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Medical Scope Journal (MSJ)
Published by Universitas Sam Ratulangi
ISSN : -     EISSN : 27153312     DOI : https://doi.org/10.35790/msj
Core Subject : Health, Science,
Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Nursing Public Health
Medical Scope Journal (MSJ) diterbitkan oleh Perhimpunan Ahli Anatomi Indonesia (PAAI) Komisariat Manado bekerjasama dengan Fakultas Kedokteran Universitas Sam Ratulangi dua kali setahun pada bulan Juni dan Desember. Tulisan yang dimuat dapat berupa artikel telaah (review article), hasil penelitian, dan laporan kasus dalam bidang ilmu kedokteran baik dalam bahasa Indonesia maupun dalam bahasa Inggris.
Arjuna Subject : Kedokteran - Kedokteran (Lain-Lain)
Articles 231 Documents
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Effectiveness and Outcome of Electronic Medical Record in Patient Service: A Systematic Review Turido Pratama
Medical Scope Journal Vol. 6 No. 2 (2024): Medical Scope Journal
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/msj.v6i2.50383

Abstract

Abstract: Using electronic medical records is one endeavor to enhance healthcare services and patient outcomes. The electronic medical record (EMR) is employed in healthcare facilities to accomplish every objective. This studyaimed to  evaluate the effectiveness and effect of medical record usage in hospitals. This was a systematic review study. Three databases—PubMed, ScienceDirect, and Cochrane—were searched for research publications in this study. Publications published during the last ten years were targeted for search. Three reviewers were involved in the screening of the title and abstract to establish eligibility. Information was acquired from the studies included in this systematic review using a data extraction form that had been pilot tested. The results obtained a total of 1341 articles selected through a search process by entering keywords in a predetermined database. Articles based on inclusion and exclusion criteria were selected, so that, seven articles were included in this study. Most of the studies indicated that EMR benefited health workers to give better clinical performances to the patients, improving quality-adjusted life year (QALY) of the patients, and reduce the mortality rates. In conclusion, implementing the EMR system may benefit health workers and increase their hospital performance. Keywords: electronic medical record; outcome; hospital; health workers
Topical Lidocaine Gel Versus Tetracaine Eye Drops for Panretinal Photo-coagulation in Proliferative Diabetic Retinopathy Ade J. Nursalim; Vera Sumual; Andrew Chietra; Christian Komaling; Stevanus Loho; Ardelia E. Wulur
Medical Scope Journal Vol. 6 No. 1 (2024): Medical Scope Journal
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/msj.v6i1.51380

Abstract

Panretinal photocoagulation (PRP) is a treatment for proliferative diabetic retinopathy (PDR). The procedure needs anesthetic agent to overcome the pain. Two widely used anesthetic agents are used in this study which are tetracaine 0.5% eyedrops and lidocaine 2% gel. This study aimed to compare the effectivity and efficacy of both anesthetic agents. A prospective randomized controlled trial was done to 40 eyes divided into two groups, group A was treated with tetracaine 0.5% eyedrop and group B with lidocaine 2% gel. Pain score was obtained subjectively from the patient and recorded during four stages of procedure. The results showed that the mean age was 56.5 years in Group A and 53.20 years in group B. Average procedure duration was 8.7 minutes in group A and 9.35 minutes in group B. Average 5 minutes pain level was 3.05 and 2.10 in group A and B consecutively. Average 10 minutes pain level was 2.65 and 2.45 in group A and B consecutively. Average during procedure pain level was 2.70 and 3.40 in group A and Group B, and average post procedure pain level was 1.20 in Group A and 1.55 in Group B. There was no significant difference between both groups’ parameters. In conclusion, the use of both agents is interchangeable and shows no differences in efficacy and effectivity. Keywords: panretinal photocoagulation; proliferative diabetic retinopathy; anesthetic agent; tetracaine; lidocaine
Validity of Predictive Markers for Post ERCP Pancreatitis Patients: A Single Centre Study Michael Tendean; Toar D. B. Mambu; Leonard A. Melatunan
Medical Scope Journal Vol. 6 No. 2 (2024): Medical Scope Journal
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/msj.v6i2.51513

Abstract

Abstract: Endoscopic retrograde cholangiopancreatography (ERCP) is a proprietary procedure, endoscopic modality, and specialized procedure used to diagnose and treat disorders of the pancreatic and biliary systems. The incidence of reported post-ERCP complications varied among several studies including post ERCP pancreatitis (PEP), duodenal perforation, and cholangitis. In this study, the author would like to show certain intra procedural factors related to PEP incidence. This was a retrospective study of secondary data of patients undergoing ERCP procedures from 2017-2022 at Prof. Dr. R. D. Kandou Hospital, Manado. Length of procedure, cannulation on pancreatic duct, pancreatogram, double wire technique, and the use of certain common bile duct (CBD) stone retrieval techniques such as endoscopic papillary balloon dilatation (EPBD) were recorded and analyzed. The results showed that based on the analyzed data, the percentage of pancreas cannulation was 8%, pancreatogram 5%, double-wire technique 3%, and EPBD procedure 10%, Incidence rate of PEP in all ERCP procedures was 19%. Increased amylase/lipase enzymes were found in 13 of 24 patients (54%) who underwent cannulation; 8 of 16 patients (50%) who underwent pancreatogram; 4 of 9 patients (44%) who underwent double wire procedure; and 10 of 30 patients (33%) who underwent EPBD. This PEP could be caused by several risk factors during ERCP including cannulation, pancreatogram, double wire, and EPBD. Number of cannulation attempt could result in trauma to the ampulla. Pancreatogram could result in hydrostatic, chemical, and allergic injury. Any manipulation of the pancreas that caused trauma could trigger the incidence of PEP. Assessment of the occurrence of PEP was based on increases in lipase and amylase enzyme values by four times the normal value and tested 6 hours after procedure. We could reduce the incidence of PEP by providing prophylactic therapy before ERCP. In conclusion, PEP is the most common complication in ERCP procedures and can be risky in patients with high risk factors. In this study, factors that affecting the incidence of PEP are cannulation, pancreatogram, double wire and EPBD. Keywords: endoscopic retrograde cholangiopancreatography; pancreatitis; complications
Tiroidektomi Endoskopi Transoral dengan Pendekatan Vestibular Untuk Nodul Tiroid: Serial 12 Pasien Pertama di RSUP Prof. Dr. R. D. Kandou Riston R. Sitompul; Victor Pontoh; Marselus Merung; Christian Manginstar
Medical Scope Journal Vol. 6 No. 2 (2024): Medical Scope Journal
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/msj.v6i2.51515

Abstract

Abstract: Transoral endoscopic thyroidectomy by vestibular approach (TOETVA), showed a comparable result to the conventional thyroidectomy, without any scar as the advantage. This study aimed to present the feasibility and safety of patients with solitary or multinodular goitre and or papillary thyroid carcinoma using TOETVA. This was a case series using 12 patients recorded undergoing TOETVA procedure. Eleven patients’ specimen obtained through FNAB resulted as benign nodule. In one patient, the nodule was malignant and unilateral, therefore, endoscopic isthmolobectomy was performed. Outcomes and measures included conversion to open conventional surgery, operative time, intraoperative blood loss, size of the thyroid gland, postoperative hospital stay, visual analogue scores, and postoperative complications. The results showed a total of 12 patients; all were women, aged 33-64 years. The size of thyroid nodules ranged from 2 cm to 7 cm. One patient got converted to open isthmus lobectomy. In this series, none of the patients were noted to have mental nerve injury but two patients developed anterior neck chin skin bruise. The mean postoperative VAS measurements were 2, 1, and no pain or 0, on the first, second, third, and seventh postoperative days, respectively. In conclusion, endoscopic thyroidectomy is feasible, safe, and comparable to open thyroidectomy and yields excellent aesthetic results. Keywords: endoscopic thyroidectomy; minimally invasive surgical procedures; thyroid neoplasms    Abstrak: Tiroidektomi endoskopi transoral dengan pendekatan vestibular (TOETVA), menunjuk-kan hasil sebanding dengan tiroidektomi konvensional, tanpa adanya bekas luka sebagai keuntungan. Penelitian ini bertujuan untuk menyajikan kelayakan dan keamanan pasien dengan penyakit gondok soliter atau multinodular dan atau karsinoma tiroid papiler menggunakan TOETVA. Jenis penelitian ialah serial kasus yang menjalani TOETVA selama Januari 2018 hingga Desember 2019 di RSUP Prof. Dr. R. D. Kandou. Terdapat 12 pasien tercatat menjalani prosedur TOETVA; 11 spesimen pasien diambil melalui FNAB dan menghasilkan nodul jinak. Pada salah satu pasien didapatkan nodul ganas unilateral sehingga dilakukan istmolobektomi endoskopi. Hasil dan tindakan termasuk konversi ke operasi konvensional terbuka, waktu operasi, kehilangan darah intraoperatif, ukuran kelenjar tiroid, rawat inap pasca operasi, VAS, dan komplikasi pasca operasi. Hasil penelitian mendapatkan 12 pasien, semuanya berjenis kelamin perempuan, berusia 33-64 tahun. Ukuran nodul tiroid berkisar 2 - 7 cm. Satu pasien diubah menjadi lobektomi terbuka. Tidak ada pasien yang tercatat mengalami cedera saraf mental, namun dua pasien mengalami memar pada kulit dagu leher bagian depan. Rerata pengukuran VAS pasca operasi ialah 2, 1, dan tidak nyeri atau 0, masing-masing pada hari pertama, kedua, ketiga, dan ketujuh pasca operasi. Simpulan penelitian ini ialah tiroidektomi endoskopi layak dilakukan, aman dan sebanding dengan tiroidektomi terbuka serta memberikan hasil estetika yang sangat baik. Kata kunci: tiroidektomi endoskopi transoral; minimal invasif; neoplasma tiroid
Hubungan Tingkat Kepatuhan Minum Obat dengan Kadar Gula Darah dan Kualitas Hidup Pasien Diabetes Melitus Tipe 2 di Klinik Imanuel Manado Deby A. Mpila; Weny I. Wiyono; Widya A. Lolo
Medical Scope Journal Vol. 6 No. 1 (2024): Medical Scope Journal
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/msj.v6i1.51696

Abstract

Abstract: Effectiveness of therapy in patients with type 2 diabetes mellitus (T2DM) is strongly supported by medication adherence. This study aimed to determine the correlation between the level of medication adherence with blood glucose level and the quality of life (QoL) of patients with T2DM at the Imanuel Clinic Manado. This was an observational analytical study with a cross sectional design. Data were obtained prospectively in the period of August to September 2023 with a sample size of 45 respondents. Data of patient medication adherence were obtained using MARS-5 questionnaire; data of patient quality of life using the DQoL-BCI questionnaire; and data of blood glucose level (FPG/2-h PG) were obtained from patient medical records. The correlation between medication adherence and blood glucose levels was statistically analyzed using the chi-square test, while the correlation between medication adherence and patients’ QoL was analyzed using Spearman Rho. A p-value of <0.05 was considered statistically significant. The results showed that there were significant correlations between medication adherence and patients’ blood glucose level (p=0.017), as well as between medication adherence and patient QoL (p=0.05) with a positive correlation coefficient and moderate correlation level (r=0.294). In conclusion, medication adherence plays an important role in the management of type 2 diabetes mellitus patients to achieve blood glucose target and improved quality of life. Keywords: type 2 diabetes mellitus; medication adherence; blood glucose level; quality of life    Abstrak: Efektivitas terapi pada pasien diabetes melitus tipe 2 (DMT2) sangat didukung oleh kepatuhan minum obat. Penelitian ini bertujuan untuk mengetahui hubungan tingkat kepatuhan minum obat dengan kadar gula darah dan kualitas hidup pasien DMT2 di Klinik Imanuel Manado. Penelitian bersifat analitik observasional dengan desain potong lintang. Data diperoleh secara prospektif pada periode Agustus–September 2023 dengan jumlah sampel sebanyak 45 responden. Data kepatuhan minum obat diperoleh menggunakan kuesioner MARS-5; data kualitas hidup pasien menggunakan kuesioner DQoL-BCI; dan data kadar gula darah (GDP, GD2PP) diperoleh dari rekam medik pasien. Hubungan antara kepatuhan minum obat dan kadar gula darah dianalisis secara statistik menggunakan uji chi-square, sedangkan hubungan kepatuhan minum obat dan kualitas hidup pasien dianalisis menggunakan Spearman Rho. Nilai p<0,05 dianggap bermakna secara statistik. Hasil penelitian menunjukkan terdapat hubungan bermakna antara kepatuhan minum obat dengan kadar gula darah (p=0,017), serta antara kepatuhan minum obat dan kualitas hidup pasien (p=0,05), dengan koefisien korelasi arah positif dan tingkat korelasi cukup kuat (r=0,294). Simpulan penelitian ini ialah kepatuhan minum obat berperan penting dalam tatalaksana terapi pasien diabetes melitus tipe 2 untuk mencapai target kadar gula darah dan perbaikan kualitas hidup. Kata kunci: diabetes melitus tipe 2; kepatuhan minum obat; kadar gula darah; kualitas hidup
Pola Penggunaan Obat Antihipertensi pada Pasien Rawat Jalan di Rumah Sakit X Manado Widya A. Lolo; Gayatri Citraningtyas; Imam Jayanto
Medical Scope Journal Vol. 6 No. 1 (2024): Medical Scope Journal
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/msj.v6i1.51701

Abstract

Abstract: Hypertension is a degenerative disease with a high prevalence which is still a health problem worldwide. This study aimed to determine the pattern of the use of antihypertensive drugs in outpatients at X hospital in Manado. This was a descriptive and observational study with a cross sectional design. Data collection was carried out retrospectively by tracing patients’ medical record data in 2022. The results obtained 56 patients that met the criteria. The patients’ characteristic data showed that hypertension was dominant in women (59%), aged 56-65 years (27%), and included in controlled hypertension (55.4%). Data on drugs received by patients showed that out of 56 patients, there were 19 patients (34%) using a single antihypertensive and 37 patients (66%) using a combination of antihypertensives.  Amlodipine was the most widely used as single antihypertensive, namely 13 patients (68.5%), while the most widely used combination of antihypertensives was amlodipine and candesartan as many as 16 patients (43%). In conclusion, the most widely used single antihypertensive is amlodipine and the combination therapy is amlodipine and candesartan. Keywords: pattern of drug use; antihypertensives; single drug; combination therapy    Abstrak: Hipertensi merupakan salah satu penyakit degeneratif dengan prevalensi tinggi yang hingga kini masih menjadi masalah kesehatan di dunia. Penelitian ini bertujuan untuk mengetahui pola penggunaan obat antihipertensi pada pasien rawat jalan di rumah sakit X Manado. Metode penelitian yang digunakan ialah observasional deskriptif dengan rancangan potong lintang.  Pengumpulan data dilakukan secara retrospektif dengan menelusuri data rekam medis pasien tahun 2022. Hasil penelitian mendapatkan 56 pasien yang memenuhi kriteria penelitian. Pada data karakteristik pasien diketahui bahwa penyakit hipertensi dominan terjadi pada perempuan (59%), usia 56-65 tahun (27%), dan termasuk dalam hipertensi terkontrol (55,4%). Data obat yang diterima pasien menunjukkan bahwa dari 56 pasien, terdapat 19 pasien (34%) menggunakan antihipertensi tunggal dan 37 pasien (66%) menggunakan antihipertensi kombinasi. Amlodipin merupakan antihipertensi tunggal yang paling banyak digunakan yaitu sebanyak 13 dari 19 pasien (68,5%), sedangkan terapi antihipertensi kombinasi yang paling banyak digunakan yaitu amlodipin dan kandesartan sebanyak 16 dari 37 pasien (43%). Simpulan penelitian ini ialah obat antihipertensi tunggal yang paling banyak digunakan ialah amlodipin dan terapi kombinasi ialah  amlodipin dan kandesartan. Kata kunci: pola penggunaan obat; antihipertensi; obat tunggal; terapi kombinasi
Exploring the Therapeutic Benefits of Silymarin Herbal Extract as a Supplement to Pulmonary Tuberculosis Treatment: A Comprehensive Review from Laboratory to Clinical Trials Muhammad I. D. Rakasiwi; Muhammad Taufik; Gusti C. Pamungkas; Muhammad Z. B. Amaanullah; Idham R. Dewantara
Medical Scope Journal Vol. 6 No. 2 (2024): Medical Scope Journal
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/msj.v6i2.51870

Abstract

Abstract: Indonesia is ranked second in the number of tuberculosis (TB) cases with an incidence rate of 300 per 1000 population. A combination of antibiotics with a minimum six-month-administration regimen is an effective first line of TB treatment. Silymarin (Sm) is a plant extract which is known to have hepatoprotective and anti-microbial effects. This literature review aimed to discuss the potential of Sm in pulmonary TB treatment, starting from laboratory studies to clinical trials in humans. Studies on the use of Sm in tuberculosis literatures were obtained from a rapid systematic search in Pubmed and ScienceDirect databases. Supporting articles were searched based on specific keywords with inclusion criteria. The in vitro test showed immunomodulatory and bactericidal capacities of Sm against Mycobacterium tuberculosis. The in vivo test of Sm administration showed that Sm was able to increase the percentage of macrophage cells expressing the cytokines NF-κB and IFN-β. Sm had a bactericidal effect at levels >50 μM. The hepatoprotective character of Sm could prevent the increase in liver enzymes in mice receiving anti-TB drugs. Clinical trials showed that administration of Sm could prevent anti-tuberculosis drug hepatoxicity. In conclusion, silymarin has the potential to be an adjuvant therapy for the treatment of anti-TB drug-sensitive or resistant tuberculosis, as well as protection against the hepatotoxic properties of anti-TB drugs. Keywords: tuberculosis; silymarin; supplementation therapy; antituberculosis therapy
Efek Pemberian Suplementasi Kombinasi Vitamin C dan Albumin Terhadap Viabilitas Spermatozoa dalam Proses Sentrifugasi (Studi In Vitro) Maria K. A. Klau; Hudi Winarso; Florence Pribadi
Medical Scope Journal Vol. 6 No. 2 (2024): Medical Scope Journal
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/msj.v6i2.52488

Abstract

Abstract: Sperm centrifugation is an important process to obtain good spermatozoa for assisted reproductive techniques. However, the centrifugation process has additional impacts such as increased reactive oxygen species (ROS) and oxidative stress affecting sperm viability due to damage of spermatozoa membrane. The use of vitamin C (ascorbic acid) can reduce elevated ROS levels, thereby protecting DNA and spermatozoa from damage caused by oxidative stress, meanwhile albumin can reduce oxidative stress and maintain the integrity of spermatozoa membrane. This study aimed to obtain the effect of combination of vitamin C and albumin on spermatozoa viability in centrifugation process. This was a true experimental in vitro study using post-test-only control design. There were four groups in this study, as follows: the control group (K); the treatment group (P1), centrifugation without vitamin C and albumin; (P2), centrifugation with vitamin C; and (P3), centrifugation with a combination of vitamin C and albumin. The Mann-Whitney test for each group showed significantly differences in spermatozoa viability (p<0.05) among them. The treatment group receiving supplementation with a combination vitamin C and albumin produced the highest viability after the control group. In conclusion, supplementation of combination of vitamin C and albumin is capable in maintaining spermatozoa in centrifugation process. Keywords: assisted reproduction technique; centrifugation; spermatozoa viability; supplementation    Abstrak: Sentrifugasi sperma merupakan proses penting untuk mendapatkan spermatozoa yang baik dalam keperluan teknik bantu reproduksi, namun proses sentrifugasi memberi dampak lain yaitu terjadinya peningkatan reactive oxygen spesies (ROS) dan stres oksidatif yang memengaruhi viabilitas spermatozoa akibat rusaknya membran spermatozoa. Pemberian vitamin C (asam askorbat) dapat menurunkan kadar ROS yang meningkat sehingga melindungi DNA dan spermatozoa dari kerusakan akibat stres oksidatif sedangkan albumin mampu mengurangi stres oksidatif dan mempertahankan integritas membran spermatozoa. Penelitian ini bertujuan untuk mengevaluasi pengaruh kombinasi vitamin C dan albumin terhadap viabilitas spermatozoa. Jenis penelitian ialah true experimental in vitro menggunakan post test only control design dengan pengamatan pada kelompok kontrol (K); kelompok perlakuan (P1) sentrifugasi tanpa vitamin C dan albumin; (P2) sentrifugasi dengan vitamin C; dan (P3) sentrifugasi dengan kombinasi vitamin C dan albumin. Hasil uji Mann-Whitney dari masing-masing kelompok menunjukkan viabilitas spermatozoa yang berbeda bermakna (p<0,05) antar satu sama lain. Kelompok perlakuan yang mendapat suplementasi kombinasi vitamin C dan albumin menghasilkan viabilitas tertinggi setelah kelompok kontrol. Simpulan penelitian ini ialah suplementasi kombinasi vitamin C dan albumin mampu mempertahankan viabilitas spermatozoa dalam proses sentrifugasi. Kata kunci: teknik bantu reproduksi; sentrifugasi; viabilitas spermatozoa; suplementasi
Sindrom Wellens Tipe B dengan Penyumbatan pada Satu Pembuluh Darah Koroner: Laporan Kasus Edmond L. Jim
Medical Scope Journal Vol. 6 No. 1 (2024): Medical Scope Journal
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/msj.v6i1.52494

Abstract

Abstract: Wellens syndrome describes a pattern of electrocardiographic (ECG) changes, especially typical T waves, that threaten the patient's safety if further examination and management are delayed. We reported a 52-year-old male with a history of previous heart attacks. The patient had a history of hypertension, hypercholestrolemia, and active smoker. Vital signs indicated stable hemodynamics. On ECG examination, a deep inversion T wave was obtained in the V2-V6 leads. In echocardio-graphy, normal heart chamber dimensions, concentric LVH, with grade I diastolic dysfunction, LV EF 52% (SIMPSONS BP), apical to mid-anterior hypokinetics, other normokinetic segments, MR Mild, with normal RV contractility. Patient was carried out elective percutaneous coronary intervention (PCI) with the results of one kulprit lesion found in LAD, 50-60% proximal-mid stenosis, 80% distal tubular stenosis, discrete stenosis 50-60% D2, and Promus Premiere 2.5x20 mm stent installation in the distal LAD. The result of TIMI flow 3 angiography evaluation was no dissection or residual stenosis that concluded CAD 1VD post DCA-PCI with 1 Stent in LAD. After the PCI, complaint of chest pain was absent, vital sign examination and physical examinations were within normal limits. The therapy provided consisted of 0.9% NaCl infusion 500cc/24 hours intravenously for hydration after PCI, and dual antiplatelets After day-3 treatment there was no increase in urea and creatinine; therefore, outpatient treatment was carried out followed by phase 2 cardiac rehabilitation. Keywords: Wellens’ syndrome; typical T wave; stenosis; left anterior descending artery    Abstrak: Sindrom Wellens menggambarkan pola perubahan elektrokardiografi (EKG), terutama gelombang T tipikal yang mengancam keselamatan pasien bila terlambat dilakukan pemeriksaan dan penatalaksanaan lebih lanjut. Kami melaporkan seorang laki-laki beruria 52 tahun dengan riwayat serangan jantung sebelumnya. Pasien memiliki riwayat hipertensi, riwayat hiperkolestrolemia, dan perokok aktif. Tanda vital menunjukkan hemodinamik stabil. Pada pemeriksaan EKG  didapatkan gelombang T inversi dalam pada sadapan V2-V6. Pada ekokardiografi didapatkan dimensi ruang jantung normal, LVH konsentrik, dengan disfungsi diastolik grade I, LV EF 52% (SIMPSONS BP), hipokinetik apikal hingga mid anterior, segmen lain normokinetik, MR Mild , dengan kontraktilitas RV normal. Pasien dilakukan intervensi koroner perkutan elektif dengan hasil satu lesi kulprit terdapat pada LAD, stenosis 50-60% proksimal-mid, stenosis tubular 80% distal, stenosis diskret 50-60% D2, dan dilakukan pemasangan stent Promus Premiere 2,5x20mm di distal LAD. Hasil evaluasi angiografi TIMI flow 3, tidak terdapat diseksi, ataupun stenosis residual yang menyimpulkan CAD 1VD post DCA-PCI dengan 1 Stent di LAD. Pasca tindakan, keluhan nyeri dada tidak ada, pemeriksaan tanda vital dan pemeriksaan fisik dalam batas normal. Terapi yang diberikan terdiri dari infus NaCl 0,9% 500cc/24jam intravena untuk hidrasi setelah IKP dan dual antiplatelet. Setelah perawatan hari ke 3 tidak didapatkan peningkatan ureum dan kreatinin, dilakukan rawat jalan yang dilanjutkan dengan rehabilitasi jantung fase 2. Kata kunci: sindrom Wellens; gelombang T tipikal; stenosis; left anterior descending artery
Effect of Acetazolamide Additional Therapy on Loop Diuretic for Achieving an Effective Treatment in Acute Heart Failure Patients: A Systematic Review Annisa T. Fadilla; Muhammad Sabri; Idham Junantaruna; Ajibaskoro P. Ibrahim
Medical Scope Journal Vol. 6 No. 1 (2024): Medical Scope Journal
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/msj.v6i1.52794

Abstract

Abstract: Hospital readmissions are primarily caused by signs and symptoms of congestion of acute heart failure (AHF). Loop diuretics are commonly used to treat volume excess. It has been suggested by earlier studies in AHF patients that combination of loop diuretics with acetazolamide can increase the effectiveness of loop diuretics. This study aimed to obtain the impact of acetazolamide addition on loop diuretic therapy in AHF patients and assess the benefit of the combination. This was a systematic review using PubMed and ScienceDirect to retrieve data in 2013 and 2023, focusing on Randomized Controlled Trials (RCTs) involving AHF patients treated with both loop diuretics and acetazolamide. The results showed that 573 patients from a total of four RCTs were included in the study. Acetazolamide additional therapy helped loop diuretic to increase natriuresis (in all of the studies) and urine output (in two studies). The congestion symptoms also reduced in patients who received acetazolamide additional therapy on dose 500 mg intravenously within three days (p<0.05) in two studies. However, patients who received acetazolamide therapy also had an increase in serum creatinine levels in two studies. In conclusion, adding acetazolamide to loop diuretic therapy can increase the effectiveness of loop diuretics to achieve successful decongestion in AHF patients. Additionally, acetazolamide-treated individuals exhibit natriuresis and urin output higher than those in the control group, despite it also raises serum creatinin level. Keywords: acetazolamide; loop diuretics; acute heart failure; decongestion

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