Hermina Novida
Department Of Internal Health, Faculty Of Medicine, Universitas Airlangga, Surabaya

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Nonsurgical Management of a Patient with Hypopituitarism Secondary to Nonfunctioning Pituitary Macroadenoma: A Case Report Martino Handoyo; Hermina Novida
Indian Journal of Forensic Medicine & Toxicology Vol. 15 No. 4 (2021): Indian Journal of Forensic Medicine & Toxicology
Publisher : Institute of Medico-legal Publications Pvt Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37506/ijfmt.v15i4.16960

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Pituitary adenoma is a benign neoplasm of pituitary gland. Pituitary adenoma, particularly a macroadenoma,may produce mass effect symptoms by compressing surrounding tissues. Due to pituitary function as aneuroendocrine organ, pituitary adenoma may also cause multiple endocrine disturbances. The authors reportthe case of a 39-year-old male patient presenting with chronic headache and history of seizure. MRI imagingrevealed pituitary macroadenoma with optic chiasm compression. Further diagnostic workup indicatedsecondary hypogonadism and adrenal insufficiency. The patient was given hormone replacement therapyand was then advised for surgery, but the patient refused any surgical procedure. Subsequent follow-upswere somewhat difficult due to poor patient adherence. Nevertheless, appropriate management of pituitaryadenoma is needed to achieve optimal result.
Diabetic Ketoacidosis in Pregnancy: A Case Report Febrian Daru Setiawan; Hermina Novida
Indian Journal of Forensic Medicine & Toxicology Vol. 16 No. 1 (2022): Indian Journal of Forensic Medicine & Toxicology
Publisher : Institute of Medico-legal Publications Pvt Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37506/ijfmt.v16i1.17498

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A 31-year-old pregnant woman complained of vomiting, shortness of breath, fever, general weakness,painful and frequent urination with sign of hypertension, tachycardia, Kussmaul breathing. Laboratorystudies showed neutrophilia, leukocytosis, hyperglycemia, hypokalemia, ketonuria, metabolic acidosis,low C-peptide, low Thyroid Stimulating Hormone, high FT4 and Staphylococcus in blood culturewas diagnosed with Diabetic Ketoacidosis, pregestational Type 1 Diabetes Mellitus, hyperemesisgravidarum, 14 weeks of pregnancy, suspect Urinary Tract Infection, hypokalemia, hypertension, andsubclinical hyperthyroidism. Besides, the patient blamed the fetus on causing the disease and financialproblem so that the patient also was diagnosed with episode of moderate depression. The patient receivedKVT1 diet therapy, fluid replacement therapy, insulin therapy, correction of hypokalemia, correctionof acidosis metabolic antibiotic and anti-hypertension. The therapies aimed to prevent maternal andfetal morbidity. Supportive psychotherapy therapy, relaxation therapy, and family psychoeducationwere also needed to improve patient’s compliant. The patient was also suggested to consult for familyplanning and glucose control before conception.
A Prediction Model of Mortality in Patients Hospitalized with Diabetic Ketoacidosis in a Tertiary Referral Hospital in Surabaya, Indonesia Hermina Novida; Fajar Setiyawan; Soebagijo Adi Soelistijo
Indian Journal of Forensic Medicine & Toxicology Vol. 15 No. 2 (2021): Indian Journal of Forensic Medicine & Toxicology
Publisher : Institute of Medico-legal Publications Pvt Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37506/ijfmt.v15i2.14751

Abstract

Background: The mortality rate of diabetic ketoacidosis (DKA) remains high in Indonesia. Differentpatterns were contributing to DKA mortality from previous studies. We aim to identify clinical and laboratoryfindings as mortality predictors of DKA.Methods: This retrospective study was conducted in a tertiary referral hospital in Surabaya. Medical recordsof DKA patients from January 2016 to December 2018 were analyzed. Clinical and laboratory data wereobtained from medical records for three years period. Clinical outcome was defined as either dischargedhome or death.Results: Fifty-six among 116 DKA patients did not survive during hospitalized. Age of 60 or older, thedepressed mental state with GCS below 13, potassium serum less than 3.5 mmol/L, and bicarbonate serumless than 15 mmol/L are found to be significant as independent factors of mortality in DKA patients.Conclusion: The mortality rate of DKA patients in this study is still high. It independently associatedwith the age of 60 years or older, depressed mental state, hypokalemia, and low bicarbonate level. Earlystratification of these predictors would help to treat patients accordingly.
In-Vitro Differentiation Adipose-Derived Mesenchymal Stem Cells into Pancreatic Progenitor Cells Hermina Novida; Agung Pranoto; Askandar Tjokroprawiro; Sony Wibisono; Purwati
Indian Journal of Forensic Medicine & Toxicology Vol. 15 No. 2 (2021): Indian Journal of Forensic Medicine & Toxicology
Publisher : Institute of Medico-legal Publications Pvt Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37506/ijfmt.v15i2.14752

Abstract

Background: Adult stem cells are currently reliable sources of mesenchymal stem cells for regenerativetherapy, include diabetes mellitus. The aim of this study is to develop endocrine pancreatic progenitor cellscharacterized by Pdx1 and insulin expression from rat adipose-derived mesenchymal stem cells using twosteps in-vitro differentiation.Methods: In this experimental study, ADMSCs were isolated from rat adipose tissue and exposed toinsulinogenic differentiation medium containing nicotinamide, activin A and glucagon-like peptide-1 (GLP1). After induction, the existence of pancreatic progenitor cells (PPCs) was confirmed by immune-stainingassay of Pdx1 and insulin.Results: After three weeks of in-vitro differentiation, expression of Pdx1 and insulin proteins showed upas green in the immunofluorescence assay. Immunofluorescence intensity of Pdx1 was higher in PPCs thanin ADMSCs control (p<0.05). Immunofluorescence intensity of insulin was also higher in PPCs than inADMSCs control (p<0.05). Therefore, in-vitro differentiation was successful to develop PPCs from ratADMSCsConclusion: This study has demonstrated the in-vitro differentiation of ADMSCs into PPCs that expressedPdx1 and insulin
PROFILE OF DIABETIC KETOACIDOSIS PATIENTS AT REGIONAL PUBLIC HOSPITAL DR. SOETOMO IN 2017 Desak Gde Ushadi Bulan Dewata; Hermina Novida; Aryati Aryati
Jurnal Berkala Epidemiologi Vol. 8 No. 3 (2020): Jurnal Berkala Epidemiologi (Periodic Epidemiology Journal)
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jbe.V8I32020.301-309

Abstract

Background: Diabetic ketoacidosis (DKA) is one of many life-threatening complications of diabetes mellitus (DM), which is characterized by severe hyperglycemia, metabolic acidosis and ketonemia. This complication can eventually lead to coma and death if not treated properly. Purpose: The aim of this study is to describe the profile of the DKA patients who were at Regional Public Hospital (RSUD) Dr. Soetomo in 2017. Methods: This study was a descriptive study that used the medical record data of DKA patients who were at RSUD Dr. Soetomo in 2017. The study’s total sample size was 63 patients. The study’s variables were gender, age, type of DM, severity of DKA, precipitating factors, main complaints, vital signs, random plasma glucose level, electrolyte level, and blood gas analysis. The frequency, mean, and standard deviation were analyzed. Results: Most of the 63 DKA patients were female (66.67%), aged from 50–59 years (38.10%). The DKA cases being handled by the Dr. Soetomo Hospital were overwhelmingly of type 2 DM patients (88.89%). More than half the patients (58.73%) experienced severe DKA. Altered states of consciousness (46.03%) and shortness of breath (26.98%) were the most common main complains made by the DKA patients. Almost all patients experienced infection (88.89%) as the precipitating factor; the most common infections were sepsis (92.86%), pneumonia (30.36%), and urinary tract infections (23.21%). Two thirds of the patients (66.67%) had a length of stay of 0–7 days. About 57.14% of the DKA patients died while undergoing treatment. Conclusion: The number of severe DKA patients and the mortality rate in our study were higher than in other studies. Females and the elderly were more prone to DKA, and the most common precipitating factor was infection.
Profile of Diabetic Foot Ulcer Patients at Tertiary Care Hospital in Surabaya, Indonesia Arisvia Sukma Hariftyani; Hermina Novida; Mouli Edward
Jurnal Berkala Epidemiologi Vol. 9 No. 3 (2021): Jurnal Berkala Epidemiologi (PERIODIC EPIDEMIOLOGY JOURNAL)
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jbe.V9I32021.293-302

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Background: Diabetic Foot Ulcer (DFU) has been associated with a high mortality rate of Diabetes Mellitus (DM) patients. Both behavioral and biological factors cause predisposition to DFU. Purpose: This research describes the profile of hospitalized DFU patients at a tertiary care hospital in Surabaya. Methods: A retrospective descriptive study that analyzed medical records of hospitalized T2DM patients with DFU in Dr. Soetomo General Hospital. Sampled respondents were patients ≥ 21 years old who were hospitalized between 2016–2018. Demographic data, clinical characteristics, medical histories, length of hospital stay, laboratory results, precipitating factors, microorganism culture results, treatment, and outcome were analyzed. Descriptive analysis is presented in the form of narratives, tables, and diagrams. Results: 9.08% of hospitalized Type 2 DM (T2DM) cases were related to foot ulcers. The average patient age was 57.00 ± 9.83 years with no gender predominance. DM was poorly controlled (Mean HbA1C 9.78±2.83%; RBG 251.83 ± 158.15 mg/dL). The majority of patients had sepsis (68.26%) and renal function impairment (62.72%). Ulcers with Wagner grades of 4–5 were frequent (41.31%). The highest percentage of sepsis (80.49%) and the average leukocyte level (22.60±11.95 x109/L) were found in gangrenous feet. Anemia was more predominant and severe in ulcers with higher Wagner grades. Trauma and Escherichia coli were the most common precipitating factors and microorganisms isolated, respectively. Amputation was performed for 82.36% of patients who were admitted to hospital with gangrene. The Lower Extremity Amputation (LEA) and mortality rates were 14.11% and 40.93%, respectively. Conclusion: DFUs were found to have a relatively high prevalence among T2DM patients, and must never be neglected due to the high associated mortality rate.
Effect of High Fat Diet on Weight Loss Through the Expression of Uncouple Protein 1 in Mice Visceral Fat Indira Syahraya; Hermina Novida; Lilik Herawati; Purwo Sri Rejeki
Folia Medica Indonesiana Vol. 56 No. 3 (2020): September
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1264.238 KB) | DOI: 10.20473/fmi.v56i3.24576

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Obesity has become an epidemic around the world. High fat diet (HFD) have been implemented as one of intervention to battle obesity. Uncouple protein 1 (UCP1) is one of the key factor on energy expenditure. The aim of this experiment is to see the macronutrients composition on weight loss and UCP1 expression in the visceral fat. Fifty male mice, 2-3 months old, 18-30 grams, were put in five different groups. K1 were fed (20% protein, 62.0% carbohydrate, 12% fat), K2 (60% protein, 0% carbohydrate, 30% fat), K3 (45% protein, 0% carbohydrate, 45% fat), K4 (30% protein, 0% carbohydrate, 60% fat), K5 (15% protein, 0% carbohydrate, 75% fat). The experiment was done in four weeks, mice body weight was measured every week. UCP1 expression seen using immunohistochemistry staining was measured at the end of the fourth week. Significant weight loss was achieved by K4 (-9.60±3.81) gram by the end of week four (p<0.05). K4 had the least amount of visceral fat. The result was that K4 achieved a significant visceral fat mass (0.02±0.06) gram compared to K1 (0.53±0.08) gram. Compared to other groups K5 expressed UCP1 more than the others (3.78±3.72) cphfp. HFD fed groups produced significant weight loss, group that had the greatest weight loss is K4. Meanwhile, each group had a variety of UCP1 expression.
A Patient With Graves’ Disease And Thyroid-Associated Orbitopathy Undergoing Radioactive Iodine in Dr. Soetomo General Academic Hospital, Surabaya Rizki Adrian Hakim; Stepanus Massora; Delfitri Lutfi; Hermina Novida
Biomolecular and Health Science Journal Vol. 4 No. 1 (2021): Biomolecular and Health Science Journal
Publisher : Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/bhsj.v4i1.26914

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Graves’ Disease (GD) is the most common etiology of thyrotoxicosis, followed by toxic multinodular goiter and toxic adenoma. GD can be managed with anti-thyroid drugs (ATDs), surgery, or radioactive iodine (RAI). Thyroid-associated orbitopathy (TAO) or Graves’ Ophthalmopathy (GO) affects 25%-50% patients with GD, and its presence usually dissuade clinicians to use RAI in treating hyperthyroidism. The presence of GO is a relative contraindication use of RAI in patients with GD, as RAI can worsen existing GO. Corticosteroid prophylaxis can be given to such patients to reduce likelihood of worsening of GO. However, patient with moderate to severe active GO is currently advised against undergoing RAI. Established guidelines recommend the use of corticosteroid prophylaxis in these patients. We reported a patients with GD and orbitopathy who was treated with RAI and was given steroid prophylaxis to prevent worsening of GO.
Facial Abscess due to Staphylococcus aureus in Patient with Type 2 Diabetes Mellitus: Case Report Dian Galuh Maharani; Hermina Novida
Biomolecular and Health Science Journal Vol. 4 No. 2 (2021): Biomolecular and Health Science Journal
Publisher : Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/bhsj.v4i2.30029

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Diabetes mellitus (DM) is a chronic disease with an increasing frequency over the last decade. DM patient has higher risk of infection than people without diabetes. Several literatures suggest a strong positive correlation between hyperglycemia and skin infections. Skin and soft tissue infections (SSTIs), including abscess which commonly caused by Staphylococcus aureus, could lead to severe and life-threatening infections. The correct diagnosis and effective management therapy should be needed to prevent further complications and reduce morbidity and mortality. We report a case about facial abscess caused by S. aureus in diabetic patient that healed after got incision drainage and antibiotics.
Risk Factor Related to Mortality of Diabetic Ketoacidosis Patients in Dr. Soetomo General Hospital Surabaya Alviano Satria Wibawa; Hermina Novida; Muhammad Faizi; Deasy Ardiany
JUXTA: Jurnal Ilmiah Mahasiswa Kedokteran Universitas Airlangga Vol. 11 No. 1 (2020): Jurnal Ilmiah Mahasiswa Kedokteran Universitas Airlangga
Publisher : Faculty of Medicine Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/juxta.V11I12020.36-40

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Introduction: Diabetic ketoacidosis (DKA) is a complication of diabetes mellitus which has a high risk of mortality. Mortality in DKA patients in developed countries is less than 5%, some other sources mention 5-10%, 2-10%, or 9-10%. Mortality events at clinics with simple facilities and elderly patients can reach 25-50%. The mortality rate of DKA patients is generally higher in infection conditions, especially in developing countries and in septic patients. Several factors such as age, sex, and high blood glucose can increase mortality risk of DKA patients. Other risk factors such as history of discontinued insulin therapy, impaired bicarbonate levels, pH, and increased leukocytes of DKA patients due to infection, abnormal albumin levels, electrolyte disturbances, and Serum Creatinine (SK) were thought to affect mortality of DKA patients. The purpose of this study was to determine the risk factors associated with mortality of DKA patients in Dr. Soetomo General Hospital Surabaya. Methods: The method used in this study was observational analytic involving 63 adult patients diagnosed with DKA with analysis using Chi-Square test. Results: From 63 patients included in this study, 37 patients diagnosed with DKA died and 26 patients lived. In a multivariate analysis, DKA severity with p = 0.001 (p < 0.005) was identified as having a relationship with mortality of DKA patients Dr. Soetomo General Hospital Surabaya. Conclusion: Severity is the only risk factor associated with mortality of DKA patients in Dr. Soetomo General Hospital Surabaya.