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ISM (Intisari Sains Medis) : Jurnal Kedokteran

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Published by Universitas Udayana

ISSN : 25033638 EISSN : - DOI : -

Core Subject : Health, Science,

Biochemistry, Genetics & Molecular Biology Medicine & Pharmacology

Intisari Sains Medis is published by Medical Scientific Community, Indonesia. Intisari Sains Medis is an international, multidisciplinary, peer-reviewed, open access journal accepts papers for publication in all aspects of Science Digest, Medical Research Development, Research Medical Field and Theory. We also publish cases from third world country, that is considered very rare and special cases.

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Search results for , issue "Vol. 12 No. 1 (2021): (Available online : 1 April 2021)" : 92 Documents clear

Pengaruh pemberian kombinasi ekstrak etanol bunga Tahi Kotok (Tagetes erecta l.) dan daun Jamblang (Syzygium cumini l.) terhadap pertumbuhan bakteri Methicillin-resistant Staphylococcus aureus (MRSA) dan Multidrug-resistant Pseudomonas aeruginosa secara Kadek Tresna Yuwana; I Dewa Made Sukrama; Ni Nengah Dwi Fatmawati
Intisari Sains Medis Vol. 12 No. 1 (2021): (Available online : 1 April 2021)
Publisher : DiscoverSys Inc.

Introduction: The increasing number of resistance cases of Methicillin-resistant Staphylococcus aureus (MRSA) and Multidrug-resistant Pseudomonas aeruginosa (MRPA) to common antibiotics has called the need for new modalities to combat these resistance problems. The ingredients that are thought to influence the growth of MRSA and MRPA are Tahi Kotok flowers (T. erecta) and Jamblang leaves (S. cumini). This study aimed to evaluate the effect of the combined Tahi Kotok flowers and Jamblang leaves ethanol extract on the growth of MRSA and MRPA bacteria.Methods: The research was conducted as a true experimental design using a post test only control group design. The combination of ethanol extract in several concentrations (25%, 50%, 75%, 100%) were tested on MRSA ATCC 3351 bacteria and MRPA bacteria cultured on agar media. The data obtained are the results of laboratory observations with the disk diffusion methods which are then statistically analyzed parametrically using the SPSS application which is shown as mean ± SEM.Results: The inhibitory activity of T. erecta flower extract with MRSA and MRPA bacteria was found. The largest inhibition zone diameter was at 75% extract concentration, with inhibition zones of 17.25 ± 1.25 cm and 11.25 ± 0.50 cm, respectively. The largest inhibition zone of S. cumini leaf experiment with MRSA bacteria was at concentration of 75 percent, which resulted in a 9.50 ± 0.57 cm inhibition diameter. In MRPA bacteria, however, there was no inhibition zone. At a concentration of 75 percent, the combination of T. erecta flower extract and S. cumini leaf had the highest inhibitory activity against MRSA bacteria, but had no inhibitory activity against MRPA bacteria.Conclusion: The concentration of extract combination in 96% ethanol influences the diameter of the MRSA inhibition zone, whereas in MRPA no inhibition zones were generated from this in vitro experiments. Latar Belakang: Meningkatnya kasus resistensi bakteri Methicillin-resistant Staphylococcus aureus (MRSA) dan Multidrug-resistant Pseudomonas aeruginosa (MRPA) terhadap antibiotik menyebabkan perlunya modalitas baru sebagai potensi untuk mengatasi masalah resistensi tersebut. Salah satu bahan yang diduga berpengaruh terhadap pertumbuhan MRSA dan MRPA adalah bunga Tahi Kotok (T. erecta) dan daun Jamblang (S. cumini). Penelitian ini ditujukan untuk melihat adanya pengaruh kombinasi ekstrak etanol bunga Tahi Kotok dan daun Jamblang terhadap pertumbuhan bakteri MRSA dan MRPA.Metode: Penelitian ini menggunakan rancangan true experimental post test only control group design. Kombinasi ekstrak etanol dalam beberapa konsentrasi (25%, 50%, 75%, 100%) diujikan pada bakteri MRSA ATCC 3351 dan MRPA yang dikultur pada media agar. Data yang diperoleh merupakan hasil pengamatan laboratorium dengan metode disk diffusion yang selanjutnya dianalisis secara statistik dengan statistik parametrik menggunakan aplikasi SPSS untuk menghitung nilai mean ± SEM. Hasil: Pada percobaan ekstrak bunga T. erecta dengan bakteri MRSA dan MRPA menunjukkan adanya daya hambat dengan daya hambat tertinggi terdapat pada konsentrasi 75%, zona hambat 17,25 ± 1,25 cm dan 11,25 ± 0,50 cm berturut-turut. Pada percobaan daun S. cumini dengan bakteri MRSA didapatkan zona hambat tertinggi pada konsentrasi 75% sebesar 9,50 ± 0,57 cm. Akan tetapi, tidak terdapat zona hambat pada bakteri MRPA. Kombinasi ekstrak bunga T. erecta dan daun S. cumini memiliki daya hambat terhadap bakteri MRSA yang tertinggi pada konsentrasi 75%, akan tetapi tidak memiliki daya hambat pada bakteri MRPA.Simpulan: Konsentrasi ekstrak kombinasi dalam etanol 96% berpengaruh terhadap diameter zona hambat MRSA tetapi tidak ditemukan zona hambat yang dihasilkan pada MRPA dari percobaan in vitro.

Kesesuaian hasil pengukuran Low Density Lipoprotein Cholesterol menggunakan persamaan Friedewald, Hopkins, dan Homogeneous Enzymatic Colorimetric Assay di RSUP Sanglah, Bali, Indonesia I Made Dharma Pramana; Ida Ayu Putri Wirawati; Ni Nyoman Mahartini
Intisari Sains Medis Vol. 12 No. 1 (2021): (Available online : 1 April 2021)
Publisher : DiscoverSys Inc.

Background: LDL-C concentration can be obtained by calculation from equations and measurement methods. There are many LDL-C equations, but the most commonly used is the Friedewald equation, and the most recent is the Hopkins equation. This study aims to determine LDL-C measurements' agreement using the Friedewald equation, Hopkins equation, and homogeneous enzymatic colorimetric assay.Methods: This was a cross-sectional study, from January-February 2020, with 570 samples LDL-C examination results by Friedewald equation, Hopkins equation, and homogeneous enzymatic colorimetric assay divided into 3 groups based on TG levels. Data were analyzed by SPSS version 17 for Windows.Results: Spearman correlation test found a near-perfect correlation between LDL-C using Friedewald and Hopkins equations to direct examinations with values r =0.921 and r =0.907. Limit of agreement from the Bland-Altman test shows an average of >90% for both equations with direct measurements. Mann-Whitney test showed a significant difference between LDL-C direct measurement and Friedewald equation in Total Group, TG 200-400 mg/dL and TG> 400 mg/dL while for Hopkins equation only in TG group> 400 mg/dL (p<0.05). Based on Total Allowable Error (TAE) analysis, LDL-C from Hopkins equation in TG group 200-400 mg/dL appears to be superior to the Friedewald equation.Conclusion: Friedewald equation and Hopkins equation give good concordance at TG levels <200 mg/dL while at triglyceride levels 200-400 mg/dL Hopkins equation gives better concordance than the Friedewald equation. At triglyceride levels,> 400 mg/dL Friedewald and Hopkins equations show low accuracy, so it is recommended to use the direct method. Latar Belakang: Konsentrasi low density lipoprotein cholesterol (LDL-C) dapat diperoleh dengan 2 cara yaitu menggunakan perhitungan dengan persamaan dan metode pengukuran langsung (direct). Banyak persamaan perhitungan LDL-C tetapi yang paling umum digunakan adalah persamaan Friedewald dan yang terbaru adalah persamaan Hopkins. Penelitian ini bertujuan untuk mengetahui kesesuaian hasil pengukuran LDL-C menggunakan persamaan Friedewald, persamaan Hopkins dan homogeneous enzymatic colorimetric assayMetode: Penelitian menggunakan rancangan analitik potong lintang dari bulan Januari-Pebruari 2020 dengan 570 sampel hasil pemeriksaan LDL-C dengan persamaan Friedewald, persamaan Hopkins dan homogeneous enzymatic colorimetric assay yang dibagi 3 kelompok berdasarkan kadar trigliserida (TG). Data dianalisis dengan SPSS versi 17 untuk Windows.Hasil: Uji statistik Spearman didapatkan korelasi mendekati sempurna antara LDL-C menggunakan persamaan Friedewald dan Hopkins terhadap pemeriksaan direct dengan nilai r=0,921 dan r=0,907. Limit of agreement dari uji Bland-Altman menunjukkan rata-rata > 90% untuk kedua persamaan dengan pengukuran direct. Uji Mann-Whitney menunjukkan perbedaan bermakna antara LDL-C pengukuran direct dengan persamaan Friedewald pada Kelompok Total, TG 200-400 mg/dL dan TG >400 mg/dL sedangkan untuk persamaan Hopkins perbedaan hasil yang bermakna hanya pada kelompok TG >400 mg/dL (p<0,05). Berdasarkan analisis Total Allowable Error (TAE), LDL-C persamaan Hopkins pada kelompok TG 200-400 mg/dL lebih unggul dari persamaan Friedewald.Kesimpulan: Persamaan Friedewald dan persamaan Hopkins memberikan kesesuaian yang baik pada kadar TG <200 mg/dL sedangkan pada kadar trigliserida 200-400 mg/dL, persamaan Hopkins memberikan kesesuaian yang lebih baik daripada persamaan Friedewald. Pada kadar TG >400mg/dL persamaan Friedewald dan Hopkins menunjukkan akurasi yang rendah sehingga disarankan untuk menggunakan metode direct.

Constipation that needs attention: late Hirschsprung disease Kristin Agustina; Ni Nyoman Margiani; Pande Putu Yuli Anandasari; Ni Made Mahastuti
Intisari Sains Medis Vol. 12 No. 1 (2021): (Available online : 1 April 2021)
Publisher : DiscoverSys Inc.

Background: Hirschprung disease (HD) or congenital aganglionic megacolon is an intestinal motor disorder that occurs in approximately 1 in 5000 live births. It makes colon fail to relax, mainly producing the symptoms of constipation. Approximately 90% of cases are diagnosed in the first year of life. Most of the remaining 10% are made in early childhood, with less than 1% being made in teenagers or adulthood.Case report: A 13 years old girl reported to the pediatric surgical outpatient department complaining constipation since birth. There was no history of delayed passage of meconium. A contrast enema study with water-soluble contrast showed high probability of ultrashort segment HD. Histopathological examination revealed neither nerve fibers with ganglion cells nor hypertrophy of nerve fibers were seen confirming the aganglionosis. Surgical treatment was performed with good clinical progression. Conclusion: Despite of its rarity, the possibility of HD should be considered in teenagers with chronic refractory constipation, especially when there was a history of delayed or non-passage of meconium after birth. An accurate diagnosis is mainly based on collective assessment of medical history, clinical examination, contrast enema study, and rectal biopsy as a gold standard.

Brittle bone brothers: osteogenesis imperfecta conventional serial case Marsha Ruthy Darmawan; Elysanti Dwi Martadiani
Intisari Sains Medis Vol. 12 No. 1 (2021): (Available online : 1 April 2021)
Publisher : DiscoverSys Inc.

Background: Osteogenesis Imperfecta (OI) is a heredity connective tissue disorder due to COL1A1/2 gene mutation, causing a defect in encoding proteins to metabolize collagen. One of OI’s manifestations to musculoskeletal is bone incompetence, hence the name Brittle bone disease. We report three cases of OI type IV in adults with pathognomonic radiology findings.Case Presentation: In Case 1, a 40-year-old Indonesian male came to the hospital with small stature and unsuited with his age. Conventional radiology examination found OI on all four extremities, anterior dislocation of left shoulder, and old fracture with an acute angle in the left radial shaft. In Case 2, a 41-year-old Indonesian male came to the hospital with short stature, causing limitation to his activities, and he confessed always to be shorter than people his age. Radiology evaluation suggests an OI in bilateral superior and inferior extremities, old fractures in the right humeral shaft also the left clavicle, acute angles right radius-ulna shaft, and osteoporosis in all visualized bones. In addition, in Case 3, a 42-year-old Indonesian male came to the hospital with short stature and pain within his bones, causing limitation to his activity. Conventional radiology imaging shows bilateral superior and inferior extremities, old fracture in the medial third of the left humerus and bilateral femur, acute-angled bilateral antebrachial-femur-cruris, and osteoporosisConclusion: Based on OI categorization, only type I and IV can live to adulthood, and the same type of OI can be found in siblings. Conventional radiology imaging provides a great help in diagnosing OI.

Evaluation of modified unilateral nasoplasty in patient with post operation of unilateral labioplasty at Malahayati Hospital Banda Aceh: a cohort study from 2017-2019 Devyana Enggar Taslim; Muhammad Taufik; Muhammad Jailani; Syamsul Rizal; Mirnasari Amirsyah
Intisari Sains Medis Vol. 12 No. 1 (2021): (Available online : 1 April 2021)
Publisher : DiscoverSys Inc.

Background: Nasal deformity associated with a cleft lip has been viewed as one of the most challenging reconstructive rhinoplasty problems.The common clinical features associated with cleft lip nasal deformity are its lack of symmetry, alar collapse on the affected side, short nasal length, loss of tip definition, obtuse nasal labial angle, and altered columella show among others. This study aims to evaluate the modified unilateral nasoplasty in a patient with post-operation of unilateral labioplasty at Malahayati Hospital Banda Aceh as a cohort study.Methods: We conducted a retrospective cohort study involving 139 patients who completed the unilateral rhinoplasty operation at Malahayati Hospital from January 2017 to November 2019. Demographic information was recorded, such as the ratio between pre–operation and post–operation, gender, and age. Data were analyzed using SPSS version 20 for Windows.Results: Our results have shown the comparison between cleft nose before rhinoplasty and cleft nose after rhinoplasty is 0.26 vs. 0.58 cm. The patients who came to the hospital to do the unilateral rhinoplasty surgery are 81.00%. Females (61.20%) experienced rhinoplasty more dominant compare to man (38.80%), and the highest age average is between 1 year old until 7 years old (71.00%)Conclusion: Improvement in procedure’s duration and better positioning of both nasal tip and nostril. Expected improvements in terms of aesthetics and functions were observed, but further documentation is still needed.

Hubungan antara pengetahuan dengan praktik pemenuhan gizi seimbang oleh ibu pada anak usia 1-5 tahun di Desa Pepelegi Kecamatan Waru Kabupaten Sidoarjo Maria Natalia Indawati
Intisari Sains Medis Vol. 12 No. 1 (2021): (Available online : 1 April 2021)
Publisher : DiscoverSys Inc.

Background: Practice of balanced nutrition fulfillment is an action to meet the nutritional needs of a person according to the needs of the body that can ultimately prevent the emergence of nutritional problems. Practice itself can be influenced by various factors, one of which is knowledge of balanced nutrition fulfillment.Aim: The study aims to determine a correlation between knowledge and the practice of balanced nutrition fulfillment.Methods: The observational analytic study involved randomly 63 samples of 882 maternal who had children aged 1-5 years in Pepelegi Village of Waru Sub-district, Sidoarjo Regency. The data consist of a knowledge group and practice one.Results: There was a correlation between knowledge and practice of balanced nutrition fulfillment of the participants (p<0.05). Most of them aged 31-40 years, with the majority of highest education level was senior high school. Most participants had sufficient levels of knowledge and good balanced nutrition fulfillment practices.Conclusion: Knowledge supplies a great practice of balanced nutrition fulfillment so either health promotion or counseling should be provided by the community health service. Latar Belakang: Praktek pemenuhan gizi seimbang merupakan suatu tindakan untuk memenuhi nutrisi seseorang sesuai dengan kebutuhan tubuh yang pada akhirnya dapat mencegah timbulnya permasalahan gizi. Praktik sendiri dapat dipengaruhi oleh berbagai faktor, salah satunya pengetahuan tentang pemenuhan gizi seimbang.Tujuan: untuk mengetahui hubungan antara pengetahuan dengan praktik pemenuhan gizi seimbang oleh ibu pada anak usia 1-5 tahun di Desa Pepelegi, Kecamatan Waru Kabupaten Sidoarjo.Metode: Penelitian analitik observasional ini melibatkan 63 sampel dari 882 ibu yang memiliki anak usia 1-5 tahun di Desa Pepelegi yang diambil secara acak. Mereka dibagi sebagai kelompok pengetahuan dan kelompok praktek pemenuhan gizi seimbang.Hasil: Terdapat hubungan antara pengetahuan dan praktik pemenuhan gizi seimbang (p<0,05). Sebagian besar responden berusia antara 31-40 tahun dengan mayoritas tingkat pendidikan terakhir adalah sekolah menengah atas (SMA). Sebagian besar responden memiliki tingkat pengetahuan yang cukup serta praktek pemenuhan gizi seimbang yang baik.Simpulan: Pengetahuan turut mempengaruhi praktik pemenuhan gizi seimbang sehingga perlu penyuluhan berkesinambungan serta praktek pemenuhan gizi seimbang yang diberikan oleh puskesmas.

Terapi penghambat Sodium Glucose Co-Transporters-2 (SGLT-2) dalam pengobatan Diabetes Melitus Tipe-2 (DM-2): tinjauan pustaka Andre Hendrajaya
Intisari Sains Medis Vol. 12 No. 1 (2021): (Available online : 1 April 2021)
Publisher : DiscoverSys Inc.

Management of type II diabetes mellitus is a science that continues to develop. Treatment of type II diabetes mellitus can affect various organ functions, one of which is the kidneys, which function to excrete glucose, namely SGLT II inhibitors. The class of sodium-glucose transport protein 2 (SGLT2) inhibitors has a new mechanism of action and is complementary to the older drugs used to treat type II diabetes. The sodium-glucose cotransporter-2 (SGLT2) protein is expressed in the proximal tubule of the renal convolution. These transporters are ideal targets for the treatment of diabetes because they account for approximately 90% of filtered glucose reabsorption SGLT2 inhibitors can be a useful option in obese and hypertensive patients because of their weight loss and antihypertensive benefits and thus benefit cardiovascular function. Patients at high risk for hypoglycemia may benefit from a combination of metformin and SGLT2 inhibitors because the risk of hypoglycemia with SGLT2 inhibitors is small when compared with insulin and sulfonylurea. Tatalaksana DM mellitus tipe II merupakan ilmu yang terus berkembang. Pengobatan DM tipe II dapat mempengaruhi berbagai fungsi organ, salah satunya adalah ginjal yang berfungsi untuk mengeksreksikan glukosa yakni penghambat SGLT II. Kelas obat penghambat sodium-glukosa transport protein 2 (SGLT2) memiliki karakteristik ini, dan mekanisme aksi yang baru melengkapi obat yang lebih lama yang digunakan untuk mengobati DM tipe II. Protein sodium-glukosa cotransporter-2 (SGLT2) diekspresikan dalam tubulus proksimal konvolusi ginjal. Transporter ini adalah target yang ideal untuk pengobatan diabetes karena mereka bertanggung jawab atas sekitar 90% dari reabsorpsi glukosa yang difiltrasi Inhibitor SGLT2 dapat menjadi pilihan yang berguna pada pasien obesitas dan hipertensi karena penurunan berat badan dan manfaat antihipertensi sehingga memberikan manfaat terhadap fungsi kardiovaskular. Pasien yang berisiko tinggi untuk hipoglikemia dapat mengambil manfaat dari kombinasi metformin dan inhibitor SGLT2 karena risiko hipoglikemia dengan inhibitor SGLT2 kecil jika dibandingkan dengan insulin dan sulfonylurea.

Profil klinis pasien dengan gejala gangguan motilitas predominan konstipasi di unit endoskopi gastrointestinal rumah sakit tersier Godfried Erycesar Yeremia Saragih; I Dewa Nyoman Wibawa; I Ketut Mariadi; Gde Somayana
Intisari Sains Medis Vol. 12 No. 1 (2021): (Available online : 1 April 2021)
Publisher : DiscoverSys Inc.

Background: Investigating constipation requires careful evaluation of general examinations cascaded into specifics to identify treatable or significant causes for early detection. This study aims to determine patients' clinical profile with symptoms of motility disorders, predominantly constipation, in the gastrointestinal endoscopy unit of the tertiary hospital.Methods: This descriptive cross-sectional study involved 82 participants collected through consecutive sampling. Patients with predominant constipation symptoms who underwent colonoscopy in Sanglah Hospital Endoscopy Unit from 2017 to 2018 were recruited. Primary data comprising clinical assessments, laboratory test results, and colonoscopy and histopathology interpretation were analyzed accordingly. Constipation and fecal incontinence severity was indicated by Patient Assessment of Constipation – Symptoms (PAC-SYM) and Jorge-Wexner score. Data was analyzed using SPSS version 25 for Windows.Results: Most of the respondents were male (62.2%). The PAC-SYM and Jorge-Wexner Score were relatively low, with mean values of 2.44±0.73 and 2.18±0.99, respectively. The prevalence of patients initially assessed with chronic constipation (57.32%) remained high (26.83%) despite adjustment being done after colonoscopic exclusion.Conclusion: Diagnostic challenges of constipation exceeded the exhaustive efforts utilizing extensive diagnostic modalities. Suboptimal treatment would be inevitable in the absence of a good-quality management algorithm. Latar Belakang: Investigasi konstipasi memerlukan kecermatan dalam mengevaluasi pemeriksaan umum yang berjenjang menjadi spesifik untuk mengidentifikasi kausa yang dapat ditangani atau bermakna terhadap deteksi dini. Penelitian ini bertujuan untuk mengetahui profil klinis pasien dengan gejala gangguan motilitas predominan konstipasi di unit endoskopi gastrointestinal Rumah Sakit Tersier.Metode: Penelitian deskriptif potong lintang ini melibatkan 82 responden yang dikumpulkan melalui pengambilan sampel secara konsekutif. Pasien dengan gejala dominan konstipasi yang menjalani kolonoskopi di Unit Endoskopi RSUP Sanglah selama tahun 2017 hingga 2018 direkrut. Data primer yang terdiri dari penilaian klinis, hasil tes laboratorium, dan interpretasi kolonoskopi maupun histopatologi dianalisis. Tingkat keparahan konstipasi dan inkontinensia feses ditunjukkan pada skor Patient Assessment of Constipation – Symptoms (PAC-SYM) dan Jorge-Wexner. Data dianalisis menggunakan SPSS versi 25 untuk Windows.Hasil: Sebagian besar atau responden berjenis kelamin laki-laki (62,2%). Skor PAC-SYM dan Jorge-Wexner relatif rendah dengan nilai rata-rata masing-masing 2,44±0,73 dan 2,18±0,99. Prevalensi pasien yang awalnya dinilai dengan konstipasi kronis (57,32%) tetap tinggi (26,83%) meskipun penyesuaian dilakukan setelah eksklusi kolonoskopi.Simpulan: Tantangan diagnostik konstipasi melebihi upaya maksimal dengan memanfaatkan modalitas diagnostik yang luas. Terapi yang kurang optimal tidak dapat dihindari jika tidak ada algoritma manajemen yang berkualitas baik.

Chorioangioma in pregnancy: a case report Rio Yoga Erlambang; I Wayan Artana Putra
Intisari Sains Medis Vol. 12 No. 1 (2021): (Available online : 1 April 2021)
Publisher : DiscoverSys Inc.

Background: Placental chorioangioma is a rare benign non-trophoblastic tumor of the placenta, derived from primitive chorionic mesenchyme. It can cause adverse outcomes on the mother and fetus, depending on its size. Most of the cases are accidentally detected during ultrasonography because small size tumors are usually asymptomatic. However, larger size of tumor can cause complications such as fetal anemia, fetal hydrops, polyhydramnios, premature birth, intrauterine growth restriction, and fetal death.Case report: A 27-year-old primigravida presented at Sanglah Hospital gynecology polyclinic at 27th-28th week of gestation. She was referred by an obstetric and gynecologist due to polyhydramnion since 26th-27th week of gestation. A 7.86 x 8.19 cm hypoechoic cysts with hyperechoic border were found during fetal scanning. Chorioangioma was suspected with SDP 9.11 cm. Amniocentesis was planned, however the patient had a premature uterine contraction. By this time, the fundal height was accordant with 31st-32nd week of gestation, and speculum examination showed rupture of membrane with 4 cm cervix dilation. Spontaneous vaginal delivery was performed and a boy neonate with 4/6 Apgar score and birth weight of 1150 g was delivered. Placenta was extracted out completely. There was no complication after delivery process. Macroscopic and microscopic placental examination confirmed the initial diagnosis, chorioangioma.Conclusion: Early management in determining the cause of polyhydroamnion is challenging and needs comprehensive investigation. Ultrasonography is a choice of method in initial detection of polyhydroamnion. Serial ultrasonography is needed to evaluate the amount of amniotic fluid and detect the probable cause of complications for mother, fetus, and delivery process. One of the complications is premature uterine contraction that causes premature birth. As a result, the fetus may not be viable and this remains one of the biggest challenges for clinicians. There are several possible causes that cannot be ruled out from polyhydroamnion differential diagnoses, such as a rare placental tumor chorioangioma.

Glaukoma sekunder pada pasien anak dengan Sindrom Sturge Weber: laporan kasus Putu Dian Megasafitri; I Gusti Ayu Ratna Suryaningrum; I Made Agus Kusumadjaja
Intisari Sains Medis Vol. 12 No. 1 (2021): (Available online : 1 April 2021)
Publisher : DiscoverSys Inc.

Background: Sturge Weber's Syndrome (SSW) is a rare congenital disorder characterized by hemangiomas found in several parts of the body, such as the ocular, intracranial, and facial skin structures. Patients with SSW often experience glaucoma as one of the frequent ocular manifestations which can occur from birth or throughout life and can cause blindness. This case report aims to report the management of a pediatric patient with SSW who underwent trabeculectomy after failing to maintain intraocular pressure with topical drugs.Case Presentation: A 5-year-old girl had increased intraocular pressure and optic nerve glaucoma signs in her right eye. This patient also had a birthmark in the form of a port-wine stain on her face's right side. After undergoing several tests, the patient was diagnosed with secondary glaucoma due to SSW with poor intraocular pressure control after 1.5 years of topical selective beta-blocker treatment. Trabeculectomy + 5-fluorouracil (5-FU) is performed to reduce intraocular pressure and prevent worsening of glaucoma. On the first day after surgery, the intraocular pressure was 20 mmHg in the right eye and decreased significantly during follow-up.Conclusion: Trabeculectomy is one of the treatment options to treat glaucoma in SSW patients, which results in reasonable control of intraocular pressure. Latar Belakang: Sindrom Sturge Weber (SSW) adalah kelainan bawaan yang jarang terjadi dimana ditandai dengan adanya hemangioma yang terdapat pada beberapa bagian tubuh, seperti struktur kulit okuler, intrakranial, dan wajah. Pasien dengan SSW sering mengalami glaukoma sebagai salah satu manifestasi okuler yang sering terjadi dimana dapat muncul sejak lahir maupun sepanjang masa kehidupannya serta dapat menyebabkan kebutaan. Laporan kasus ini bertujuan untuk melaporkan penatalaksanaan pada pasien anak dengan SSW yang menjalani prosedur trabekulektomi setelah gagal mempertahankan tekanan intraokuler dengan obat topikal.Presentasi Kasus: Seorang anak perempuan berusia 5 tahun mengalami peningkatan tekanan intraokuler dan tanda-tanda saraf optik glaukoma di mata kanannya. Pasien ini juga memiliki tanda lahir berupa port wine stain di bagian kanan wajahnya. Setelah menjalani beberapa pemeriksaan, pasien terdiagnosa menderita glaukoma sekunder oleh karena SSW dengan kontrol tekanan intraokuler yang buruk setelah 1,5 tahun menjalani pengobatan topikal golongan beta bloker selektif. Operasi trabekulektomi + 5-fluorouracil (5-FU)dilakukan untuk menurunkan tekanan intraokuler dan mencegah perburukan glaukoma. Pada hari pertama setelah operasi, tekanan intraokuler menjadi 20 mmHg pada mata kanan dan berkurang secara bermakna selama masa tindak lanjut.Kesimpulan: Trabekulektomi merupakan salah satu pengobatan pilihan untuk mengobati glaukoma pada pasien SSW yang menghasilkan kontrol tekanan intraokuler yang baik.

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