Nuclear medicine in Indonesia has a quite long history since the late 1960s. There are some problems and obstacles that have to be solved and overcome in order to develop nuclear medicine services, spread the services to reach every target area, and implement new novel therapeutic nuclear medicine as well. The right strategy and strong effort should be performed for a successful result. Theranostics nuclear medicine will play a more prominent role in the management of cancer patients.
Humans ; Indonesia ; Nuclear Medicine ; Theranostic Nanomedicine

No abstract available.
Asian Continental Ancestry Group* ; Humans

Nuclear medicine in Indonesia has a quite long history since the late 1960s. There are some problems and obstacles that have to be solved and overcome in order to develop nuclear medicine services, spread the services to reach every target area, and implement new novel therapeutic nuclear medicine as well. The right strategy and strong effort should be performed for a successful result. Theranostics nuclear medicine will play a more prominent role in the management of cancer patients.

Background: Myasthenia gravis is an autoimmune disorder which affects the neuromuscular junction, resulting in muscle weakness and respiratory complications. Recurrent myasthenic crises may necessitate mechanical ventilation due to respiratory failure.Case Report: We present a 21-year-old female with myasthenia gravis who experienced recurrent myasthenic crises requiring mechanical ventilation. She underwent plasma exchange therapy and inspiratory muscle training (IMT) program to improve respiratory function. Gradual ventilator adjustments and a structured IMT protocol led to significant improvements in oxygenation and carbon dioxide elimination. The patient met the weaning criteria, including the PaO2/FiO2 ratio and rapid shallow breathing index, and was successfully extubated after 12 days of mechanical ventilation. Conclusion This case highlights the importance of a multidisciplinary approach in managing myasthenic crises and suggests that IMT may expedite weaning from mechanical ventilation.

Background: Myasthenia gravis is an autoimmune disorder which affects the neuromuscular junction, resulting in muscle weakness and respiratory complications. Recurrent myasthenic crises may necessitate mechanical ventilation due to respiratory failure.Case Report: We present a 21-year-old female with myasthenia gravis who experienced recurrent myasthenic crises requiring mechanical ventilation. She underwent plasma exchange therapy and inspiratory muscle training (IMT) program to improve respiratory function. Gradual ventilator adjustments and a structured IMT protocol led to significant improvements in oxygenation and carbon dioxide elimination. The patient met the weaning criteria, including the PaO2/FiO2 ratio and rapid shallow breathing index, and was successfully extubated after 12 days of mechanical ventilation. Conclusion This case highlights the importance of a multidisciplinary approach in managing myasthenic crises and suggests that IMT may expedite weaning from mechanical ventilation.

Background: Myasthenia gravis is an autoimmune disorder which affects the neuromuscular junction, resulting in muscle weakness and respiratory complications. Recurrent myasthenic crises may necessitate mechanical ventilation due to respiratory failure.Case Report: We present a 21-year-old female with myasthenia gravis who experienced recurrent myasthenic crises requiring mechanical ventilation. She underwent plasma exchange therapy and inspiratory muscle training (IMT) program to improve respiratory function. Gradual ventilator adjustments and a structured IMT protocol led to significant improvements in oxygenation and carbon dioxide elimination. The patient met the weaning criteria, including the PaO2/FiO2 ratio and rapid shallow breathing index, and was successfully extubated after 12 days of mechanical ventilation. Conclusion This case highlights the importance of a multidisciplinary approach in managing myasthenic crises and suggests that IMT may expedite weaning from mechanical ventilation.

PURPOSE: A head injury (HI) may cause a skull fracture, which may or may not be associated with injury to the brain. In essence, a skull base fracture (SBF) is a linear fracture at the base of the skull. Loss of consciousness and Glasgow coma score (GCS) may vary depending on an associated intracranial pathology. The pathomechanism is believed to be caused by high energy impact directly to the mastoid and supraorbital bone or indirectly from the cranial vault. Aim of this study is to define the correlation between SBF and intracranial hemorrhage (ICH) in patients with HI. METHODS: Analysis of data obtained from a retrospective review of medical records and from a systematized database pertaining to diagnostic criteria of SBF patients based only on clinical symptoms associated with ICH caused by HI treated in the Department of Neurosurgery at Dr. Hasan Sadikin Hospital, Bandung, Indonesia from January 1, 2012 to December 31, 2017. The exclusion criteria included age less than 15 years and no head computed tomography (CT) scan examination provided. RESULTS: A total of 9006 patients were included into this study in which they were divided into 3 groups: group 1, HI with no ICH; group 2, HI with single ICH and group 3, HI with multiple ICH. In all the SBF cases, SBF at anterior fossa accounted for 69.40% of them, which were mostly accompanied with mild HI (64.70%). Severity of HI and site of SBF correlated with the existence of traumatic brain lesions on CT scan, thus these factors were able to predict whether there were traumatic brain lesions or not. Most of the patients with epidural hemorrhage (EDH) has single traumatic lesion on CT scan, whereas most of the patients with cerebral contusion (CC) has multiple traumatic lesions on CT scan. On patients with both traumatic brain injury and SBF, most of the patients with anterior fossa SBF has EDH; whereas most of the patients with middle fossa SBF were accompanied with CC. Surgery was not required for most of the patients with SBF. CONCLUSION SBFs were strongly correlated with traumatic ICH lesions patients with anterior fossa SBF were more likely to suffer EDH whereas with middle fossa SBF were more likely to suffer CC.

Introduction: The incidence of depression in coronary artery disease (CAD) is higher than in the general population. The factor is associated with depression is learned helplessness. Helplessness is one of the domains of illness cognition, which is someone’s preoccupation with unpleasant side effects of chronic disease related to daily functioning. Aim of this study was to determine the correlation between helplessness of illness cognition and symptoms of depression in CAD at Hasan Sadikin Hospital (RSHS), Bandung from November to December 2020. Method: The research method is a quantitative study with a cross-sectional design on CAD patients, male, and aged 55 years and over. Illness Cognition Questionnaire (ICQ) was used to assess illness cognition and depressive symptoms were assessed using the Patient Health Questionnaire-9 (PHQ-9). Results: This study involved 86 participants with a mean age of 62.4 ± 5.53 years, an average length of treatment of 3.4 ± 3.45 years, and 34 people (39.5%) had depressive symptoms. Of the 34 people who had depressive symptoms there were 4 persons (4.65%) with moderate depressive episodes and 1 person (1.16%) with major depressive episodes. The bivariate analysis using the rank Spearman correlation coefficient found that helplessness (r=0.337, p=0.001) had a significant relationship with depressive symptoms; whereas acceptance and perceived of benefit had no significant relationship with depression (r=-0.125, p=0.126,) and (r=0.035, p=0.374) respectively. Conclusion: This study concludes that depressive symptoms have a significant correlation with helplessness of illness cognition in CAD patient and there is a role of physician and cardiologist to help patients with these problems.

INTRODUCTION: Rheumatoid arthritis (RA) is one of systemic chronic progressive inflammatory disorders based on immunological disharmonies. Poorly controlled systemic inflammation in RA often leads to renal diseases such as secondary amyloidosis. CASE PRESENTATION: A 30-year-old man complained of swelling and tenderness of multiple joints gradually worsened the past 7 years. His laboratory examination showed anemia, positive rheumatoid factor (RF) and anti-citrullinated protein antibody (ACPA). C-reactive protein (CRP) was 48.7 mg/L (Normal value is <5 mg/L), increase in serum creatinine and protein was +3 in urine. His estimated glomerular filtration rate (e-GFR) was 58.3 mL/min/1.73 m2 Radiologic examinations of joints revealed features that support the diagnosis of rheumatoid arthritis. Renal biopsy was done revealed amyloid deposit. He was diagnosed with rheumatoid arthritis and secondary renal amyloidosis. CONCLUSION: Early proper diagnosis of RA is important and immunosuppressive drugs might slow disease progression by controlling the inflammatory process We discussed the importance of early diagnosis and the use of better treatment in managing RA to prevent renal amyloidosis.
Amyloidosis ; Arthritis, Rheumatoid ; Early Diagnosis

Objective: This study aimed to assess the awareness of periodontal disease and level of knowledgeof the relationship between smoking and periodontal disease amongst subjects who were smokersverses non-smokers. Methods: A questionnaire looking at knowledge of respondents regardinggum disease and knowledge and awareness about oral impacts of smoking on periodontal diseasewas developed and pretested in Dental Faculty University of Malaya. Basic Periodontal Examination(BPE) index was used to assess periodontal status. Results: The questionnaire was answered by130 subjects. Prevalence of smoking was 14.6%. A total of 58.6% non-smokers and 57.9% smokersknew about periodontal disease. However, only 26.1% non-smokers and 10.5% smokers knew thatthe cause for periodontal disease was plaque. More non-smokers than smokers knew that smokingaffected periodontal health (80.2% and 68.4% respectively) (p>0.05) and tooth mobility was an effect ofsmoking on periodontal health (27.0% and 0%) (p<0.05). Regarding source of information on effect ofsmoking on periodontal health, 63.2% smokers and 63.1% non-smokers reported obtaining informationthrough the mass media. However, only 31.6% smokers and 28.8% non-smokers were informed bytheir dentist. Conclusion: The awareness of periodontal disease and knowledge of the relationshipbetween smoking and periodontal disease was low in this selected population of smokers and nonsmokers.