated with the clinical degree of severe-critical COVID-19.Conclusion: The presence of comorbid hypertension, diabetes mellitus, chronic disease accompanied by an abnormal chest x-ray was a predictor of severe-critical COVID-19 infection.

Gambaran neurogenic bladder pada pemeriksaan voiding cystourethrography: serial kasus Kadek Ieke Sugeng Kurniawan; Nyoman Srie Laksminingsih; Firman Parulian Sitanggang
Intisari Sains Medis Vol. 12 No. 3 (2021): (Available online: 1 December 2021)
Publisher : DiscoverSys Inc.

Latar Belakang: Neurogenic bladder (kandung kemih neurogenik) adalah suatu kelainan pada kandung kemih yang disebabkan karena terdapat kerusakan maupun penyakit yang menyerang sistem saraf pada daerah inervasi saluran kemih bagian bawah. Neurogenic bladder merupakan suatu proses yang kompleks di mana diperlukan suatu proses anamnesis, pemeriksaan fisik dan pemeriksaan penunjang yang seksama dalam menentukan diagnosis penyakit tersebut. Voiding Cystouretrography (VCUG) merupakan salah satu pemeriksaan radiologi yang memiliki peran penting dalam menegakan diagnosis neurogenic bladder serta penentuan terapi dan pencegahan komplikasi lebih lanjut. Serial kasus ini akan membahas tiga kasus neurogenic bladder berdasarkan pemeriksaan voiding cystourethrography serta beberapa etiologi dan komplikasi yang dapat menyertainya.Kasus: Pasien pertama yaitu wanita usia 13 tahun dengan klinis neurogenic bladder dan vesicoureteric reflux (VUR). Pada pemeriksaan VCUG didapatkan neurogenic bladder tipe UMN dengan gambaran cystitis kronis, vesicoureteric reflux (VUR) kiri grade V, parsial obstruksi pada ureter kiri 1/3 distal setinggi UVJ, spina bifida pada corpus vertebra L4, dan sacralisasi pada L5. Pasien kedua adalah laki-laki usia 7 bulan dengan manifestasi klinis infeksi saluran kemih. Hasil pemeriksaan VCUG didapatkan gambaran neurogenic bladder tipe UMN dengan posterior urethral valve disertai dengan cystitis dan divertikulosis. Pasien ketiga merupakan laki-laki usia 34 tahun dengan gambaran klinis striktur uretra. Pada pemeriksaan VCUG didapatkan striktur total urethra pars membranacea, neurogenic bladder tipe UMN dengan cystitis dan divertikel dinding posterior buli serta vesicolithiasis multipel.Simpulan: Pemerikasan VCUG memegang peranan penting dalam mendiagnosis neurogenic bladderbeserta beberapa etiologi dan komplikasi yang dapat menyertainya, sehingga penatalaksanaan pasien optimal dan prognosis pasien menjadi lebih baik.Background: Neurogenic bladder is a bladder disorder caused by any damage or disease that attacks the nervous system in the lower urinary tract. Neurogenic bladder is a complex process that requires thorough history taking, physical examination, and supporting radiology examination in determining the diagnosis of the disease. The voiding cystourethrography (VCUG) is radiological imaging that has an essential role in establishing the diagnosis of the neurogenic bladder. It also helps in determining therapy and preventing further complications. This case series aims to elaborate on three neurogenic bladder patients focusing on voiding cystourethrography and the etiology and complications concerning the disease.Cases: The first patient was a 13-year-old girl with clinical neurogenic bladder and vesicoureteral reflux (VUR). The radiograph from VCUG examination revealed UMN type neurogenic bladder with chronic cystitis, left vesicoureteral reflux (VUR) grade V, partial obstruction in the left 1/3 distal ureter at UVJ level, spina bifida in the L4 vertebral body, and sacralization at L5. The second patient was a 7-month-old boy with clinical manifestations of urinary tract infection. The results of the VCUG examination found a neurogenic bladder of the UMN type with a posterior urethral valve accompanied by cystitis and diverticulosis. The third patient was a 34-year-old man with clinical features of urethral stricture. On VCUG examination, total stricture of the urethra pars membranacea, neurogenic bladder UMN type with cystitis and posterior bladder wall diverticula, and multiple vesicolithiasis were found.Conclusion: VCUG examination plays an important role in diagnosing neurogenic bladder and several etiologies and complications that can accompany it. In addition, optimal patient management and better prognosis can be achieved.

Congenital syphilis present with pemphigus syphilitics and atelectatic congenital pneumonia: a case report Callista Beatrice; Indriana Triastuti; I Gde Doddy Kurnia Indrawan
Intisari Sains Medis Vol. 12 No. 3 (2021): (Available online: 1 December 2021)
Publisher : DiscoverSys Inc.

Background: Congenital syphilis is an infectious disease of newborns caused by Treponema pallidum, a spirochete bacterium, from vertical transmission from infected mother to fetus. Diagnosis of congenital syphilis can be difficult because two-thirds of affected infants are asymptomatic at birth, and the signs of symptomatic infants are diverse. Familiarity with the various presentations is essential to early diagnosis and treatment.Case Description: A male preterm, 35 weeks gestation baby, born by vaginal delivery from G1P0 mother with syphilis latent phase, with Treponema pallidum hemagglutination assay (TPHA) titer reactive (1:2560) with no treatment during the antenatal period. The baby was born with low birth weight, respiratory distress syndrome, hepatosplenomegaly, and skin rash. Diffuse desquamation and fissures also multiple eroded pale blisters are known as pemphigus syphilitics. TPHA was also reactive at the same level as the mother. Complete blood count showed severe respiratory acidosis (pH: 6,8), leucocytosis (46.420/uL), thrombocytosis (414.000/uL), lymphocytosis (40,3%), and monocytosis (16%). Radiology showed severe atelectatic left lung and course nodular congenital pneumonia of the right lung. The baby was intubated and injected with penicillin procaine 50.000 IU/kg/day intramuscularly in the neonatal intensive care unit (NICU). However, due to severe atelectatic lung and acidosis, this case resulted in a fatal outcome.Conclusion: Broad desquamation, multiple fissures, and eroded pale blisters (vesiculobullous lesions) known as pemphigus syphilitics should alert clinicians as an early manifestation of congenital syphilis. Other manifestations include congenital pneumonia, typically atelectatic or nodular type, and hepatosplenomegaly. Treatment should be started promptly to decrease its morbidity and mortality.

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Bali

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Home Page

OAI Link

Editorial Team

Contact

Reviewer

Google Scholar

Contact Name -

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Phone -

Journal Mail Official -

Editorial Address -

Location Kota denpasar, Bali INDONESIA

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Contact Name
-

Contact Email
-

Phone
-

Journal Mail Official
-

Editorial Address
-

Location
Kota denpasar,

Bali

INDONESIA