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Hyperthyroid Heart Disease With Some Comorbidities Hasanuddin, Abdi Dzul Ikram; Dunggio, Sandra; Zubaidi, Hannan
Green Medical Journal Vol 2 No 1 April (2020): Green Medical Journal
Publisher : Fakultas Kedokteran Universitas Muslim Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (272.231 KB) | DOI: 10.33096/gmj.v2i1.39

Abstract

Thyroid disease is quite common. The cardiovascular clinical manifestations of hyperthyroidism are palpitation, systolic hypertension, fatigue, or with the basis of existing heart disease, angina or heart failure. In men, the disease is more frequently to develop into congestive heart failure than in women, thus more exploration is needed. This case report discussed a 42-year-old male patient who was admitted to the emergency department due to palpitations, shortness of breath aggravated with activity and lie down position, and alleviated with resting, cough with white sputum, epigastric pain, and constipation since the past 3 days. He was diagnosed with a history of hyperthyroidism and congestive heart disease 1 year ago and routinely consumed propylthiouracil (PTU). He had a history of herniotomy 10 days before admission. The patient did not have a history of hypertension, diabetes mellitus, or hypercholesterolemia. The patient has a smoking habit of up to 3 packs/day since a teenager. The patient was diagnosed with hyperthyroid heart disease (congestive heart failure, atrial fibrillation, and coronary heart disease) with comorbid of electrolyte imbalance, hypoalbuminemia, and thrombocytopenia. The patient was treated in the Intensive Care Unit (ICU) and was given oxygen therapy, crystalloid infusion, antithyroid drug, beta-blocker, diuretics, digitalis, anti-angina, anti-thrombotic, and adjunct therapy. The patient was treated for 8 days in ICU, followed by 2 days in the ward with a good outcome. Early detection and intervention followed by close monitoring is key management for the patient with hyperthyroid heart disease, especially in a male patient, to achieve a better outcome.
Immune Response toward Mycobacterium Tuberculosis Infection Ikram Hasanuddin, Abdi Dzul; Roswita, Nanang; Virnanda Amu, Ivan
Green Medical Journal Vol 2 No 2 August (2020): Green Medical Journal
Publisher : Fakultas Kedokteran Universitas Muslim Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33096/gmj.v2i2.47

Abstract

Understanding the human immune response toward Mycobacterium tuberculosis infection is important for controlling its infection. Its transmission through the air consists of "droplets nuclei" containing TB bacilli. After initial infection, the human body will provide diverse immune responses and will determine different clinico-histopathologic finding. This response starts from innate immunity that consists of phagocytosis by distal alveolar macrophages or nasal microfold cells, then will be continued by dendritic cells to be transferred to mediastinal lymph nodes to induced adaptive immune responses. This response is mediated by cells through IFN- γ signaling which will enhance phagocytosis. If this response is effective, there will be a latent infection with an initial histopathological finding of caseosa granulomas and predominantly followed by chronic granulomas. In a few cases, it can be reactivated via the IL-10 activation pathway and exogenous factors, it will induce a great adaptive immune reaction and provide more severe clinico-histopathological manifestation. The existence of the human body's immune response to Mycobacterium tuberculosis, etiher innate or adaptive immunity will determine the clinical course and pathology that will occur.
Persistence Detection of Sars-Cov-2 RNA in Healthcare Workers with COVID-19: A Case Report Jum Ahmad, Ilzy; Mulyo, Sostro; Ikram Hasanuddin, Abdi Dzul
Green Medical Journal Vol 2 No 3 December (2020): Green Medical Journal
Publisher : Fakultas Kedokteran Universitas Muslim Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33096/gmj.v2i3.63

Abstract

Coronavirus Disease 2019 (Covid-19) has now become a concern around the world. Until 6 September 2020, there were 190,665 cases in Indonesia, and it was in the third rank of most cases in the Asian region. It is important to determine the criteria of return to work for healthcare workers with Covid-19 positive in Indonesia. This case report discussed a female patient, 32 years old with chief complaint of fever and itchy throat since 2 days ago. She is a health care worker in the hospital, with a history of treating patients with positive confirmation of Covid-19 for 2 days in the ordinary ward before the case was confirmed with a history of contact approximately 5 days ago. The patient was diagnosed with positive confirmation of Covid-19 and was required for self-isolation. The patient still had positive results of RT-PCR Covid-19 up to the third examination in 30 days after the initial RT-PCR testing, although received specific antiviral treatment with oral oseltamivir and oral supplementation. Based on growing evidence that Sars-Cov-2 may not infectious for more than ten days in the mild-moderate disease, this case report is strengthening the use of symptom-based strategic approach to determine when to return to work in Indonesian healthcare workers with positive COVID-19.