Pendahuluan: Anosmia merupakan salah satu karakteristik klinis pasien COVID-19. Anosmia dilaporkan sebagai gejala pertama sebelum gejala yang lain. Penelitian sebelumnya menunjukkan anosmia berimplikasi sebagai faktor prognosis protektif pada pasien COVID-19. Melalui penelitian ini diharapkan dapat menggambarkan karakteristik pasien COVID-19 dengan gejala anosmia serta hubungannya dengan derajat keparahan.Metode: Penelitian studi deskriptif, cross-sectional, retrospektif dengan jumlah sampel 149 pasien dikonfirmasi COVID-19. Penelitian ini dilakukan pada pasien rawat inap mulai tanggal 01 Maret hingga 31 Juli 2020 di rumah sakit Primasatya Husada Citra Surabaya (RS PHC Surabaya). Pasien COVID-19 dibagi menjadi dua grup yaitu dengan dan tanpa gejala anosmia. Karakteristik klinis pasien dideskripsikan pada tabel dan dilakukan penghitungan odd ratio untuk mengetahui faktor risiko terjadinya derajat keparahan berat pada pasien COVID-19.Hasil: Pasien yang mengalami anosmia rata-rata berusia 32 tahun dengan jenis kelamin perempuan lebih banyak (63,2%), pasien dengan gejala anosmia didapatkan lebih banyak pasien dengan derajat keparahan rendah (89,5%) dengan odd ratio terjadinya derajat keparahan berat 0,479. Pasien dengan gejala anosmia disertai dengan gejala lain seperti batuk, rinorea, nyeri tenggorokan, sesak, nyeri kepala, dan nyeri otot (p < 0,05).Kesimpulan: Pasien COVID-19 dengan gejala anosmia memiliki derajat keparahan yang lebih ringan dibandingkan pasien yang tanpa gejala anosmia.
Background: Coronavirus 2019 (COVID-19) is a global pandemic with various clinical manifestations and is affected by multifactor. Epidemiological data of COVID-19 in Indonesia, especially in Surabaya have not been well established yet. Purpose: This study aims to provide the COVID-19 patients profile in Surabaya City, Indonesia. Method: The study data were retrospectively collected from electrical medical records in Primasatya Husada Citra (PHC) Hospital of Surabaya, one of the referral hospitals for COVID-19 in Surabaya. Descriptive and Spearman correlation statistics were done for data analysis. Results: Between 1 July – 31 August 2020, 456 subjects were diagnosed positive for COVID-19 by real-time polymerase chain reaction and enrolled in the study. Study subjects were dominated by the group age of 21-30 (26.75%), male (60.30%), living in East Surabaya (16.22%), and mild to moderate disease severity (47.59%) according to the patient’s clinical manifestation, respiration rate, and peripheral oxygen saturation. Subjects with symptoms were majorly having cough (37.93%), fever (29.38%), malaise (28.07%), and dyspnoea (25.00%). Positive correlation was found between disease severity and group of age (r=0.35; p=0.01), gender (r = 0.13; p=0.01), comorbidities (diabetes mellitus, hypertension, and cardiovascular disease), and X-ray findings (r=0.14; p=0.02). A negative correlation was found between disease severity and the region of domicile (r=-0.15; p=0.01). Conclusion: This epidemiological data of COVID-19 patients in Surabaya city, Indonesia, may help in diagnosing COVID-19 patients and improving health management strategies during a pandemic. Patients need to be aware of COVID-19 and understand disease transmission, especially with symptoms and risk factors.
Introduction: Amyotrophic lateral sclerosis (ALS) is the most common motor neuron disease. Based on the clinical manifestation, it is divided into spinal form and bulbar form. Bulbar form ALS is divided into two, progressive bulbar and isolated bulbar ALS (IBALS). Patients are diagnosed with IBALS whensymptoms are isolated in the bulbar region for at least six months. The prevalence of IBALS represents only 4% of the neuron disease.Objective: To provide the diagnostic approach of IBALS case based on the clinical signs and symptoms, physical examination, laboratory and radiology findings, electromyography, and fiber optic laryngoscopy examination.Case: A 64-year-old woman presented with slurred speech, the symptoms appeared 2 years ago. Within the last 6 months, the symptoms deteriorated, the patient was unable to speak, and had major difficulty in swallowing food and drinks. The functional status impairment was limited in the bulbar region.Laboratory and radiology findings did not lead to any certain disease. Electromyography and fiber optic laryngoscopy results suggesting a motor neuron disease.Conclusion: It is important to diagnose ALS patients to determine the treatment, progressivity, and prognosis of the disease.Keywords: amyotrophic lateral sclerosis, bulbar form, diagnosis
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