Asmarawati, Tri Pudy
Airlangga University

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Acute Pericarditis in Patient with Systemic Lupus Erythematosus: A Case Report Ratri, Anudya Kartika; Alsagaff, Mochamad Yusuf; Asmarawati, Tri Pudy
Indonesian Journal of Cardiology Vol 39 No 1 (2018): January - March 2018
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (0.036 KB) | DOI: 10.30701/ijc.v39i1.793

Abstract

Acute pericarditis is a common disorder caused by inflammation of the pericardium and can occur as an isolated entity or as a manifestation of an underlying systemic disease. The diagnosis of acute pericarditis is established when a patient has at least two of the following symptoms or signs: chest pain consistent with pericarditis, pericardial friction rub, typical ECG changes, or a pericardial effusion of more than trivial size. Systemic Lupus Erythematosus (SLE) is a chronic autoimmune systemic disorder with unknown etio-pathogenesis. Upon the susceptible genetic, hormonal and abnormal immunologic background, the environmental factors may play role as trigger to permit disease development. Cardiovascular complications occur in more than half of the patients with SLE. Pericarditis is the most studied cardiovascular manifestation, although often not evident clinically, and it is included in the American College of Rheumatology (ACR) classification criteria for SLE. We report a clinical case of initially unremarkably findings which progressed to SLE complicated by full-blown acute pericarditis. A brief review of acute pericarditis, including etiology, clinical presentation, ECG criteria, echocardiographic manifestation, and treatment is presented.   Abstrak Perikarditis akut adalah penyakit yang disebabkan oleh inflamasi dari perikard, dapat terjadi sebagai entitas penyakit primer maupun sekunder sebagai manifestasi dari penyakit sistemik yang mendasarinya. Diagnosis perikarditis akut ditegakkan saat pasien mengalami setidaknya dua dari tanda atau gejala berikut: nyeri dada spesifik perikarditis, pericardial friction rub, perubahan EKG tipikal, atau adanya efusi perikard dengan ukuran lebih dari trivial. Lupus Eritematosus Sistemik (LES) adalah penyakit autoimun sistemik kronis dengan etiopatogenesis yang belum diketahui. Adanya kepekaan genetik, latar belakang imunologis abnormal dan hormonal, serta faktor lingkungan memegang peran sebagai pemicu perkembangan penyakit. Komplikasi kardiovaskular terjadi pada lebih dari setengah pasien dengan SLE. Perikarditis merupakan manifestasi kardiovaskular yang paling sering dijumpai, meskipun jarang ditemukan patognomonis secara klinis, dan termasuk dalam kriteria klasifikasi LES menurut American College of Rheumatology (ACR). Berikut kami laporkan kasus dengan presentasi klinis febris dan takikardia yang kemudian mengarah pada LES dengan komplikasi perikarditis akut. Kami sertakan juga ulasan tentang perikarditis akut, termasuk etiologi, presentasi klinis, kriteria EKG, manifestasi ekokardiografis, dan terapi.
Relationship between Neutrophil-Lymphocyte Ratio and Disease Severity in COVID-19 Patients in Isolation Ward of Dr. Soetomo General Teaching Hospital Heri Krisnata Ginting; M. Vitanata Arfijanto; Tri Pudy Asmarawati; S. Ugroseno Yudho Bintoro
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.v16i1.17558

Abstract

This study was conducted to prove the relationship between the neutrophil-lymphocyte ratio and theseverity of COVID-19. A retrospective cohort study using medical record data of inpatients from Juneto July 2020. Analysis of the NLR relationship and the degree of severity using the Mann Whitney testif the data had an abnormal distribution. Significant if p<0.05 and 95% confidence interval. If there weresignificant results, we try to measure the cut-off of NLR value to predict severe and non-severe clinicalsymptoms. Total study subjects were 110 patients, with a male as many as 65 (59.1%), the median agewas 53.5 years (range 20-88). Most of the comorbidities were diabetes mellitus (35.5%), followed byhypertension (30%). The severity of clinical symptoms was 50% in the non-severe and severe groups,respectively. The NLR value was higher in the severe group. Mann-Whitney test showed significantdifferences in the value of NLR between the severe group and the not severe group with the p-value<0.001. Receiver operating characteristic (ROC) curve analysis area under the curve (AUC) of NLRon day-1 was 0.716 (CI 95%: 0.605 - 0.826), and the cut-off point of the prediction severity diseaseat day-7 was ≥ 6.14 with a sensitivity of 71% and a specificity of 69.1%. The neutrophil-lymphocyteratio value with severe symptoms was higher than the neutrophil ratio value for lymphocytes with nonseveresymptoms in patients with COVID-19.
Predictor of Mortality COVID-19 in Two Referral Hospital in Surabaya, Indonesia Usman Hadi; Bramanton; Tri Pudy Asmarawati; Musofa Rusli; Nasronudin; Brian Eka Rachman; M. Vitanata Arfijanto
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.v16i1.17659

Abstract

Introduction: World Health Organization had identified COVID-19 in January 2019. This disease is caused by SARS-CoV-2, which spread throughout the world and became a pandemic on March 20, 2020. COVID-19 is still a health problem because it has not clear whether the patients will be cured and survive from the disease or not. This study aims to determine the predictors of mortality from COVID-19 at Dr. Soetomo General Academic Hospital and Universitas Airlangga Hospital in Surabaya, Indonesia.Method: This study was conducted in Dr. Soetomo General Academic Hospital (referral hospital for COVID-19, 1500 beds) and Universitas Airlangga Hospital (Referal Hospital for COVID-19, 600 beds). The study used data on patients with confirmed COVID-19 who were hospitalized at these two referral hospitals. Predictors of mortality were analyzed using logistic regressions.Result: There were 247 COVID-19 patients enrolled in this study, all patients were tested positive PCR SARS-CoV-2. The main complaints were cough, nasal congestion, dyspnea, and fever. Significant predictor mortality in this study were age >60 years old (OR: 3.24, 95% CI, 1.36 - 7.70), chronic kidney disease (OR: 5.71, 95% CI, 2.05 - 15.89), obesity (OR: 8.22, 95% CI,1.5 - 54.17), malignancy (OR: 6.025, 95% CI, 1.1- 33.00), coronary heart disease (OR: 5.31, 95% CI, 1.28 - 21.98) , and C-reactive protein >10 mg/L (OR 4.603, 95% CI, 2.03 - 10.44).Conclusions: Obesity and the presence of malignancy, chronic kidney disease, heart disease and age >60 yearsold are the strongest predictors of mortality in people with COVID-19, despite high CRP results.
ORAL CANDIDIASIS IN HIV PATIENT SUFFERING PNEUMOCYSTIC CARINII PNEUMONIA Dahlia Riyanto; Rindang Tanjungsari; Tri Pudy Asmarawati; Desiana Radithia
Dentino : Jurnal Kedokteran Gigi Vol 5, No 1 (2020)
Publisher : FKG Unlam

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20527/dentino.v5i1.8126

Abstract

Background: HIV/AIDS infection provoked opportunistic infection systhemically and intraorally. Pneumocystic carinii pneumonia (PCP) and Oral candidiasis (OC) is the most prevalent opportunistic infection among HIV/AIDS patient and may serve as indicator of low CD4 count in HIV infection. Objective: This paper reports management of oral candidiasis in pneumocystic carinii pneumonia that affects a patient with HIV. Case: A 39 year-old man was hospitalized for pneumocystic carinii pneumonia with weakness of gait and emaciated posture. He was also diagnosed of HIV/AIDS infection through CD4 count and HIV rapid test. Intraoral white patches was reported occured within 2 days being hospitalized. Several tests were ordered resulting, metabolic acidosis, CD4 count were 10 cells/μL, HIV rapid test (ICT) was reactive for 3 methods, and microbiologic examination was positif to C.albicans from the smear of white plaque. The patient also diagnosed with OC pseudomembranous type. Case Management: Patient was treated using intravenous fluconazole 100 mg/day for five days and antiseptic mouthwash. Recovery was achieved within 3 weeks follow-up along with given anti retroviral (ARV) treatment by the internist. Conclusion: Management of OC in HIV/AIDS patient with PCP infection in this case were used systemic antifungal and antiseptic mouthwash. The multidiciplinary approach in managing this case obtained successful therapy.
Acute Pericarditis in Patient with Systemic Lupus Erythematosus: A Case Report Anudya Kartika Ratri; Mochamad Yusuf Alsagaff; Tri Pudy Asmarawati
Jurnal Kardiologi Indonesia Vol 39 No 1 (2018): January - March 2018
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.v39i1.793

Abstract

Acute pericarditis is a common disorder caused by inflammation of the pericardium and can occur as an isolated entity or as a manifestation of an underlying systemic disease. The diagnosis of acute pericarditis is established when a patient has at least two of the following symptoms or signs: chest pain consistent with pericarditis, pericardial friction rub, typical ECG changes, or a pericardial effusion of more than trivial size. Systemic Lupus Erythematosus (SLE) is a chronic autoimmune systemic disorder with unknown etio-pathogenesis. Upon the susceptible genetic, hormonal and abnormal immunologic background, the environmental factors may play role as trigger to permit disease development. Cardiovascular complications occur in more than half of the patients with SLE. Pericarditis is the most studied cardiovascular manifestation, although often not evident clinically, and it is included in the American College of Rheumatology (ACR) classification criteria for SLE. We report a clinical case of initially unremarkably findings which progressed to SLE complicated by full-blown acute pericarditis. A brief review of acute pericarditis, including etiology, clinical presentation, ECG criteria, echocardiographic manifestation, and treatment is presented. Abstrak Perikarditis akut adalah penyakit yang disebabkan oleh inflamasi dari perikard, dapat terjadi sebagai entitas penyakit primer maupun sekunder sebagai manifestasi dari penyakit sistemik yang mendasarinya. Diagnosis perikarditis akut ditegakkan saat pasien mengalami setidaknya dua dari tanda atau gejala berikut: nyeri dada spesifik perikarditis, pericardial friction rub, perubahan EKG tipikal, atau adanya efusi perikard dengan ukuran lebih dari trivial. Lupus Eritematosus Sistemik (LES) adalah penyakit autoimun sistemik kronis dengan etiopatogenesis yang belum diketahui. Adanya kepekaan genetik, latar belakang imunologis abnormal dan hormonal, serta faktor lingkungan memegang peran sebagai pemicu perkembangan penyakit. Komplikasi kardiovaskular terjadi pada lebih dari setengah pasien dengan SLE. Perikarditis merupakan manifestasi kardiovaskular yang paling sering dijumpai, meskipun jarang ditemukan patognomonis secara klinis, dan termasuk dalam kriteria klasifikasi LES menurut American College of Rheumatology (ACR). Berikut kami laporkan kasus dengan presentasi klinis febris dan takikardia yang kemudian mengarah pada LES dengan komplikasi perikarditis akut. Kami sertakan juga ulasan tentang perikarditis akut, termasuk etiologi, presentasi klinis, kriteria EKG, manifestasi ekokardiografis, dan terapi.