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Sebayang, Abed Nego Okthara
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Medicine & Pharmacology

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Novel Oral Anti Coagulants (NOACs) as Anti Thrombotic on Atrial Fibrillation Patients Sebayang, Abed Nego Okthara
SCRIPTA SCORE Scientific Medical Journal Vol. 1 No. 2 (2020): SCRIPTA SCORE Scientific Medical Journal
Publisher : Talenta Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (689.198 KB) | DOI: 10.32734/scripta.v1i2.1232

Abstract

ABSTRACT Atrial Fibrillation (AF) is an arrhythmia characterized by disorganization of atrial depolarization resulting in the impaired mechanical function of the atrium. Management of AF aims to prevent complications of ischemic stroke and systemic embolism, carried out by the administration of anticoagulant, warfarin, but warfarin has many side effects. New Oral Anticoagulants (NOAC) can be used as alternatives in preventing complications of AF.New anticoagulants such as dabigatran, rivaroxaban, and apixaban have better effects than other anticoagulants such as warfarin and have major side effects of bleeding and minimal relevant bleeding. Based on a national survey in Denmark to see a balance between stroke and intracranial bleeding, CHA2DS2-VASc 1 scores were only apixaban and both dabigatran doses (110 mg bid and 150 mg bid) which provided better clinical benefits than warfarin, but if the CHA2DS2- score VASc ≥2 of all NOACs is superior to warfarin. Atrial fibrillation can cause ischemic stroke and systemic embolism. New Oral Anticoagulant (NOACs) can be used as a solution to prevent complications from AF with minimal side effects. It is expected that the presence of new anticoagulants can reduce the rate of ischemic stroke and ischemic embolism due to AF with minimal side effects of bleeding and other side effects. Keywords: Anticoagulant, Atrial Fibrillation, NOAC, Warfarin ABSTRAK Atrial Fibrilasi (AF) adalah suatu aritmia yang ditandai dengan disorganisasi dari depolarisasi atrium sehingga berakibat pada gangguan fungsi mekanik atrium. Penatalaksanaan AF bertujuan mencegah komplikasiyakni stroke iskemik dan emboli sistemik, dilakukan dengan cara pemberian anti-koagulan yakni warfarin. Pemberian warfarin memiliki banyak efek samping. Novel Oral Anti Coagulants (NOAC) dapat dijadikan alternatif dalam mencegah komplikasi AF. Anti-koagulan baru seperti dabigatran, rivaroxaban dan apixaban memiliki efektifitas yang lebih baik daripada anti-koagulan lainnya seperti warfarin dan memiliki efek samping perdarahan mayor dan perdarahan relevan yang minimal. Berdasarkan survei nasional di Denmark untuk melihat keseimbangan antara stroke dan perdarahan intra-kranial didapatkan bila skor Congestive heart failure, Hypertension, Age ≥75 years (skor 2), Diabetes mellitus, Stroke history (skor 2), peripheral Vascular disease, Age between 65 to 74 years, Sex Category (female) dan “C” adalah adanya disfungsi ventrikel kiri sedang hingga berat (Left Ventricular Ejection Fraction/LVEF ≤ 40%) CHA2DS2-VASc 1 hanya apixaban dan kedua dosis dabigatran (110 mg b.i.ddan 150 mg b.i.d) yang memberikan manfaat klinis yang lebih baik daripada warfarin, tetapi apabila skor CHA2DS2-VASc ≥2 seluruh NOAC lebih superior dibanding warfarin.AF dapat menyebabkan stroke iskemik dan emboli sistemik.NOAC dapat dijadikan solusi untuk mencegah komplikasi dari AF dengan efek samping yang minimal. Diharapkan dengan hadirnya anti-koagulan baru dapat menurunkan angka stroke iskemik dan emboli iskemik akibat AF dengan efek samping perdarahan dan efek samping lainnya yang minimal. Kata Kunci: Antikoagulan, Atrial Fibrilasi, NOAC, Warfarin
Perawatan Diagnostik dan Konservatif Hidropneumotorax karena Tuberkulosis pada Anak Laki-Laki Berusia 17 Tahun: Laporan Kasus Sebayang, Abed Nego Okthara
SCRIPTA SCORE Scientific Medical Journal Vol. 2 No. 1 (2020): SCRIPTA SCORE Scientific Medical Journal
Publisher : Talenta Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32734/scripta.v2i1.3527

Abstract

Background: Pulmonary tuberculosis is an infectious disease of the lungs caused by Mycobacterium Tuberculosis. The prevalence of pulmonary tuberculosis in Indonesia is estimated at 420,000 every year. Pulmonary tuberculosis is transmitted from person to person through droplet infection. Complications that can occur in pulmonary tuberculosis are empyema, pleural effusion, hydropneumothorax and even fibrothorax. Case Illustration: A 17 years old boy was entered the hospital with the complaint of dyspnea. The patient appeared such indications as: pulse is 104/minute, blood pressure 119/70 mmHg, temperature 37 0C, respiratory rate is 28/minute, SpO2 is 90%. Physical examination showed tachypnea, asymmetrical chest wall movement, weak vesicular sound in the right lung, radiography examination showed right hydropneumothorax. Discussion: Pulmonary tuberculosis is a chronic infectious granulomatous disease caused by Mycobacterium Tuberculosis. This disease usually attacks the lungs. In this case pulmonary tuberculosis with hydropneumothorax was found. The given treatment was water seal drainage installation, oral 4-FDC, oral acetyl cysteine and during treatment the patient is given advice to blow balloons every day. Treatment is carried out for eight days and showed a good response. Conclusion: Pulmonary tuberculosis is an infectious disease of the lungs caused by Mycobacterium tuberculosis. In this case, pulmonary tuberculosis with hydropneumothorax was found. Appropriate management is needed to reduce the level of morbidity in these patients. Keywords: dyspnea, hydropneumothorax, tuberculosis     Latar Belakang: Tuberkulosis paru adalah penyakit infeksi pada paru yang disebabkan oleh Mycobacterium tuberculosis. Prevalensi TB paru di Indonesia diperkirakan 420.000 setiap tahun. Tuberkulosis paru ditularkan dari orang ke orang melalui droplet. Komplikasi yang dapat terjadi pada tuberkulosis paru adalah empyema, efusi pleura, hidropneumotoraks, dan bahkan fibrotoraks. Ilustrasi Kasus: Seorang anak laki-laki berusia 17 tahun datang ke rumah sakit dengan keluhan dyspnea. Pasien datang dengan indikasi seperti: denyut nadi 104 / menit, tekanan darah 119/70 mmHg, suhu 37 0C, laju pernapasan 28 / menit, SpO2 90%. Pemeriksaan fisik menunjukkan takipnea, gerakan dinding dada asimetris, suara vesikular lemah di paru kanan, pemeriksaan radiografi menunjukkan hidropneumotoraks dextra. Pembahasan: Tuberkulosis paru adalah penyakit granulomatosa menular kronis yang disebabkan oleh Mycobacterium tuberculosis. Penyakit ini biasanya menyerang paru-paru. Dalam kasus ini ditemukan tuberkulosis paru dengan hidropneumotoraks. Penatalaksanaan yang diberikan adalah pemasangan drainase seal air, oral 4-FDC, asetil sistein, dan selama perawatan pasien diberikan saran untuk meniup balon setiap hari. Perawatan dilakukan selama delapan hari dan menunjukkan respons yang baik. Kesimpulan: Tuberkulosis paru adalah penyakit infeksi paru-paru yang disebabkan oleh Mycobacterium tuberculosis. Dalam kasus ini, ditemukan tuberkulosis paru dengan hidropneumotoraks. Manajemen yang tepat diperlukan untuk mengurangi tingkat morbiditas pada pasien ini. Kata kunci: dyspnea, hidropneumotoraks, tuberkulosis
Endovascular Aortic Repair (EVAR) Method in The Management of Abdominal Aortic Aneurysm Sebayang, Abed Nego Okthara; Hidayat, Niko Azhari
SCRIPTA SCORE Scientific Medical Journal Vol. 2 No. 1 (2020): SCRIPTA SCORE Scientific Medical Journal
Publisher : Talenta Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32734/scripta.v2i1.3530

Abstract

Aortic disease is a collection of diseases of the aorta, which includes aortic aneurysms; acute aortic infections consisting of aortic dissection, intramular hematoma, penetration of atherosclerotic ulcers (PAU) and traumatic injury to the aorta; pseudoaneurysm; aortic rupture; Marfan syndrome; and congenital abnormalities such as coarctation of the aorta. One of the aortic diseases that cause the death rate to increase according to the 2010 Global Burden Disease is aortic aneurysm. Abdominal aortic aneurysm (AAA) is a focal dilatation of the aortic segment. The diagnosis of AAA is done by history taking, physical examination and supporting examination. Management at AAA aims to prevent aortic wall rupture. An alternative procedure without open surgery is endovascular aortic repair (EVAR) using prostheses. It is expected that through the EVAR method, mortality and morbidity due to AAA can be reduced. Keywords: abdominal aortic aneursym, EVAR, prostheses     Penyakit aorta merupakan kumpulan penyakit pada aorta yang meliputi aneurisma aorta; sindrom aorta akut berupa diseksi aorta, hematoma intramular, penetrating atherosclerosis ulcer (PAU) dan cedera akibat trauma pada aorta; pseudoaneurysm; ruptur aorta; sindrom Marfan; serta penyakit kongenital seperti koarktasio aorta. Salah satu penyakit aorta yang menyebabkan angka kematian meningkat menurut Global Burden Disease 2010 adalah aneurisma aorta. Aneurisma aorta abdominalis (AAA) merupakan dilatasi fokal pada segmen aorta. Penegakan diagnosis AAA dilakukan dengan anamnesis, pemeriksaan fisik dan pemeriksaan penunjang. Penatalaksanaan pada AAA bertujuan untuk mencegah pecahnya dinding aorta. Prosedur alternatif tanpa pembedahan terbuka yang dijadikan pilihan adalah endovascular aortic repair (EVAR) menggunakan protesa. Diharapkan melalui metode EVAR angka mortalitas dan morbiditas akibat AAA dapat diturunkan. Kata kunci: aneurisma aorta abdominalis, EVAR, protesa
Spontaneous Pneumothorax Sebayang, Abed Nego Okthara; Kurniawan, Setiadi Drajad
SCRIPTA SCORE Scientific Medical Journal Vol. 4 No. 1 (2022): SCRIPTA SCORE Scientific Medical Journal
Publisher : Talenta Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32734/scripta.v4i1.8118

Abstract

Background: Pneumothorax is a medical emergency which is defined as an abnormal condition where there is air in the pleural cavity which physiologically contains only a small amount of fluid. Pneumothorax can arise spontaneously or as a result of trauma. Method: The method used in this study is a literature review. The literature study conducted by the author is by searching various written sources, whether in the form of books, archives, magazines, articles and journals, or documents that are relevant to the problem being studied. Discussion: Pneumothorax is classified as primary spontaneous if it occurs in the absence of basic lung disease or thoracic trauma. Pneumothorax is classified as secondary spontaneous if it is caused by basic lung disease. The etiology of primary spontaneous pneumothorax is pleural bleb and bulla. A bleb (air pocket) or bulla is a small air-filled pocket that forms between the lung and pleural tissues. The risk factors associated with pneumothorax are smoking and body thinness. Conclusion: The initial management of spontaneous pneumothorax includes emergency management. Furthermore, management can be divided into conservative and invasive management
On-Pump and Off-Pump Coronary Artery Bypass Grafting As An Open Heart Surgery Procedure In Management Of Coronary Heart Disease Sebayang, Abed Nego Okthara; Abdulgani, Hafil Budianto
SCRIPTA SCORE Scientific Medical Journal Vol. 4 No. 2 (2023): SCRIPTA SCORE Scientific Medical Journal
Publisher : Talenta Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32734/scripta.v4i2.10281

Abstract

Introduction: Coronary heart disease is a condition in which fatty deposits in the heart's coronary arteries change the role and shape of the streets and obstruct blood flow to the heart. Invasive management is known as coronary artery bypass grafting and is divided into two techniques: on-pump coronary artery bypass and off-pump coronary artery bypass. Method: The method used in this study is a systematic review. The literature study conducted by the author is by searching various written sources, whether in the form of books, archives, magazines, articles and journals, or documents that are relevant to the problem being studied. Discussion: The on-pump coronary artery bypass technique is performed using a cardiopulmonary bypass machine which replaces the function of the heart and lungs during the operation process, and the off-pump coronary artery bypass technique is performed without using a cardiopulmonary bypass machine so that the heart keeps beating during the operation. Both of these techniques give equally good results, and their selection depends on the clinical situation of the patient and the cardiac surgeon. Conclusion: Coronary artery bypass grafting is a surgical technique that is currently the choice in managing coronary heart disease patients when treatment and Percutaneous coronary intervention do not provide the best results. There are two techniques for performing CABG, namely on-pump coronary artery bypass and off-pump coronary artery bypass Keyword: Coronary heart disease,  Coronary Artery, On pump coronary artery bypass, off-pump coronary artery bypass   Pendahuluan: Penyakit jantung koroner adalah suatu kondisi di mana timbunan lemak di arteri koroner jantung mengubah peran dan bentuk jalan dan menghalangi aliran darah ke jantung. Penatalaksanaan invasif dikenal sebagai pencangkokan bypass arteri koroner dan dibagi menjadi dua teknik: bypass arteri koroner on-pump dan bypass arteri koroner off-pump. Metode: Metode yang digunakan dalam penelitian ini adalah sistematika review. Studi kepustakaan yang dilakukan penulis adalah dengan menelusuri berbagai sumber tertulis, baik berupa buku, arsip, majalah, artikel dan jurnal, maupun dokumen-dokumen yang relevan dengan masalah yang diteliti. Diskusi: Teknik bypass arteri koroner on-pump dilakukan dengan menggunakan mesin cardiopulmonary bypass yang menggantikan fungsi jantung dan paru-paru selama proses operasi, dan teknik bypass arteri koroner off-pump dilakukan tanpa menggunakan mesin cardiopulmonary bypass sehingga jantung terus berdetak selama operasi. Kedua teknik ini memberikan hasil yang sama baiknya, dan pemilihannya tergantung pada situasi klinis pasien dan ahli bedah jantung. Kesimpulan: Pencangkokan bypass arteri koroner merupakan teknik bedah yang saat ini menjadi pilihan dalam penanganan pasien penyakit jantung koroner ketika pengobatan dan intervensi koroner perkutan tidak memberikan hasil terbaik. Ada dua teknik untuk melakukan CABG, yaitu bypass arteri koroner on-pump dan bypass arteri koroner off-pump Kata Kunci: penyakit jantung koroner, arteri koroner, bedah pintas koroner
Co-Authors Abdulgani, Hafil Budianto Hidayat, Niko Azhari Kurniawan, Setiadi Drajad