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Case report: Therapeutic approach to secondary polycythemia vera in an adult with eisenmenger syndrome Lil Alamin, Rahmatan; Raharjo, Fajar; Gunawan, Michelle; Wardhani, Shinta
Deka in Medicine Vol. 1 No. 3 (2024): December 2024
Publisher : PT. DEKA RESEARCH INSTITUTE

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.69863/dim.2024.e433

Abstract

BACKGROUND: Secondary Polycythemia Vera due to Eisenmenger Syndrome remains a big challenge, and the reported cases regarding this condition are still scanty. CASE: This was a case of a 22-year-old girl who, since childhood, had complaints of fatigue most of the time and thus showed more intolerance to heavy physical work. She had a history of a congenital heart defect, with lip and finger cyanosis that increased upon fatigue, and she had undergone Bi-directional Cavo-pulmonary Shunt. Physical examination showed cyanosis with clubbing of fingers with low oxygen saturation. Further diagnosis testing revealed this was a case of Eisenmenger Syndrome due to congenital heart abnormalities, with Polycythemia Vera: Secondary to the diagnosis. The patient also had a hemoglobin level of 21.1g/dL and a hematocrit level of 64.2%. Based on the diagnosis, treatment was given in the form of hydration therapy along with medications. Additionally, phlebotomy was performed. Because the patient improved clinically from the applied treatment, the patient was discharged after 5 days. CONCLUSION: Early diagnosis, a multidisciplinary approach, and proper interventions are important in the management of Eisenmenger Syndrome and associated Polycythemia Vera to avoid complications and hence improve outcomes.
From joint to heart: Cardiovascular implications of rheumatoid arthritis Raharjo, Fajar; Anjarwani, Setyasih
Deka in Medicine Vol. 1 No. 3 (2024): December 2024
Publisher : PT. DEKA RESEARCH INSTITUTE

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.69863/dim.2024.e361

Abstract

Rheumatoid arthritis is a commonly encountered autoimmune disease and a progressive chronic inflammatory condition that often leads to permanent joint damage. Systemic inflammation in rheumatoid arthritis is linked to various comorbid conditions such as interstitial lung disease, osteoporosis, metabolic syndrome, cardiovascular disease, infections, malignancies, cognitive dysfunction, depression, and fatigue, which can increase morbidity and mortality in rheumatoid arthritis patients. Approximately 36% of patients report worse health and limitations in daily activities, while nearly 30% require more assistance with personal care compared to individuals without rheumatoid arthritis. Epidemiological data from 1990 to 2017 show an incidence of rheumatoid arthritis of 246.6 per 100,000 people aged 33-54 years, with prevalence in women 2-3 times higher. In Southeast Asia, the incidence is 89 per 100,000 in individuals aged 13-22 years, while in Indonesia, it is estimated at around 5-7.5 per 100,000 population. Cardiovascular disease is the primary cause of mortality in rheumatoid arthritis patients, with myocardial infarction being the major contributor. The pathogenesis of rheumatoid arthritis is still complex and involves immunological processes that occur long before joint inflammation symptoms appear, including genetic modifications and environmental factors that lead to deimination and joint disturbances. Cardiovascular manifestations, particularly myocardial infarction, occur due to an atherosclerotic process triggered by rheumatoid antibody complexes. Given the higher cardiovascular risk in rheumatoid arthritis patients, early detection and awareness of these manifestations are crucial for better management.
SISTEM PENDUKUNG KEPUTUSAN METODE SAW UNTUK SELEKSI PPNPN TELADAN DI STASIUN METEOROLOGI AHMAD YANI Palupi, Dian; Eksawati, Rini; Raharjo, Fajar; Wiratno, Amat; Nugroho, Kristiawan; Ardhianto, Eka
JOURNAL OF SCIENCE AND SOCIAL RESEARCH Vol 8, No 3 (2025): August 2025
Publisher : Smart Education

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.54314/jssr.v8i3.4157

Abstract

Abstract: The selection of exemplary Government Employees Non-Civil Servants (PPNPN) is a strategic initiative aimed at fostering a productive, disciplined, and professional work culture within government institutions. This system is designed to assist the evaluation and selection process of outstanding PPNPN at Ahmad Yani Meteorological Station, replacing conventional assessment methods that previously focused mainly on attendance and communication, which were often considered subjective and time-consuming. The evaluation involved 10 PPNPN assessed based on eight key criteria: productivity, personality and loyalty, attendance, job responsibility, initiative, honesty, neatness, and teamwork. Data were collected through questionnaires distributed to Civil Servants (ASN) at Ahmad Yani Meteorological Station, who are directly involved in the daily performance assessment of the PPNPN. The results show that the Simple Additive Weighting (SAW) method effectively ranked PPNPN performance, with the highest score of 100 achieved by MH and the lowest score of 95.2 by HS. The implementation of the SAW method is expected to provide transparent, objective, and measurable results to support data-driven decision-making in employee performance evaluations. Keyword: Decision Support System; SAW; PPNPN; Performance Evaluation Abstrak: Pemilihan Pegawai Pemerintah Non Pegawai Negeri (PPNPN) teladan merupakan langkah strategis dalam mendorong budaya kerja yang produktif, disiplin, dan profesional di lingkungan instansi pemerintahan. Sistem ini dirancang untuk menjadi alat bantu dalam proses evaluasi dan seleksi PPNPN teladan di Stasiun Meteorologi Ahmad Yani, menggantikan metode penilaian konvensional yang sebelumnya hanya berpusat pada presensi dan komunikasi yang dinilai kurang objektif dan memakan waktu. Prosesevaluasi melibatkan 10 orang PPNPN yang dinilai berdasarkan delapan kriteria utama, yakni produktivitas, perilaku kepribadian dan loyalitas, kehadiran, tanggung jawab pekerjaan, inisiatif, kejujuran, kerapihan, dan kerjasama. Data dikumpulkan melalui penyebaran kuesioner kepada Aparatur Sipil Negara (ASN) di Stasiun Meteorologi Ahmad Yani sebagai responden yang terlibat langsung dalam penilaian kinerja harian para PPNPN. Hasil penelitian menunjukan bahwa metode SAW berhasil menyusun peringkat kinerja PPNPN secara efektif. Dimana didapat nilai tertinggi yaitu 100 atas nama MH dan nilai terendah yaitu HS dengan nilai 95.2. Dengan metode SAW ini diharapkan mampu memberikan hasil yang transparan, objektif, dan terukur dalam mendukung proses pengambilan keputusan berbasis data dalam evaluasi kinerja pegawai. Kata kunci: Sistem Pendukung Keputusan; Simple Additive Weighting; PPNPN;                    Penilaian Kinerja