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All Journal e-CliniC JURNAL BIOMEDIK Medical Scope Journal (MSJ)
Agnes L. Panda
Universitas Sam Ratulangi Manado
Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Nursing Public Health

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Journal : JURNAL BIOMEDIK

 1 
THE COMPARISON OF ANKLE BRACHIAL INDEX IN PATIENTS WITH AND WITHOUT ACS IN PROF. DR. R. D. KANDOU HOSPITAL, MANADO Moeljono, Elfan; Suhartono, Iman Y.; Ransun, Terrance; Tedjo, Fonny M.; Panda, Agnes L.; Lefrandt, Reginald L.
JURNAL BIOMEDIK : JBM Vol 5, No 2 (2013): JURNAL BIOMEDIK : JBM
Publisher : UNIVERSITAS SAM RATULANGI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/jbm.5.2.2013.2594

Abstract

Abstrak: Walaupun merupakan pengukuran sederhana dan non-invasif, ankle brachial index (ABI) menunjukkan sensitifitas dan spesifisitas yang tinggi dalam mendiagnosis penyakit arteri perifer pada nilai ABI ?0,9. ABI juga merupakan indikator yang kuat untuk mengetahui penyakit aterosklerosis pada area vaskular lainnya. Penelitian ini bertujuan untuk menentukan perbandingan antara ABI pada pasien dengan atau tanpa sindroma koroner akut (SKA). Penelitian ini menggunakan analisis analitik observasional dengan desain potong lintang. Subyek penelitian ialah pasien dengan SKA dan pasien tanpa SKA yang datang ke Departemen Kardiologi dan Pembuluh Darah RSU Prof. Dr. R.D Kandou, Manado bulan September-Desember 2012. Nilai normal ABI yaitu >0,9 dan <1,4, sedangkan ABI <0,9 perlu dipertimbangkan abnormal. Nilai ABI >1,4 dipertimbangkan tidak valid dan diekslusi. Hubungan antara variabel dievaluasi menggunakan SPSS. Hasil penelitian memperlihatkan 33 pasien SKA (72,8% laki-laki) dan 33 pasien tanpa SKA (81,8% laki-laki) sebagai subyek penelitian. Rerata usia pasien SKA 57 tahun dan tanpa SKA 52,3 tahun. Angka kejadian pasien SKA dengan ABI abnormal lebih tinggi, yaitu 82,1% vs 17,9% (P < 0,001). Uji chi-square menunjukkan terdapatnya hubungan antara SKA dan peningkatan risiko ABI abnormal (OR 12, P < 0,05). Simpulan: Sindroma koroner akut berhubungan dengan peningkatan risiko dari ABI abnormal. Kata kunci: Ankle brachial index, sindroma koroner akut.   Abstract: Although the ankle-brachial index (ABI) is a simple and non-invasive measurement, it shows a high sensitivity and specificity in the diagnosis of peripheral arterial disease (PAD) when its value is ?0.9. Moreover, ABI is a powerful indicator of atherosclerotic diseases in other vascular areas. This study aimed to determine the comparison between ankle brachial indices (ABI) in patients with or  without acute coronary syndrome (ACS). This was an analytical observational study with a cross sectional design. We measured ABI indices in 33 patients with ACS and 33 patients without ACS admitted to the Department of Cardiology and Vascular Medicine, Prof. Dr. R.D. Kandou Hospital, Manado. The normal ABI is >0.9 and <1.4. However, ABI <0.9 was considered as abnormal. On the other hand, ABI >1.4 was considered invalid and then excluded. The association of variables was evaluated by SPSS software. The results showed that there were 33 ACS patients (72.8% male) and 33 patient without ACS (81.8% male). ACS patients were older (57 vs 52.3 years). ACS patients had more prevalent abnormal ABI (82.1% vs 17.9%; P < 0.001). Chi square test showed that ACS was associated with an increased risk of abnormal ABI (OR 12, P < 0.05). Conclusion: ACS was associated with an increased risk of abnormal ABI. Keywords: ankle brachial index, acute coronary syndrome.
KORELASI ANTARA INTERVAL S2-OPENING SNAP DAN MITRAL VALVE AREA YANG DIIDENTIFIKASI DENGAN COLOR SPECTROGRAPH PHONOCARDIOGRAPHY PADA PASIEN MITRAL STENOSIS Suhartono, Iman Y.; Ransun, Terrance; Kawilarang, Michael S.; Moeljono, Elfan; Tedjo, Fonny M.; Panda, Agnes L.; Awaloei, Jan H.; Lefrandt, Reginald L.
Jurnal Biomedik : JBM Vol 5, No 2 (2013): JURNAL BIOMEDIK : JBM
Publisher : UNIVERSITAS SAM RATULANGI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/jbm.5.2.2013.2596

Abstract

Abstract: Color spectrograph phonocardiography (CSP) is a method for recording heart sounds by using a digital stethoscope. The recorded result can be analyzed by using a soft ware. CSP can identify the opening snap (OS) and measure the S2-OS interval. This study aimed to determine the correlation between adjusted S2-OS to the mitral valve area (MVA) in mitral stenosis (MS) patients. The samples were MS patients admitted to the ICCU and the ward of Prof. Dr. R.D. Kandou Hospital, Manado. Patients with atrial fibrillation were excluded. Every patient underwent echocardiography and CSP to obtain the MVA and S2-OS interval. The adjusted S2-OS interval is the S2-OS interval divided by the number of heart beats (milisecond/beat per minute). Variables were analyzed by using the Pearson correlation test. The results showed that there were 14 MS patients involved in this study. There was a strong correlation between adjusted S2-OS interval and MVA. Estimated MVA was obtained by using the formula MVA = -1.358 + 2.07. Conclusion: The adjusted S2-OS interval was strongly correlated to the MVA of MS Patients and could predict the MVA value. Keywords: color spectrograph phonocardiography, S2-OS interval, mitral valve area, mitral stenosis, echocardiography.   Abstrak: Color spectrograph phonocardiography (CSP) merupakan metode merekam bunyi jantung dengan menggunakan stetoskop digital. Hasil rekaman ini dapat dianalisis dengan piranti lunak. CSP dapat mengidentifikasi opening snap (OS) dan mengukur interval S2 – OS. Penelitian ini bertujuan untuk mendeteksi korelasi antara interval S2-OS yang sudah disesuaikan dengan mitral valve area (MVA) pada pasien mitral stenosis (MS). Sampel penelitian ialah pasien mitral stenosis yang dirawat di ICCU dan bangsal BLU RSUP Prof. Dr. R.D. Kandou Manado. Pasien dengan atrial fibrilasi dieksklusi. Masing-masing pasien menjalani pemeriksaan echocardiography dan CSP untuk memperoleh MVA dan interval S2-OS. Interval S2-OS yang telah disesuaikan adalah interval S2-OS yang dibagi dengan denyut jantung (milidetik/denyut jantung per menit). Variabel-variabel tersebut dianalisis dengan menggunakan analisis korelasi Pearson. Hasil penelitian memperlihatkan  sebanyak 14 pasien mitral stenosis diikutsertakan dalam penelitian. Terdapat korelasi sangat kuat antara interval S2-OS yang telah disesuaikan dengan MVA. Estimasi MVA dapat diperoleh dari persamaan MVA = -1,358 + 2,07.(Interval S2-OS yang telah disesuaikan). Simpulan: Interval S2-OS yang telah disesuaikan memiliki korelasi yang sangat kuat dengan MVA pada pasien-pasien mitral stenosis. Interval S2-OS yang telah disesuaikan dapat memperkirakan nilai MVA. Kata kunci: color spectrograph phonocardiography, interval S2-OS, mitral valve area, mitral stenosis, echocardiography.
Profil lipid pada wanita dengan sindrom koroner akut ., Ronaldi; Adriana, Ike; Rotty, Monique; Lefrandt, Reginald L.; Panda, Agnes L.
Jurnal Biomedik : JBM Vol 8, No 2 (2016): JURNAL BIOMEDIK : JBM
Publisher : UNIVERSITAS SAM RATULANGI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/jbm.8.2.2016.12666

Abstract

Abstract: Females with acute coronary syndrome (ACS) display different characteristics from the opposite gender. Currently, only limited data were available regarding the characteristic of ACS in females, especially in Manado. This study aimed to obtain the lipid profile of females with ACS at Prof. Dr. R. D. Kandou Hospital Manado in 2012-2013. This was a descriptive retrospective study with a cross sectional design. Subjects were all female patients with ACS who were admitted to Prof. Dr. R. D. Kandou Hospital Manado from January 2012 to December 2013. Data were collected based on the medical record. Exclusion criteria included incomplete data and non-ACS as the main diagnosis. There were 81 women as subjects in this study. The mean age was 61.59±10.78 years. Unstable angina pectoris, non-ST elevation myocardial infarction, ST elevation myocardial infarction were found in 38 (46.9%), 15 (18.5%), and 28 (34.6%) patients consecutively. Mean value of total cholesterol, low density lipoprotein (LDL), high density lipoprotein (HDL), and trygliserida levels were as follows: 218.17±48.88, 145.91±47.30, 39.72±15.99, and 153±65.55 mg/dl. High level of total cholesterol, LDL, and trygliserida were found in 52 (64.2%), 50 (61.7%), 14 (17.3%) patients consecutively meanwhile low HDL level was found in 51(63%) patients. Diabetes mellitus and hypertension were found in 24 (29.6%) and 58 (71.6%) patients. The mean length of stay was 8.44±4.36 days.Keywords: female, lipid profile, acute coronary syndromeAbstrak: Wanita dengan sindrom koroner akut (SKA) menampilkan karakteristik yang berbeda daripada laki-laki dengan SKA. Sampai saat ini, masih tersedia sedikit data mengenai karakteristik SKA pada wanita. Penelitian ini bertujuan mendapatkan gambaran profil lipid pada wanita dengan SKA yang dirawat di RSUP Prof. Dr. R. D. Kandou. Jenis penelitian ini deskriptif retrospektif dengan desain potong lintang. Subyek penelitian ialah pasien wanita dengan SKA yang dirawat di RSUP Prof. Dr. R. D. Kandou, Manado dari Januari 2012-Desember 2013. Data dikumpulkan dari rekam medis. Kriteria eksklusi meliputi data yang tidak lengkap dan diagnosis selain SKA sebagai diagnosis utama. Hasil penelitian mendapatkan subyek 81 pasien wanita dengan usia rata-rata 61,59±10,78 tahun. Angina pektoris tak stabil ditemukan pada 38 pasien (46,9%), non-ST segment elevation myocardial infarction pada 15 pasien (18,5%), dan ST segment elevation myocardial infarction pada 28 pasien (34,6%). Kadar rerata kolesterol total, low density lipoprotein (LDL), high density lipoprotein (HDL), dan trigliserida ialah berturut-turut 218,17±48,88, 145,91±47,30, 39,72±15,99, dan 153±65,55 mg/dl. Kadar kolesterol total, LDL, trigliserida yang tinggi ditemukan berturut-turut pada 52 pasien (64,2%), 50 pasien (61,7%), dan 14 pasien (17,3%) sedangkan kadar HDL yang rendah ditemukan pada 51 pasien (63%). Diabetes melitus dan hipertensi ditemukan pada 24 pasien (29,6%) dan 58 pasien (71,6%). Rerata lama perawatan di rumah sakit ialah 8,44±4,36 hari.Kata kunci: wanita, profil lipid, sindrom koroner akut
PROFILE OF ATRIAL FIBRILATION IN PROF. R.D. KANDOU HOSPITAL MANADO FROM SEPTEMBER 2012 – FEBRUARY 2013 Kawilarang, Michael S.; Suhartono, Iman Y.; Moeljono, Elfan; Wangko, Loretta C.; Panda, Agnes L.; Lefrandt, Reginald L.
Jurnal Biomedik : JBM Vol 5, No 2 (2013): JURNAL BIOMEDIK : JBM
Publisher : UNIVERSITAS SAM RATULANGI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/jbm.5.2.2013.2595

Abstract

Abstrak: Fibrilasi atrial merupakan gangguan irama jantung menetap yang paling sering dijumpai di praktek sehari-hari, ditandai oleh adanya aktivasi atrium yang tidak terorganisasi dan kontraksi atrium dan ventrikel yang tidak terkoodinasi. Meskipun banyak laporan mengenai fibrilasi atrial di Indonesia, tetapi hal ini belum pernah dilaporkan di Sulawesi Utara. Penelitian ini bertujuan untuk mendapatkan profil fibrilasi atrial di Manado. Data diambil dari pasien fibrilasi atrial di Bagian Jantung dan Pembuluh Darah, Prof R D Kandou, Manado, sejak September 2012-Februari 2013. Variabel yang diamati ialah jenis kelamin, usia, penyakit penyerta, ekokardiografi, dan terapi. Sebanyak 84 pasien diikutsertakan dalam penelitian ini, terdiri dari 42 laki-laki dan 42 perempuan dengan usia 21-84 tahun dengan rincian 53 pasien berusia ≥60 tahun dan 30 pasien <60 tahun. Pada 59 pasien yang dilakukan ekokardiografi, 39 pasien (66,1%) mempunyai fraksi ejeksi ≥55%; dan 20 pasien (33,9%) <55% (rerata 55,8%). Pembesaran atrium kiri ditemukan pada 33 pasien (55,9%) dan trombus pada 13 pasien (22%). Penyakit penyerta yang ditemukan ialah: hipertensi pada 35 pasien (41,7%); gagal jantung 40 pasien (40,76%); penyakit jantung koroner 20 pasien (23,8%); penyakit jantung katub 21 pasien (25%); penyakit paru 6 pasien (7%); hipertiroid 5 pasien (6%); dan tanpa penyakit penyerta 1 pasien (1,2%). Pada 70 pasien (83,3%) diberikan terapi bisoprolol; 2 pasien (2,4%) digoksin; 3 pasien (3,5%) amiodaron; 7 pasien (8,4%) bisoprolol dan digoksin; dan 2 (2,4%) bisoprolol dan amiodaron. Obat antikoagulan oral diberikan pada 28 pasien (33,03%), dan aspirin pada 40 pasien (47,6%). Stroke ditemukan pada 4 pasien (4,8%); satu orang diantaranya meninggal akibat stroke. Simpulan: Fibrilasi atrial lebih sering ditemukan pada usia lanjut. Gagal jantung dan hipertensi merupakan penyakit penyerta yang tersering, sehingga perlu diwaspadai. Bisoprolol merupakan pilihan terapi yang tersering diberikan, dan angka komplikasi dan kematiannya rendah. Kata kunci: fibrilasi atrial, penyakit penyerta, terapi.   Abstract: Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia encountered in clinical practice characterized by disorganized atrial activation and uncoordinated contraction of the atria and ventricle. Although there are many reports regarding the profile of atrial fibrillation (AF) in Indonesia, none have been published in North Sulawesi. This study aimed to provide epidemiological data regarding atrial fibrillation profile in Manado. We reviewed medical records of outpatients diagnosed with AF in the Department of Cardiology and Vascular Medicine, Prof. Dr. R.D. Kandou Hospital, Manado, from September 2012-February 2013. Relevant variables such as gender, age, co-morbids, echocardiography, and medical therapy were documented. The results showed that a total of 84 patients with AF were enrolled in the study. There were 42 males (50%) and 42 females (50%) with age ranges from 21 to 84 years (mean 60.74 years), of these 53 patients (63%) were ≥60 years and 31 patients (37%) <60 years. From the total 84 patients, 59 patients underwent echocardiography examinations: 39 patients (66.1%) had ejection fraction (EF) ≥55%; and 20 patients (33.9%) had EF <55% (mean 55.8%). Left atrial enlargement was found in 33 patients (55.9%) and thrombus was found in 13 patients (22%). Besides suffering from AF, 35 patients (41.7%) had hypertension, 40 (40.76%) had congestive heart failure, 20 (23.8%) had coronary artery disease, 21 (25%) had valvular heart diseases, 6 (7%) had pulmonary diseases, 5 (6%) had hyperthyroidism, and 1 (1.2%)  had no comorbid. Seventy patients (83.3%) were treated with bisoprolol, 2 (2.4%) with digoxin, 3 (3.5%) with amiodarone, 7 (8.4%) with bisoprolol and digoxin, and 2 (2.4%) with bisoprolol and amiodarone. Oral anticoagulant was used in 28 patients (33.3%), and aspirin in 40 patients (47.6%). Strokes were found in four patients (4.8%); one died due to stroke. Conclusion: The prevalence of AF was higher in the elderly. Congestive heart failure and hypertension were the most common co-morbids found, thus, greater awareness is needed. Bisoprolol was used as the highest proportion of treatment in AF patients, and the complication and mortality rates were low. Keywords: atrial fibrillation, comorbids, therapy.
Co-Authors Aaron Ch. Rambi Alia, Jaka K. Anjani, Ni Made Christin Tatukude, Christin Desire Sutrisno Dewanti, Lidia A. D. Dewi U. Djafar, Dewi U. Edmond L. Jim Elfan Moeljono Emor, Engelin E. Fitri Jumalang Fonny M. Tedjo Ike Adriana, Ike Iman Y. Suhartono Ira Posangi Jacqueline A. Fuzairi, Jacqueline A. Jan H. Awaloei Janry A. Pangemanan Janry Pangemanan Jeffrey Ongkowijaya Linda W. A. Rotty Loretta C. Wangko Masola, Adhytia B. C. P. Michael S. Kawilarang Monique Rotty, Monique Parera, Ferdinand I. Polii, Natalia C. I. Polii, Natalia Ch. Reginald L. Lefrandt Ronaldi ., Ronaldi Santoso, Richard L. Setiono, Richella M. W. Sihombing, David H. P. Sitepu, Ade M. Starry H. Rampengan Tambuwun, Christa F.D. Terrance Ransun Tumbel, Mawarni I.S. Ventje Kawengian Victor F. F. Joseph, Victor F. F. Wagiu, Mutiara B. Wenas, Mercilia F.