Nicholas Prathama Limalvin | Universitas Udayana (original) (raw)

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Papers by Nicholas Prathama Limalvin

International Journal of Research in Medical Sciences

I Ankylosing spondylitis (AS) known as autoimmune disease with chronic inflammation within verteb... more I Ankylosing spondylitis (AS) known as autoimmune disease with chronic inflammation within vertebral bone, characterized with bamboo spine. AS with cervical and temporomandibular joint involvement can lead to difficult airway. In this report, we present an AS patient with severe ARDS (acute respiratory distress syndrome) due to COVID-19 who was successfully intubated using video laryngoscope. A-37 years old male, came to emergency room in agitated condition, history of AS with cervical spine and temporomandibular joint involvement, history of pulmonary tuberculosis in 2008, and haven’t been vaccinated (COVID-19). This patient was diagnosed with severe ARDS due to COVID-19 with GCS 3-1-3, respiratory rate 36 times per minute, maximum peripheral saturation only 90% with Jackson Rees and pCO2 103 mmHg. These conditions are indication for endotracheal intubation. With the aid of video laryngoscope, endotracheal intubation was successfully performed. Improvements of peripheral saturation...

International Journal of Advances in Medicine

International Journal of Research in Medical Sciences, 2023

Ankylosing spondylitis (AS) known as autoimmune disease with chronic inflammation within vertebra... more Ankylosing spondylitis (AS) known as autoimmune disease with chronic inflammation within vertebral bone, characterized with bamboo spine. AS with cervical and temporomandibular joint involvement can lead to difficult airway. In this report, we present an AS patient with severe ARDS (acute respiratory distress syndrome) due to COVID-19 who was successfully intubated using video laryngoscope. A-37 years old male, came to emergency room in agitated condition, history of AS with cervical spine and temporomandibular joint involvement, history of pulmonary tuberculosis in 2008, and haven’t been vaccinated (COVID-19). This patient was diagnosed with severe ARDS due to COVID-19 with GCS 3-1-3, respiratory rate 36 times per minute, maximum peripheral saturation only 90% with Jackson Rees and pCO2 103 mmHg. These conditions are indication for endotracheal intubation. With the aid of video laryngoscope, endotracheal intubation was successfully performed. Improvements of peripheral saturation and blood gas analysis were obtained after intubation. This patient was included in the criteria for intubation due to respiratory rate over 30 times per minute and pCO2 more than 100 mmHg. Based on difficult airway predictor (MOANS, LEMON, RODS and SHORT), this patient was categorized as hard to ventilate and hard to intubate so it is necessary to prepare supraglottic airway device if intubation fails or surgical cricothyrotomy if intubation and supraglottic device fail. In difficult airway conditions, endotracheal intubation is ideally performed without muscle relaxants or awake intubation. The use of video laryngoscope is a recommended procedure in difficult airway management as in AS patient or in head and neck trauma cases. The availability of video laryngoscope in every hospital will maximize airway management in emergency room in Indonesia.

International Journal of Advances in Medicine, 2023

Indonesia has been known as an endemic country of tuberculosis (TB). Most of the cases are pulmon... more Indonesia has been known as an endemic country of tuberculosis (TB). Most of the cases are pulmonary TB, and pleural effusion is one of the common cases. Untreated pleural effusion can become massive pleural effusion, a true emergency case in the emergency room. In this report we present a 21-years-old female patient with new onset massive pleural effusion due to TB infection. A 21-year-old female patient with no previous medical illness came to ER with shortness of breaths since a week ago. Cough and unmeasured fever have been reported since a month ago. Tachypnea, extreme tachycardia, asymmetric chest movement, decreased vocal fremitus, dullness of percussion, and decreased left pulmonary sound were found. Chest x-ray showed a massive left pleural effusion with tracheal deviation. High flow nasal cannula was given due to blood gas analysis interpreting moderate respiratory distress. Thoracentesis was immediately performed with estimated 1200 CC yellow coloured fluid production. Other laboratory findings include hyponatremia and hypoalbuminemia. This patient was diagnosed with pleural effusion type pulmonary TB, treated with anti-TB drugs, mucolytic, corticosteroid, and analgesics. Serial chest x-rays showed improvement of pleural effusion. In developing countries like Indonesia, the most common causes of pleural effusion was TB infection besides malignancy. A massive pleural effusion diagnosis can be established with history taking, physical examination, chest sonography, chest x-ray, and/or CT-scan. Thoracentesis must be performed within minutes after massive pleural effusion was established.

MNJ (Malang Neurology Journal), 2021

Industrial revolution 4.0 has changed the health industry. Medical treatments derived from the la... more Industrial revolution 4.0 has changed the health industry. Medical treatments derived from the latest technologies are expected to improve health and economic status. The rapid development of technology has influenced the learning and clinical practice of medicine. Virtual Reality (VR) is one of the latest technologies that is currently being implemented as a treatment for neurological disorders. This article seeks to give an overview of the development of VR implementation in neurorehabilitation. The data source of this article is research and studies published in NCBI, PubMed, Cochrane, and other relevant online databases. From this article, it is found that VR can be used as a pain reliever and motor function rehabilitation for patients with balance and gait deficits. VR is used to distract patients’ attention to pain for a short time period. VR also improves motor function recovery in stroke patients. Cybersickness is usually reported as a side effect of using VR and it depends ...