Medical Profession Journal of Lampung

Herpes Zoster of Right Facial Region

Resati Nando Panonsih — 2024-04-25

Herpes zoster is a manifestation of reactivation of latent endogenous infection of the varicella zoster virus in the neurons of the dorsal root sensory ganglion, cranial nerve ganglion or autonomic nerve ganglion which spreads to nerve tissue and skin in the same segment. Herpes zoster occurs sporadically throughout the year without knowing the season. The incidence of herpes zoster reaches two to three cases per thousand population each year. The incidence and severity of the disease increases with age. More than half of all cases reported occur in people over 60 years of age and complications occur in almost 50% of people in old age. Herpes zoster is rarely found at an early age (children and young adults), but when it occurs, it is likely due to maternal varicella during pregnancy. The incidence of herpes zoster in men and women is the same. The risk of disease increases with the presence of malignancy, or with bone marrow/kidney transplantation or HIV infection. There is no gender predilection. Herpes zoster is contagious but its transmission capacity is small compared to varicella. The treatment received by the patient was observing bleeding, checking vital signs periodically, and providing pharmacological treatment in the form of acyclovir 400mg tablets and acyclovir cream. Patients are advised to check in a week later. The prognosis for this patient is dubia ad bonam.

Secondary Amenorrhea

Fonda Octarianingsih Shariff — 2024-04-25

Primary amenorrhea is a condition where menstruation does not occur in women aged 16 years. This situation occurs in women of reproductive age 0.1-2.5%. Meanwhile, secondary amenorrhea is the absence of menstruation for three cycles or 6 cycles after previously having a normal menstrual cycle. The incidence rate is around 1 to 5% in women of reproductive age. Treatment or management of amenorrhea depends on the cause. If the cause is drastic weight loss or obesity, sufferers are advised to follow an appropriate diet. If the cause is excessive exercise, sufferers are advised to reduce it. If the cause is a tumor, then surgery is performed to remove the tumor. So basically treating amenorrhoea always requires the help of a doctor to help diagnose or find the cause. The patient came to the Pertamina Bintang Amin Husada Hospital polyclinic on February 6 2024 with complaints of no menstruation since 4 months accompanied by lower abdominal and back pain. The treatment obtained by the patient was observation of bleeding, checking vital signs regularly, norelut tab twice a day, 2 tablets for 5 days, the patient was advised to diet. The prognosis for this patient is dubia ad bonam. The working diagnosis in this case is secondary amenorrhea based on clinical considerations, physical examination findings, and supporting examinations.

Dysphonia in a Patient with Unilateral Plika Vocal Paresis

Melia Munasiah — 2024-04-25

Hoarse voice (dysphonia) is one of the reasons for consultation (1%) in all primary health services. Vocal cord paralysis is reduced movement or paralysis of the vocal cords. This situation is a manifestation of disease that occurs in the cranial cavity, larynx, thorax and mediastinum which causes paralysis of the vagus nerve and recurrent laryngeal nerve. Mr. I, a 56 year old male, came with complaints of sudden loss of voice. Complaints appeared 11 days before admission to the hospital (SMRS). Another complaint that is felt is that patients choke more easily when drinking. Complaints are felt to be getting worse day by day. The patient had previously been given antibiotics and anti-inflammatory drugs given at the puskesmas but there was no improvement either. The patient was previously hospitalized due to complaints of excessive vomiting. The patient's general status is within normal limits. LFO results showed adductor type unilateral paramedian vocal fold paralysis in the dextra paramedian position. The patient was given a physiotherapy plan and given steroids and vitamin B12. Voice therapy can be an effective treatment option in patients with unilateral paresis of the vocal folds and should be considered individualized according to the patient's age.

Comparison Between Video-Assisted Thoracoscopic Surgery versus Thoracotomy for Non Small Cell Lung Cancer : A Systematic Review and Meta-Analysis

Fuad Iqbal Elka Putra — 2024-04-28

Video-assisted thoracic surgery (VATS) lobectomy provides a minimally invasive approach for the management of early-stage lung cancer. This systematic review and meta-analysis is aim to provide the outcomes between VATS and thoracotomy lobectomy. The research is aim to compare between video-assisted thoracoscopis surgery and thoracotomy in non small cell lung cancer patient. Five articles databases were searched via PubMed. Primary outcomes were operative time, postoperative hospital stay, chest drainage volume, chest drainage time, and number of lymph node dissesction. Review Manager (RevMan) [computer program] version 5.4 was used to pool the data. There were significant results VATS has shorter postoperative length of stay (95% CI 1.08 to 4.83) and chest drainage volume (CI 25.83 to 344.98). There were not significant results in terms of operative time (95%CI -30.88 to 40.10), chest drainage time (95%CI -0.95 to 2.50), and number of lymph node rdissection (95%CI -0.67 to 1.740). VATS lobectomy is superior to thoracotomy lobectomy in terms of shorter postoperative length of stay (95% CI 1.08 to 4.83) and chest drainage volume (CI 25.83 to 344.98). The results also showed no significant differences between the two treatment modalities regarding the operative time, chest drainage time, and number of lymph nodes dissected.

Laporan Kasus: Case Report: Primigravida as a Risk Factor for Preeclampsia

Dinni Istiqomah — 2024-04-29

Hypertension in pregnancy (HDK) is one of the main causes of maternal death and is a significant cause of maternal and child morbidity. Preeclampsia is the presence of specific hypertension caused by pregnancy accompanied by disorders of other organ systems at a gestational age of more than 20 weeks. There are several risk factors for preeclampsia, namely nullipara (primigravida), age ≥ 40 years, BMI ≥ 35, family history of preeclampsia, multifetal pregnancy and pregnancy interval > 10 years. This study is a case report. Data was obtained from a 22 year old woman who came with complaints of being at term pregnant with complaints of heartburn accompanied by headaches, shortness of breath, nausea and vomiting since 3 weeks before hospital admission. The patient has suffered from hypertension since 7 months of pregnancy, but the patient does not regularly take medication. On physical examination, blood pressure was found to be 152/112 mmHg and urinalysis examination showed positive nitrite, protein 500 mg/dl. The patient was diagnosed with severe preeclampsia. Primigravida is the most important risk factor found in these patients. Several previous studies have shown that there is a relationship between primigravida and the incidence of preeclampsia, where preeclampsia occurs more often in primigravida than multigravida. There are various theories that explain the process of preeclampsia in primigravida, but no theory is considered absolutely correct to date. Therefore, intervention is needed for early prevention and early management of preeclampsia, especially in primigravida.

Proper Management of Underweight and Anemia in Tuberculosis Patients Increases The Improvement Time During Two-Week Treatment Follow-Up

Adityo Wibowo — 2024-04-30

Tuberculosis (TB) continues to be the leading cause of disease and mortality caused by chronic pulmonary infection. The World Health Organization (WHO) considers that one-third of the global population is infected with Mycobacterium tuberculosis (Mtb). Mycobacterium tuberculosis infection results in persistent lung damage, which is characterized by ongoing inflammation that damages lung tissue. The patient additionally experienced a cough for almost one month, with clear mucous, absence of blood, and mild shortness of breath. Patients had decreases in body weight and loss of appetite for about three weeks. Night sweats appeared within one month. There was no specific complaint of gastrointestinal symptoms. The patient's nutritional management was focused primarily on oral intake, with a total daily consumption of 1690 kcal. The daily protein, carbohydrate, and fat consumption is divided into 42.45 grams of protein, 253.5 grams of carbohydrates, and 37.5 grams of fat. There was no history of food allergy from the patient, therefore we decided not to impose any dietary restrictions. The improvement in body weight was used to monitor the outcome of the nutritional intervention. Nutritional issues have emerged as a significant contributor to an increasing percentage of individuals with low hemoglobin (Hb), influencing TB-related morbidity. The most prevalent causes of anemia in tuberculosis are nutritional deficiencies and malabsorption as a result of appetite loss. Poor intake of food has also been linked to an increased risk of disseminated TB. To improve treatment outcomes, nutritional support should be provided in addition to tuberculosis medicine.