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A 23 year old Healthy Male with Syncope after Playing Futsal: A Case of Exertional Rhabdomyolysis
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| Pengarang | : | David Kristianus, Jonkie Budi Tirtadjaja |
| Nama Majalah/Jurnal | : | CDK Cermin dunia kedokteran |
| Volume / Edisi | : | 52 (No. 7) |
| Halaman | : | 480-483 |
| Abstrak | : | Exertional rhabdomyolysis (ER) is a medical condition resulting from strenuous exercise characterized by skeletal muscle damage followed by the release of intracellular components into the circulation. ER has various clinical manifestations and is associated with various complications that increase morbidity and mortality. Case: A 23-year-old male came to the emergency department with decreased consciousness after playing futsal. After urinary catheter insertion, brown-colored urine was observed. Laboratory examination showed increased serum CK level (199,011 IU/L), increased serum creatinine, hyperkalemia, and metabolic acidosis. The diagnosis was exertional rhabdomyolysis, acute kidney injury, hyperkalemia, and metabolic acidosis. Conclusion: The condition of the patient improved after aggressive intravenous rehydration, intravenous insulin, and sodium bicarbonate therapy. Prompt diagnosis and appropriate management can reduce complications, morbidity and mortality. |
Spontaneous Perirenal Hemorrhage in Patient with Antiphospholipid Syndrome
| Pengarang | : | William Adipurnama, Jacinda Risha Oktaviani, Nicholas Andrian Singgih, Cecilia Noviyanti Salim, Derry Wendians Suhanto, Egi Edward Manuputty, Budiawan Atmadja |
| Nama Majalah/Jurnal | : | CDK Cermin dunia kedokteran |
| Volume / Edisi | : | 52 (No. 7) |
| Halaman | : | 475-479 |
| Abstrak | : | Spontaneous perirenal hemorrhage (SPH), also known as Wunderlich syndrome, is a rare condition that can potentially progress into life-threatening non-traumatic retroperitoneal hemorrhage. Common symptoms include acute flank or abdominal pain, a palpable flank mass, and fulminant hypovolemia, collectively referred to as Lenk’s triad, and diagnosis is typically established radiologically using a CT scan. Antiphospholipid syndrome (APS) - a rare, immune-mediated hypercoagulable disorder that occurs in only 5 cases per 100,000 people per year worldwide. It is immune-mediated, characterized by persistent antiphospholipid antibodies (APLA) that cause both arteries and venous thrombosis, and can present as peripheral arterial disease (PAD), acute arterial occlusion, and early atherosclerosis. Case : A 33-year-old woman with chronic kidney disease (CKD) presented with SPH and incidentally diagnosed with peripheral arterial disease (PAD) and APS. Conclusion : Conservative management was beneficial for SPH without the need for surgical intervention; however, antithrombotic therapy for PAD posed additional challenges before the patient was eventually discharged in improved condition for outpatient follow-up. |
Unidentified Extraperitoneal Bladder Trauma: A Case with Normal Cystography
| Pengarang | : | Reza Affandi, Yufi Aulia Azmi, Soetojo Wirjopranoto |
| Nama Majalah/Jurnal | : | CDK Cermin dunia kedokteran |
| Volume / Edisi | : | 52 (No. 7) |
| Halaman | : | 471-474 |
| Abstrak | : | Bladder trauma is the second most commonly injured organ in the genitourinary system after the kidney. The injury can be caused by a variety of mechanisms, including blunt trauma, penetrating trauma, and iatrogenic procedures. Case: A 21-year-old male with multiple injuries following a motorbike accident. Upon examination, a foreign body was detected in the right thigh. A CT scan revealed a metal rod impaled in the patient’s bladder without any contrast leakage. The patient was planned for foreign body removal and bladder repair. During the removal, bladder leakage was detected. The patient underwent foreign body removal and bladder repair. Discussion: This case underscores the importance of considering bladder injury in trauma patients, even in the absence of classic clinical signs such as haematuria. It also highlights the potential limitations of initial imaging techniques like cystography in detecting bladder injuries when foreign bodies are present. Conclusion: This case emphasizes the importance of maintaining a high index of suspicion and considering intraoperative exploration or additional diagnostic methods when imaging findings are inconclusive. Revising the diagnostic protocol for trauma patients with suspected bladder injury, especially if a foreign body is present, is essential to avoid missed diagnoses and improve patient outcomes. |
Nasopharyngeal Carcinoma: Risk Factors, Early Detection, Diagnosis, and Management
| Pengarang | : | Evita Zevanya, Arin Dwi Iswarini |
| Nama Majalah/Jurnal | : | CDK Cermin dunia kedokteran |
| Volume / Edisi | : | 52 (No. 7) |
| Halaman | : | 460-470 |
| Abstrak | : | Nasopharyngeal carcinoma is a malignant tumor originating from nasopharyngeal epithelium; it is endemic in several regions, including Indonesia. This malignancy is the fourth most frequent cancer case in Indonesia. The etiology is not fully understood. The risk factors involve interactions between genetic and environmental factors, including age, gender, family history of nasopharyngeal carcinoma, consumption of fermented foods, and Epstein-Barr virus (EBV) infection. Early detection used EBV serology, EBV DNA plasma, and endoscopy; the IgG NPC strip is commonly used in Indonesia. The gold standard for diagnosis is biopsy and histopathological examination. The management of the disease depends on its stage. Intensity-modulated radiotherapy (IMRT) has shown several advantages over conventional radiotherapy. Follow-up is necessary to evaluate the outcome and remission. |
Diagnosis and Management of Cerebral Tuberculoma
| Pengarang | : | Lulu Anandita Putri |
| Nama Majalah/Jurnal | : | CDK Cermin dunia kedokteran |
| Volume / Edisi | : | 52 (No. 7) |
| Halaman | : | 456-459 |
| Abstrak | : | Cerebral tuberculoma is a rare but serious manifestation of tuberculosis (TB) caused by Mycobacterium tuberculosis infection in the central nervous system. This granulomatous lesion, characterized by necrotic tissue in the brain parenchyma, accounts for approximately 1.4% of all TB cases. It predominantly affects high-risk populations including children, HIV/AIDS patients, and immunocompromised individuals. Clinical diagnosis remains challenging due to nonspecific symptoms such as persistent headaches, seizures, and focal neurological deficits that often mimic brain tumors. Advanced neuroimaging, particularly MRI, plays a crucial diagnostic role by demonstrating pathognomonic ring-enhancing lesions with surrounding edema. Cerebrospinal fluid analysis typically reveals lymphocytic pleocytosis, though its sensitivity is limited. Current treatment protocols recommend prolonged (minimum 12 months) combination anti-tuberculosis therapy using isoniazid and rifampin as firstline agents. Adjuvant corticosteroids are indicated for managing paradoxical reactions and cerebral edema. Neurosurgical intervention becomes necessary for large lesions (>2 cm) causing mass effect or hydrocephalus. With timely diagnosis and appropriate treatment, the prognosis is favorable, achieving up to 85% cure rates. However, delayed intervention significantly worsens outcomes, emphasizing the importance of early recognition in endemic regions. This condition highlights the neurological burden of TB and the need for improved diagnostic strategies. |
Comparison of Pre- and Postoperative IOP in Triamcinolone-Assisted Vitrectomy Patients with and without Lens Surgery
| Pengarang | : | Ade John Nursalim, Vera Sumual, Ardelia Emily Wulur |
| Nama Majalah/Jurnal | : | CDK Cermin dunia kedokteran |
| Volume / Edisi | : | 52 (No. 7) |
| Halaman | : | 449-455 |
| Abstrak | : | This retrospective study evaluates the impact of triamcinolone-assisted vitrectomy on intraocular pressure (IOP) in patients undergoing vitreoretinal surgery, with particular focus on comparing outcomes in patients with and without lens surgery. Methods: Medical records of patients treated at R.D. Kandou Hospital from May 2019 to May 2024 were reviewed, and pre- and postoperative IOP values were analyzed. A total of 35 patients met the inclusion criteria. Results: The results show a significant reduction in IOP at all postoperative intervals, with mean differences of 11.12 mmHg at 1 day, 8.60 mmHg at 1 week, 13.23 mmHg at 1 month, and 16.91 mmHg at 3 months postoperatively. Analysis revealed no significant difference in IOP outcomes between phakic and pseudophakic patients. Conclusion: These findings indicate that triamcinolone-assisted vitrectomy effectively lowers IOP, regardless of lens status. |
Relationship between Stress Level and Quality of Life of Tuberculosis Patients at Puskesmas Perumnas II Pontianak, Indonesia
| Pengarang | : | Shella Sakila, Agus Fitriangga, Muhammad In’am Ilmiawan |
| Nama Majalah/Jurnal | : | CDK Cermin dunia kedokteran |
| Volume / Edisi | : | 52 (No. 7) |
| Halaman | : | 439-448 |
| Abstrak | : | Tuberculosis patients need long-term treatment. The effects of anti-tuberculosis drugs and stigma in society may cause stress, which can decrease the patient’s quality of life. This research aims to search for the correlation between stress level and quality of life in tuberculosis patients in Puskesmas Perumnas II Pontianak. Methods: An analytical study with a cross-sectional approach was conducted in January 2021 at Puskesmas Perumnas II Pontianak. The total sampling technique acquired 24 respondents. Analysis was performed using the Spearman rank correlation test. Results: The stress level was 83.3% in normal stress, 8.3% mild stress, 8.3% moderate stress, 79% of respondents had a good quality of life, and 21% of respondents had a poor quality of life. The Spearman rank correlation test results showed no significant correlation between stress level and quality of life (p=0,195). Conclusion: No significant correlation between stress level and quality of life in tuberculosis patients in the Puskesmas Perumnas II Pontianak. |
Germ Pattern of Culture Examination Results at Siti Fatimah Hospital Palembang City, South Sumatra, Indonesia
| Pengarang | : | Dedi Yanto Husada, Ririn Eviningtyas |
| Nama Majalah/Jurnal | : | CDK Cermin dunia kedokteran |
| Volume / Edisi | : | 52 (No. 7) |
| Halaman | : | 433-438 |
| Abstrak | : | Bacterial culture examination is the diagnostic standard for various infectious diseases. This descriptive research aims to determine the microorganism pattern in culture examinations at Siti Fatimah Regional Hospital, Palembang, South Sumatra, Indonesia. Methods: Secondary data were from records of microorganism culture examination results at the Clinical Pathology Laboratory of Siti Fatimah Regional Hospital, South Sumatra Province, from January to December 2022. Result: During that period, 217 samples were collected from various sources: 64 (29.5%) blood samples, 25 (11.5%) urine samples, 47 (21.7%) pus samples, 64 (29.5%) sputum samples, and 17 (7.8%) body fluid samples. Most samples’ characteristics were from patients who were >18-60 years old, male, and non-intensive inpatient ward patients. A total of 137 (63.1%) samples showed positive growth, mostly from sputum (60 samples; 93.8%), with the majority of bacteria being Klebsiella pneumoniae (11 samples; 18.3%). The most frequently detected bacteria in blood and urine cultures was Pseudomonas aeruginosa, in 5 samples (29.5%) and 3 samples (27.3%), respectively. Staphylococcus aureus was largely seen in pus (8 samples; 20%) and body fluid (3 samples; 33.3%) cultures. Conclusion: The results of the culture examination showed that most positive germ growth came from sputum, with the most bacteria found being Pseudomonas aeruginosa, Staphylococcus aureus, and Klebsiella pneumoniae. |
Effectiveness of Influenza Vaccine on the Risk of Pneumonia Complications in Children
| Pengarang | : | Devina Subagio, Devani Subagio |
| Nama Majalah/Jurnal | : | CDK Cermin dunia kedokteran |
| Volume / Edisi | : | 52 (No. 6) |
| Halaman | : | 427-732 |
| Abstrak | : | Influenza is an acute respiratory infection (ARI) caused by the influenza virus. World Health Organization (WHO) states that influenza virus infection causes 99% deaths in children under 5 years of age in developing countries. Transmission between individuals is fast because the influenza virus is transmitted through droplets. Symptoms of influenza disease vary; most are mild and self-limiting, but in some cases, it can cause severe complications and have an impact on mortality. Pneumonia is one of the most common complications of influenza, especially in the pediatric population. Influenza vaccination is an effective option for preventing infection and its complications. Several studies have shown that influenza vaccination can reduce influenza cases and the incidence of influenza-related pneumonia hospitalizations. |
Comparison of Efficacy and Safety of Inactivated Influenza Vaccine and Deadly Influenza Vaccine in Children with Asthma: A Systematic Review and Meta-Analysis
| Pengarang | : | Arohid Allatib, S.Ked, dr. Handre Putra, Sp.A, Mahfudz Shidiq, S.Ked, Pedro Markus Sanggara Purba, S.Ked, Etheldreda Oleshya Keylavan Wibowo Viera |
| Nama Majalah/Jurnal | : | CDK Cermin dunia kedokteran |
| Volume / Edisi | : | 52 (No. 6) |
| Halaman | : | 418-426 |
| Abstrak | : | Asthma patients are at higher risk of experiencing respiratory morbidity due to influenza, vaccination is recommended for this group. This study aims to compare the efficacy and side effects between live-attenuated influenza vaccines (LAIV) and inactivated influenza vaccines (IIV) in asthmatic children. Methods: This research use PRISMA guidelines, with studies sourced from PubMed, Cochrane, and Embase. ROB2 and ROBINS were employed to assess the risk of bias. Quantitative analysis was performed using Review Manager v5.4. Results: A total of 4,753 samples were collected, consisting of 2,390 intervention patients and 2,363 control patients. The meta-analysis results showed that influenza infection was more likely to occur in patients who received the inactivated influenza vaccine [pooled OR = 0.58; 95% CI (0.43, 0.78)}. Conclusion: The recommended vaccine type is the live-attenuated influenza vaccine, as no significant differences in side effects were observed between the two vaccines. |