Farindira Vesti Rahmasari, Winny Setyonugroho, I Ketut Swarjana, Desto Arisandi, Tri Wulandari Kesetyaningsih

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CaseReport
Case Report
Research
Diabetes Article
insipidus in patiens with traumatic severe brain injury
Diabetes insipidus in patiens with traumatic severe brain injury
Yudha Adi Prabowo1, Prananda Surya Airlangga2
The
Yudha association
Adi Prabowo1,between demographic
Prananda Surya Airlangga2and attitude factors with
1) Resident of Anesthesiology and Intensive Care of RSUD Dr. Soetomo, Medical Faculty of
the practice
1) Resident
Airlangga of malaria and
ofUniversity.
Anesthesiology prevention among
Intensive Care the
of RSUD Dr.rural community
Soetomo, inof
Medical Faculty
Airlangga
Purworejo University.
district, Indonesia
2) Staff Departement of Anesthesiology and Reanimation of RSUD Dr. Soetomo, Medical Fac-
ulty of Airlangga University.
Farindira
ulty ofVesti Rahmasari
Airlangga , Winny Setyonugroho2, I Ketut Swarjana3, Desto Arisandi4, Tri
University.
1*
Wulandari Kesetyaningsih 5
1,5) Department of Parasitology, School of Medicine, Faculty of Medicine and Health Sciences, Universitas Muhammadiyah
Yogyakarta
A2) RMagister
T I CofLHospital
E I NAdministration,
FO ABSTRACT
ABSTRACT
Universitas Muhammadiyah Yogyakarta
Traumatic severe brain injury is a fatal injury, with a
3) Institute of Technology and Health Sciences Bali
Submitted : Januari
4) Institute of Health 2019
Guna Bangsa, Yogyakarta mortality rate of up to 50%. About 1.5 million people
Accepted : February 2019 experience severe brain injury in the United States. There
Published : Mei 2019 are more than 50,000 deaths and 500,000 incidents of
ARTICLE INFO ABSTRACT
permanent neurological sequelae. About 85% of mortality
Keywords: occurs in the first 2 weeks after the injury. One complication
Malaria is one of the global health problems that is faced
Submitted : July 2020 of a severe brain injury is diabetes insipidus. There are no
Diabetes insipidus, brain injury, by many countries, including Indonesia. This study aimed
Accepted : November 2020 definitive data on the incidence of diabetes insipidus in
hypernatremia,: desmopressin, to examine the association between demographic and
Published January 2021ICU patients with traumatic severe brain injury of Indonesia
attitude factors with malaria prevention in the rural areas
Correspondence: so far. In this case report, a male, 45 years old, was taken
of Purworejo District, Indonesia. A community survey
Keywords:
to
wasthe conducted
Emergency in Installation
Purworejo (IRD)
Districtafter
that experiencing
involved 147a
yud180987@yahoo.com
Malaria, prevention practice, traffic accident 12 hours before being hospitalized.
respondents by using simple random sampling to select After
the
mosquito net, Indonesia surgery, the signs
respondents. of diabetes interview
A questionnaire insipidus was
was presented
used by
to collect
polyuria
data about demographic factors, attitudes, and malaria/
of 300cc / hour urine production and 149mmol
*Correspondence: L hypernatremia, although the immediate administration of
prevention practices. A Chi-square test was performed
farindira.vesti@gmail.com desmopressin,
to examine the the association
patients clinical
betweenand hemodynamic
demographic and was
not shown any improvements. The patient passed away in the
attitude factors with the practice of malaria prevention
days five of treatment in the Intensive Care Unit (ICU). The
in the community. Among 147 respondents, 80 (54.4%)
main treatments
respondents for diabetes
conducted insipidus
malaria in traumatic
prevention practice severe
using
brain injury are adequate rehydration and administration
bed mosquito net in their own houses. Demographic factors
of
suchdesmopressin.
as education Adequate hypovolemic,
level (p<0.001), occupation polyuric and
(p=0.016),
hypernatremia corrections are the keys to the
and attitude factor (p=0.006) were significantly associated successful
treatment of diabetes insipidus. Diabetes insipidus in cases
with the use of bed mosquito net for malaria prevention
of brain injury
practice. requires complicated
Meanwhile, 63 (42.9%)treatment.
respondentsTherefore,
used
in the case of being handled improperly, it can bring death.
ventilation mosquito net for malaria prevention practice.
Demographic factors such as education level (p<0.001),
ABSTRAK age groups (p=0.005), occupation (p=0.002), and attitude
Cedera factorfatal,
otak berat traumatis adalah cedera (p=0.001) were associated
dengan tingkat significantly
Cedera otak berat traumatis adalah cedera fatal, dengan tingkat kematian hingga 50%. Sekitar 1,5
kematian hingga with the
50%. Sekitar 1,5
mengalami cedera otak use
berat di of ventilation
Amerika Serikat.mosquito
Terdapat net for
lebih malaria
juta orang mengalami cedera otak berat di Amerika Serikat. Terdapat lebih dari 50.000 kematian
juta orang dari 50.000 prevention
kematian
practice. Overall, malaria
85%prevention by using
dan 500.000 insiden gangguan neurologis permanen. Sekitar 85% kematian terjadi dalam 2 minggu
dan 500.000 insiden gangguan neurologis permanen. Sekitar kematian terjadi both2 bed
dalam and
minggu
ventilation mosquito nets were very low percentages.
pertama setelah cedera. Salah satu komplikasi dari cedera otak yang parah adalah diabetes insipidus.
Tidak ada data pasti tentang kejadian diabetes insipidus pada pasien dengan cedera otak traumatis
1
113
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Case Report
berat di Indonesia sejauh ini. Pada laporan kasus ini, seorang pria, 45 tahun, dibawa ke Instalasi
INTRODUCTION three main keys are available such as availability
Rawat Darurat (IRD) setelah mengalami kecelakaan lalu lintas 12 jam sebelum dirawat di rumah
Diabetes
sakit. Setelah
insipidus in patiens
operasi, tanda-tanda
with traumatic
of Artemisinin severe brainpoliuria
Combination injury
Therapy (ACT)
Malaria is a life-threatening disease diabetes
caused byinsipidus drugs; ditandai
rapiddengan adanya techniques
diagnostic produksi
with
Yudha
parasitesAdi Prabowo1,
transmitted Prananda
to humans throughSuryabitesAirlangga2
urin 300cc / jam dan hipernatremia 149 mmol / L, meskipun segera diberikan desmopresin, kondis
Rapid Diagnostic Test (RDT); and prevention
klinis dan hemodinamik pasien tidak menunjukkan perbaikan. Pasien meninggal pada hari kelima
of infected of
1) Resident Anopheles
Anesthesiology femaleandmosquitoes
Intensive Carestrategies
of RSUDusing Dr. Soetomo,
Long LastingMedical Faculty ofNets
Insecticide
perawatan
(WHO, di Unit
2018).
Airlangga Perawatan
Malaria
University. Intensif in
is spread (ICU).
95 Perawatan utama untuk
(LLIN) mosquito nets diabetes insipidus
or Impregnated pada
Treated
cedera otak berat traumatis adalah rehidrasi dan pemberian desmopresin yang adekuat. Koreksi
countries, and even 3.2 billion people in the
Nets (ITNs), backed by a strong commitment
hipovolemik,
world
ultylive
of in poliurik,
the
Airlangga dan of
riskyUniversity.
area hipernatremia
malaria (WHO, yang adekuat
from local adalah kunci keberhasilan
government (Kementrianpengobatan
Kesehatan
diabetes
2016). Ininsipidus.
2017, around Diabetes
219 insipidus dalam kasus
million malaria RI, 2017). According to WHO, the yang
cedera otak membutuhkan perawatan most
rumit. Karena itu, jika ditangani dengan tidak tepat, bisa menyebabkan kematian.
cases were reported globally, and in 2018 important in preventing malaria is vector
the number of malaria cases increased to 228
ABSTRACT control, such as reducing mosquito bites’
ARTICLE INFO
Kata
millionkunci
cases, with 93% in Africa
: Diabetes region
insipidus, and
Traumaticcederasevere
otak, hipernatremia,
brain to
opportunity injury
humans.desmopressin,
is a The
fatalpeople ICU
injury, with in
living a
Correspondence
Submitted : Januari
3,4% in the South-East 2019
Asia region.
: yud180987@yahoo.com There
mortality rate theof up to 50%.
high-risk areas of About
malaria 1.5 aremillion people
recommended
Accepted
were 405,000 :deaths February due 2019to malariaexperience
(WHO, severe to usebrain injury in nets,
mosquito the United
including States. There
bed and
Published
2019). In Indonesia,
INTRODUCTION : Mei 2019 the number ofare Annual
more than CASE REPORT
50,000
ventilation deaths and
mosquito nets500,000
(WHO, incidents
2019). There of
Parasite Incidence (API)
Traumatic brain injury is a fatal injury, of malaria was
with neurological
permanent are currently sequelae. About
three types of 85% of mortality
mosquito net:
A 45-year-old man was taken to the Emergency
0.68
a per 1000
mortality
Keywords: rate citizens,
of up and ACT About
to 50%. percentage 1.5
occurs in the first 2 weeks after the injury. One complication
simple untreated net, Insecticidal Treated Nets
Hospital (IRD) Dr. Soetomo after a motorcycle
coveragepeople
million was 97% with insevere
2018.brain Malaria
injury casesin
of a severe brain injury is diabetes insipidus. There are no
(ITNs), accident
and long-lasting insecticide-treated
Diabetes insipidus, traffic 12 hours before being
occurred
the around
United States thebrain
hills,injury,
have border areas,
more than rivers,
50,000
hypernatremia,
and paddy desmopressin, ICU definitive data
neton the incidence
(LLINs)
hospitalized. (Lover,
The of diabetes
Sutton,
patient Asy,insipidus
is unconscious & Wilder- in
since
deaths and fields
500,000 in Purworejo
permanent District. With with Smith,
neurological
patients traumatic
2011). severe
ITNs brain
are injury
estimated
the accident occurred. First aid was given in the of Indonesia
twice times
a vector density
sequelae (Agha of and 0.38–3.85
Thompson, mosquitoes/
2006).
so far. In this case report, a male, 45 years old, was taken
more effective compared to untreated nets and
Correspondence: previous health facility; RSUD Tuban, thus the
individuals/hour, the Anopheles to species
Approximately 85% of mortality occurs in the the Emergency
provideInstallation
more than (IRD) after experiencing
70% protection. These nets a
patient was referred to IRD Dr. Soetomo.
yud180987@yahoo.com
accounts for transmission in 76–88
first 2 weeks after the injury, which traffic percent
exhibits of
accident
are 12
The hours has
dip-treated
patient before
usingbeing
attached a a hospitalized.
synthetic After
pyrethroid
collar brace at the
endemic malaria areas in Purworejosurgery,
the initial impact of systemic hypotension and District the insecticide,
signs of indiabetes
either insipidus
deltamethrin was oforpresented
permethrin.by
arrival resuscitation room Dr. RSUD
during the year
intracranial (Murhandarwati
hypertension et al.,
(Benvenga 2015;
et al., of 300cc
polyuria ITNs / hour
should urine
be production
re-infused and
with 149mmol
insecticide /
Soetomo. Responding to pain, with the
Mursid,
2000). Sudibyakto, Gunawan, Sutomo, &
L hypernatremia, although the immediate administration of
every six months for optimum efficacy.
examination of anisocoria round pupils This4/3
Windraswara,
One 2015). oMalaria
of the complications f a severe cases
brain have
injury
desmopressin, the
method patients
caused clinical and
a logistical hemodynamic
issue in rural was
areas.
mm, both eye light reflexes were decreased.
decreased
is diabetes from 2010 to
insipidus. 2014,and
(Agha but Thompson,
thenot shown any improvements. The patient passed away in the
malaria Fresh, long-lasting insecticide nets
Spontaneous breathing 30 times per (LLINs)
minute
handling program neither lowers the days five of treatment in the Intensive Care Unit (ICU). The
2006; Hannon et al., 2012). Diabetes insipidus cases in in most countries replaced the use ofbreath
ITNs
presented with an additional gurgling
endemic
is areas
a disease nor maintain
caused by the in the free
lower endemic
production,
main treatments for
(Bachou, diabetes insipidus
Tylleskär, in traumatic
Kaddu-Mulindwa, severe &
with oxygen saturation of 92% using an oxygen
area (Kementrian Kesehatan
secretion, and function of Anti brain RI, 2020).
Diuretic injury mask
are adequate
Tumwine, rehydration and 2015;
administration
of 5 2006;
liters Bhatt et al.,
per minute. Blood Masum
pressure et
Purworejo (ADH).
Hormone District had a previous
Kidney of history
abnormalities
desmopressin. Adequate hypovolemic,
al., 2010). Another study suggests that using polyuric and
110/75 mmHg (MAP 86), pulse 120 times per
of malaria
were marked fluctuation cases. Meanwhile,
by the unresponsiveness of
hypernatremia corrections
a bed
minute. netTip of are
while the
sleeping
the keys
might
extremity to were
the
reducesuccessful
malaria
warm, dry
Purworejo canADH
physiological be categorized
stimulation, as awhich
malaria- is
likelihood in Maluku but not in two other
and red with an examination of capillary refill
endemic area whose cases have remained
characterized by excessive thirst (polydipsia) of brain injury requires
locations, complicated
namely North treatment. andTherefore,
time <2 seconds. The Maluku East Nusa
right parietooccipital
throughout the year (Rejeki, Fuad,
and large amounts of urine (polyuria). There is Widartono,
Tenggara (Ipa,
hematoma was Widawati,
found. The Laksono, Kusrini,
patient was
Murhandarwati, & Kusnanto, 2019). Malaria
no definitive data on the incidence of diabetes & Dhewantara, 2020). In some areas, thewithuse
immediately suctioned and oxygenated
cases started increasing in 2014 with 567
insipidus in patients with severe brain injury of ITNs also seemed less protective, although
ABSTRAK Jackson Reese 10 liters per minute, a two-lane
cases,
in constantly
Indonesia so far. 720 cases in 2015 and 2017, the use of ITN
intravenous line iswas
considered
attached one and of30°
thehead-
most
Cedera
and reach
Diabetes otak beratintraumatis
720
insipidus 2018
in cases adalah
(Dinas cedera
Kesehatan
of brain fatal, dengan tingkat kematian hingga 50%. Sekitar 1,5
injury cost-effective and preventive malaria
up position. The patient was prepared to be strategies.
juta orang complicated
Purworejo,
requires mengalami
2019). cedera otak berat
treatment. di Amerika Serikat. Terdapat lebih dari 50.000 kematian
Diabetes These results
intubated areETT
using consistent
No.7 withand several
the lip studies
border
dan 500.000can
insipidus insiden
lead gangguan
to death neurologis
when permanen. Sekitar 85% kematian terjadi dalam 2 minggu
handled
Indonesia is committed to eliminating malaria that 21cm.
was suggested The unused
ventilator bedusednetsPCV (ITNs)
mode treated
with
pertama setelah cedera. Salah
improperly. satu komplikasi dari cedera otak yang parah adalah diabetes insipidus.
in accordance Therefore,
with the 2007the 60th authors
WHO global are with insecticide projected an increase in malaria
RR 16, PC 15, trigger 2, I: E 1: 2, FiO2 50%.
Tidak ada datadiscussing
interested pasti tentang thekejadian diabetes ofinsipidus pada pasien dengan cedera otak traumatis
agreement in (Kementrian Kesehatan management
RI, 2009). incidence (Asante & Asenso-Okyere, 2003;
Elimination of malaria is very likely because Iliyasu, Babashani, Abubakar, Salahudeen, &
2
114
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CaseReport
Case
Aliyu, Report
2013; Monasch et al., 2004; Pinchoff et went to malaria-endemic areas; (3) Willing to
Diabetes
al., 2015). insipidus in patiens with traumaticparticipate
severe brain injury in this study to fulfill
voluntarily
Diabetes insipidus in patiens with traumatic severe brain injury
Yudha Adi Prabowo1, Prananda Surya
Many efforts have been made in terms of malaria Airlangga2informed consent from the respondents or a
1) Resident
prevention andofcontrol.
Anesthesiology
However, and did notCareparent
Intensive
they of RSUD or guardian in the case
Dr. Soetomo, Medicalof children.
Faculty Theof
1) Resident
focusAirlangga of Anesthesiology
University.
comprehensively and Intensive
on active involvement Care exclusion
of RSUD criteria
Dr. include
Soetomo, respondents
Medical Faculty with
of
Airlangga community. Therefore, local malnutrition, respondents with other infections
the local University.
and
communities’ efforts with their but do not cause by malaria (anamnesis and
concerted
demographic situation are vital in improving microscopy examination), pregnant women,
the malaria disease control plan. In this sense, and mother who is breastfeeding.
it is essential to understand people’s views on This research protocol was reviewed and
malaria
A R T I and
CLE to Iidentify ABSTRACT
ABSTRACT
N F O specific factors that approved by The National Ethics Commission
contribute to fluctuations in transmissionTraumatic
and severe
(Number: brain injury is a fatal injury, with a
14035/KEP-UNISA/I/2020).
Submitted : Januari 2019
to help develop the best strategy to achieve the Respondents have provided1.5
mortality rate of up to 50%. About million
written people
approval
Accepted : February 2019
goal of malaria eradication. Therefore,experience
research severe
for theirbrain injury in the
involvement in United
the study.States. There
For this
Published : Mei 2019
is needed to examine the relationship between analysis, the respondents’ identities have allof
are more than 50,000 deaths and 500,000 incidents
demographic factors and attitudes withpermanent
malaria neurological
been removed sequelae. About
from the dataset. 85% Theof research
mortality
Keywords:practices in rural areas of Purworejo
prevention occurs in the first 2 weeks after the injury. One complication
tools that used in this study was a questionnaire
District,
DiabetesIndonesia.
insipidus, brain injury, of a severe brain injury is diabetes insipidus. There are no
that developed by researchers consisting of
hypernatremia, desmopressin, ICU definitive data
(1) on the incidence
demographic factorsof such
diabetes insipidus
as age, gender,in
METHODS patients with traumatic severe brain injury
education level, number of family members, of Indonesia
and respondent’s occupation; (2) attitude
A cross-sectional study was conducted in the
to the Emergency Installation
of respondents (IRD) malaria
towards after experiencing
disease and a
rural areas of Purworejo District in Central
yud180987@yahoo.com
traffic accident 12 hours before being hospitalized.
prevention; (3) practice on malaria prevention After
Java Province of Indonesia. There were 147
surgery, the about
signs of diabetes
using bed insipidus was presented
and ventilation mosquito by
respondents recruited and involved in this
polyuria of 300cc
nets. Furthermore, data were collected by /
/ hour urine production and 149mmol
study. The inclusion criteria, including (1)
an interview with the respondents in the
respondents age 5-55 years old with malaria
desmopressin, the patients
community. clinical
Before the and hemodynamic
interview was started,was
risk (divided into three parts: 1. Socio-
the respondents were explained about this
ecological status: gender, age, occupation,
research’s objectives and asked them to be
and behaviors; 2. Individual-level: lack of
main treatments for diabetes
involved insipidus
in this study. in traumatic
In addition, severe
respondents
knowledge, unimproved housing, mosquito net,
brain injury were
are adequate
asked torehydration
give a signatureand administration
before the
mosquito coils, protective clothes, repellent,
of desmopressin.
interview Adequate hypovolemic,
was started. polyuric test
The Chi-square and
staying outdoor overnight; 3. Household-level:
hypernatremia corrections are the keys
was performed to examine the association to the successful
number of inhabitants, household condition,
between demographic and attitude factors
availability of mosquito breeding sites around
of brain injury
withrequires complicated
the practice of malaria treatment.
prevention Therefore,
in the
the home, household economic condition,
community.
ITNs ownership); (2) respondents with history
ABSTRAK
1
115
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126 mosquito nets. Furthermore, data were collected by an interview with the respondents
Case Report
127 RESULTS
in the community. Before the interview was started, 50% ofthe therespondents
respondentswere wereexplained
having 3-4 family
128 Diabetes
about 147
Among
sakit.
thisinsipidus
research's
respondents,
Setelah operasi,
inthe
patiens
objectives
tanda-tanda
and with
majority asked traumatic
them
membersto be(57.1%).severeinbrain
involved injury
this study.
diabetes ofinsipidus ditandai dengan adanya poliuria produksi
In
129 addition,
them were respondents
age 21-60 years were asked to give
old (76,9%), a signature before the interview was started.
Yudha Adi Prabowo1, Prananda Surya Airlangga2 In all areas, most participants included in the
130 The
female Chi-square
(61.2%), andtestthewas performed
education to was
level examine study the association
appeared between
the demographic
most good attitude (61.2%).
131 an elementary
and
perawatan attitude school
factors
di Unit (63.9%).
with the Based
practice onof the
malaria A prevention
large in the
percentage community.
Perawatan Intensif (ICU). Perawatan utama untuk diabetes insipidus pada of the participant had
Airlangga University.
type of occupation, most participants were attained the use of bed mosquito net (54.4%)
132 RESULTS
engaged
hipovolemik, in farming
poliurik, (39.5%). More than
dan hipernatremia yang adekuat and not adalah
used ventilation mosquito net
kunci keberhasilan (57.1%).
pengobatan
133
diabetes insipidus. Diabetes insipidus dalam kasus cedera otak membutuhkan perawatan yang
134 Table 1. Demographic characteristics of respondents in rural areas of Purworejo
135 District, Indonesia (n=147)
136 ARTICLE INFO ABSTRACT
Kata kunci : Diabetes insipidus, cederasevere
Traumatic otak, hipernatremia, desmopressin, ICU
Variables nbrain injury % is a fatal injury, with a
Correspondence
: yud180987@yahoo.commortality
Respondent's age (years) rate of up to 50%. About 1.5 million people
Accepted : February 2019 experience severe 10 brain injury
<21 years 6.8 in the United States. There
Published
INTRODUCTION : Mei 2019 are more CASE
than REPORT
50,000 deaths
21-60 years 113 76.9and 500,000 incidents of
Traumatic brain injury >60is years
a fatal injury, with neurological
permanent 24 sequelae. About
16.3 85% of mortality
A 45-year-old man was taken to the Emergency
a mortality rate of Gender
Keywords: up to 50%. About 1.5
million people with Male severe brain injury in
traffic 57 accident 38.812 hours before being
Diabetes insipidus, brain injury,
the United States have more than 50,000
Female ICU definitive data on 90the incidence
hospitalized. 61.2
The of diabetes
patient insipidus
is unconscious in
since
hypernatremia, desmopressin,
deaths and 500,000 Education
permanent level neurological
patients with traumatic severe brain injury
sequelae (Agha and Thompson,
Elementary school 2006). 94 63.9
previous health facility; RSUD Tuban, thus the
Correspondence:
Junior high school
Approximately 85% of mortality occurs in the to the Emergency 40Installation 27.2(IRD) after experiencing a
yud180987@yahoo.com
first 2 weeks after the Senior high
injury, school
which exhibits 11hours has 7.5
traffic accident The 12 patient before being a hospitalized.
attached collar brace at After
the
Higher educationsurgery, the arrival
the initial impact of systemic hypotension and 2
signs of indiabetes 1.4 insipidus
resuscitation room was ofpresented
Dr. RSUD by
intracranial hypertension Occupation(Benvenga polyuria
et al., of 300cc / hour urine production
Soetomo. Responding to pain, with the and 149mmol /
2000). Farmer 58 39.5
examination of anisocoria round pupils 4/3
One of the complications Household mother
of a severe brain injury
desmopressin, mm, the 44patients
both 29.9
eye clinical and hemodynamic
light reflexes was
were decreased.
Employers
is diabetes insipidus. (Agha and Thompson, 20 13.6
Spontaneous breathing 30 times per minute
Employee
2006; Hannon et al., 2012). Diabetes insipidus 25 with 17.0
presented an additional gurgling breath
Number of family
is a disease caused by the lower production, member
main treatments for diabetes insipidus in traumatic severe
with oxygen saturation of 92% using an oxygen
1-2 family
secretion, and function of Anti brain membersDiuretic injury mask 17
are adequate 11.6
rehydration
of 5 liters per minute. and Blood
administration
pressure
Hormone (ADH). 3-4 family abnormalities
Kidney membersof desmopressin. 84Adequate 57.1hypovolemic,
110/75 mmHg (MAP 86), pulse 120 times per polyuric and
>4 family
were marked by the unresponsiveness members of
hypernatremia 46
corrections 31.3
minute. Tip of are
the the keys to were
extremity the warm,
successful
dry
137 physiological ADH stimulation, which is
146 Table
Among 2. 147Attitude and practice
respondents, of malaria
the majority of them prevention
were among respondents in rural
138 characterized by excessive thirst (polydipsia) of brain injury
time <2 age
requires 21-60 years
complicated
seconds. The old (76,9%),
treatment.
right Therefore,
parietooccipital
147
139 areas
female of Purworejo
(61.2%), andDistrict,
the Indonesia
education
and large amounts of urine (polyuria). There is (n=147)
level was an elementary school (63.9%).
in the case of being handled improperly, it can bring death. Based on
hematoma was found. The patient was
140 no definitive data on the incidence of diabetes
the type of occupation, most participants were engaged immediately in farming (39.5%).
suctioned andMore than
oxygenated with
Variables
insipidus in patients with severe brain injury n %
141 50%
ABSTRAK of the respondents were having 3-4 family members (57.1%).
Jackson Reese 10 liters per minute, a two-lane
142 in Indonesia soAttitude
far. toward malaria disease intravenous line was attached and 30° head-
Cedera otak berat
Good
Diabetes insipidus traumatis
in cases adalah cedera
of brain fatal, dengan tingkat 90
injury kematian61.2 hingga 50%. Sekitar 1,5
143 up position. The patient was prepared to be
juta orang mengalami
Poor cedera otak
requires complicated treatment. Diabetes berat di Amerika Serikat. Terdapat
57 lebih
38.8 dari 50.000 kematian
intubated using ETT No.7 and the lip border
dan 500.000can
insipidus insiden
lead gangguan
Category to of neurologis
using
death permanen.
a bed mosquito
when handled net Sekitar 85% kematian terjadi dalam 2 minggu
144
Use was 21cm. The ventilator
80 parah 54.4 used PCV mode with
pertama
improperly. Therefore, the authors are cedera
setelah cedera. Salah satu komplikasi dari otak yang adalah diabetes insipidus.
Not used RR 16, PC 15, trigger 2, I: E 1: 2, FiO2 50%.
67 dengan 45.6cedera otak traumatis
145 Tidak ada data
interested pasti
in discussingtentang thekejadian diabetes
management of insipidus pada pasien
Category of using a ventilation mosquito net
Use 63 42.9
Not used 84 57.1
148
2
149
116
In all areas, most participants included in the study appeared the most good attitude
4
Category of using a bed mosquito net
Use QANUN 80Vol 5 54.4
MEDIKA No41.l no
JANUARY 2021
QANUN MEDIKA VOL.4
VOL no 11 Mei
Mei 2019
2019
Not used 67 45.6
Category of using a ventilation mosquito net
Use 63 42.9
148
Not used QANUN
QANUN MEDIKA
MEDIKA 84 57.1
JURNAL
JURNALKEDOKTERAN
KEDOKTERANFKUM
FKUMSURABAYA
SURABAYA
149 In all areas, most participants included in the study appeared the most good attitude
150 (61.2%). A large percentage of the participant had attained the use of bed mosquito
151 net (54.4%) and not used ventilation mosquito net (57.1%).
CaseReport
Case Report
152
Diabetes
Table 3. insipidus in patiens with
with traumatic severe brain injury
153 Diabetes insipidus
Factors in patiens
associated with
the traumatic
practice severe
of malaria brainamong
prevention injury
154 Yudha Adi Prabowo1,
respondents Prananda
in rural areas SuryaDistrict,
of Purworejo Airlangga2
Indonesia (n=147)
155 Yudha Adi Prabowo1, Prananda Surya Airlangga2
1) Resident
AirlanggaofUniversity.
Anesthesiology and Use
Intensive
of bedCare of RSUD Dr. Soetomo,
mosquito Medical Faculty of
Use of ventilation
Airlangga University. net mosquito
2) Staff Departement of Anesthesiology and Reanimation of RSUD Dr. Soetomo, Medical Fac- net
Variables
ulty of Airlangga University. Used Not Used Not used
ulty of Airlangga University. n (%) used n (%) n (%)
n (%)
Respondent's age (years)
<21 years 4 ABSTRACT
(40.0)
ABSTRACT 6 (60.0) 2 (20.0) 8 (80.0)
ARTICLE INFO
21-60 years 49Traumatic severe64 63
brain injury is a fatal 50 (44.2)
injury, with a
Submitted : Januari 2019 (43.4) (56.6)
mortality rate (55.8)About 1.5 million people
of up to 50%.
>60 years : February 2019
Accepted 14 10 19 5 (20.8)
experience severe brain injury in the United States. There
Published : Mei 2019 (58.3) (41.7) (79.2)
are more than 50,000 deaths and 500,000 incidents of
*p value 0.382 0.005*
permanent neurological sequelae. About 85% of mortality
Gender
Male 21 36 27 30 (52.6)
Diabetes insipidus, brain injury, of a severe brain injury is diabetes insipidus. There are no
(36.8) (63.2) (47.4)
Female
hypernatremia, desmopressin, ICU 46definitive data 44 on the incidence
57 of diabetes insipidus in
33 (36.7)
patients
(51.1) with traumatic
(48.9) severe
(63.3) brain injury of Indonesia
*p value
0.091 0.057
Education level to the Emergency Installation (IRD) after experiencing a
yud180987@yahoo.com
Elementary school 56 traffic accident
38 12 hours before
66 being hospitalized.
28 (29.8) After
surgery, the (40.4)
(59.6) signs of diabetes
(70.2)insipidus was presented by
Junior high school polyuria
8 (20.0) of 300cc
32 / hour urine
15 production 25 and
(62.5)149mmol /
(80.0) (37.5)
Senior high school 2 desmopressin,
(18.2) the
9 (81.8) patients
Jurnal 2clinical and hemodynamic
(18.2) Qanun
Kedokteran 9Medika
(81.8) was
Higher education 1 not shown any improvements. The patient passed away in the
(50.0) 1 (50.0) 1 (50.0) 1 (50.0)
*p value <0.001* <0.001*
main treatments for diabetes insipidus in traumatic severe
Occupation
Farmer 32 26 35 23 (39.7)
of desmopressin. Adequate hypovolemic, polyuric 5 and
(55.2) (44.8) (60.3)
Household mother 22hypernatremia 22 corrections 33are the keys to the
11 (25.0) successful
(50.0) (50.0) (75.0)
Employers 3 of brain injury
(15.0) 17 requires complicated
8 (40.0) treatment.
12 (60.0)Therefore,
(85.0)
Employee 10 15 8 (32.0) 17 (68.0)
ABSTRAK (40.0) (60.0)
*p value 0.016* 0.002* hingga 50%. Sekitar 1,5
Cedera otak berat traumatis adalah cedera fatal, dengan tingkat kematian
Number of familyotak berat di Amerika Serikat. Terdapat lebih dari 50.000 kematian
juta orang mengalami cedera
member
1-2 family members 10 7 (41.2) 12 5 (29.4)
(58.8) (70.6)
3-4 family members 35 49 44 40 (47.6)
(41.7) (58.3) (52.4)
>4 family members 22 24 28 18 (39.1)
(47.8) 1 (52.2) (60.9)
117
*p-value 0.404 0.318
Occupation
QANUN
Farmer MEDIKA Vol 5 No 1 32 QANUN
QANUN
JANUARY 2021
26 MEDIKA
35 VOL.4
MEDIKA VOL 4 .l23
no
No 11 Mei
(39.7)Mei2019
2019
(55.2) (44.8) (60.3)
Household mother 22 22 33 11 (25.0)
QANUN
QANUN MEDIKA
MEDIKA
(50.0) (50.0) (75.0)
Employers JURNAL 3 (15.0)
JURNALKEDOKTERAN
KEDOKTERAN 17FKUM
FKUMSURABAYA 8 (40.0)
SURABAYA 12 (60.0)
(85.0)
Employee 10 15 8 (32.0) 17 (68.0)
(40.0) (60.0)
*p Report
Case value 0.016* 0.002*
Number of family
Diabetes
member
sakit.
insipidus in patiens with traumatic severe brain injury
Setelah operasi, tanda-tanda diabetes insipidus ditandai dengan adanya poliuria produksi
1-2 family
Yudha members Prananda
Adi Prabowo1, 10Surya Airlangga2 7 (41.2)
urin 300cc / jam dan hipernatremia 149 mmol / L, meskipun segera diberikan desmopresin, kondis 12 5 (29.4)
(58.8) (70.6)
1)3-4
Resident of Anesthesiology and35 Intensive Care49of RSUD Dr.44Soetomo, Medical Faculty of
family members 40 (47.6)
perawatan
Airlangga di Unit Perawatan Intensif (ICU). Perawatan utama untuk diabetes insipidus pada
University. (41.7) (58.3) (52.4)
>4 family members 22 24 28 18 (39.1)
hipovolemik, poliurik,
ulty of Airlangga dan hipernatremia
University. (47.8) yang adekuat (52.2) adalah kunci keberhasilan pengobatan
(60.9)
diabetes
*p-value insipidus. Diabetes insipidus 0.404 dalam kasus cedera otak membutuhkan perawatan yang
0.318
Attitude toward malaria
AR disease
TICLE INFO ABSTRACT
Kata
Good kunci : Diabetes insipidus,
34Traumaticcederasevere
otak, hipernatremia,
23 42
brain injury desmopressin,
is a fatal 15 (26.3) ICUwith a
injury,
Correspondence
: yud180987@yahoo.com
(59.6)
mortality rate (40.4) (73.7)About 1.5 million people
of up to 50%.
Accepted
Poor : February 2019 33experience severe 57 42 in the United
brain injury 48 (53.3) States. There
Published
INTRODUCTION : Mei 2019 (36.7)
are more than CASE
(63.3) REPORT
50,000 deaths (46.7) and 500,000 incidents of
*p-value brain injury is a fatal injury,
Traumatic 0.006* with neurological
permanent 0.001*
sequelae. About
A 45-year-old man was taken to the Emergency 85% of mortality
156 a mortality rate of up to 50%. About
Keywords: 1.5
Table
Table 33people depicted
depicted a crude a association
crude association
between and Residual Spray factors Insecticide (Hasyim,
157 million with severe brain injury in demographical and attitude
traffic with
between demographical and attitude factors Dale, Groneberg, Kuch, & Müller, being
accident 12 hours before 2019;
158 the United States
the practice ofdesmopressin,have more
malaria prevention than 50,000
among
definitive respondents
data in rural
on the
hospitalized. areas.
incidence
The Among
of
patient diabetes 147insipidus
is unconscious in
since
hypernatremia,
with the practice of malaria ICU prevention Ipa et al., 2020; Setiyaningsih, Trapsilowati,
159 deaths and 500,000
respondents, permanent
the Chi-square neurological
analyses patients
demonstratedwith thetraumatic
that the severe
percentage
accident&occurred. brain
of
First injury
using
aid wasbedof Indonesia
given et in the
among respondents in rural areas. Among Mujiyono, Lasmiati, 2018; Sitohang al.,
160 sequelae
and (Agha
ventilation and Thompson,
mosquito net was very 2006).
low, previous health facility; RSUD Tuban, thus the
especially age <21 years old. In using bed
Correspondence:
147 respondents, the Chi-square analyses 2018). Purworejo, Central Java, Indonesia, is
Approximately 85% of mortality occurs in the
and ventilationthat mosquito net, men were to the
lessEmergency Installation (IRD) Education
likely compared after experiencing a
161 demonstrated
yud180987@yahoo.com the percentage of using considered a tomalaria-endemic
women. area with the
first 2 weeks after the injury, which traffic exhibits accident The 12 hours
patient before
has being a hospitalized.
attached collar After
brace at the
162 was significantly associated
bed and ventilation mosquito net was very with the practice of malaria prevention (p<0.05).
highest cases in 2015. Nowadays, Purworejo There is
the initial impact of systemic hypotension and surgery, the arrival
signs of indiabetes insipidus was ofpresented by
163 was especially
low, a statistically agesignificant
<21 yearsassociation
old. In using occupationresuscitation
betweencategorized and
as good attitude
a malaria room
low with Dr.area
endemic RSUD
with
intracranial hypertension (Benvenga polyuria et al., of 300cc
Soetomo. / hour urine production
Responding and 149mmol
to pain, with 2018; /
the
164 bed and ventilation
practice. There was mosquito
a statisticallynet,significant
men wereassociation stable incidence
between age(Setiyaningsih
and the used et al.,
of
2000). L hypernatremia, although the immediate administration of
examination of 2018).
anisocoria round pupils with
4/3
less likely compared
ventilation mosquito net to for
women.
malaria Education
prevention Sitohang et al., Our study analyzed
165 One of the complications of a severe brain injury (p=0.005).
desmopressin, mm, the patients clinical
both eye light and hemodynamic
reflexes bywere was
decreased.
166 was significantly associated with the practice a questionnaire developed researchers to
is diabetes insipidus. (Agha and Thompson, not shown any improvements. The patient passed away in the
of malaria prevention (p<0.05). There was a describe the association between demographic
2006; Hannon et al., 2012). Diabetes insipidus days five of treatment in the Intensive Care Unit (ICU). The
presented
167 statistically
DISCUSSION significant association between and attitudewith an with
factors additional
the practicegurgling breath
of malaria
is a disease caused by the lower production, main treatments for diabetes insipidus in
with oxygen saturation of 92% using an oxygen traumatic severe
occupation and good attitude with practice. prevention among the rural community. In
secretion, and function of Anti brain Diuretic injury mask
are adequate
of our rehydration
5 liters per minute. and Blood
administration
168 There was a statistically
The Indonesian significant
Government association
delivered general,
some elimination study
programs reveals an pressure
that education
through level,
Hormone (ADH). Kidney abnormalities of desmopressin. Adequate hypovolemic,
169 between
integrated age and
approach the
which used of ventilation
targeted in age
2030of (Indonesia, groups, occupation,
2016; Sitohang etkeys and
al., 2018). attitude factors
were marked by the unresponsiveness hypernatremia corrections
minute. Tip of are
the the
extremity to were
the successful
170 mosquito net
This comprehensivefor malaria prevention
solution involves (p=0.005).
the were
continuous associated
distribution significantly
of insecticide- with warm,
the usedry of
physiological ADH stimulation, which is
treated bed nets in highly resistantof districts ventilation
every two mosquito net for malaria prevention
171 characterized by excessive thirst (polydipsia)
DISCUSSION brain injury time <2 years,
requires
practice.
the The
complicated
seconds. distribution
treatment. of Therefore,
right parietooccipital
172 Artemisinin Combination Therapy
and large amounts of urine (polyuria). There is (ACT), and Residual Spray Insecticide
hematoma was found. The patient was (Hasyim,
173 no definitive data on the incidence of diabetes
The Indonesian Kuch,
Dale, Groneberg, Government
& Müller, 2019; delivered In2020;
this study,
Ipa et al.,immediately we identified
Setiyaningsih,
suctioned andthat
Trapsilowati, age and use
oxygenated of
with
insipidus in patients with severe brain injury
some elimination programs through an
ABSTRAK ventilation mosquito net for malaria prevention
Jackson Reese 10 liters per minute, a two-lane
in Indonesiaapproach
integrated so far. which targeted in 2030 was stated asline
intravenous statistically
was attached significant. The use
and 30° head-of
Cedera otak berat traumatis adalah cedera fatal, dengan tingkat
bedposition. kematian
and ventilation hingga
mosquito 50%. Sekitar 1,5
Diabetes
(Indonesia, insipidus
2016; in cases of
Sitohang et brain injury
al., 2018). up The patient was net constitutively
prepared to be
juta orang
requires mengalami cedera
complicated treatment.
This comprehensive otak berat
solution Diabetes di
involves Amerika 49% Serikat.
and Terdapat
63% in agelebih dari
between 50.000
21 kematian
6 tolip
60border
years
intubated using ETT No.7 and the
dan 500.000
insipidus
the continuous insiden
can lead gangguan
to death of
distribution neurologis
when permanen.
handled
insecticide- Sekitar
were21cm. 85%
muchThe kematian
higher terjadi
than used otherdalam 2
groups.minggu
This
was ventilator PCV mode with
pertama
improperly. setelah
treated bed nets cedera.
Therefore, Salah
in highlythe satu komplikasi
authors
resistant dari
are
districts cedera otak yang parah adalah
may be due to the well-ordered distribution diabetes insipidus.
Tidak
every adatwo
interested data pasti
years,tentang
in discussing thethekejadian
managementdiabetes
distribution ofinsipidus
of of bed padanetspasien
and can denganalsocedera
reach otak manytraumatis
villages,
Artemisinin Combination Therapy (ACT), especially those with a history of high malaria
2
118
QANUN MEDIKA
QANUN Vol 5 VOL.4
MEDIKA No41.l no
VOL JANUARY
no 11 Mei 2021
Mei 2019
2019
QANUN
QANUN MEDIKA
MEDIKA
JURNAL
JURNALKEDOKTERAN
KEDOKTERANFKUM
FKUMSURABAYA
SURABAYA
CaseReport
Case
cases Report(Setiyaningsih et al., 2018). This by using the attitude questionnaire section. The
locally
Diabetes
is insipidus
also in line with otherin patiens
studies with traumatic
(Hetzel et severe brain
al., traumatic
majority injury (61.2%) have a good
of respondents
Diabetes insipidus in patiens with severe brain injury
2012;
YudhaLiu AdietPrabowo1,
al., 2015) Prananda
even though the ITN/
Surya attitude towards malaria prevention, with the
Airlangga2
Yudha
LLIN Adi rate
usage Prabowo1, Prananda
is the lowest (70.5%) Surya
in adultAirlangga2
1) Resident of Anesthesiology and Intensive Careuse
of of bed mosquito
RSUD Dr. Soetomo,net (54.4%).
MedicalGood attitude
Faculty of
men (≥15
1) Resident years)
of because men
Anesthesiology
Airlangga University. often
and go to
Intensive theCareisofrepresented
RSUD Dr. by belief
Soetomo, in disease
Medical prevention
Faculty of
forest and returnUniversity.
Airlangga to their village. They may carry behavior at the individual and household
malaria
ulty from the forest
of Airlangga to their community. levels. Nearly 50% of participants used self-
University.
Otherultystudies also support
of Airlangga this result that protection against mosquito bites by installing
University.
malaria is more common in the economically a mosquito net. There was also a significant
active age population (Tadesse, Fogarty, & relationship between the use of bed nets and
Deressa, 2018). Meanwhile, another study practice (Kumar, Rathi, Lal, Goel, & care,
ABSTRACT
ABSTRACT
ARTICLE INFO
shows that age was associated withTraumatic positive severe
2018). brain
Research in 5isprovinces
injury in Indonesia’s
a fatal injury, with a
Submitted
malaria : Januari
test results 2019
(Tadesse et al., 2018). This eastern part shows about
mortality rate of up to 50%. About 1.5 million half of thepeople
total
Acceptedwith a: study
contrasts February
in 3572019
households where severe
experience respondents indicated
brain injury utilization
in the ITNs (Ipa et
United States. There
Published
age, education :level,
Mei 2019
and occupation are weremore
not than
al., 2020).
50,000 deaths and 500,000 incidents of
significantly related to the use of insecticide-
permanent neurological sequelae. About
The health effects 85% bed
of using treated of nets
mortality
have
treated
Keywords:bed nets, but for household occupants
been confirmed in a variety of transmission
who had LLIN, 74.7% of individualsof a severe brain injury is diabetes insipidus. There are no
over the settings (Gamble, Ekwaru, Garner, & Ter
Diabetes
age of 18 insipidus, brain (Sanjana
use their LLIN injury, et al., 2006).
hypernatremia, desmopressin, ICU definitive data on the
Kuile, incidence
2007; Lengeler,of diabetes
2004). The insipidus
use of in
According to previous research conducted
patients inwith traumatic severe brain injury
appropriate and effective mosquito nets can of Indonesia
North West Ethiopia, it was found that socio- reduce transmission by up to 90 percent in
Correspondence:
demographic factors such as age, educational
to the Emergency Installation
the community and(IRD) after experiencing
can reduce all causes ofa
yud180987@yahoo.com
status, gender, occupation, and religiontraffic were notaccident 12 hours before being hospitalized.
under-five mortality by 44 percent (Eisele, After
statistically significant with malaria prevention
surgery, the Larsen,
signs of &diabetes
Steketee,insipidus
2010). One was of
presented
the factorsby
(Alelign & Petros, 2018). In addition,polyuria religion, of 300cc
contributing to this success was the relatively/
occupation, and age group did not significantlyL hypernatremia, although the immediate administration of
low cost, ease of use, and flexibility of
affect attitudes to malaria preventiondesmopressin,
(Assan, distribution
the patients clinical
(WHO, and hemodynamic
2010). Most respondents was
Takian, Hanafi-Bojd, Rahimiforoushani, & did not use a ventilation mosquito net (57.1%).
Nematolahi, 2017). days five of treatment in the Intensive Care Unit (ICU). The
Other studies have determined various factors
Meanwhile, respondents with a goodmain treatments
attitude for diabetes
in various insipidus
settings, the mostin traumatic
common severe
of which
towards malaria prevention have abrain injury are
higher are users
adequate rehydration
complaining thatand
theyadministration
are too hot
of desmopressin.
percentage of used bed and ventilation mosquito under Adequate
the network, hypovolemic,
few mosquitoes polyuric and
around
hypernatremia corrections are the keys
nets than respondents with a poor attitude. or malaria is not a severe problem, ITN is no to the successful
The attitude toward malaria prevention treatment of diabetes insipidus. Diabetes insipidus in cases
has longer effective, ITN is in bad condition, ITN is
a statistically significant association with theinjury
of brain requires
being stored.complicated
It can be saidtreatment.
difficultiesTherefore,
of laying
use of both bed and ventilation mosquito in the case of being handled improperly, it can bring death.
nets nets in traditional houses and lack of adequate
for malaria prevention (p=0.006 and p=0.001, space under the network for all household
respectively).
ABSTRAK In this research, attitude can be members (Batega, 2004; Baume, Reithinger,
categorized into two categories, namely poor & Woldehanna, 2009). Efforts to increase the
attitude (less than 80%: 7 – 23 scores) and a good use of bed nets should focus on clear local
attitude (80 -100% : 24 - 28 scores) for analytical evidence of why people use or do not use bed
purposes (Bloom, 1956). Researchers find out nets. There is, however, a lack of dedicated
the risk, prevention, and treatment of malaria and well-designed research on the reasons
for not using nets, as indicated by a recently
1
119
QANUN MEDIKA
VOL 4 .lNo
no11 Mei
Mei2019
2019
QANUN
QANUN MEDIKA
MEDIKA
JURNAL
JURNALKEDOKTERAN
KEDOKTERANFKUM
FKUMSURABAYA
SURABAYA
Case Report
Noor, Omumbo, Amin, Zurovac, & Snow,
published literature review. Tentatively, this
2006; Ordinioha, 2007). It is maybe because,
Diabetes
analysis found
sakit. Setelah of
insipidus
operasi,
in
that heat-related
tanda-tanda
patiens with
discomfort traumatic
diabetes insipidus ditandai
in recent
severe
dengan
years, primary
brain
adanya
injuryschools
poliuria produksi
and secondary
and absence mosquitoes were frequently
have concentrated on disease prevention and
reported as reasons for disuse, whereas in
1) Resident
this survey, of Anesthesiology
these reasons were andstated
IntensivelessCaresanitation
of RSUD education,
Dr. Soetomo, including
Medicalbed net use
Faculty of in
perawatan
Airlangga
frequently. di Unit Perawatan
University.
Some clearly valueIntensif
the mosquito(ICU). Perawatan
the district utama
where untuk diabetes surveyed
the villages insipidus inpada this
study are
net as a valuable household asset (sometimes located. This systematic educational
hipovolemik,
ulty of to
belonging poliurik,
Airlangga
certain dan hipernatremia
University.
individuals) even though yang adekuat
programadalah kunci keberhasilan
may explain the high prevalence pengobatan of
diabetes insipidus. Diabetes insipidus
it is used for defense against mosquitoes that dalam kasus
nets cedera
in otak
these membutuhkan
villages, although perawatan
respondentsyang
transmit malaria (Pulford, Hetzel, Bryant, only graduated from elementary school
program (Ndjinga & Minakawa, 2010). It is
ASiba,
RT& I CMueller,
L E I N2011). F O It is also ABSTRACT possible
Kata kunci : Diabetes
by geographic area in Purworejo Traumatic insipidus, cedera
that the severe contradictory
otak, to other
hipernatremia,
brain injury studies
a fatal that
desmopressin,
is respondents
ICUwith a
injury,
Correspondence
Submitted
insufficient (and : Januari 2019 heterogeneous)
: yud180987@yahoo.com
somewhat mortality rate need of more
up to years
50%. ofAbout
education 1.5 to use a bed
million people net
Accepted : February
supply of bed nets could be due to the 2019 experience (García-Basteiro et al., 2011;
entire severe brain injury in the United States. There Yitayew, Enyew,
Published
INTRODUCTION
distribution system’s: Mei 2019 many factors.are more than
Village Goshu,
CASE & Treatment,
REPORT
50,000 deaths and 2018).
500,000 incidents of
Traumatic
accessibility brainhasinjury
beenis adescribed
fatal injury, as with
permanent
the neurological
The occupation sequelae. About
was significantly
A 45-year-old man was taken to the Emergency 85% of mortality
associated with
a mortality
Keywords: rate of up to 50%.
primary determinant of net ownership (Hetzel About 1.5
the practice of using both bed and ventilation
million
et al., people Contrary
2012). with severe to brain studies
other injury in
in mosquitoaccident
traffic nets for malaria
12 hours preventionbefore (p=0.016
being
the United States
Ratanakiri Province, have
Cambodiamore than
found 50,000
definitive
a very data andon p=0.002,
the incidence
hospitalized. of diabetes
The respectively).
patient insipidus
The
is unconscious highest in
since
hypernatremia, desmopressin, ICU
deaths and 500,000
high percentage permanent nets
of mosquito neurological
patients
use. The with traumatic
percentage severe
of using brain
both injury
bed
the accident occurred. First aid was given in the andof Indonesia
ventilation
sequelae
results (Agha that
showed and 95.8%Thompson,
of 2006).
respondents mosquito nets were a farmer and household
Correspondence:
used a mosquito net at home, 83.8% used to the Emergency
mother.Installation
It was about (IRD) 55.2
patient was referred to IRD Dr. Soetomo. after
andexperiencing
50% of using a
yud180987@yahoo.com
first 2 weeks clothing
after the forinjury, which exhibits
long-sleeved malaria traffic
prevention accident
bed12
The hours has
mosquito
patient before
for being
netattached a hospitalized.
the farmer collar and After
household
brace at the
the initial impact of systemic hypotension and
(Yasuoka et al., 2018). Other studiessurgery, showed the arrival
signs of inand
mother, diabetes
aboutinsipidus
resuscitation 60.3room was of
and presented
75% Dr.ofRSUD by
using
intracranial
that most of hypertension
the respondents (Benvenga et al., of 300cc
(95.8%)polyuria
thought /
ventilation hour urine
mosquito production
net
Soetomo. Responding to pain, with the for and
the 149mmol
farmer and /
2000).
that malaria was a preventable andL hypernatremia, although the immediate administration of
curable household mother.
examination The majority
of anisocoria round of participants
pupils 4/3
One o f
disease. t he c omplications o f a
s evere b rain i njury
desmopressin, the
who were
mm, patients
both engaged clinical and
eye light inreflexes hemodynamic
farmingwere also decreased. was
correlated
is diabetes insipidus. (Agha and Thompson, not shown any improvements. The patient passed away in the
with another study
Spontaneous (Ipa et
breathing 30 al., 2020;per
times Liuminute
et al.,
The percentage of using bed and ventilation
2015). Several
presented authors
with an have highlighted
additional gurgling breath that
mosquito net was high among respondents who
is a disease caused by the lower production, main treatments for
households’ diabetes insipidus
socioeconomic in
with oxygen saturation of 92% using an oxygen traumatic
status severe
affects bed
graduated from elementary school compare to
secretion, and function of Anti brain Diuretic injury mask
are usage
net adequate
of 5 and isrehydration
liters theper
most and Blood
important
minute. administration
determinant
pressure
other education levels. Education levels were
Hormone (ADH). Kidney abnormalities of desmopressin. Adequate hypovolemic,
of net use. More wealthy families are much
significantly associated with the use of both
were marked by the unresponsiveness of
hypernatremia more corrections
minute. likely toare
Tip of usethe
the nets keys
extremity to were
(Hetzel the successful
et warm,
al., 2012;
dry
bed and ventilation mosquito nets (p<0.001).
physiological ADH stimulation, which is
Koenker & Kilian, 2014; Xu, Liao, Liu, Nie,
This study also in line with another study in
characterized by excessive thirst (polydipsia) of brain injury time requires
& Havumaki, complicated
<2 seconds. 2014). The This treatment.
could
right beTherefore,
explained
parietooccipital
Myanmar and Kenya (N Ng’ang’a et al., 2009).
and large amounts of urine (polyuria). There is in the case of being handled improperly, it can bring death.
by the fact that
hematoma was farmers
found. and The
householdpatient mothers
was
Another study for bivariate analysis shows
no definitive data on the incidence of diabetes also reach from
immediately malariaand
suctioned message with radio,
oxygenated with
any significant correlation between education
ABSTRAK newspaper, internet, television,
Jackson Reese 10 liters per minute, a two-lane and other print
and malaria knowledge, even though 53.3%
in Indonesia so far. media by a well-promoting
intravenous line was attached malariaand elimination
30° head-
participants
Cedera otak graduate
berat from elementary
traumatis school
Diabetes insipidus in cases adalah cedera
of brain fatal, dengan tingkat kematian hingga 50%. Sekitar 1,5
injury up position. The patient was prepared office.
program from Purworejo, district health to be
(Trapsilowati,
juta orang Pujiyanti,
mengalami & Wigati,
cedera otak 2018).diThe
berat Amerika Serikat. Terdapat lebih dari 50.000 kematian
requires complicated treatment. Diabetes Household
intubated mothers
using ETT possibly
No.7 have
and more
the lip time
border to
bed 500.000
dan net useinsiden
is also associatedneurologis with adequate
insipidus can lead gangguan
to death when handled permanen. Sekitar 85% kematian terjadi dalam 2 minggu
learn21cm.
was information during used
The ventilator theirPCV home modeactivity,
with
knowledge
pertama about
setelah malaria
cedera. Salah transmission
satuauthors
komplikasi and dari cedera otak yang parah adalah diabetes insipidus.
improperly. Therefore, the are it will help to understand all
RR 16, PC 15, trigger 2, I: E 1: 2, FiO2 50%. about the malaria
parent’s
Tidak adaperception
data of bed nets
pasti tentang (Eisele et al.,insipidus pada pasien dengan cedera otak traumatis
interested in discussing thekejadian
management diabetes of prevention program. This program has started to
2009; Noor, Kirui, Brooker, & Snow, 2009;
develop and expanded since 2008. The control
2
120
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VOL JANUARY
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2019
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JURNAL
JURNALKEDOKTERAN
KEDOKTERANFKUM
FKUMSURABAYA
SURABAYA
Case
Case
of Report
Report
malaria vectors that have been carried out (2019). WhatsApp: a supplementary tool
Diabetes
in insipidus
the Purworejo in patiens
region includes with traumatic
insecticide- severe brain injury
for improving bedbrain
nets universal coverage
Diabetes insipidus in patiens with traumatic severe injury
treated mosquito nets and house
Yudha Adi Prabowo1, Prananda Surya Airlangga2 spraying campaign in Mozambique. BMC Health
Yudha
with Adi Prabowo1,
insecticides Prananda
(Indoor Residual Surya Airlangga2
SprayingCare of RSUD Services 1-7.Faculty of
1) Resident of Anesthesiology and Intensive Dr.Research,
Soetomo,19(1),
Medical
/ 1)
IRS). Malaria
Resident prevention
AirlanggaofUniversity. is also carried out
Anesthesiology and Intensive CareAsante, of RSUD F. Dr.
A., Soetomo, Medical Faculty
& Asenso-Okyere, of
K. (2003).
through patient
Airlangga care and
University. adequate treatment
Economic burden of malaria in Ghana. A
and preventive medication
ulty of Airlangga University. for pregnant
Technical Report Submitted to the World
women ulty (B2P2VRP,
of Airlangga2015; Indonesia, 2016;
University. Health Organisation (WHO), African
Talipouo et al., 2019). In order to increase the Regional Office (AFRO)., 1-81.
community’s knowledge and understanding of
malaria and its preventive action, additional ABSTRACT
ABSTRACT Assan, A., Takian, A., Hanafi-Bojd, A. A.,
ARTICLE INFO Rahimiforoushani, A., & Nematolahi,
sensitization resources such as community Traumatic severe brain injury is a fatal injury, with a
Submittedfocus
educators, : Januari 2019
group discussions, or social rate of S.up J.to
mortality
J. o. P. H. P. (2017). Knowledge,
50%. About 1.5 million people
Accepted
media (Facebook,: February
WhatsApp, 2019YouTube), which attitude, and practice about malaria:
Published
are now commonly : Meiused
2019by the public, Socio-demographic implications for
are should
more than 50,000 deaths and 500,000 incidents of
be used. However, the use of social permanent malaria control in rural Ghana. J Public
media to neurological sequelae. About 85% of mortality
educate the population at the national level is Health Policy, 38(4), 445-463. doi:
10.1057/s41271-017-0088-6
still not common and maybe a goodof a severe brain injury is diabetes insipidus. There are no
way to
Diabetes insipidus,
communicate brain
with the injury, (Arroz et al.,
population B2P2VRP. (2015). Laporan rikhus vektora
hypernatremia,
2019) desmopressin, ICU definitive data on the incidence of diabetes insipidus in
Propinsisevere
patients with traumatic Jawa Tengah, salatiga.
brain injury of Indonesia
Bachou, H., Tylleskär, T., Kaddu-Mulindwa,
CONCLUSION to the Emergency D.Installation (IRD) after experiencing
yud180987@yahoo.com H., & Tumwine, J. K. J. B. i. d.a
The practice of malaria prevention among traffic accident 12 hours before being hospitalized.
(2006). Bacteraemia among severely After
respondents in Purworejo District of Indonesia surgery, the signs malnourished
of diabetes insipidus was presented
children by
infected
was very low. Education level, type of polyuria of 300cc and uninfected with the human/
occupation, and attitude towards L hypernatremia, although the immediate administration of
malaria immunodeficiency virus-1 in Kampala,
prevention were associated with both desmopressin,
bed the Uganda.
patients BMCclinical and hemodynamic
Infectious was
Disease, 6(1),
and ventilation mosquito used. Improving not shown any improvements. The patient passed away in the
160.
malaria prevention by increasing awareness days five of treatment in the Intensive Care Unit (ICU). The
of
main nets Batega,
treatments D. W. (2004).
for diabetes Knowledge
insipidus in traumatic attitudes
severe
communities for using bed and ventilation
and practices about malaria treatment
is needed to decrease morbidity and mortality
due to malaria. of desmopressin. and prevention
Adequate in Uganda. polyuric
hypovolemic, Final Reportand
prepared are
hypernatremia corrections for Ministry
the keys of
to Health in part
the successful
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FKUMSURABAYA
SURABAYA
Case Report
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a fatal injury, with a
Correspondence
Submitted
Purworejo. : Januari 2019
: yud180987@yahoo.com mortality rate of up to 50%. About M.,
Iliyasu, Z., Babashani, 1.5 Abubakar, I. S.,
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Assessment with
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A 45-year-old man was taken to the Emergency in
a mortality
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people
children
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brain injury,
brain across
injury in traffic 630-635.
15 accident 12 hours before being
the United States have more than 50,000
countries desmopressin,
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hospitalized.
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(2016). of
Thediabetes
patient is insipidus
unconscious
desk review in
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Correspondence: Ipa, M.,Installation
Widawati, (IRD)
M., Laksono, A. D., Kusrini,
Approximately 85% of mortality occurs in the to the Emergency after experiencing
patient was referred to IRD Dr. Soetomo. a
yud180987@yahoo.com
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first 2 weeks after the injury, which traffic R. W.
exhibits I., & Dhewantara, P. W. J. P. O. (2020).
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the
J. I. j. o. e. (2010). Protective surgery,
the initial impact of systemic hypotension and efficacy the signs Variation of preventive practices and
arrivalof indiabetes insipidus
resuscitation room was ofpresented
Dr. RSUD by
of interventions
intracranial hypertension for preventing malaria
(Benvenga polyuria et al., of 300cc its
/ association
hour urine with malaria
production and infection
149mmol /
Soetomo. Responding to pain, with the
2000). mortality in children in Plasmodium in eastern Indonesia:
L hypernatremia, although the immediate administration of Findings from
One ofalciparum endemic
f the complications of areas.
a severe International
brain injury
desmopressin, mm, the community-based
patients
both eye clinical and survey.
light reflexes hemodynamic Plos was
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One
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is diabetes Epidemiology,
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293/
presented an additional gurgling
is a disease
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Ekwaru, by P.the
J., lower
Garner, production,
main
P., & Tertreatments for diabetes insipidus
MENKES/SK/IV/2009. in traumatic
with oxygen saturation of 92% using an oxygen severe
secretion,
Kuile,and F. O.function of Anti Diuretic
brain injury mask
are adequate rehydration
J. P. M. (2007). Insecticide- of 5 liters
Kementrian Kesehatan RI. and
per minute. administration
Blood
(2017). pressure
Buku Saku
Hormone treated(ADH).
nets for the Kidney
prevention abnormalities
ofof desmopressin.
malaria Adequate hypovolemic,
110/75 mmHg (MAP 86), pulse 120 times per polyuric and :
Menuju Eliminasi Malaria. Jakarta
were inmarked
pregnancy: by the unresponsiveness
a systematic review of
hypernatremia
of corrections
minute. are
Tip of ofthe the keys
extremity to were
the warm,
successful dry
Ministry Health. 1-30.
physiological ADH stimulation, which PLoS is
randomised controlled trials.treatment of diabetes insipidus. Diabetes insipidus in cases
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& Kilian,and A. oxygenated
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C., Baltazar, G., Rehman, A. M., Matias,
in Indonesia so far. intravenous line was attached and 30° head-
Cedera A.,otak
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. . .berat
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in cases adalah fatal, dengan country
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1,5
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in children up position.
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Plos patient was prepared
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juta orang mengalami
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under insiden
five and household bed permanen.
net intubated using ETT No.7 and the lip border
dan 500.000
insipidus can lead gangguan
to death neurologis
when handled SekitarV.,
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m., & care, p. (2018). Malaria and dengue: insipidus.
Guinea. Malaria Journal, 179. insipidus
10(1),diabetes RR 16, PC 15, trigger 2, I: E 1: 2, FiO2 50%.
Tidak ada data pasti tentang
interested in discussing the management of kejadian pada pasien dengan
Knowledge, attitude,cedera otak and
practice, traumatis
effect
2
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SURABAYA
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yud180987@yahoo.com implications forbeing
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Zurovac, D., & Snow, R. W. (2006).
desmopressin, the Wealth,
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clinical education
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and physicalwas
Monasch, R., Reinisch, A., Steketee,not shown any improvements. The patient passed away in the
R. W.,
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Child coverage with mosquito brain nets and 5(1), 5.
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Adequate The use ofpolyuric
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1
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SURABAYA
Case Report
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prevention
not using a mosquito netinsipidus ditandai dengan adanya
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Yudha Adione Prabowo1, Prananda
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10(1),di
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University.
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hipovolemik,
ulty poliurik,
of Airlangga dan hipernatremia yang adekuat
University. adalah kunci keberhasilan pengobatan
Murhandarwati, E. E. H., & Kusnanto, Tindakan Masyarakat pada Peningkatan
diabetes insipidus. Diabetes insipidus dalam kasus cedera otak membutuhkan perawatan yang
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patterns of malaria at cross-boundaries Tahun 2015. J Aspirator, 10(1), 9-14.
A R Tarea I C in
L EMenoreh I N F OHills, Java, Indonesia. ABSTRACT
Kata kunci : Diabetes insipidus, cederasevere
Traumatic otak,
WHO. hipernatremia,
(2010).
brain Worldis
injury desmopressin,
Malaria
a fatal Report ICU
injury, 2009.
with a
Malaria Journal 18(1), 80.
Correspondence
: yud180987@yahoo.com mortality rate of up (2016).
to 50%. About 1.5 million
Sanjana, P., Barcus,
Accepted : February M. 2019
J., Bangs, M. J., WHO. World malaria reportpeople
2015:
experience severe World brain injury
Health in the United States. There
Organization.
Ompusunggu,
Published
INTRODUCTION : Mei S., 2019 Elyazar, I., Marwoto, CASE REPORT
H., . . . hygiene. (2006). Survey of WHO. (2018). World Malaria
Traumatic brain injury is a fatal injury, with neurological
permanent sequelae. About
A 45-year-old man was taken to the Emergency 85% Report 2018.
of mortality
community
a mortality rate of knowledge,
up to 50%. attitudes,
About and
1.5 Geneva: World Health Organization. 3,
practices during a malaria
million people with severe brain injury epidemic in
in 1-210.
Diabetes insipidus,
central Java, brain injury, Am. of a severe brain injury is diabetes insipidus. There are no
Indonesia. J. Trop.
traffic accident 12 hours before being
the United States have more than definitive 50,000 data WHO.on the incidence
(2019).
hospitalized. The World of Malaria
patient diabetes insipidus
Report:
is unconscious in
2019.
since
hypernatremia,
Med. Hyg., desmopressin,
75(5), 783-789. ICU
deaths and 500,000 permanent neurological patients with traumatic
(1), severe
1-232. brain injury
sequelae
Setiyaningsih, (Agha and Thompson,
R., Trapsilowati, 2006).
W., Mujiyono,
Correspondence: Xu, J.-w., Liao, Y.-m., Liu, H., Nie, R.-h., &
M., & Lasmiati, L. (2018). Pengendalian to the Emergency Installation (IRD) after experiencing a
yud180987@yahoo.com Havumaki, J. J. P. O. (2014). Use of bed
first 2 Vektor
weeks after
Malaria the injury,
di Daerah which Endemis
exhibits
traffic accident
The 12 hours before
patient being a hospitalized. After
nets andhas attached
factors collar brace
that influence bed netat the
use
the initial impact of systemic hypotension and
Kabupaten Purworejo, Indonesia.
surgery, the arrival
signs of indiabetes insipidus was ofpresented by
amongresuscitation
Jinuo ethnic room minority in Dr.Southern
RSUD
intracranial
Balaba:hypertension
Jurnal Litbang (Benvenga et al., of 300cc
Pengendalian
polyuria Soetomo. / hour urine production and 149mmol /
China.Responding
Plos One Journal, to pain, with the
9(7), e103780.
2000).Penyakit Bersumber Binatang
One oBanjarnegara,
f the complications 1-12. of a severe brain injury
desmopressin, Yasuoka,
mm, the both J.,
patients
eye Kikuchi,
clinical K.,
and Nanishi,
light reflexes hemodynamic K., Ly,was
were decreased. P.,
is diabetes insipidus. (Agha and Thompson, Thavrin, B., Omatsu,
not shown any improvements. The patient passed away in the T.,
Spontaneous breathing 30 times per minute & Mizutani, T.
Sitohang, V., Sariwati, E., Fajariyani, S. B.,
2006; Hannon et al., 2012). Diabetes insipidus J. B. with
p. h.an (2018). Malaria knowledge,
Hwang, D., Kurnia, B., Hapsari,days five of treatment in the Intensive Care Unit (ICU). The
R. K., . presented additional gurgling breath
is a disease caused by the lower production, main treatments preventive
for diabetes actions,
insipidus in
with oxygen saturation of 92% using an oxygen and
traumatic treatment-
severe
. . Hawley, W. A. J. M. j. (2018). Malaria
secretion, and function of Anti brain Diuretic injury seeking
are adequate
mask behavior
of 5 liters among
rehydration
per minute. and ethnic minorities
administration
Blood pressure
elimination in Indonesia: halfway
Hormone (ADH). Kidney abnormalities of desmopressin. in Ratanakiri
Adequate Province,
hypovolemic,
110/75 mmHg (MAP 86), pulse 120 times per Cambodia:
polyuric and a
there. The Lancet Global Health, 6(6),
were marked by the unresponsiveness of
hypernatremia minute. community-based
corrections
Tip of are
the the cross-sectional
keys to were
extremity the warm, survey.
successful
dry
e604-e606.
physiological ADH stimulation, which is BMC Public Health, 18(1),
and red with an examination of capillary refill 1206.
Tadesse, F., Fogarty, A. W., & Deressa,
characterized by excessive thirst (polydipsia) W. injury
of brain time requires
<2 A. complicated
seconds. The H. treatment.
right Therefore,
Yitayew, E., Enyew, D., parietooccipital
Goshu, Y. A. J.
(2018). Prevalence and
and large amounts of urine (polyuria). There is associated risk
hematoma was found. The patient was
M. R., & Treatment. (2018). Utilization
factors of malaria among adults in East
no definitive data on the incidence of diabetes immediately suctioned Factors
and oxygenated with
and Associated of Insecticide
Shewa Zone of Oromia
ABSTRAK Regional State, Jackson Reese 10 liters per minute, a two-lane
Treated Bed Net among Pregnant Women
Ethiopia:
in Indonesia so afar.cross-sectional study. BMC intravenous line Antenatal
was attached and 30° head-
Cedera otak
Public
Diabetes berat
Health,
insipidus traumatis
18(1),
in adalah
25.
cases cedera
of brain fatal, dengan Attending
injury tingkat kematian hinggaClinic of Addis
50%. Sekitar 1,5
up position.
Zemen The patient
Hospital, was prepared
North-Western to be
Ethiopia:
juta orang
requires mengalami
complicated cedera otak berat di Amerika Serikat. Terdapat lebih dari 50.000 kematian
Talipouo,
dan 500.000 A., Ngadjeu,
insiden C.treatment.
gangguan
Diabetes
S., Doumbe-Belisse,
neurologis
intubated
permanen. Sekitar An 85% using ETT No.7
Institutional
kematianBased
and the lip
Study.
terjadi dalam
border
2 Hindawi
minggu
insipidus can
P., setelah lead
Djamouko-Djonkam, to death when handled
L.,komplikasi
Sonhafouo- was 21cm. TheResearch ventilatorand used PCV mode with
pertama
improperly. cedera. Salah
Therefore, the satu authors are dari cedera Malaria
otak yang parah adalah Treatment, 2018.
diabetes insipidus.
Tidak ada data
interested pasti tentang
in discussing thekejadian
managementdiabetes ofinsipidus pada pasien dengan cedera otak traumatis
2
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