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All Journal Medika Kartika : Jurnal Kedokteran dan Kesehatan The ASEAN Journal of Military and Preventive Medicine
Prihati Pujowaskito
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Dentistry Health Professions Medicine & Pharmacology Veterinary

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LAPORAN KASUS PERBEDAAN EKSTRIM ANTARA OFFICE DAN AMBULATORY BLOOD PRESSURE: APAKAH BENAR SEBUAH HIPERTENSI TIDAK TERKONTROL? Prihati Pujowaskito; Tami Sertilia Tartila; Fatima Defina Khamarul Jannah; Novaro Adeneur Tafriend
Medika Kartika : Jurnal Kedokteran dan Kesehatan Vol 5 No 1 (2022): Medika Kartika : Jurnal Kesehatan dan Kedokteran
Publisher : Fakultas Kedokteran Universitas Jenderal Achmad Yani

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (273.005 KB)

Abstract

White Coat Uncontrolled hypertension (WCUH) menjadi salah satu pertimbangan yang dinilai pada pasien hipertensi tidak terkontrol. Penilaian lebih jauh dibutuhkan untuk menghindari terjadinya medikasi berlebihan. Pada penelitian ini, penulis meneliti sebuah kasus WCUH yang ekstrem, yang ditemukan pada saat melakukan pemeriksaan ambulatory blood pressure monitoring (ABPM). Subyek penelitian adalah perempuan berusia 66 tahun pasien rutin poli rawat jalan departemen jantung RSPAD Gatot Soebroto dengan diagnosis hipertensi tidak terkontrol, Coronary artery disease (CAD) post Percutaneous Coronary Intervention (PCI), dan diabetes melitus tipe 2. Pasien termasuk ke dalam kategori overweight dengan kadar gula darah yang tidak terkontrol dan diberikan terapi hipertensi agresif yang diberikan dengan, Angiotensin Receptor Bloker (ARB), Calcium Chanel Blocker (CCB), Beta Blockers, diuretik dan klonidin, tekanan darah sistolik pasien masih terukur 160 mmHg di poliklinik. Hasil ekokardiografi menunjukkan adanya hiperterofi konsentrik ventrikel kiri. Hasil pemeriksaan ABPM menemukan bahwa rerata tekanan darah dua puluh empat jam pasien adalah 93,6/59 mmHg, dengan rerata tekanan darah day-time 90/55 mmHg dan night time 98,7/65.2 mmHg, serta hipotensi intermiten dengan reverse dipper pattern. Tekanan darah terendah yang terekam adalah 69/44 mmHg, dan tekanan darah tertinggi terukur pada 211/186 mmHg. Pasien terdiagnosis dengan White Coat Uncontrolled Hypertension (WCUH), dan melakukan penyesuaian terapi yang diberikan. Kasus ini menekankan perlunya identifikasi dan eksklusi diagnosis WCUH pada pasien hipertensi tidak terkontrol dengan ABPM supaya pasien mendapatkan terapi yang sesuai dan mencegah hipotensi yang tidak diinginkan. DOI : 10.35990/mk.v5n1.p79-90
PENGENALAN TERHADAP IMUNOTERAPI REGENERATIF MAKROFAG UNTUK KARDIOMIOPATI TANPA OPSI PERAWATAN : SEBUAH TEROBOSAN BARU TERAPI PASIEN Prihati Pujowaskito; Terawan Agus Putranto
Medika Kartika : Jurnal Kedokteran dan Kesehatan Vol 4 No 1 (2020): Medika Kartika : Jurnal Kedokteran dan Kesehatan
Publisher : Fakultas Kedokteran Universitas Jenderal Achmad Yani

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Terapi imunoterapi memiliki peran menjanjikan dalam pengobatan pasien terbaru. Penerapan terapi sel untuk pengobatan penyakit kardiovaskular berpotensi mencapai tujuan terapi regenerasi kardiovaskular. Status terapi saat ini untuk kardiovaskular tidak memadai sehingga pengembangan alternatif yang aman dan efisien sangat diperlukan. Laporan kasus bertujuan membuktikan bahwa vaksin regeneratif makrofag dapat menjadi pilihan terapi untuk pasien kardiomiopati yang tidak memiliki pilihan terapi lain untuk perawatan. Metode dengan regeneratif makrofag dipilih berasal dari manusia yang dikembangkan menjadi vaksin untuk pasien kardiomiopati. Komponen darah monosit pasien dipisahkan dari komponen darah lain dan diberi perlakukan selama 4 hari. Monosit diprogram menjadi regeneratif makrofag. Ekokardiografi transthorakal dilakukan sebelum dan satu bulan setelah imunoterapi untuk mendukung tampilan klinis pasien. Pemeriksaan elektrokardiografi, x-ray thorax dan ekokardiografi dilakukan. Hasil elektrokardiografi sebelum dan sesudah terapi menunjukkan multipel ventrikel ekstrasistol. Hasil ekokardiografi sebelum terapi menunjukkan hipertrofi ventrikel kiri, disfungsi diastolik, ventrikel hipokinetik dengan ejeksi fraksi yang rendah (44%). Hasil terapi vaksin regeneratif makrofag pada pasien menunjukkan terdapat perubahan bermakna pemeriksaan ekokardiografi yaitu hipertrofi ventrikel kiri, normokinetik, disfungsi diastolik, dan peningkatan ejeksi fraksi (56%). Imunoterapi vaksin regeneratif makrofag menghasilkan perubahan bermakna status klinis dan ekokardiografi. DOI : 10.35990/mk.v4n1.p49-61
Mosquito Shield-Transfluthrin Spatial Repellents Against Malaria-Transmitting Anopheles: A Systematic Review and Meta-Analysis Dinda Nurhanifah; Dian Dewi; Anggie Azzura; Hanum Fadhilah; Fitrawan Alfiansyah; Anastasia Renate; Prihati Pujowaskito
The ASEAN Journal of Military and Preventive Medicine Vol. 2 No. 1 (2025): January
Publisher : Perkumpulan Kedokteran Militer

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47353/ajmpm.v2i1.24

Abstract

Background: Malaria remains a major mosquito-borne disease in tropical and subtropical regions. Although insecticide-treated nets and indoor residual spraying have contributed to malaria control, residual transmission and pyrethroid resistance require complementary vector control strategies. Mosquito Shield™ is a transfluthrin-based passive spatial repellent designed to reduce human–Anopheles contact. This systematic review and meta-analysis aimed to evaluate the effectiveness of Mosquito Shield in reducing exposure to malaria-transmitting Anopheles mosquitoes. Methods: A systematic literature search was conducted in November 2024 using Medline/PubMed, Scopus, ScienceDirect, and Cochrane for studies published between 2019 and 2024. Eligible studies were randomized or cluster-randomized controlled trials conducted in malaria-endemic or epidemic-prone areas that evaluated transfluthrin-based Mosquito Shield compared with placebo. Outcomes included Human Landing Catch, incidence rate ratio or risk ratio, and protective efficacy. Risk of bias was assessed using RoB 2.0, and meta-analysis was performed using Review Manager 5.4.1 with a random-effects model. Discussion: Two studies met the inclusion criteria. Mosquito Shield reduced Anopheles landing rates compared with placebo, with protective efficacy ranging from 34.2% to 70%. The pooled risk ratio was 0.45 (95% CI: 0.21–0.98; p = 0.04), indicating a significant reduction in mosquito exposure. However, heterogeneity was high (I² = 95%). Conclusion: Mosquito Shield™ may reduce exposure to malaria-transmitting Anopheles mosquitoes, but evidence remains limited by the small number of studies and substantial heterogeneity.
Cooper Test Performance and Total Flight Hours as Predictors of Hypoxia Tolerance Among Indonesian Air Force Pilots Bimo Wiratomo Baskoro; Nurfanida Librianty; Haneng Marissangan; Prihati Pujowaskito; Andri Welly
The ASEAN Journal of Military and Preventive Medicine Vol. 3 No. 2 (2026): July
Publisher : Perkumpulan Kedokteran Militer

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47353/ajmpm.v3i2.65

Abstract

Background: Hypoxia remains one of the most significant physiological threats encountered by military pilots during flight operations, particularly at high altitudes. Reduced oxygen availability can impair cognitive performance, decision-making ability, and operational effectiveness, thereby increasing the risk of aviation incidents. Physical fitness and flight experience are considered important factors that may influence an individual's tolerance to hypoxic exposure. Objective: This study aimed to analyze the relationship between Cooper Test performance and total flight hours with hypoxia tolerance among Indonesian Air Force pilots at dr. Saryanto Institute of Aviation and Aerospace Medicine. Methods: A cross-sectional analytical study was conducted involving 142 Indonesian Air Force pilots who underwent Indoctrination and Aerophysiology Training (ILA) at dr. Saryanto Institute of Aviation and Aerospace Medicine. Secondary data were obtained from medical records, including Cooper Test scores, total flight hours, and hypoxia tolerance measured using Time of Useful Consciousness (TUC). Statistical analyses were performed using Spearman correlation and multivariate regression tests. Results:The mean Cooper Test score was 50.18 ± 7.80, while the mean total flight hours were 1,570.90 ± 1,728.50 hours. The average TUC was 171.27 ± 53.86 seconds. A significant positive correlation was observed between Cooper Test performance and hypoxia tolerance (p < 0.05). Total flight hours demonstrated a significant moderate negative correlation with hypoxia tolerance (p < 0.05). Multivariate analysis showed that total flight hours exerted a greater influence on hypoxia tolerance than Cooper Test performance. Conclusion: Both Cooper Test performance and total flight hours were significantly associated with hypoxia tolerance among Indonesian Air Force pilots. Flight experience demonstrated a stronger predictive value than physical fitness. These findings highlight the importance of maintaining optimal physical fitness and implementing appropriate flight-hour management strategies to improve hypoxia tolerance and aviation safety.
Co-Authors Anastasia Renate Andri Welly Anggie Azzura Bimo Wiratomo Baskoro Dian Dewi Dinda Nurhanifah Fatima Defina Khamarul Jannah Fitrawan Alfiansyah Haneng Marissangan Hanum Fadhilah Librianty, Nurfanida Novaro Adeneur Tafriend Tami Sertilia Tartila Terawan Agus Putranto