Anna Felita, Ivanna Sarahfebi, Anastasia Nadya, P. Anjali, Chandni P. Daryanani
Background Puberty is a transitional period in children with acceleration of growth and development of secondary sexual characteristics. When this period appears before the age of 8 to 9 years in children, it is called precocious puberty. Depending on the primary source of the hormonal production, precocious puberty may be classified as central (gonadotropin dependent or true) or peripheral (gonadotropin independent or precocious pseudo-puberty). Case presentation We herein report a case of precocious puberty in a 7,5-year-old girl who has shown early sign of secondary sexual development. Patients complained pain on her nipple, her breasts began to grow in size, and changes in her body odour, but had no complaints about her pubic hair growth and any vaginal discharge. Laboratory findings shown high level in fertility hormones and level of bone age is equal to 10-year-old girl. Patient then had begun to receive monthly therapy of Leuprolide. Conclusion Detailed history taking on chronological order of thelarche, pubarche, menarche, and adrenarche, followed by assessment on family history, nutritional history, child developmental history, medication history, and neurological complaints should be done in order to diagnose precocious puberty. Physical examination and other examination of bone age determination, Luteinizing Hormone and Follicle-Stimulating Hormone level, and pelvic ultrasound are essentials in defining the diagnosis and treatment. Leuprolide is indicated for Central Precocious Puberty patient who have advanced bone age at the time of initial evaluation. As a clinician, it is necessary to diagnose precocious puberty as soon as possible to have good prognosis for the patient.
{"title":"Precocious Puberty: A Case Report","authors":"Anna Felita, Ivanna Sarahfebi, Anastasia Nadya, P. Anjali, Chandni P. Daryanani","doi":"10.58376/mcu.v1i1.9","DOIUrl":"https://doi.org/10.58376/mcu.v1i1.9","url":null,"abstract":"Background \u0000Puberty is a transitional period in children with acceleration of growth and development of secondary sexual characteristics. When this period appears before the age of 8 to 9 years in children, it is called precocious puberty. Depending on the primary source of the hormonal production, precocious puberty may be classified as central (gonadotropin dependent or true) or peripheral (gonadotropin independent or precocious pseudo-puberty). \u0000Case presentation \u0000We herein report a case of precocious puberty in a 7,5-year-old girl who has shown early sign of secondary sexual development. Patients complained pain on her nipple, her breasts began to grow in size, and changes in her body odour, but had no complaints about her pubic hair growth and any vaginal discharge. Laboratory findings shown high level in fertility hormones and level of bone age is equal to 10-year-old girl. Patient then had begun to receive monthly therapy of Leuprolide. \u0000Conclusion \u0000Detailed history taking on chronological order of thelarche, pubarche, menarche, and adrenarche, followed by assessment on family history, nutritional history, child developmental history, medication history, and neurological complaints should be done in order to diagnose precocious puberty. Physical examination and other examination of bone age determination, Luteinizing Hormone and Follicle-Stimulating Hormone level, and pelvic ultrasound are essentials in defining the diagnosis and treatment. Leuprolide is indicated for Central Precocious Puberty patient who have advanced bone age at the time of initial evaluation. As a clinician, it is necessary to diagnose precocious puberty as soon as possible to have good prognosis for the patient.","PeriodicalId":406002,"journal":{"name":"Medical Clinical Update","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129708389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Putu Intan Kusuma Wardani, Christina Pretaliana, Henry Theo Prawira Sugitto, Eqen Desmonta, Kevin Hersan, Vannesa Shelly, Varda Natasya Hutapea, Fadhilla Liefya Zahraisha, Jeffrey Christian Mahardhika, Nafthalena, Theresia Monica Rahardjo
Background Hyperglycemic crisis is emergency caused by metabolic problems due to uncontrolled diabetes mellitus. Hyperglycemic crisis consists of Hyperosmolar Hyperglycemic State (HHS) and Diabetic Ketoacidosis. Both are caused by relative or absolute deficiency of insulin; deficiency of insulin could be caused by type 1 and type 2 diabetes. Case presentation A 46-year-old woman came to the emergency room of Unggul Karsa Medika Hospital presenting with breathlessness which had occurred for a week. Her breathlessness was more severe on the day she presented to the emergency room. One week before, she went to a clinic nearby because of epigastric pain, but after returning home she felt breathless. After a few days, her breathlessness started to worsen, so she decided to go to emergency room. The patient had severe acidosis and high blood glucose. Hyperglycemia protocol of rehydration and insulin drip intravenously, accompanied by sodium bicarbonate and potassium chloride were given. Mechanical ventilation was used. The patient was healed and discharged safely after 9 days of hospitalization. Conclusion Hyperglycemic crisis is one of true emergency that can lead to mortality, thus prompt diagnosis and treatment should be done. It is important for clinicians to differ between HHS and DKA. HHS is caused by the relative or absolute deficiency of insulin while DKA is characterized by absolute insulin deficiency which prevents the body from metabolizing carbohydrates and results in severe hyperglycemia. In DKA and HHS the main goal of therapy is to rehydrate, correct hyperglycemia, and to correct electrolyte imbalances.
{"title":"Hyperglycemic Crisis in Uncontrolled Diabetes Mellitus Type 2 Presenting as Breathlessness","authors":"Putu Intan Kusuma Wardani, Christina Pretaliana, Henry Theo Prawira Sugitto, Eqen Desmonta, Kevin Hersan, Vannesa Shelly, Varda Natasya Hutapea, Fadhilla Liefya Zahraisha, Jeffrey Christian Mahardhika, Nafthalena, Theresia Monica Rahardjo","doi":"10.58376/mcu.v1i1.13","DOIUrl":"https://doi.org/10.58376/mcu.v1i1.13","url":null,"abstract":"Background \u0000Hyperglycemic crisis is emergency caused by metabolic problems due to uncontrolled diabetes mellitus. Hyperglycemic crisis consists of Hyperosmolar Hyperglycemic State (HHS) and Diabetic Ketoacidosis. Both are caused by relative or absolute deficiency of insulin; deficiency of insulin could be caused by type 1 and type 2 diabetes. \u0000Case presentation \u0000A 46-year-old woman came to the emergency room of Unggul Karsa Medika Hospital presenting with breathlessness which had occurred for a week. Her breathlessness was more severe on the day she presented to the emergency room. One week before, she went to a clinic nearby because of epigastric pain, but after returning home she felt breathless. After a few days, her breathlessness started to worsen, so she decided to go to emergency room. The patient had severe acidosis and high blood glucose. Hyperglycemia protocol of rehydration and insulin drip intravenously, accompanied by sodium bicarbonate and potassium chloride were given. Mechanical ventilation was used. The patient was healed and discharged safely after 9 days of hospitalization. \u0000Conclusion \u0000Hyperglycemic crisis is one of true emergency that can lead to mortality, thus prompt diagnosis and treatment should be done. It is important for clinicians to differ between HHS and DKA. HHS is caused by the relative or absolute deficiency of insulin while DKA is characterized by absolute insulin deficiency which prevents the body from metabolizing carbohydrates and results in severe hyperglycemia. In DKA and HHS the main goal of therapy is to rehydrate, correct hyperglycemia, and to correct electrolyte imbalances.","PeriodicalId":406002,"journal":{"name":"Medical Clinical Update","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128713302","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Theresia Monica Rahardjo, Yoctaf Octora Kadam, Jeffrey Christian Mahardhika
Background Maternal Mortality Rate (MMR) is an indicator that reflects various aspects including the quality of healthcare from clinical standpoint, the quality of healthcare system, the quality of health insurance, the quality of referral systems and non-health aspects that related to healthcare such as economic, social, cultural, and education aspects. In order to reduce MMR, healthcare quality of maternity services should be increased. Patient satisfaction is one of indicators for healthcare quality. In this study, we aim to describe patient satisfaction in maternity room of Unggul Karsa Medika Hospital, Bandung, West Java, Indonesia. Methods This is a quantitative descriptive study conducted in Maternity Room, Unggul Karsa Medika Hospital, Bandung, West Java, Indonesia. The design of the study was cross-sectional. The research was conducted from April to June 2022. Minimal total sample of 97. Total sample that obtained in this study was 150 subjects. Sampling method used in this study was consecutive sampling. Results Percentage of total patient satisfaction of maternity room were slightly increasing from April to June 2022, with highest value was in June 2022 of 94,2%. Four out of six elements of patient satisfaction were increasing, which were speed of services, friendliness and responsiveness, clarity of information and instructions, and completeness of infrastructure and facilities. Conclusion Unggul Karsa Medika Hospital through its excellence service of maternity room has played a significant role to reduce maternal mortality rate in Indonesia, since good and increasing results in patient satisfaction of maternity room service from April to June 2022.
{"title":"Patient Satisfaction and Characteristics of Maternity Room from April to June 2022 at Unggul Karsa Medika Hospital","authors":"Theresia Monica Rahardjo, Yoctaf Octora Kadam, Jeffrey Christian Mahardhika","doi":"10.58376/mcu.v1i1.3","DOIUrl":"https://doi.org/10.58376/mcu.v1i1.3","url":null,"abstract":"Background\u0000Maternal Mortality Rate (MMR) is an indicator that reflects various aspects including the quality of healthcare from clinical standpoint, the quality of healthcare system, the quality of health insurance, the quality of referral systems and non-health aspects that related to healthcare such as economic, social, cultural, and education aspects. In order to reduce MMR, healthcare quality of maternity services should be increased. Patient satisfaction is one of indicators for healthcare quality. In this study, we aim to describe patient satisfaction in maternity room of Unggul Karsa Medika Hospital, Bandung, West Java, Indonesia.\u0000Methods\u0000This is a quantitative descriptive study conducted in Maternity Room, Unggul Karsa Medika Hospital, Bandung, West Java, Indonesia. The design of the study was cross-sectional. The research was conducted from April to June 2022. Minimal total sample of 97. Total sample that obtained in this study was 150 subjects. Sampling method used in this study was consecutive sampling.\u0000Results\u0000Percentage of total patient satisfaction of maternity room were slightly increasing from April to June 2022, with highest value was in June 2022 of 94,2%. Four out of six elements of patient satisfaction were increasing, which were speed of services, friendliness and responsiveness, clarity of information and instructions, and completeness of infrastructure and facilities.\u0000Conclusion\u0000Unggul Karsa Medika Hospital through its excellence service of maternity room has played a significant role to reduce maternal mortality rate in Indonesia, since good and increasing results in patient satisfaction of maternity room service from April to June 2022.","PeriodicalId":406002,"journal":{"name":"Medical Clinical Update","volume":"7 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115247430","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Tubo-ovarian abscess (TOA) is one of acute complications of pelvic inflammatory disease that usually occur in woman of childbearing age. Factors associated with TOA are reproductive age, Intra-Uterine Device (IUD) insertion, multiple sexual partners, and a history of a prior episode of PID. The classic presentation of a TOA includes abdominal pain, pelvic mass on examination, fever, and leukocytosis. However, prompt diagnostic evaluation must be undertaken to specify the diagnosis. Tubo-ovarian abscess can be found on imaging with ultrasonography, computed tomography (CT), or magnetic resonance imaging (MRI). Ultrasonography as the cheaper of all could be used as first-line diagnostic modality. This study presents an example of ultrasonography examination of 42-year-old woman presenting with stomach pain and fever. Abdominal ultrasonography was performed and we found abscess formation in adnexa. Emergency surgery was performed and antibiotics were given after surgery. This study showed us how abdominal ultrasound could diagnose tubo-ovarian abscess.
{"title":"Ultrasonography in Tubo-Ovarian Abscess: A Case Study","authors":"Muhamad Rafdhi, Ririn Angeline Limbong, Fransiska Ayu Septiani Pratama Putri, Daniel Riskiandi, Maxzillion Sky Kasnadi, Stefanie Sumartono, Apriani Lam, Syifa Navisah, Nadya Ariella, Mathias Rusli","doi":"10.58376/mcu.v1i1.17","DOIUrl":"https://doi.org/10.58376/mcu.v1i1.17","url":null,"abstract":"Tubo-ovarian abscess (TOA) is one of acute complications of pelvic inflammatory disease that usually occur in woman of childbearing age. Factors associated with TOA are reproductive age, Intra-Uterine Device (IUD) insertion, multiple sexual partners, and a history of a prior episode of PID. The classic presentation of a TOA includes abdominal pain, pelvic mass on examination, fever, and leukocytosis. However, prompt diagnostic evaluation must be undertaken to specify the diagnosis. Tubo-ovarian abscess can be found on imaging with ultrasonography, computed tomography (CT), or magnetic resonance imaging (MRI). Ultrasonography as the cheaper of all could be used as first-line diagnostic modality. This study presents an example of ultrasonography examination of 42-year-old woman presenting with stomach pain and fever. Abdominal ultrasonography was performed and we found abscess formation in adnexa. Emergency surgery was performed and antibiotics were given after surgery. This study showed us how abdominal ultrasound could diagnose tubo-ovarian abscess.","PeriodicalId":406002,"journal":{"name":"Medical Clinical Update","volume":"121 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114056350","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ilham Setiorizaldi, Amandianti Arimbi Tedjaningrum, Cindy Grace Panggabean, Enjelina Nangin, Jeffrey Christian Mahardhika, Chandni P. Daryanani
Dengue encephalopathy is a very common neurological complication of dengue fever. Dengue encephalopathy or dengue hemorrhagic fever (DHF) with Central Nervous System (CNS) involvement used to be considered a relatively rare condition. However, the number of cases reported in human studies were increasing every year. Many factors caused the encephalopathy dengue. Possible mechanisms are hepatic failure (hepatic encephalopathy), cerebral hypoperfusion (shock), cerebral edema (vascular leakage) electrolyte disturbances, and intracranial hemorrhage due to thrombocytopenia or coagulopathy, which are secondary mechanisms of hepatic failure. Computed Tomography (CT) scan or Magnetic Resonance Imaging (MRI) of brain can be done to make certain of the diagnosis. The results can suggest the presence of extensive involvement of the bilateral cerebellar region, brain stem, and thalamus along with peculiar rim enhancement. Treatment in Intensive Care Unit (ICU) with a multidisciplinary team is required due to the patients’ decreased level of consciousness, underlying problems of airway, breathing, and circulation, comorbidities, and considerations of specific etiology.
{"title":"Pediatric Dengue Encephalopathy: A Review","authors":"Ilham Setiorizaldi, Amandianti Arimbi Tedjaningrum, Cindy Grace Panggabean, Enjelina Nangin, Jeffrey Christian Mahardhika, Chandni P. Daryanani","doi":"10.58376/mcu.v1i1.5","DOIUrl":"https://doi.org/10.58376/mcu.v1i1.5","url":null,"abstract":"Dengue encephalopathy is a very common neurological complication of dengue fever. Dengue encephalopathy or dengue hemorrhagic fever (DHF) with Central Nervous System (CNS) involvement used to be considered a relatively rare condition. However, the number of cases reported in human studies were increasing every year. Many factors caused the encephalopathy dengue. Possible mechanisms are hepatic failure (hepatic encephalopathy), cerebral hypoperfusion (shock), cerebral edema (vascular leakage) electrolyte disturbances, and intracranial hemorrhage due to thrombocytopenia or coagulopathy, which are secondary mechanisms of hepatic failure. Computed Tomography (CT) scan or Magnetic Resonance Imaging (MRI) of brain can be done to make certain of the diagnosis. The results can suggest the presence of extensive involvement of the bilateral cerebellar region, brain stem, and thalamus along with peculiar rim enhancement. Treatment in Intensive Care Unit (ICU) with a multidisciplinary team is required due to the patients’ decreased level of consciousness, underlying problems of airway, breathing, and circulation, comorbidities, and considerations of specific etiology.","PeriodicalId":406002,"journal":{"name":"Medical Clinical Update","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131394838","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background Cryptorchidism or Undescended testis (UDT) is a common birth defect in male genitalia, in which at least one testicle is absent from the scrotum. The missing testicle can be found along the inguinal canal or in the ectopic case could go as far as the pre-pubic area or perineum. Case report A 35-year-old man came to the Unggul Karsa Medika Hospital with a complaint of a lump in the right groin. He said that his lump has been felt since the patient was a child, comes and goes, and has become more clearly visible in the last 2 weeks. On physical examination, a lump was found in the right inguinal area without discoloration and pain, with a negative Valsalva test, and no right testicle was found. Conclusion It is possible that abnormality in intrauterine hormonal function has a role in the etiology of UDT. Adult UDT usually happens due to late diagnosis by physician and lack of insight of the parents about surgery necessity and its complications. Reduced fertility, risk of cancer, testicular torsion, as well as psychological issues are factors that supports the need for surgery. Orchiectomy remains the treatment of choice for adult UDT, including in our case, due to the risk of testicular cancer.
{"title":"The Undescended Testis in Adult Life: A Case Report","authors":"Fabianus Ferdian Damario, Alicka Octorevia Witjaksono, Angela Mulyana Sugiaman, Kellen Clementine, Yeppy Arief Nurzaman","doi":"10.58376/mcu.v1i1.7","DOIUrl":"https://doi.org/10.58376/mcu.v1i1.7","url":null,"abstract":"Background \u0000Cryptorchidism or Undescended testis (UDT) is a common birth defect in male genitalia, in which at least one testicle is absent from the scrotum. The missing testicle can be found along the inguinal canal or in the ectopic case could go as far as the pre-pubic area or perineum. \u0000Case report \u0000A 35-year-old man came to the Unggul Karsa Medika Hospital with a complaint of a lump in the right groin. He said that his lump has been felt since the patient was a child, comes and goes, and has become more clearly visible in the last 2 weeks. On physical examination, a lump was found in the right inguinal area without discoloration and pain, with a negative Valsalva test, and no right testicle was found. \u0000Conclusion \u0000It is possible that abnormality in intrauterine hormonal function has a role in the etiology of UDT. Adult UDT usually happens due to late diagnosis by physician and lack of insight of the parents about surgery necessity and its complications. Reduced fertility, risk of cancer, testicular torsion, as well as psychological issues are factors that supports the need for surgery. Orchiectomy remains the treatment of choice for adult UDT, including in our case, due to the risk of testicular cancer.","PeriodicalId":406002,"journal":{"name":"Medical Clinical Update","volume":"4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131395505","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Angelina Vanessa Prasethio, Aldwin Wiranata Fam, Ayen Giovina, Hendi Fuki Lukmanta, Ingrid Anjani, Kadek Ayu Sri Purniawati, Komang Intania Putri Pelangi, Mutia Utami Ariani, Pinkan Al Shabrina, Mathias Rusli
Acute appendicitis is one of the most common diagnosis suspected in patients with acute abdominal pain. Classic symptoms such as right iliac fossa pain, anorexia, nausea, constipation, and vomiting only occur in 50% of cases. Thus, other diagnostic modalities are still needed to help doctors conclude the definitive diagnosis that lead to prompt treatment. Ultrasound examination of the abdomen could be good choice since it is relatively faster, cheaper, and quite accurate in diagnosing appendicitis. This study presents an example of ultrasonography examination of patient with abdominal pain suspected of appendicitis. Ultrasound imaging showed echoic inflamed fat with appendix diameter of 13,1 mm indicates acute inflammation of appendicitis. Dilated appendix which is more than 6 mm in size was one of the supportive sign to propose appendicitis. This finding was in line with the patient’s signs and symptoms, thus acute appendicitis was diagnosed. The patient went to surgery and appendectomy was performed. This study showed us how abdominal ultrasound could add diagnostic value to diagnose acute appendicitis.
{"title":"Ultrasonography Findings in Acute Appendicitis: A Case Study","authors":"Angelina Vanessa Prasethio, Aldwin Wiranata Fam, Ayen Giovina, Hendi Fuki Lukmanta, Ingrid Anjani, Kadek Ayu Sri Purniawati, Komang Intania Putri Pelangi, Mutia Utami Ariani, Pinkan Al Shabrina, Mathias Rusli","doi":"10.58376/mcu.v1i1.18","DOIUrl":"https://doi.org/10.58376/mcu.v1i1.18","url":null,"abstract":"Acute appendicitis is one of the most common diagnosis suspected in patients with acute abdominal pain. Classic symptoms such as right iliac fossa pain, anorexia, nausea, constipation, and vomiting only occur in 50% of cases. Thus, other diagnostic modalities are still needed to help doctors conclude the definitive diagnosis that lead to prompt treatment. Ultrasound examination of the abdomen could be good choice since it is relatively faster, cheaper, and quite accurate in diagnosing appendicitis. This study presents an example of ultrasonography examination of patient with abdominal pain suspected of appendicitis. Ultrasound imaging showed echoic inflamed fat with appendix diameter of 13,1 mm indicates acute inflammation of appendicitis. Dilated appendix which is more than 6 mm in size was one of the supportive sign to propose appendicitis. This finding was in line with the patient’s signs and symptoms, thus acute appendicitis was diagnosed. The patient went to surgery and appendectomy was performed. This study showed us how abdominal ultrasound could add diagnostic value to diagnose acute appendicitis.","PeriodicalId":406002,"journal":{"name":"Medical Clinical Update","volume":"33 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122197423","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Angelica Agnesia Rening, Aulia Okti Wulandari, Bherline Novita Wijaya, Destiya Ulfah Riany, Fiorentina Elitasari, Ignatius Jonathan, Ni luh Putu Trisanti, Veren Antonie, Mathias Rusli
Meningitis is defined as inflammation of the meninges, which consists of dura mater, arachnoid mater, and pia mater. Meningitis can be caused by infectious and non-infectious processes such as autoimmune disorders, cancer, drug reactions. Meningitis can have a varied clinical presentation. Symptoms such as fever, neck pain or stiffness, photophobia, headache, dizziness, confusion, delirium, irritability, and nausea or vomiting may present. Signs of increased intracranial pressure such as altered mental status, neurologic deficits, and seizures indicate poor prognosis. Meningitis is diagnosed through cerebrospinal fluid analysis. However, there is controversy that the lumbar puncture could lead to brain herniation in the presence of increased intracranial pressure. Thus, Computed Tomography Scan (CT scan) could be alternative modality. In this case, we present meningitis diagnosed with CT scan of brain.
{"title":"Meningitis Diagnosed With Computed Tomography Scan of Brain","authors":"Angelica Agnesia Rening, Aulia Okti Wulandari, Bherline Novita Wijaya, Destiya Ulfah Riany, Fiorentina Elitasari, Ignatius Jonathan, Ni luh Putu Trisanti, Veren Antonie, Mathias Rusli","doi":"10.58376/mcu.v1i1.15","DOIUrl":"https://doi.org/10.58376/mcu.v1i1.15","url":null,"abstract":"Meningitis is defined as inflammation of the meninges, which consists of dura mater, arachnoid mater, and pia mater. Meningitis can be caused by infectious and non-infectious processes such as autoimmune disorders, cancer, drug reactions. Meningitis can have a varied clinical presentation. Symptoms such as fever, neck pain or stiffness, photophobia, headache, dizziness, confusion, delirium, irritability, and nausea or vomiting may present. Signs of increased intracranial pressure such as altered mental status, neurologic deficits, and seizures indicate poor prognosis. Meningitis is diagnosed through cerebrospinal fluid analysis. However, there is controversy that the lumbar puncture could lead to brain herniation in the presence of increased intracranial pressure. Thus, Computed Tomography Scan (CT scan) could be alternative modality. In this case, we present meningitis diagnosed with CT scan of brain.","PeriodicalId":406002,"journal":{"name":"Medical Clinical Update","volume":"23 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131586512","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background Sudden sensorineural hearing loss (SSNHL) commonly known as sudden deafness, is an unexplained, rapid loss of hearing either all at once or over a few days in which patients experience a sudden drop in hearing. It is commonly linked to infections, head trauma, autoimmune diseases, iatrogenic, severe infections, blood circulation problems, neurological disorders, such as multiple sclerosis, disorders of the inner ear, such as Ménière’s disease, and even metabolic disorders such as diabetes mellitus. We presented a case of sudden sensorineural hearing loss in a secondary hospital in Indonesia to add more knowledge on this topic. Case presentation A 76-year-old male, had chief complain of a sudden right sided hearing loss. There were no other symptoms and he had no history of trauma to the ear. The patient had hypertension and consumed amlodipine and clonidine regularly. Patient had normal otoscopic and rhinoscopy examination results. Audiometry shown a hearing threshold of 37 dB in the left ear and 117 dB in the right ear, both in air and bone conducted pure-tone stimuli and tympanogram showed type As in both ears. A diagnosis of right ear sudden sensorineural hearing loss was made, and medical treatment consisted of methylprednisolone, acyclovir, mecobalamin, vitamin B6, ranitidine and omeprazole were given to the patient. Conclusion Pathophysiology of this disease are labyrinthine viral infection, labyrinthine vascular compromise, intracochlear membrane ruptures, and immune-mediated inner ear disease. In our case, we suspect that both ischemic vascular disease and viral infection as the cause of ISHHL. If there is no definitive or treatable etiology found, treatment regimen should be dictated by the most likely factors involved, which were systemic steroids and acyclovir in our case.
{"title":"Sudden Sensorineural Hearing Loss (SSNHL): Case Report","authors":"Fikrilah Abdul Azis, Afiya Shafa Kamilah, Arifiana Larasati Restyani, Athaya Miraghassani, Henny Widyastuti","doi":"10.58376/mcu.v1i1.8","DOIUrl":"https://doi.org/10.58376/mcu.v1i1.8","url":null,"abstract":"Background \u0000Sudden sensorineural hearing loss (SSNHL) commonly known as sudden deafness, is an unexplained, rapid loss of hearing either all at once or over a few days in which patients experience a sudden drop in hearing. It is commonly linked to infections, head trauma, autoimmune diseases, iatrogenic, severe infections, blood circulation problems, neurological disorders, such as multiple sclerosis, disorders of the inner ear, such as Ménière’s disease, and even metabolic disorders such as diabetes mellitus. We presented a case of sudden sensorineural hearing loss in a secondary hospital in Indonesia to add more knowledge on this topic. \u0000Case presentation \u0000A 76-year-old male, had chief complain of a sudden right sided hearing loss. There were no other symptoms and he had no history of trauma to the ear. The patient had hypertension and consumed amlodipine and clonidine regularly. Patient had normal otoscopic and rhinoscopy examination results. Audiometry shown a hearing threshold of 37 dB in the left ear and 117 dB in the right ear, both in air and bone conducted pure-tone stimuli and tympanogram showed type As in both ears. A diagnosis of right ear sudden sensorineural hearing loss was made, and medical treatment consisted of methylprednisolone, acyclovir, mecobalamin, vitamin B6, ranitidine and omeprazole were given to the patient. \u0000Conclusion \u0000Pathophysiology of this disease are labyrinthine viral infection, labyrinthine vascular compromise, intracochlear membrane ruptures, and immune-mediated inner ear disease. In our case, we suspect that both ischemic vascular disease and viral infection as the cause of ISHHL. If there is no definitive or treatable etiology found, treatment regimen should be dictated by the most likely factors involved, which were systemic steroids and acyclovir in our case.","PeriodicalId":406002,"journal":{"name":"Medical Clinical Update","volume":"14 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124871110","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Liyenka Belusi Tantra, Nathalia Gabriella, Stephanie Astrid Gunawan, Nabilla Aisya Zhavira, Theresia Monica Rahardjo, Epi Panjaitan, Peter Nugraha Soekmadji
Background Psoriasis is a chronic inflammatory skin disease with a strong genetic predisposition and autoimmune pathogenic traits. Psoriasis vulgaris is also called plaque-type psoriasis, and is the most prevalent type. Psoriasis vulgaris is chronic inflammatory disease and characterized by periods of attack and remission. The chronicity of psoriasis vulgaris can affect patient’s quality of life. Case presentation A 33-year-old male came to Unggul Karsa Medika Hospital’s outpatient department with itchy, scaly, red plaques all over his body except his palms, soles, and face. The patient went to the dermatologist because his symptoms were getting worse and worse. Dermatologic examination concludes the lesions as multiple, generalized, discrete, circumscriptive, elevated, dry, regular-discoid erythematous plaques with psoriasiform scales located at the patient’s head, ears, nape, back, chest, belly, both arms and legs. Conclusion The diagnosis of psoriasis vulgaris was made based on history and clinical symptoms, supported by histopathological results. Treatment optimization and transitioning for moderate-to-severe plaque psoriasis include methotrexate or cyclosporine, along with topical therapy and supportive therapy.
{"title":"Psoriasis: A Case Report","authors":"Liyenka Belusi Tantra, Nathalia Gabriella, Stephanie Astrid Gunawan, Nabilla Aisya Zhavira, Theresia Monica Rahardjo, Epi Panjaitan, Peter Nugraha Soekmadji","doi":"10.58376/mcu.v1i1.10","DOIUrl":"https://doi.org/10.58376/mcu.v1i1.10","url":null,"abstract":"Background \u0000Psoriasis is a chronic inflammatory skin disease with a strong genetic predisposition and autoimmune pathogenic traits. Psoriasis vulgaris is also called plaque-type psoriasis, and is the most prevalent type. Psoriasis vulgaris is chronic inflammatory disease and characterized by periods of attack and remission. The chronicity of psoriasis vulgaris can affect patient’s quality of life. \u0000Case presentation \u0000A 33-year-old male came to Unggul Karsa Medika Hospital’s outpatient department with itchy, scaly, red plaques all over his body except his palms, soles, and face. The patient went to the dermatologist because his symptoms were getting worse and worse. Dermatologic examination concludes the lesions as multiple, generalized, discrete, circumscriptive, elevated, dry, regular-discoid erythematous plaques with psoriasiform scales located at the patient’s head, ears, nape, back, chest, belly, both arms and legs. \u0000Conclusion \u0000The diagnosis of psoriasis vulgaris was made based on history and clinical symptoms, supported by histopathological results. Treatment optimization and transitioning for moderate-to-severe plaque psoriasis include methotrexate or cyclosporine, along with topical therapy and supportive therapy.","PeriodicalId":406002,"journal":{"name":"Medical Clinical Update","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130792049","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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