Cermin Dunia Kedokteran

Germ Pattern of Culture Examination Results at Siti Fatimah Hospital Palembang City, South Sumatra, Indonesia

Dedi Yanto Husada — 2025-07-07

Introduction: 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.

Relationship between Stress Level and Quality of Life of Tuberculosis Patients at Puskesmas Perumnas II Pontianak, Indonesia

Shella Sakila — 2025-07-07

Introduction: 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.

Comparison of Pre- and Postoperative IOP in TriamcinoloneAssisted Vitrectomy Patients with and without Lens Surgery

Ade John Nursalim — 2025-07-07

Introduction: 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.

Diagnosis and Management of Cerebral Tuberculoma

Lulu Anandita Putri — 2025-07-07

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.

Nasopharyngeal Carcinoma: Risk Factors, Early Detection, Diagnosis, and Management

Evita Zevanya — 2025-07-07

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.

Unidentified Extraperitoneal Bladder Trauma: A Case with Normal Cystography

Reza Affandi — 2025-07-07

Introduction: 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.

Spontaneous Perirenal Hemorrhage in Patient with Antiphospholipid Syndrome

William Adipurnama — 2025-07-07

Introduction: 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.

A 23-year-old Healthy Male with Syncope after Playing Futsal: A Case of Exertional Rhabdomyolysis

David Kristianus — 2025-07-07

Introduction: 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.

Effect of Smoking on the Incidence of Cutaneous Squamous Cell Carcinoma: Evidence-based Case Report

Faiqueen Dhia Salsabila Firlana Adnan — 2025-07-07

Introduction: Cutaneous squamous cell carcinoma (SCC) is the second most prevalent skin cancer in the world. The correlation between smoking and cutaneous SCC is still inconclusive. Methods: Further investigation through literature search was conducted in 3 databases, which were PubMed, Scopus, and Cochrane. The investigators also conducted hand searching by examining references in each acquired article. Selection of articles is based on established inclusion and exclusion criteria. Critical appraisal used instruments from the Oxford Centre for Evidence-Based Medicine and the CASP checklist. Results: All four selected articles show that smokers have a higher risk of cutaneous SCC with OR 1.08 to 2.96. Conclusion: Smoking increases the risk of cutaneous SCC.

Statin Efficacy in the Management of Graves' Ophthalmopathy

Maria Vania Tri Ekaputri — 2025-07-07

Graves’ ophthalmopathy (OG) is an ocular manifestation of autoimmune thyroid disease. The inflammation and tissue remodeling of OG can cause mild to severe symptoms that can damage the nerves in the eye and lead to blindness. Early identification of diagnosis, classification of activity and severity of the disease, and risk factors for the disease are crucial. Those steps can support comprehensive further management to prevent severe and permanent damage. The complex interactions between endogenous (unmodifiable), exogenous (modifiable), and environmental factors play as risk factors for OG development. Hypercholesterolemia which is also caused by long-term systemic inflammation is one of the risk factors associated with OG. Hypercholesterolemia can be treated by administering statin. Beside it’s role in lowering cholesterol level, statins have preventive and therapeutic effects especially in patient with active moderate to severe OG. Statin also have pleiotropic effects, act as immunoregulator, inhibiting adipogenesis and synergize with methylprednisolone in management of OG.

Effectiveness of Color Vision Aids and Devices for Color Blind Patients

Petra Irfanya — 2025-07-07

Introduction: Color blindness, or color vision deficiency, is an eye condition that can reduce quality of life. Tinted contact lenses have been researched as a potential tool for correcting color blindness. Methods: This review aims to identify the effectiveness of color blindness aids and devices for patients with color vision deficiency as an alternative to enhance their quality of life. Article searches were conducted through electronic databases Google Scholar and PubMed using the keywords “color vision deficiency device,” “color blindness device,” and “color vision deficiency management.” Inclusion criteria included articles published between 2018-2023, full texts, writing in English, alignment of titles with abstracts, and validity of research methods. Results: The literature search yielded 98 articles; 8 articles met the inclusion criteria. Analysis of these 8 articles showed that color blindness devices and aids provide subjective new color perception and interpretation for color-blind individuals, but the objective effectiveness of these tools was not significant. Conclusion: The importance of public awareness of color blindness and the importance of developing more effective color-blind tools and devices. Further research is needed to develop color blindness devices and aids.

Role of Extended Focused Assessment with Sonography for Trauma (eFAST) in Thoracic and Abdominal Trauma Patients

Liem Marcella Nathania — 2025-07-07

Trauma is the biggest cause of death in young people. Among these traumas, 80% are blunt traumas, mostly to the thorax and abdomen. Blunt trauma can cause bleeding, which increases mortality. Prompt intervention can reduce mortality. eFAST (extended focused assessment with sonography for trauma) is a bedside ultrasound examination indicated for abdominal and thoracic trauma patients, which is limited to 4 examination windows in the abdomen to evaluate for hemoperitoneum, hemothorax, and pericardial effusion. The eFAST examination uses ultrasound equipment that is widely available in the emergency department and can be performed bedside, making it less time-consuming. eFAST has a high sensitivity and specificity, which is helpful in its role as a screening modality. The eFAST examination has many advantages, such as ease of use, being noninvasive, being fast, being easy to find, and not using radiation or contrast material, making it safe for children and pregnant women, and being inexpensive. The eFAST examination is important for the diagnosis of thoracoabdominal trauma, as it enables rapid screening.