Acta medica Indonesiana最新文献

{"title":"Anti-Inflamatory Drug for Myocardial Injury in Acute Coronary Syndrome.","authors":"Ryan Ranitya","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Acute coronary syndrome (ACS) as the acute setting of coronary chronic syndrome has been widely known to have high mortality rates. ST segment elevation of myocardial infarction (STEMI) is one category of ACS which occurs when major coronary arteries are fully blocked acutely and diminish coronary flow leading to myocardial injury and necrosis. Epidemiology data showed that global prevalence varied from 3.8% in patients whose age to 9.5%. The national heart survey of Indonesia also revealed the rising trends of STEMI from 0.63% in 2013 to 1.5% in 2018. STEMI is associated with high mortality despite advanced system and management such as primary percutaneous coronary intervention (PCI). Colchisine is derived from Colchicum autumnale plant and known for remedies for a long time since 1500 BC. The remedy effect is due to combination anti-inflammatory actions. Key actions include decrease neutrophile L-selectin expression on endothelial cell and interfere the interaction of neutrophile-platelet which is leading to atherothrombosis. The idea to use colchisine in STEMI patients to reduce mortality rate is presumed through this mechanism. To date, colchisine already known to reduce anti-inflammatory markers in ACS. Colchisine is widely known to be safe and effective as anti-inflammatory drug. Numerous studies had investigated the effect of colchisine in various setting of coronary artery disease. Unfortunately, various results had made it unclear. Meanwhile, the mechanism of colchisine in acute and chronic coronary syndrome need to be explored comprehensively. The evidence of clinical studies for the beneficial use of colchisine in ACS  especially in STEMI is still insufficient. The ongoing studies worth to be waited for the supporting clinical evidence for the use of colchisine in acute coronary syndrome.</p>","PeriodicalId":6889,"journal":{"name":"Acta medica Indonesiana","volume":"57 1","pages":"1-2"},"PeriodicalIF":0.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143954983","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":"A Rare Case of Late Onset Familial Long QT Syndrome Presented with Recurrent Cardiac Arrest, Complete Heart Block, and NSTEMI.","authors":"Hendra Gunawan, Muhammad Yamin","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Long QT Syndrome (LQTS) is a rare cardiac condition whose etiology is acquired or congenital. It has a wide range of clinical manifestations ranging from asymptomatic to sudden cardiac death due to malignant arrhythmia such as ventricular tachycardia. Congenital LQTS usually occurs at an early age in the form of prolonged QT interval in ECG examination, but such a condition may occur in later life. Therefore, QT interval should be assessed thoroughly to minimize the risk of iatrogenic ventricular tachycardia. A 72-year-old Javanese female with recurrent syncope episodes for 8 months was referred to the emergency department for temporary pacemaker implantation due to a complete heart block and NSTEMI. Family history revealed a first-degree family history of sudden cardiac death. She had a history of recurrent cardiac arrest due to ventricular arrhythmia and was treated with amiodarone continuous intravenous infusion in the previous hospital. During examination in the emergency department, she experienced another episode of cardiac arrest due to ventricular arrhythmia. Electrocardiogram examination pre-cardiac arrest revealed a complete heart block, atrial rate 60 bpm, ventricle rate 60 bpm, T Inversion in I, aVL, V2-V6, with prolonged QT interval (QT 616 ms, QTc 578 ms). Thus, amiodarone was subsequently stopped, and defibrillation was administered under ACLS guidelines. After the return of spontaneous circulation, revascularization was conducted due to ongoing typical chest pain and increased troponin level (117 ng/mL) to the LAD. Despite optimal revascularization and normal electrolyte level (Sodium 137 mEq/L, Potassium 3.8 mEq/L, Chloride 104.5 mEq/L), prolonged QT interval was observed in the patient until the 9th day post-revascularization and the double-chamber pacemaker implantation was conducted on patient. Thus, the prolonged QT interval subsided after double-chamber pacemaker implantation. Long QT Syndrome may occur at any period of life and may be asymptomatic. A thorough ECG examination before commencing treatment on a patient was pivotal to preventing malignant arrhythmia.</p>","PeriodicalId":6889,"journal":{"name":"Acta medica Indonesiana","volume":"57 1","pages":"94-101"},"PeriodicalIF":0.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143962013","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":"Isolated Pulmonary Arterial Thrombosis in Patient with Eisenmenger Syndrome Treated with Catheter-directed Thrombolysis: A Case Report and Literature Review.","authors":"Dya Pratama Andryan, Vienna Rossimarina, Daniel Paringotan L Tobing, Taofan Taofan, Bambang Widyantoro","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The concept of venous thromboembolism (VTE) has recently been revisited because of evidence of a new spectrum of the disease called in situ pulmonary arterial thrombosis (ISPAT). We present the case of a 40-year-old female with shortness of breath, who was referred from a regional hospital because of a secundum atrial septal defect. Using echocardiography and computed tomography pulmonary angiogram, she was diagnosed with ISPAT. She received catheter-directed thrombolysis with good results. Knowing the difference in diagnostic clues between classical VTE and ISPAT is crucial, especially for managing the patient correctly.</p>","PeriodicalId":6889,"journal":{"name":"Acta medica Indonesiana","volume":"57 1","pages":"102-106"},"PeriodicalIF":0.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143962779","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":"\"Super Responder\" of Percutaneous Bicaval Valve Implantation for Severe Tricuspid Regurgitation: A Case Report.","authors":"Ignatius Yansen, Bayushi Eka Putra, Muhammad Yamin, Simon Salim","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Tricuspid Regurgitation (TR) surgical treatment is associated to high operative mortality, suboptimal long-term survival, and frequent TR recurrence after repair, especially in the elderly. This case report highlights our early experience of TricValve implantation in Indonesia, conducted on a 72-year-old male patient with severe tricuspid regurgitation and advanced right ventricular dysfunction. In this context, the TricValve system offers a promising, less invasive alternative. Despite previous pharmacological management, our patient had been readmitted multiple times due to refractory right heart failure. One month post-TricValve implantation, he showed significant symptomatic relief and stable cardiac function as evidenced by echocardiographic measurements. This case underscores the potential utility of the TricValve system in providing an effective, lower-risk treatment option for patients not suited for traditional surgical intervention.</p>","PeriodicalId":6889,"journal":{"name":"Acta medica Indonesiana","volume":"57 1","pages":"87-93"},"PeriodicalIF":0.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143958303","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":"Investigating Elevated E-Selectin and P-Selectin Levels in Non-Arteritic Anterior Ischemic Optic Neuropathy (NAION) Patients: The Stepping Stone to a Future Clinical Approach.","authors":"Syntia Nusanti, Andhika Rachman, Brigitta Marcia Budihardja, Lourisa Ruth Eldinia, Nadia Delima Andini, Arief Kartasasmita, M Sidik, Seskoati Prayitnaningsih, Alida Roswita Harahap, Aria Kekalih, Tjahjono Darminto Gondhowiardjo","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Studies regarding hypercoagulation in Non-Arteritic Anterior Ischemic Optic Neuropathy (NAION) patients have produced conflicting results. With a presumption that the early coagulation phase may affect the occurrence of NAION, this study aims to investigate the early coagulation markers, E-selectin and P-selectin, to determine whether these biomolecular changes play a significant role in NAION, thus potentially leading to a better clinical approach.</p><p><strong>Methods: </strong>A cross-sectional study involving two groups of NAION subjects, a hypercoagulation group and a non-hypercoagulation group, was conducted in the Neuro-Ophthalmology Division, Department of Ophthalmology, FKUI-RSCM Kirana from October 2020 to April 2022. All patients were evaluated for E-selectin and P-selectin levels measured using flow cytometry.  Results: A total of 42 subjects comprising 14 hypercoagulation and 28 non-hypercoagulation subjects were included. In all subjects, E-selectin was strongly correlated with P-selectin (r = 0.862, p < 0.001). There was no significant difference in E-selectin and P-selectin values between the groups (p = 0.317 for E-selectin, and p = 0.575 for P-selectin). Prothrombin time and international normalized ratio (INR) were inversely correlated with both E-selectin and P-selectin in the hypercoagulation group (p = 0.032, p = 0.030 for E-selectin and p = 0.044, p = 0.036 for P-selectin). There was no significant correlation between E-selectin and P-selectin for NAION-associated metabolic risk factors. However, higher E-selectin and P-selectin values were found in the presence of risk factors except for P-selectin in the hypertension group.</p><p><strong>Conclusion: </strong>This interesting finding opens up the potential for considering the involvement of E-selectin and P-selectin in the diagnostic strategy for NAION. It prompts consideration of whether assessing E-selectin and P-selectin levels should be recommended for all NAION patients. Furthermore, considering the role of E-selectin and P-selectin in the early coagulation process, future studies are also needed to further evaluate whether anticoagulants could play a role in the choice of treatment for NAION despite a clinically hypercoagulable state.</p>","PeriodicalId":6889,"journal":{"name":"Acta medica Indonesiana","volume":"56 4","pages":"445-450"},"PeriodicalIF":0.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143045013","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 Efforts to Implement a Malaria Elimination Strategy in The Highly Endemic Malaria Region of Papua Province, Indonesia.","authors":"Erni Juwita Nelwan","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>In 2023, Indonesia's Ministry of Health reported that nearly 75% of districts and cities in the country were free from malaria transmission, meaning 90% of the population lived in malaria-free zones. However, Papua Province, which accounts for only 1.5% of Indonesia's population, continues to contribute over 90% of the national malaria cases, with more than 16,000 reported cases in 2023.Indonesia has recently completed a malaria vaccine trial, the IDSPZV1, which included the PfSPZ Vaccine and PfSPZ-CVac (CQ), conducted among soldiers deployed to Papua Province, New Guinea, for 10 months. These soldiers were from a battalion located in a malaria-free area in Bangkinang, Riau Province. The results of this clinical trial will be reported separately, but this significant development could offer a potential solution to reduce the risk of malaria infection, particularly among travelers, such as domestic tourists or soldiers visiting Papua.This edition highlights the recent findings from a malaria study conducted in Iwaka District, Mimika, Papua, which revealed that nearly half of the patients presenting with fever at the district hospital were diagnosed with malaria (N=863 patients). The authors explored various factors, including the prevalence of malaria, patient characteristics, history of malaria exposure, housing and environmental conditions, as well as malaria prevention measures among the study participants.In addition to uncomplicated malaria infections, severe malaria cases remain a significant issue, contributing to high mortality rates. Nainggolan et al. investigated the role of host factors, particularly ABO blood groups, in the likelihood of developing severe malaria.Understanding the dynamics of disease prevalence, and risk factors related to both the host and the environment, along with the potential availability of vaccines, chemoprevention, and other preventive measures, are crucial to achieving zero malaria in the island of New Guinea, Papua Province.</p>","PeriodicalId":6889,"journal":{"name":"Acta medica Indonesiana","volume":"56 4","pages":"441"},"PeriodicalIF":0.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143045242","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":"Prevalence and Risk Factors of Malaria in Iwaka District, Mimika, Papua.","authors":"Novyan Lusiyana","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Papua is a high-endemic region for malaria in Indonesia. Malaria transmission is heavily influenced by environmental factors, particularly those related to vector breeding habitats and the homes of infected individuals. Communities in high-endemic areas also exhibit risk behaviors that can increase the likelihood of malaria transmission.</p><p><strong>Methods: </strong>This cross-sectional study was conducted in Iwaka District, Mimika, Papua, and included residents aged 18 years and older who had lived in the district for at least six months and exhibited symptoms of malaria. Subjects with a history of malaria or those under antimalarial treatment in the last two weeks were excluded. We collected demographic characteristics, malaria history, environmental factors, and behavioral components using a structured questionnaire. Each subject underwent a malaria examination using a rapid diagnostic test (RDT). Data were analyzed using STATA software.</p><p><strong>Results: </strong>A total of 863 subjects met the inclusion and exclusion criteria. Of these, 429 (49.7%) were diagnosed with malaria. Malaria cases were predominantly found among males, individuals aged 21- 40 years, those with secondary education, and those working as farmers. Malaria incidence was associated with having family members who had malaria, living near stagnant water, and residing within 100 meters of forests or fields (p < 0.05). The use of bed nets, mosquito repellents, and long-sleeved clothing was low, and most houses had wooden walls without wire mesh protection.</p><p><strong>Conclusion: </strong>Malaria prevalence in Iwaka District is extremely high, with risk factors including age, gender, proximity to stagnant water and forests/fields, and family history of malaria.</p>","PeriodicalId":6889,"journal":{"name":"Acta medica Indonesiana","volume":"56 4","pages":"493-500"},"PeriodicalIF":0.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143045221","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":"Critical Management of Haemodynamically Unstable Acute Pulmonary Embolism in COVID-19.","authors":"Eka Adip Pradipta, Vienna Rossimarina, Indira Kemalasari, Siska Suridanda Danny","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Increased thrombotic events that occur in up to one-third of patients with COVID-19 are predominantly pulmonary emboli (PE), which are associated with higher severity and increased mortality. Acute PE should therefore be one of the main differential diagnoses among patients with hemodynamic instability. Early treatment of such a condition with systemic thrombolysis remains the first line of treatment especially in patients with COVID-19, which hinders further invasive intervention. The aim of this report is to describe a typical case of hemodynamically unstable acute PE with COVID-19 management in our center to emphasize the role of early detection and prompt treatment of such a condition. A 66-year-old male suspected of having COVID-19 initially presented with shortness of breath and desaturation with normal physical examination, and turned out to be COVID-19 positive. In the isolation ward, he had a cardiac arrest, and bedside echocardiography showed a fresh thrombus had developed in the right atria with signs of acute right ventricular dysfunction. The diagnosis of acute PE with hemodynamic instability was established, and systemic thrombolysis was immediately initiated. The patient recovered well with improvement in his symptoms and was eventually safely discharged. Our case demonstrates how early recognition and prompt treatment of acute PE especially in COVID-19 patients with hemodynamic instability is a life-saving intervention. Identifying the subtle clues of acute PE in emergency situations remains the main challenge.</p>","PeriodicalId":6889,"journal":{"name":"Acta medica Indonesiana","volume":"56 4","pages":"530-536"},"PeriodicalIF":0.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143045433","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":"Cardiac Tamponade Due to Right Ventricle Perforation: A Rare Complication of Catheter Ablation for Ventricular Tachycardia Storm.","authors":"Annisa Puspitasari Nachrowi, Simon Salim, Angga Pramudita, Muhammad Yamin","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Cardiac tamponade is a rare but fatal complication of catheter ablation. We are reporting a case of a 73-year-old male with ventricular tachycardia (VT) storm undergoing urgent VT ablation, who was later found to have right ventricle (RV) perforation-an unusual site for catheter ablation complication. The patient underwent isochronal late activation mapping (ILAM)-based ablation and elimination of local abnormal ventricular activities (LAVA). After procedure, his blood pressure rapidly decreased, and he was found to have cardiac tamponade. The tamponade was recurring despite of pericardial pigtail placement; thus, the patient was prepared for open-heart surgery. To preserve blood, auto transfusion was used as a bridging therapy.</p>","PeriodicalId":6889,"journal":{"name":"Acta medica Indonesiana","volume":"56 4","pages":"501-506"},"PeriodicalIF":0.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143045409","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":"Outcome Prediction in Infectious Disease.","authors":"Khie Chen Lie, Yosia Yonggara, Adeline Pasaribu, Sharifah Shakinah, Leonard Nainggolan","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Sepsis is a critical, life-threatening condition that demands precise prediction to mitigate adverse outcomes. The heterogeneity of sepsis leads to variable prognoses, making early and accurate identification increasingly difficult. Despite ongoing advancements, no single gold standard has emerged for sepsis prediction. Current research explores a range of prognostic tools, from traditional scoring systems and biomarkers to cutting-edge omics technologies and artificial intelligence. These tools can differ significantly across patient populations and clinical settings, such as the emergency department (ED) and intensive care unit (ICU). This review aims to critically evaluate the development and application of outcome prediction modalities in sepsis and other infectious diseases, highlighting the progress made and identifying areas for further research.</p>","PeriodicalId":6889,"journal":{"name":"Acta medica Indonesiana","volume":"56 4","pages":"537-554"},"PeriodicalIF":0.7,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143045026","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}