bluuebunny/crossref_metadata_2025 huggingface dataset:
Karakteristik analisa gas darah dan elektrolit pasien COVID-19 di RSUD Wangaya Denpasar
Authors: Jaya Xaverius Sastra , Budiasa Gede Ngurah , Tedja I Gusti Ayu Wiradari , Ginting Yoshevine Lorisika , Basri Nelson Manurung
Published: November 2023

Background: Various laboratory results have been identified as predictors that can assist in diagnosis, disease staging, monitoring and treatment, prognosis, and surveillance in COVID-19 patients. Very little data is available on the analysis of blood gases (AGD) analysis electrolytes in COVID-19 patients.
Method: This study uses a descriptive study research method. The number of subjects was obtained by a total sampling approach with a total of 49 patients. The data was taken from the results of the examination of COVID-19 patients at the Clinical Pathology Laboratory of Wangaya Hospital from January to February 2022. This study used 2 variables, namely blood gas and electrolyte analysis of COVID-19 patients.
Result: A total of 49 patients were obtained. From 49 patients, the average age of patients with COVID-19 was 61.49 years with an age range of 20 to 97 years. Most of the COVID-19 patients had metabolic acidosis (21 patients; 42.9%). Compensatory conditions were found in 19 patients (38.8%). Electrolyte results on sodium levels were mostly normal values. Potassium results in most patients are at normal potassium levels. Chloride levels are mostly at normal chloride levels.
Conclusion: This study is expected to provide an overview of the analysis of blood gases and electrolytes of COVID-19 patients in determining the management of COVID-19 patients and can be used as a reference for further research.
 
Latar Belakang. Hasil laboratorium telah diidentifikasi sebagai prediktor yang dapat membantu dalam diagnosis, penentuan stadium penyakit, pemantauan dan pengobatan, prognosis hingga surveilenas pada pasien COVID-19. Sangat sedikit data yang tersedia pada hasil analisis gas darah (AGD) dan elektrolit pada pasien COVID-19.
Metode. Penelitian ini menggunakan metode penelitian studi deskriptif. Jumlah subjek didapatkan  dengan pendekatan total sampling  dengan total 49 pasien. Data diambil dari hasil pemeriksaan pasien COVID-19 di Laboratorium Patologi Klinik RSUD Wangaya dari Januari hingga Februari 2022. Penelitian ini menggunakan 2 variabel yaitu Analisa gas darah dan elektrolit pasien COVID-19.
Hasil. Didapatkan total 49 pasien. Dari 49 pasien didapatkan rata-rata usia pasien yang COVID-19 adalah 61,49 tahun dengan rentang usia 20 sampai 97 tahun. Pasien COVID-19 sebagian besar mengalami asidosis metabolik (21 pasien;42,9%). Kondisi kompensasi ditemukan pada 19 pasien (38,8%). Hasil elektrolit pada kadar natrium sebagian besar berada pada nilai normal. Hasil kalium sebagian besar pasien berada pada kadar kalium yang normal. Kadar klorida sebagian besar berada pada kadar klorida yang normal.
Kesimpulan. Penelitian ini diharapkan dapat memberikan gambaran analisa gas darah dan elektrolit pasien COVID-19 dalam menentukan manajemen pasien COVID-19 dan dapat digunakan sebagai dasar acuan penelitian selanjutnya.
The role of Botulinum toxin type A for prevention and treatment of cleft lip palate (CLP) post-operative scar: a systematic review
Authors: Bachtiar Priska Yunita
Published: November 2023

Background. Cleft lip palate (CLP) defects are the common orofacial defects found in newborns. The main treatment is lip and palate surgery, often resulting in a hypertrophic scar that significantly affects the patient's aesthetic appearance. Several studies showed the role of Botulinum toxin type A injections for prevention and treatment of CLP post-operative scarThis systematic review aims to review the role of Botulinum toxin type A for prevention and treatment of cleft lip palate surgery scar.
Method. Online databases were searched for relevant studies from Google Scholar, PubMed and ProQuest. Data sources were searched using MeSH terms "botulinum toxin," "cleft lip palate," and "surgery scar" for all publications up to October 2022. All English papers regarding the role of Botulinum toxin type A in preventing and treating CLP post-operative scar were included. Papers not available in full text or English and not an experimental study were excluded.
Result. Six studies are included in this systematic review consisting of three randomized controlled trials and three clinical studies. The experimental group received Botulinum toxin type A injections, while the control group received an injection of normal saline or other topical treatment. All of the included studies showed positive results regarding the role of Botulinum toxin type A marked with reduced scar width, good Vancouver Scar Scale (VSS), Visual Analogue Scale (VAS), patient satisfaction and no complications or side effects were found.
Conclusion. The Botulinum toxin type A showed promising results for the prevention and treatment of CLP post-operative scar.
Uji daya hambat minyak atsiri kulit buah jeruk bali (Citrus maxima) terhadap bakteri Pseudomonas aeruginosa
Authors: Sadeva I Gede Krisna Arim , Budayanti Ni Nyoman Sri , Hendrayana Made Agus , Sukrama I Dewa Made
Published: November 2023

Background: Pseudomonas aeruginosa is a gram-negative bacterium that is commonly associated with Healthcare-Associated infections (HAI), particularly Multidrug-resistance (MDR) P. aeruginosa. The polyphenolic compounds found in the peel of pomelo (C. maxima) are reported to have shown an effective antimicrobial effect. Therefore, this study aimed to investigate the inhibitory effect of C. maxima peel essential oil on the growth of P. aeruginosa bacteria.
Methods: This in vitro study evaluates the inhibitory effect of C. maxima peel essential oil against clinical isolate strains (SP47) and MDR P. aeruginosa by measuring the diameter of the inhibition zone (mm). Five series of essential oil concentrations (20%, 40%, 60%, 80%, and 100%) and the control group were used in the paper disk diffusion test with three repetitions (triplet). All data were statistically analyzed using SPSS ver. 20.
Results: A total of 4.85 mL of essential oil from 7.2 kg of C. maxima fruit peel was obtained. Inhibition zones were observed in clinical isolates of P. aeruginosa by concentrations of 60%, 80%, 100%, and K+ with means of 6.27±0.08 mm; 6.71±0.19 mm; 9.08±0.29 mm; and 40.8±0.48 mm, respectively. In MDR P. aeruginosa, the inhibition zone by concentrations of 80%, 100%, and K+ with means of 6.45±0.13 mm; 7.15±0.13 mm; and 9.08±0.34 mm, respectively. There was a significant difference in the mean diameter within groups (p<0.05).
Conclusion: C. maxima fruit peel essential oil was able to inhibit the growth of P. aeruginosa bacteria, both clinical and MDR isolates. There were differences in inhibition between the concentration series.
 
Metode: Penelitian ini merupakan studi in vitro yang mengevaluasi daya hambat minyak atsiri kulit buah C. maxima terhadap strain isolat klinis (SP47) dan MDR P. aeruginosa melalui pengukuran diameter zona hambat (mm). Sebanyak lima seri konsentrasi minyak atsiri (20%, 40%, 60%, 80%, dan 100%) dan kelompok kontrol digunakan dalam uji paper disk diffusion dengan pengulangan sebanyak tiga kali (triplet) Seluruh data dianalisis secara statistik menggunakan SPSS ver. 20.
Hasil: Sebanyak 4,85 mL minyak atsiri dari 7,2 kg kulit buah C. maxima diperoleh dengan metode destilasi uap. Zona hambat teramati pada isolat klinis P. aeruginosa oleh konsetrasi 60%, 80%, 100%, dan K+ dengan rerata sebesar 6,27±0,08 mm; 6,71±0,19 mm; 9,08±0,29 mm; dan 40,8±0,48 mm berturut-turut. Zona hambat juga teramati pada isolat MDR P. aeruginosa oleh konsetrasi 80%, 100%, dan K+ dengan rerata sebesar 6,45±0,13 mm; 7,15±0,13 mm; dan 9,08±0,34 mm berturut-turut. Terdapat perbedaan rerata diameter yang signifikan antar kelompok uji (p<0,05).
Simpulan: Minyak atsiri kulit buah C. maxima mampu menghambat pertumbuhan bakteri P. aeruginosa baik isolat klinis maupun MDR. Adapun terdapat perbedaan daya hambat antar seri konsentrasi.
Kata kunci: antimikroba, citrus maxima, minyak atsiri, multidrug resistant
Overview of fractures caused by The 2018 Lombok earthquake in Radiology Department of General Hospital of North Lombok Regency West Nusa Tenggara, Indonesia
Authors: Ma’ruf Fauzy , Aprianturi Wiwik Sari
Published: November 2023

Introduction: The Lombok earthquake that occurred in July-August 2018 has caused many casualties, both deaths and injuries. North Lombok regency is the district that suffered the most fatalities. Therefore, the data on the number of patients examined in the radiology department of the General Hospital of North Lombok Regency can provide an overview of the condition of injured victims in the district. This retrospective research aims to provide an overview of fracture patients of Lombok earthquake victims conducted in the radiology department.
Method: The data were collected from the medical records of Lombok earthquake victims who were examined in the Radiology department during August 2018.
Result: A total of 378 patients were examined. From the x-ray examination, 111 victims suffered fractures. Most of the victims were female and aged >15 to 65 years old. Most of them suffered single region fractures (75 victims) and multiple region fractures (36 victims). Meanwhile, the most fractures suffered by the victims were the lower limb fractures identified in 60 victims (54%) and the shoulder-upper limb fractures found in 32 victims (28.9%). The remaining 19 victims suffered fractures of ankle –foot, wrist-hand, head, ribs, spine and pelvis.
Conclusion: The 2018 Lombok earthquake has had a health impact and increased morbidity and mortality, a total of 111 victims experienced fractures in the earthquake.
Management of thyroid crisis in a patient with febrile neutropenia
Authors: Gotera Wira , Sugiharto Stephanie , Nugraha Ida Bagus Aditya
Published: November 2023

Introduction: Thyroid storm is a life-threatening complication of acute hyperthyroidism. The diagnosis of thyroid storm can only be based on its clinical manifestations, which include decreased consciousness, high fever, heart failure, diarrhea and jaundice. Antithyroid drug therapy (ATD) is one option for treating hyperthyroidism, along with surgery and radioactive iodine. ATD is thought to cause neutropenia through the agranulocytosis pathway. The most common symptoms are fever and sore throat accompanied by symptoms of a thyroid crisis. There is no specific method for predicting the appearance of febrile neutropenia caused by ATD. Routine complete blood counts in patients taking ATD should be performed. The diagnosis of febrile neutropenia due to ATD needs to be done immediately so that timely intervention can be carried out and reduce mortality.
Case Presentation: a 25 years old female with thyroid crisis and febrile neutropenia. Clinical findings in the patient include fever, decreased consciousness, palpitation, excessive sweat, diarrhea, nausea and vomiting, weight loss, and the laboratory findings of leukopenia and neutropenia of (leucocyte 1.03x103/uL, neutrophil 1.90x103/ul). Ultrasonography examination of the thyroid reveals a thyroiditis image with multiple solid nodules. Blood smear examination reveals leukopenia with differential count examination of blood showed neutropenia, moderate lymphocytosis, erythrocyte hypochromic micrositer, poikilocytosis ovalocyte, teardrop cell, fragmentosist and target cell. Polychromasia and normoblast cells are not found.
Conclusion: Thyroid crisis refers to the clinical findings and thyroid hormone test results. There is no specific method to predict the appearance of febrile neutropenia caused by the antithyroid drug. Frequent blood tests must be done in patients who consume antithyroid drugs.
Tatalaksana komprehensif pada supraventricular tachycardia (SVT) anak dengan riwayat kardiomiopati dilatasi : Laporan kasus dan telaah pustaka
Authors: Luh Made Indrasuari  , Sari Linda Silvana
Published: November 2023

Introduction: Supraventricular tachycardia (SVT) is one of the children's most common heart rhythm abnormalities. Episodes of SVT attacks in children are often recurring and, if not properly recognized, can be life-threatening. This case reports the incidence of SVT in children and its management, supported by a literature review
Case Description: A 1-year-old boy came to the hospital complaining of palpitations accompanied by an increase in carotid pulse and cold sweat 30 minutes before entering the hospital. The patient has a history of dilated cardiomyopathy and had the same complaint at the age of 6 months. On physical examination, blood pressure was 197/68 mmHg, pulse 235x/m, respiratory rate 32x/m accompanied by cold acral. The EKG showed SVT. Initial non-pharmacological management is carried out with vagal maneuvers, namely circular massage in the carotid sinus area for 10 seconds, followed by ice packs for 10 seconds. Then pharmacological cardioversion with amiodarone was carried out and continued with amiodarone maintenance therapy and treatment in the PICU room, as well as chest X-ray investigations and echocardiography.
Conclusion: Diagnosis of SVT is based on a detailed history and physical examination. EKG and echocardiography should be performed in children suspected of having SVT. Successful elimination of SVT results in improved quality of life in pediatrics regarding physical, emotional, social, school and psychosocial functioning.
 
Pendahuluan : Supraventricular tachycardia (SVT) merupakan salah satu kelainan irama jantung yang paling sering muncul pada anak. Episode serangan SVT pada anak sering berulang dan jika tidak dikenali dengan baik dapat mengancam nyawa. Kasus ini melaporkan kejadian SVT pada anak serta manajemen yang dilakukan dengan ditunjang telaah pustaka
Laporan Kasus : Laki-laki usia 1 tahun datang ke ke rumah sakit dengan keluhan berdebar disertai peningkatan pulsasi nadi karotis dan keringat dingin sejak 30 menit sebelum masuk rumah sakit. Pasien memiliki riwayat kardiomiopati dilatasi dan sempat mengalami keluhan yang sama pada usia 6 bulan. Pada pemeriksaan fisik didapatkan tensi 97/68 mmHg, nadi 235x/m, laju napas 32x/m disertai dengan akral dingin. Pada EKG ditemukan gambaran SVT. Tatalaksana awal non-farmakologi dilakukan dengan vagal manuver yaitu pemijatan sirkular di area sinus karotis selama 10 detik dan dilanjutkan dengan kompres es selama 10 detik. Dilakukan kardioversi farmakologis dengan amiodaron dan dilanjutkan terapi rumatan amiodaron. Dilakukan pemeriksaan penunjang rontgen thorax dan echocardiografi pada pasien.
Kesimpulan : Untuk menegakkan diagnosis SVT,  anamnesis terperinci dan pemeriksaan fisik sangat penting untuk dilakukan. EKG dan ekokardiografi harus dilakukan pada anak yang diduga menderita SVT. Keberhasilan eliminasi SVT menghasilkan peningkatan kualitas hidup pediatrik mengenai fungsi fisik, emosional, sosial, sekolah dan psikososial.
Gambaran klinis dan laboratoris penderita penyakit ginjal kronis yang menjalani hemodialisis di RSUD Muara Teweh, Barito Utara, Kalimantan Tengah
Authors: Putra I Gede Suprayoga Sukmana , Islamiah Ahadini
Published: November 2023

Introduction: Chronic kidney disease (CKD) is defined by changes in kidney structure, function, or both. CKD shows a variety of clinical and laboratory abnormalities.
Purpose: This study aims to determine the clinical and laboratory features of CKD patients undergoing HD at Muara Teweh Hospital.
Methods: This research is an observational descriptive study conducted at the Hemodialysis Unit of Muara Teweh Hospital in January 2023. The sampling method used was total sampling.
Results: Most of the samples were female (56.1%), aged 40-60 years (68.3%), and had HD for more than 3 months (51.2%). The most common complaints were nausea (46.3%), muscle/bone pain (36.6%), and shortness of breath (34.1%). From the physical examination, it was found that most of them had grade II hypertension (48.8%), normal nutritional status (68.3%), oliguria (68.3%), and peripheral edema (63.4%). The average hemoglobin level was 9.05 g/dL, urea 128.80 mg/dL, and creatinine 9.17 mg/dL. The average glomerular filtration rate was 7.31 mL/min/1.73 m2.
Conclusion: The main clinical features of CKD in this study were nausea, muscle/bone pain, shortness of breath, grade II hypertension, normal nutritional status, and fluid retention while the laboratory features were anemia, uremia, and hypercreatininemia.
 
Pendahuluan: Penyakit ginjal kronis (PGK) merupakan kondisi kelainan medis yang ditandai dengan adanya  perubahan pada struktur ginjal, fungsi, atau keduanya. PGK menunjukkan beragam kelainan klinis dan laboratoris.
Tujuan: Penelitian ini bertujuan untuk mengetahui gambaran klinis dan laboratoris penderita PGK yang menjalani HD di RSUD Muara Teweh.
Metode: Penelitian ini merupakan penelitian deskriptif observasional yang dilakukan di Unit Hemodialisis RSUD Muara Teweh pada bulan Januari 2023. Metode pengambilan sampel yang digunakan adalah total sampling.
Hasil: Sebagian besar sampel berjenis kelamin perempuan (56,1%), berusia 40-60 tahun (68,3%), dan menjalani HD lebih dari 3 bulan (51,2%). Keluhan yang paling banyak ditemukan adalah mual (46,3%), nyeri otot/tulang (36,6%), dan sesak nafas (34,1%). Dari pemeriksaan fisik didapatkan sebagian besar mengalami hipertensi derajat II (48,8%), status gizi normal (68,3%), oliguria (68,3%), dan edema perifer (63,4%). Kadar rata-rata hemoglobin adalah 9,05 g/dL, ureum 128,80 mg/dL, dan kreatinin 9,17 mg/dL. Laju filtrasi glomerulus rata-rata adalah 7,31 mL/mnt/1,73 m2.
Simpulan: Gambaran klinis utama PGK pada penelitian ini adalah mual, nyeri otot/tulang, sesak nafas, hipertensi derajat II, status gizi normal, dan retensi cairan sedangkan gambaran laboratorisnya adalah anemia, uremia, dan hiperkreatininemia.
Kadar vitamin D receptor plasma yang rendah merupakan faktor risiko terjadinya psoriasis vulgaris
Authors: Permana Aditya , Adiguna Made Swastika , Rusyati Luh Made Mas
Published: November 2023

Introduction: Psoriasis is a chronic autoimmune cutaneous disorder, which the exact etiology remains unknown. There is study showed psoriasis is associated with low levels of vitamin D. In recent years, vitamin D acted by vitamin D receptor (VDR) has been reported, which keratinocyte is one of the tissues presenting vitamin D receptor. This study aims to prove that low levels vitamin D receptor plasma is a risk factor for psoriasis vulgaris.
Method: This case-control study design in 25 patients with psoriasis vulgaris as cases and 25 controls who fulfilled the inclusion and exclusion criteria as well as in matching based on age and gender in Dermatovenereology Polyclinic of I.G.N.G Ngoerah Hosptital, then performed venous blood sampling as material examination vitamin D receptor plasma levels with enzyme-linked immunosorbent assay (ELISA) technique. The collected data was analyzed using SPSS version 20.0 with Pearson Chi square test to obtain Odds Ratio. This study showed that vitamin D receptor plasma levels in the case group were significantly lower than the control group (p<0.05).
Result: Odds ratio for vitamin D receptor plasma was 46.00 (95% CI= 8.03-263.63; p<0.001).
Conclusion: Based on these study results we can conclude low levels vitamin D receptor plasma as a risk factor the occurrence of psoriasis vulgaris. 
 
Pendahuluan: Psoriasis merupakan penyakit kulit autoimun kronis yang belum diketahui penyebabnya dengan jelas. Terdapat penelitian yang menunjukkan psoriasis berhubungan dengan kadar vitamin D yang rendah. Beberapa tahun terakhir, terdapat penelitian yang menyatakan bahwa vitamin D bekerja melalui vitamin D receptor (VDR), dimana keratinosit merupakan salah satu jaringan yang mempresentasikan VDR. Penelitian ini bertujuan untuk membuktikan bahwa kadar vitamin D receptor plasma yang rendah merupakan faktor risiko terjadinya psoriasis vulgaris.
Metode: Penelitian ini menggunakan rancangan case control study yang melibatkan 25 pasien psoriasis vulgaris sebagai kasus dan 25 kontrol yang memenuhi kriteria inklusi dan eksklusi serta dilakukan matching berdasarkan umur dan jenis kelamin di Poliklinik Ilmu Kesehatan Kulit dan Kelamin RSUP I.G.N.G Ngoerah Denpasar, kemudian dilakukan pengambilan darah vena sebagai pemeriksaan kadar vitamin D receptor plasma menggunakan teknik enzyme-linked immunosorbent assay (ELISA). Data yang terkumpul kemudian dianalisis menggunakan SPSS versi 20.0 dengan uji Pearson Chi Square untuk mendapatkan Odds rasio.
Hasil: Pada penelitian ini menunjukkan bahwa kadar vitamin D receptor plasma pada kelompok kasus lebih rendah secara bermakna dibandingkan kelompok kontrol (p<0,05) dengan Odds rasio untuk kadar vitamin D receptor plasma adalah 46,00 (IK 95%= 8,03-263,63, p<0,001).
Simpulan: Berdasarkan penelitian ini dapat disimpulkan bahwa kadar vitamin D receptor plasma yang rendah merupakan faktor risiko terjadinya psoriasis vulgaris.
Pasien stroke akibat sengatan lebah di Rumah Sakit TK. II Dustira Cimahi, Jawa Barat, tahun 2022: sebuah laporan kasus
Authors: Adyaksa Ngakan Made , Sweetasari Aprilia Grace
Published: November 2023

Background: Bee sting venom is quite common in Indonesia. Allergic reactions at the sting site such as edema, erythema, itching and burning sensations are common manifestations of bee venom poisoning. In this case report, we report a 68-year-old man with a bee bite and experiencing complications in the form of a neurological deficit.
Case Presentation: A 68-year-old man was brought by his family to the Dustira Hospital Emergency Room because of complaints of decreased consciousness. The sudden loss of consciousness was felt by the family and the right-side experienced weakness. The patient cannot communicate, understand the contents of the other person's speech or speak to express his intentions. On physical examination, the patient was found to be somnolent with a blood pressure of 150/90mmHg and a temperature of 37.9 degrees Celsius. On neurological examination, a decrease in motor strength was found. On CT scan without contrast, an infarction was found in the cortical subcortical area in the left temporoparietooccipital region (embolism).
Conclusion: Unusual and more severe complications have also been seen such as anaphylactic shock, myocardial infarction, acute renal failure, pulmonary hemorrhage and atrial fibrillation. Neurologic complications are rare in bee venom poisoning.
 
Latar Belakang: Racun sengatan lebah cukup umum di Indonesia. Reaksi alergi di tempat sengatan seperti edema, eritema, sensasi gatal dan rasa terbakar adalah manifestasi yang umum terjadi dari keracunan racun lebah. Dalam laporan kasus ini kami laporkan seorang laki-laki usia 68 tahun dengan gigitan lebah dan mengalami komplikasi berupa defisit neurologis.
Presentasi Kasus: Seorang laki-laki berusia 68 tahun dibawa oleh keluarga ke Instalasi Gawat Darurat RS Dustira karena keluhan penurunan kesadaran. Penurunan kesadaran dirasakan keluarga mendadak dan sisi sebelah kanan mengalami kelemahan. Pasien tidak dapat berkomunikasi, memahami isi pembicaraan lawan bicara maupun berbicara mengutarakan maksudnya. Pada pemeriksaan fisik pasien ditemukan kesadaran pasien somnolen dengan tekanan darah 150/90mmHg dan suhu 37,9 derajat Celcius. Pada pemeriksaan neurologi ditemukan penurunan kekuatan motorik. Pada pemeriksaan CT-Scan tanpa kontras didapatkan infark di daerah kortikal subkortikal regio temporoparietooksipital sinistra (emboli).
Kesimpulan: Komplikasi yang tidak biasa dan lebih parah juga terlihat seperti syok anafilaksis, infark miokard, gagal ginjal akut, perdarahan paru dan fibrilasi atrium. Komplikasi neurologi jarang terjadi pada keracunan racun lebah.
Hypernatremic hemorrhagic encephalopathy as an unexpected critical complication in children: a case report from a tertiary hospital
Authors: Saunders Ricky , Suparyatha Ida Bagus Gde , Wati Dyah Kanya , Hartawan I Nyoman Budi , Satyarsa Agung Bagus Sista
Published: November 2023

Introduction: Hypernatremic hemorrhagic encephalopathy (HHE) is one of the complications of hypernatremic dehydration which is relatively uncommon in patients with hypernatremia. Severe hypernatremia might lead to brain shrinkage resulting in intracranial bleeding which can increase morbidity and mortality, especially in children. Hypernatremic hemorrhagic encephalopathy is harmful, but only limited cases are reported. This case highlights the role of cautious management of hypernatremic dehydration and the need for intense monitoring due to the unexpected complication of HHE.
Case presentation: A 4 months old female infant presented with a decreased consciousness. She showed signs of shock along with acute diarrhoea and severe dehydration. Laboratory findings revealed severe hypernatremia and high septic marker. Rehydration and correction of hypernatremia were done, but during the process, several episodes of general tonic-clonic seizure occurred. A Head CT scan was done and showed subdural hemorrhage in the posterior interhemispheric fissure and intraventricular hemorrhage in the posterior horn of the right lateral ventricle. Conservative management was undertaken and the patient was clinically improved progressively. On the 11th day of hospitalization, the patient's condition had been significantly improved without neurological sequelae and was later discharged on the 11th day of hospitalization.
Conclusion: Close monitoring of clinical, neurological, and laboratory examination is essential in the management of hypernatremic dehydration due to the possibility of HHE, even when on the right procedure. Once neurological complication is suspected, an immediate imaging study should be performed and modifying therapy is required.
A uterine leiomyoma with the prolapse large pedunculated submucosal myoma: a case report
Authors: Cahyono Endy , Iskandar Teuku Mirza , Ambari Ediwibowo , Putra Very Great Eka , Lubena  , Trisanto Apdhika Kristian
Published: November 2023

Introduction: Leiomyoma is a benign tumor that originates from the smooth muscle cells of the uterus and is one of the most common tumors in women. Sometimes, this tumor can become very large and even stick out of the vagina, which is called prolapse pedunculated myoma. Having a large fibroid with prolapse myoma that protrudes out of the vagina can cause problems like a low blood count or anemia, infection risk, blockage of other organs, and tissue necrosis. Therefore, this condition needs a different treatment approach than other cases.
Case Report: A 50-year-old woman, P1A1, complained of bleeding from the vagina accompanied by a mass that protrudes out of the vagina, and also having an enlarged abdomen. On physical examination, the patient appears pale. Abdominal examination presence of a mass as high as the umbilicus. On a gynecological examination, Fluxus was found. In the vagina, there is a blue-black mass the size of a fist coming out of it. Hemoglobin examination obtained a result of 10.2 gr/dl. Gynecologic ultrasound examination showed the uterus with a size of more than 9.42 x 15.68 x 13.27 cm, a positive endometrial thickening, and there also appeared a hyperechoic mass with a size of 7.38 x 8.11 cm. Abdominal MSCT examination using contrast showed enlargement of the uterus with solid inhomogeneous mass and intramural calcification. There is also a mass and cervical prolapse to the perineum, mild hydronephrosis, and right proximal hydroureter. It is also found multiple lymphadenopathies in paraaortic and common iliac lymph nodes. The patient then decided to perform a total abdominal hysterectomy.
Conclusion: Total abdominal hysterectomy is one of the procedures that can be done on patients who are experiencing symptoms, such as bleeding caused by a large leiomyoma size and the presence of prolapse pedunculated submucosal myoma.
Appendisitis akut dengan kecurigaan ruptur pada kista korpus luteum: laporan kasus
Authors: Santosa Ayuningtyas Anatika
Published: November 2023

Background: Appendicitis is an acute or chronic inflammatory process that occurs in the vermiform appendix due to an obstruction that occurs in the lumen of the appendix. Acute appendicitis is one of the most common acute abdomen cases in patients in the emergency room. This case study aims to evaluate the acute appendicitis with suspected rupture of a corpus luteum cyst
Case Presentation: A 17-year-old woman with complaints of abdominal pain accompanied by nausea, vomiting, and fever, which is supported by investigations towards acute appendicitis was admitted to the Siloam Hospital, Denpasar, Bali. On physical examination, the patient was aware of compost mentis with a general condition that looked mildly ill, Blood Pressure 120/70 mmHg, Pulse: 76 times/minutes, Respiration 16 times/minutes, Ttemperature 36.3oC, SpO2 98% room air, and Visual Analogue Scales (VAS) was 7. However, the CT scan of the abdomen not only found a swollen appendix but also found suspicion of intra-peritoneal bleeding due to corpus luteal cyst rupture. The patient was then given an injection of omeprazole 40 mg IV, primperan 10 mg IV, and ketorolac 30 mg IV. After being given the drug injection, complaints were felt to decrease and the patient was allowed to be outpatient.
Conclusion: Appendicitis can cause serious complications, namely perforation of the appendix which can cause peritonitis and sepsis thereby increasing morbidity and mortality, so it needs to be known as early as possible to prevent worsening.
 
Latar Belakang: Apendisitis adalah proses inflamasi akut atau kronis yang terjadi pada apendiks vermiformis akibat adanya sumbatan yang terjadi pada lumen apendiks. Apendisitis akut merupakan salah satu kasus akut abdomen yang paling sering terjadi pada pasien di ruang gawat darurat. Studi kasus ini bertujuan untuk mengevaluasi apendisitis akut dengan dugaan pecahnya kista korpus luteum
Presentasi Kasus: Seorang wanita berusia 17 tahun dengan keluhan nyeri perut disertai mual, muntah, dan demam, yang didukung pemeriksaan penunjang ke arah apendisitis akut, dirawat di Rumah Sakit Siloam, Denpasar, Bali. Pada pemeriksaan fisik diketahui pasien kompos mentis dengan keadaan umum tampak sakit ringan, tekanan darah 120/70 mmHg, nadi 76 kali/menit, Respirasi 16 kali/menit, suhu 36.3oC, SpO2 98% udara ruangan, dan Visual Analogue Scales (VAS) adalah 7. Namun, CT scan perut tidak hanya menemukan apendiks yang membengkak tetapi juga menemukan kecurigaan adanya perdarahan intra-peritoneal akibat pecahnya kista korpus luteal. Pasien kemudian diberikan suntikan omeprazole 40 mg IV, primer 10 mg IV, dan ketorolac 30 mg IV. Setelah diberikan obat suntik keluhan dirasakan berkurang dan pasien diperbolehkan untuk berobat jalan.
Kesimpulan: Apendisitis dapat menimbulkan komplikasi yang serius yaitu perforasi apendiks yang dapat menyebabkan peritonitis dan sepsis sehingga meningkatkan morbiditas dan mortalitas, sehingga perlu diketahui sedini mungkin untuk mencegah perburukan.
The outcome of oxygen therapy on desaturated patient with moderate to severe symptoms in Kogabwilhan II Indrapura Field Hospital
Authors: Hafizh Rizky Prasetya  , Erwin Astha Triyono  , Paulus Budiono Notopuro  , Leny Kartina
Published: November 2023

Background: Since the first outbreak of Coronavirus Disease 2019 (COVID-19) in late 2019 in Wuhan, the SARS-CoV virus has grown rapidly and spread around the globe. The virus invades respiratory epithelium, causing inflammation and damage to lung cells, which causes impaired gas exchange and leads to a desaturated state. Kogabwilhan II Indrapura Field Hospital in Surabaya was an initial emergency hospital for asymptomatic and mild-symptomatic COVID-19 patients. Due to the massive surge of COVID-19 cases in East Java, it had to treat moderate and severe symptomatic patients.
Aim:  The study aims to report clinical prognosis post-COVID-19 infection. 
Method: This is a retrospective descriptive study in Kogabwilhan II Indrapura Field Hospital with desaturated COVID-19 patients from March 2020 to October 2021 as samples.
Results: Of 471 admitted COVID-19 patients with desaturation, 36.9% were moderate-symptomatic, and 63.9% had severe ones. All patients received oxygen therapy and multivitamins. Then, 29.7% of patients were cured, while 70.3% were referred. 48.4% of referred patients were bonam, 10.2% were pronounced deceased, and 11.7% were unknown.
Conclusion: Most patients declared cured after being referred to another center.
Pre-exposure prophylaxis (PrEP) pada pencegahan human immunodeficiency virus (HIV) dan dampaknya terhadap infeksi menular seksual
Authors: Mahariski Pande Agung , Puspawati Ni Made Dwi , Indira I Gusti Ayu Agung Elis , Praharsini I Gusti Ayu Agung , Permana Aditya
Published: November 2023

As part of a comprehensive strategy to prevent human immunodeficiency virus (HIV) infection, pre-exposure prophylaxis (PrEP), safe sex practices, routine HIV testing, HIV risk reduction counseling, and consistent and correct use of condoms are largely effective in HIV prevention. Pre-exposure prophylaxis is intended for people who engage in high-risk sexual behavior and do not use condoms consistently. The use of PrEP is widely promoted in the man who have sex with men (MSM) community, including MSM who wish to practice safer sex in sexual relationships with casual partners who have difficulty sharing HIV status and sexually transmitted infections (STIs) with sexual partners. However, due to the inconsistent practice of using condoms when using PrEP, there is an impact, namely an increase in the incidence of other sexually transmitted infections. In addition to the increased transmission of disease, especially bacterial infections, PrEP also has a protective effect against the herpes simplex virus (HSV). This literature review discusses PrEP and its impact on sexually transmitted infections.
 
 
Sebagai bagian dari strategi pencegahan komprehensif infeksi human immunodeficiency virus (HIV), penggunaan pre-exposure prophylaxis (PrEP) disertai praktik seks aman, tes HIV rutin, konseling pengurangan risiko HIV, dan penggunaan kondom yang konsisten dan benar sebagian besar efektif terhadap pencegahan HIV. Pre-exposure prophylaxis ditujukan untuk orang yang melakukan perilaku seksual berisiko tinggi dan tidak menggunakan kondom secara konsisten. Penggunaan PrEP dipromosikan secara luas pada komunitas laki-laki suka dengan laki-laki (LSL), termasuk LSL yang ingin mempraktekkan seks yang lebih aman pada hubungan seksual dengan pasangan tidak tetap yang sulit berbagi status HIV dan infeksi menular seksual (IMS) pada pasangan seksual tersebut. Namun, oleh karena praktik penggunaan kondom yang tidak konsisten saat menggunakan PrEP, terdapat dampak yang timbul yaitu adanya peningkatan kejadian infeksi menular seksual lainnya. Selain adanya transmisi penyakit terutama infeksi bakteri yang meningkat, penggunaan PrEP ternyata juga memiliki dampak efek protektif terhadap herpes simplex virus (HSV). Tinjauan pustaka ini membahas mengenai PrEP dan dampaknya pada infeksi menular seksual.
Correlation of delta shock index and lactate clearance in shock patients treated in pediatric intensive care unit at Prof Dr. I.G.N.G Ngoerah Hospital
Authors: Wati Dyah Kanya , Putu Ayunda Trisnia  , Suryawan I Wayan Bikin , Windiani I Gusti Ayu Trisna , Suwarba I Gusti Ngurah , Gustawan I Wayan
Published: November 2023

Introduction: Lactate was an examination done in patients with shock as a predictor of mortality. The delta shock index (DSI) is one of the parameters that are easy to do but very limited studies related to the benefits of DSI have been found. This study aimed at determining the correlation of DSI and lactate clearance levels in pediatric shock patients treated at the Pediatric Intensive Care Unit (PICU) of Prof Dr. I.G.N.G Ngoerah  Hospital.
Method: This was a prospective cohort study of children diagnosed with shock in a pediatric emergency ward or PICU Prof Dr. I.G.N.G Ngoerah  Hospital. A Spearman correlation test was done since the data distribution was abnormal. Multivariate analysis with multiple regression tests was carried out to assess the pure effect of lactate clearance with DSI. The level of significance was determined based on p <0.05. The general linear model analysis is done on variables that are repeated measurements.
Result: There were 39 subjects obtained in this study, with 34 subjects surviving and 5 subjects not surviving. The median lactate clearance was 28.5 (-95 - 77.7), with a median DSI of 0.45 (0.04-1.3). There were significant differences in the decrease of shock index over time (p = 0.034). The correlation test results showed a weak positive between lactate clearance with DSI (r = +0.351) and p = 0.028. Multivariate analysis test results obtained a value of â 0.002 with p = 0.071.
Conclusion: There was a weak positive correlation between lactate clearance and DSI. There were significant differences in the decrease of shock index over time between survivors and non-survivors.
Unique problems of pneumonia in obese children: a literature review
Authors: Mayangsari Ayu Setyorini Mestika
Published: November 2023

Background: Obesity in children has its impact when the child experiences infectious conditions common in childhood, such as pneumonia. The increasing incidence of obesity in children in the last three decades forms the basis for compiling this review article. This review article aims to provide current insights about the impact of obesity on respiratory physiology, inflammatory conditions in pneumonia, and drug pharmacodynamics.
Methods: This literature review uses the latest literature relevant to matters affecting pneumonia management and clinical approach in children with obesity. This literature was obtained from various sources of other scientific literature.
Results: Obesity affects the respiratory physiology of children to collapse more easily, energy use becomes less efficient, children become tired, and hypoxemia occurs easily. Obesity also increases the degree and ease of inflammation in pneumonia and affects the pharmacodynamics of several drugs commonly used to manage pneumonia.
Conclusion: Management of pneumonia in children with obesity requires vigilance and more stringent monitoring and adjustment of drug doses.
Lamotrigine-induced Stevens-Johnson Syndrome Toxic Epidermal Necrolysis (SJS/TEN) overlap with transaminitis in an Asian female: a case report
Authors: Mathonie Michelin , Claudia Grace , Wisan Angel Benny
Published: November 2023

Background: Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis (SJS/TEN) is a dermatologic emergency characterized by extensive epidermal detachments. The most frequent etiology is drug reaction within an interval of the last 8 weeks. SJS/TEN may occur in any age, race, and gender; however, there is an increased risk in patients over 65. SJS and TEN are differentiated based on the extent of epidermal detachments, which is <10% in SJS, 10-30% in SJS-TEN overlap, and >30% in TEN. This case study aims to evaluate the Lamotrigine-induced Stevens-Johnson Syndrome Toxic Epidermal Necrolysis (SJS/TEN) overlap with transaminitis in an Asian female.
Case Presentation: A 34-year-old woman presented with a pruritic and burning rash on almost all body parts. The suspected causative drug was lamotrigine, which she consumed within the last 2 weeks. Mucosal involvement was also found on the lips and genital mucosal. The affected body surface area was approximately 20%, with a positive Nikolsky sign. Laboratory studies showed elevated liver function tests. Based on the history, physical examination, and biopsy, the patient was diagnosed with SJS/TEN overlap. The suspected causative drug was immediately stopped, and supportive and systemic corticosteroid treatments were provided. The SCORTEN was 2, with a mortality rate of 12.1%. After a few days, the patient's condition had improved, the liver function test was normal, and there was no significant complication.
Conclusion: SJS-TEN is a part of epidermal necrolysis, characterized by an extensive epidermal detachment. The management of SJS/TEN includes early detection, immediately stopping the suspected drugs, administering systemic corticosteroids, and other supportive treatments.
Dyke-Davidoff-Masson syndrome: an unusual cause of epilepsy
Authors: Jaya I Gusti Amanda , Suwarba I Gusti Ngurah Made , Mahalini Dewi Sutriani , Margiani Ni Nyoman
Published: November 2023

Background: Dyke-Davidoff-Masson syndrome (DDMS) is a rare neurological condition with unknown global prevalence and incidence. The characteristic clinical features include facial asymmetry, seizures, and contralateral hemiplegia. Signature neuroimaging findings include unilateral brain volume loss, ventriculomegaly, compensatory bone hypertrophy resulting in cerebral hemiatrophy, calvarial thickening and hyperpneumatization of paranasal and frontal sinuses neuroimaging.
Case Presentation: 4-year-old girl patient presented seizures (diagnosed as epilepsy) and complained of left-sided hemiplegia since 1 year ago. Neurological examination revealed left-sided spastic hemiplegia with brisk tendon reflexes and extensor planter response on the left side, increased reflexes physiology in the left limb, and positive Babinski on the left leg. MRI showed right cerebral hemiatrophy with ex vacuo dilatation of the right lateral, III and IV ventricles, with hyper pneumatization of the right ethmoid sinus and right left mastoid Aircell and elevation of the right petrous ridge, and falcine displacement to the right as far as +/- 7mm and blurring right hippocampus, suspected atrophy. Therapy, she got multiple anti-epileptic drugs.
Conclusion: Diagnosis of DDMS is made by a triad of hemiplegia, contralateral hemiatrophy, seizures, and classical radiological features. Imaging is important in diagnosing this rare entity and differentiating it from other causes of cerebral hemiatrophy. The long-term prognosis is good, provided the clinical entity is recognized early and managed appropriately.
Bifurcated rib as major diagnostic criteria of Gorlin syndrome in paediatric patient: a rare case report
Authors: Gozal Kenny , Sandiwidayat Komang Septian
Published: November 2023

Background: Bifurcated rib or Bifid rib is considered to be an anatomical overgrowth anomaly of the chest wall, forming a forked sternal end. Diagnosis of this condition is generally an incidental finding on imaging or post-mortem examination. Most of the cases were asymptomatic and established as part of Gorlin syndrome. Here we describe a rare case of chest wall deformity in a paediatric patient, and our approach for this case with limited cost and resources.
Case Presentation: A 5-year-old boy, presented at orthopedic outpatient clinic with complaint of a painless lump in his upper left chest. No significant history of infection, malignancy or any congenital syndromes. Chest imaging revealed a bifid left 4th rib at the sternal end.
Conclusion: There is currently no data on the best approach to managing bifid ribs. In addition, genetic testing for susceptible genes should be strongly considered. In this situation with limited cost and resources, we suggest close monitoring with regular follow-ups for the patient as the best approach, including detection of any other diagnostic criteria of Gorlin syndrome, to ensure better prognosis and quality of life for this patient.
Profile of psoriasis vulgaris patients receiving secukinumab therapy in 2019-2021
Authors: Sudarsa Prima Sanjiwani Saraswati , Rusyati Luh Made Mas , Suryawati Nyoman , Hostiadi Michael , Murti Nyoman Indra Karunia
Published: November 2023

Introduction: Psoriasis vulgaris can affect patients' quality of life due to its clinical appearance, expensive treatment costs, and side effects of therapy. Effective long-term treatment with secukinumab injection can help improve this condition. This study aims to identify psoriasis vulgaris conditions with secukinumab injection based on disease severity and quality of life.
Methods: This study is a cross-sectional descriptive study. Data were taken from patients' medical records at the Dermatology and Venerology Polyclinic of Prof. dr. I G. N. G. Ngoerah Hospital, Denpasar, Bali, from January 2019-December 2021. Demographic characteristics variables were age, gender and history of comorbidities. Variables that reflect disease severity and quality of life were body surface area (BSA), Psoriasis Area Severity Index (PASI) and Dermatology Life Quality Index (DLQI). The distribution of BSA, PASI and DLQI scores is shown in a box plot. In comparison, the distribution of the number of cases based on each category of BSA, PASI and DLQI is presented in a proportion table.
Results: There were 17 patients, mostly men, with a mean age of 38. Patients' Diagnoses were divided into psoriasis vulgaris (52.9%) and psoriasis vulgaris with psoriatic arthritis (47.1%). Based on BSA, clinical improvement was seen two weeks after initiation of therapy, while the BSA grade category improved when entering the maintenance phase. Based on the PASI score, were decreased after an average of 1 week since initiation, and the PASI grade category improved after an average of 2 weeks. Finally, based on the DLQI score, the patient's quality of life improved after an average of 4 weeks since initiation.
Conclusions: There was an improvement in the severity of psoriasis vulgaris according to BSA, PASI score and overall DLQI after two cycles of initial dosing of secukinumab injection.
Endometriosis of the appendix mimicking appendicitis: Histomorphology and case report
Authors: Ida Bagus Ari Sudewa , Luh Dewi Rahayu , Ida Bagus Caka Gunantara , Ni Luh Gde Sagita Dewi
Published: November 2023

Introduction: Even though endometriosis is relatively common among women of reproductive age, endometriosis of the appendix is rare. It has various clinical presentations and sometimes mimics appendicitis. Diagnosis is made from microscopic examination.
Case Description: Here, we report a case of a 42-year-old woman with severe right lower abdominal pain. An appendectomy was performed, and the tissue specimen was analyzed. Endometrial glands and stroma were found in the muscularis propria and serosa. The diagnosis of appendiceal endometriosis was established histologically.
Conclusion: Endometriosis of the appendix is a rare case. It can mimic appendicitis and is hard to detect preoperatively. A histopathology examination was recommended to confirm the diagnosis.