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All Journal E-Jurnal Medika Udayana Archives of The Medicine and Case Reports
Ni Made Dharma Laksmi
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Health Professions Medicine & Pharmacology Nursing Public Health

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APLASTIC ANEMIA Ni Made Dharma Laksmi; Sianny Herawati; Wayan Putu Sutirta Yasa
E-Jurnal Medika Udayana vol 2 no 7 (2013):e-jurnal medika udayana
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (232.386 KB)

Abstract

Aplastic Anemia describes a disorder of the clinical syndrome is marked by a deficiency of red blood cells, neutrophils, monocytes and platelets in the absence of other forms of bone marrow damage. Aplastic anemia is classified as a rare disease in developed countries the incidence of 3-6 cases / 1 million inhabitants / year. The exact cause of someone suffering from aplastic anemia also can not be established with certainty, but there are several sources of potential risk factors. Prognosis or course of the disease varies widely aplastic anemia, but without treatment generally gives a poor prognosis
PERBEDAAN ANTARA KADAR TROPONIN T PLASMA DAN SKOR GLOBAL LONGITUDINAL STRAIN EKOKARDIOGRAFI SEBELUM DAN SETELAH HEMODIALISIS PADA PASIEN HEMODIALISIS REGULER Dharma Laksmi, Ni Made; Pradnyana DS, Bagus Ari; Widiana, I Gede Raka
E-Jurnal Medika Udayana Vol 12 No 4 (2023): E-Jurnal Medika Udayana
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24843/MU.2023.V12.i04.P06

Abstract

ABSTRAK Latar Belakang:Sebagaimana diketahui bahwa proses hemodialisis sangat erat kaitannya dengan peningkatan angka kematian yang disebabkan oleh kondisi kardiovaskuler. Kematian pada pasien hemodialisis (HD) tidak hanya disebabkan oleh proses aterosklerosis klasik. Proses HD diduga terkait dengan perubahan hemodinamik dan juga gangguan perfusi koroner yang mengakibatkan stunning miokard. Walaupun mayoritas kematian pada pasien HD disebabkan oleh penyakit kardiovaskuler, namun sebagian besar pasien tersebut (>50%) masih memiliki fraksi ejeksi atau ejection fraction (EF) yang baik. Ekokardiografi global longitudinal strain (GLS) dan pemeriksaan high sensitivity troponin T jantung (hs Troponin T) diharapkan dapat mendeteksi dini disfungsi ventrikel kiri subklinis dan cedera miokard yang dipicu oleh proses HD.Metode:Penelitian ini merupakan penelitian observasional dengan desain before-after dengan random number sampling. Sebanyak 60 pasien menjalani HD reguler 2 kali per minggu dengan EF ? 50% di RS Prof. dr. I.G.N.G. RSUD Ngorah. Skor GLS dengan transtorakal ekokardiografi (TTE) dua dimensi speckle-tracking echocardiography (STE) dan hs Troponin T plasma yang diukur segera sebelum dan sesudah HD.Hasil:Pada penelitian ini didapatkan perbedaan nilai rerata skor GLS yang bermakna sebelum dan sesudah hemodialisis (-21,04 ± 3,65 hingga -17,60 ± 3,17) dengan selisih -3,43 (IK 95% -3,978 - (-2,894), p <0,001). Namun tidak terdapat perbedaan bermakna rerata hs Troponin T sebelum dan sesudah HD (0,105 ± 0,142 ng/ml menjadi 0,104 ± 0,158 ng/ml) dengan selisih 0,001 (IK 95% -0,008 - 0,103, p 0,800) . Selain itu, tidak ditemukan hubungan signifikan antara perubahan hs Troponin T dan perubahan GLS (r = 0,071, r2 0,005, p 0,588). Pada analisis multivariat ditemukan adanya korelasi yang bermakna yang menunjukkan adanya korelasi positif dan kuat (r = 0,730) antara volume ultrafiltrasi, riwayat gagal jantung kronis Kelas Fungsional (Fc) I-II, dan penggunaan penyekat beta terhadap perubahan GLS. Kejadian HD dikaitkan dengan perubahan GLS melalui volume preload (ultrafiltrasi) dan didukung oleh gagal jantung kronis dan penggunaan penyekat beta. Kata Kunci : Hemodialisis., Global Longitudinal Strain., hs Troponin T., Preload., Gagal Jantung Kronis, Penyekat Beta.
Early Invasive versus Conservative Strategies in Cardiogenic Shock: A Meta-Analysis Ni Made Dharma Laksmi
Archives of The Medicine and Case Reports Vol. 6 No. 1 (2025): Archives of The Medicine and Case Reports
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/amcr.v6i1.687

Abstract

Cardiogenic shock (CS) carries a high mortality rate. While early invasive strategies (EIS) like percutaneous coronary intervention (PCI) are often advocated, their superiority over conservative strategies (CS) remains debated. This meta-analysis compared the efficacy and safety of EIS versus CS in patients with CS. A systematic search of PubMed, Embase, and the Cochrane Library was conducted from January 2013 to December 2024. Randomized controlled trials (RCTs) and observational studies comparing EIS (early PCI, mechanical circulatory support) with CS (initial medical therapy) in adult CS patients were included. The primary outcome was all-cause mortality at 30 days. Secondary outcomes included in-hospital mortality, stroke, major bleeding, and acute kidney injury. A random-effects model was used to pool data. Nine studies (n=4,875 patients) were included. EIS was associated with a significantly lower risk of 30-day mortality compared to CS (risk ratio [RR] 0.78; 95% confidence interval [CI] 0.65-0.93; p=0.006). Similarly, EIS reduced in-hospital mortality (RR 0.72; 95% CI 0.61-0.85; p=0.001). There was no significant difference in the incidence of stroke or major bleeding between the two groups. However, EIS was associated with a higher risk of acute kidney injury (RR 1.20; 95% CI 1.05-1.37; p=0.008). In conclusion, in patients with CS, EIS was associated with significantly lower 30-day and in-hospital mortality compared to CS. However, EIS may increase the risk of acute kidney injury. Further research is needed to identify specific patient subgroups that may benefit most from EIS.
Co-Authors I Gde Raka Widiana I Wayan Putu Sutirta Yasa Pradnyana DS, Bagus Ari Sianny Herawati