Bali Medical Journal最新文献

{"title":"Sarcopenia as an indicator of nutritional status and outcome predictor for colorectal cancer in Javanese ethnic","authors":"Damianus Hipolitus, A. Handaya, Agus Barmawi","doi":"10.15562/bmj.v12i1.3706","DOIUrl":"https://doi.org/10.15562/bmj.v12i1.3706","url":null,"abstract":"Background: Sarcopenia is a negative predictor of colorectal cancer outcomes, while colorectal cancer is at risk of developing malnutrition due to the disease process. This study aims to determine the relationship between sarcopenia and nutritional status and analyze the effect of sarcopenia on the outcome of rectal cancer patients.\u0000Method: A cross-sectional study was conducted on colorectal cancer patients of Javanese ethnicity who performed preoperative abdominal CT scans at dr. Sardjito Hospital in Yogyakarta between June and December 2019. Sarcopenia is based on measuring muscle mass index at the third lumbar vertebra level <36.0 cm2/m2 for men and < 29.0 cm2/m2 for women. Statistical analyzes using SPSS version 20 for Windows were performed to find out the correlation.\u0000Results: Of 46 patients, 56.5% were male and 43.5% female, with a mean age of 53.57. Sarcopenia was found in 47.8% of patients, mostly in women than men (63.6% vs. 36.4% p=0.019). Underweight was mostly found in the sarcopenia group compared to non-sarcopenia (59.1% vs. 20.8% p=0.019). The sarcopenia group has longer LOS than non-sarcopenia (14.73±13.474 vs. 12.29 ±4.165; p=0.404). The mortality of the sarcopenia group was 1.56 times higher compared to the non-sarcopenia (57.1% vs. 42.9%; OR=1.56; 95%CI=0.307-7.890; p=0.964). Haemoglobin, albumin, total protein, CEA, histopathology, tumor location and procedure were not significantly correlated to sarcopenia.\u0000Conclusion: Underweight nutritional status and females are correlated with sarcopenia. Sarcopenia tends to be treated longer and has higher mortality than non-sarcopenia.","PeriodicalId":44369,"journal":{"name":"Bali Medical Journal","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2022-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43967635","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of intravenous remifentanil and fentanyl postoperative delirium incidence in patients receiving elective orthopedic surgeries","authors":"Hanung Aryana, Dedi Susila, Belindo Wirabuana","doi":"10.15562/bmj.v11i3.3851","DOIUrl":"https://doi.org/10.15562/bmj.v11i3.3851","url":null,"abstract":"Background: The use of certain opioids associated differently with the incidence of postoperative delirium (POD). Remifentanil and fentanyl are short-acting opioids widely used in surgery; however, studies assessing their relationship with POD incidence are still limited. This study aimed to determine the association of remifentanil and fentanyl uses with the incidence of POD in elective orthopedic surgery patients.\u0000Methods: A cross-sectional study was conducted in Surgical Unit at Dr Soetomo General Academic Hospital in Surabaya, Indonesia from August to September 2022. Patients who underwent elective orthopedic surgery and used remifentanil (n=16) and fentanyl (n=14) as postoperative analgesia were enrolled in the study. Delirium was assessed using Confusion Assessment Method-ICU tool (CAM-ICU). The associations of remifentanil and fentanyl use as well as patients’ characteristics with POD incidence were assessed statistically.\u0000Results: Our data found that there was no significant difference between the incidence of POD with the use of remifentanil (p=0.125) in orthopedic surgery patients. The total doses of fentanyl and morphine equivalent (of remifentanil or fentanyl) were associated significantly with the POD incidence (p=0.010 and p=0.002, respectively). Other factors associated with POD incidence were the use of bone cement during the surgery (p=0.034), duration of surgery (p<0.001), and bleeding volume during the surgery (p=0.024).\u0000Conclusions: Our study showed high dose of fentanyl, use of bone cement, longer duration of surgery, and high bleeding volume have greater risk of developing POD in orthopedic surgery patients.","PeriodicalId":44369,"journal":{"name":"Bali Medical Journal","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47530912","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparation of intestinal fatty acid binding protein (I-FABP) level between pre- and post-surgery and its associated determinants in patients with microscopic otorhinolaryngology surgeries","authors":"Y. Atmajaya, Mohammad Satriyo Wibowo, P. Airlangga, Maulydia, Prihatma Kriswidyatomo, Muhtarum Yusuf, B. Utomo","doi":"10.15562/bmj.v11i3.3893","DOIUrl":"https://doi.org/10.15562/bmj.v11i3.3893","url":null,"abstract":"Introduction: Intestinal fatty acid binding protein (I-FABP) is expected could be used as predictor of tissue hypoperfusion. This study sought to compare the level of I-FABP between pre- and post-surgery and its associated determinants in patients with otorhinolaryngology surgeries using general anesthesia with controlled hypotension (CH) technique.\u0000Methods: We did a cross-sectional study was conducted among patients that underwent elective surgeries at Dr. Soetomo in Surabaya, Indonesia. Those who underwent surgeries using general anesthesia with CH technique were recruited in the study. I-FABP levels were measured using ELISA 1 hour before the surgery and 30 minutes after general anesthesia ended. Fisher's exact test and Mann-Whitney test were used to determine the determinants associated with changes of I-FABP level between pre- and post-surgery.\u0000Results: A total of 31 patients who underwent the surgeries with general anesthesia and CH technique were included in this study. The median of I-FABP level pre- and post-surgery was 0.639 ng/mL to 0.779 ng/mL, respectively suggesting there was a significant increase of I-FABP level after the CH technique (p<0.001). Gender and ASA score did not associate with I-FABP level changes pre- and post-surgery with p=0.333 and 0.060, respectively. Age, BMI did not associate with changes of I-FABP level between pre- and post-surgery (p=0.747 and p=0.051, respectively). Surgery duration, anesthesia duration, systolic, diastolic and MAP all also had no association with changes of the I-FABP level with p>0.05.\u0000Conclusion: The levels of I-FABP increased significantly in post-surgery in patients with otorhinolaryngology surgeries using general anesthesia with CH. Further studies are warranted to confirm this result with bigger sample size.","PeriodicalId":44369,"journal":{"name":"Bali Medical Journal","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43457355","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of neutrophil gelatinase-associated lipocalin (NGAL) as a acute prerenal kidney injury marker: Exploring factors associated with its postoperative levels in hypotension-controlled otorhinolaryngology surgery","authors":"Andy Nauman Saputra, P. Airlangga, Boby Abdul Rahman, Edward Kusuma, Prihatma Kriswidyatomo, Christrijogo Sumartomo","doi":"10.15562/bmj.v11i3.3868","DOIUrl":"https://doi.org/10.15562/bmj.v11i3.3868","url":null,"abstract":"Introduction: Acute kidney injury (AKI) is a sudden decrease in kidney function due to damage within seven days or less, thus inducing an early stress response that can be promptly detected by biomarkers, such as Neutrophil Gelatinase-Associated Lipocalin (NGAL). The aim of this study was to analyse the role of NGAL level as a biomarker of postoperative prerenal AKI in patients who underwent otorhinolaryngology surgery with controlled hypotension.\u0000Methods: A prospective study was conducted among patients that underwent otorhinolaryngology surgery with controlled hypotension. Patients were selected with purposive sampling. NGAL level was measured using enzyme-linked immunosorbent assay (ELISA) from venous blood collected 1-hour pre- and 2-hour post-surgery. NGAL levels were compared between preoperative and postoperative states. Wilcoxon and Spearman test were used to determine the correlation between NGAL levels and parameters of AKI.\u0000Results: A total of 30 patients underwent a varies of otorhinolaryngology surgeries were recruited in this study. Our data suggested no significant different between the level of NGAL during preoperative and postoperative (184.73±120.09 ng/mL vs 175.80±129.97 ng/mL). Pre-operative laboratory parameters of AKI such as blood urea nitrogen (BUN), serum creatine (SCr), BUN/SCr ratio, and GFR had no correlation with postoperative NGAL level. In addition, systolic blood pressure, diastolic blood pressure, MAP, heart rate, EtCO2, duration of surgery and the duration of controlled hypotension had no correlation with postoperative NGAL.\u0000Conclusion: NGAL levels have nonsignificant role as biomarker of incidence of postoperative prerenal AKI in patients who receiving otorhinolaryngology surgery with controlled hypotension. However, further study with the bigger sample size is warrant to confirm the findings of this study.","PeriodicalId":44369,"journal":{"name":"Bali Medical Journal","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41964939","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnosis challenges of a patient with peritoneal tuberculosis masquerading as ovarian malignancy: a case report","authors":"Anggoro Satrio Bimantoro, U. Maimunah","doi":"10.15562/bmj.v11i3.3892","DOIUrl":"https://doi.org/10.15562/bmj.v11i3.3892","url":null,"abstract":"Background: Peritoneal tuberculosis (PTB) could mimic advanced ovarian cancer cases, making its diagnosis challenging. Comprehensive and conscientious examinations for diagnosis are needed to differentiate such cases to avoid inappropriate treatment. We report a problematic diagnosis of PTB that mimic ovarian malignancy.\u0000Case Presentation: A 20-year-old female patient with history of multiple rehospitalizations, presented with complaints of abdominal pain, nausea/vomiting, low-grade fever, and weight loss in the last five months. In the first admission, patient was suspected with malignant ovarian cyst due to clinical features of malignancy with normal chest X-ray, abdominal USG suggested ovarian cyst in both ovaries, high levels of Ca125. However abdominal CT-scan showed thickening in peritoneum which suggested PTB. The patient was planned for urgent laparotomy while waiting for GenExpert result. On the second admission, patient presented with recurrent abdominal pain, GenExpert sputum and stool showed negative result, and planned for surgery but the patient refused. On the last admission, patient diagnosed with impending bowel obstruction and underwent abdominal CT-scan with contrast showed diffuse multiloculated cystic lesion in cavum pelvic and multiple prominent mesenteric lymph nodes that suggested abdominal TB with abscess in cavum pelvic. Exploratory laparotomy revealed conglomeration, pus and tubercles in the peritoneum. A TB was confirmed based on pathology and microbiology examination from tissue biopsy and pus.\u0000Conclusion: We reported patients with PTB with unspecific clinical symptoms which suspected as ovarian malignancy. This study highlights the challenges in diagnosing PTB and therefore PTB could be considered a differential diagnosis in patients suspected of ovarian malignancy in the TB endemic countries.","PeriodicalId":44369,"journal":{"name":"Bali Medical Journal","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45390399","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correlation of S100B level and postoperative cognitive dysfunction (POCD) events among patients with ear, nose and throat (ENT) surgeries with controlled hypotension","authors":"Boby Abdul Rahman, P. Airlangga, Andy Nauman Saputra, Prihatma Kriswidyatomo, Agustina Salinding, Hamzah, Maulidya, Muhtarum Yusuf","doi":"10.15562/bmj.v11i3.3847","DOIUrl":"https://doi.org/10.15562/bmj.v11i3.3847","url":null,"abstract":"Introduction: Controlled hypotension is one of the techniques applied to several microscopic ear, nose, and throat (ENT) surgeries. However, this technique has risks and complications, which result in impaired perfusion and oxygenation of organs including the brain that could trigger the postoperative cognitive dysfunction (POCD). Damage that occurs in brain cells can trigger the secretion of biomarker proteins in the blood, one of which is S100B which can indicate nerve damage in the intra and postoperative period. This study aimed to analyze the correlation between S100B protein level and the incidence of POCD in patients who received ENT surgeries with controlled hypotension.\u0000Methods: A cross-sectional study was conducted among patients that underwent elective ENT surgeries at Dr. Soetomo General Academic Hospital, Surabaya, from July to August 2022. Cognitive function was assessed using Mini-mental State Examination (MMSE) at 12 hours before and 2 and 24 hours after surgery. The level of S100B was measured using enzyme-linked immunosorbent assay (ELISA) 12 hours prior surgery and 30 minutes post-surgery.\u0000Results: A total of 31 patients were recruited in the study, including a mean age of 31.7 years. The mean S100B levels in POCD patients pre- and postoperative were 311.97 ng/L, and 415.34 ng/L, respectively. In non-POCD patients, the mean levels of S100B pre and postoperative were 436.90 ng/L, and 444.29 ng/L, respectively. There were 3 (9.7%) patients experienced POCD. Our data suggested there was a significant difference between preoperative and postoperative S100B levels in the groups of patients with POCD (103.37ng/L) and non-POCD (7.38 ng/L) (p<0.001). Patients that experienced POCD had significantly increased S100B compared to those who did not.\u0000Conclusion: There is a correlation between changes of S100B levels and the incidence of POCD in patients undergoing ENT surgeries with controlled hypotension.","PeriodicalId":44369,"journal":{"name":"Bali Medical Journal","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45446282","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The relationship between inflammatory markers and vitamin D levels with the severity of coronary artery disease in elderly patients","authors":"Charles Limantoro, Fandy Santoso, C. Suharti, Trilaksana Nugroho","doi":"10.15562/bmj.v11i3.3631","DOIUrl":"https://doi.org/10.15562/bmj.v11i3.3631","url":null,"abstract":"Introduction: Coronary artery disease (CAD) is the accumulation of atherosclerotic plaques in the coronary arteries. CAD is the most common cause of death worldwide, and its prevalence continues to increase, especially in the elderly population. Atherosclerosis is a chronic inflammatory condition that involves various inflammatory markers, including tumor necrosis factor-alpha (TNF-α) and interleukin-6 (IL-6). In the inflammatory process, vitamin D plays an essential role in developing atherosclerotic plaques affecting the severity of CAD. The elderly are susceptible to vitamin D deficiency and an increase in the inflammatory process related to the severity of CAD. Therefore, this study aims to prove the relationship between inflammatory markers and vitamin D levels with the severity of CAD in elderly patients.\u0000Methods: This study used a cross-sectional design in stable CAD patients aged 60 - 75 years who had passed through coronary arteriography. The severity was assessed from the angiography results using the Synergy between PCI with Taxus and Cardiac Surgery (SYNTAX) score, which 3 cardiovascular consultants evaluated and the average outcome was calculated. TNF-α, IL-6, and vitamin D were taken during angiography and examined using high sensitivity enzyme-linked immunoabsorbent assay (ELISA). The correlation test was analyzed using Spearman's Rank correlation test.\u0000Results: A total of 38 subjects were included in this study, where 30 (78.9%) patients were male. The mean age of the patients was 64.79 years, and the prevalence of vitamin D deficiency was 57.9%. There was a moderately significant positive correlation between markers of inflammation TNF-α (r=0.499, p=0.001) and IL-6 (r=0.518, p=0.001) and the SYNTAX score. A weak negative correlation was also discovered between vitamin D and the SYNTAX score (r=-0.335, p=0.040).\u0000Conclusion: The levels of inflammatory markers (TNF-α and IL-6) and vitamin D correlated with the severity of CAD in elderly patients.","PeriodicalId":44369,"journal":{"name":"Bali Medical Journal","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48185813","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Variation of conus medullaris location based on magnetic resonance imaging of the lumbar spine in Indonesia: A study at Dr Soetomo General Academic Hospital, Surabaya, Indonesia","authors":"A. Adhiatma, C. Waloejo, Belindo Wirabuana, E. Rahardjo","doi":"10.15562/bmj.v11i3.3867","DOIUrl":"https://doi.org/10.15562/bmj.v11i3.3867","url":null,"abstract":"Introduction: Recognition of conus medullaris position, contains lumbosacral plexuses which supply motor and sensory innervation to the whole lower limb, pelvic and perineal areas, is critical to avoid injury due to lumbar procedures, such as spinal anesthesia and lumbar punctures. This study aimed to investigate the position of conus medullaris among Indonesians through magnetic resonance imaging (MRI) of the lumbar spine at Dr. Soetomo General Academic Hospital in order to minimize the risk of conus medullaris trauma.\u0000Methods: A retrospective study was conducted to investigate the conus medullaris level and its correlation to gender and age Indonesian patients. The data were collected from lumbar MRI at Dr Soetomo General Academic Hospital during January 2020 and December 2021. The level variations of conus medullaris were recorded and determined as the highest, lowest and most common location descriptively.\u0000Results: A total of 257 patients (126 male and 131 female) were included. The highest level of conus medullaris was in T11-T12 vertebrae (five patients). There were 12 patients in T12 vertebrae, T12–L1 in 86 patients, L1 in 62 patients, L1–L2 in 76 patients, and L2 in 12 patients. The lowest level was in between L2 and L3 vertebrae in 4 patients. Gender and age had no association with conus medullaris level.\u0000Conclusion: The lowest level of conus medullaris was in between L2 and L3 vertebrae. The lumbar procedure such as punctures should be done below the L3 to avoid conus medullaris puncture trauma.","PeriodicalId":44369,"journal":{"name":"Bali Medical Journal","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47795503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of neuron-specific enolase (NSE) and S100B protein in the incidence of acute postoperative cognitive dysfunction (POCD) in geriatric patients receiving general anesthesia","authors":"Muhammad Alvin, P. Airlangga, Edward Kusuma, Prihatma Kriswidyatomo, Pudji Lestari, Yunias Setiawati","doi":"10.15562/bmj.v11i3.3846","DOIUrl":"https://doi.org/10.15562/bmj.v11i3.3846","url":null,"abstract":"Introduction: Postoperative cognitive dysfunction (POCD) following general anesthesia is frequent among geriatric patients worldwide. Neuroinflammation and neuronal injury have been associated with the incidence of POCD. Some biomarkers of brain damage including neuron-specific enolase (NSE) and S100B protein have been widely studied; however, their association with the incidence of POCD is still controversial. This study aimed to assess the correlation of serum NSE and S100B levels with the incidence of POCD among geriatric patients receiving general anesthesia.\u0000Methods: A prospective cohort study was conducted among geriatric patients receiving general anesthesia at Dr. Soetomo Hospital, Surabaya from July to October 2022. The Montreal Cognitive Assessment (MoCA) INA instrument was used to assess POCD, and enzyme-linked immunosorbent assay (ELISA) was used to quantify the levels of serum NSE and S100B. Spearman’s rank correlation was implemented to identify the correlation of MoCA INA scores with the levels of NSE and S100B. Mann-Whitney analysis was used to determine the association between NSE and S100B levels with the incidence of POCD. A p-value of ≤0.05 was considered statistically significant.\u0000Results: A total of 48 patients were enrolled in the study and 16.7% of them had POCD. Spearman’s correlation test suggested no significant correlation between MoCA INA score with serum NSE level (rs:-0.095; p=0.522) and S100B level (rs:-0.213; p=0.146). Mann-Whitney analysis indicated no significant difference in the NSE and S100B levels of patients with and without POCD (p=0.3470 and p=0.097, respectively).\u0000Conclusion: There was no significant association between NSE and S100B levels with the incidence of POCD among geriatric patients receiving general anesthesia during elective surgeries at Dr. Soetomo Hospital, Surabaya.","PeriodicalId":44369,"journal":{"name":"Bali Medical Journal","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2022-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46528583","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Emergency thrombectomy in acute upper limb ischemia patient with diabetes mellitus","authors":"Yunita Arif, H. Novida","doi":"10.15562/bmj.v11i3.3822","DOIUrl":"https://doi.org/10.15562/bmj.v11i3.3822","url":null,"abstract":"Background: Acute limb ischemia is a sudden decrease in limb blood perfusion with an onset of less than 14 days, most commonly occurs in lower extremities. Diabetes mellitus, one of diseases underlying peripheral artery disease, complicates the pathophysiology of acute limb ischemia. In this case report we present a patient with type 2 diabetes mellitus and acute limb ischemia in the left upper extremity that had successful thrombectomy treatment.\u0000Case presentation: A 58-year-old female patient came to the Emergency Care Unit of Dr. Soetomo General Hospital with the continuous pain in the five fingers to the palm of the left hand for the past two days. The numbness spread from the elbow to the left fingers, making them weak and difficult to grip. Those five fingers were pale and cold as well. The left hand had no pulsated radialis and ulnar artery, weak brachial pulse and undetected pulse oximetry result. The patient was diagnosed with type 2 diabetes mellitus since 2005 and has a controlled treatment. On the first day of hospitalization, the patient was scheduled for emergency thrombectomy at Dr. Soetomo General Hospital. Follow-up on the seventh-day post-surgery, the patient had no complaints of pain and pale in the left hand and the brachial, ulnar and radial arteries were palpable.\u0000Conclusion: Acute limb ischemia is uncommon in the upper extremities but we found that it has an excellent prognosis with early revascularization, even in a patient with diabetes mellitus. The treatment must be in conjunction with aggressive diabetes mellitus treatment to avoid acute limb ischemia worsening","PeriodicalId":44369,"journal":{"name":"Bali Medical Journal","volume":" ","pages":""},"PeriodicalIF":0.2,"publicationDate":"2022-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44839740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}