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"Tuberculosis is a common infectious disease in our community. The management of this disease become more difficult and also the prognosis when there were an advanced complication and a high prevalence of multidrugs resistance. We report a -10-year-old female patient with pyopneaenatorax with history of discontinuing tuberculosis drugs before"

"Leptospirosis is a wide-spread zoonosis in the world, especially in the tropical countries. Ninety percent of cases are characterized by abrupt fever and have good prognosis, but in 10% of cases, exacerbation will occur and the mortality rate is about 10%. Leptospirosis may strike the entire organ, including gastrointestinal tract. Pancreatitis in leptospira is characterized by increased serum amylase levels, with mean values of five times normal. Early diagnosis and prompt treatment will engender good prognosis. Treatment of acute pancreatitis caused by leptospira is similar with other acute pancreatitis treatment caused by other agents. The pathophysiology of leptospira infection includes endotoxin, hemolysis and lipase."

"Latar Belakang: Tuberkulosis Paru (TB Paru) merupakan penyakit infeksi yang bersifat kronis dengan tingkat morbiditas dan mortalitas yang tinggi. Perubahan metabolisme akibat infeksi Mycobacterium Tuberkulosa(M.TB) dan aktivasi sistem neurohormal turut berperan terhadap terjadinya malnutrisi, yang dapat memberikan efek negatif terhadap prognosis pasien dengan TB Paru. Penderita TB Paru mengalami penurunan kapasitas fungsional dan kualitas hidup. Terapi Medik Gizi sejak awal diagnosis ditegakkan, akan mendukung proses pemulihan pasien TB.Kasus :Dalam serial kasus ini, dipaparkan empat kasus pasien TB Paru dengan berbagai faktor risiko, diantaranya adalah penyakit TB Paru, TB Miliar, PPOK et causa TB Paru, Meningitis TB. Pada awal pemeriksaan didapatkan adanya defisiensi asupan makronutrien dan mikronutrien, hipoalbuminemia, CRP yang meningkat, hemoglobin (Hb) yang turun, penurunan kapasitas fungsional dan kualitas hidup. Terapi medik gizi diberikan secara individual, sesuai dengan kondisi klinis, hasil pemeriksaan laboratorium, dan analisis asupan makan terakhir. Hasil:Tiga dari empat pasien mengalami peningkatan asupan, perbaikan kondisi klinis, dan kapasitas fungsional serta kualitas hidup pasien. Status nutrisi pasien tidak mengalami perburukan selama perawatan,Kesimpulan:Terapi Medik gizi yang adekuat pada pasien TB dapat mempertahankan status nutrisi pasien dan mendukung perbaikan kondisi klinis, kapasitas fungsional, serta kualitas hidup pasien.

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Background:

Pulmonary tuberculosis (pulmonary TB) is a chronic infectious disease with high morbidity and mortality. Changes in metabolism due to infection with Mycobacterium Tuberculosis and activation of the neurohormal system contribute to the occurrence of malnutrition, which can have a negative effect on the prognosis of patients with pulmonary TB. Patients with pulmonary TB have decreased functional capacity and quality of life.Early medical nutrition therapywill support the recovery process of pulmonary TB patients.

Case :

In this case series, four cases of pulmonary TB patients were presented with various risk factors, including pulmonary TB disease, miliar TB, COPD et causa lung TB, and TB meningitis. Deficiency of macro and micronutrient intake, hypoalbuminemia, increased CRP, decreased hemoglobin (Hb), decreased functional capacity and quality of life were found at the beginning of examination. Nutrition medical therapy is given individually, according to clinical conditions, results of laboratory examinations, and analysis of recent food intake.

Result :

Three out of four patients experience increased intake, improvement of clinical conditions, functional capacity and quality of life. The nutritional status of patients did not experience worsening during treatment.

Conclusion:

Adequate nutritional medical therapy in TB patients can maintain patient nutritional status and support improvement of clinical conditions, functional capacity, and quality of life."

"ABSTRACTDiabetic gastroenteropathy is a common complication in prolonged diabetic patients, particularly patients with poor glycemic control or other complications, including all form of diabetic complication on the gastrointestinal tract, which prompts various symptoms of heartburn, abdominal pain, nausea, vomiting, even constipation, diarrhea, and fecal incontinence. The underlying pathophysiology of this complication manifestations are different on each organ or symptom, but may include autonomic nervous system neuropathy, loss of Interstitial Cell of Cajal as gastric muscle pacemaker leading to dysmotility, impair of liquid transportation and motoric function, as well as hyperglycemia causing oxidative stress, and other factors like Insulin-Growth Factor I inducing smooth muscle atrophy. Diabetic gastroenteropathy is one of major morbidity on diabetes mellitus patients. Patients with this complication need to be well diagnosed and ruled out other diagnosis possibilities. Management of the complication includes resolving main symptoms and maintaining good glycemic control. With growing number of diabetes mellitus patients and the prevalence of diabetic gastroenteropathy complication not being well recorded, caused by lack of attention and knowledge of healthcare provider in identifying the complication; it is important to be able to identify and to give early treatment to diabetic gastroenteropathy patients, to increase quality of life and maintain glycemic control of the patient."

"TB atau Tuberkulosis adalah suatu penyakit infeksi yang disebabkan oleh bakteri micro tuberculosis dan dapat disembuhkan dengan pengobatan teratur, diawasi oleh tim Pemantauan Terapi Obat (PTO). Proses pemantauan terapi obat merupakan proses yang panjang dan komprehensif dan harus dilakukan secara berkesinmabungan untuk sampai ke tujuan terapi tercapai. Penilitian ini bertujuan untuk melakukan pemantauan terapi obat pada pasien yang telah diseleksidengan mengidentifikasi data terapi untuk menetapkan ketepatan terapi dan mengidentifikasi masalah terkait penggunaan terapi tuberkulosis pada pasien yang memiliki komplikasi penyakit. PTO dilakukan secara retrospektif pada salah satu pasien menggunakan data sekunder berupa rekam medik pasien dan hasil laboratorium. Berdasarkan pemantauan terapi obat yang dilakukan terhadap Tn. A dan dilakukan analisis DRP untuk aspek kesesuaian dosis dan potensi interaksi obat. Dosis OAT yang diberikan kepada pasien sudah memenuhi kesesuaian dosis namun ditemukan potensi terjadinya interaksi obat dengan kategori monitor yaitu interaksi antara obat atorvastatin dan digoxin, kemudian interaksi rifampisin dengan isoniazid dan rifampisin dengan pirazinamid dengan kategori interaksi serius. Diperlukan monitoring terhadap gejala interaksi obat yang mungkin muncul dari ketiga kemungkinan interaksi obat ini serta memastikan pasien mengonsumsi obat-obatan secara teratur sesuai jadwal.

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TB or Tuberculosis is an infectious disease caused by micro tuberculosis bacteria and can be cured with regular medication, supervised by the Drug Therapy Monitoring (PTO) team. The process of monitoring drug therapy is a long and comprehensive process and must be carried out continuously to achieve the goals of therapy. This study aims to monitor drug therapy in selected patients by identifying therapeutic data to determine the appropriateness of therapy and identify problems related to the use of tuberculosis therapy in patients who have disease complications. PTO was performed retrospectively on one of the patients using secondary data in the form of patient medical records and laboratory results. Based on the monitoring of drug therapy carried out on Mr. A and DRP analysis was carried out for aspects of dosage suitability and potential drug interactions. The dose of anti-tuberculosis drugs given to patients met the appropriate dose, but there was a potential for drug interactions in the monitoring category, namely interactions between atorvastatin and digoxin, then interactions between rifampicin and isoniazid and rifampicin with pyrazinamide in the category of serious interactions. It is necessary to monitor the symptoms of drug interactions that may arise from these three possible drug interactions and ensure that patients take drugs regularly according to schedule."

"Pyogenic liver abscess may have serious complications that need specific management. We reported a case of a young male patient aged 24 years old and complained of abdominal enlargement since 2 (two) weeks before. Abdominal ultrasound revealed multiple liver abscesses. Liver aspiration was performed and about 500 cc of yellowish purulent fluid was drained. During hospitalization the symptoms of fever and shortness of breath were getting worse although adequate antibiotic treatment had been given. Chest X-ray examination showed elevated right hemidiaphragm and right pleural effusion. Thoracocentesis and proof puncture showed purulent fluid. He was diagnosed with empyema as a complication of pyogenie liver abscess. Water Sealed Drainage (WSD) was performed to evacuate the fluid and he was given antibiotics. The patient's condition improved in several days."