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Vitamin D dan paparan sinar matahari untuk mencegah COVID-19. Fakta atau mitos ? Mexitalia, Maria; Susilawati, Martvera; Pratiwi, Rina; Susanto, JC
Medica Hospitalia : Journal of Clinical Medicine Vol. 7 No. 1A (2020): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (347.862 KB) | DOI: 10.36408/mhjcm.v7i1A.474

Abstract

Latar Belakang : Paparan sinar matahari pada kulit merupakan cara terbaik untuk sintesis vitamin D. Kadar vitamin D yang adekuat dalam tubuh merupakan proteksi terhadap berbagai penyakit seperti penyakit degeneratif, kanker dan juga infeksi saluran napas. Beberapa penelitian menghubungkan kadar vitamin D yang rendah dengan morbiditas dan mortalitas COVID-19. Hal ini menyebabkan fenomena baru pada masyarakat yaitu kebiasaan berjemur. Tujuan : Artikel ini akan membahas tentang metabolisme vitamin D, peran sinar matahari dalam mengaktifkan vitamin D di dalam tubuh, dan peran vitamin D dalam berbagai penyakit, khususnya mekanisme imunitas untuk COVID-19. Diskusi : Vitamin D meningkatkan kekebalan alami seluler terutama dengan cara menginduksi peptida antimikroba, yang meliputi cathelicidin, LL-37, 1,25-dihdroxyvitamin D dan defensins. Selain itu vitamin D akan meningkatkan sekresi hidrogen peroksida pada sel monosit. Pemberian vitamin D dosis tinggi sebanyak 10.000 IU/hari selama beberapa minggu dilanjutkan 5000 IU/hari bermanfaat untuk mencegah COVID-19, walaupun hasilnya masih memerlukan penelitian lebih lanjut. Absorpsi sinar matahari ke dalam tubuh manusia dipengaruhi oleh warna kulit, penggunaan bahan pakaian dan tabir surya , dan luas pajanan. Paparan sinar matahari sebesar satu Minimal Erythemal Dose (MED) pada orang dewasa dapat meningkatkan konsentrasi vitamin D setara dengan suplementasi 10.000 – 25.000 IU. Penelitian pada bayi yang diberi paparan 3 kali seminggu @ 5 menit pada jam 10.00-14.00, dengan paparan 50% area tubuh selama 2 bulan, mendapatkan kenaikan 25(OH)D sebesar 8,9 ng/mL. Simpulan : Vitamin D yang diaktifkan oleh paparan sinar matahari sangat bermanfaat sebagai proteksi berbagai penyakit termasuk juga pada COVID-19, walaupun efektifitasnya masih memerlukan penelitian lebih lanjut. Kata Kunci : COVID-19, vitamin D, paparan sinar matahari Background : The exposured of sunlight on the skin is the best way for vitamin D synthesis. Adequate vitamin D levels are protection against various diseases such as degenerative diseases, cancer and also respiratory infections. Several studies have linked between low vitamin D levels with COVID-19 morbidity and mortality. This causes a new phenomenon in the community, namely sunbathing. Purpose : This review rearticle will discuss about vitamin D metabolism, the role of sunlight in activating vitamin D in the body, and the role of vitamin D in various diseases, specifically the immune mechanism for COVID-19.Discussion : Vitamin D increases cellular innate immunity mainly by inducing antimicrobial peptides, which include cathelicidin, LL-37, 1,25-dihdroxyvitamin D and defensins, and also increase the secretion of hydrogen peroxide in monocyte cells. The administration of high-dose vitamin D of 10,000 IU / day for several weeks followed by 5000 IU / day is useful to prevent COVID-19, although the results still require further research. The sun exposure to activated vitamin D body is affected by skin color, using of clothing and sunscreen, and area of ??exposure. Sun exposure of one Minimum Erythemal Dose (MED) in adults can increase vitamin D concentrations equivalent to 10,000 - 25,000 IU vitamin D supplementation. Study on infants who were given exposure 3 times a week @ 5 minutes at 10:00 to 14:00, with exposure 50% of body surface area for 2 months, increased 25(OH)D of 8.9 ng/mL. Conclusion : Vitamin D which is activated by sun exposure is very useful as protection for various diseases including COVID-19, although its effectiveness still requires further research. Keywords : vitamin D, sun exposure, COVID-19.
Stenting of Ductus Arteriosus for Duct-Dependent Pulmonary Circulation: An Emergency and Life Saving Procedure: Stenting of Ductus Arteriosus for Duct-Dependent Pulmonary Circulation: An Emergency and Life Saving Procedure Permitasari, Desy Ayu; Andini, Aulia Rizki; Ayukusuma, Anggita Rahma; Susilawati, Martvera; Priyatno, Agus
Medica Hospitalia : Journal of Clinical Medicine Vol. 9 No. 3 (2022): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36408/mhjcm.v9i3.637

Abstract

BACKGROUND: Critical congenital heart defect with ductal-dependent pulmonary flow presents as a life-threatening condition. The patency of ductus arteriosus is required to supply blood flow into the lung. Stent implantation into ductus arteriosus has been proposed as non-surgical management for critical congenital heart disease with duct-dependent. CASE DESCRIPTION: We present full-term newborns who had critical congenital heart disease with ductal-dependent pulmonary blood blow and successfully managed with ductal stenting. Patient A, a 13-days-old male newborn had Tetralogy of Fallot-Pulmonary Atresia, restrictive Ventricular Septal Defect (VSD) and patent ductus arteriosus (PDA). Patient B, a 5-days-old female newborn had Tricuspid Atresia, restrictive VSD, PDA, and multiple congenital anomaly. Patient C, a 2-days-old female newborn had PA-IVS, PDA with stretched Patent Foramen Ovale (PFO). Prostaglandin-E1 infusion was started at first and stopped 6 hours prior to the procedure. All patients underwent ductus arteriosus stenting via femoral artery approach with drug-eluting stent. Pulmonary vascular markings were increased and oxygen saturations were improved in all of the patient. 5-month follow up, patients were in stable condition and prepared for surgical correction.   DISCUSSION: Ductal stenting in patient with duct-dependent pulmonary circulation appears to be an alternative to surgery. It provides bridging palliation until the time of definitive surgery. The effectiveness of the procedure was highlighted by the fact that all the patients showed a significant improvement in arterial saturation and pulmonary vascular marking. CONCLUSION: Stenting of ductus arteriosus is feasible and safe with great result. Early detection and timely management are imperative to save the life. KEYWORDS: critical congenital heart defect, ductus arteriosus, ductal stenting, ductal-dependent pulmonary blood flow