Cermin Dunia Kedokteran

Overview of Chronic Osteomyelitis Cases at Level II Kartika Husada Hospital, Kubu Raya Regency, West Kalimantan Province January 2015 - December 2017

Cahayo Mahandro Mahandro — 2024-08-08

Osteomyelitis is a bacterial infection in bone or bone marrow. This study was a retrospective descriptive study of chronic osteomyelitis cases at Kartika Husada Level II Army Hospital of Kubu Raya Regency from January 2015 to December 2017 as well as a description of its management. There were 47 subjects taken based on their medical records. Surgical management was done in 39 cases (83.0%), consisting of debridement and sequestrectomy (33 cases), debridement (4 cases), and amputation (2 cases). Surgical management was combined with non-surgical management.

Qualitative Study of Hospital A's Emergency Room Management Strategy in Facing COVID-19 as Input for Management of the Threat of Infectious Disease Outbreaks

Willy Johan — 2024-08-08

Background: Reflecting on the COVID pandemic, many emergency departments (ED) experienced difficulties in responding to health crises caused by emerging infectious diseases. This qualitative research explores the strategic management of one of the hospital EDs assigned as a COVID referral hospital. Methods: In-depth interviews with 10 key informants, observation, and document analysis. Peer discussions with experts were also carried out to ensure the validity of the existing data. Results: The research results show that RS A prepared surge capacity (space, staff, supply, and system) before the crisis, and the disaster management system has been prepared and continuously updated. Conclusion: In addition to being designed to optimize medical services for emergency patients, emergency departments must also be prepared to deal with disasters. The spare capacity that has been prepared by the Hospital A Emergency Unit in the face of disasters can be fully utilized in the
COVID-19 pandemic.

Post-COVID-19 Neurological Disorders

Patricia Michelle Lukito — 2024-08-08

Post-COVID-19 neurological disorders, also known as post-covid neurology syndrome (PCNS), are an integral part of long COVID and include various health problems that can last for several weeks, several months, or even years. These neurological disorders can vary, such as postCOVID fatigue syndrome, ognitive impairment, anosmia and ageusia, headaches, or diseases such as stroke and GBS, which still require further research on the mechanisms. Until now, there has been no definitive diagnostic examination, so the history and physical examination must be precise. Further management is given according to the complaint.

Catamenial Pneumothorax: Pathophysiology, Diagnosis, and Management

Angelina Patricia Chandra — 2024-08-08

Catamenial pneumothorax is a rare condition in the spectrum of thoracic endometriosis syndrome (TES), women of reproductive age experience spontaneous pneumothorax episodes that occur around the time of menstruation. Although infrequent, cases of recurrent pneumothorax accompanied by a history of pelvic surgery, menstrual pain, and infertility should raise clinical suspicion. Diagnosis involves a comprehensive history, radiological examination, and video laparoscopy as the definitive diagnostic method. Management includes symptomatic management with pleural drainage, followed by minimally invasive operative therapy and hormonal therapy for 6-12 months post-initial management. The recurrence of catamenial pneumothorax remains a problem, and its prognosis and impact are not yet fully understood.

Morbus Hansen (MH) Reinfection and Inappropriate Methylprednisolone Use

wenly susanto — 2024-08-08

Background: Morbus Hansen (MH), or leprosy, is a chronic granulomatous infection caused by Mycobacterium leprae. This disease still has a negative stigma, leading to ostracism. Methylprednisolone use can affect the risk of leprosy re-infection. Case: A 55-year-old female with complaints of abdominal pain, nausea, vomiting, and weakness accompanied by an active leprosy reaction. The patient had a history of leprosy treatment at the Sumenep Health Center in 2000 and at Sumberglagah Leprosy Hospital in 2004, but did not return for an acid-fast bacilli (BTA) check after therapy. She takes methylprednisolone 4 mg once or twice daily to manage an itch or rash. Her dermatological status was a symmetrical leprosy reaction throughout the body, accompanied by erythematous nodules and ulcerated nodules. Smear MH examination results +3 in indirect bacteriology and 25 bacteria in indirect microbiology. Treatment for multibacillary leprosy for 12–18 months and education were planned to increase patient awareness and compliance and appropriate steroid drug use.

Necrotizing Enterocolitis, Sepsis, and Diarrhea Due to Cow’s Milk Allergy in A Full-Term Infant with Hypothyroidism

Runi Arumndari — 2024-08-08

Necrotizing enterocolitis (NEC) remains one of the most common gastrointestinal diseases in neonates, with high morbidity and mortality. An 8-day-old full-term baby girl was admitted with an initial diagnosis of sepsis and acute diarrhea due to a cow’s milk allergy. Her condition worsened on the 4th day of hospitalization with abdominal distention, bradypnea, and vomiting. An abdominal x-ray showed increased bowel gas. She had a slightly lowered FT4. The findings met Bell’s criteria for the diagnosis of NEC. After being given meropenem and levothyroxine for 7 days, she was discharged on the 12th day of hospitalization in good condition. NEC is allegedly to be a multifactorial disease, with predisposing factors of cow’s milk formula (CMF) feeding or not breast-fed since birth, sepsis, and hypothyroidism. The combination of clinical symptoms, radiologic findings, and risk factor tracing is important in the diagnosis and management of NEC.

Potential of Citicoline in Inhibiting Cognitive Function Decline in Mild Cognitive Impairment

Elvan Wiyarta — 2024-08-08

Background: Citicoline has been associated with the improvement of various neurological conditions. This article aims to explore the potential of citicoline in preventing cognitive decline in mild cognitive impairment (MCI). Methods: A comprehensive literature search was conducted through 10 databases. Studies selected should include adult with cognitive impairment using citicoline. Articles were selected according to specified inclusion and exclusion criteria. A critical review and Level of Evidence assessment is done. Results: From a total of 265 studies obtained, 15 were selected and analyzed. The results show that citicoline has the potential to prevent cognitive decline, in patients with MCI, Alzheimer’s disease, Parkinson’s disease, ischemic stroke, and also in healthy individuals. Although results were varied, citicoline has consistently shown significant improvements in Mini-Mental State Examination (MMSE) scores and other cognitive tests. Conclusion: Citicoline has a potential in preventing cognitive decline in MCI. More research is needed to understand its long-term effects and mechanism of action.

Amoxicillin versus Cotrimoxazole for Treating Non-severe Pneumonia: A Systematic Review

Riana Suwarni — 2024-08-08

Introduction: Pneumonia is still one of the common causes of death in children under 5 years old in low-middle-income countries. The common cause of pneumonia is bacteria, requiring antibiotics as treatment. This systematic review evaluates the efficacy of amoxicillin and cotrimoxazole in treating pneumonia. Methods: This systematic review used PRISMA rules to analyze Pubmed and Europe PMC articles. The dose, duration, and therapeutic failure of amoxicillin and cotrimoxazole were assessed. Results: A total of 336 articles were selected for title and abstract screening. Four articles met the requirements, and two were selected for systematic review analysis. A total of 20,646 patients were analyzed, 11,633 (56.3%) received amoxicillin and 9,013 (43.7%) received cotrimoxazole. There was no significant difference in treatment failure between amoxicillin and cotrimoxazole. Conclusion: Amoxicillin has the same efficacy as cotrimoxazole for the management of non-severe pneumonia in children under 5 years old.

Comparison of Effectiveness of Leflunomide with Methotrexate for Rheumatoid Arthritis Therapy

Kemal Akbar Suryoadji — 2024-08-08

Background: Rheumatoid arthritis (RA) is a chronic inflammatory autoimmune disease characterized by symmetrical joint involvement and extra-articular manifestations. Methotrexate and leflunomide are disease modifying anti-rheumatic drugs(DMARD) and use as treatment options for rheumatoid arthritis. This report aims to compare the effectiveness of leflunomide with methotrexate as therapy for rheumatoid arthritis. Methods: Literature search was carried out through three electronic databases: PubMed, Cochrane, and EBSCOHost with specific keywords based on PICO. Selection was in accordance with inclusion and exclusion criteria based on the clinical question. Selected literature was critically reviewed using an adapted instrument from the University of Oxford’s CEBM. Result: One systematic review and meta-analysis literature by Alfaro-Lara, et al, (2017) was obtained. The results showed a trend towards methotrexate in achieving response according to American College of Rheumatology (ACR20) (0.88 [95% CI: 0.74-1.06]; p = 0.18), reduction in joint swelling was greater with methotrexate (-0.82 [95% CI: 0.24-1.39]; p = 0.006), no significant difference in joint pain reduction (p>0.05). Liver enzyme elevations were more frequent with leflunomide (0.38 [0.27-0.53]; p = 0.007); gastrointestinal (GI) complaints were more frequent with methotrexate (1.44 [1.17-1.79]; p = 0.0007), no significant difference in the incidence of non-severe infections. Conclusion: Leflunomide has the same efficacy as methotrexate for RA therapy; more reduction of joint swelling with methotrexate. Leflunomide was associated with greater increases in liver enzymes, but fewer GI complaints.

Supporting Examinations for Hair Disorders

Adina Miltania Tasmil — 2024-08-09

Hair evaluation methods are grouped into three main categories: non-invasive methods (for example: questionnaire, daily hair counts, standardized wash test, 60-s hair count, global photographs, dermoscopy, hair weight, contrasting felt examination, phototrichogram, TrichoScan, and polarizing and surface electron microscopy), semi-invasive methods (for example: trichogram and unit area trichogram), and invasive methods (for example: scalp biopsy). This article explores supporting examinations for the diagnosis of hair disorders.