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A Complex Pediatric Case: Cerebral Palsy Complicated by Severe Pneumonia and Atelectasis
Gatiningrum, Anindita;
Udin, Muchammad Fahrul
Jurnal Kedokteran Brawijaya Vol. 33 No. 3 (2025)
Publisher : Fakultas Kedokteran Universitas Brawijaya
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DOI: 10.21776/ub.jkb.2022.033.03.11
Cerebral palsy (CP) is a non-progressive motor and cognitive disorder resulting from brain injury during development. Cerebral palsy (CP) promotes the development of respiratory disorders, including pneumonia and atelectasis. In this case, an 8-year-old male with cerebral palsy presented with complaints of shortness of breath, intermittent fever, productive cough, and decreased appetite. His respiratory rate was 28 beats per minute, SpO2 was 85%, and temperature was 37°C. Chest X-ray showed right pleural effusion with atelectasis, pneumonia in the left lung, emphysematous lung, and thoracic scoliosis. Bronchoscopy examination showed total atelectasis in the middle lobe of the right lung, with Streptococcus mitis or Streptococcus oralis identified through microbiological examination. Individuals with CP are susceptible to respiratory diseases due to neuromuscular impairment of the laryngeal muscles. This impairment can progress to atelectasis and pneumonia, representing the most common respiratory complications in CP.
The Correlation of Infection Prevention and Control Knowledge and ESBL Carriage Rate among Healthcare Workers in a Hospital in Indonesia
Fanani, Navalia Azkarifda;
Krisniawati, Nia;
Wicaksono, Madya Ardi;
Hestiyani, Rani Afifah Nur;
Widhi, Anriani Puspita Karunia Ning
Jurnal Kedokteran Brawijaya Vol. 33 No. 3 (2025)
Publisher : Fakultas Kedokteran Universitas Brawijaya
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DOI: 10.21776/ub.jkb.2025.033.03.3
Extended-spectrum beta-lactamase (ESBL) is an enzyme resulting from bacterial gene mutations that can restrict the activity of beta-lactam antibiotics, such as penicillin, the first, second, and third generation of cephalosporin, and monobactam, except cephamycin and carbapenem. ESBL can cause healthcare-associated infections (HAIs). Infection prevention and control (IPC) is a comprehensive effort to prevent HAIs in healthcare facilities. This research investigated the correlation between IPC knowledge level and the incidence of extended-spectrum beta-lactamase (ESBL) producing bacteria carriers in hospital healthcare workers. This research was conducted as observational analytical research using the quantitative and cross-sectional approaches. The research used purposive sampling, involving 61 healthcare workers at Banjarnegara Islamic Hospital. Research instruments included a 24-item questionnaire assessing IPC knowledge and rectal swabs intended to detect the incidence of ESBL carriers using the CHROMagar™ ESBL medium. Most respondents have a relatively good understanding of IPC, with a median score of 16 (25%). Of the 61 rectal swab samples, eight incidences of ESBL carriers were identified (13%). The isolates of the recognized carriers consist of five Escherichia coli (63%), two Klebsiella pneumoniae (25%), and one Acinetobacter baumannii (12%). Statistical analysis using the Mann-Whitney hypothesis test with the SPSS software showed a significant value of 0.493. Therefore, there is no correlation between IPC knowledge level and the incidence of extended-spectrum beta-lactamase-producing bacteria carriers in hospital healthcare workers.
Predictive Value of CA-125 for Endometriosis Staging at a Tertiary Hospital in Indonesia
Angelia Ratnasari, Affi;
Budi Hastuti, Uki Retno;
Ismiaulia, Vidya
Jurnal Kedokteran Brawijaya Vol. 33 No. 3 (2025)
Publisher : Fakultas Kedokteran Universitas Brawijaya
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DOI: 10.21776/ub.jkb.2025.033.03.1
Endometriosis, affecting around 176 million women globally, is typically diagnosed through invasive laparoscopic inspection and histological confirmation. Due to the invasiveness of this method, noninvasive diagnostic alternatives like serum CA-125 assays are gaining interest. This study aims to determine the correlation between the tumor marker CA-125 and the stages of endometriosis, as classified by the revised American Society for Reproductive Medicine (rASRM) score. Data were retrospectively collected from the medical records of 24 reproductive-age women diagnosed with endometriosis at Dr. Moewardi General Hospital in Surakarta City, Indonesia. The dataset included patient age, serum CA-125 levels, rASRM scores, comorbidities, and surgical history. Statistical analysis involved the use of Pearson Chi-Square tests for nominal variables and independent t-tests or Mann-Whitney U-tests for scaled variables to evaluate the association between endometriosis stages (grouped into Stage I-II and Stage III-IV) and CA-125 levels (categorized as normal or elevated). A significant correlation was observed between higher stages of endometriosis (stage III-IV) and elevated CA-125 levels (p=0.040). Additionally, normal CA-125 levels were significantly associated with lower stages of endometriosis (stage I-II) (p=0.046). Furthermore, an association was found between type 2 diabetes and elevated CA-125 levels (p=0.037). In conclusion, our study suggests that elevated CA-125 levels correlate with higher stages of endometriosis (stage III-IV) and type 2 diabetes, indicating its potential as a biomarker for endometriosis severity.
Catamenial Pneumothorax due to Suspected Thoracic Endometriosis Syndrome in a Woman with Adenomyosis and Cystoma Ovarii
Antariksa, Genta;
Dwikarlina, Intan;
Sutrisno, Sutrisno;
Yudhanto, Hendy Setyo
Jurnal Kedokteran Brawijaya Vol. 33 No. 3 (2025)
Publisher : Fakultas Kedokteran Universitas Brawijaya
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DOI: 10.21776/ub.jkb.2025.033.03.10
Catamenial pneumothorax (CP) is a recurrent spontaneous pneumothorax during the menstruation period and is often associated with thoracic-pelvic endometriosis. This case study reported a 39-year-old woman who presented with recurrent shortness of breath, particularly during menstruation. The patient also experienced severe dysmenorrhea and difficulty getting pregnant. Despite a negative sputum test, a history of chest tube insertion and tuberculosis treatment were identified. Elevated levels of the CA-125 marker were observed in a previous examination. Physical examination revealed decreased fremitus sounds on the mediobasal side, chest expansion, and right lung breath sounds. The plain radiograph displayed a visceral pleural line, air-fluid level appearance, and the collapse of the right hemithorax accompanied by fibrosis. The patient underwent inpatient treatment and had a chest tube inserted. A decortication thoracotomy procedure was performed, and anatomical pathology microscopic examination of the right lung tissue revealed a non-specific chronic inflammatory process accompanied by fibrosis.
Remained Insect's Body Part in the Corneal Stroma: A Rare Case Report
Abdillah, Fauzi;
Widyanto, Ilham Aditya;
Ariany, Dessira Rizka Tri
Jurnal Kedokteran Brawijaya Vol. 33 No. 3 (2025)
Publisher : Fakultas Kedokteran Universitas Brawijaya
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DOI: 10.21776/ub.jkb.2025.033.03.12
Corneal foreign bodies are the second most common cornea disease after corneal abrasion. The causes of foreign bodies in the cornea vary, most often due to lack of eye protection. Patients with foreign bodies in the cornea usually complain pain, a lump in the eyes, visual acuity deficit, watery eyes, red eyes, sticky eyes, and photophobia. Rapid and effective treatment is needed to avoid the risk of worsening the patient's condition and decreasing vision or even permanent blindness. In this case, we report a 41-year-old male who suffered an eye injury due to insect's body parts remaining in the corneal stroma while riding a motorbike. Foreign body extraction, eye irrigation, topical and systemic antibiotics and steroids, topical cycloplegic are the various treatment modalities for better result. Further examination could be done to find out the chemical elements of insect's toxin so that more adequate therapies can be given.
Human-induced Pluripotent Stem Cell Potential for Schizophrenia Therapy: A Literature Review
Kusumadewi, Andrian Fajar;
Adi, Winengku Basuki
Jurnal Kedokteran Brawijaya Vol. 33 No. 3 (2025)
Publisher : Fakultas Kedokteran Universitas Brawijaya
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DOI: 10.21776/ub.jkb.2025.033.03.6
Schizophrenia is a severe and chronic mental disorder characterized by a neurodegenerative process. Currently, there has been no cure for schizophrenia. However, a newer significant potential for modeling and curing schizophrenia has been recognized in human-induced pluripotent stem cells (HiPSCs), which are obtained from adult somatic cell reprogramming. This study aimed to assess the potential of HiPSCs in schizophrenia by reviewing relevant scientific journals published in reputable databases such as Springer, Elsevier, Science Direct, Nature, and Pubmed, in the last 10 years. Research findings indicate that stem cells can help determine the effectiveness of antipsychotics and repair damaged neuronal cells in certain areas of the brain by transplanting programmed stem cells. The proliferative ability of neuronal cells in schizophrenia tends to decline, affecting their physiological neurogenesis. HiPSCs have the potential to return the neuronal function in schizophrenia, offering new hope in psychiatry.
Mohs Micrographic Surgery for Morpheaform Type Basal Cell Carcinoma: A Case Report
Larasaty, Nanda Shaskia;
Widiatmoko, Arif;
Retnani, Diah Prabawati
Jurnal Kedokteran Brawijaya Vol. 33 No. 3 (2025)
Publisher : Fakultas Kedokteran Universitas Brawijaya
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DOI: 10.21776/ub.jkb.2025.033.03.9
Morpheaform basal cell carcinoma (BCC) is an infiltrative and destructive type of BCC with a high recurrence, necessitating effective and minimally invasive management. Mohs Micrographic Surgery (MMS) is a treatment option for BCC with high conservation results of the entire tumor wall with minimal removal of surrounding healthy tissue, and the lowest recurrence rate compared to other treatment options. In this study, we report a 48-year-old woman with dark spots on the left cheek area that had enlarged over the past year. Dermatological examinations showed hyperpigmentation patches with indistinct borders, irregular edges, and telangiectasis. Fine Needle Aspiration Biopsy (FNAB) confirmed BCC, and the patient underwent Mohs Micrographic Surgery (MMS) for tumor removal. The post-procedural follow-up showed a good outcome.
Self-Care Management Education Using a Pocketbook on Illness Perception Improvement in Psoriasis Patients
Fatma, Endah Panca Lydia;
Sari, Dewi Purnama;
Rohmadani, Dewi;
Windarwati , Heni Dwi;
Susanto, Akhiyan Hadi
Jurnal Kedokteran Brawijaya Vol. 33 No. 3 (2025)
Publisher : Fakultas Kedokteran Universitas Brawijaya
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DOI: 10.21776/ub.jkb.2025.033.03.5
Psoriasis is an autoimmune disease affecting the integumentary and organ systems. It impacts daily activities and degrades self-esteem. Meanwhile, there is a minimum amount of literature about self-care management education for Psoriasis. Pocketbooks can be used as an alternate learning tool for self-care management by making them more portable among patients. The aims are to foster a positive perception of illness and self-determination regarding Psoriasis. This study evaluated the effectiveness of providing self-care management education using a pocketbook on the illness perception of Psoriasis. The research employed a mixed-methods design, combining quasi-experimental and qualitative approaches. The study involves 30 participants diagnosed with Psoriasis. Participants are divided into two groups: a control and an intervention group. The Brief Illness Perception Questionnaire (B-IPQ) was utilized to assess the participants' perceptions of their illness before and after the intervention. A paired t-test was used to compare pre-test and post-test scores within each group. A two-sample t-test was employed to compare the mean differences between the control and intervention groups. The significance level was set at a p-value of 0.05. The interview data were transcribed verbatim using thematic analysis. The study indicates a difference in the illness perception of patients between control and intervention groups with a significance value of 0.000. Patients report that understanding triggers and management strategies allow for better health. Pocketbook is a practical education approach improving illness perceptions of Psoriasis. Recognizing triggers and adopting management techniques, patients are able to take steps to deal with flare-ups and improve their well-being.
Depression Levels and CD4 Counts in HIV Patients at Dr. Saiful Anwar General Hospital Malang
Budiarti, Niniek;
Patra Utama, Haniel;
Agustin Purwantiningrum, Danik;
Dwiastuti Wisnu Putri, Winarni Dian
Jurnal Kedokteran Brawijaya Vol. 33 No. 3 (2025)
Publisher : Fakultas Kedokteran Universitas Brawijaya
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DOI: 10.21776/ub.jkb.2025.033.03.2
Untreated depression in HIV patients is associated with lower CD4 cell counts attributed to the excessive HPA axis activity, which leads to increased cortisol secretion. This can accelerate the progression of HIV through shifting cytokine production from Th1 to Th2, which triggers CD4 cell destruction and stimulates HIV replication. This study aimed to determine the relationship between depression levels and CD4 counts in HIV patients at Dr. Saiful Anwar General Hospital Malang. This study used a quantitative method with an analytical observational study design and a cross-sectional approach. A total of 30 participants were selected through purposive sampling. The Beck Depression Inventory-II (BDI-II) questionnaire was used to evaluate the participants' depression levels. Six participants were identified with moderate depression, while 24 participants exhibited either no depression or minimal depression. The Spearman's Rank Correlation Coefficient test showed p=0.183, p>0.05, with a correlation coefficient of -0.250, indicating no significant relationship between the depression levels and CD4 cell count in HIV patients at Dr. Saiful Anwar General Hospital Malang. Nevertheless, among the study subjects with moderate depression (6 participants), low CD4 counts (≤345cells/mm3) were observed, suggesting a tendency for depression levels to be associated with CD4 count.
Aminophylline Induced Blood Pressure Decrease in Patients with Acute Phase Non-Hemorrhagic Stroke and Chronic Obstrutive Pulmonary Disease (COPD)
Sahil Haikal, Sayyid Muhammad;
Dirgantara Putra, Aryo
Jurnal Kedokteran Brawijaya Vol. 33 No. 3 (2025)
Publisher : Fakultas Kedokteran Universitas Brawijaya
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DOI: 10.21776/ub.jkb.2025.033.03.13
Stroke and Chronic Obstrutive Pulmonary Disease (COPD) are two diseases that have high mortality and disability rates in the world. Smoking is one of the risk factors that cause these two diseases. The occurrence of Non-Hemorrhagic Stroke (NHS) and COPD simultaneously in one patient will cause a poor prognosis and more comprehensive treatment. In addition, there are no therapeutic guidelines for these two diseases if they occur together. This case report reports a case of NHS and COPD in a 64-year-old man who received aminophylline therapy. The patient experienced hypotension on the second day of treatment induced by aminophylline administration. Discontinuation of aminophylline therapy in the patient and administration of other supportive therapies for NHS and COPD showed improvements in blood pressure and other medical conditions related to the patient's disease on the sixth day of treatment. A decrease in blood pressure by >15% in the acute phase of NHS is a quite dangerous condition because it causes a lack of collateral blood flow which results in a lack of blood flow in the penumbra area. Administration of aminophylline has the effect of lowering blood pressure because it increases the release of catecholamines that stimulate beta adrenergic to reduce vascular resistance. Aminophylline should be given >48 hours after the attack to prevent the expansion of cerebral infarction and recurrent NHS attacks and strict monitoring is required when administering COPD therapy accompanied by NHS in relation to the effects caused by the administration of this therapy.