Background: Papillary thyroid carcinoma (PTC) is the most prevalent subtype of thyroid cancer, accounting for 80–85% of thyroid malignancies. Diagnosis is primarily established through fine needle aspiration biopsy (FNAB) categorized by the Bethesda system. Thyroid dysfunction and elevated inflammatory markers are commonly associated with advanced stages of thyroid cancer. Case Presentation: A 51-year-old male presented with a gradually enlarging left neck mass over four years, accompanied by hoarseness and a history of discontinued chemotherapy. Laboratory findings revealed an elevated erythrocyte sedimentation rate (107 mm/hour), mild anemia (Hb 10 g/dL), hyperuricemia (7.5–11.5 mg/dL), and a hyperthyroid profile with FT4 3.63 ng/dL and suppressed TSHs (<0.05 mIU/L). MRI demonstrated a left thyroid mass with multiple lymphadenopathies. FNAB identified typical features of papillary carcinoma, including follicular epithelial cells, intranuclear inclusions, and papillary structures, consistent with Bethesda category VI papillary thyroid adenocarcinoma. The patient was treated with systemic chemotherapy using doxorubicin and cisplatin. Conclusion: This case underscores the value of integrating clinical, laboratory, and cytopathological assessments in diagnosing papillary thyroid carcinoma. A Bethesda VI FNAB result provides a definitive diagnosis, while laboratory abnormalities corroborate systemic malignancy. Multimodal therapy with systemic chemotherapy is a reasonable option in patients with regional metastasis. Latar Belakang: Karsinoma tiroid papiler (KTP) merupakan jenis kanker tiroid yang paling sering ditemukan, mencakup sekitar 80–85% dari seluruh keganasan tiroid. Diagnosis biasanya ditegakkan melalui aspirasi jarum halus (FNAB) dengan sistem klasifikasi Bethesda. Gangguan fungsi tiroid serta peningkatan marker inflamasi sering dijumpai pada keganasan tiroid stadium lanjut. Presentasi Kasus: Seorang laki-laki berusia 51 tahun datang dengan benjolan di leher kiri yang membesar progresif selama empat tahun terakhir, disertai suara serak dan riwayat kemoterapi yang terhenti. Pemeriksaan laboratorium menunjukkan laju endap darah (LED) 107 mm/jam, anemia ringan (Hb 10 g/dL), hiperurisemia (7,5–11,5 mg/dL), serta pola hipertiroid dengan FT4 3,63 ng/dL dan TSHs <0,05 mIU/L. MRI memperlihatkan massa tiroid kiri dengan limfadenopati multipel. FNAB menunjukkan ciri khas karsinoma papiler berupa sel epitel folikel, inklusi intranuklear, dan pola pertumbuhan papiler, sesuai dengan kategori Bethesda VI adenokarsinoma papiler tiroid. Pasien menjalani kemoterapi sistemik dengan doxorubicin dan cisplatin. Kesimpulan: Kasus ini menekankan pentingnya mengintegrasikan data klinis, laboratorium, dan sitopatologi dalam menegakkan diagnosis karsinoma tiroid papiler. Hasil FNAB Bethesda VI memberikan konfirmasi diagnosis, sementara kelainan laboratorium mendukung adanya proses keganasan sistemik. Pendekatan multimodal dengan kemoterapi sistemik dapat menjadi pilihan rasional pada kasus dengan metastasis regional.
Background: Meningioma is a tumor that originates from meningothelial cells in the brain, and 4% of all meningiomas are orbital tumors. Most meningiomas are benign, develop slowly, and often do not cause any symptoms initially. MRI and marker examinations can predict Meningioma. Hematological examination related to inflammatory markers can provide information. This mechanism is not clearly understood yet, but many cases have used NLR as a marker of systemic inflammation associated with cancer. This research aimed to determine the differences in NLR levels between meningioma patients and controls. Methods: This research was a cross-sectional analytical study and a historical control. Researchers compared the results of a group of meningioma patients from 2018 until June 2023, with a control group of healthy ophthalmology residents that did not receive treatment, with a total of 60 subjects. This will be analyzed descriptively, bivariately, and using an ANCOVA test. Results: The Mann-Whitney test yielded a median value of 2.285 in the meningioma group, with an interquartile range (IQR) of 2.2, while in the control group, it was 1.845 with an IQR of 0.69. Analysis of Covariance (ANCOVA) found that the NLR levels were not statistically significantly different (p=0.104). Conclusions: There is a difference in NLR levels in meningioma patients when compared to controls.
Introduction: There have been very few cases of glioma in the corpus callosum documented this far. Butterfly glioblastoma in the corpus callosum is 2.9% of all instances and the median overall survival is six months. Gliomas frequently cause headaches, elevated intracranial pressure, cognitive decline (difficulty thinking and understanding, memory issues), seizures, and personality changes. Central vertigo, however, is not a typical symptom of corpus callosum glioma, according to the literature Central vertigo is an uncommon early symptom in patients with butterfly glioma in the corpus callosum, and this case report intends to describe a patient with this condition who experienced it. Case Presentation: A 75-year-old male patient came to the emergency room with complaints of dizziness, nausea, and vomiting. After 3 days of treatment in the hospital, the patient complained of a severe headache. Motor examination found hemiparesis flaccid dextra grade 4. Sensory examination was normal, the patient said there were no complaints about vision. Nystagmus was positive. MRI examination of the head with contrast showed an impression that pointed to a butterfly glioma of the posterior corpus callosum (splenium) with a differential diagnosis of primary CNS lymphoma. The patient in this case was diagnosed with central vertigo et causa primary cerebral tumor (butterfly glioma) with a differential diagnosis of primary CNS lymphoma. Conclusion: In this case, patient with butterfly glioma had vertigo as an early symptom, where vertigo is a rare manifestation in cases of butterfly glioma in the corpus callosum. In glioma patients, symptoms generally show headache, vomiting, seizures, decreased consciousness as symptoms of increased intracranial pressure (ICP). In previous studies, vertigo was rarely found as an early manifestation in cases of glioma and vertigo symptoms can be caused by pressure on the cerebellum. Further examination is needed to determine the exact diagnosis of the case. Pendahuluan: Glioma pada corpus callosum merupakan kasus yang jarang dilaporkan hingga saat ini. Prevalensi glioblastoma butterfly pada corpus callosum adalah 2,9% dari semua kasus dan median overall survival mencapai 6 bulan. Gejala umum glioma meliputi gejala peningkatan tekanan intrakranial, sakit kepala, penurunan kognitif (masalah memori, kesulitan berpikir dan memahami), kejang, dan perubahan kepribadian. Namun, menurut literatur, vertigo sentral bukan merupakan manifestasi umum dari glioma corpus callosum. Manifestasi ini dapat terjadi karena adanya desakan di cerebellum. Laporan kasus ini bertujuan untuk memaparkan kasus pasien butterfly glioma dengan manifestasi klinis awal vertigo sentral yang merupakan gejala awal yang jarang terjadi pada pasien butterfly glioma pada corpus callosum. Kasus: Pasien laki-laki berusia 75 tahun datang ke IGD dengan keluhan pusing berputar, mual, dan muntah. Setelah perawatan selama tiga hari di rumah sakit, pasien mengeluh nyeri kepala yang terasa berat. Pemeriksaan motorik didapatkan hemiparesis flaksid desktra grade 4. Pemeriksaan sensorik dalam batas normal, pasien mengatakan tidak ada keluhan pada penglihatan. Nistagmus didapatkan positif. Pemeriksaan MRI kepala dengan kontras menunjukkan kesan yang mengarah pada gambaran butterfly glioma corpus callosum posterior (splenium) dengan diagnosis banding primary CNS lympoma. Pasien pada kasus ini yang didiagnosis dengan vertigo sentral et causa tumor serebri primer (butterfly glioma) dengan diagnosis banding primary CNS lymphoma. Simpulan: Pada kasus ini pasien dengan butterfly glioma didapatkan vertigo sebagai gejala awal, dimana vertigo merupakan manifestasi jarang pada kasus glioma butterfly pada corpus callosum. Pada pasien glioma umumnya menunjukan gejala nyeri kepala, muntah, kejang, penurunan kesadaran sebagai gejala peningkatan tekanan intracranial (TIK). Pada penelitian sebelumnya jarang dijumpai vertigo sebagai manifestasi awal pada kasus glioma dan gejala vertigo dapat disebabkan oleh penekanan terhadap cerebellum. Pemeriksaan lebih lanjut diperlukan untuk menentukan diagnosis pasti dari kasus.
Introduction: Mental health problems can affect various groups such as the disabled, domestic helpers, workers, and the unemployed. Unfortunately, it is often ignored, even though its impact can affect the overall quality of life. Therefore, this study aims to determine the description of mental health in a group of kite craftsmen in Sinduwati Village, Sidemen District, Karangasem Regency. Methods: This study uses a cross-sectional study design in Sinduwat Village, Sidemen District, Karangasem. Screening will be conducted offline using a deep interview using the GAD-7 and PHQ-9 questionnaires. Data were analyzed in the form of descriptive data using spss. Results: This study obtained 26 respondents who met the inclusion criteria. The average age of respondents was 42.23 years. A total of 34.61% of the sample experienced mild depression, 19.20% experienced mild depression, and 46, 19% did not experience depression. In addition, 26.92% experienced mild anxiety, 19.20% with moderate anxiety, 15.38% experienced severe and 38.5% did not experience anxiety. Conclusion: Based on the results it can be concluded that the level of depressive symptoms, and anxiety in the community of Sinduwati Village, Karangasem. Pendahuluan: Masalah kesehatan mental dapat menyerang berbagai golongan seperti disabilitas, pembantu rumah tangga, pekerja, dan pengangguran. Sayangnya, seringkali diabaikan, padahal dampaknya dapat memengaruhi kualitas hidup secara keseluruhan. Untuk itu penelitian ini bertujuan mengetahui gambaran kesehatan mental pada kelompok pengerajin layang - layang di Desa Sinduwati, Kecamatan Sidemen, Kabupaten Karangasem. Metode: Penilitain ini menggunakan desain studi potong lintang di Desa Sinduwat, Kecamatan Sidemen, Karangasem. Skrining akan dilakukan secara offline menggunakan deep interview menggunakan kuisioner GAD-7 dan PHQ-9. Data dianalisis dalam bentuk data deskriptif menggunakan spss. Hasil: Pada penelitian ini diperoleh 26 responden yang memenuhi kriteria inklusi. Usia rerata responden adalah 42,23 tahun. Sebanyak 34,61% sampel mengalami depresi ringan, 19,20% mengalami deprrsi ringan, dan 46, 19% tidak megalami depresi. Selain itu, didaptkan 26,92% mengalami kecemasan ringan, 19,20% dengan cemasan sedang, 15,38% mengalami berat dan 38,5% tidak mengalami kecemasan. Simpulan: Berdasarkan hasil dapat disimpulkan bahwa didapatkan tingkat gejala depresi, dan kecemasan dalam masyarakat Desa Sinduwati, Karangasem.
Introduction: Cholangitis is a frequent and severe complication following Kasai portoenterostomy in children with biliary atresia, significantly impacting native liver survival. Although prophylactic strategies such as antibiotics have been widely employed, their effectiveness remains inconclusive. Methods: A systematic review was conducted in accordance with PRISMA 2020 guidelines. Comprehensive literature searches were performed in PubMed, Cochrane Library, Scopus, and Web of Science up to June 2025. Eligible studies included randomized controlled trials and observational cohorts evaluating prophylactic interventions to prevent cholangitis post-Kasai in pediatric patients. Data extraction focused on study characteristics, interventions, outcomes, and methodological quality assessed using RoB 2 and the Newcastle-Ottawa Scale. Results: Six primary studies involving 454 patients were included. One randomized controlled trial demonstrated that oral TMP-SMX or neomycin for six months postoperatively significantly reduced cholangitis recurrence compared to historical controls. Another study showed early intravenous antibiotics followed by oral TMP-SMX reduced cholangitis incidence. However, three retrospective cohorts found no significant benefit of antibiotic prophylaxis in reducing infection rates or improving transplant-free survival. One study evaluating Roux-en-Y limb length suggested that surgical configuration may influence cholangitis risk. Methodological quality ranged from low to high, with heterogeneity in interventions and follow-up duration. Conclusion: Oral prophylactic antibiotics, particularly TMP-SMX, may offer benefit in reducing postoperative cholangitis following the Kasai procedure. Nonetheless, current evidence remains inconsistent. Standardized multicenter trials are warranted to establish optimal preventive strategies.
