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All Journal ISM (Intisari Sains Medis) : Jurnal Kedokteran
Yopie Afriandi Habibie
Division of Thoracic Cardiac and Vascular Surgery, Department of Surgery, Faculty of Medicine Universitas Syiah Kuala, The Dr. Zainoel Abidin General Hospital, Banda Aceh, Indonesia
Biochemistry, Genetics & Molecular Biology Medicine & Pharmacology

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Revascularization limb salvage in chronic limb-threatening ischemia: does open surgery still the best option in the era of endovascular therapy? Ashabul Anhar; Yopie Afriandi Habibie
Intisari Sains Medis Vol. 11 No. 1 (2020): (Available online: 1 April 2020)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (537.536 KB) | DOI: 10.15562/ism.v11i1.745

Abstract

Introduction: Chronic limb-threatening ischemia (CLTI) is considered the most severe pattern of peripheral artery disease. It is defined by the presence of chronic ischemic rest pain, ulceration or gangrene attributable to the occlusion of peripheral arterial vessels who suffered from diabetes mellitus type 2, and also associated with physical, as well as psychosocial, consequences such as amputation and depression. Successful revascularization decreases the major amputation rate in patients with CLTI. The efficacy of peripheral bypass grafts and percutaneous transluminal angioplasty in accomplishing limb salvage has been recognized.Case Description: A 42-year-old man came to the RSUZA emergency room with chief complaints claudication above the right thigh and continuous pain (rest pain) at the right lower extremity since 9 months ago. History of finger amputation 2nd, 3rd and 4th right foot since 10 months ago at local hospital, and now there are necrotic wounds on his toes. Patients suffered from type 2 diabetes mellitus and have bad habits such as smoking 3 packs a day all the time. Physical examination has a wound in the lower leg area of more than 10 cm x 8 cm. Right ankle-brachial index (ABI) 0.6 and left ABI 1.3. CT-angiography (CTA) shows infra inguinal type D TASC II classification. A revascularization procedure is performed to salvage the limb with the right femoro-popliteal bypass technique with graft R-SVG and debridement in the right lower leg area so that chronic right lower limb ischemia can be overcome. Systemic heparinization was given post operatively and complaints of pain in the right lower limb begin to disappear. Patient was discharged on the 5th day of treatment with good results.Conclusion: Open surgical bypass continues to be a primary treatment of choice, durable approach in a significant proportion of patients. Lower extremity bypass grafting is most successful with a good quality, long, single-segment autogenous vein of at least 3.5mm diameter. 
Acute thromboembolic ischemic stroke in rural hospital, the role of early treatment in reducing brain damage Munzirul Akbar; Yopie Afriandi Habibie; Mursyida Mursyida
Intisari Sains Medis Vol. 12 No. 1 (2021): (Available online : 1 April 2021)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (281.101 KB) | DOI: 10.15562/ism.v12i1.1018

Abstract

Introduction: Stroke has a high mortality and disability rate, and the main cause of physical disability in productive age and elderly. In developed countries stroke is the number one cause of admission of patients to hospital, with a mortality proportion of 20%  within the first 28 days of treatmentCase Report: A 45-year-old man came to the neurology polyclinic of RSUD Aceh Besar on March 21st, 2021 with chief complaints of the general weakness of the left limb, complete numbness and heavy feeling in the left limb since 4 hours of before admission which is felt to be getting weaker from time to time, happened suddenly when the patient was working collecting stones. He complained of dizziness as well, and did not decrease while resting. After the attack, the patient remains conscious with no headache, no nausea and vomiting, no double images were seen. On Siriraj score showed result of -4. The patient was hospitalized with injection of Citicolin 1000 mg and then discharged 5 days later with significant improvement.Conclusion: Ischemic Stroke requires fast, precise and accurate handling to prevent and avoid disability and even death. One of the effective efforts is to organize health promotion and preventive programs starting from the First Level Health Facility (FKTP) on an ongoing basis to the community.
Co-Authors Ashabul Anhar Munzirul Akbar Mursyida Mursyida