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INDONESIA
Medicina
Published by Universitas Udayana
ISSN : -     EISSN : -     DOI : -
Core Subject : Health,
Medicine & Pharmacology
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Articles 234 Documents
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Tethered cord syndrome Sukarini, Ni Putu; Budiarsa, IGN; Widyadharma, I Putu Eka
Medicina Vol 47 No 1 (2016): Januari 2016
Publisher : Medicina

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Abstract

Tethered cord syndrome adalah kelainan neurologis yang disebabkan oleh perlengketan jaringan yang membatasi pergerakan medula spinalis. Kasus ini jarang ditemukan di RSUP Sanglah Denpasar. Seorang anak perempuan, 15 tahun, dengan keluhan tidak dapat menahan kencing dan cenderung keluar tanpa disadari (inkontinensia uri) sejak ± 10 tahun yang lalu yang disertai dengan rasa tebal pada daerah pantat. Hasil MRI torakal didapatkan simpulan mengarah pada tethered cord sampai setinggi S1 dengan adanya dilatasi kanal spinal setinggi L2 s/d S1, observasi hidromielia medula spinalis setinggi Th 11 s/d L3, dan observasi adanya lipomielokel/lipomielomeningokel dd/intradural lipoma setinggi S1-S2. Pada kasus dilakukan release terhadap medula spinalis dan pengangkatan jaringan yang diduga suatu massa lipomeningokel. Hasil patologi anatomi berupa jaringan lemak matur yang di antaranya terdapat berkas saraf perifer yang mendukung suatu lipomielomeningokel. Tethered cord syndrome is a neurological disorder caused by tissue attachments that limit the movement of the spinal cord. This cause was seldom found in Sanglah hospital, Denpasar. We have a case of 15-years old child with chief complain of urine incontinence for about 10 years and numbness around her buttock. The result of her thoracal MRI has shown tethered cord until level of S1 with spinal canal dilatation from L1 until S1, hydromyelia spinal cord from T11 until L3, and there was also lipomyelocele/lipomyelomeningocele. The result of patology anatomy examination was mature fat tissue, include also some of periphery nerve tissue, wisch supported for lipomyelomeningocele.
HEMATOMA AURIKULA Indah, Sari; PS, Eka
Medicina Vol 44 No 3 (2013): September 2013
Publisher : Medicina

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Abstract

Hematoma aurikula merupakan sekuele yang terjadi akibat trauma langsung pada daun telingayang menyebabkan penimbunan darah dalam ruang antara perikondrium dan kartilago yang biasanyaditemukan pada pegulat atau petinju. Keterlambatan diagnosis serta penanganan dapat menimbulkankomplikasi dimana salah satunya adalah telinga kembang kol atau cauliflower ear. Penatalaksanaanhematoma aurikula cukup bervariasi, namun tujuan utama pengobatan tersebut adalah mengevakuasidarah subperikondrial, mencegah kekambuhan, dan mencegah terjadinya infeksi. Dilaporkan satukasus hematoma aurikula pada seorang laki-laki dewasa berusia 68 tahun di Rumah Sakit UmumPusat ( RSUP)  Sanglah-Denpasar yang telah dilakukan penanganan aspirasi serta bebat tekanmenggunakan teknik bolster yang memberikan hasil yang baik.
OBAT ANTIEPILEPSI SEBAGAI PENCEGAHAN MIGREN Adnyana IM, Oka
Medicina Vol 38 No 3 (2007): September 2007
Publisher : Medicina

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Abstract

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JUMLAH CD4+ ABSOLUT IBU HAMIL YANG TERINFEKSI HUMAN IMMUNODEFICIENCY VIRUS PADA TRIMESTER III LEBIH RENDAH DIBANDINGKAN SAAT PASCA-PERSALINAN Widianti, Lidia; Suwiyoga, Ketut; Adnyana, Ida Bagus Putra
Medicina Vol 46 No 3 (2015): September 2015
Publisher : Medicina

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Abstract

Human immunodeficiency virus (HIV) merupakan penyakit infeksi yang hingga saat ini masihmemiliki insidens yang cukup tinggi dikalangan wanita hamil. Wanita hamil yang terinfeksi HIVakan lebih rentan mengalami kematian langsung maupun kematian obstetric seperti perdarahan postpartum,sepsis puerpuralisdan komplikasi dari sectiocaesaria.Kematian yang disebabkan oleh karenaAIDSbisa terjadi secara langsung saat kehamilan maupun sebagai penyebab tidak langsung akibatdariinfeksi opportunistik. Penelitian ini bertujuan untuk membuktikan bahwa jumlah clusterofdiffrentiation+ (CD4+) absolut ibu hamil yang terinfeksi HIV saat trimester III lebih rendah dari padasaatpasca-persalinan. Metode penelitian ini adalah studi longitudinaldi Poliklinik PMTCT KebidanandanKandungan Rumah Sakit Umum Pusat (RSUP) Sanglah, Denpasar yang dilakukan mulai bulanAgustus2011 hingga Desember 2013 dengan sampel penelitian sebanyak 20 pasien. Sampel adalahibuhamil terinfeksi HIV saat trimester III. Kemudian dilakukan perhitungan kadar CD4+ absolut,dandilakukan pengukuran CD4+ absolut kembali saat 7 hari pasca-persalinan. Analisis data dilakukandenganuji t-paireddenganbantuan SPSSfor windows 17.0 versiondengan batas kemaknaan (P)<0,05.Ujit-pairedsaattrimester III mendapatkan rerata jumlah CD4+ absolut sebesar 357,90 (SB 238,81)dandibandingkan dengan saat 7 hari pasca-persalinan dengan rerata jumlah CD4+ absolut sebesar421,50(SB 213,57) [beda rerata -63,60 (IK 95% -122,8 sampai -4,4), P= 0,037]. Disimpulkan bahwajumlahCD4+ absolut pada wanita hamil terinfeksi HIV saat hamil trimester III lebih rendahdibandingkansaat pasca-persalinan. [MEDICINA2015;46:166-9].Human immunodeficiency virus (HIV) is an infectious disease that still have high incidence amongpregnancy women. Pregnancy women with HIV infection are more vulnerable to direct mortality eitherobstetric mortality such as haemoragic post-parturition, septic puerpuralis and caesarean sectioncomplication. Mortality due to AIDS could become direct cause due to obstetric complication or indirectcause due to opportunistic infection. The aim of this study was to prove that CD4+ absolute level inpregnancy infected by HIV in third trimester is lower than on post-parturition. The study method waslongitudinal study that conducted in PMTCT Clinic Obstetrics and Gynecology, Sanglah Hospital,Denpasar, which was taken from August 2011 to December 2013 with a sample of 20 patients. Sampleswere pregnant women infected with HIV during the third trimester. Then calculate the absolute levelsof CD4 + and the measurements of CD4 + absolute were repeated at 7 days post-parturition. Dataanalysis was wearing paired t-test using SPSS for windows version 17.0 with significance value (P)<0.05.Analysis result showed that mean CD4+ absolute levels that were obtained on third trimester was357.90 (SD 238.81) and compared with the 7 days after delivery was 421.50 (SD 213.57) with meandifferences -63.60 (95% CI -122.8 to -4.4), P= 0.037. It was concluded that CD4+ absolute levels inpregnant women with HIV during the third trimester of pregnancy is lower than on post-parturition.[MEDICINA 2015;46:166-9].
PRIMARY CUTANEOUS HISTOPLASMOSIS PADA PASIEN DENGAN INFEKSI HUMAN IMMUNODEFICIENCY VIRUS (HIV) Upadana, Nyoman; Suryawati, Nyoman; Saputra, Herman
Medicina Vol 44 No 2 (2013): Mei 2013
Publisher : Medicina

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Abstract

Histoplasmosis adalah penyakit granulomatosa disebabkan oleh jamur dimorphic Histoplasma capsulatum. Lesi kulit merupakan bentuk sekunder, tetapi dapat juga primer pada kasus self inoculation. Kasus adalah laki-laki 27 tahun dengan benjolan sejak 3 bulan yang lalu, diawali pada kedua kaki meluas ke tangan dan wajah. Pemeriksaan kulit didapatkan papul, nodul, dan ulkus dengan tepi landai, tertutup krusta tebal. Hasil pemeriksaan CD4 adalah 4/mm3. Pemeriksaan histopatologi pada stroma tampak sebaran sel histiosit mengandung mikroorganisme, bentuk bulat, berdinding tebal, berwarna eosinofilik, dan dikelilingi oleh clear halo. Positif dengan pewarnaan periodic acid schiff dan grocott methenamic silver, dan sesuai untuk Histoplasma capsulatum. Diagnosis pasien adalah primary cutaneous histoplasmosis dan diterapi flukonazol 200 mg IV dengan respon terapi yang baik. [MEDICINA 2013;44:113-117].
MALE TERM NEONATE WITH BLADDER EXSTROPHY–EPISPADIAS COMPLEX Utami Budha, Made Indah Nastiti; Retayasa, I Wayan; Kardana, I Made; *, Bowolaksono; Kawiyana, Ketut Siki
Medicina Vol 40 No 1 (2009): Januari 2009
Publisher : Medicina

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Abstract

Bladder exstrophy is a malformation of the bladder, in which the bladder and related structures are turned inside out. Bladder exstrophy affects one in approximately 50,000 livebirths. Male to female ratio is 2.3 : 1. Epispadias is commonly seen with exstrophy of the bladder. The cause and nature of the faulty development is not yet clear. The diagnosis is generally immediately apparent. Bladder exstrophy is a surgical correctable birth defect. In this case, bladder exstrophy–epispadias complex founded in male term neonate. On inspection was founded bladder everted through a midline lower abdominal wall defect, widening of the pubic symphisis and epispadias. Urology ultrasound revealed absent of the right kidney at right fossa renalis or in pelvic cavity, slight hydronephrosis of left kidney, no appearance of bladder in pelvic cavity. Patient underwent surgery during hospitalized in Sanglah Hospital - Denpasar. This patient was referred to the Congenital Anomaly Team in Dr. Soetomo Hospital - Surabaya because there was wound dehiscence during post operation care.[MEDICINA 2009;40:60-4].
THROMBOCYTOPENIA IN DENGUE HAEMORRHAGIC FEVER Sutirta-Yasa, I Wayan Putu; Tirta Putra, Gede Agus Eka; Rahmawati, Ana
Medicina Vol 43 No 2 (2012): Mei 2012
Publisher : Medicina

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Abstract

The incidence and geographical distribution of dengue has gradually increased during the past decade. Today, dengue is considered one of the most important arthropod-borne viral diseasases in humans in term of morbidity and mortality. Dengue infection   a potential life-threatening dengue hemorrhagic fever (DHF) / dengue shock syndrome(DSS), characterized by thrombocytopenia and increased vascular permiability. Thrombocytopenia causes bleeding, but in   DHF patients with thrombocytopenia do not always develop bleeding manifestation. The pathogenesis of thrombocytopenia are not cleared. Multiple factors  may be involved in the machanisms leading to thrombocytopenia in DHF/DSS patients.
Shift worker sleep disorder Suliani, Ni Made Oka; Utami, Desak Ketut Indrasari
Medicina Vol 47 No 1 (2016): Januari 2016
Publisher : Medicina

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Abstract

Shift worker sleep disorder (SWSD) adalah gangguan tidur irama sirkadian yang ditandai dengan insomnia dan kantuk berlebihan yang terjadi pada mereka yang bekerja diluar periode tidur yang tipikal atau disebut juga jam-jam yang non-tradisional yaitu pukul 22.00-06.00. Pekerja shift berisiko lebih tinggi untuk mengalami tekanan darah tinggi, berat badan berlebih dan diabetes bahkan meningkatkan risiko kanker. Gangguan tidur mengakibatkan disregulasi sumbu hipotalamus hipofise adrenal. Pekerja shift harus memperhatikan tidurnya bukan hanya untuk kesehatannya sendiri namun juga untuk mencegah kecelakaan kerja yang dapat merugikan banyak orang. Terapi SWSD meliputi terapi farmakologis dan non-farmakologis. Terapi non-farmakologis mencakup pengaturan jadwal kerja, modifikasi lingkungan, dan menghindari konsumsi kafein, alkohol, serta nikotin. Terapi farmakologis meliputi konsumsi hormon melatonin dan obat-obatan yang dapat memodifikasi tidur. Shift worker sleep disorder (SWSD) is a circadian rhythm sleep disorder characterized by insomnia and excessive sleepiness that occurs in those who work outside of typical hours of sleep period, also called the nontraditional hours at 22:00 until 06:00. Shift workers are at higher risk for developing high blood pressure, excess weight and diabetes, even increase the risk of cancer. Sleep disorders cause dysregulation of the hypopituitary hypophysis adrenal axis. Shift workers must sleep properly not only to preserve their own health, but also to prevent accidents that can harm many people. Therapies SWSD include pharmacological and nonpharmacological therapy. Nonpharmacological therapy include improving work schedules, environmental modifications and also avoiding caffeine, alcohol, and nicotine. Pharmacologic therapy includes the consumption of the melatonin hormone and drugs that can modify sleep.
HYPERTROPHIC OBSTRUCTIVE CARDIOMYOPATHY IN AN 8-MONTH OLD FEMALE INFANT SUSPECTED INFANTILE ONSET POMPE DISEASE Purnami, Made Dwi; Gunawijaya, Eka
Medicina Vol 45 No 2 (2014): Mei 2014
Publisher : Medicina

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Abstract

Hypertrophic cardiomyopathy (HCM) is an autosomal dominant cardiac disorder marked with muscular hypertrophy of the left ventricle, associated obstruction of left ventricular outflow. About 0.2% of all cases worldwide. The majority of patients are asymptomatic, and some present with severe activity- limiting symptoms. The diagnosis of HCM before the age of 2 years is rare and usually discovered by chance, during the investigation of a murmur. Progressive disease characterized by prominent cardiomegaly, cadiomyopathy, hepatomegaly, musle weakness or hypotonia, respiratory distress, feeding difficulties and failure to thrive as presenting sign and symptoms are often referred to infantile Pompe disease. A deficiency of of the enzyme acid alpha glucosidase disease, result in lysosomal accumulation of glycogen in heart and skeletal muscle. Cardiorespiratory failure is the cause of significant morbidity and mortality in the first year of life. We reported a rare case, 8 month-old female with frequent respiratory distress since 2 months before admission. Physical examination showed dyspnea with chest wall retraction, no cyanosis, with grade III systolic murmur at midclavicular line sinistra, ICS IV- V and floopy infant. Chest films showed   pneumonia and cardiomegaly. The echocardiogram demonstrated bi-ventricular and interventricular hypertrophy with left ventricular obstruction. Laboratory finding there was increased levels of glutamic oxaloacetic acid transferase, alanin aminotransferase, and lactate dehydrogenase. Patient was diagnosed with hypertrophic obstructive cardiomyopathy of suspected infantile onset pompe disease. Despite medical treatment with propanolol dan diuretics, there was no significant improvement and she was died after 26th days of treatment in intermediate ward. [MEDICINA 2014;45:108-14]    
ACCURACY OF RAPID TEST OF STORED ACUTE PHASE SERUM FOR DIAGNOSE JAPANESE ENCEPHALITIS Subanada, Ida Bagus; Kari, I Komang
Medicina Vol 44 No 1 (2013): Januari 2013
Publisher : Medicina

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Abstract

Japanese encephalitis (JE) is common viral encephalitis with high sequele and mortality. With some limitations, there are several diagnostic tool to diagnose of JE. The objecive of this study was to know the accuracy of rapid test of stored acute phase serum for diagnose of JE. We conducted diagnostic test of stored acute phase serum of encephalitis patients with MAC ELISA of cerebrospinal fluid as a gold standard. Sensitivity, specificity, positive predictive value (PPV), negative predictive value NPV), positive likelihood ratio (PLR), negative likelihood ratio (NLR), and post-test probability were calculated. This study found the prevalence of JE was 42.1%, sensitivity 15.7 % (95% CI 9.2 to 22.2%), specificity 95.7% (95% CI 92.1 to 99.3%), PPV 72.7% (95% CI 64.8 to 80.6%), NPV 60.9% (95% CI 52.2 to 69.6%), PLR 3.7, NLR 0.9, and post-test probability was 0.73. We concluded that rapid test of acute phase stored serum was insensitive but specific to diagnose of JE.

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