Paul L Tahalele
Department Of Surgery, Airlangga University Medical School/Dr. Soetomo General Hospital, Surabaya, East Java

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PERCUTANEOUS TRANSLUMINAL ANGIOPLASTY IN SUBCLAVIAN VEIN STENOSIS CAUSED BY CENTRAL VENOUS CATHETERIZATION FOR HEMODIALYSIS ACCESS IN CHRONIC KIDNEY DISEASE PATIENTS Laksono, Gerardo; Motulo, Yosis Y; Tahalele, Paul L
JOURNAL OF WIDYA MEDIKA JUNIOR Vol 6, No 1 (2024): January
Publisher : FAKULTAS KEDOKTERAN UNIVERSITAS KATOLIK WIDYA MANDALA SURABAYA

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33508/jwmj.v6i1.5390

Abstract

Introduction: The increased of central vein access for hemodialysis in chronic kidney disease patients has led to increase of side effect in clinically relevant stenosis of subclavian vein. One of therapeutic options to solve stenosis of subclavian vein is endovascular treatment Percutaneous Transluminal Angioplasty (PTA) .Objectives: To show our experience in treating subclavian vein stenosis using Endovacular treatment Percutaneous Transluminal Angioplasty (PTA). Materials and Methods: A retrospective study in 62 chronic kidney disease patients who undergo hemodyalisis with stenosis of subclavian vein treated with PTA in 3 hospitals in Surabaya from October 2017-October 2020 with range age 18-70 years was conducted .Results: We performed PTA for subclavian vein stenosis in 62 cases. Partial stenosis was found in 35 cases and total occlusion in 27 cases. For 27 total occlusion cases, 19 cases can still be opened, but 8 cases can’t be opened or recanalization and we drop out these patient. 54 cases (87%) were good and 8 cases (13%) can’t be open. The result of PTA in treating stenosis of subclavian vein was good. The result of reduced in arm swelling and using doppler USG follow up are 100%(54/54) after 1 month, 100%(54/54) after 3 months, 90.7% (49/54) after 6 months.Conclusion: Percutaneous Transluminal Angioplasty (PTA) is effective in treating subclavian vein stenosis reliefe its symptomps. The patency rate is 90.7% after 6 months post procedure of PTA.
THE RELATIONSHIP BETWEEN SMOKING HABITS AND THE INCIDENCE OF CHRONIC URTICARIA IN CIVITAS WIDYA MANDALA CATHOLIC UNIVERSITY SURABAYA Harijati, Erna; Dian Putri, Maria Patricia; Tahalele, Paul L; Khoesasih, Antonius Kevin
JOURNAL OF WIDYA MEDIKA JUNIOR Vol 6, No 3 (2024): July
Publisher : FAKULTAS KEDOKTERAN UNIVERSITAS KATOLIK WIDYA MANDALA SURABAYA

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33508/jwmj.v6i3.5760

Abstract

Background: Urticaria is a heterogeneous disease with multiple causative factors. A thorough literature research has revealed a very limited amount of evidence about the effects of smoking and alcohol consumption habits on the clinical characteristics of urticaria.. Atopic allergic which mean urticaria can affect all populations, but is most common in those aged between 20 to >60 years. Smoking has been reported to play a role in the onset of Urticaria. Substances in cigarette smoke can interact with body cells, resulting in the formation of free radicals or Reactive Oxygen Species (ROS).Objective: To see the relationship between smoking habit and the incidence of chronic urticaria among civitas at Widya Mandala Surabaya.Methods: The method used in this study was a case-control study by taking a population of civitas at the Widya Mandala Surabaya who had smoking history from 2020 to 2023. A sample of 94 people was obtained who had met the inclusion and exclusion criteria of the study. The sample of this study was divided into two groups consisting of a case group and a control group.Results: The results of the Contigency Coefficient Correlation test showed a significant p value of 0.031 <0.05, which means that there is an important correlation between smoking and the incidence of chronic urticaria among civitas at the Widya Mandala Surabaya.Conclusion: It is proven that there is a relationship between smoking and the incidence of chronic urticaria in civitas of Widya Mandala Surabaya.
CORRELATION OF THE FLAT FOOT AND THE SEVERITY OF SCOLIOSIS IN ELDERLY PATIENTS AT PHC HOSPITAL SURABAYA Arief, Teuku; Ricardo, Henry; Tahalele, Paul L; Huang, Velinda
JOURNAL OF WIDYA MEDIKA JUNIOR Vol 6, No 3 (2024): July
Publisher : FAKULTAS KEDOKTERAN UNIVERSITAS KATOLIK WIDYA MANDALA SURABAYA

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33508/jwmj.v6i3.5765

Abstract

Background: The main symptoms of Scoliosis are changes in body posture, such as unlevel shoulders, rib prominence, or waistline asymmetry. Some previous studies have shown major role of feet a in supporting the body weight support and providing dynamic balance in gait function. Moreover, flat foot (pes planus) may cause lower limb rotation and low back pain possibly due to altered postural reactions and subsequent compensatory patterns between the spine and lower extremitiesObjective: To explain the correlation between the incidence of pes planus and the severity of scoliosis in elderly patients (≥60 y.o) at PHC Surabaya Hospital.Method: This research is an analytical research using a cross sectional study, used probability sampling with purposive sampling. The minimum number of samples required in this research was calculated using the Lemeshow formula, resulting in 69 samples. Data were collected in the form of primary data (Clarke's angle measurement results in the medial longitudinal arch [MLA]) and secondary data (medical records) from 69 patients with a history of scoliosis (using the Cobb Angle Criteria) at PHC Surabaya Hospital in August – October 2023 by Specialist in Orthopedics and Traumatology. Then tested with the Spearman Correlation test using the Statistical Package for the Social Sciences (SPSS) version 29.Results: Of the 69 patients diagnosed with flat foot (pes planus) studied, it was found that 57 patients (82.6%) had scoliosis, but based on the results of statistical analysis of the two variables these were not significantly correlated (p = 0.932).Conclusion: There were no significant results regarding the correlation between the incidence of flat foot (pes planus) and the severity of scoliosis at PHC Surabaya Hospital. This is related to the inclusion and exclusion criteria set by researchers, such as age, BMI, and past medical history.
THE CORELATION OF THE QUALITY OF ANTENATAL CARE VISITS WITH THE INCIDENT OF ASPHYXIA NEONATORUM AT PHC HOSPITAL SURABAYA Noorlaksmiatmo, Harno Prihadi; Budipramana, Edwin; Tahalele, Paul L; Merici, Angela
JOURNAL OF WIDYA MEDIKA JUNIOR Vol 6, No 3 (2024): July
Publisher : FAKULTAS KEDOKTERAN UNIVERSITAS KATOLIK WIDYA MANDALA SURABAYA

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33508/jwmj.v6i3.5762

Abstract

Background: Birth asphyxia is the one of the very common problem in neonatal health care. Its incidence is very high in the developing country where health facilities are restricted to urban area, and these factors can be prevented through standard Antenatal Care (ANC) visits. ANC is medical care provided by healthcare professionals to mothers during pregnancy, administered by medical personnel and conducted according to established standards. This ANC monitors the health and development of both the mother and the fetus for early detection of risks and health issues during pregnancy.Objective: To determine the relationship between the quality of ANC visits and the occurrence of Asphyxia Neonatorum at PHC Hospital Surabaya.Method: This research is an observational analytic study with a case-control study design, employing a retrospective approach. The sampling in the study utilized probability sampling, specifically employing the simple random sampling technique. The statistical method used to examine the relationship between the quality of ANC visits and Asphyxia (APGAR Score ≤3-6) through the analysis of odds ratio comparison using the Chi-square statistical test.Result: The statistical analysis of the relationship between the quality of ANC visits and the occurrence of Asphyxia shows significant results with a p-value of 0.001 (p < 0.05).Conclusion: The compliance of pregnant women in adhering to standard ANC visits ensures the health of both the mother and the baby during pregnancy.
Pemakaian Nitroglycerin Intravena Invivo Sebagai Antidotum Efek Heparin Dhihintia Jiwangga; Paul L. Tahalele; Achmad Basori
JURNAL WIDYA MEDIKA Vol. 4 No. 2 (2018)
Publisher : FAKULTAS KEDOKTERAN UNIVERSITAS KATOLIK WIDYA MANDALA SURABAYA

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33508/jwm.v4i2.1813

Abstract

Introduction: intravenous nitroglycerin, if given simultaneously with heparin, can obstruct the heparin's anticoagulant effect, but it still remains controversy. This statement underlies researcher to authenticate whether intravenous nitroglycerin can neutralize heparin Aim: to find out if intravenous nitroglycerin can neutralize heparin Method: this research is an in vivo experiment with a rabbit as the experimental subject at The Pharmacology Department of The Medical Faculty of The Airlangga University. The experimental subjects are divided into a control group and a treatment. The control group is only given a dose of heparin, while the treatment is given a dose of heparin and some doses of intravenous nitroglycerin. Each of this experimental subjects will be examined its activated clotting time (ACT) score with a hemochrone. The statistical test that will be used is the normality test with one sample kolmogorov smirnov test Result: the administration of 3 mg/kg dose of intravenous glyceryl trinitrate after the administration of 3 mg/kg heparin can reduce the ACT value or neutralize the heparin's anticoagulant effect significantly with the value p= 0,001 (pc0,005). The group that receives 6 mg/kg glyceryl trinitrate, if compared to the prior ACT before the administration of 6 mg/kg glyceryl trinitrate, has a change with the value p= 0,001 (PO, 05). The group that receives 9 mg/kg glyceryl trinitrate, if compared to the prior ACT before the administration of 9 mg/kg glyceryl trinitrate, has a significant change with p=0,010 (P
When Do We Need Pleural Surgery? Paul L Tahalele; Merlinda Dwintasari; Y Motulo; Yan Efrata Sembiring; Dhihintia Jiwangga Suta
JURNAL WIDYA MEDIKA Vol. 5 No. 2 (2019)
Publisher : FAKULTAS KEDOKTERAN UNIVERSITAS KATOLIK WIDYA MANDALA SURABAYA

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33508/jwm.v5i2.2200

Abstract

Pleural sac is an enclosed sac covering the lung that consist of two membranes, i.e. parietal and visceral pleura. It has a cavity filled with small amount fluid that plays important role to provide smooth sliding of lung during respiration. Change or disturbance in the pleural cavity and or the pleura itself may result in restriction of lung expansion causing ventilation compromise. Pathology of pleura may result from varying etiology. It may present as inflammatory pleural effusion, non-inflammatory pleural effusion, pneumothorax, hematothorax, fibrothorax, pleural tumors, and cylothorax. Diagnostic tool for pleural diseases may be made from the simplest chest x-ray, ultrasound, computed tomography, MRI and histopathological studies. There are several treatment options for managing pleural diseases. It consist non operatif treatment, pleural drainage, decortication or pleurectomy, pleurodesis, and/ or resection of pleural tumor through procedure VATS, or open thoracotomy. Indications for surgery are traumatic or spontaneous pneumothorax, hematothorax, cylothorax, failure of non operatif treatment, fibrothorax or schwarte limiting lung expansion, mesothelioma, and recurrent pneumothorax or malignant pleural effusion. Decision for surgery need appropriate timing and planning regarding different pathology and different etiology.
Pneumomediastinum Paul L Tahalele; Merlinda Dwintasari; Y Motulo; Yan Efrata Sembiring; Dhihintia Jiwangga Suta
JURNAL WIDYA MEDIKA Vol. 5 No. 2 (2019)
Publisher : FAKULTAS KEDOKTERAN UNIVERSITAS KATOLIK WIDYA MANDALA SURABAYA

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33508/jwm.v5i2.2201

Abstract

Mediastinum is defined as the area demarcated by the thoracic inlet superiorly, the diphragm inferiorly, and the pleural cavities laterally. The mediastinum is a division of the thoracic cavity that contains thymus gland, the heart, trachea and portions of the seophagus, and other structures. Mediastinum divided into 3 region, anterior, posterior, superior, and middle regions. Pneumomediastinum or emphysematous mediastinum is existence of free air in the mediastinum due to spontaneous or secondary reasons. That can be confirmed with thorax X-Ray or CT- Scan thorax. The symptomps are severe central chest pain, shortness of breath, subcutaneous emphysema, laboured breathing and voice distortion. In physical diagnosis, especially on auscultation, there is spesific sign called “Hamman’s Crunch” (crunching sound corresponding with the cardiac cycle (Hamman’s Crunch). Pneumomediastinum can leadto pneumopericardium, pneumotoraks, penumoretroperitonium or penumoperitonium. Air in the mediastinal cavity can be absorbed by itself slowly, so penumomediastinum can treated non-operatively.
AN ANIMATED MODELS DEVELOPMENT OF CARDIOVASCULAR SYSTEM IN PHARMACOLOGY LEARNING MODULE FOR MEDICAL STUDENTS Bernadette Dian Novita; Paul L Tahalele; Gerardo AK Laksono
JURNAL WIDYA MEDIKA Vol. 7 No. 1 (2021): April
Publisher : FAKULTAS KEDOKTERAN UNIVERSITAS KATOLIK WIDYA MANDALA SURABAYA

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33508/jwm.v7i1.3168

Abstract

Hypertension is the most known common cardiovascular disease. Based on the Indonesian Competency Standard of Medical Doctors (StandarKompetensiDokter Indonesia or SKDI), the management of essential hypertension is at 4A or the highest level. Therefore, doctors should be able to establish a complete and independent diagnosis and management. The student passing rate in the cardiovascular system at the undergraduate level of medical education of Faculty of Medicine Widya Mandala Catholic University (FK UKWMS) was around 60-70%. This study is an evaluation to develop learning methods that would improve student learning outcomes. The development of this animation model is aimed to increase the engagement process in Pharmacology learning, especially in the cardiovascular system. 98 active students participated in this study, divided into 74 undergraduate students and 24 clinical internship students. The evaluation was carried out using a pre-test and a post-test related to pharmacological animation video exposure. Using the Wilcoxon different test, there was a significant difference between the pre-test and post-test results, especially in the clinical internship program’s students. This animated model was expected to help students to determine the rational determination of hypertension therapy.
TELEMEDICINE AS AN OPTION FOR HEALTH SERVICE LIMITATIONS IN COVID-19 PANDEMIC ERA Bernadette Dian Novita; Sianty Dewi; Evelyn Ongkodjojo; Agatha Christi Palupi; Immanuel Michael; Paul L. Tahalele
JURNAL WIDYA MEDIKA Vol. 7 No. 2 (2021): October
Publisher : FAKULTAS KEDOKTERAN UNIVERSITAS KATOLIK WIDYA MANDALA SURABAYA

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33508/jwm.v7i2.3430

Abstract

Coronavirus disease 2019 (COVID-19) pandemic era provides a new habit in form of self-quarantine or physical distancing. The recommendation is to delay visits to health facilities if it is not in the emergency condition to slow down the spread of COVID-19 transmission. This study aims to develop a telemedicine system that integrates three main components, namely doctors, patients, and hospital management in Gotong Royong Hospital Surabaya to minimize the transmission of COVID-19 while still provides comprehensive health services. The development of telemedicine service is divided into 3 stages. In the first stage, emergency screening was carried out by developing Frequently Asked Questions (FAQs). The second stage was continued with prototype testing and the last part was improving the system to create a better referral system. Gotong Royong Hospital telemedicine has been active since June 2021, within 2 months, 45 patients are willing to use telemedicine services. The results showed that telemedicine was easily accepted by patients in internal medicine clinic services (p
COMPLETE REPAIR OF TETRALOGY OF FALLOT (TOF) ON BEATING HEART SURGERY WITHOUT AORTIC CROSS CLAMPING : REPORT OF A CASE Gerardo AK Laksono; Heroe Soebroto; Paul L Tahalele
JURNAL WIDYA MEDIKA Vol. 7 No. 2 (2021): October
Publisher : FAKULTAS KEDOKTERAN UNIVERSITAS KATOLIK WIDYA MANDALA SURABAYA

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33508/jwm.v7i2.3516

Abstract

Introduction: Reperfusion injury is a well-known phenomenon that occurred in cardioplegic techniques with cardiopulmonary bypass. Therefore great effort is made to prevent reperfusion injury. Beating Heart Continuous Coronary Perfusion (BHCCP) surgery is one of the alternative techniques to improve an ischemic reperfusion injury in open-heart surgery, either in pediatric or in adult. This technique can be done in complete repair of tetralogy of Fallot (TOF). Purpose: To report our first experience in doing complete repair of TOF using beating heart technique without aortic cross-clamping Case Report: A five-year-old boy came on to ER on January 6th, 2012, with a history of cyanotic since birth. His echocardiography and catheterization concluded a tetralogy of Fallot with a McGoon ratio of 1.95 (the diameter of RPA and LPA were 9.14 mm and 8.79 mm, respectively). A complete repair of TOF was done using beating heart surgery without aortic cross-clamping technique. One month post-surgery evaluation, there weren't any neurological or motor disorders. Echocardiography results showed no residual pulmonary stenosis, but 0.2 mm residual VSD was found. Conclusion: This heart rate technique is an alternative method of myocardial protection in cardiac surgery. In several cardiac centres globally, this technique is relatively safe and can be used during surgery, especially in the total correction of TOF.
Co-Authors Achmad Basori, Achmad Adi Nugroho Adri Gabriel Sooai Agatha Christi Palupi Agustinus Bimo Gumelar Agustinus Bimo Gumelar Albert Setiawan Alyssa Claudia Valerie Gunawan Amadeo, Jovan Anggorwasito, Jose L Anggowarsito, Jose L Arief, Teuku Audrey Fedora Irawan Bernadette Dian Novita Bernadette Dian Novita Bernadette Dian Novita Bernadette Dian Novita Dewi Budipramana, Edwin Claudia Tjipto Daniel DH Silitonga Delvi Vorst Dewi, I.G.A.P.D Dhihintia Jiwangga Dhihintia Jiwangga Suta Dhihintia Jiwangga Suta Dian Putri, Maria Patricia Dorothea Kusumaningrat Dyana Sarvasti Ellenora R Mustikaningrat Ellenora R Mustikaningrat Epriyanto T Darmadi Erwin, Ferdinand Evelyn Ongkodjojo Febianingrum, Adhani Ferdinand Erwin Gerardo AK Laksono Gerardo AK Laksono Gerardo AK Laksono Gerardo AK Laksono Gerardo Axel Ruslie Gerardo Laksono Grace Margaretha Ludia Hanindita, Meta Herdiana Harijati, Erna Hendrata, Adi Pramono Hendrawan, Kevin Anggakusuma Herman YL Wihastyoko Huang, Velinda Hutama, Andreas MS Immanuel Michael Irene L Parengkuan Jose L. Anggowarsito Joseph, Herman Kartana, Kartana Kevin Samsudin Kevin Samsudin Kevin Samsudin Khoesasih, Antonius Kevin Kuncorojakti, Suryo Laksono, Gerardo Laksono, Gerardo AK M. Nahak, Belinda Peregrina Maria S Ganggur Martha Ervina Melvin F Gonga Merici, Angela Merlinda Dwintasari Merlinda Dwintasari Mitchell Theny Motulo, Yosis Y Nevan Go Ni Nyoman Ratih Dharmapatni Niluh Suwasanti Niluh Suwasanti Ninik Asmaningsih Soemyarso Noorlaksmiatmo, Harno Prihadi Novita, Bernadette Dian Nunung Nugroho Oktavianus Y Ampur Oktavianus Y Ampur Rahayu, Titien Ricardo, Evan Ricardo, Henry Riskky Vitria Prasetyo Sembiring, Yan Efrata Sianty Dewi Sianty Dewi Soebroto, Heroe Soediono, Endang Isbandiati Sumi WIjaya, Sumi Suwasanti, Niluh Theresia Cindy Limantoro Titiek Ernawati Tjahjono, Yudy Tridharmadi, Epriyanto Wahyuni Widoretno, Elisabeth Tri Wedharga, I Gede Putu Adhi Wihastyoko, HYL Wijaya, Hendy Wilson Christianto Khudrati Wismaya, IGP Wegen Y Motulo Y Motulo Young, Andre Zenia Angelina