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Relationship Between P Wave Peak Time In Leads II And V1 With Left Ventricle Diastolic Function In Hypertension Patients Ihsan, Muhammad; Akbar, Nizam Zikri; Lubis, Hilfan Ade Putra
Journal of Society Medicine Vol. 2 No. 6 (2023): June
Publisher : CoinReads Media Prima

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47353/jsocmed.v2i6.67

Introduction: Left ventricular diastolic dysfunction is common in patients with hypertension. Inadequate management can cause complications such as hypertensive heart disease. Electrocardiography as a tool that is easy to find in health services is known to be able to detect left ventricular diastolic dysfunction. The purpose of this study was to examine the relationship between P wave peak time in leads II and V1 by electrocardiography with left ventricular diastolic function. Method: This study was a cross-sectional study that was conducted by collecting 111 patients with a history of hypertension at RSUP HAM from October 2021 to November 2022. The P wave peak time was measured in leads II and V1 on the ECG. Diastolic function was assessed using echocardiography. A bivariate test was performed to assess the correlation between the two variables. Furthermore, ROC analysis was performed to assess the P wave peak time as a predictor of left ventricular diastolic function. Results: : Total subjects were 111 hypertensive patients consisting of 49 (31.4%) hypertensive patients with normal diastolic function and 62 (68.6%) hypertensive patients with diastolic dysfunction. In bivariate analysis, a significant difference was found between the P wave peak time in lead II of hypertensive patients with normal diastolic function and hypertensive patients with diastolic dysfunction (65.47± 2.5 vs 68.9 ± 2.7;p = 0.001). Based on the ROC analysis, it was found that the P wave peak time could predict left ventricular diastolic dysfunction in hypertensive patients with AUC = 0.81 in lead II. Conclusion: The P wave peak time in lead II can be a predictor of diastolic dysfunction in hypertensive patients.

The Relationship between Transient Ischemic Dilation (TID) and Severity of Coronary Artery Disease (CAD) in Patients with Chronic Coronary Syndrome (CCS) in Haji Adam Malik Medan, Indonesia Tamba, Ratna Mariana; Lubis, Hilfan Ade Putra; Mukhtar, Zulfikri; Sitepu, Andika; Habib, Faisal; Andra, Cut Aryfa; Haykal, T. Bob
Journal of Society Medicine Vol. 2 No. 9 (2023): September
Publisher : CoinReads Media Prima

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47353/jsocmed.v2i9.88

Introduction: TID ratio derived from ratio of LV volume in stress and rest phase of MPS. It is said that this phenomenon has been a useful marker of severe CAD, that can be present with atypical angina. This occurs due to global myocardial hypoperfusion caused by severe and extensive CAD. Method: This study was an analytic observational study with a retrospective cohort design in CCS patients who underwent Myocardial Perfusion SPECT at Haji Adam Malik General Hospital from January 2022 to April 2023. All participants underwent MPS with Tc99m sestamibi with pharmacology Adenosine stress test and coronary angiography. The MPS could be performed before or after coronary angiography without any revascularization procedure between the two examination preocedures. An unpaired t-test analysis was performed to find the mean difference in TID values in the mild CAD and moderate-severe CAD groups. Results: The study subjects totaled 93 people with an average age of 55.87±7.44. It was found that the TID value was significantly different between the two groups of mild and moderate-severe CAD based on Syntax score, 0.906±0.13 vs 1.03±0.11 in the mild vs moderate-severe CAD group (p<0.001). Bivariate analysis showed that in this study, the ratio of TID was only associate with LV ESV and LV EDV in stress phase of MPS (p = 0.001). Conclusion: There is a relationship between TID and CAD severity based on Syntax score with higher TID values in patients with moderate-severe CAD compared to patients with mild CAD. TID ratio was only depends on severity od CAD and directly proportional to the volume of LV in the stress phase, suitable to the theory that said TID ratio comes from ratio of LV volume in stress and rest phase of MPS.

The Relationship between LDL/ HDL Ratio and Coronary Lesion Severity Measured by Syntax Score in Patients with Non-Elevation Acute Myocardial Infarction at Hajj Adam Malik General Hospital, Medan Hashmi, T. Rifqi; Hasan, Harris; Lubis, Hilfan Ade Putra
Journal of Society Medicine Vol. 3 No. 5 (2024): May
Publisher : CoinReads Media Prima

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47353/jsocmed.v3i5.146

Introduction: Coronary artery disease (CAD), results from reduced myocardial perfusion leading to angina, myocardial infarction (MI), and/or heart failure. It accounts for one third to one half of cardiovascular cases. A higher SYNTAX score indicates a more complex condition and poorer prognosis in patients undergoing coronary revascularization especially with PCI. This study aims to determine how the LDL/HDL ratio relates to the complexity of coronary lesions (Syntax Score) in coronary heart disease based on characteristics. Methods: The type of this study was observational analytic retrospective with a cross sectional design. The study was conducted using secondary data through medical record data of patients diagnosed with NSTEMI. Results: The subjects were 60 people with an average age of 58,1±8,629. It was found that the mean value of the LDL/HDL ratio was 3,95±3,837, in patients with an LDL/HDL ratio ≥ 2.517 it was found that there were 40 sample(66.7%) of whom had a lesion severity level of Syntax score ≥23 ,27 samples (45%), and in patients with an LDL/HDL ratio < 2.517, 20 samples (33.3%) were found to have a lesion severity level of Syntax score ≥ 23 with 4 samples (6.7%). Conclusion: There is a relationship between the LDL/HDL ratio and the severity of CAD based on the Syntax score with LDL/HDL ratio values being higher in patients with moderate-severe CAD than in patients with mild CAD.

The Relationship between Heart Rate Recovery and Rate Pressure Product on Coronary Lesion Severity Using Syntax Score in Stable Angina Pectoris Patients at Haji Adam Malik Hospital Medan Adam, Faisal; Andra, Cut Aryfa; Lubis, Hilfan Ade Putra
Journal of Society Medicine Vol. 3 No. 7 (2024): July
Publisher : CoinReads Media Prima

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47353/jsocmed.v3i7.158

Introduction: RPP is used as a marker of cardiac function. RPP reflects the function of the heart in fulfilling oxygen demand stably and continuously during activity. Slow decline of HRR is associated with risk factors for atherosclerosis, similar to hypertension and dyslipidaemia There has not been much research on HRR and RPP in coronary heart disease. The aim of this study is to examine the relationship between RPP and syntax score in stable coronary heart disease. Methods: This study is an observational analytic study with a cross sectional design to determine the relationship between HRR and RPP to the severity of coronary lesions using the syntax score in stable angina pectoris patients. Sampling was carried out at the Haji Adam Malik Hospital Medan from February. HRR and RPP scores were obtained from cardiac exercise testing and syntax scores were obtained from coronary angiography after validation by an interventionist. EF data were taken from echocardiography results validated by consultant echocardiographers. Statistical data analysis using computer statistical tools, p value <0.05 was considered statistically significant. Results: From angiographic data in samples with syntax score ≥ 23, there were 23 (100%) LAD, 21 (91.3%) LCx, and 22 (95.7%) RCA involvement. In samples with Syntax score < 23, there were single vessel lesions as many as 11 (40.07%), two vessels as many as 12 (44.4%), and three vessels as many as 4 (14.8%). From the test results, there was a significant relationship between HRR and RPP and SYNTAX score with a p value <0.05 (<0.001) in both variables. Conclusion: There was a significant association in HRR scores and RPP scores between groups with SYNTAX scores ≥ 23 and SYNTAX scores < 23.

Description of JA Medical Skincare Medan Beauticianâ€™s Low Back Pain Based on Duration of Work Vivienne; Arsyad, Abdurrahman Mousa; Lubis, Bastian; Lubis, Hilfan Ade Putra
Asian Australasian Neuro and Health Science Journal (AANHS-J) Vol. 6 No. 1 (2024): AANHS Journal
Publisher : Talenta Universitas Sumatera Utara

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32734/aanhsj.v6i1.14925

Introduction: Low Back Pain (LBP) is defined as pain and discomfort located below the costal margin to the inferior gluteal fold, with or without pain in the legs. LBP is a common condition that can occur in all age groups with acute or chronic episodes. Beauticians are more susceptible to musculoskeletal disorders. This line of work tends to involve limited positions, repetitive movements, standing for more than 8 hours or sitting in a bent position during activities. This study aims to determine the characteristics of low back pain based on work duration among beauticians of the JA Medical Skincare beauty clinic Medan. Method: The method used in this research was descriptive quantitative with a total sampling technique. The research population was 60 beauticians from the JA Medical SkincareÂ Beauty Clinic Medan. The data were collected by having the respondents fill out a questionnaire. Results: The research results revealed that beauticians at the JA Medical Skincare beauty clinic who were at risk of experiencing low back pain were individuals aged under 30 years (51.8%), those with BMI > 27 or categorized as obese (60%), and those with a working duration of more than 8 hours (49,1%). These groups exhibited higher percentages of complaints related to low back pain. In general, almost all ages have the potential to experience low back pain. Beauticians who work long hours and do not pay attention to ergonomic factors would have caused continuous static loads on their back and are at risk of experiencing complaints of low back pain. Keywords: Beautician; Duration of work; Low back pain

Prevalence of Congenital Heart Disease and Pediatric Rhythm Disorder or Arrhythmia in Children in Rantau-Prapat City, North Sumatra, Indonesia Lubis, Anggia Chairuddin; Nasution, Ali Nafiah; Lubis, Hilfan Ade Putra
Journal of Endocrinology, Tropical Medicine, and Infectious Disease (JETROMI) Vol. 5 No. 4 (2023): Journal of Endocrinology, Tropical Medicine, and Infectious Disease (JETROMI)
Publisher : TALENTA Publisher, Universitas Sumatera Utara

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32734/jetromi.v5i4.14332

Background: Cardiovascular diseases (CVD) are responsible for the leading cause of a 30%Â global mortality rate and are a major contributor to reducing the quality of life. Approximately 25% of the cardiovascular mortality rate is caused by sudden cardiac deaths and cardiac arrhythmias are one of the causes of sudden cardiac deaths. Besides that, Congenital Heart Disease (CHD) also contributes mortality rate in children. Long-term experience has provided evidence that systematic screening, with 12-lead ECG, after history and physical examination, is effective in identifying individuals with potentially lethal cardiovascular disease for early intervention. However, in Indonesia screening for heart abnormalities and rhythm disorder in children has not yet been systematically established. Method: This study was a descriptive study conducted through a cross-sectional study design. The primary objective was to assess the congenital heart disease (CHD) and Arryhtmia prevalence in children in Rantau City. Data was collected from interviews and on-the-spot examination with validated measurement tools. Data was analyzed using SPSS version 26. Categorical variables were presented using frequency (n) and percentage (%), and numerical variables with normally distributed data were presented with mean and standard deviation (SD). In non-normally distributed data, numerical variables were presented using the median and interquartile range. Results: There were 157 children included in this study. Most subjects were female (n=94, 59.9%) in the age range of 12 to 16 years old. Most subjects (n=129, 82.2%) had normal sinus rhythm. The only rhythm disorder that was found in this study was sinus tachycardia (n=28, 17,8%). One subject (0,9%) had congenital heart disease, which was a secundum atrial septal defect. Conclusion: In the children population in Rantau-Prapat city, the most common arrhythmia found in children was sinus tachycardia. The atrial septal defect was the only congenital heart disease found.

Alteration of Right Ventricular-Pulmonary Arterial Coupling Before and After Decongestion in Non-Preserved Fraction Acute Heart Failure Patients at Adam Malik Hospital Medan Brahmana, Andrew Timanta; Ketaren, Andre Pasha; Andra, Cut Aryfa; Lubis, Anggia Chairuddin; Haykal, Teuku Bob; Siregar, Yasmine Fitrina; Lubis, Hilfan Ade Putra; Purba, Joy Wulansari; Akbar, Nizam Zikri
Journal of Society Medicine Vol. 4 No. 1 (2025): January
Publisher : CoinReads Media Prima

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.71197/jsocmed.v4i1.190

Objective: To assess whether there is right ventricular-pulmonary artery (RV-PA coupling by tricuspid annular plane systolic excursion/pulmonary artery systolic pressure TAPSE/PASP) changes in determining the clinical results of decongestion in patients with acute heart failure (AHF) with non-preserved ejection fraction (non-HFpEF) before and after decongestive at Adam Malik Hospital Medan. Methods: This study is an observational study with a prospective approach and consecutively collected, in patients AHF with non-HFpEF at Adam Malik Hospital Medan in the period from September 2023 until November 2024d. The sample is an eligible population that meets the inclusion and exclusion criterias. Results: This study consisted total 44 subjects with majority of 37 men (75%), an average age of 61 years old. A total of 28 subjects (63.6%) had hypertension as comorbid. There were 33 people (75%) who had sinus rhythm. The most acute heart failure phenotype commonly found was acute decompensated heart failure (ADHF) with 21 subjects. The longest length of stay AHF was cardiogenic shock with a median of 9 days. A significant decrease in median heart (p 0.0001), tricpuspid valve gradient (TVG) examination showed a significant decrease in (p 0.0001), PASP examination had a significant decrease in the average (p 0.0001), RV-PA coupling showed a significant increment (p 0.0001). A significant relationship was found between RV-PA coupling changes and decongestion in all acute heart failure groups (p 0.005). No significant relationship between RV-PA coupling ratio with length of stay was found. Conclusion: There were differences found in RV-PA coupling as increment with significant value in complete and partial decongestion groups, with a RV-PA coupling cut-off value of 0.65 and sensitivity and specificity of 68.8% and 67.9%, respectively.

Association between frontal QRS-T angle and thrombus burden in patients with ST-elevation myocardial infarction: A single-center cross-sectional study Azmi, Muhammad; Nasution, Ali Nafiah; Lubis, Hilfan Ade Putra; Siregar, Abdullah Afif; Habib, Faisal; Sitepu, Andika
Heart Science Journal Vol. 6 No. 4 (2025): The Pursuit of Precision: Navigating Risks, Refining Diagnosis, and Securing Lo
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2025.006.04.13

BACKGROUND: ST-Elevation Myocardial Infarction (STEMI) is one of the leading causes of global morbidity and mortality, with burden of thrombus as an influential factor of clinical outcomes. OBJECTIVES: The purpose of this study was to evaluate the relationship between frontal QRS-T (fQRST) angle and thrombus burden in STEMI patients. METHODS: A cross-sectional study was carried out at Haji Adam Malik General Hospital, Medan, between January 2024 and July 2024. STEMI patients who underwent coronary angiography were included. The fQRST angle was measured using a 12-lead electrocardiogram (ECG), the thrombus burden was graded according to the Thrombolysis in Myocardial Infarction (TIMI) grading system. Statistical analysis included Spearman's correlation and Receiver Operating Characteristic (ROC) curve analysis. RESULTS: 108 STEMI patients were included in the study. The fQRST angle was strongly positively correlated with thrombus burden (r = 0.61–0.80, p < 0.05). Patients with more thrombus burden had larger fQRST angles compared to patients with less thrombus burden. Additionally, diabetes mellitus and symptom delay exceeding 12 hours were highly correlated with higher thrombus burden (p < 0.05), whereas infarct-related artery (IRA) location was not significantly associated (p > 0.05). ROC curve demonstrated that the fQRST angle had an AUC of 0.88 (p = 0.001) At the optimal cut-off value of 61°, the sensitivity and specificity were 88.3% and 87.5% (95% CI of 88.5%–98.2).

Exclusive Breastfeeding Versus Combination Feeding on Incidence of Atopic Dermatitis: A Comparative Study Nova Zairina Lubis; Wijaya, Albert; Lubis, Hilfan Ade Putra; Pase, Muhammad Aron
SCRIPTA SCORE Scientific Medical Journal Vol. 6 No. 2 (2025): SCRIPTA SCORE Scientific Medical Journal
Publisher : Talenta Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32734/scripta.v6i2.17865

Background. In spite of the extensive research on the potential protective effects of exclusive breastfeeding in preventing the occurrence of atopic dermatitis and the involvement of cowâ€™s milk allergy as a triggering factor, controversies regarding this issue persist. Objective. This study analyzes the comparison of the incidence of AD among infants exclusively breastfed compared to those who receive a combination of formula milk and breastfeeding. Methods. This study is an analytical research with a cross-sectional approach, conducted at Puskesmas Sentosa Baru Medan in August 2023. The sample consisted of 114 infants, which divided into two groups: exclusively breastfed infants and the other consisting of infants who received a combination of breastfeeding and formula milk, selected through consecutive sampling. The diagnosis of AD was based on a questionnaire modified from the Hanifin-Rajka criteria. Results. According to the research findings, among the exclusively breastfed infants, 11 (19,3%) were found to have AD, whereas in the opposing group, there were 12 (21,1%) cases of AD. Statistical analysis indicated no significant difference in the incidence of AD based on early feeding history (p=0,815). The prevalence ratio of AD infants from both study group is 1,10. Conclusions. Infants who receive a combination of breast milk and formula feeding have an elevated risk of 1,1 times for the onset of AD compared to those who are exclusively breastfed. There is no significant difference in the incidence of AD among infants who are exclusively breastfed and those who receive a combination of breast and formula feeding. Latar belakang. Meskipun telah banyak penelitian mengenai potensi efek perlindungan ASI eksklusif dalam mencegah terjadinya dermatitis atopik dan keterlibatan alergi susu sapi sebagai faktor pemicu, kontroversi mengenai hal ini masih terus berlanjut. Tujuan. Penelitian ini bertujuan untuk menganalisis perbandingan kejadian DA pada bayi yang mendapat ASI eksklusif dibandingkan dengan bayi yang mendapat kombinasi susu formula dan ASI. Metode. Penelitian ini merupakan penelitian analitik dengan pendekatan potong lintang, yang dilakukan di Puskesmas Sentosa Baru Medan pada bulan Agustus 2023. Sampel terdiri dari 114 bayi, yang dibagi menjadi dua kelompok yaitu bayi yang diberi ASI eksklusif dan bayi yang diberi kombinasi ASI dan susu formula, yang dipilih secara consecutive sampling. Selanjutnya, diagnosis DA didasarkan pada kuesioner yang dimodifikasi dari kriteria Hanifin-Rajka. Hasil. Menurut temuan penelitian, di antara bayi yang disusui secara eksklusif, 11 (19,3%) ditemukan menderita DA, sedangkan pada kelompok yang tidak disusui, terdapat 12 (21,1%) kasus DA. Analisis statistik menunjukkan tidak ada perbedaan yang signifikan dalam kejadian PJB berdasarkan riwayat pemberian makanan awal (p=0,815). Rasio prevalensi bayi AD dari kedua kelompok penelitian adalah 1,10. Kesimpulan. Bayi yang menerima kombinasi ASI dan susu formula memiliki risiko 1,1 kali lebih tinggi untuk mengalami PJB dibandingkan dengan bayi yang mendapat ASI eksklusif. Tidak ada perbedaan yang signifikan dalam kejadian DA antara bayi yang diberi ASI eksklusif dan mereka yang menerima kombinasi ASI dan susu formula.

Association between atherogenic index of plasma and coronary lesion severity in NSTEMI patients Nasution, Umi Hazzar; Sitepu , Andika; Haykal, Teuku Bob; Siregar, Yasmine; Lubis, Hilfan Ade Putra; Ketaren, Andre Pasha; Hasan, Harris
Heart Science Journal Vol. 7 No. 1 (2026): Accelerating Clinical Breakthroughs: The Journey from Molecular Discovery to Pa
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.hsj.2026.007.01.13

Background: Early identification of the severity of coronary lesions is very important to determine the appropriate management strategy, especially in patients with non-ST-elevation myocardial infarction (NSTEMI). Objective: This study aimed to determine the relationship between the Atherogenic Index of Plasma (AIP) and the severity of coronary lesions in NSTEMI patients. Methods: This study was an analytical observational cross-sectional design conducted at Haji Adam Malik Hospital, Medan, in 2023. Data were collected from medical records of NSTEMI patients and coronary angiography results. Statistical analysis was performed to assess the relationship between AIP and the severity of coronary lesions, including bivariate tests and multivariate logistic regression. Result: A total of 101 NSTEMI patients were included in this study. AIP values were significantly higher in patients with moderate to severe coronary lesions compared to those with mild lesions. An AIP ≥ 0.434 showed a sensitivity of 64.1% and specificity of 67.6% in predicting moderate to severe lesions. Multivariate analysis showed that AIP was the strongest independent predictor of coronary lesion severity, along with age, diabetes mellitus, and ejection fraction. Conclusion: AIP is significantly associated with the severity of coronary lesions in NSTEMI patients and can be used as a simple yet effective risk indicator.

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