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All Journal Indonesian Journal of Cardiology Journal of the Indonesian Medical Association : Majalah Kedokteran Indonesia Sanus Medical Journal
Halomoan, Reynaldo
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Biochemistry, Genetics & Molecular Biology Education Health Professions Immunology & microbiology Medicine & Pharmacology Nursing Public Health

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Chronic Limb Ischemia: Awareness and Treatment in Primary Care Purwowiyoto, Sidhi Laksono; Halomoan, Reynaldo
Sanus Medical Journal Vol. 5 No. 1 (2023)
Publisher : Universitas Muhammadiyah Prof. Dr. Hamka (UHAMKA Press)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22236/sanus.v5i1.6347

Abstract

Chronic limb ischemia (CLI) is a type of peripheral arterial disease (PAD) that is still underdiagnosed and undertreated despite the increasing incidence, thus becoming a global health burden. The prevalence of PAD is quite high, approximately around 200 million globally in the adult population and increased drastically in older age population. It might be difficult to diagnose at an early stage because around 20-50% patients may be asymptomatic. More than 70% of primary physicians also did not notice that the diagnosis was already established during screening of the PAD patients. All these problems could increase the incidence of PAD in the following year. The untreated conditions will develop into a more severe form of PAD known as chronic limb-threatening ischemia (or critical limb ischemia), and patients are at a higher risk of having limb loss, and also increased morbidity and mortality. The primary physicians in the primary health facilities hold an important role in the early diagnosis and management of patients with CLI symptoms or with risk factors of CLI. Due to the limitation of diagnostic testing modality at primary health facilities, the physician can assess the ankle-brachial index (ABI) to determine the presence of CLI. Management of the disease is different for every patient and is customized based on the other comorbidities. Risk factors should be controlled in order to achieve a better outcome. A good management strategy will improve the condition. This review aims to describe how to give an early diagnosis and management for CLI patients in primary health care.
PULMONARY EMBOLISM WITH ANTIPHOSPHOLIPID SYNDROME: A CASE REPORT Purwowiyoto, Sidhi Laksono; M, Ferel; R, Yeria; Halomoan, Reynaldo; Kurniawan
Sanus Medical Journal Vol. 2 No. 2 (2021)
Publisher : Universitas Muhammadiyah Prof. Dr. Hamka (UHAMKA Press)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22236/sanus.v2i2.7256

Abstract

Antiphospolypid sí­ndrome (APS) is a systemic autoimmune condition that is related to vascular thrombosis. Patients with APS are at risk for developing pulmonary embolism (PE) events. In this case, we present a 68 years old female with complaints of sudden onset of persistent shortness of breath for two days. No past medical history was identified. Physical and diagnostic examination revealed the presence of PE and antiphospolipid antibodies. Diagnosis of PE and APS were made. Patients then received initial anticoagulant using enoxaparin subcutaneously. Initial anticoagulants in patients with APS and PE should be administered. However, it is important to choose the right anticoagulant. DOAC is contraindicated due to the increased risk of thromboembolic events.
Is Radiofrequency Ablation Better than Venous Stripping for Management of Chronic Venous Insufficiency? Halomoan, Reynaldo; Singjie, Leonard Christianto; Setiawan, Jonny
Majalah Kedokteran Indonesia Vol 71 No 5 (2021): Journal of The Indonesian Medical Association - Majalah Kedokteran Indonesia, Vo
Publisher : PENGURUS BESAR IKATAN DOKTER INDONESIA (PB IDI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47830/jinma-vol.71.5-2021-519

Abstract

Chronic venous insufficiency (CVI) is a disease of the vein due to valve dysfunction, venous obstruction, or both. This results in increased vein pressure and related to disruption in the vein system.
Cryptogenic Stroke: A Challenge in Diagnosis and Management Purwowiyoto, Sidhi Laksono; Setianto, Budhi; Panindhita, Gea; Halomoan, Reynaldo; Wiryawan, I Nyoman
Jurnal Kardiologi Indonesia Vol 42 No 3 (2021): Indonesian Journal of Cardiology: July - September 2021
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.1149

Abstract

Ischemic stroke is responsible for 85% of all stroke globally. However, the etiology of around a quarter of ischemic stroke are undetermined, this is called cryptogenic stroke. This kind of stroke affects younger population. Several mechanism are associated with the incidence of cryptogenic stroke such as paroxysmal atrial fibrillation, patent foramen ovale, atherosclerosis, and atrial cardiopathy. Despite many advanced knowledge on stroke generally, cryptogenic stroke is still a challenge in clinical settings. To understand more about cryptogenic stroke, a new term of embolic strokes of undetermined source (ESUS) is proposed and may need a specific workup. Specific workup aims to detect any silent risk factors and also to evaluate the cardiac structure. The term of ESUS also leads to the understanding that cryptogenic stroke is highly related to embolic mechanism and anticoagulation administration might benefit the patients. However, the result of several recent studies showed that anticoagulant was not superior to antiplatelet, and antiplatelet is still the preferred treatment. Studies on PFO closure also shows different result, but the majority of the trials showed benefit of PFO closure in reducing the risk of stroke recurrence.
Co-Authors Budhi Setianto Jonny Setiawan Kurniawan M, Ferel Panindhita, Gea Purwowiyoto, Sidhi Laksono R, Yeria Singjie, Leonard Christianto Wiryawan, I Nyoman