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A Child with HIV (Human Immunodeficiency Virus) Infection Accompanied by Severe Acute Malnutrition: A Case Report
Get PDFJoint United Nations Programme in HIV/AIDS (UNAIDS) reported that 1.8 million children under 15 years old had HIV with 150,000 new pediatric cases in 2015, and only 49% had an antiretroviral (ARV) therapy. Mortality in HIV-infected children with severe acute malnutrition was 30.4% in Africa. A 1-year and 8-months-old girl was hospitalized due to diarrhea, vomiting, oral thrush, and recurrent fever before admission. She has been hospitalized for HIV infection one month ago and treated with ARV. Her mother was treated with ARV before. Physical examination showed a severely ill, poorly nourished, stunting, and conscious child with normal vital signs. There was oral thrush. The evidence of nutritional marasmus was old man face, piano sign, wasting, and baggy pants. Laboratory findings revealed anemia, positive antigen and antibody of HIV infection, and low Cluster of Differentiation 4 (CD4). She was treated with ARV, Cotrimoxazole, and management of malnutrition and diarrhea. The prognosis of the patient was poor. A 1-year and 8-months-old girl with HIV infection complicated with severe acute malnutrition, acute diarrhea, oral thrush, and anemia of chronic disease were reported. The diagnosis was based on clinical and laboratory findings. Management focused on the therapy of HIV and accompanying illness. The prognosis was poor
Profile of Minimal and Non-Minimal Change Nephrotic Syndrome in Children: A Cross-Sectional Study
Get PDFIntroduction: Idiopathic nephrotic syndrome (INS) is the most common kidney disease in children. Histopathological features classify the disease into minimal change nephrotic syndrome (MCNS) and non-minimal change nephrotic syndrome (NMCNS). Clinical and laboratory characteristics are considered to be useful in estimating the underlying pathological changes. This study aimed to assess the spectrum of clinical and laboratory profiles in children suffering from MCNS and NMCNS.
Methods: This was a cross-sectional study using medical records of patients hospitalized at Dr. Wahidin Sudirohusodo Central General Hospital and Hasanuddin University Teaching Hospital from January 2016 to August 2018. Subjects were classified into MCNS and NMCNS groups and evaluated for age, sex, hypertension, degree of edema, degree of hematuria, proteinuria level, cholesterol level, albumin level, urea level, and creatinine level. Data were analyzed by using chi-square, fisher's exact test Mann Whitney analysis, multivariate by logistic multiple regression analysis, and diagnostic test.
Results: Of the 36 subjects enrolled, 10 (27.8%) had MCNS, and 26 (72.2%) had NMCNS. Bivariate analysis showed significant differences in hypertension (p=0.020; OR=12.3; 95% CI 1.35-111.61) and hematuria (p=0.018; OR=7.7 ; 95% CI 1.52-39.75). Multivariate analysis indicated that only hematuria is a significant predictor (p=0.014; OR=7.778; 95% CI 1.522 – 39.754). The diagnostic test of NMCNS showed hematuria sensitivity at 77% and specificity at 70% with a positive predictive value of 87% and a negative predictive value of 46%.
Conclusion: Our study showed that hematuria is a sensitive predictor of NMCNS
Cupping Therapy for Temporary Reduction of Blood Pressure in Hypertension Patients
Get PDFIntroduction: Hypertension is still a major problem in the field of health problems in general. One therapy to cure hypertension is cupping technique therapy.
Objectives: To find a picture of a brief decrease in blood pressure in patients with hypertension using cupping therapy techniques.
Methods: This study was a descriptive study using purposive sampling totaling 85 populations and 46 samples.
Results: The results showed that the average systolic blood pressure before cupping was 164.78 mmHg decreased by 10.87 mmHg to 153.91 mmHg after cupping and the average diastolic blood pressure before cupping was 99.78 mmHg decreased by 4.13 mmHg to 95.65 mmHg.
Conclusion: The results showed that cupping technique therapy can reduce blood pressure for a moment in hypertension sufferers
The Profile of Lung Adenocarcinoma Patients with Positive EGFR Mutation
Get PDFBackground: The high mortality rate in pulmonary carcinoma is a problem encountered in various countries, including Indonesia. According to WHO, there are 2.09 million people affected by lung cancer and 1.76 million deaths due to lung cancer worldwide. This study was aimed to determine the profile of lung adenocarcinoma patients with positive EGFR mutation.
Methods: The study was descriptive study with cross-sectional approach using secondary data obtained from medical records of lung adenocarcinoma patients.
Results: The present study revealed that lung adenocarcinoma was found higher in patients with age >40 years old (93.9%) compared to those with age <40 years old. It was also higher in male (66.7%) than in female patients. Most patient with lung adenocarcinoma were at the IIIB stage (42.4%). It was also reported that higher cases was found in patients with history of smoking more than 15 years (42.4%). Hemoptoe was the most reported clinical symptoms in patients with lung adenocarcinoma (87.9%). Lung adenocarcinoma was also observed higher in patients without family history of pulmonary adenocarcinoma (81.8%). Seventeen of 33 EGFR mutations (51.5%) were observed in exon 19 and fourteen (48.5%) were in exon 21.
Conclusion: The most common EGFR mutation lung adenocarcinoma was observed in exon 19
Nutrition Therapy on Cutaneous Lymphoma Patient with Anemia and Hypoalbuminemia: A Case Report
Get PDFNutrition is a part of cancer management during therapy, recovery, remission, and recurrence prevention. Malnutrition and cachexia often occur in cancer patients and influence morbidity, mortality, and quality of life, especially in the advanced stage of malignancy. We reported a case of cutaneous lymphoma with anemia and hypoalbuminemia in the terminal condition. This case report focuses on nutritional therapy and palliative care on nutrition. We reported a case of a 40-year-old-man with Cutaneous Lymphoma (CL) and moderate protein-energy malnutrition that was developed to severe protein-energy malnutrition due to difficulty in dietary access. He had an eating problem because of multiple tumors and ulcers on his mouth. We provided access for parenteral nutrition from Central Venous Catheter (CVC) and orogastric tube (OGT) for enteral feeding. Even though the dietary target was never accomplished, there was a slight recovery on hypoalbuminemia and renal function during hospitalization. This case showed a considerable challenge in nutritional therapy due to limited dietary access. Since death was inevitable, we have tried different dietary access to provide adequate intake
The Analysis of Factors that Influencing Mother's Knowledge Level on Basic Immunization
Get PDFIntroduction: One of the goals of WHO formulated at the Atlanta meeting in 1978 was to achieve health for all by 2000. The purpose of this study is to describe the factors that influence the level of mother’s knowledge regarding basic immunization.
Methods: The research was conducted in January - February 2020 in the Dahlia Health Center in Makassar. The sample was 80 mothers whose babies were immunized at the Dahlia Health Center. A purposive sampling method was used. The data collection method used was a survey questionnaire that was distributed to respondents. The data analysis used was a univariate data analysis using the SPSS.
Results: The largest subjects were senior high school education and the smallest subjects were university education. Most of the subjects were housewives or unemployed (75%) and the least of the subjects were civil servants (3.75%). Most subjects in this study were aged 21-35 years old (53.75%) and the least subjects were under 20 years old (15%). All respondents were Muslim (100%). Most of the family environment factors that their family did not accompany them for immunization (53.75%) and community environmental factors that around people brought their children for immunization (100%).
Conclusion: All factors of this study affect the mother’s knowledge but we can conclude that the most role influence of factors to knowledge mother were environment and religion
Analysis of Obstetric Medical Determinant Factors toward Mothers with the Stunting Children
Get PDFIntroduction: Toddlerhood is a period that is very sensitive to the environment so more attention is needed especially the adequacy of nutrition. Nutrition problems, especially stunting in a toddler can inhibit the growth and development of the children. This study aimed to identify various obstetric medical characteristics and determine the obstetric medical determinant factors that most influence pregnant women with the incidence of stunting in Mamuju Regency, West Sulawesi.
Methods: This study was conducted from June until August 2019 in Mamuju Regency, West Sulawesi. The total samples in this study were 88 people who were taken from mothers who had stunting toddlers aged 2-5 years old in Mamuju Regency, West Sulawesi. A total sampling method was used. A cross-sectional with the retrospective approach with a regression test. Data instruments were used questionnaires, observation sheets, and checklists.
Results: The result of the stunting study was found from the toddler nutrient data from January until June 2020 in West Sulawesi by using total sampling. The researchers found a sufficient influence for the complication during childbirth factor, while the weak relation of the stunting based on the ages, parity, pregnancy spacing, poor obstetric history, comorbid disease, maternal surface, neonatal surface, hemoglobin levels, and the history of Sectio Caesarea (SC).
Conclusion: One of the obstetric medical factors that have a sufficient relationship for causing the stunting for children is the complication during childbirth, while other obstetric medical factors have a very weak relation to the stunting case
A Rare Case of Chronic Intracerebral Foreign Body
Get PDFIntroduction: Intracranial foreign bodies are usually caused by trauma that penetrates the cranium. Gunshot wounds are the most common cause, while non-missile intracranial penetration is rare. The patient’s clinical condition highly depends on the mechanism, anatomical location of the lesion, and related injuries. Possible complications include intracerebral hemorrhage, contusion, major injury on the vascular, and meningitis. In this article, we report case of intracerebral nail extraction from a patient with right cerebral foreign body.
Case presentation: A 22-year-old man with a history of unspecified schizophrenia reported with reduced awareness accompanied by weakness of his left limb. During a head CT scan of the head, there are several tubular foreign bodies in the right cerebral. Craniotomy for foreign body extraction and drainage of the cerebral abscess is immediately performed. Four days after surgery, the patient had increased awareness, although there was no significant improvement in motor strength. One month after discharged from hospital there was slight improvement in motor strength.
Conclusion: Extraction of foreign bodies by a surgical procedure is mandatory and should be performed thoroughly. The administration of antibiotics, anticonvulsants, physiotherapy, and psychiatric follow-up should be added to the treatment of this patient.Pendahuluan : Benda asing intracranial biasanya disebabkan trauma tembus pada cranium. Luka tembak merupakan penyebab tersering sedangkan penetrasi intracranial oleh non misil jarang terjadi. kondisi klinis pasien sangat tergantung pada mekanisme, lokasi anatomi lesi dan cedera terkait. Komplikasi yang dapat terjadi berupa perdarahan intraserebral, kontosio, cedera major pada vascular dan meningitis. Di artikel ini kami melaporkan kasus ekstraksi paku dari intraserebral pasien dengan corpus alienum cerebri dextra.
Presentasi kasus : Seorang pria berusia 22 tahun dengan riwayat skizofrenia Yang Tak Tergolongkan datang dengan penurunan kesadaran disertai kelemahan anggota gerak kiri. Pada pemeriksaan CT scan kepala didapatkan multiple corpus alienum berbentuk tubular pada cerebri dextra. Craniectomy ekstraksi corpus alienum dan drainase abses cerebri segera dilakukan. Empat hari setelah operasi didapatkan perbaikan kesadaran, namun belum didapatkan peningkatan kekuatan motorik yang signifikan.
Kesimpulan : tindakan ekstraksi corpus alienum dengan tindakan operatif harus dilakukan dan pengangkatan benda asing harus dilakukan secara menyeleruh. Pemberian antibiotik, antikonvulsan, fisioterapi dan follow up psikiatri harus ditambahakan pada penatalaksanaan pasien ini
Blood Pressure and Heat Shock Protein 70 Levels Related to Acute Ischemic Stroke Severity
Get PDFIntroduction: Hypertension is a risk factor of ischemic stroke, the prevalence of ischemic stroke in Indonesia is 34.1%. Heat Shock Protein (HSP) 70 increases in hypertension and acute phase of ischemic stroke. To determine differences of blood pressure (BP) and HSP 70 levels, related to the acute ischemic stroke severity.
Methods: This was a cross-sectional study that was carried out in the Neurological Ward of Dr.M.Djamil Hospital and National Stroke Hospital, from May to September 2019. Inclusion criteria were obtained consecutively. BP was measured with a sphygmomanometer, stroke severity was measured by NIHSS, and HSP 70 levels was analyzed by the ELISA. Computerized statistical analyzes were performed using SPSS software version 23.0 for windows. The result was statistically significant if the p-value < 0.05.
Results: There were 40 samples consisted of 26 (65%) male, mean age 59.78 years. The systolic BP ranging from 130 to 190 mmHg (median 160), the diastolic BP ranging from 70 to 100 mmHg (median 90), the HSP 70 levels ranging from 2.50 to 19.56 ng/mL (median 2.72). There were 18 patients with mild stroke and 22 patients with moderate stroke. There was no significant difference between systolic blood pressure (SBP), diastolic blood pressure (DBP), and severity of stroke (p=0,369; p=0,221, respectively). There was no significant difference between HSP 70 levels and the severity of stroke (p=0,312). There was no relation between the degree of BP and HSP 70 levels.
Conclusion: There were no significant differences of SBP, DBP, and HSP 70 with the acute ischemic stroke severity
Hyperthyroid Heart Disease With Some Comorbidities
Get PDFThyroid disease is quite common. The cardiovascular clinical manifestations of hyperthyroidism are palpitation, systolic hypertension, fatigue, or with the basis of existing heart disease, angina or heart failure. In men, the disease is more frequently to develop into congestive heart failure than in women, thus more exploration is needed. This case report discussed a 42-year-old male patient who was admitted to the emergency department due to palpitations, shortness of breath aggravated with activity and lie down position, and alleviated with resting, cough with white sputum, epigastric pain, and constipation since the past 3 days. He was diagnosed with a history of hyperthyroidism and congestive heart disease 1 year ago and routinely consumed propylthiouracil (PTU). He had a history of herniotomy 10 days before admission. The patient did not have a history of hypertension, diabetes mellitus, or hypercholesterolemia. The patient has a smoking habit of up to 3 packs/day since a teenager. The patient was diagnosed with hyperthyroid heart disease (congestive heart failure, atrial fibrillation, and coronary heart disease) with comorbid of electrolyte imbalance, hypoalbuminemia, and thrombocytopenia. The patient was treated in the Intensive Care Unit (ICU) and was given oxygen therapy, crystalloid infusion, antithyroid drug, beta-blocker, diuretics, digitalis, anti-angina, anti-thrombotic, and adjunct therapy. The patient was treated for 8 days in ICU, followed by 2 days in the ward with a good outcome. Early detection and intervention followed by close monitoring is key management for the patient with hyperthyroid heart disease, especially in a male patient, to achieve a better outcome