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Tjahjono, Cholid
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Biochemistry, Genetics & Molecular Biology Health Professions Medicine & Pharmacology Nursing Public Health

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Strategi Manajemen Kardiomiopati Peripartum: Perkembangan Dalam Menghadapi Tantangan Kesehatan Maternal Setyowati, Danti Utami; Mayangsari, Veny; Tjahjono, Cholid
Jurnal Klinik dan Riset Kesehatan Vol 3 No 3 (2024): Edisi Juni
Publisher : RSUD Dr. Saiful Anwar Province of East Java

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.11594/jk-risk.03.3.7

Abstract

Cardiomyopathies are uncommon, although they are significant contributors to serious cardiovascular problems during pregnancy. Prior to pregnancy, it is crucial to have a thorough understanding of the potential dangers linked to cardiomyopathies and how to effectively treat them in pregnant women with significant pre-existing diseases. This knowledge is essential for providing appropriate guidance to patients. Given that all interventions relate to both the mother and the fetus, it is crucial to focus on providing the most efficient care for both. Maternal illness complicates pregnancy in approximately 1-4% of instances. There is a lack of comprehensive data on the frequency and occurrence of heart disease connected to pregnancy in most regions of the world including peripartum cardiomyopathy (PPCM) which was the predominant causes of maternal mortality in the UK in the mid of 2000’s. PPCM may result in persistent systolic dysfunction over an extended period of time. Although heart disease is a prominent, if not the primary, cause of death among pregnant or postpartum women across the country. PPCM is frequently misdiagnosed as a result of insufficient awareness among both medical professionals and the general public. The absence of an early and precise diagnosis of this ailment can have life-threatening implications for women affected by PPCM. Patients who had an early diagnosis saw a more expedited recovery compared to patients who received a late diagnosis. Improving the early monitoring, detection and diagnosis is linked to better recovery.
Kasus Iskemia Tungkai Akut yang Tidak Terduga pada Pasien Sindrom Nefrotik Erickatulistiawan, Gallusena; Tjahjono, Cholid; Kurnianingsih, Novi
Jurnal Klinik dan Riset Kesehatan Vol 4 No 1 (2024): Edisi Oktober
Publisher : RSUD Dr. Saiful Anwar Province of East Java

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.11594/jk-risk.04.1.9

Abstract

Background: Acute Limb Ischemia ALI requires urgent intervention to avert irreversible tissue damage, with treatment complexity increasing in patients with nephrotic syndrome. Case Presentation: A 23-year-old female with nephrotic syndrome presented acute right leg pain. Examination showed erythema and a cold sensation in the affected leg. Ultrasound revealed no blood flow in certain leg arteries. Despite multiple thrombectomies and heparin treatment, only minimal improvement was observed. The patient underwent a below-knee amputation after unsuccessful attempts to restore blood flow. Her condition worsened with new vascular occlusions, requiring Catheter Direct Thrombolysis CDT. Post-CDT, she suffered severe bleeding, hemorrhagic shock, cardiac arrest, and multi-organ complications, leading to her death on treatment day 35. Discussion: This case illustrates the complexities of managing ALI in patients with nephrotic syndrome, which increases hypercoagulability and vascular complication risks. It highlights the need for an integrated nephrology and vascular approach, considering the high risks of hemorrhagic and thrombotic complications. A comprehensive and multidisciplinary treatment strategy is crucial, especially with vigilant monitoring for severe complications like infection and sepsis, to enhance treatment outcomes in similar cases. Conclusion: This case of a 23-year-old woman with ALI and nephrotic syndrome presented significant treatment challenges. Despite numerous interventions, including thrombectomies and CDT, severe complications ensued, emphasizing the need for comprehensive management and further research in similar complex conditions.
Peran Latihan Disupervisi pada Pasien dengan Penyakit Arteri Perifer Eksremitas Bawah Lestari, Defyna; Tjahjono, Cholid
Jurnal Klinik dan Riset Kesehatan Vol 4 No 2 (2025): Edisi Februari
Publisher : RSUD Dr. Saiful Anwar Province of East Java

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.11594/jk-risk.04.2.6

Abstract

Peripheral arterial disease is a disorder caused by decreased blood flow to the extremities. The process of atherosclerosis generally causes it and manifests as claudication. In addition to optimal medical and endovascular therapy, non-pharmacological management of PAP has been proven to be effective in reducing symptoms and improving walking ability and quality of life. Walking exercise can increase blood flow, which allows oxygen and nutrients to reach the muscles more efficiently and triggers the angiogenesis process. Supervised exercise programs in PAP patients are considered important as primary therapy to improve functional capacity and quality of life for long-term management.
Kasus Iskemia Tungkai Akut yang Tidak Terduga pada Pasien Sindrom Nefrotik Erickatulistiawan, Gallusena; Tjahjono, Cholid; Kurnianingsih, Novi
Jurnal Klinik dan Riset Kesehatan Vol 4 No 1 (2024): Edisi Oktober
Publisher : RSUD Dr. Saiful Anwar Province of East Java

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.11594/jk-risk.04.1.9

Abstract

Background: Acute Limb Ischemia ALI requires urgent intervention to avert irreversible tissue damage, with treatment complexity increasing in patients with nephrotic syndrome. Case Presentation: A 23-year-old female with nephrotic syndrome presented acute right leg pain. Examination showed erythema and a cold sensation in the affected leg. Ultrasound revealed no blood flow in certain leg arteries. Despite multiple thrombectomies and heparin treatment, only minimal improvement was observed. The patient underwent a below-knee amputation after unsuccessful attempts to restore blood flow. Her condition worsened with new vascular occlusions, requiring Catheter Direct Thrombolysis CDT. Post-CDT, she suffered severe bleeding, hemorrhagic shock, cardiac arrest, and multi-organ complications, leading to her death on treatment day 35. Discussion: This case illustrates the complexities of managing ALI in patients with nephrotic syndrome, which increases hypercoagulability and vascular complication risks. It highlights the need for an integrated nephrology and vascular approach, considering the high risks of hemorrhagic and thrombotic complications. A comprehensive and multidisciplinary treatment strategy is crucial, especially with vigilant monitoring for severe complications like infection and sepsis, to enhance treatment outcomes in similar cases. Conclusion: This case of a 23-year-old woman with ALI and nephrotic syndrome presented significant treatment challenges. Despite numerous interventions, including thrombectomies and CDT, severe complications ensued, emphasizing the need for comprehensive management and further research in similar complex conditions.
Strategi Manajemen Kardiomiopati Peripartum: Perkembangan Dalam Menghadapi Tantangan Kesehatan Maternal Setyowati, Danti Utami; Mayangsari, Veny; Tjahjono, Cholid
Jurnal Klinik dan Riset Kesehatan Vol 3 No 3 (2024): Edisi Juni
Publisher : RSUD Dr. Saiful Anwar Province of East Java

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.11594/jk-risk.03.3.7

Abstract

Cardiomyopathies are uncommon, although they are significant contributors to serious cardiovascular problems during pregnancy. Prior to pregnancy, it is crucial to have a thorough understanding of the potential dangers linked to cardiomyopathies and how to effectively treat them in pregnant women with significant pre-existing diseases. This knowledge is essential for providing appropriate guidance to patients. Given that all interventions relate to both the mother and the fetus, it is crucial to focus on providing the most efficient care for both. Maternal illness complicates pregnancy in approximately 1-4% of instances. There is a lack of comprehensive data on the frequency and occurrence of heart disease connected to pregnancy in most regions of the world including peripartum cardiomyopathy (PPCM) which was the predominant causes of maternal mortality in the UK in the mid of 2000’s. PPCM may result in persistent systolic dysfunction over an extended period of time. Although heart disease is a prominent, if not the primary, cause of death among pregnant or postpartum women across the country. PPCM is frequently misdiagnosed as a result of insufficient awareness among both medical professionals and the general public. The absence of an early and precise diagnosis of this ailment can have life-threatening implications for women affected by PPCM. Patients who had an early diagnosis saw a more expedited recovery compared to patients who received a late diagnosis. Improving the early monitoring, detection and diagnosis is linked to better recovery.
Peran Latihan Disupervisi pada Pasien dengan Penyakit Arteri Perifer Eksremitas Bawah Lestari, Defyna; Tjahjono, Cholid
Jurnal Klinik dan Riset Kesehatan Vol 4 No 2 (2025): Edisi Februari
Publisher : RSUD Dr. Saiful Anwar Province of East Java

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.11594/jk-risk.04.2.6

Abstract

Peripheral arterial disease is a disorder caused by decreased blood flow to the extremities. The process of atherosclerosis generally causes it and manifests as claudication. In addition to optimal medical and endovascular therapy, non-pharmacological management of PAP has been proven to be effective in reducing symptoms and improving walking ability and quality of life. Walking exercise can increase blood flow, which allows oxygen and nutrients to reach the muscles more efficiently and triggers the angiogenesis process. Supervised exercise programs in PAP patients are considered important as primary therapy to improve functional capacity and quality of life for long-term management.
Co-Authors Erickatulistiawan, Gallusena Kurnianingsih, Novi Lestari, Defyna Mayangsari, Veny Setyowati, Danti Utami