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Helmi Ismunandar
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Uveitis Intermediet dengan Glaukoma Sekunder Okuli Sinistra Desty Marini; Rani Himayani; Helmi Ismunandar
Medula Vol 10 No 1 (2020): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v10i1.44

Abstract

Uveitis is inflammation that occurs in the uvea tract. Intermediate uveitis is inflammation of the vitreous body, the retinal blood vessels. The most caused of secondary glaucoma is inflammation of the eye. Glaucoma is one thah cause increases intraocular pressure causing optic nerve damage and interference with the visual loss. Case description, female patients within 32 years came with the main complaint that the left eye visual loss since one week ago. Complaints the patients are headache, nausea, vomiting at three times, and glare when the eyes exposed to sunlight. Headache especially in the left eyelid. Wearing glasses (+), red eye history (+). Ophthalmological examination found on right eye visus 2/60, left eye visus 1/300, right eye intraocular pressure 10mmHg and left eye 58mmHg. Examination of the anterior segment of the right eye was within normal, anterior segment of the left eye was palpebra pseudoptosis, fornix and bulbi, tarsal conjunctiva injection, ciliary injection, corneal edema, precipitous keratic, deep anterior chamber, hypopion of zero point five millimeters, pupil dilatation, iris kripta, pupillary reflexes, the lens, vitreous not visible because the media was heavy. The mechanism of IOP increase in open-angle glaucoma caused by uveitis were hypersecretion, blockage of the trabecular meshwork, inflammation of the trabecular meshwork, trabeculum and endothelium damage, and glaucoma caused long-term use corticosteroids. Treatment used was carbonic anhydrase inhibitors, beta adrenergic inhibitors, topical and systemic anti-inflammatory drugs.
Osteochondritis Dissecans Helmi Ismunandar
Medula Vol 10 No 1 (2020): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v10i1.50

Abstract

Osteochodritis dissecans (OCD) is a focal change in the subcondral bone. This alteration results in either partial or complete osteochondral fragmentation. OCD usually suffered by athletes (children, adolescents, or adults). Osteochondritis dissecans is source of pain and knee dysfunction during adolescent growth. It need to detected early to avoid secondary osteoarthritis. It most commonly occurs in the knee (75%), elbows (5%), and ankles (4%). Total incidence of OCD in the distal femur is 6,09 per 100.000 people per year. Male’s incidence (8,82-10 per 100.000) is higher than women’s (3,32- 4,04 per 100.000). Juvenile type knee OCD usually occurs at age 11,3-13,4 years. The average age on adult OCD is 17- 36 years. The pathogenesis of OCD is still not fully understood. Impact injuries can cause edema or bleeding in the subarticular bone. Local ischemic arises due to capillaries squeezing or thrombus formation. In certain circumstances, osteochondral fractures or fragmentation can occur. OCD can be treated both nonoperatively and operatively.
Pengaruh Pemberian Kombinasi Citosan Dan Cangkang Kulit Telur Sebagai Tandur Tulang Pada Penanganan Fraktur Helmi Ismunandar
Medula Vol 10 No 2 (2020): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v10i2.53

Abstract

Fracture management affects the quality and quantity of osteogenic responses. Chitosan plays an important role in bone tissue engineering in the last two decades. Chicken eggshell contains apatite hydroxy, calcium, strontium, boron, zinc, copper, fluoride, magnesium, iron, and phosphorus which are needed in the process of bone healing. This is a comparative laboratory experimental research. There are 2 treatment groups. Rat’s right femur in both groups were fractured. There was no bone graft administration at Group I, whereas there was bone graft administration at group II. The bone graft was combination of citosan and eggshell. Histological examination was performed at 5th week and It was assessed by Salkeld score. In group I, the mean Salkeld histological score was 0.4 ± 0.5. In group II the mean Salkeld histological score was 1.2 ± 0.8. Kalseld's histology score in group II was higher than the first group. Based on the Mann-Whitney examination, it can be concluded that there is a significant difference (p <0.035) in the bone healing process between group I and group II.
Perforated Corneal Ulcer and Iris Oculi Sinistra Prolapse Fitriani Antika Dhamayanti; Rani Himayani; Helmi Ismunandar
Medula Vol 9 No 4 (2020): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v9i4.222

Abstract

Corneal ulcer is a pathological condition of the cornea characterized by suppurative infiltrates accompanied by a resonating corneal defect,corneal tissue discontinuity that can occur from the epithelium to the stroma. Corneal ulcers can occur due to trauma by foreign objects or diseases that cause the entry of bacteria or fungi into the cornea, causing infection or inflammation. Mr. 90 years old came with complaints that the left eye cannot see accompanied by bleeding out of clot. This complaint begins with the trauma he experienced since 1 week ago. Complaints that are felt by red eyes (+), pain (+), blurred vision (+), glare (+), swelling of the eyelids (+) and then a fluid in the form of blood and white fluid accompanied by thick yellowish from his left eye. On physical examination obtained ophthalmological status obtained 6/60 right eye vision, left eye vision zero visual field. In the superior palpebra et inferior oculi sinistra there is edema (+), NLP vision, conjunctival injection (+), ciliary injection (+), corneal perforation and cloudy stromal infiltrate (+), prolapsed iris with blood clots and yellowish fluid. The treatment given to these patients is in the form of operative and non-operative management. The operative action performed on this patient is oculi sinistra eviseration. The non-operative action taken is Ceftriaxone 2x1 gram injection, As. Mefenamat 3x500mg, Ranitidine 2x1 amp, Gentamicin Salp.
Laporan Kasus : Anak Perempuan Usia 12 Tahun dengan Selulitis Preseptal Nabila Fatimah Az-Zahra; Rani Himayani; Helmi Ismunandar
Medula Vol 9 No 4 (2020): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v9i4.226

Abstract

One of the most common infections of the eyelid and periorbital soft tissues is preseptal cellulitis that is characterized by acute eyelid erythema and edema. Preseptal cellulitis are much more common in young children than adults. In addition, preseptal cellulitis is more frequent than orbital cellulitis. Preseptal cellulitis occurs anterior to the orbital septum. Preseptal cellulitis is a common infection of the eyelid and periorbital soft tissue that is characterized by acute erythema and edema of the eyelid.Most preseptal cellulitis is caused by local spread of sinusitis or adjacent dacryocystitis, external eye infection, or after trauma to the eyelidPreseptal cellulitis generally occurs in children rather than adults.Radiological examination such as imaging with MRI or CT is not indicated unless suspected orbital cellulitis or eyelid abscess is present, or there is a failure to respond to therapy.Administration of antibiotics in patients with preseptal cellulitis caused by bacterial infection must be started as soon as possible.This study discusses the case of girl with preseptal cellulitis who were treated with appropriate antibiotics.
Endoftalmitis Et Causa Ulkus Kornea dan Glaukoma Sekunder dengan Penyakit Mata Tiroid di Bidang Agromedicine Rosy Osiana; Rani Himayani; Helmi Ismunandar
Medula Vol 9 No 4 (2020): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v9i4.235

Abstract

Thyroid Eye Disease (TED) is a disease of the eye that is characterized by bilateral proptosis which is added by increasing levels of T3, T4 and increasing TSH levels. TED patients are common exposure to keratitis in the cornea that is not properly closed and not completely closed by the palpebra. Corneal ulcers can occur due to keratitis. TED patients can also be approved with glaucoma. 31-year-old man who came with the main complaint that refused perfect vision since 2 weeks of SMRS. The initial complaint of the patient was raised casually for the second time since 3 weeks of SMRS. The patient has a view about the use leaf extract of the right eye so that make red eye and vision decrease increasingly then left eye and enlarge white spots. In patients complaining of weight loss of 14 kg for 1 month released with weakness, nausea, sweating, and shaking compilation in resting conditions. At the time of physical examination found a general situation, the level of compost mentis awareness, blood pressure 140/100 mmhg, pulse 130 x / min. The results of physical examination on the eyes obtained sharp vision of VOD 1/300 and VOS 6/60, exoftamus (+) ODS, ciliary injection (+) OD, conjunctival injection (+) ODS, corneal edema (+) OD, cumhipopion (+ ) OD size 2 mm x 1 mm, shallow anterio OD occer camera, and ODS secret (+). Laboratory examination T3 and T4 increased and TSH decreased. Treatment involves education, antibiotik, antihistamin, kalium, beta blocker, antifungal, diuretic, and steroid.
Fibrous Displasia DIMAS Arrohmansyah; Helmi Ismunandar; Rani Himayani
Medula Vol 11 No 1 (2021): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v11i1.173

Abstract

Fibrous dysplasia is a benign intramedullary fibro-oseus lesion. Fibrous dysplasia occurs from the post-zygotic somatic activation (gain-of-function) mutation in GNAS, which encodes the G-protein associated with the AMP pathway, Gsα. Involvement of the skin, bone, and endocrine system is consistent with mutation events early in embryogenesis, which occur prior to differentiation of the 3 embryonic layers. The diagnosis can only be made after a thorough evaluation of the degree of skeletal disease that is monostotic / polyostotic and the presence of extra-skeletal manifestations. Monostotic fibrous dysplasia is defined as the presence of fibrous dysplasia at only one skeleton site. Polyostotic fibrous dysplasia is defined as the presence of fibrous dysplasia at more than one skeletal site without extra-skeletal manifestations. Examination can be done with plain radiographs or CT scans which are useful for determining the direction of malignancy. Lifestyle optimization is the main target of fibrous dysplasia therapy. Medical treatment is recommended to reduce pain, stabilize lesions, and support bone structures to avoid fractures. While surgical therapy is preferred in treating deformities, to avoid pathological fractures, and to treat symptomatic lesions. Malignant transformation in FD is very rare but routine follow-up should be done.
VAKSIN CORONA VIRUS DISEASE 2019 Anggun Elidya; Ghalib Nasser; Innou Dhanu; Rani Himayani; Helmi Ismunandar
Medula Vol 11 No 1 (2021): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v11i1.176

Abstract

Corona Virus Disease 19 (COVID-19) is a virus that emerged at the end of 2019 which is known to have originated of Wuhan which is the capital of Hubei Province, China. Based on data from the World Health Organization (WHO) until January 31, 2021, 235 countries were infected with COVID-19 and 103 million sufferers worldwide and the death rate reached 2,220,000 with symptoms include high fever, difficulty breathing and coughing, and recognition of these symptoms takes 2 to 14 days after infection. Prevention of COVID-19 can be stopped by early detection, isolation and vaccine administration. The mRNA vaccine is an mRNA encoding antigen that is translated in the host's cellular machine by vaccination. This type of vaccine has a self-amplifying genomic structure that causes extreme RNA replication in the cytosol, such as the example of Pfizer BioTech with the name BNT162 (3 LNP-mRNAs) entering its third phase. Deactivated Virus-Based Vaccine (PiCoVacc) is the development of a conventional vaccine starting with in-vitro neutralization and isolating strands of the SARS-CoV-2 virus. This type of vaccine is the SARS-CoV-2 vaccine (inactivated) which has been distributed to several countries such as Turkey, Brazil and Indonesia by administering two times (0 14) intramuscularly (0.5cc). Subunit vaccines are vaccines that include one or more antigens that can stimulate the host immune system. The DNA vaccine is a vaccine consisting of a plasmid DNA molecule encoding one or more antigens and a SARS-CoV-2 (Ad5-nCoV) Adenovirus Type-5 Vector-Based Vaccine which uses the recombinant adenovirus type 5 (Ad5) vector through spike glycoproteins from the Covid strand -19.
Co-Authors Anggun Elidya Desty Marini DIMAS Arrohmansyah Fitriani Antika Dhamayanti Ghalib Nasser Innou Dhanu Nabila Fatimah Az-Zahra Rani Himayani Rosy Osiana