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All Journal International Journal of Integrated Health Sciences Majalah Kedokteran Bandung Althea Medical Journal Indonesian Journal of Cardiology
Januar Wibawa Martha
Faculty of Medicine, Padjadjaran University, Bandung
Health Professions Medicine & Pharmacology

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Knowledge, Attitude and Practice of Diabetes Mellitus Type 2 Patients towards Compliance to Treatment in Pusat Kesehatan Masyarakat Zahari, Asila Zahiri binti; Yunivita, Vycke; Martha, Januar Wibawa
Althea Medical Journal Vol 3, No 3 (2016)
Publisher : Althea Medical Journal

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (159.548 KB)

Abstract

Background: Diabetes mellitus (DM) is one of the top ten chronic diseases in the world and the prevalence of this disease will increase in the future including in Indonesia. Treatment of DM needs collaboration between the patients and the providers to prevent multiorgan complications and increase the compliance to treatment. The correlation among the level of knowledge (K), attitude (A) and practice (P) plays an important role of patients towards compliance to treatment. The objectives of this study was to identify the level of knowledge, attitude and practice of DMT2 patient towards compliance to treatment at a primary care facility.Methods: This study was carried out by using cross sectional descriptive study from August until November 2013 in Public Health Center (Pusat Kesehatan Masyarakat/Puskesmas) Tanjungsari, Sumedang, West Java. There were 49 respondents and the sampling method used was non-probability sampling. The data was collected through face to face interview using questionnaire which consist of 27 questions about knowledge, attitude and practice. The collected data was anayzed using computer and was presented in the form of tables and a figure.Results: This study discovered that 22 patients had moderate knowledge, 17 patients had good knowledge and 10 patients had poor knowledge. As for attitude, there were 32 patients had good attitude and 17 patients had moderate attitude. Whereas, for practice, 44 patients were good and 5 patients were moderate.Conclusions: Majority of respondent had moderate knowledge, good attitude and practices. [AMJ.2016;3(3):416–20]DOI: 10.15850/amj.v3n3.871
Hubungan Beberapa Faktor Klinis dan Pengobatan Penyakit Arteri Koroner dengan Pembentukan dan Gradasi Kolateral Arteri Koroner Martha, Januar Wibawa; Purnomowati, Augustine
Majalah Kedokteran Bandung Vol 49, No 4 (2017)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (550.29 KB) | DOI: 10.15395/mkb.v49n4.1199

Abstract

Penyakit arteri koroner (PAK) ditandai lesi aterosklerosis yang menyebabkan penurunan suplai oksigen ke miokardium. Sebagian pasien PAK membentuk pembuluh kolateral yang menambah suplai darah ke miokardium. Pembentukan kolateral didasari proses angiogenesis dan dipengaruhi oleh berbagai faktor. Aspirin telah digunakan sebagai pencegahan angiogenesis. Penelitian ini bertujuan mencari pengaruh faktor klinis dan pengobatan terhadap pembentukan kolateral koroner. Penelitian ini menggunakan metode potong lintang pada pasien PAK yang dilakukan angiografi koroner. Klasifikasi kolateral koroner dinilai menggunakan kriteria Rentrop. Subjek penelitian dibagi menjadi kolateral baik dan kolateral buruk, ditentukan berdasar atas penilaian intervensionis. Faktor yang dianalisis adalah keluhan angina, obat-obatan, lesi stenosis, dan faktor risiko kardiovaskular. Analisis statistik menggunakan korelasi Spearman dan regresi logistik. Sebanyak 382 pasien diikutsertakan dalam penelitian. Seluruh subjek penelitian memiliki stenosis koroner di atas 80% pada salah satu arteri koroner. Analisis kolateral koroner mendapatkan 164 pasien kolateral baik dan 158 orang kolateral buruk. Secara bivariat, faktor-faktor yang berpengaruh pada pembentukan kolateral koroner yang buruk adalah: penggunaan inhibitor ACE (p=0,048), penggunaan aspirin (p=0,047), oklusi pada pembuluh left circumflex (p=0,032), tidak ada keluhan angina (p=0,036), dan diabetes (p=0,047). Regresi logistik tidak menunjukkan kemaknaan dari faktor-faktor diatas terhadap pembentukan kolateral koroner (p=0,088). Penelitian ini menyimpulkan bahwa aspirin, inhibitor ACE, oklusi pembuluh left circumflex, tidak ada keluhan angina dan riwayat diabetes memiliki potensi untuk menghambat pembentukan kolateral koroner. [MKB. 2017;49(4):274–80]Kata kunci: Faktor klinis, kolateral koroner, penyakit arteri koroner Relationship between Several Clinical and Treatment Factors in Cad Patients in Coronary Collateral Development and Gradation Coronary artery disease (CAD) involves atherosclerotic plaques that caused reduction of myocardial oxygen supply. Some CAD patients develop collaterals which augment myocardial blood circulation. Angiogenesis is a precursor for collateral development and influenced by multiple factors. Aspirin has been used as an angiogenesis inhibitor. This study was intended to elucidate clinical and treatment factors that may affect collateral development. This study employed cross-sectional methodology. Subjects were CAD patients who underwent coronary angiography. Grading of coronary collaterals was classified using Rentrop criteria. Subjects were categorized into poor collaterals and good collaterals, determined by an interventionist. Factors  analyzed were anginal symptoms, medications, stenotic lesions, and cardiovascular risk factors. Data were examined using Pearson or Spearman correlation and logistic regression. A total of 382 patients were selected. All subjects had 80% or more stenotic lesions in one or more coronary arteries. There were 164 patients assigned as good collaterals and 158 patients was assigned as poor collaterals. Factors that hampered collateral development were: ACE (p=0.048) and aspirin (p=0.047) use, occlusion of left circumflex artery (p=0.032), no anginal symptoms (p=0.036) and diabetics (p=0,047). None of these factors was statistically significant in logistic regression (p=0.088). The study concluded that aspirin has a potential to diminish coronary collateral development. [MKB. 2017;49(4):274–80]Key words: Clinical factors, coronary artery disease, coronary collaterals
HUBUNGAN KADAR LEPTIN SERUM DENGAN KOMPLEKSITAS LESI KORONER BERDASARKAN SKOR SYNTAX PADA PENDERITA PENYAKIT ARTERI KORONER STABIL Ashari, Fajar; Aprami, Toni Mustahsani; Akbar, Muhammad Rizki; Purnomowati, Augustine; Martha, Januar Wibawa; Achmad, Chaerul; Martanto, Erwan
Majalah Kedokteran Bandung Vol 48, No 1 (2016)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (165.975 KB) | DOI: 10.15395/mkb.v48n1.730

Abstract

Leptin memiliki peran penting dalam pembentukan plak ateroskleosis dengan mengaktifkan respons sel imun dan respons inflamasi ataupun peran langsung terhadap dinding pembuluh darah koroner. Penelitian terdahulu mengenai hubungan antara kadar leptin serum dan kompleksitas lesi koroner masih menunjukkan kontroversi. Penelitian ini bertujuan mengetahui hubungan antara kadar leptin serum dan kompleksitas lesi koroner berdasarkan skor SYNTAX pada penderita penyakit arteri koroner stabil. Metode penelitian berupa observasional, deskriptif, dan analisis korelasi dengan rancangan potong lintang. Subjek penelitian sebanyak 44 orang penderita penyakit arteri koroner (PAK) stabil yang memenuhi kriteria inklusi, menjalani pemeriksaan angiografi koroner di Rumah Sakit Dr. Hasan Sadikin Bandung selama bulan Januari?Mei 2014. Pengambilan sampel darah untuk pemeriksaan kadar leptin serum dilakukan sebelum tindakan angiografi. Kompleksitas lesi arteri koroner dinilai menggunakan skor SYNTAX. Hasil penelitian didapatkan subjek penelitian 84% laki-laki dengan usia rata-rata 54,68 (+10,24) tahun. Indeks massa tubuh rata-rata 24,71 (+ 3,05) kg/m2. Faktor risiko terbanyak adalah dislipidemia (84%), merokok (72%), hipertensi (38,4%), diabetes melitus (22,7%), dan obesitas (4,5%). Median kadar leptin serum 7.242 (780?36.929) pq/mL, nilai rata-rata skor SYNTAX sebesar 19,52 (+9,93). Analisis menggunakan uji korelasi rank-Spearman tidak didapatkan hubungan (p=0,61; r= 0,078). Perbedaan hasil penelitian ini dengan penelitian sebelumnya disebabkan oleh perbedaan subjek dan kriteria penilaian kompleksitas lesi arteri koroner. Simpulan, tidak terdapat hubungan antara kadar leptin serum dan kompleksitas lesi koroner berdasarkan skor SYNTAX pada penderita penyakit arteri koroner stabil. [MKB. 2016;48(1):26?31]Kata kunci: Kompleksitas lesi koroner, leptin serum, penyakit arteri koroner stabil, skor SYNTAXCorrelation between Serum Leptin Levels and Complexity of Coronary Artery Lesion based on SYNTAX Score in Patients with Stable Coronary Artery DiseaseAbstractLeptin has been shown to play a potential role in the atherosclerotic plaque formation by activating immune and inflammatory cells or directly acting on the vessel wall. Earlier reports of the correlation of serum leptin levels with the degree of coronary lesion stated are still controversial. This study determined the correlation between serum leptin levels and complexity of coronary artery lesion in patients with stable coronary artery disease (SCAD). This is an observational cross-sectional study. Data were collected from January to May 2014 in Dr. Hasan Sadikin Central General Hospital Bandung. Blood samples were collected before angiography procedures. The complexity of coronary artery lesion was assessed using SYNTAX score. There were 44 patients who met inclusion criteria, male 84%, median age 54.68 (+10.24) years. Mean body mass index 24.71 (+ 3.05) kg/m2. Dyslipidemia was the most common risk factor (84%), followed by smoking (72%), hypertension (38.4%), diabetes mellitus (22.7%), and obesity (4.5%). Median leptin level was 7,242 (780-36,929) pq/mL. Mean SYNTAX score was 19.52 (+9.93). Leptin level had no correlation with the complexity of coronary artery lesion (p=0.61, r=0.078). The difference between this study from prior studies might be caused by differences in subject selection and criteria used for complexity of coronary artery lesion. In conclusion, there is no correlation between serum leptin levels and complexity of coronary artery lesion in patients with stable coronary artery disease. [MKB. 2016;48(1):26?31]Key words: Complexity of coronary artery lesion, leptin, stable coronary artery disease, SYNTAX score
Controlled Resistant Hypertension Following A Successful Renal Artery Stenting: A Rare Case Report in A Developing Country Munita, Fatihatul Firdaus; Tiksnadi, Badai Bhatara; Martha, Januar Wibawa; Ratna, Margareta Ginanti
Jurnal Kardiologi Indonesia Vol 45 No 2 (2024): April - June, 2024
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.1687

Abstract

Background Renal artery stenosis is among the etiologies of secondary hypertension in which the diagnosis and therapy are difficult. We report a case of a patient with uncontrollable hypertension with frequent episodes of malignant hypertension, treated with renal artery stenting. Case Illustration A 36-year-old female visited the cardiovascular polyclinic on a common control for her hypertension. She was diagnosed with hypertension two years, and she had several episodes of malignant hypertension. At the beginning of her treatment, she has prescribed an angiotensin-converting-enzyme inhibitor, yet her pressure was uncontrolled and worsened. By the visit, she was treated using two alpha-2-adrenergic agonists, a loop diuretic, a beta-blocker, a calcium-channel blocker, an angiotensin-receptor blocker, and an aldosterone-receptor antagonist without any satisfactory outcome on her blood pressure status. She had a blood pressure of 196/130 mmHg with tachycardia of 112 times/minute. We found cardiomegaly on physical examination, which was proven by a chest x-ray. Echocardiography indicated hypertensive heart disease. Screening for secondary hypertension, including laboratory tests (complete blood count, potassium, sodium, creatinine, fasting glucose, lipid profile, urinalysis, thyroid-stimulating hormone, and 24-hour urinary-free cortisol), suggested normal results. Renal ultrasound and doppler were also conducted and showed a suspicion of right renal artery stenosis. Therefore, angiography of the renal artery was performed for diagnosis and therapy when indicated. The angiography suggested a normal left renal artery, while the right artery had a 95% stenosis on the proximal part. An intravascular ultrasound-guided percutaneous transluminal angioplasty on her right renal artery was conducted, and two vascular stents were implanted. The patient showed a remarkable development following her decreasing blood pressure on follow-up. After one week, her blood pressure is controllable on a single antihypertensive and antiplatelet therapy. Conclusion The diagnosis and management of a patient with resistant hypertension might be challenging, particularly in the setting of a developing country. Renal artery angiography, among other examinations, might be crucial in the diagnosis sequence, yet it was only sometimes readily available. We present a case in which a diagnosis of renal artery stenosis was made, followed by a definite treatment resulting in unprecedented hypertension control. An identifiable etiology is the key to a proper and the best treatment option for the patient.
Comparison of Left Ventricular Function after His Bundle Pacing vs Left Bundle Branch Area Pacing Implantation Prakoso, Kurniawan; Wibawa, Kevin; Karwiky, Giky; Akbar, Mohammad Rizki; Martha, Januar Wibawa; Iqbal, Mohammad
Jurnal Kardiologi Indonesia Vol 45 No 2 (2024): April - June, 2024
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.1708

Abstract

Background: Right ventricular pacing may lead to deterioration of left ventricular (LV) function. Recent guideline suggests the use of conduction system pacing (CSP) with either his bundle pacing (HBP) or left bundle branch area pacing (LBBAP). This study aimed to investigate the difference of LV function between HBP and LBBAP. Methods: This is a prospective cohort study enrolling patients age >18 years requiring CSP implantation from June 2020 to January 2024 in Hasan Sadikin General Hospital, Bandung. Data regarding QRS duration and several echocardiography parameters were obtained at baseline and during follow up within 1 year after CSP implantation. Results: From 66 patients, 35 were included in the HBP group. There was no difference in QRS duration at baseline between both groups with higher left ventricular ejection fraction (LVEF) in HBP group (51.2 ± 13.9% vs 45.6 ± 11.1%, p=0.078). During follow up, HBP group showed narrower QRS duration (113.40 ± 17.06ms vs 120.81 ± 12.12ms, p=0.029). LV function was preserved in HBP group while there was a trend of LV function improvement in LBBAP group (53.1 ± 11.7% in LBBAP vs 53.9 ± 11.5% in HBP group, p=0.536). Further analysis in 33 patients with LV dysfunction showed a trend of LVEF improvement in both groups (35.3 ± 7.9% to 44.6 ± 11.28% in HBP and 38.7 ± 6.9% to 51.4 ± 13.1% in LBBAP group). Conclusion: HBP resulted in narrower QRS complex. However, both HBP and LBBAP showed a trend of LV function improvement in patients with LV dysfunction.
Novel Echocardiographic Parameter Assessing Pulmonary Vascular Resistance in Patient with Acyanotic Congenital Heart Disease Natadikarta, Muhammad Raihan Ramadhan; Cool, Charlotte Johanna; Khalid, Achmad Fitrah; Sukmadi, Norman; Martha, Januar Wibawa
Jurnal Kardiologi Indonesia Vol 45 No 4 (2024): Online First - Indonesian Journal of Cardiology April-June 2021
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.1790

Abstract

Background Pulmonary vascular resistance (PVR) is an important variable in management of acyanotic congenital heart disease. Right heart catheterization (RHC) using impedance catheter remains gold standard for pulmonary vascular resistance (PVR) measurement. The ratio of peak tricuspid regurgitant velocity to the right ventricular outflow tract time-velocity integral (TRVmax/RVOTVTI) was presented as a reliable non-invasive method of estimating PVR. Recently, right ventricular 2-dimensional speckle tracking strain (RVGLS) was proven as a new promising parameter to evaluate PVR. This study performed to examine whether this new non-invasive variable ratio (TRVmax/RVGLS) provides clinically reliable method to determine pulmonary vascular resistance (PVR) obtained by echocardiography. Methods Right-heart catheterization and echocardiographic examination were performed in 56 patients with congenital heart disease. The ratio of TRVmax/RVOTVTI and TRVmax/RVGLS analysis performed using receiver-operating characteristic curve analysis, a cutoff value for the ratio was generated to determine PVR more than 5 WU. Results A TRVmax/RVOTVTI cutoff value of 0.21 provided a sensitivity of 77.1% and a specificity of 81% (CI 81% to 97.5%) and TRVmax/RVGLS cutoff value of -23.16 provided sensitivity of 74.3% and a specificity of 90.5% to determine PVR > 5 WU (CI 79.6% to 98.2%). Conclusions The echocardiography parameter (TRVmax/RVGLS) could serve as a dependable noninvasive method to predict PVR greater than 5 WU in acyanotic congenital heart disease patients.
In-Hospital Outcomes Comparison Between Off-Pump and On-Pump CABG: Indonesian Tertiary Center Experience Dewi, Triwedya Indra; Jungjunan, Ridho; Raharjo, Pradana Pratomo; Rezkita, Aliya Rahmadewi; Hidayat, Syarief; Martha, Januar Wibawa; Nusjirwan, Rama; Akbar, Mohammad Rizki
International Journal of Integrated Health Sciences Vol 13, No 2 (2025)
Publisher : Faculty of Medicine Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15850/ijihs.v13n2.4119

Abstract

Background: Coronary artery disease (CAD) often requires revascularization. Coronary artery bypass grafting (CABG) is a cornerstone intervention that improves patients’ survival. Both on-pump and off-pump CABG have their own advantages and limitations, with reported outcomes vary across studies.Objective: to investigate the differences in the outcomes of patients undergoing off-pump and on-pump CABG.Methods: A retrospective cohort study was performed on 186 patients aged ≥18 years undergoing on-pump or off-pump CABG between June 2020 and December 2023. Outcomes included were all-cause mortality, postoperative acute renal failure, length of postoperative stay, and complete revascularization rate. Comparative analysis was conducted using Chi-Square test and independent T-test. Multivariate analysis, including logistic regression tests, was carried out to identify independent predictors associated with each outcome.Results: The on-pump group presented more diabetes (42.9% vs. 28.4%; P=0.040) and lower left ventricular ejection fraction (LVEF) values (43 [IQR 16–79] vs. 53 [23–75]; P=0.001). Patients in this group also had higher rates of postoperative renal failure (61.5% vs. 24.2%; P<0.001), longer stays (64.8% vs. 41.1%; P=0.001), and better complete revascularization (98.9% vs. 92.6%; P=0.035), but no significant difference in mortality (16.5% vs. 13.7%; P =0.594). Multivariate analysis identified diabetes, LVEF ≤40%, and postoperative renal failure as predictors of mortality.Conclusions: On-pump CABG is associated with higher rates of complete revascularization. However, the adoption of this technique is linked to a higher risk of postoperative acute kidney failure and prolonged hospital stays. No difference in mortality is observed between those with off-pump and on-pump.
Co-Authors Akbar, Mohammad Rizki Augustine Purnomowati Badai Bhatara Tiksnadi Chaerul Achmad Cool, Charlotte Johanna Daniel Happy Putra Dewi, Triwedya Indra Erwan Martanto Fajar Ashari, Fajar Fatihatul Firdaus Munita, Fatihatul Firdaus Jungjunan, Ridho Karwiky, Giky Khalid, Achmad Fitrah Muhammad Rizki Akbar, Muhammad Rizki Natadikarta, Muhammad Raihan Ramadhan Prakoso, Kurniawan Raharjo, Pradana Pratomo Rama Nusjirwan Ratna, Margareta Ginanti Rezkita, Aliya Rahmadewi Sukmadi, Norman Syarief Hidayat Toni Mustahsani Aprami, Toni Mustahsani Wibawa, Kevin Yunivita, Vycke Zahari, Asila Zahiri binti