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Amiodarone, Extreme AV Block and Pseudo-Pacemaker Syndrome: A Malady Caused By A Cure Mamasta, Khairuman Fitrah Ananda; Sianturi, Agustina; Sarumpaet, Abigail Christine
Journal of Social Research Vol. 4 No. 8 (2025): Journal of Social Research
Publisher : International Journal Labs

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55324/josr.v4i7.2691

Abstract

Amiodarone is a potent antiarrhythmic that is used to treat supraventricular tachycardia (SVT). However, its substantial impact on atrioventricular (AV) nodal conduction can obscure or exacerbate underlying delays, resulting in rare conditions such as pseudo-pacemaker syndrome (PPMS). This syndrome is the result of an extreme prolongation of the PR interval, which results in AV dyssynchrony and hemodynamic compromise in the absence of an implanted device. A 25-year-old male presented with SVT, which was further complicated by hypokalemia. The case revealed a pre-existing AV nodal conduction delay. Therefore, we present the case. The patient transitioned to sinus rhythm after receiving amiodarone; however, they experienced a persistent and severe PR interval prolongation that exceeded 400 ms. The symptoms of vertigo and palpitations, which were consistent with PPMS, were induced by this severe conduction block and persisted for more than ten days, a reflection of the long half-life of amiodarone. This case concludes that amiodarone can dangerously exacerbate latent AV nodal disease in young adults, underscoring the necessity of recognizing PPMS as a clinical consequence of iatrogenic PR prolongation and emphasizing the need for cautious use and monitoring of antiarrhythmic drugs in patients with any evidence of conduction abnormalities.
Upaya Meningkatkan Penggunaan Bahasa Inggris Melalui Aplikasi Kahoot dan Bimbingan Pembelajaran Pendidikan Agama Kristen Melalui Konseling Di SMA Pembangunan Galang Bangun, Bangun; Sianturi, Agustina; Sinaga, Dea Cantika; Sitanggang, Tami Rahmadana; Panjaitan, Venika
Innovative: Journal Of Social Science Research Vol. 4 No. 3 (2024): Innovative: Journal Of Social Science Research
Publisher : Universitas Pahlawan Tuanku Tambusai

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.31004/innovative.v4i3.10476

Abstract

Artikel ini membahas tentang penggunaan aplikasi Kahoot sebagai media pembelajaran Bahasa Inggris dan agama kristen. Kegiatan pengabdian ini dilakukan untuk meningkatkan kemampuan berbahasa Inggris melalui aplikasi Kahoot dan bimbingan pembelajaran Pendidikan agama Kristen melalui konseling,sekaligus untuk membimbing siswa untuk selalu disiplin dalam kegiatan pembelajaran di sekolah. Tujuan penelitian ini adalah untuk mengetahui apakah aplikasi Kahoot dapat meningkatkan minat belajar Bahasa Inggris siswa. Berdasarkan analisis yang dilakukan ditemukan bahwa aplikasi Kahoot dapat meningkatkan minat belajar siswa. Kahoot bisa digunakan untuk mengeksplorasi pengetahuan dan pemahaman siswa tentang topik pembelajaran dan membantu siswa untuk memvalidasi pemahaman. Meskipun penggunaan aplikasi Kahoot masih belum dikalangan siswa SMA dengan mudahnya fituryang ada, aplikasi ini dapat memungkinkan seseorang untuk belajar dan beradaptasi dengan cepat.
INTEGRATING GEOGEBRA IN LEARNING RIGHT TRIANGLE GEOMETRY:A DESCRIPTIVE STUDY OF FIRST-YEAR UNIVERSITY STUDENTS’ RESPONSES Sianturi, Agustina; Ningsih, Yunika Lestaria
Perpendicular : Journal of Mathematics Education and Learning Vol. 1 No. 2 (2025): Perpendicular : Journal of Mathematics Education and Learning
Publisher : CV. Doki Course and Training

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.61994/perpendicular.v1i2.1531

Abstract

The rapid development of digital technology has significantly influenced instructional practices in mathematics education, particularly in the teaching of abstract and conceptually demanding topics such as geometry and trigonometry. One foundational topic that frequently presents learning challenges is right triangle geometry, which underpins students’ understanding of trigonometric ratios and their applications. This study aims to describe university students’ responses to the use of GeoGebra as a technology-assisted learning tool in right triangle geometry instruction. Employing a descriptive survey research design, the study involved 30 first-year students enrolled in a Mathematics Education program at Universitas PGRI Palembang. Data were collected through a structured student response questionnaire administered after a GeoGebra-assisted learning session. The questionnaire examined four aspects: perceived conceptual understanding, learning motivation, interactivity, and ease of problem solving. Data were analyzed using descriptive statistics in the form of percentage distributions. The findings indicate that students demonstrated positive to very positive responses across all assessed aspects, particularly in learning motivation and perceived conceptual clarity supported by visual representations. While the results do not claim instructional effectiveness or learning gains, they suggest that GeoGebra is perceived as a supportive and engaging tool for learning right triangle geometry. The study contributes descriptive evidence regarding students’ perceptions of GeoGebra-based instruction and provides pedagogical insights for mathematics educators integrating digital tools in geometry learning.
Diagnostic Accuracy and Clinical Outcomes in Acute Coronary Syndrome of OMI/NOMI VS STEMI/NSTEMI: a Systematic Review Mamasta, Khairuman Fitrah Ananda; Sianturi, Agustina
Jurnal Locus Penelitian dan Pengabdian Vol. 4 No. 11 (2025): JURNAL LOCUS: Penelitian dan Pengabdian
Publisher : Riviera Publishing

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.58344/locus.v4i11.5024

Abstract

Background: In the current STEMI-based model for diagnosing acute myocardial infarction (AMI), many patients classified as NSTEMI may actually have undetected acute coronary occlusion. As a result, these patients miss the opportunity for timely reperfusion therapy and experience worse outcomes than those with non-occlusive myocardial infarction (NOMI). To address this issue, a revised paradigm has been proposed that differentiates occlusion MI (OMI) from non-occlusion MI (NOMI). Methods: This systematic review included eight studies published between 2020 and 2024. All studies evaluated patients with acute coronary syndrome (ACS), comparing diagnostic performance and clinical outcomes between the traditional STEMI/NSTEMI paradigm and the emerging OMI/NOMI paradigm. The studies employed various designs, including retrospective cohorts, case-control analyses, and cross-sectional studies, to assess diagnostic accuracy and treatment outcomes. Results: Evaluation of ECG diagnostic performance showed that OMI-specific ECG patterns had significantly higher sensitivity (86%) and diagnostic accuracy (89%) compared to standard STEMI criteria (41% sensitivity, 77% accuracy). Several studies reported substantial delays in recognition and management of OMI when relying solely on STEMI criteria. Evidence consistently demonstrated that patients with OMI, especially those misclassified as NSTEMI, had outcomes equal to or worse than those with STEMI. Conclusion: The OMI paradigm highlights major quality gaps in the emergency care of ACS patients. Transitioning from the traditional STEMI/NSTEMI model to OMI/NOMI classification can improve diagnostic precision, identify care delays, and guide quality improvement interventions to optimize patient outcomes.
EFFECTIVENESS OF LOW VERSUS HIGH DOSE STATINS FOR REDUCING MAJOR CARDIOVASCULAR EVENTS: A SYSTEMATIC REVIEW AND META-ANALYSIS: EFEKTIVITAS STATIN DOSIS RENDAH DAN TINGGI TERHADAP KEJADIAN KARDIOVASKULAR MAYOR: SUATU TINJAUAN SISTEMATISDAN META-ANALISIS Ananda, Khairuman Fitrah; Sarumpaet, Abigail Christine; Sianturi, Agustina
Ibnu Sina: Jurnal Kedokteran dan Kesehatan - Fakultas Kedokteran Universitas Islam Sumatera Utara Vol. 25 No. 1 (2026): Januari 2026
Publisher : Faculty of Medicine Universitas Islam Sumatera Utara

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30743/ibnusina.v25i1.981

Abstract

Coronary heart disease (CHD) remains a leading cause of global mortality. Statins are first-line therapy for reducing major adverse cardiovascular events (MACE); however, the optimal dosing strategy remains debated, particularly between ACC/AHA guidelines recommending high-dose statins and ESC guidelines favoring a stepwise approach. Asian populations with SLCO1B1 gene polymorphisms are at increased risk for statin-related adverse effects, such as myopathy and hepatotoxicity. This study aimed to assess the efficacy and safety of high-dose versus low-dose statins in reducing MACE among patients with coronary artery disease (CAD). Methods: A systematic review and meta-analysis were conducted following PRISMA 2020 guidelines. Literature searches were performed in PubMed, Embase, Cochrane Library, and Scopus (2020–2025). Ten studies (n = 43,985) were included in the final analysis. Random-effects meta-analysis was performed using Review Manager 5.4. Funnel plot asymmetry suggested potential publication bias. High-dose statins significantly reduced MACE risk (RR 0.85; p = 0.004) and LDL-C levels, but increased myopathy (OR 2.3) and hepatotoxicity risks, especially in SLCO1B1 polymorphism carriers. Low-dose statins plus ezetimibe achieved comparable LDL-C reduction with fewer adverse events. High-dose statin therapy significantly increased the relative risk of myopathy (OR 2.3; 95% CI 1.8–2.9), particularly in genetically susceptible individuals. Conclusion: High-dose statins improve cardiovascular outcomes but require close monitoring. Low-dose statins with ezetimibe offer a safer alternative, supporting personalized therapy based on genetic and clinical factors.
META-ANALYSIS OF RANDOMIZED CONTROLLED TRIALS ON FINERENONE FOR CARDIOVASCULAR OUTCOMES IN TYPE 2 DIABETES AND CHRONIC KIDNEY DISEASE: META-ANALISIS UJI ACAK TERKONTROL FINERENON TERHADAP LUARAN KARDIOVASKULAR PADA DIABETES TIPE 2 DAN PENYAKIT GINJAL KRONIK Ananda, Khairuman Fitrah; Sarumpaet, Abigail Christine; Sianturi, Agustina
Ibnu Sina: Jurnal Kedokteran dan Kesehatan - Fakultas Kedokteran Universitas Islam Sumatera Utara Vol. 25 No. 1 (2026): Januari 2026
Publisher : Faculty of Medicine Universitas Islam Sumatera Utara

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30743/ibnusina.v25i1.984

Abstract

Patients with chronic kidney disease and type 2 diabetes mellitus are at high risk for cardiovascular events. Finerenone, a non-steroidal mineralocorticoid receptor antagonist, shows potential as an additional therapy with cardioprotective effects. We conducted a meta-analysis based on data from randomized controlled trials by systematically searching the PubMed and ScienceDirect databases, using the PICOS framework: chronic kidney disease and type 2 diabetes mellitus (P); finerenone (I); placebo (C); cardiovascular outcomes (O); and randomized controlled trials (S). We included articles published within the last 10 years and available in full-text format. A total of 4 RCTs were included in this analysis. Statistical analysis was performed using the Random Effect Model. The analysis showed that finerenone reduced the odds of non-fatal myocardial infarction by 9% compared to placebo (OR 0.91; 95% CI: 0.80–1.03) and reduced the risk of hospitalization due to heart failure by 17% (OR 0.73; 95% CI: 0.66–0.82). All statistical results were significant, except for non-fatal myocardial infarction. The heterogeneity level was assessed as low to moderate (I² = 10%, 0%, and 58%). Risk of bias assessment using the RoB-2 tool indicated that all included studies had a low risk of bias. Finerenone demonstrated better outcomes compared to placebo, suggesting its potential benefit in improving cardiovascular outcomes in this population.