Cryptococcal Menigitis

Cryptococcal meningitis due to Cryptococcus is the commonest clinical manifestation, although pneumonia, skin and soft tissue infections are also known to occur. The most serious infections usually develop in patients with defective cell-mediated immunity, for example AIDS, patients undergoing organ transplantation, patients with malignancy, patients undergoing corticosteroid treatment and patients with sarcoidosis. The incidence increases along with the skyrocketing HIV cases although in some countries become less frequent since introduction of HAART. The patient usually presents with malaise, headache, fever and visual disturbance and altered mental status. Signs include meningism, papilooedema, cranial nerve palsies and reduced conscious level. The diagnosis is usually straight forward with the finding of this yeast through India ink staining, culture, highly sensitive and specific cryptococcal antigen testing of CSF or serum if CSF can not be obtained. Prompt diagnosis and treatment are crucial although with the current optimal treatment, mortality rate is high. Significantly raised intracranial pressure and other specific condition such as reconstitution syndrome in HIV patient contribute to unfavourable outcome

Reconstruction of Murabahah Contract Schemes in Sharia Banking

The high level of margin in murabahah financing makes people perceive that this financing is more expensive than credit financing at conventional banks. Some other people also still think that Islamic banking is not fully sharia. The purpose of this study is to evaluate the development and practice of murabahah financing in Islamic banking today and then offer two alternatives so that Islamic bank financing products can compete competitively with credit products at conventional banks. The two alternatives offered are related to the pricing scheme and method along with the margin in this financing. This paper is a conceptual study by observing and analyzing information related to sharia banking products. In connection with the concepts or ideas presented in this paper, it contains theories and or interpretations of concepts in different ways and according to the purpose of the paper.  This paper can provide a new understanding of the steps that Islamic banking needs to take to attract public interest and reach a wider range of consumers

Neurosistiserkosis

Sistiserkosis merupakan infeksi pada jaringan oleh karena kista lrva cacing pita babi. Kista dari larva cacing ini dapat menginfeksi pada jaringan oto, otak, mata, dan jaringan yang lain. Merupakan penyebab penyakit oleh karena parasit tersering pada sistem saraf manusia dan penyebab tersering dari epilepsi dapatan pada negara berkembang, terutamapada negara Amerika Latin, India, Afrika dan China. Sistiserkosis ini dapat menyerang organ-organ seperti: otot, mata, otak, kulit dan struktur lain. Pada siklus Taenia solium, manusia merupakan satu-satunya host defenitif dan menjadi tempat tumbuhnya cacing pita dewasa (Taenia solium), sedangkan manusia dan babdi juga sebagai host intermediate yang menjadi tempat dari larva/cysticerci. Sistiserkosis ini terjadi oleh karena menelan telur dari cacing pita dewasa yang dikeluarkan bersama dnegan kotoran manusia yang terinfeksi. Embrio akan dikeluarjan dari telur oleh karena pengaruh asam lambung dan cairan usus. Larva ini dapat menembus dinding usus yang kemudian masuk ke sistem pembuluh darah yang selanjutnya akan menyebar ke otot, otak dan jaringan yang lain. Cacing ini membesar sampai 1 cm dalam waktu 2-3 bulan. Di luar sistem saraf, sistiserkosis tidak menyebabkan gejala yang berarti. Subkutan sistiserkosis memberikan gejala nodul yang tidak nyeri, bergerak dan tidak besar

HIV Associated Tuberculous Meningitis-Diagnostic and Therapeutic Challenges

The HIV-infected individual is at greater risk of developing TBM, particularly at a stage of more advanced immunosuppression. The cinical presentation of tuberculous meningitis in HIV-infected individuals is more likely to include an altered level of consciousness, cranial imaging is more likely to show cerebral infarctions, and the yield of culture of cerebrospinal fluid may also be greater. Therapeutic approach include OAT, corticosteroid and treatment of the other complication such as infarct, hydrocephalus etc. Risk of mortality is highly correlated with the clinical stage at presentation and initiation of OAT

Patofisiologi Iskemik Stroke Terkini (Patophysiology Update of Ischemic Stroke)

Stroke is a leading cause of disability and health worldwide. Recent data shows that ischaemic stroke is constituting around 80% of all strokes. A better management of stroke can be achieved only if the pathophysiology is properly understood. common conditions associated with ischaemic stroke are trombosis, atherisclerotic proccess, emboli and reducing blood pressure. Appropriate treatment is required as incidence of disability and death are still high. Brain is a small organ with higher consumtion of glucose and oxygen. Failure to provide its need results in permanent damage. This irreversible condition is heralded by depletion of energy metabolites and failure of the cell membrane to maintains its physiologic gradients with dramatic disruption of ion and waterhomeostasis. Atherosclerosis is iniating blood flow disruption, resulting in local reaction and leading to vascular obstruction. This event contributes to inflammatory process, brain oedema, neurond death and penumbra expansion. Understanding of this pathophysiology will reduce incidence of death and disability

Nyeri pada HIV

Nyeri adalah salah satu gejala yang sering didapatkan pada penderita dengan infeksi HIV. Dengan makin banyaknya obat antiretrovirus yang baru makin banyak penderita yang dapat ditangani dan makin banyak pula keluhan nyeri yang didapatkan pada penderita HIV. Seringkali gejala nyeri ini timbul, walaupun tidak didapatkan infeksi oportunistik seperti Sarcoma Kapossi (O'Neill, 1993)

Neuropati pada Penderita HIV

The purpose of this article is to enhanced our knowledge in diagnosis and treatment of peripheral neuropathies in Human Immunodeficiency Virus (HIV) patients.Peripheral neuropathies are common in HIV infection. Symptomatic neuropathy occurs in approxymately 10-15% of HIV infected patients overall. Peripheral neuropathies are complex and diverse, complicate all stages of the HIV disease and cause considerable morbidity and disability in HIV-infected individuals and AIDS patients. There are major clinical types of HIV-associated neuropathies, Seroconversion-related neuropathies, Distal Sensory Polyneuropathy (DSP), acute and chronic inflammatory demyelination polyradiculomyelopathy and nucleoside associated toxic neuropathies. Distal sensory polyneuropathy occurs approximately 30% of patient with a CD4 cell count at below 200/?L. Due to many disease associated with HIV management and treatment of the patient is depend on clinical presentasion, diagnosis and degree of HIV disease, we will discuss these various complication according to the degree of HIV disease

Diagnosis dan Tatalaksana Neurosisterkosis

Introduction : Cysticercosis is a parasitic infection that results from ingestion of eggs of the adult tapeworm, Taenia solium (T. solium). Neurocysticercosis is the most common paracytic infection of the brain and a leading cause of epilepsy in the developing country. This disease is endemic in some part of Indonesia. Discussion : Mode of transmission is human to human and pig to human. The life cycle involves humans as a definite host and pigs as an intermediate host. Human becomes infected when they ingest raw or undercooked "measly pork" that contains viable cycticercus. Albendazole and praziquantel are drugs of choice to treat neurocysticercosis. Wheter and when antiparasitic drugs should be administered is controversial. Prevention strategies need to cease the life cycle of this parasite. Better understanding of the mechanisms of neurocysticercosis and the life cycle of T. solium is needed to develop appropriate intervention and prevention program

Infeksi Toksoplasma pada Sistem Saraf

Toxoplasmic encephalitis (TE) is caused by the protozoan Toxoplasma gondii. Disease appears to occur almost exclusively because of reactivation of latent tissue cysts. Toxoplasmosis is the leading cause of focal central nervous system (CNS) disease in HIV/AIDS. CNS toxoplasmosisin HIV-infected patients is usually a complication of the late phase of the disease. Primary infection occasionally is associated with acute cerebral or disseminated disease. Human infection occurs through contact with a protozoal in different forms (bradyzoite, tachyzoites, sporulated oocyst containing sporozoite or cyst containing bradyzoite) and through different ways of transmission: congenital, organ transplants, parenteral; occupational infection is rare and oral infection occurs more frequently. The objective of the article was to provide neurologists and others with evidence-based guidelins for the diagnosis and treatment of toxoplasmosis enchephalitis

The Effect of profitability, solvency, audit committee, and audit quality on audit delay

Based on the Financial Services Authority (OJK) No. 20/POJK.04/2016, Go Public companies listed on the Indonesia Stock Exchange (IDX) must submit annual financial reports that have been audited by independent auditors by the end of the fourth month within 120 days after the closing year ends. Therefore, the auditor needs sufficient time to gather evidence that can support them opinion. This study aims to obtain empirical evidence regarding the effect of profitability, solvency, audit committee, and audit quality on audit delay. The sample used in this study were 24 Property and Real Estate companies listed on the IDX as well as primary data (survey) at Public Accounting Firms taken in the attachments of journals and theses during the 2015-2019 period. The hypothesis test used is a multiple linear regression analysis with software eviews 12 version. The results of the study show that profitability (X1) and audit quality (X4) had a negative effect, solvency (X2) had a positive effect and the audit committee (X3) did not effect audit delay (Y). There is a significant increase in the average value every year