Made Satria Yudha Dewangga
Departemen/KSM Ilmu Penyakit Jantung Dan Pembuluh Darah, Fakultas Kedokteran, Universitas Udayana-RSUP Sanglah Denpasar, Bali, Indonesia

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Ekstraksi lead crt ventrikel kiri yang patah Isyana Miranti; Made Satria Yudha Dewangga; Widyo Mahargo; Sulistiyati Bayu Utami; yoga Yuniadi
Jurnal Kardiologi Indonesia Vol. 36, No. 3 Juli - September 2015
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.v36i3.478

Abstract

In recent years, implantation of cardiac resynchronization therapy (CRT) devices has significantly increased. Left ventricular (LV) pacing through the Coronary Sinus (CS) is the standard approach for CRT. Many LV lead placement techniques to get lead stability and optimal threshold, one with wire PCI. We presented a case with LV lead CRT extraction were broken after being fitted with wire PCI with stabilization purpose and to obtain an appropriate threshold, the extraction was done by snaring techniques.
Efek ekstrak sambiloto (Andrographis paniculata) terhadap ekspresi matrix metalloproteinase-1 dan hipertrofi jantung pada mencit yang terpapar asap rokok I Made Agus Endra Permana; I Nyoman Wiryawan; Wayan Aryadana; I Gde Raka Widiana; I Gusti Kamasan Nyoman Arijana; I Made Satria Yudha Dewangga
Intisari Sains Medis Vol. 12 No. 2 (2021): (Available Online: 1 August 2021)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (566.204 KB) | DOI: 10.15562/ism.v12i2.1090

Abstract

Introduction: Sambiloto (Andrographis paniculata) is a plant that is often used in traditional medicine and is known to have antioxidant, anti-inflammatory and cardiovascular effects. There are many studies of sambiloto on inflammatory markers, but there is no study on the effect of sambiloto on MMP-1 expression. The purpose of this study was to determine the effect of sambiloto on MMP-1 expression and cardiac hypertrophy in mice exposed to cigarette smoke.Methods: This research is an experimental analytic study with a randomized post test only control group design. Thirty-two healthy male Swiss Webster mice aged 8-10 weeks weighing 20-30 grams were divided into 4 groups, namely: control group (standard feed + exposure to cigarette smoke), P1 (standard feed + exposure to cigarette smoke + sambiloto extract 18 mg/ kg BW), P2 (standard feed + exposure to cigarette smoke + sambiloto extract 29 mg/kg BW), P3 (standard feed + exposure to cigarette smoke + sambiloto extract 40 mg/kg BW). All groups were followed for 60 days.Results: There was a significant difference in MMP-1 expression between the control group and all treatment groups. There were significant differences in MMP-1 expression between groups P1 and P2, and between P1 and P3 groups. There was a significant difference in heart weight/weight ratio between the control group and all treatment groups. There was a significant difference in the heart weight/body weight ratio between the P1 and P3 groups.Conclusion: The administration of sambiloto extract decreased the expression of MMP-1 with a tendency for its effect to increase with increasing dose and the optimal dose was found in the sambiloto extract 29 mg/kg BW. The difference in the effect of sambiloto extract on cardiac hypertrophy only appeared after the dose was increased to 40 mg/kg BW Latar Belakang: Sambiloto (Andrographis paniculata) merupakan tanaman yang sering dipakai dalam pengobatan tradisional dan diketahui mempunyai efek antioksidan, anti inflamasi dan efek pada sistem kardiovaskular. Terdapat banyak penelitian sambiloto terhadap marker inflamasi, tetapi belum ada penelitian tentang efek ekstrak sambiloto terhadap ekspresi MMP-1. Tujuan dari penelitian ini untuk mengetahui efek ekstrak sambiloto terhadap ekspresi MMP-1 dan hipertrofi jantung pada mencit yang terpapar asap rokok.Metode: Penelitian ini adalah penelitian analitik eksperimental dengan rancangan randomized post test only control group design. Tiga puluh dua mencit Swiss Webster jantan sehat berumur 8-10 minggu dengan berat 20-30 gram dibagi menjadi 4 kelompok yaitu: kelompok kontrol (pakan standar + paparan asap rokok), P1 (pakan standar + paparan asap rokok + ekstrak sambiloto 18 mg/kg BB), P2 (pakan standar + paparan asap rokok + ekstrak sambiloto 29 mg/kg BB), P3 (pakan standar + paparan asap rokok + ekstrak sambiloto 40 mg/kg BB). Semua kelompok diikuti selama 60 hari.Hasil: Terdapat perbedaan signifikan ekspresi MMP-1 antara kelompok kontrol dengan semua kelompok perlakuan. Terdapat perbedaan signifikan ekspresi MMP-1 antara kelompok P1 dengan P2, dan antara P1 dengan P3. Terdapat perbedaan signifikan rasio berat jantung/berat badan antara kelompok kontrol dengan semua kelompok perlakuan. Terdapat perbedaan signifikan rasio berat jantung/berat badan antara kelompok P1 dengan P3. Simpulan: Pemberian ekstrak sambiloto menurunkan ekspresi MMP-1 dengan kecenderungan efeknya meningkat dengan peningkatan dosis dan dosis optimal terdapat pada ekstrak sambiloto 29 mg/kg BB. Perbedaan efek ekstrak sambiloto terhadap hipertrofi jantung baru muncul setelah dosis ditingkatkan menjadi 40 mg/kg BB.  
Efek ekstrak sambiloto (Andrographis paniculata) terhadap ekspresi vascular cell adhesion molecule-1 (VCAM-1) dan intimal media thickness (IMT) pada mencit yang terpapar asap rokok I Made Adi Satria Darma; Wayan Aryadana; I Nyoman Wiryawan; I Gede Raka Widiana; I Gusti Nyoman Kamasan Arijana; Made Satria Yudha Dewangga
Intisari Sains Medis Vol. 12 No. 3 (2021): (Available online: 1 December 2021)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (943.858 KB) | DOI: 10.15562/ism.v12i3.1175

Abstract

Introduction: Sambiloto (Andrographis paniculata) is a plant that spread almost throughout the Indonesian archipelago and has been used for a long time as traditional medicine. Several previous literatures reported that sambiloto has anti-inflammatory and antioxidant effects, so its use is useful in cardiovascular disease, especially in reducing the process of atherosclerosis. The purpose of this study was to determine the effect of giving sambiloto extract on markers of inflammation and atherosclerosis in the form of VCAM-1 expression and IMT in mice exposed to cigarette smoke.Methods: This study used an experimental analytical method with a post-test-only group design. Using 32 healthy adult male mice weighing 20-30 grams were divided into four treatment groups, namely: control group (P0) only given exposure to cigarette smoke and treatment group 1 (P1), 2 (P2), and 3 (P3) given exposure cigarettes and sambiloto extract with doses of 18, 29, and 40 mg/kg/day. Exposure is given for 60 days, then the VCAM-1 expression and IMT in the aortic arch were examined histologically.Results: There were significant differences in VCAM-1 expression and IMT between the control group and all treatment groups. There was a significant decrease in VCAM-1 expression between P1 and P2 and P2 and P3. There was a significant decrease in IMT between P1 and P2 and P2 and P3.Conclusion: Sambiloto extract has effect in decreasing VCAM-1 expression and IMT. That effect strengthens with increasing dose. The maximum effect is obtained with the use of a dose of 40 mg/kg/day. Latar Belakang: Sambiloto (Andrographis paniculata) merupakan tanaman yang tersebar hampir di seluruh nusantara dan telah digunakan sejak lama oleh masyarakat Indonesia sebagai obat tradisional. Dari beberapa literatur sebelumnya melaporkan sambiloto memiliki efek antiinflamasi dan antioksidan sehingga bermaafaat dalam bidang penyakit kardiovaskular terutama mengurangi proses aterosklerosis. Tujuan dari penelitian ini untuk mengetahui efek pemberian ekstrak sambiloto terhadap petanda inflamasi dan atherosklerosis berupa ekspresi VCAM-1 dan IMT pada mencit yang terpapar asap rokok.    Metode: Penelitian ini menggunakan metode analitik eksperimental dengan rancangan post test only group design. Menggunakan 32 ekor mencit jantan dewasa kondisi sehat dengan berat 20-30 gram dibagi menjadi empat kelompok perlakuan yaitu kelompok kontrol (P0) hanya diberikan paparan asap rokok dan kelompok perlakuan 1 (P1), 2 (P2), dan 3 (P3) diberikan paparan rokok sigaret dan ekstrak sambiloto dengan dosis 18, 29, dan 40 mg/kg/hari. Paparan diberikan selama 60 hari, kemudian dilakukan pemeriksaan histologi ekspresi VCAM-1 dan IMT pada arkus aorta mencit.Hasil: Terdapat perbedaan yang bermakna ekspresi VCAM-1 dan IMT antara kelompok kontrol dengan semua kelompok perlakuan. Terdapat penurunan bermakna ekspresi VCAM-1 antara P1 dengan P2 dan P2 dengan P3. Terdapat penurunan bermakna tebal IMT antara P1 dengan P2 dan P2 dengan P3.Simpulan: Ekstrak sambiloto memiliki efek menurunkan ekspresi VCAM-1 dan tebal IMT. Efek tersebut meningkat dengan peningkatan dosis. Efek maksimal diperoleh dengan penggunaan dosis 40 mg/kg/hari.
Gambaran karakteristik pasien in hospital cardiac arrest dan luaran pasca resusitasi jantung paru oleh tim code blue di RSUP Sanglah Made Satria Yudha Dewangga; Hendy Wirawan; Anak Agung Ayu Dwi Adelia Yasmin
Intisari Sains Medis Vol. 13 No. 1 (2022): (Available Online : 1 April 2022)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (334.484 KB) | DOI: 10.15562/ism.v13i1.1280

Abstract

Background: Cardiac arrest is a medical emergency due to the sudden cessation of the heart’s mechanical function. Cardiac arrest can be reversible with appropriate intervention, but otherwise, it can be fatal and result in death. The incidence of cardiac arrest in hospital or in-hospital cardiac arrest (IHCA) needs to be considered because it is associated with high mortality and describes an early detection system and hospital response speed. In this study, the authors examined the characteristics of the incidence of IHCA and cardiopulmonary resuscitation carried out by the code blue team at the Sanglah Central General Hospital (RSUP), including outcome trends and survival of IHCA patients after cardiopulmonary resuscitation.Methods: The authors analyzed the incidence of IHCA at Sanglah Hospital in 2021 in a retrospective cohort by tracing the patient’s medical records from January to December 2021. The sample was collected using a non-randomized consecutive sampling technique, then univariate analysis was performed to get an overview of the proportion and percentage distribution, as well as analysis. Bivariate method to determine the relationship between age group, comorbidities, response time of the code blue team, and the etiology of cardiac arrest on resuscitation outcomes.Results: In IHCA patients who were resuscitated at Sanglah Hospital, 26.2% had a successful return of spontaneous circulation (ROSC), with >50% of patients dying within <24 hours and only 1% returning home recovering. The majority of IHCA patients were men aged 40 years or older, with a Charlson Comorbidity Index (CCI) 3, with noncardiac causes. Most resuscitation was performed within 5 minutes of the sound of the code blue signal. There was no significant relationship between age group, CCI score, etiology of cardiac arrest, and response time of the code blue team with resuscitation outcomes.Conclusion: IHCA patients at Sanglah Hospital have a relatively low survival rate, but the code blue efforts have been going well. There were no significant differences in the outcome of ROSC and death based on age group variables, comorbidities, response time of the code blue team, and the etiology of cardiac arrest. Latar Belakang: Henti jantung adalah keadaan darurat medis akibat berhentinya fungsi mekanis jantung secara tiba-tiba. Henti jantung dapat bersifat reversible dengan intervensi yang tepat, namun sebaliknya dapat bersifat fatal dan mengakibatkan kematian. Kejadian henti jantung di dalam rumah sakit atau in hospital cardiac arrest (IHCA) perlu diperhatikan karena berkaitan dengan mortalitas yang tinggi serta menggambarkan sistem deteksi dini dan kecepatan respon rumah sakit. Pada penelitian ini, penulis meneliti gambaran karakteristik kejadian IHCA dan resusitasi jantung paru yang dilakukan oleh tim code blue di Rumah Sakit Umum Pusat (RSUP) Sanglah, termasuk tren luaran dan kesintasan pasien IHCA pasca resusitasi jantung paru.Metode: Penulis menganalisis kejadian IHCA di RSUP Sanglah pada tahun 2021 secara kohort retrospektif melalui penelusuran rekam medis pasien dari bulan Januari hingga Desember 2021. Sampel dikumpulkan dengan teknik non randomized consecutive sampling, kemudian dilakukan analisis univariat untuk mendapat gambaran proporsi dan distribusi persentase, serta analisis bivariat untuk mengetahui hubungan antara kelompok usia, komorbid, waktu respon tim code blue, dan etiologi henti jantung terhadap luaran resusitasi.Hasil: Pada pasien yang IHCA yang diresusitasi di RSUP Sanglah, 26,2% yang berhasil mengalami return of spontaneous circulation (ROSC), dengan >50% pasien meninggal dalam waktu <24 jam dan hanya 1% yang pulang dalam kondisi sembuh. Mayoritas pasien IHCA adalah laki-laki usia 40 tahun atau lebih, dengan Charlson Comorbidity Index (CCI) ?3, dengan penyebab nonkardiak. Sebagian besar resusitasi sudah dilakukan dalam waktu 5 menit setelah dibunyikannya tanda code blue. Tidak terdapat hubungan yang signifikan antara kelompok usia, skor CCI, etiologi henti jantung, serta waktu respon tim code blue dengan luaran resusitasi.Simpulan: Pasien IHCA di RSUP Sanglah memiliki angka kesintasan yang relatif rendah, namun upaya code blue sudah berjalan dengan baik. Tidak ada perbedaan kejadian luaran ROSC maupun meninggal yang signifikan berdasarkan variabel kelompok usia, komorbid, waktu respon tim code blue, dan etiologi henti jantung.