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A Case Report of Autoimmune Hemolytic Anemia with Deep Vein Thrombosis in a 16-year-old Girl - Is It Systemic Lupus Erythematosus
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| Pengarang | : | Muhammad Buchori, Ivan Joalsen Mangaratua, Fidel Corona, Kevin Sanjaya, Laily Mulyani |
| Nama Majalah/Jurnal | : | CDK Cermin dunia kedokteran |
| Volume / Edisi | : | 52 (No. 11) |
| Halaman | : | 731-737 |
| Abstrak | : | Systemic lupus erythematosus (SLE) is an autoimmune disease with various clinical manifestations. Multiorgan involvement is associated with a worse prognosis. SLE in pediatrics is rare, with an estimated incidence of 0.3–0.9 per 100,000 children. Case: A 16-year-old Asian girl was admitted with pain, swelling, and a bluish discoloration with blisters on the right leg for 6 days. She had a history of facial rash, hair loss, and oral ulcer. Doppler ultrasound showed deep vein thrombosis in the right lower extremity with acute thrombosis, with visible soft-material intraluminal thrombus. Coombs test was 4+ positive. Elevated total bilirubin 2.2 mg/dL, indirect bilirubin 0.9 mg/dL, and elevated reticulocyte 5.2%. ANA test result is borderline 0.8, and anti-DS DNA negative. CT angiography showed proximal total occlusion of the right dorsalis pedis artery, DVT along the external iliac vein, femoral vein, and popliteal vein to the proximal 1/3 of the right posterior tibial vein. Diagnosis of an autoimmune disease leading to autoimmune hemolytic anemia and deep vein thrombosis was suspected. Her condition improved after corticosteroids and anticoagulant treatment. Conclusion: A 16-year-old girl was diagnosed with autoimmune hemolytic anemia, deep vein thrombosis, and suspected systemic lupus erythematosus. Early recognition of unusual manifestations of SLE is important. |
Chronic Bilateral Earlobes Thickening: A Case Report of Irritant Contact Dermatitis Mimicking Leprosy
| Pengarang | : | Maria Ulfa Noor Alika, Felix Hartanto |
| Nama Majalah/Jurnal | : | CDK Cermin dunia kedokteran |
| Volume / Edisi | : | 52 (No. 11) |
| Halaman | : | 727-730 |
| Abstrak | : | Irritant contact dermatitis (ICD) is an inflammatory cutaneous disorder induced by the breakdown of the barrier and activation of innate immune responses. In the chronic stage, plaques thicken and cause scaling, hyperkeratosis, fissures, rhagades,and/or lichenification. Case: A 34-year-old male presented with both earlobe thickening and minor numbness, particularly whilesweating or being exposed to direct sunlight. Physical examination revealed erythematous patches, as well as edema and thickness of both earlobes. Patch test and slit skin smears yielded negative findings, ruling out allergic contact dermatitis (ACD) and leprosy. The diagnosis of irritant contact dermatitis was caused by sweat and sun exposure. The treatment consisted of twice daily ofdesoximethasone and mupirocin cream, and 10 mg loratadine once daily. Discussion: ICD is an inflammatory cutaneous disorder induced by the breakdown of the skin barrier and the activation of the innate immune response. Thickening and numbness of both earlobes are caused by repetitive irritation from sweat and sunlight exposure over time. Conclusion: Irritant contact dermatitis in both earlobes should be differentiated from other skin diseases, particularly leprosy. |
A Case Report of Congenital Corneal Opacity: Challenges of Keratoplasty Surgery in Children
| Pengarang | : | Dian Estu Yulia, Yura Pradiptama, Sabrina Tan |
| Nama Majalah/Jurnal | : | CDK Cermin dunia kedokteran |
| Volume / Edisi | : | 52 (No. 11) |
| Halaman | : | 722-726 |
| Abstrak | : | Congenital corneal opacity (CCO) is a group of anterior segment dysgenesis of the eye manifested by corneal transparency loss at birth or during the first 4 weeks of life. CCO is one of the most prominent disease entities in anterior segment dysgenesis. CCO resulted from disruptions in mesodermal development, particularly affecting the anterior segment of the eye. Case:A 2-week-old boy with bilateral CCO. One week post-keratoplasty surgery, the parents reported no complaints but had difficulty administering eye drops. Physical examination showed a clearer corneal graft. One month later, a cloudy graft and broken sutures were noted, indicating graft rejection. The family was educated on the importance of consistent medication for any future graft surgery. Discussion: The surgical option for CCO is corneal graft or keratoplasty. Keratoplasty is a corneal transplant where a clear donor graft replaces the central opaque cornea. Conclusion: A comprehensive workup is essential for diagnosing CCO. Keratoplasty can restore corneal clarity and vision, but pediatric cases require careful patient education and comprehensive follow-up. |
Hyperbaric Oxygen Therapy as a Treatment for Sudden Deafness
| Pengarang | : | Gabriela Widjaja |
| Nama Majalah/Jurnal | : | CDK Cermin dunia kedokteran |
| Volume / Edisi | : | 52 (No. 11) |
| Halaman | : | 717-721 |
| Abstrak | : | Sudden deafness or sudden sensorineural hearing loss is sensorineural deafness which is an ENT emergency because it can become permanent if not treated immediately. Sudden deafness is characterized by a sensorineural hearing loss of at least 30 dB within less than 72 hours. Most causes of sudden deafness are unknown (idiopathic) so treatment is empirical. The principles of managing sudden deafness are early detection, early diagnosis, and early treatment. The main treatment for sudden deafness is oral steroids, intratympanic, or a combination of both. Hyperbaric oxygen therapy (HBOT) has become a promising adjuvant therapy, working by increasing oxygenation in the perilymph and ischemic cochlear tissue. Several studies have shown that combining HBOT with steroids provides superior results compared to steroid monotherapy, especially in cases of severe deafness and if started within two weeks of symptom onset. Further research is still needed to confirm the effectiveness of hyperbaric oxygen therapy as a treatment for sudden deafness. |
Autoimmune Bullous Diseases in the Elderly
| Pengarang | : | dr. Gilang Widratama Putra, dr. Putu Dyah Ayu Saraswati, M.Sc, Sp.DVE |
| Nama Majalah/Jurnal | : | CDK Cermin dunia kedokteran |
| Volume / Edisi | : | 52 (No. 11) |
| Halaman | : | 713-716 |
| Abstrak | : | The increase in cases of bullous diseases in the elderly is related to various factors. Aging causes a decline in skin structure and integrity, making it more susceptible to bullous diseases. This disease occurs because the aging process causes immune system dysregulation, which increases the risk of autoimmune conditions. Bullous diseases that commonly occur in the elderly are usually bullous pemphigoid (an autoimmune bullous condition) and pemphigus vulgaris (a skin disease that causes blisters), which are associated with significant morbidity and mortality. Bullous pemphigoid is characterized by tense subepidermal blisters, while pemphigus vulgaris is characterized by loose suprabasal blisters that rupture easily. Histopathological examination and direct immunofluorescence are the gold standard for diagnosis. The management of autoimmune bullous diseases in the elderly is generally the same as for bullous diseases in general, such as corticosteroids and immunosuppressive agents. However, appropriate and effective management is necessary, along with increased attention to the risks of polypharmacy and drug side effects that may cause new problems in elderly patients, including an increased risk of infection, osteoporosis, and metabolic complications. |
Several Factors Contributing to Nutritional Disorders in Children at the Maubesi Community Health Center, East Nusa Tenggara: A Retrospective Cohort Study
| Pengarang | : | Yunri Steviani Saudale |
| Nama Majalah/Jurnal | : | CDK Cermin dunia kedokteran |
| Volume / Edisi | : | 52 (No. 11) |
| Halaman | : | 706-712 |
| Abstrak | : | In Indonesia, the incidence of nutritional disorders (malnutrition) in children aged 0–59 months in 2023 reached 8.5%. Methods: A retrospective cohort study was conducted on 48 children in the Maubesi Health Center working area, East Nusa Tenggara, in January–June 2024 to assess the relationship between gender, birth weight and length, number of siblings, place of birth, exclusive breastfeeding, immunization status, medical history, food variation, mother’s age and education, mother’soccupation, mother’s weight before pregnancy, mother’s Hb levels during pregnancy, mother’s history of hypertension and diabetes, and antenatal care (ANC) visits with the incidence of malnutrition and severe malnutrition. Data were obtained from the Integrated SIGIZI application, and children’s nutritional status was measured using the WHO (2006) weight-for-height chart. Results: Theanalysis used Fisher’s exact test and Spearman’s rank correlation test. A significant relationship was found between the number of ANC visits and the incidence of both malnutrition and severe malnutrition (p = 0.001), which showed a weak negative correlation: r(44) = -0.139, p = 0.357. Conclusion: In this study, a negative correlation was obtained between the number of ANC visits andthe incidence of undernutrition and severe malnutrition. |
The Relationship Between Obesity and Mortality in Heart Failure Patients
| Pengarang | : | Annisa Oktrivia Dewi, Tira Alfiani Laariya, Tri Yunanto Arliono |
| Nama Majalah/Jurnal | : | CDK Cermin dunia kedokteran |
| Volume / Edisi | : | 52 (No. 11) |
| Halaman | : | 701-705 |
| Abstrak | : | Obesity is a condition of excessive accumulation of body fat. Obesity has a greater risk of death from cardiovascular diseases. Heart failure is a clinical syndrome caused by structural and functional defects of the myocardium that result in impaired ventricular filling or blood ejection. This study was conducted to determine the relationship between obesity and mortality in heart failure patients at a teaching hospital in Yogyakarta. Methods: A cross-sectional quantitative study with an observational analytical research design from the secondary data from medical records of heart failure patients in January 2018–March 2024. Data was analyzed using Fisher’s exact test. Results: A total of 108 patients met the inclusion and exclusion criteria. Data analysis showed a p-value = 0.216 (>0.05). In this study, 61.1% of heart failure patients were male. The results showed that the mortality rate was higher in obese patients (11.1%) compared to non-obese patients (5.55%). Conclusion: There was no relationship between obesity and mortality among heart failure patients. |
The Effect of Vitamin D on the Immune System of Leprosy Patients
| Pengarang | : | Florentina Ranni Eka Rovanza |
| Nama Majalah/Jurnal | : | CDK Cermin dunia kedokteran |
| Volume / Edisi | : | 52 (No. 10) |
| Halaman | : | 697-700 |
| Abstrak | : | Leprosy is a chronic infectious disease caused by Mycobacterium leprae. Vitamin D is a fat-soluble vitamin that plays an important role in bone metabolism with an anti-inflammatory and immune-modulating properties. Recent studies show a role of vitamin D on the immune system of leprosy patients. Vitamin D in its active form (1,25 (OH)2 D binds to the vitamin D receptor on macrophages. Vitamin D stimulates the production of cathelicidin and defesin, antimicrobial peptides that can kill Mycobacterium leprae. Vitamin D enhances the Th1 immune response by producing IL12, which is important against intracellular bacteria. Vitamin D suppresses excessive TH2 immune response to prevent disease progression. Vitamin D deficiency has a strong negative correlation with increased levels of pro inflammatory cytokines such as TNF -α. TNF-α, an inflammatory modulator, has been found to be significantly elevated in skin lesions of leprosy patients experiencing type 2 leprosy reactions. High levels of TNF-α play a direct role in myelin sheath damage, bone resorption stimulation, and inhibition of bone collagen synthesis. These factors likely explain clinical symptoms such as neurological disorders and disability in leprosy patients. Based on the above findings, vitamin D has effects on the immune system of leprosy patients. |
Bibliometric Analysis of Nutritional Benefits in Sarcopenia
| Pengarang | : | Citra Pratiwi |
| Nama Majalah/Jurnal | : | CDK Cermin dunia kedokteran |
| Volume / Edisi | : | 52 (No. 10) |
| Halaman | : | 689-696 |
| Abstrak | : | The benefits of nutrition in sarcopenia include maintaining muscle mass and improving physical condition. The bibliometric analysis aims to visualize future trends and opportunities for nutritional research in sarcopenia. Methods: Data was gathered from the Scopus database. The BIBLIO checklist is used as a guideline for quantitative analysis of bibliographic data using keywords “diet”, “nutritional approach,” and “sarcopenia”, on literature published between 2015 and 2025. Selection of types, articles, reviews, and conference papers in English, with final or in-press publication status. Studies involving “nonhuman” subjects were excluded. Analysis was conducted using the R and VOSviewer to visualize author networks, keywords, and publication trends. Results: A total of 1,337 documents were found, with 57,860 citations, ranging from 117 to 13,203 document citations per year. H-index is 109. The top three journals were Clinical Nutrition (60 articles), Journal of Nutrition, Health and Aging (44 articles), and Frontiers in Nutrition (33 articles). Publications have increased over the past 10 years. The majority of publications were original articles (60.1%), followed by reviews (38.3%), and conference papers (1.5%). There are 5 clusters of co-occurrence topics from keywords. Conclusion: Research trends focus on sarcopenia prevention. Future studies could explore the effects of vitamin D and the mediterranean diet on sarcopenia. |
Diagnosis of Sarcopenia in Geriatrics using Actigraph wGT3XBT Accelerometer: A Narrative Review
| Pengarang | : | Fatmanur Hurulhanifa, Nimas Adiani Sekar Laranti, Hanifa Nur Shabrina, Norina Agatri, Gembong Satria Mahardhika |
| Nama Majalah/Jurnal | : | CDK Cermin dunia kedokteran |
| Volume / Edisi | : | 52 (No. 10) |
| Halaman | : | 683-688 |
| Abstrak | : | Sarcopenia is a degenerative condition of age-related decline in muscle mass and strength. The worldwide occurrence of sarcopenia varied from 8% to 36% in those under the age of 60, and from 10% to 27% in those aged 60 and above. There is 9.92% or around 26.82 million, elderly people in Indonesia. Several studies have stated that in 2020, the incidence of sarcopenia in Indonesia ranged from 9.1% to 59%. Various studies have shown that accelerometers can provide a quantitative measurement of physical activity, positively correlated with muscle mass and strength in the elderly. Accelerometers, particularly the Actigraph wGT3X-BT, offer an objective approach to measuring physical activity and provide important insights into sarcopenia. Accelerometers offer an unbiased method for quantifying physical activity, offering valuable information on sarcopenia, and serving as a clinical diagnostic tool for this disorder characterized by reduced muscle mass and function. Literature review suggests that the Actigraph wGT3X-BT accelerometer has great potential for early detection and diagnosis of sarcopenia. The integrated use of this technology is expected to improve the accuracy of diagnosis and enable more effective interventions, thereby improving the quality of life of the elderly in Indonesia. |