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Kurniawan RB, Oktafia P, Saputra PBT, Purwati DD, Saputra ME, Maghfirah I, Faizah NN, Oktaviono YH, Alkaff FF. The roles of C-reactive protein-albumin ratio as a novel prognostic biomarker in heart failure patients: A systematic review. Curr Probl Cardiol 2024; 49:102475. [PMID: 38401823 DOI: 10.1016/j.cpcardiol.2024.102475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Accepted: 02/20/2024] [Indexed: 02/26/2024]
Abstract
C-Reactive Protein (CRP)-albumin ratio (CAR) is a novel prognostic biomarker that is predicted to be a more reliable indicator than CRP or albumin alone. Therefore, this systematic review aimed to evaluate the role of CAR in predicting poor outcomes of heart failure (HF) patients. We conducted a literature search across ProQuest, PubMed, ScienceDirect, Web of Science, and Scopus. All related studies assessing CAR and reporting mortality outcomes or other adverse outcomes were assessed. A total of five studies with a total of 1821 patients were included in this review. CAR is significantly associated with all-causes in-hospital mortality and out-hospital mortality in patients with acute and chronic heart failure. CAR is associated with higher hospitalization rates, the number of hospitalizations, severe New York Heart Association (NYHA) classification, and the risk of advanced HF. In conclusion, CAR is significantly associated with poor HF outcomes including all-cause mortality (cardiac and non-cardiac death).
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Affiliation(s)
| | - Pratista Oktafia
- Faculty of Medicine, Universitas Airlangga, Surabaya, East Java, Indonesia
| | - Pandit Bagus Tri Saputra
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Airlangga - Dr. Soetomo General Academic Hospital, Surabaya, East Java, Indonesia; Cardiovascular Research and Innovation Center, Universitas Airlangga, Surabaya, East Java, Indonesia
| | - Dinda Dwi Purwati
- Faculty of Medicine, Universitas Airlangga, Surabaya, East Java, Indonesia
| | - Mahendra Eko Saputra
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Airlangga - Dr. Soetomo General Academic Hospital, Surabaya, East Java, Indonesia; Cardiovascular Research and Innovation Center, Universitas Airlangga, Surabaya, East Java, Indonesia
| | - Irma Maghfirah
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Airlangga - Dr. Soetomo General Academic Hospital, Surabaya, East Java, Indonesia; Cardiovascular Research and Innovation Center, Universitas Airlangga, Surabaya, East Java, Indonesia
| | - Novia Nurul Faizah
- Division of Cardiovascular Medicine, Graduate School of Medicine, Kobe University, Kobe, Japan
| | - Yudi Her Oktaviono
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Airlangga - Dr. Soetomo General Academic Hospital, Surabaya, East Java, Indonesia; Cardiovascular Research and Innovation Center, Universitas Airlangga, Surabaya, East Java, Indonesia.
| | - Firas Farisi Alkaff
- Division of Nephrology, Department of Internal Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands; Division of Pharmacology and Therapy, Department of Anatomy, Histology, and Pharmacology, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia.
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Purba AKR, Rosyid AN, Handayani S, Rachman BE, Romdhoni AC, Al Farabi MJ, Wahyuhadi J, Prananingtias R, Rahayu AN, Alkaff FF, Azmi YA, Prasetyo S, Nadjib M, Gutjahr LP, Humaidy RF. Economic Evaluation of COVID-19 Screening Tests and Surveillance Strategies in Low-Income, Middle-Income, and High-Income Countries: A Systematic Review. Med Sci Monit 2024; 30:e943863. [PMID: 38643358 PMCID: PMC11044836 DOI: 10.12659/msm.943863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Accepted: 03/11/2024] [Indexed: 04/22/2024] Open
Abstract
BACKGROUND Economic evaluation of the testing strategies to control transmission and monitor the severity of COVID-19 after the pandemic is essential. This study aimed to review the economic evaluation of COVID-19 tests and to construct a model with outcomes in terms of cost and test acceptability for surveillance in the post-pandemic period in low-income, middle-income, and high-income countries. MATERIAL AND METHODS We performed the systematic review following PRISMA guidelines through MEDLINE and EMBASE databases. We included the relevant studies that reported the economic evaluation of COVID-19 tests for surveillance. Also, we input current probability, sensitivity, and specificity for COVID-19 surveillance in the post-pandemic period. RESULTS A total of 104 articles met the eligibility criteria, and 8 articles were reviewed and assessed for quality. The specificity and sensitivity of COVID-19 screening tests were reported as 80% to 90% and 40% to 90%, respectively. The target population presented a mortality rate between 0.2% and 19.2% in the post-pandemic period. The implementation model of COVID-19 screening tests for surveillance with a cost mean for molecular and antigen tests was US$ 46.64 (min-max US $0.25-$105.39) and US $6.15 (min-max US $2-$10), respectively. CONCLUSIONS For the allocation budget for the COVID-19 surveillance test, it is essential to consider the incidence and mortality of the post-pandemic period in low-income, middle-income, and high-income countries. A robust method to evaluate outcomes is needed to prevent increasing COVID-19 incidents earlier.
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Affiliation(s)
- Abdul Khairul Rizki Purba
- Division of Pharmacology and Therapy, Department of Anatomy Histology and Pharmacology, Faculty of Medicine, Universitas Airlangga, Surabaya, Eest Java, Indonesia
- Department of Health Science, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
- Medical Education Master Program, Faculty of Medicine, Universitas Airlangga, Surabaya, West Java, Indonesia
| | - Alfian Nur Rosyid
- Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Airlangga, Surabaya, Eest Java, Indonesia
| | - Samsriyaningsih Handayani
- Department of Public Health and Preventive Medicine, Faculty of Medicine, Universitas Airlangga, Surabaya, Eest Java, Indonesia
| | - Brian Eka Rachman
- Department of Internal Medicine, Faculty of Medicine, Universitas Airlangga, Surabaya, Eest Java, Indonesia
| | - Achmad Chusnu Romdhoni
- Department of Otorhinolaryngology-Head and Neck Surgery, Faculty of Medicine, Universitas Airlangga, Surabaya, Eest Java, Indonesia
| | - Makhyan Jibril Al Farabi
- Department of Cardiology and Vascular Medicine, Universitas Airlangga/Soetomo General Hospital, Surabaya, Eest Java, Indonesia
| | - Joni Wahyuhadi
- Department of Neurosurgery, Faculty of medicine, Universitas Airlangga, Surabaya, Eest Java, Indonesia
| | - Rosita Prananingtias
- Department of Medical Record, Universitas Airlangga Hospital, Surabaya, Eest Java, Indonesia
| | - Ainun Nitsa Rahayu
- Faculty of Medicine, Universitas Airlangga, Surabaya, Eest Java, Indonesia
| | - Firas Farisi Alkaff
- Division of Pharmacology and Therapy, Department of Anatomy, Histology, and Pharmacology, Faculty of Medicine, Universitas Airlangga, Surabaya, Eest Java, Indonesia
- Division of Nephrology, Department of Internal Medicine, University Medical Center Groningen, Groningen, The Netherlands
| | - Yufi Aulia Azmi
- Department of Urology, Faculty of Medicine, Universitas Airlangga-Dr. Soetomo General Academic Hospital, Surabaya, Eest Java, Indonesia
- Department Department of Health Sciences, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Sabarinah Prasetyo
- Department of Biostatistic and Population Studies, Faculty of Public Health, Universitas Indonesia, Depok, West Java, Indonesia
| | - Mardiati Nadjib
- Department of Health Administration and Health Policy, Faculty of Public Health, Universitas Indonesia, Depok, West Java, Indonesia
| | | | - Raudia Faridah Humaidy
- Department of Public Health and Preventive Medicine, Faculty of Medicine, Universitas Airlangga, Surabaya, Eest Java, Indonesia
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Widiarti W, Saputra PBT, Mustofa A, Meitavany EN, Oktaviono YH, Alkaff FF. The roles of thyroidectomy in patients with amiodarone-induced thyrotoxicosis: A systematic review. Curr Probl Cardiol 2024; 49:102395. [PMID: 38232922 DOI: 10.1016/j.cpcardiol.2024.102395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Accepted: 01/14/2024] [Indexed: 01/19/2024]
Abstract
The principal management of Amiodarone-induced-thyrotoxicosis (AIT) is balancing cardiac-thyroid conditions. However, the role of thyroidectomy is still contentious. This systematic review aims to provide insights into the roles of thyroidectomy in the management of AIT. This systematic review encompasses 303 AIT patients who underwent thyroidectomy from 14 studies. The indication of thyroidectomy can be due to cardiac factors, thyrotoxicosis conditions, and patient-physician considerations. Thyroidectomy is more effective in improving thyroid hormone status, cardiac function, and mortality compared to optimal medical therapy, especially in those with left ventricular ejection fraction < 40 %. Thyroidectomy is effective in improving cardiac function and mortality due to shorter duration for achieving euthyroid. Thyroidectomy and medical therapy have comparable side effects. However, the identification of high-risk patients may reduce thyroidectomy complications. Thus, thyroidectomy should not be viewed as the last resource and should be performed immediately when indicated.
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Affiliation(s)
| | - Pandit Bagus Tri Saputra
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Airlangga - Dr. Soetomo General Academic Hospital, Surabaya, Indonesia; Cardiovascular Research and Innovation Center, Universitas Airlangga, Surabaya, Indonesia
| | - Ali Mustofa
- Faculty of Medicine, Universitas Airlangga, Indonesia
| | - Estya Nadya Meitavany
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom
| | - Yudi Her Oktaviono
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Airlangga - Dr. Soetomo General Academic Hospital, Surabaya, Indonesia; Cardiovascular Research and Innovation Center, Universitas Airlangga, Surabaya, Indonesia.
| | - Firas Farisi Alkaff
- Division of Nephrology, Department of Internal Medicine, University Medical Center Groningen, Groningen, Netherlands; Division of Pharmacology and Therapy, Department of Anatomy, Histology, and Pharmacology, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia.
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Oktaviono YH, Saputra PBT, Arnindita JN, Afgriyuspita LS, Kurniawan RB, Pasahari D, Milla C, Wungu CDK, Susilo H, Multazam CECZ, Alkaff FF. Clinical characteristics and surgical outcomes of cardiac myxoma: A meta-analysis of worldwide experience. Eur J Surg Oncol 2024; 50:107940. [PMID: 38219702 DOI: 10.1016/j.ejso.2023.107940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2023] [Accepted: 12/26/2023] [Indexed: 01/16/2024]
Abstract
Cardiac myxoma is the most common primary cardiac tumor. However, existing literature mainly consists of single-center experiences with limited subjects. This systematic review aimed to provide data on clinical characteristics and surgical outcomes of cardiac myxoma. We performed a thorough literature search on May 23, 2023 on PubMed, ProQuest, ScienceDirect, Scopus, and Web of Science. The inclusion criteria were English full-text, observational studies, and included >20 subjects. From the search, 112 studies with a total of 8150 patients were included in the analysis. The mean age was 51 years (95 % confidence interval [95%CI] = 49.1-52.3), and the majority were females (64.3 % [95 % CI = 62.8-65.8 %]). The most common clinical manifestation was cardiovascular symptoms. Echocardiography can diagnose almost all cases (98.1 % [95 % CI = 95.8-99.6 %]). Cardiac myxoma was mostly prevalent in left atrium (85.3 % [95%CI = 83.3-87 %]) and predominantly with pedunculated morphology (75.6 % [95%CI = 64.1-84.3 %]). Post-tumor excision outcomes were excellent, with an early mortality of 1.27 % (95 % CI = 0.8-1.8 %), late mortality rate of 4.7 (95 % CI = 2.5-7.4) per 1000 person-years, and recurrence rate at 0.5 (95 % CI = 0.0-1.1) per 1000 person-years. Tumor excision is warranted in a timely manner once the cardiac myxoma diagnosis is established.
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Affiliation(s)
- Yudi Her Oktaviono
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Airlangga - General Academic Hospital Dr. Soetomo, Surabaya, Indonesia; Cardiovascular Research and Innovation Center, Universitas Airlangga, Surabaya, Indonesia.
| | - Pandit Bagus Tri Saputra
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Airlangga - General Academic Hospital Dr. Soetomo, Surabaya, Indonesia; Cardiovascular Research and Innovation Center, Universitas Airlangga, Surabaya, Indonesia.
| | - Jannatin Nisa Arnindita
- Cardiovascular Research and Innovation Center, Universitas Airlangga, Surabaya, Indonesia; Faculty of Medicine, Universitas Airlangga, Indonesia
| | | | | | - Diar Pasahari
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Airlangga - General Academic Hospital Dr. Soetomo, Surabaya, Indonesia
| | - Clonia Milla
- Faculty of Medicine, Universitas Airlangga, Indonesia
| | - Citrawati Dyah Kencono Wungu
- Department of Physiology and Medical Biochemistry, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia; Institute of Tropical Disease, Universitas Airlangga, Surabaya, Indonesia
| | - Hendri Susilo
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Airlangga - Universitas Airlangga Hospital, Surabaya, East Java, Indonesia
| | | | - Firas Farisi Alkaff
- Division of Nephrology, Department of Internal Medicine, University Medical Center Groningen, Groningen, Netherlands; Division of Pharmacology and Therapy, Department of Anatomy, Histology, and Pharmacology, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia.
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Wirjopranoto S, Alkaff FF, Yogiswara N, Azmi YA, Purba AKR, Soetanto KM. Pediatric genitourinary injuries: 7-year experience at the largest tertiary referral hospital in Eastern part of Indonesia. J Pediatr Urol 2024; 20:117.e1-117.e5. [PMID: 37863703 DOI: 10.1016/j.jpurol.2023.09.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 08/28/2023] [Accepted: 09/25/2023] [Indexed: 10/22/2023]
Abstract
INTRODUCTION The anatomical variations between children and adults render pediatric patients more prone to urogenital trauma. However, it is not known for certain whether children are more prone to genitourinary trauma than adults. The aim of the study is to scrutinize the characteristic of pediatric genitourinary trauma at, the largest tertiary hospital in Eastern part of Indonesia. STUDY DESIGN The design of the study was analytic retrospective gathering medical records of all pediatric patients with urogenital trauma with total sampling. The number of patients, ages, genders, etiology, locations, and management were collected. Data was statistically analyzed using SPSS®, and p < 0.05 was considered statistically significant. RESULTS We found 13.5 (10-15.5) years as the median age in our 60 samples. Boy (75.00%), renal trauma (56.67%), abdominal and pelvic trauma (96.67%), traffic accident (91.67%), suprapubic catheterization (52.17%), and hemodynamically stable (91.67) was among the majority. We also found that non-operative management was in majority. Statistical analysis demonstrated significant differences for management and grade of injury (p < 0.05). DISCUSSIONS This is, to the best of our knowledge, the first study of genitourinary injuries in children who were treated at a tertiary hospital in Indonesia during the course of the 7-year research period. The limitations of this study are retrospective character and conducted in single institution. CONCLUSION The highest incidence of pediatric urogenital trauma is renal trauma due to traffic accident, which often multitrauma. Future prospective multi-center studies should be done to corroborate the results.
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Affiliation(s)
- Soetojo Wirjopranoto
- Department of Urology, Faculty of Medicine, Universitas Airlangga, the Netherlands.
| | - Firas Farisi Alkaff
- Division of Pharmacology and Therapy, Department of Anatomy, Histology, And Pharmacology, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia; Division of Nephrology, Department of Internal Medicine, University Medical Center Groningen, Groningen, the Netherlands.
| | - Niwanda Yogiswara
- Department of Urology, Faculty of Medicine, Universitas Airlangga, the Netherlands.
| | - Yufi Aulia Azmi
- Department of Urology, Faculty of Medicine, Universitas Airlangga, Groningen, the Netherlands; Department of Health Sciences, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
| | - Abdul Khairul Rizki Purba
- Division of Pharmacology and Therapy, Department of Anatomy, Histology, And Pharmacology, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia.
| | - Kevin Muliawan Soetanto
- Department of Immunology, Faculty of Medicine Siriraj Hospital, Mahidol University, Thailand.
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Alsagaff MY, Wardhani LFK, Nugraha RA, Putra TS, Khrisna BPD, Al-Farabi MJ, Gunadi RI, Azmi Y, Budianto CP, Fagi RA, Luthfah N, Subagjo A, Oktaviono YH, Lefi A, Dharmadjati BB, Alkaff FF, Pikir BS. Quantification of hs-Troponin Levels and Global Longitudinal Strain among Critical COVID-19 Patients with Myocardial Involvement. J Clin Med 2024; 13:352. [PMID: 38256486 PMCID: PMC10816186 DOI: 10.3390/jcm13020352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 12/29/2023] [Accepted: 12/30/2023] [Indexed: 01/24/2024] Open
Abstract
Background. Myocardial involvement among critically ill patients with coronavirus disease 2019 (COVID-19) often has worse outcomes. An imbalance in the oxygen supply causes the excessive release of pro-inflammatory cytokines, which results in increased ventilation requirements and the risk of death in COVID-19 patients. Purpose. We evaluated the association between the hs-troponin I levels and global longitudinal strain (GLS) as evidence of myocardial involvement among critical COVID-19 patients. Methods. We conducted a prospective cohort study from 1 February to 31 July 2021 at RSUD Dr. Soetomo, Surabaya, as a COVID-19 referral center. Of the 65 critical COVID-19 patients included, 41 (63.1%) were men, with a median age (interquartile range) of 51.0 years (20.0-75.0). Subjects were recruited based on WHO criteria for severe COVID-19, and myocardial involvement in the form of myocarditis was assessed using CDC criteria. Subjects were examined using echocardiography to measure the GLS, and blood samples were taken to measure the hs-troponin. Subjects were then followed for their need for mechanical ventilation and in-hospital mortality. Results. Severe COVID-19 patients with cardiac injury were associated with an increased need for intubation (78.5%) and an increased incidence of myocarditis (50.8%). There was a relationship between the use of intubation and the risk of death in patients (66.7% vs. 33.3%, p-value < 0.001). Decreased GLS and increased hs-troponin were associated with increased myocarditis (p values < 0.001 and 0.004, respectively). Decreased GLS was associated with a higher need for mechanical ventilation (12.17 + 4.79 vs. 15.65 + 4.90, p-value = 0.02) and higher mortality (11.36 + 4.64 vs. 14.74 + 4.82; p-value = 0.005). Elevated hs-troponin was associated with a higher need for mechanical ventilation (25.33% vs. 3.56%, p-value = 0.002) and higher mortality (34.57% vs. 5.76%, p-value = 0.002). Conclusions. Critically ill COVID-19 patients with myocardial involvement and elevated cardiac troponin levels are associated with a higher need for mechanical ventilation and higher mortality.
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Affiliation(s)
- Mochamad Yusuf Alsagaff
- Department of Cardiology and Vascular Medicine, Faculty of Medicine Universitas Airlangga—Dr. Soetomo General Hospital, Jalan Mayjend Prof. Dr. Moestopo 6-8, Surabaya 60286, Indonesia; (L.F.K.W.); (R.A.N.); (T.S.P.); (B.P.D.K.); (M.J.A.-F.); (R.I.G.); (Y.A.); (C.P.B.); (R.A.F.); (N.L.); (A.S.); (Y.H.O.); (A.L.); (B.B.D.); (B.S.P.)
| | - Louisa Fadjri Kusuma Wardhani
- Department of Cardiology and Vascular Medicine, Faculty of Medicine Universitas Airlangga—Dr. Soetomo General Hospital, Jalan Mayjend Prof. Dr. Moestopo 6-8, Surabaya 60286, Indonesia; (L.F.K.W.); (R.A.N.); (T.S.P.); (B.P.D.K.); (M.J.A.-F.); (R.I.G.); (Y.A.); (C.P.B.); (R.A.F.); (N.L.); (A.S.); (Y.H.O.); (A.L.); (B.B.D.); (B.S.P.)
| | - Ricardo Adrian Nugraha
- Department of Cardiology and Vascular Medicine, Faculty of Medicine Universitas Airlangga—Dr. Soetomo General Hospital, Jalan Mayjend Prof. Dr. Moestopo 6-8, Surabaya 60286, Indonesia; (L.F.K.W.); (R.A.N.); (T.S.P.); (B.P.D.K.); (M.J.A.-F.); (R.I.G.); (Y.A.); (C.P.B.); (R.A.F.); (N.L.); (A.S.); (Y.H.O.); (A.L.); (B.B.D.); (B.S.P.)
| | - Tony Santoso Putra
- Department of Cardiology and Vascular Medicine, Faculty of Medicine Universitas Airlangga—Dr. Soetomo General Hospital, Jalan Mayjend Prof. Dr. Moestopo 6-8, Surabaya 60286, Indonesia; (L.F.K.W.); (R.A.N.); (T.S.P.); (B.P.D.K.); (M.J.A.-F.); (R.I.G.); (Y.A.); (C.P.B.); (R.A.F.); (N.L.); (A.S.); (Y.H.O.); (A.L.); (B.B.D.); (B.S.P.)
| | - Bagus Putra Dharma Khrisna
- Department of Cardiology and Vascular Medicine, Faculty of Medicine Universitas Airlangga—Dr. Soetomo General Hospital, Jalan Mayjend Prof. Dr. Moestopo 6-8, Surabaya 60286, Indonesia; (L.F.K.W.); (R.A.N.); (T.S.P.); (B.P.D.K.); (M.J.A.-F.); (R.I.G.); (Y.A.); (C.P.B.); (R.A.F.); (N.L.); (A.S.); (Y.H.O.); (A.L.); (B.B.D.); (B.S.P.)
| | - Makhyan Jibril Al-Farabi
- Department of Cardiology and Vascular Medicine, Faculty of Medicine Universitas Airlangga—Dr. Soetomo General Hospital, Jalan Mayjend Prof. Dr. Moestopo 6-8, Surabaya 60286, Indonesia; (L.F.K.W.); (R.A.N.); (T.S.P.); (B.P.D.K.); (M.J.A.-F.); (R.I.G.); (Y.A.); (C.P.B.); (R.A.F.); (N.L.); (A.S.); (Y.H.O.); (A.L.); (B.B.D.); (B.S.P.)
| | - Ruth Irena Gunadi
- Department of Cardiology and Vascular Medicine, Faculty of Medicine Universitas Airlangga—Dr. Soetomo General Hospital, Jalan Mayjend Prof. Dr. Moestopo 6-8, Surabaya 60286, Indonesia; (L.F.K.W.); (R.A.N.); (T.S.P.); (B.P.D.K.); (M.J.A.-F.); (R.I.G.); (Y.A.); (C.P.B.); (R.A.F.); (N.L.); (A.S.); (Y.H.O.); (A.L.); (B.B.D.); (B.S.P.)
| | - Yusuf Azmi
- Department of Cardiology and Vascular Medicine, Faculty of Medicine Universitas Airlangga—Dr. Soetomo General Hospital, Jalan Mayjend Prof. Dr. Moestopo 6-8, Surabaya 60286, Indonesia; (L.F.K.W.); (R.A.N.); (T.S.P.); (B.P.D.K.); (M.J.A.-F.); (R.I.G.); (Y.A.); (C.P.B.); (R.A.F.); (N.L.); (A.S.); (Y.H.O.); (A.L.); (B.B.D.); (B.S.P.)
| | - Christian Pramudita Budianto
- Department of Cardiology and Vascular Medicine, Faculty of Medicine Universitas Airlangga—Dr. Soetomo General Hospital, Jalan Mayjend Prof. Dr. Moestopo 6-8, Surabaya 60286, Indonesia; (L.F.K.W.); (R.A.N.); (T.S.P.); (B.P.D.K.); (M.J.A.-F.); (R.I.G.); (Y.A.); (C.P.B.); (R.A.F.); (N.L.); (A.S.); (Y.H.O.); (A.L.); (B.B.D.); (B.S.P.)
| | - Rosi Amrilla Fagi
- Department of Cardiology and Vascular Medicine, Faculty of Medicine Universitas Airlangga—Dr. Soetomo General Hospital, Jalan Mayjend Prof. Dr. Moestopo 6-8, Surabaya 60286, Indonesia; (L.F.K.W.); (R.A.N.); (T.S.P.); (B.P.D.K.); (M.J.A.-F.); (R.I.G.); (Y.A.); (C.P.B.); (R.A.F.); (N.L.); (A.S.); (Y.H.O.); (A.L.); (B.B.D.); (B.S.P.)
| | - Nadya Luthfah
- Department of Cardiology and Vascular Medicine, Faculty of Medicine Universitas Airlangga—Dr. Soetomo General Hospital, Jalan Mayjend Prof. Dr. Moestopo 6-8, Surabaya 60286, Indonesia; (L.F.K.W.); (R.A.N.); (T.S.P.); (B.P.D.K.); (M.J.A.-F.); (R.I.G.); (Y.A.); (C.P.B.); (R.A.F.); (N.L.); (A.S.); (Y.H.O.); (A.L.); (B.B.D.); (B.S.P.)
| | - Agus Subagjo
- Department of Cardiology and Vascular Medicine, Faculty of Medicine Universitas Airlangga—Dr. Soetomo General Hospital, Jalan Mayjend Prof. Dr. Moestopo 6-8, Surabaya 60286, Indonesia; (L.F.K.W.); (R.A.N.); (T.S.P.); (B.P.D.K.); (M.J.A.-F.); (R.I.G.); (Y.A.); (C.P.B.); (R.A.F.); (N.L.); (A.S.); (Y.H.O.); (A.L.); (B.B.D.); (B.S.P.)
| | - Yudi Her Oktaviono
- Department of Cardiology and Vascular Medicine, Faculty of Medicine Universitas Airlangga—Dr. Soetomo General Hospital, Jalan Mayjend Prof. Dr. Moestopo 6-8, Surabaya 60286, Indonesia; (L.F.K.W.); (R.A.N.); (T.S.P.); (B.P.D.K.); (M.J.A.-F.); (R.I.G.); (Y.A.); (C.P.B.); (R.A.F.); (N.L.); (A.S.); (Y.H.O.); (A.L.); (B.B.D.); (B.S.P.)
| | - Achmad Lefi
- Department of Cardiology and Vascular Medicine, Faculty of Medicine Universitas Airlangga—Dr. Soetomo General Hospital, Jalan Mayjend Prof. Dr. Moestopo 6-8, Surabaya 60286, Indonesia; (L.F.K.W.); (R.A.N.); (T.S.P.); (B.P.D.K.); (M.J.A.-F.); (R.I.G.); (Y.A.); (C.P.B.); (R.A.F.); (N.L.); (A.S.); (Y.H.O.); (A.L.); (B.B.D.); (B.S.P.)
| | - Budi Baktijasa Dharmadjati
- Department of Cardiology and Vascular Medicine, Faculty of Medicine Universitas Airlangga—Dr. Soetomo General Hospital, Jalan Mayjend Prof. Dr. Moestopo 6-8, Surabaya 60286, Indonesia; (L.F.K.W.); (R.A.N.); (T.S.P.); (B.P.D.K.); (M.J.A.-F.); (R.I.G.); (Y.A.); (C.P.B.); (R.A.F.); (N.L.); (A.S.); (Y.H.O.); (A.L.); (B.B.D.); (B.S.P.)
| | | | - Budi Susetyo Pikir
- Department of Cardiology and Vascular Medicine, Faculty of Medicine Universitas Airlangga—Dr. Soetomo General Hospital, Jalan Mayjend Prof. Dr. Moestopo 6-8, Surabaya 60286, Indonesia; (L.F.K.W.); (R.A.N.); (T.S.P.); (B.P.D.K.); (M.J.A.-F.); (R.I.G.); (Y.A.); (C.P.B.); (R.A.F.); (N.L.); (A.S.); (Y.H.O.); (A.L.); (B.B.D.); (B.S.P.)
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Rokhman MR, Alkaff FF, van Dorst PWM, At Thobari J, Postma MJ, van der Schans J, Boersma C. Economic Evaluations of Screening Programs for Chronic Kidney Disease: A Systematic Review. Value Health 2024; 27:117-128. [PMID: 37657659 DOI: 10.1016/j.jval.2023.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 07/11/2023] [Accepted: 08/04/2023] [Indexed: 09/03/2023]
Abstract
OBJECTIVES The aim of this review is to appraise and assimilate evidence from studies that have reported on the cost-effectiveness of screening programs for chronic kidney disease (CKD). METHODS The study protocol was registered on International Prospective Register of Systematic Reviews (PROSPERO). The final search was conducted on 18 January 2023 using 7 databases. Screening of articles, data extraction, and quality assessment was performed by 2 independent reviewers. The ISPOR-AMCP-NPC checklist was used to assess the credibility of the included studies. RESULTS From 4948 retrieved studies, a final total of 20 studies were included in the qualitative synthesis. Studies found that screening in diabetic populations was cost-effective (n = 8, 57%) or even cost-saving (n = 6, 43%). Four studies (67%) found that screening in hypertensive populations was also cost-effective. For the general population, findings were inconsistent across studies in which many found screening to be cost-effective (n = 11, 69%), some cost-saving (n = 2, 12%), and others not cost-effective (n = 3, 19%). The most influential parameters identified were prevalence of CKD and cost of screening. CONCLUSIONS Screening for CKD in patients with diabetes or hypertension is recommended from a cost-effectiveness point of view. For the general population, despite some inconsistent findings, the majority of studies demonstrated that screening in this population is cost-effective, depending mainly on the prevalence and the costs of screening. Healthcare decision makers need to consider the prevalence, stratification strategies, and advocate for lower screening costs to reduce the burden on healthcare budgets and to make screening even more favorable from the health-economic perspective.
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Affiliation(s)
- M Rifqi Rokhman
- Unit of Global Health, Department of Health Sciences, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands; Institute of Science in Healthy Ageing & healthcaRE (SHARE), University Medical Center Groningen, University of Groningen, Groningen, The Netherlands; Faculty of Pharmacy, Universitas Gadjah Mada, Yogyakarta, Indonesia.
| | - Firas Farisi Alkaff
- Division of Nephrology, Department of Internal Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands; Division of Pharmacology and Therapy, Department of Anatomy, Histology, and Pharmacology, Faculty of Medicine Universitas Airlangga, Surabaya, Indonesia
| | - Pim W M van Dorst
- Unit of Global Health, Department of Health Sciences, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Jarir At Thobari
- Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Maarten J Postma
- Unit of Global Health, Department of Health Sciences, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands; Institute of Science in Healthy Ageing & healthcaRE (SHARE), University Medical Center Groningen, University of Groningen, Groningen, The Netherlands; Department of Economics, Econometrics and Finance, Faculty of Economics & Business, University of Groningen, Groningen, The Netherlands; Unit of PharmacoTherapy, Epidemiology and Economics (PTE2), Department of Pharmacy, University of Groningen, Groningen, The Netherlands; Department of Pharmacology and Therapy, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia; Center of Excellence in Higher Education for Pharmaceutical Care Innovation, Universitas Padjadjaran, Bandung, Indonesia
| | - Jurjen van der Schans
- Unit of Global Health, Department of Health Sciences, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands; Institute of Science in Healthy Ageing & healthcaRE (SHARE), University Medical Center Groningen, University of Groningen, Groningen, The Netherlands; Department of Economics, Econometrics and Finance, Faculty of Economics & Business, University of Groningen, Groningen, The Netherlands
| | - Cornelis Boersma
- Unit of Global Health, Department of Health Sciences, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands; Faculty of Management Sciences, Open University, Heerlen, The Netherlands
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8
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Lusida M, Arifijanto MV, Rachman BE, Alkaff FF. Difficulty in management of acute invasive fungal rhinosinusitis in Indonesia during the COVID-19 pandemic: A case report. Respir Med Case Rep 2023; 46:101916. [PMID: 38046461 PMCID: PMC10689262 DOI: 10.1016/j.rmcr.2023.101916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 08/22/2023] [Accepted: 09/06/2023] [Indexed: 12/05/2023] Open
Abstract
Invasive fungal rhinosinusitis is a rare disease with a high morbidity and mortality rate. Lately, COVID-19 has been associated with an increased incidence of this disease. We present the first case of COVID-19-associated acute invasive fungal rhinosinusitis found in Indonesia. The risk factors for the disease include corticosteroid use and antibiotic use. The case was complicated with left orbital cellulitis and cerebral abscess. Difficulty of management in Indonesia during the COVID-19 pandemic includes hesitancy of the patient to seek medical care and the availability of surgical team for COVID-19-positive patients. Monitoring of corticosteroid and antibiotic use must be emphasized during the pandemic. Awareness of the disease needs to be increased in Indonesia.
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Affiliation(s)
- Michael Lusida
- Department of Internal Medicine, Faculty of Medicine, Universitas Airlangga-Dr. Soetomo General Hospital, Surabaya, 60286, Indonesia
| | - M. Vitanata Arifijanto
- Department of Internal Medicine, Faculty of Medicine, Universitas Airlangga-Dr. Soetomo General Hospital, Surabaya, 60286, Indonesia
- Division of Tropical Medicine and Infectious Disease, Faculty of Medicine, Universitas Airlangga-Dr. Soetomo General Hospital, Surabaya, 60286, Indonesia
| | - Brian Eka Rachman
- Department of Internal Medicine, Faculty of Medicine, Universitas Airlangga-Dr. Soetomo General Hospital, Surabaya, 60286, Indonesia
- Division of Tropical Medicine and Infectious Disease, Faculty of Medicine, Universitas Airlangga-Dr. Soetomo General Hospital, Surabaya, 60286, Indonesia
| | - Firas Farisi Alkaff
- Division of Pharmacology and Therapy, Department of Anatomy, Histology, And Pharmacology, Faculty of Medicine Universitas Airlangga, Surabaya, East Java 60132, Indonesia
- Division of Nephrology, Department of Internal Medicine, University Medical Center Groningen, Hanzeplein 1, 9713 GZ, Groningen, the Netherlands
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9
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Salima S, Wibowo MH, Dewayani BM, Nisa AS, Alkaff FF. Recurrent Partial Hydatidiform Mole: A Case Report of Seven Consecutive Molar Pregnancies. Int J Womens Health 2023; 15:1239-1244. [PMID: 37554967 PMCID: PMC10406109 DOI: 10.2147/ijwh.s421386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 07/27/2023] [Indexed: 08/10/2023] Open
Abstract
Hydatidiform mole (HM) is an aberrant pregnancy characterized by atypical trophoblastic hyperplasia, hydropic chorionic villi, and deprived fetal development. There are two types of HM, ie, complete (CHM) and partial (PHM). Both CHM and PHM can recur; however, the recurrence of PHM is very scarce compared to CHM. In this report, we present a case of a 33-year-old woman with recurrent PHM for 7 times without any normal pregnancy in-between. PHM was determined by histology examination. The patient underwent suction curettage and was followed up with serial β-hCG levels. Recurrent PHM, although rare, is associated with an increased incidence of malignancy. A series of clinical and β-hCG evaluation should be warranted because of the possibility of gestational trophoblastic neoplasia development.
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Affiliation(s)
- Siti Salima
- Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Padjadjaran-Dr. Hasan Sadikin Hospital, Bandung, Indonesia
| | - Mulyohadi Hadi Wibowo
- Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Padjadjaran-Dr. Hasan Sadikin Hospital, Bandung, Indonesia
| | - Birgitta M Dewayani
- Department of Pathology of Anatomy, Faculty of Medicine, Universitas Padjadjaran-Dr. Hasan Sadikin Hospital, Bandung, Indonesia
| | - Aisyah Shofiatun Nisa
- Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Padjadjaran-Dr. Hasan Sadikin Hospital, Bandung, Indonesia
| | - Firas Farisi Alkaff
- Division of Pharmacology and Therapy, Department of Anatomy, Histology, and Pharmacology, Faculty of Medicine Universitas Airlangga, Surabaya, Indonesia
- Division of Nephrology, Department of Internal Medicine, University Medical Center Groningen, Groningen, the Netherlands
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10
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Salamah S, Khafiyya AN, Ramadhani R, Arfiana MR, Syamsuri I, Faizah NN, Nugraha D, Arifin B, Alkaff FF. Outcomes of the Indonesian Chronic Disease Management Program (PROLANIS) in Patients with Hypertension During the COVID-19 Pandemic in Rural Areas: A Preliminary Evaluation Study. Med Sci Monit 2023; 29:e939797. [PMID: 37170483 DOI: 10.12659/msm.939797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/13/2023] Open
Abstract
BACKGROUND The Indonesian Chronic Disease Management Program (PROLANIS) is a government program that aims to improve the health outcomes of patients with chronic diseases, including hypertension. This preliminary study aimed to evaluate the impacts of the coronavirus disease 2019 (COVID-19) pandemic on the health outcomes of hypertension patients in rural areas who were enrolled in PROLANIS. MATERIAL AND METHODS This study used data from 4 PROLANIS groups in East Java province. The data were collected from participants' 6-month evaluations at 3 time points: before the COVID-19 pandemic in December 2019 (T0), during the COVID-19 pandemic in June 2020 (T1), and in December 2020 (T2). Evaluated parameters were body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), total cholesterol (TC), low-density lipid (LDL), high-density lipid (HDL), triglyceride (TG), and estimated glomerular filtration rate (eGFR). RESULTS There were 91 patients included in the analyses. Compared to T0, BMI, blood pressure, eGFR, and TC had significantly deteriorated at T1, but LDL, HDL, and TG showed no marked changes. At T2, BMI, DBP, and TC were similar to T0. On the other hand, SBP and eGFR did not improve, while HDL significantly deteriorated. Stratified based on age, worsening of DBP, TC, and LDL at T1 and eGFR at T1 and T2 was only observed in those aged 60 years and older. CONCLUSIONS This preliminary study showed that the health outcomes of hypertension patients in rural areas who were enrolled in PROLANIS were negatively impacted during the COVID-19 pandemic, with the elderly being the most affected.
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Affiliation(s)
- Sovia Salamah
- Department of Public Health and Preventive Medicine, Faculty of Medicine Universitas Airlangga, Surabaya, East Java, Indonesia
- Division of Nephrology, Department of Internal Medicine, University Medical Center Groningen, Groningen, Netherlands
| | | | - Ristra Ramadhani
- Department of Otorhinolaryngology Head and Neck Surgery, Faculty of Medicine Universitas Airlangga - Dr. Soetomo General Academic Hospital, Surabaya, East Java, Indonesia
| | | | - Ibrahim Syamsuri
- Department of Pulmonology and Respiratory Medicine, Faculty of Medicine Universitas Airlangga - Dr. Soetomo General Academic Hospital, Surabaya, East Java, Indonesia
| | - Novia Nurul Faizah
- Faculty of Medicine, Universitas Airlangga, Surabaya, East Java, Indonesia
| | - David Nugraha
- Faculty of Medicine, Universitas Airlangga, Surabaya, East Java, Indonesia
| | - Bustanul Arifin
- Faculty of Pharmacy, Universitas Hasanuddin, Makassar, South Sulawesi, Indonesia
- Department of Health Sciences, University Medical Center Groningen, Groningen, Netherlands
| | - Firas Farisi Alkaff
- Division of Nephrology, Department of Internal Medicine, University Medical Center Groningen, Groningen, Netherlands
- Division of Pharmacology and Therapy, Department of Anatomy, Histology, and Pharmacology, Faculty of Medicine Universitas Airlangga, Surabaya, East Java, Indonesia
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11
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Nugraha D, Salamah S, Luke K, Wibowo ZK, Witarto AP, Deswima C, Kloping NA, Witarto BS, Syamlan AT, Irzaldy A, Rochmanti M, Sari DR, Sakina S, Alkaff FF. Evaluation of Health-Related Quality of Life and Mental Health in 729 Medical Students in Indonesia During the COVID-19 Pandemic. Med Sci Monit 2023; 29:e938892. [PMID: 36755476 PMCID: PMC9926794 DOI: 10.12659/msm.938892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic has impacted the health-related quality of life (HRQoL) and mental health worldwide. However, its impact on medical students in Indonesia has not been well documented. This study aimed to evaluate HRQoL and mental health in 729 Indonesian medical students during the COVID-19 pandemic. MATERIAL AND METHODS We conducted a cross-sectional study from 31 August to 30 September 2021. The study instrument was an online questionnaire that was distributed via social media platforms. The 12-item short form version 2 (SF12v2) was used to measure HRQoL, and the 21-item Depression, Anxiety, and Stress Scale (DASS-21) was used to measure mental health. RESULTS From 729 Indonesian medical students included in the analyses, 37.3% had impaired physical component and 66.9% had impaired mental component of HRQoL. The determinants were medical students' island of residence, history of hospitalization, and family member's hospitalization and death due to COVID-19. Concerning mental health, the prevalence of reported symptoms of depression, anxiety, and stress were 45.4%, 65.2%, and 60.9%, respectively. Sex, study method, grade, previous COVID-19 disease severity, comorbidities, previous learning experience, and history of family isolation were identified as the determinants of mental health. CONCLUSIONS This study highlights the adverse effects of COVID-19 on HRQoL and mental health in Indonesian medical students. The results identified key associations, including SARS-CoV-2 infection and comorbidities experienced by the students, the health of their families, including grief following bereavement, and the effects of social isolation during the pandemic.
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Affiliation(s)
- David Nugraha
- Medical Program, Faculty of Medicine Universitas Airlangga, Surabaya, Indonesia,Airlangga Medical Students Research Group (AIRMEDS-21), Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
| | - Sovia Salamah
- Department of Public Health and Preventive Medicine, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia,Division of Nephrology, Department of Internal Medicine, University Medical Center Groningen, Groningen, The Netherlands
| | - Kevin Luke
- Medical Program, Faculty of Medicine Universitas Airlangga, Surabaya, Indonesia,Airlangga Medical Students Research Group (AIRMEDS-21), Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
| | - Zefo Kiyosi Wibowo
- Medical Program, Faculty of Medicine Universitas Airlangga, Surabaya, Indonesia,Airlangga Medical Students Research Group (AIRMEDS-21), Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
| | - Andro Pramana Witarto
- Medical Program, Faculty of Medicine Universitas Airlangga, Surabaya, Indonesia,Airlangga Medical Students Research Group (AIRMEDS-21), Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
| | - Caesariska Deswima
- Medical Program, Faculty of Medicine Universitas Airlangga, Surabaya, Indonesia,Airlangga Medical Students Research Group (AIRMEDS-21), Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
| | - Nabila Ananda Kloping
- Medical Program, Faculty of Medicine Universitas Airlangga, Surabaya, Indonesia,Airlangga Medical Students Research Group (AIRMEDS-21), Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
| | - Bendix Samarta Witarto
- Medical Program, Faculty of Medicine Universitas Airlangga, Surabaya, Indonesia,Airlangga Medical Students Research Group (AIRMEDS-21), Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
| | - Adila Taufik Syamlan
- Department of Psychiatry, Faculty of Medicine Universitas Airlangga – Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
| | - Abyan Irzaldy
- Department of Public Health, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Maftuchah Rochmanti
- Division of Pharmacology and Therapy, Department of Anatomy, Histology, and Pharmacology, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
| | - Dewi Ratna Sari
- Division Anatomy and Histology, Department of Anatomy, Histology, and Pharmacology, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
| | - Sakina Sakina
- Division Anatomy and Histology, Department of Anatomy, Histology, and Pharmacology, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
| | - Firas Farisi Alkaff
- Division of Nephrology, Department of Internal Medicine, University Medical Center Groningen, Groningen, The Netherlands,Division of Pharmacology and Therapy, Department of Anatomy, Histology, and Pharmacology, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
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12
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Azmi YA, Alkaff FF, Purba AKR, Renaldo J, Yogiswara N, Postma MJ. Factors for In-Hospital Mortality in 145 Male Patients with Fournier's Gangrene: A 10-Year Observational Study from a Single Tertiary Referral Center in Indonesia. Med Sci Monit 2022; 28:e938578. [PMID: 36560855 PMCID: PMC9793639 DOI: 10.12659/msm.938578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Fournier's gangrene (FG) is a potentially fatal necrotizing infection. Due to the rapid progression of the disease, the fatality rate remains high despite advances in therapy. This 10-year observational study from a single tertiary referral center in Indonesia aimed to identify the risk factors for in-hospital mortality from 145 male patients diagnosed with FG. MATERIAL AND METHODS This retrospective cohort study was conducted at one of Indonesia's largest tertiary referral hospitals. The risk factors of in-hospital mortality were analysed using data collected through hospital medical records. All patients diagnosed with FG from January 2012 until December 2021 were included. Outcome measured was sociodemographic factors, comorbidities, laboratory findings, length of stay, culture results, and disease outcome. The microbiological culture was performed on FG lesions isolates. The statistical analysis was conducted using SPSS version 26.0. RESULTS The analysis included 145 male patients with a median age of 52 (IQR, 43-61) years. Of them, 38 (26.20%) patients died. There were more patients with diabetes mellitus (DM) in non-survivor groups compared to survivor groups (76.3% vs 57%, p=0.035). On multivariate analysis, DM and Clostridium perfringens infection were found to be independent factors of in-hospital mortality [adjusted odds ratio (aOR)2.583, 95% confidence interval (CI)=1.061-6.289, aOR 5.982,95% CI=1.241-28.828, respectively]. CONCLUSIONS The mortality rate for FG was considerably high. DM and Clostridium perfringens infection were shown to be independent risk factors for mortality among men.
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Affiliation(s)
- Yufi Aulia Azmi
- Department of Urology, Faculty of Medicine, Universitas Airlangga – Dr. Soetomo General Academic Hospital, Surabaya, Indonesia,Department of Health Sciences, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Firas Farisi Alkaff
- Division of Nephrology, Department of Internal Medicine, University Medical Center Groningen, Groningen, The Netherlands,Division of Pharmacology and Therapy, Department of Anatomy, Histology, and Pharmacology, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
| | - Abdul Khairul Rizki Purba
- Department of Health Sciences, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands,Division of Pharmacology and Therapy, Department of Anatomy, Histology, and Pharmacology, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
| | - Johan Renaldo
- Department of Urology, Faculty of Medicine, Universitas Airlangga – Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
| | - Niwanda Yogiswara
- Department of Urology, Faculty of Medicine, Universitas Airlangga – Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
| | - Maarten J. Postma
- Department of Health Sciences, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands,Division of Pharmacology and Therapy, Department of Anatomy, Histology, and Pharmacology, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia,Institute of Science in Healthy Ageing & healthcaRE (SHARE), University Medical Center Groningen, University of Groningen, Groningen, The Netherlands,Unit of PharmacoTherapy, Epidemiology and Economics (PTE2), Department of Pharmacy, University of Groningen, Groningen, The Netherlands,Department of Economics, Econometrics and Finance, Faculty of Economics & Business, University of Groningen, Groningen, The Netherlands
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13
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Bakhriansyah J, Semita IGPG, Suryawan IGR, Azmi Y, Sanjaya ID, Ikawaty R, Nugraha D, Alkaff FF. Purulent pericarditis in advanced thymoma: A case report. Radiol Case Rep 2022; 17:3996-4000. [PMID: 36032205 PMCID: PMC9403901 DOI: 10.1016/j.radcr.2022.07.099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 07/25/2022] [Accepted: 07/28/2022] [Indexed: 12/03/2022] Open
Abstract
Thymoma is the most common primary anterior mediastinum mass with various clinical manifestations, and one of the manifestations is pericardial effusion. While pericardial effusion in thymoma is usually serous, it can become purulent when an infection occurs in a nearby organ, albeit rare. In this report, we present a rare case of a 27-year-old woman who had purulent pericarditis secondary to an advanced thymoma. The patient came to the emergency department with the chief complaints of worsening chest discomfort, non-productive cough, and fever in the past 2 weeks. The patient was diagnosed with thymoma 5 months prior. Based on the examinations, it was discovered that the patient had pericarditis. After the pericardiocentesis was performed and the fluid was examined, the patient was diagnosed with purulent pericarditis secondary to thymoma. The patient was then treated with intravenous antibiotic and pericardial drain. Unfortunately, the patient's condition deteriorated, and the patient died on the fifth day of hospitalization. This case highlights an infrequent but potentially life-threatening complication of thymoma. In addition, thymic pathologies should be included as a rare etiology in the differential diagnosis of purulent pericardial effusion.
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Putra BFK, Dharmadjati BB, Budiarto M, Intan RE, Alkaff FF. Association between donor's age and expression of cardiomyocyte marker quantity on adipocyte-derived mesenchymal stem cell. Med Glas (Zenica) 2022; 19. [PMID: 35924808 DOI: 10.17392/1478-22] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 04/14/2022] [Accepted: 06/02/2022] [Indexed: 02/18/2024]
Abstract
Aim Adipocyte-derived mesenchymal stem cells (AMSCs) have recently been studied as a potential new approach for regeneration treatment of heart failure and ischemic myocardium. However, donor's age is thought to affect the ability of AMSC cells to differentiate into cardiomyocytes. This study aimed to analyse the association between donor's age with the expression of cardiomyocyte marker cardiac isoform of Troponin-T (cTnT) quantity on AMSCs. Methods Subcutaneous adipose tissue was taken from donors of 3 different age groups (30-40, 41-50, and >50 years old), and then processed into AMSC cells by insert culture. AMSC cell phenotype was identified by assessing the quantity of mesenchymal markers expression (CD34, CD45, CD90, CD105) using indirect immunofluorescence technique. Afterwards, cTnT expression, a marker for cardiomyocyte differentiation from AMSC cells, was evaluated under the fluorescent microscope. The comparison was done between the 3 different age groups. Results The comparative test and post hoc analysis showed that there were differences in the expression of CD34, CD45, CD90, CD105, and cTnT between the three age groups (all p<0.05). Furthermore, there were strong negative correlations between age and CD34, CD90, CD105 and cTnT (r= -0.844, -0.914, -0.899, and -0.738, respectively), while the correlation was positive between age and CD45 (r=0.899). Conclusion Expression quantity of mesenchymal markers and cardiomyocyte markers from AMSC cells were affected by the donor's age. The higher the donor age group, the lower the expression quantity of mesenchymal markers (except CD45) and cTnT.
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Affiliation(s)
- Bagus Fitriadi Kurnia Putra
- Department of Cardiology and Vascular Medicine, Faculty of Medicine Universitas Airlangga, Surabaya, East Java, Indonesia
| | - Budi Baktijasa Dharmadjati
- Department of Cardiology and Vascular Medicine, Faculty of Medicine Universitas Airlangga, Surabaya, East Java, Indonesia
| | - Mohammad Budiarto
- Department of Cardiology and Vascular Medicine, Faculty of Medicine Universitas Airlangga, Surabaya, East Java, Indonesia
| | - Ryan Enast Intan
- Department of Cardiology and Vascular Medicine, Faculty of Medicine Universitas Airlangga, Surabaya, East Java, Indonesia
| | - Firas Farisi Alkaff
- Department of Anatomy, Histology, and Pharmacology, Faculty of Medicine Universitas Airlangga, Surabaya, East Java, Indonesia
- Department of Internal Medicine, University Medical Centre Groningen, Groningen, The Netherlands
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15
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Bhisma MS, Pratanu I, Intan RE, Alkaff FF. Inherited thrombophilia transpires with severe coronary arterial thrombosis in wide range of age backgrounds: A report of 3 cases. Ann Med Surg (Lond) 2022; 78:103730. [PMID: 35600193 PMCID: PMC9118514 DOI: 10.1016/j.amsu.2022.103730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 05/01/2022] [Accepted: 05/04/2022] [Indexed: 11/30/2022] Open
Abstract
Introduction and importance: Protein C and S deficiency are some of the coagulation cascade disorders which may also contributes not only to venous thromboembolism (VTE), but also rarely to arterial thrombosis. Here we present a report of 3 severe coronary artery disease (CAD) cases ranging from very young to elderly patients with concomitant inherited thrombophilia. Case presentation The first case was a chronic coronary syndrome from a very young male patient with history of VTE without any other risk factor of CAD. The second case was about premature CAD with triple chronic total occlusion (RCA, LCX, LAD) in patient under 45 years old, with single risk factor. The third case was about accelerated atherosclerosis progression from previously non significant stenosis in RCA into total occlusion in RCA and inferior STEMI in old patient on supposely adequate double anti platelet agent. Clinical discussion All patients had protein C and/or S deficiency and first degree family history of VTE, therefore inherited thrombophilia was diagnosed. We gave them oral anticoagulant in addition to their standard treatment for secondary prevention with good outcome and without further adverse event. Conclusion It is important to raise awareness to perform screening inherited thrombophilia as an important risk factor for CAD in special subgroup such as young age patient with rapid course progression and family history of VTE. The use of oral anticoagulants as either prophylactic or therapeutic purpose in patients with inherited thrombophilia are safe and effective. However, further research is still needed. Inherited thrombophilia is a rare disease that can causes coronary arterial thrombosis. Inherited thrombophilia screening should be done in special subgroup of patients. There is no treatment guideline for CAD patients with inherited thrombophilia.
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Prastowo RA, Eko Putranto JN, Pratanu I, Intan RE, Alkaff FF. Association between arteriovenous access flow and ventricular function: A cross-sectional study. Ann Med Surg (Lond) 2022; 77:103649. [PMID: 35638015 PMCID: PMC9142546 DOI: 10.1016/j.amsu.2022.103649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 04/14/2022] [Accepted: 04/15/2022] [Indexed: 11/26/2022] Open
Abstract
Background Permanent hemodialysis access comes with a myriad of problems on top of the well-known benefits; flow disturbances, risk of infection and revision being among them. All of these could eventually lead to impaired cardiac function. Even so, the relationship between impaired cardiac function due to arteriovenous access in patients undergoing hemodialysis has not been clearly described. This study aimed to analyze the relationship of flow in an artificial arteriovenous access with left and right ventricular function in patients with chronic kidney disease (CKD) undergoing hemodialysis at a referral hospital in Indonesia. Material and methods This was a cross sectional study with consecutive sampling technique. Samples were patients with CKD undergoing hemodialysis at Dr. Soetomo General Hospital from December 2021to January 2022. A total of 47 patients who met the inclusion criteria underwent Doppler ultrasound to assess arteriovenous access flow and transthoracic echocardiography to assess left and right ventricle function. Results From 47 patients, 26 (55.3%) had high arteriovenous access flow. The clinical characteristics of the patients between the high and low arteriovenous access flow groups were not significantly different. We found that the value of left ventricular ejection fraction in the non-high-flow access group was significantly higher than the high-flow access group (p < 0.05). Other than that, the median right ventricle fractional area changes in the non-high-flow access group was also higher than the high-flow access group (p < 0.05). Conclusion Arteriovenous access flow as measured by Doppler ultrasonography has a significant relationship with impaired left and right ventricular functions based on systolic function parameters from echocardiography. There is an association between arteriovenous access flow and ventricular function. The higher the access flow, the lower the left ventricular systolic function. The higher the access flow, the lower the right ventricular systolic function. It is important to periodically evaluate the access flow of hemodialysis patients.
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Oen A, Sukmajaya WP, Alkaff FF, Sukmajaya AC, Inez SI. Low Back Pain Physiotherapy: Does Expectation Really Influence Outcome? Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.8578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Objectives: Low Back Pain (LBP) is prevalent in most people of working age. The morbidity it causes cannot be taken lightly, as is its economic burden. Physiotherapy has long been prescribed to LBP patients, but treatment outcome measurements, along with the factors influencing it, have not been widely evaluated. In this study, we aim to assess the correlation between patient’s expectation and LBP physical therapy outcome.
Methods: This was a cross sectional study conducted at physical rehabilitation outpatient clinic in September-December 2019. Participants were patients with LBP who were treated with physical therapy. One series of physical therapy consists of 5 sessions of modality only or modality with exercise therapy; one patient underwent 2 sessions per week. Oswestry disability index (ODI) score was used to evaluate treatment outcome and Stanford Expectation of Treatment Scale score was used to evaluate patient’s expectation. Data was collected twice, before and after 1 series of therapy.
Results: There were 91 participants included in this study, most of whom were female. Most patients reported a significant decrease in ODI score, irrespective of the LBP chronicity or nutritional status. However, patients who received a combination of physical exercises and modalities reported lower after therapy ODI than those who only received modalities (p=0.009). No correlation was found between positive (p=0.567) or negative (p=0.910) expectations with ODI improvement.
Conclusion: Our study did not find any correlation between positive or negative expectations towards ODI score improvement.
Keywords: Low back pain; Physical therapy; Treatment outcome; Patient expectation; ODI score
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Intan RE, Alkaff FF, Oktaviono YH, Nugraha RA, Octora TN, Jonatan M, Balti DR, Hasibuan FS, Radi B, Santoso A. Retrospective Study of the Association Between Platelet-to-Lymphocyte Ratio in Patients with Acute Coronary Syndrome on Admission to a Rural Referral Center in East Java, Indonesia, and the Incidence of New Symptomatic Heart Failure at 6 Months. Med Sci Monit 2022; 28:e935002. [PMID: 35232953 PMCID: PMC8900449 DOI: 10.12659/msm.935002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Background This was a retrospective study conducted at a rural referral center in East Java, Indonesia, to evaluate the association between the platelet-to-lymphocyte ratio (PLR) on hospital admission and the incidence of new symptomatic heart failure (HF) within 6 months in patients with acute coronary syndrome (ACS). Material/Methods The study population consisted of all ACS patients who were hospitalized between 1 January and 31 December 2018 at a non-percutaneous coronary intervention-capable secondary referral hospital and came for a routine follow-up until 6 months afterwards. The diagnosis of new symptomatic HF was based on International Classification of Diseases 10th revision code I50.9. Results From 126 hospitalized patients, 92 patients were included in the analysis. The incidence rate of new symptomatic HF at 6 months was 70.65%. High PLR upon initial admission was significantly associated with new symptomatic HF incidence (odds ratio=1.70, P<0.001). PLR was also able to discriminate new symptomatic HF incidence at 6 months with area under the curve of 0.83 (P=0.001). Multivariate Cox regression analysis showed that PLR was an independent predictor for new symptomatic HF incidence (hazard ratio=4.5, P=0.001). Conclusions In a rural center in Indonesia, the PLR was independently correlated with the onset of new symptomatic HF in patients with ACS 6 months after hospital admission. The PLR may be a supplementary biomarker for clinical outcomes in patients with ACS for use in resource-limited regions.
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Affiliation(s)
- Ryan Enast Intan
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Airlangga – Dr. Soetomo General Hospital, Surabaya, Indonesia
| | - Firas Farisi Alkaff
- Division of Pharmacology and Therapy, Department of Anatomy, Histology, and Pharmacology, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
| | - Yudi Her Oktaviono
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Airlangga – Dr. Soetomo General Hospital, Surabaya, Indonesia
| | - Ricardo Adrian Nugraha
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Airlangga – Dr. Soetomo General Hospital, Surabaya, Indonesia
| | - Tan Nicko Octora
- Department of Anesthesiology and Reanimation, Faculty of Medicine, Universitas Airlangga – Dr. Soetomo General Hospital, Surabaya, Indonesia
| | - Michael Jonatan
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Airlangga – Dr. Soetomo General Hospital, Surabaya, Indonesia
| | - Dimas Rio Balti
- Department of Cardiology and Vascular Medicine, Ngimbang General Hospital, Lamongan, Indonesia
| | - Fani Suslina Hasibuan
- Department of Cardiology and Vascular Medicine, Dr. Koesma General Hospital, Tuban, Indonesia
| | - Basuni Radi
- Department of Cardiovascular Prevention and Rehabilitation, National Cardiovascular Center Harapan Kita, Jakarta, Indonesia
| | - Anwar Santoso
- Department of Cardiovascular Prevention and Rehabilitation, National Cardiovascular Center Harapan Kita, Jakarta, Indonesia
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Mahdi BA, Suryantoro SD, Romadhon PZ, Windradi C, Widiyastuti KN, Novendrianto D, Widiasi ED, Agustin ED, Firdausa S, Alkaff FF. Convalescent Plasma Therapy: The Early Use in Moderate to Severe COVID-19 Patients in Hospitals with Limited Resources. IJTID 2021. [DOI: 10.20473/ijtid.v9i3.29113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
COVID-19 cases in Indonesia in the period of June-July 2021 showed a catastrophic spike. During this period, a recently discovered variant, the delta variant, appeared to be one of the sources of COVID-19 infection. Treatment modalities are limited due to reduced stock of drugs. A case of a 63-year-old man has been reported, with a history of having been vaccinated with two doses of Sinovac, experiencing moderate-to-severe symptoms of COVID-19 infection then given convalescent plasma therapy since his initial admission to the hospital. Three days after being given convalescent plasma therapy, the improvement was noticeable. Shortness of breath, cough, fever, and weakness were less complained. On the seventh day the patient fully recovered and got discharged. Convalescent plasma therapy was e ective in early stage and was able to improve outcomes. Indonesia needs sucient stocks of convalescent plasma as a therapy to overcome the limitations of medicines.
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20
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Harsono AB, Hidayat YM, Winarno GNA, Nisa AS, Alkaff FF. A Case of Rapid Transformation from Hydatidiform Mole to Invasive Mole: The Importance of β-hCG (Human Chorionic Gonadotropin) Serum Levels in Follow-Up Evaluation. Am J Case Rep 2021; 22:e931156. [PMID: 34127641 PMCID: PMC8216494 DOI: 10.12659/ajcr.931156] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 05/11/2021] [Accepted: 04/23/2021] [Indexed: 11/09/2022]
Abstract
BACKGROUND Gestational trophoblastic disease (GTD) is a spectrum of disorders consisting of premalignant (ie, complete [CHM] and partial hydatidiform moles [PHM]) and malignant conditions (ie, invasive moles, choriocarcinoma, placental site trophoblastic tumors, and epithelioid trophoblastic tumor). If GTD persists after initial treatment and has persistent elevated beta human chorionic gonadotropin (ß-hCG), it is referred to as post-molar gestational trophoblastic neoplasia (pGTN). To date, there is no detailed information regarding how fast invasive moles can develop from CHM. However, the risk of developing any pGTN from CHM is rare within 1 month and is greatest in the first 12 months after evacuation, with most cases presenting within 6 months. CASE REPORT We present a case of a 46-year-old primigravida woman with rapid transformation of an invasive mole. In the beginning, the patient had a chief concern of a uterus size greater than the gestational dates. Laboratory evaluation showed high ß-hCG serum level (>300 000 mIU/mL), and ultrasonography evaluation revealed a hydatidiform mole. Suction evacuation and curettage procedures were then performed. Pathology evaluation afterwards revealed a complete hydatidiform mole without any sign of malignancy. Twenty-two days afterwards, the patient came to the emergency room with vaginal bleeding. ß-hCG serum level was high (53 969 mIU/mL), and ultrasonography examination showed the presence of fluid filling the uterine cavity. The patient was then diagnosed with GTN, and hysterectomy was chosen as the treatment of choice. After the surgery, her ß-hCG serum level gradually reverted back to normal. CONCLUSIONS Invasive moles can develop less than 1 month after suction evacuation and curettage procedure for CHM. Serial ß-hCG serum level evaluation according to the guideline should be performed to prevent late diagnosis, which could lead to the development of metastasis and worsen the prognosis.
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Affiliation(s)
- Ali Budi Harsono
- Department of Obstetrics and Gynecology, Faculty of Medicine, UniversitasPadjadjaran-Dr. Hasan Sadikin Hospital, Bandung, Indonesia
| | - Yudi Mulyana Hidayat
- Department of Obstetrics and Gynecology, Faculty of Medicine, UniversitasPadjadjaran-Dr. Hasan Sadikin Hospital, Bandung, Indonesia
| | - Gatot Nyarumenteng A. Winarno
- Department of Obstetrics and Gynecology, Faculty of Medicine, UniversitasPadjadjaran-Dr. Hasan Sadikin Hospital, Bandung, Indonesia
| | - Aisyah Shofiatun Nisa
- Department of Obstetrics and Gynecology, Faculty of Medicine, UniversitasPadjadjaran-Dr. Hasan Sadikin Hospital, Bandung, Indonesia
| | - Firas Farisi Alkaff
- Division of Pharmacology and Therapy, Department of Anatomy, Histology, and Pharmacology, Faculty of Medicine Universitas Airlangga, Surabaya, Indonesia
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Widiarti W, Sukmajaya AC, Nugraha D, Alkaff FF. Cardioprotective properties of glucagon-like peptide-1 receptor agonists in type 2 diabetes mellitus patients: A systematic review. Diabetes Metab Syndr 2021; 15:837-843. [PMID: 33866119 DOI: 10.1016/j.dsx.2021.04.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 03/31/2021] [Accepted: 04/01/2021] [Indexed: 02/06/2023]
Abstract
BACKGROUND AND AIMS Cardiovascular disease is one of the main contributors for the mortality in type 2 diabetes mellitus (T2DM) patients. Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) had shown cardiovascular benefits which may be advantageous to reduce mortality in T2DM patients. This systematic review focused on analyzing the effects of GLP-1 RAs on cardiovascular outcomes. METHODS We conducted an extensive search through JSTOR, PubMed, Scopus, EBSCohost, and CENTRAL. All related studies assessing the use of GLP-1 RAs in T2DM patients from inception up to October 2020 were screened. Any cardioprotective properties as the outcomes were obtained. RESULTS A total of six studies (4 randomized, 2 observational) with a total of 182.205 patients were included in this review. The GLP-1 RAs used were either liraglutide or exenatide in combination with antihypertensive or antilipidemic drugs. All studies showed that GLP-1 RA significantly caused weight loss and improved cardiac functional capacity by increasing left ventricular ejection fraction and reducing end-systolic and end-diastolic left ventricle volume. GLP-1 RA also improved myocardial blood flow without affecting myocardial glucose uptake. However, GLP-1 RA failed to show its effect in reducing blood pressure and improving lipid profiles. CONCLUSIONS Despite the limited number of studies, consistent data showed that GLP-1 RA has several cardioprotective properties.
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Affiliation(s)
- Wynne Widiarti
- Faculty of Medicine Universitas Airlangga, Surabaya, Indonesia
| | | | - David Nugraha
- Faculty of Medicine Universitas Airlangga, Surabaya, Indonesia
| | - Firas Farisi Alkaff
- Divison of Pharmacology and Therapy, Department of Anatomy, Histology, and Pharmacology, Faculty of Medicine Universitas Airlangga, Surabaya, Indonesia; Department of Internal Medicine, University Medical Center Groningen, Groningen, the Netherlands.
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Hutama SA, Alkaff FF, Intan RE, Maharani CD, Indriaswati L, Zuhria I. Recurrent keratoconjunctivitis as the sole manifestation of COVID-19 infection: A case report. Eur J Ophthalmol 2021; 32:NP17-NP21. [PMID: 33781126 PMCID: PMC9294609 DOI: 10.1177/11206721211006583] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Introduction: Ocular symptoms are uncommon manifestations of coronavirus disease 2019
(COVID-19) infection. Earlier study reported that dry eye, blurred vision,
foreign body sensation, tearing, itching, conjunctival secretion,
conjunctival congestion, ocular pain, and photophobia are among the ocular
symptoms that could be found in COVID-19 patients. However, there are only a
few reports available regarding corneal involvement in this disease. Here we
report a case of keratoconjunctivitis as the only symptom of COVID-19
infection. Case description: A 27-year-old man who worked as an obstetrics and gynecology resident came to
the outpatient clinic with the chief complaints of eye discomfort, foreign
body sensation, conjunctival hyperemia, lacrimation, and photophobia in his
right eye for the past 3 weeks. Fluorescence test showed a small corneal
lesion. The patient was then diagnosed with keratoconjunctivitis. A week
after the treatment, all symptoms were resolved. A month later, the patient
came to the emergency room with the same eye complaints but with a more
severe pain. The fluorescence test showed wider corneal lesion compared to
last month. The result from the corneal swab is negative for bacterial or
fungal infection, indicating a viral infection. Afterwards, reverse
transcriptase polymerase chain reaction test from nasopharyngeal swab was
performed and revealed that the patient was positive for COVID-19. Conclusions: This case report showed that keratoconjunctivitis may occur as the only
manifestation of COVID-19 infection. Thus, patient presented with
unexplainable eye symptoms should be evaluated for COVID-19 infection.
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Affiliation(s)
| | - Firas Farisi Alkaff
- Division of Pharmacology and Therapy, Department of Anatomy, Histology, and Pharmacology, Faculty of Medicine Universitas Airlangga, Surabaya, Indonesia
| | | | - Citra Dewi Maharani
- Department of Ophthalmology, Faculty of Medicine Universitas Airlangga - Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
| | - Luki Indriaswati
- Department of Ophthalmology, Faculty of Medicine Universitas Airlangga - Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
| | - Ismi Zuhria
- Department of Ophthalmology, Faculty of Medicine Universitas Airlangga - Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
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Alkaff FF, Illavi F, Salamah S, Setiyawati W, Ramadhani R, Purwantini E, Tahapary DL. The Impact of the Indonesian Chronic Disease Management Program (PROLANIS) on Metabolic Control and Renal Function of Type 2 Diabetes Mellitus Patients in Primary Care Setting. J Prim Care Community Health 2021; 12:2150132720984409. [PMID: 33472499 PMCID: PMC7829517 DOI: 10.1177/2150132720984409] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 11/20/2020] [Accepted: 12/01/2020] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Indonesia through its government National Health Insurance System has launched a non-communicable and chronic disease management program named Indonesian Chronic Disease Management Program (PROLANIS), with Type 2 Diabetes Mellitus (T2DM) and hypertension as the main focus. However, study that evaluates the clinical impact of PROLANIS in patients with T2DM is still scarce to this date. This study aims to evaluate the metabolic control and renal function of PROLANIS participants with T2DM every six month within the first 18-months of implementation. METHODS This study was a retrospective cohort study conducted at Wates sub-district, East Java using secondary data from PROLANIS group report from April 2018 to October 2019. The study population was T2DM patients who voluntarily joined the PROLANIS group in April 2018. The six-month-evaluation included metabolic parameters [body mass index (BMI), blood pressure, hemoglobin A1C, total cholesterol, high-density lipid, low-density lipid, and triglyceride (TG)] and renal parameters [blood urea nitrogen (BUN), creatinine serum, and urinary microalbumin]. Paired t-test and wilcoxon signed-rank test was used for the analysis, and the P-value was adjusted using Bonferroni correction. A P-value < .0015 was considered statistically significant, while a P-value between .0015 and .003 was considered as marginally significant. RESULTS A total of 30 participants were included in the analysis. Following the PROLANIS implementation, the only parameter of metabolic control that showed significant improvement was TG serum level (P < .001). Despite the worsening status of other metabolic parameters, the changes were not statistically significant except for BMI that was marginally significant (P = .002). From renal function, only BUN serum level was significantly deteriorated (P < .001), while the others did not significantly change. CONCLUSION PROLANIS implementation in our study population seems to be ineffective. Future study with more primary healthcare centers needs to be done to scrutinize the clinical impact of this program nationwide.
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Affiliation(s)
- Firas Farisi Alkaff
- Department of Pharmacology and Therapy,
Faculty of Medicine Universitas Airlangga, Surabaya, East Java, Indonesia
| | - Fauzan Illavi
- Department of Internal Medicine,
Dr.Cipto Mangunkusumo General Hospital, Faculty of Medicine Universitas Indonesia,
Central Jakarta, Jakarta, Indonesia
| | - Sovia Salamah
- Department of Public Health and
Preventive Medicine, Faculty of Medicine Universitas Airlangga, Surabaya, East Java,
Indonesia
| | - Wiwit Setiyawati
- Faculty of Medicine Universitas
Airlangga, Surabaya, East Java, Indonesia
| | - Ristra Ramadhani
- Faculty of Medicine Universitas
Airlangga, Surabaya, East Java, Indonesia
| | - Elly Purwantini
- Politeknik Elektronika Negeri Surabaya,
Surabaya, East Java, Indonesia
| | - Dicky L. Tahapary
- Department of Internal Medicine,
Dr.Cipto Mangunkusumo General Hospital, Faculty of Medicine Universitas Indonesia,
Central Jakarta, Jakarta, Indonesia
- Metabolic, Cardiovascular, and Aging
Cluster, The Indonesian Medical Education and Research Institute,Faculty of Medicine
Universitas Indonesia, Central Jakarta, Jakarta, Indonesia
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Suryawan IGR, Bakhriansyah J, Puspitasari M, Gandi P, Intan RE, Alkaff FF. To reperfuse or not to reperfuse: a case report of Wellens' syndrome with suspected COVID-19 infection. Egypt Heart J 2020; 72:58. [PMID: 32923003 PMCID: PMC7479297 DOI: 10.1186/s43044-020-00094-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 08/27/2020] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Wellens' syndrome is known to be associated with left anterior descending artery occlusion that could lead to an extensive anterior wall myocardial infarction. Thus, emergency cardiac catheterization is needed. However, during coronavirus disease 2019 (COVID-19) pandemic, it is recommended for hemodynamically stable acute coronary syndrome patients with COVID-19 infection to be treated conservatively in an isolated hospital ward. CASE PRESENTATION We report an 85-year-old patient with chief complaints of typical, squeezing chest pain in the past 4 h. The patient had a high fever, dyspnea, sore throat, and fatigue for 3 days. He had previously come into contact with COVID-19 positive relatives. The patient was hemodynamically stable and pulmonary auscultation revealed coarse rales in the entire lung. Electrocardiography (ECG) evaluation during the pain episode showed non-specific ST-T changes in lead V2-V5. After sublingual nitrate was administered, ECG evaluation during the pain-free period revealed a biphasic T wave inversion in lead V2 and V3. Laboratory workup showed elevated cardiac marker and leucopenia with neutrophilia and lymphopenia. Rapid immunochromatographic test and initial severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) reverse transcription-polymerase chain reaction (RT-PCR) evaluation from nasopharyngeal swab showed negative results. However, radiographic evaluations suggest the diagnosis of COVID-19 infection. While waiting for the second RT-PCR evaluation, the patient was diagnosed with Wellens' syndrome with suspected COVID-19 infection. The patient was treated conservatively according to national guidelines and scheduled for elective cardiac catheterization. On the third day, the patient felt better and insisted on being discharged home. Ten days after discharged, the patient died of myocardial infarction. CONCLUSION Emergency cardiac catheterization should be done for patient with Wellens' syndrome, regardless of the COVID-19 infection status.
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Affiliation(s)
- I Gde Rurus Suryawan
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Airlangga – Dr. Soetomo General Academic Hospital, Jl. Mayjen Prof. Dr. Moestopo No. 6-8, Surabaya, East Java 60286 Indonesia
| | - Jordan Bakhriansyah
- Department of Cardiology and Vascular Medicine, Husada Utama Hospital, Surabaya, Indonesia
- Faculty of Medicine, Universitas Surabaya, Surabaya, Indonesia
| | - Mia Puspitasari
- Faculty of Medicine, Universitas Surabaya, Surabaya, Indonesia
| | - Parama Gandi
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Airlangga – Dr. Soetomo General Academic Hospital, Jl. Mayjen Prof. Dr. Moestopo No. 6-8, Surabaya, East Java 60286 Indonesia
| | - Ryan Enast Intan
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Airlangga – Dr. Soetomo General Academic Hospital, Jl. Mayjen Prof. Dr. Moestopo No. 6-8, Surabaya, East Java 60286 Indonesia
| | - Firas Farisi Alkaff
- Department of Pharmacology, Faculty of Medicine Universitas Airlangga, Surabaya, Indonesia
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25
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Hasibuan FS, Intan RE, Wilujeng HRT, Octora TN, Dharmajati BB, Gandi P, Alkaff FF. Triangular QRS-ST-T Waveform Electrocardiographic Pattern in Acute Myopericarditis: A Case Report from a Limited-Resources Hospital. Am J Case Rep 2020; 21:e926360. [PMID: 33100320 PMCID: PMC7598149 DOI: 10.12659/ajcr.926360] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Triangular QRS-ST-T waveform (TW) electrocardiography pattern has been found to be associated with poor prognosis in patients with ST-segment elevation myocardial infarction (STEMI). It identifies a subset of patients at high risk of both ventricular fibrillation and cardiogenic shock, with high in-hospital mortality. Therefore, aggressive treatment is needed in patients presenting with this electrocardiography pattern. However, this pattern is rarely present in non-ischemic cardiac diseases. CASE REPORT We report the case of a 50-year-old man who came to our emergency room with a chief complaint of gastrointestinal problems and partial bowel obstruction. After failure of initial conservative treatment, laparotomy was planned. Just before the surgery, the patient felt a non-specific chest discomfort and showed ST-segment elevation on ECG and slight elevation of cardiac enzyme. He was then treated for STEMI with an intravenous thrombolytic. However, the degree of ST-segment elevation further increased and showed a TW pattern. Transthoracic echocardiography revealed a moderate pericardial effusion with normal ejection fraction and a normokinetic left ventricle; hence, a diagnosis of acute myopericarditis was made. After treatment with low-dose steroid and colchicine, his symptoms improved, the electrocardiography pattern returned to normal, and the gastrointestinal symptoms resolved. CONCLUSIONS To the best of our knowledge, this is the first case report of an acute myopericarditis presenting with a TW electrocardiography pattern. Myopericarditis should always be considered in the differential diagnosis of acute chest pain and ST segment electrocardiography changes, including TW pattern. The use of echocardiography can help determine the diagnosis of myopericarditis.
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Affiliation(s)
- Fani Suslina Hasibuan
- Department of Cardiology and Vascular Medicine, Dr. R. Koesma General Hospital, Tuban, Indonesia
| | - Ryan Enast Intan
- Department of Cardiology and Vascular Medicine, Dr. R. Koesma General Hospital, Tuban, Indonesia.,Faculty of Medicine Universitas Airlangga, Surabaya, Indonesia
| | | | - Tan Nicko Octora
- Department of Cardiology and Vascular Medicine, Dr. R. Koesma General Hospital, Tuban, Indonesia.,Faculty of Medicine Universitas Airlangga, Surabaya, Indonesia
| | - Budi Baktijasa Dharmajati
- Department of Cardiology and Vascular Medicine, Faculty of Medicine Universitas Airlangga - Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
| | - Parama Gandi
- Department of Cardiology and Vascular Medicine, Faculty of Medicine Universitas Airlangga - Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
| | - Firas Farisi Alkaff
- Department of Pharmacology, Faculty of Medicine Universitas Airlangga, Surabaya, Indonesia
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Alkaff FF, Salamah S, Syamlan AT, Sukmajaya WP, Nugraha RA, Jonatan M, Sulistiawati S. Standard precaution adherence among clinical medical students in HIV and non-HIV ward in Indonesia. J Educ Health Promot 2020; 9:122. [PMID: 32642478 PMCID: PMC7325780 DOI: 10.4103/jehp.jehp_45_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Accepted: 02/01/2020] [Indexed: 06/11/2023]
Abstract
INTRODUCTION Health-care workers, especially medical intern, are at risk of exposed to blood and other body fluids in the course of their work. To reduce the risk, standard precaution (SP) is introduced. Among all communicable diseases that could be transmitted, human immunodeficiency virus (HIV) is the most stigmatized disease. However, there are some government hospitals that separated adult HIV patients with other patients to prevent additional infection. This study aims to evaluate the impact of ward separation on SP adherence. MATERIALS AND METHODS This was an observational study conducted in March 2017 in a tertiary referral hospital for the eastern part of Indonesia. The participants were 150 medical students who underwent the past year of their clinical rotation. They were given a three-part questionnaire, consisting of their background, their SP practice in the HIV ward and non-HIV wards, and their perception and attitude regarding SP. McNemar's test and Fisher's exact test were used for the statistical analysis, using SPSS version 23.0 for Windows. RESULTS Participants were more adhered to SP (hand hygiene, wear mask as indicated, and wear glove as indicated) in the HIV ward compare to non-HIV wards (P = 0.002, P = 0.001, and P = 0.001, respectively). Almost all participants were more careful in implementing SP in the HIV ward than in non-HIV wards and were more concerned of getting needlestick injury in the HIV ward than in non-HIV ward. CONCLUSION HIV and non-HIV ward separation negatively impact medical students' SP adherence.
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Affiliation(s)
- Firas Farisi Alkaff
- Department of Pharmacology, Faculty of Medicine Universitas Airlangga, Surabaya, East Java, Indonesia
| | - Sovia Salamah
- Department of Public Health and Preventive Medicine, Faculty of Medicine Universitas Airlangga, Surabaya, East Java, Indonesia
| | - Adila Taufik Syamlan
- Department of Public Health and Preventive Medicine, Faculty of Medicine Universitas Airlangga, Surabaya, East Java, Indonesia
| | - William Putera Sukmajaya
- Department of Orthopedics and Traumatology, Faculty of Medicine, Brawijaya University, Malang, Indonesia
| | - Ricardo Adrian Nugraha
- Department of Cardiology and Vascular Medicine, Faculty of Medicine Universitas Airlangga – Dr. Soetomo General Hospital, Surabaya, East Java, Indonesia
| | - Michael Jonatan
- Department of Biomedicine, Faculty of Medicine Universitas Airlangga, Surabaya, East Java, Indonesia
| | - Sulistiawati Sulistiawati
- Department of Public Health and Preventive Medicine, Faculty of Medicine Universitas Airlangga, Surabaya, East Java, Indonesia
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Alkaff FF, Sukmajaya WP, Intan RE, Salamah S. Effectivity of Indonesia Chronic Disease Management Program (PROLANIS) to Control Hypertension and its Comorbidities at Primary Health Care. Open Access Maced J Med Sci 2020. [DOI: 10.3889/oamjms.2020.4583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND: National prevalence of hypertension in Indonesia is increasing in the past few years. One of the reasons is because of the weaknesses in health systems, particularly at the primary care level. To resolve this issue, Indonesian government launched a chronic disease care program (PROLANIS) designed to be done at primary health care with the aim to control hypertension. Wates primary health care routinely conducts the program from April 2018.
AIM: This study aims to evaluate the effectivity of PROLANIS in controlling hypertension and its comorbidities at Wates primary health care.
METHODS: This study was an observational retrospective cohort study using secondary data from PROLANIS report at Wates primary health care in Mojokerto city, Indonesia. The study population was hypertensive patients that voluntarily joined the program on April 2018 and routinely attend evaluation follow-up every 6 months. Follow-up evaluation including blood pressure (BP), body mass index (BMI), total cholesterol (TC), high-density lipid (HDL), low-density lipid (LDL), triglyceride, and estimated glomerular filtration rate (eGFR).
RESULTS: There were 44 participants included for the analysis. Median systolic and diastolic BP were always within normal range. Triglyceride serum level showed an improvement in every follow-up evaluation. BMI and LDL showed an improvement in the first follow-up but deteriorated afterward. TC only showed a remarkable improvement in the last follow-up evaluation, while HDL and eGFR result were fluctuate.
CONCLUSION: PROLANIS was effective to control BP at Wates primary health care, but not effective to control all comorbidities. Future study needs to be done to elucidate the effectivity of this program countrywide.
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Flynn J, Alkaff FF, Sukmajaya WP, Salamah S. Comparison of WHO growth standard and national Indonesian growth reference in determining prevalence and determinants of stunting and underweight in children under five: a cross-sectional study from Musi sub-district. F1000Res 2020; 9:324. [PMID: 32551096 PMCID: PMC7281657 DOI: 10.12688/f1000research.23156.4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/04/2021] [Indexed: 11/25/2022] Open
Abstract
Background: Determination of stunting and wasting always uses the WHO growth standard in Indonesia. However, it is believed that Indonesian children are “below” the global standard, thus the WHO standard is not reliable to present the actual prevalence. This study aims to compare the prevalence and determinants of stunting and underweight using WHO growth standard and national Indonesian growth reference. Methods: This was a cross-sectional study carried out in Musi sub-district, East Nusa Tenggara province in July 2019. East Nusa Tenggara province had the highest prevalence of stunting and underweight in Indonesia. The study population were children under five, and total sampling method was used for this study. Length/height-for-age and weight-for-age were plotted using WHO standard and national Indonesian reference. Univariate and multivariate binomial logistic regression were used for statistical analysis. Results: The prevalence of stunting and underweight were higher for the WHO standard than the national reference (53.9% vs 10.7% and 29.17% vs 17.7%; all p < 0.001). After adjusted for confounding factors, when the WHO standard was used, determinants of stunting were maternal mid-upper arm circumference below 23.5cm and maternal height below 150cm; determinants of underweight were intrauterine growth restriction, young maternal age during pregnancy, and multiple parities. When the national reference was used, no determinants was found for stunting; the determinants of underweight were intrauterine growth restriction and maternal education. Conclusions: The WHO standard is not suitable for representing child growth in Musi sub-district. Future studies should be done to re-evaluate the prevalence and determinants of stunting and underweight nationwide using the national Indonesian reference.
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Affiliation(s)
- Jeannie Flynn
- Oeolo Primary Healthcare, Jln. Tetu Neno, Timor Tengah Utara District, East Nusa Tenggara Province, 85662, Indonesia
| | - Firas Farisi Alkaff
- Department of Pharmacology, Faculty of Medicine, Universitas Airlangga, Jl. Mayjend Prof. Dr. Moestopo No 47, Surabaya, East Java, 60132, Indonesia
| | - William Putera Sukmajaya
- Department of Orthopedics and Traumatology, Faculty of Medicine, Brawijaya University, Jl. Jaksa Agung Suprapto No 2, Malang, East Java, 65111, Indonesia
| | - Sovia Salamah
- Department of Public Health and Preventive Medicine, Faculty of Medicine, Universitas Airlangga, Jl. Mayjend Prof. Dr. Moestopo No 47, Surabaya, East Java, 60132, Indonesia
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Alkaff FF, Sukmajaya WP, Armadani A, Moksidy RC, Salma RS, Rifqi K, Nugrayekti GW. The effectivity of pictorial health warning to motivate smoking cessation in rural area: A study from Losari village, Indonesia. J Educ Health Promot 2020; 9:67. [PMID: 32490002 PMCID: PMC7255587 DOI: 10.4103/jehp.jehp_436_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/27/2019] [Accepted: 10/21/2019] [Indexed: 06/11/2023]
Abstract
INTRODUCTION Smoking is a significant health problem among Indonesian adolescents and adults. The Indonesian government had issued several policies to alleviate this problem, including placement of pictorial health warning (PHW) on cigarette package. There had been several evaluation studies regarding the effectivity of PHW in urban areas but none in rural areas. This study aims to evaluate the effectivity of PHW in motivating smoking cessation in a rural area in Indonesia. MATERIALS AND METHODS This was a descriptive cross-sectional study conducted in August 2017 in Losari village, Indonesia. Respondents of this study were villagers aged 18-60 years who were active smokers and purchased cigarette with PHW on the package. The research instruments for this study were questionnaire and printout pictures of each PHW approved by the Indonesian government. RESULTS There were 94 respondents recruited in this study. Among them, only 26 (27.7%) stated that PHW motivated them to stop smoking. From the five figures of PHW, a picture of lung cancer was the most effective PHW to motivate smoking cessation. Eighty-one of 94 respondents affirm that there are other factors besides PHW that might motivate them to stop smoking. Most of them agreed that an increase in cigarette price will force them to stop smoking. CONCLUSIONS Current PHW used on cigarette package might be ineffective in motivating smoking cessation at Losari village. Further study with larger samples needs to be done to confirm this finding.
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Affiliation(s)
- Firas Farisi Alkaff
- Department of Pharmacology, Faculty of Medicine Universitas Airlangga, Surabaya, Indonesia
| | - William Putera Sukmajaya
- Department of Orthopedics and Traumatology, Faculty of Medicine Universitas Brawijaya, Malang, Indonesia
| | - Amelya Armadani
- Medical Student, Faculty of Medicine Universitas Airlangga, Surabaya, Indonesia
| | | | - Rina Syarifah Salma
- Medical Student, Faculty of Medicine Universitas Airlangga, Surabaya, Indonesia
| | - Kafin Rifqi
- Medical Student, Faculty of Medicine Universitas Airlangga, Surabaya, Indonesia
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Sukmajaya W, Alkaff FF, Oen A, Sukmajaya AC. Williams Flexion Exercise for Low Back Pain: A Possible Implementation in Rural Areas. Open Access Maced J Med Sci 2020. [DOI: 10.3889/oamjms.2020.3988] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
AIM: Low back pain (LBP) is a widespread complaint of all age groups. The economic burden of LBP is high, and physiotherapy has proven to reduce this. Unfortunately, physiotherapy or exercise regimen is rarely prescribed to LBP patients by doctors. Until now, there was no study regarding the application of physiotherapy exercise in Indonesia. This study aims to evaluate the effect of Williams flexion exercise (WFE) toward people with LBP.
METHODS: This was a pretest-posttest experimental study design of PROLANIS participants with LBP complaints in one of the primary health-care centers in Jombang, East Java, Indonesia, on June 2018–July 2018. The total sampling method was used in this study. Participants’ basic clinical data and Oswestry Disability Index (ODI) were obtained through a self-administered questionnaire. WFE was taught to the participants through a presentation, video, and live demonstration. After 1 month, ODI of the participants was reassessed.
RESULTS: There were 42 participants included in this study. There was a significant ODI difference between pre- and post-WFE implementation (31.05 ± 17.40 vs. 14.10 ± 11.78, p = 0.019). Higher exercise frequency (>1 times/day) was associated with further reduction in ODI compared to lower exercise frequency group (1 time/day) (22.09 ± 19.09 vs. 7.38 ± 12.58, p = 0.017). There was no significant difference in ODI reduction between geriatric and non-geriatric participants (p = 0.24).
CONCLUSION: WFE improves functional symptoms of LBP regardless of age. This exercise could be implemented in a primary health-care setting in future to reduce the cost for LBP treatment.
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Intan RE, Hasibuan FS, Nugraha RA, Octora TN, Alkaff FF. Proximal Pulmonary Artery Aneurysm Secondary to Suspected Pulmonary Hypertension Treated with Conservative Therapy in Limited Resource Setting. Am J Case Rep 2019; 20:1805-1811. [PMID: 31796724 DOI: 10.12659/ajcr.918827] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Pulmonary artery aneurysm (PAA) is a rare disease in cardiovascular system. This disease is difficult to diagnose and less often considered due to its non-specific clinical manifestations. Until now there are no clear guidelines about its optimal management because of the small number of reported cases. CASE REPORT We report a 56-year-old male with chief complain of atypical bilateral chest pain and shortness of breath. Initial electrocardiogram (ECG) and laboratory evaluation showed no sign of ischemic heart disease. After the patient was stabilized, he was evaluated using chest x-ray, transthoracic echocardiography (TTE), and multi slice computed tomography (MSCT). The patient was then diagnosed with PAA secondary to suspicion of pulmonary hypertension (PH) with chronic obstructive pulmonary disease and heart failure. Conservative treatment was chosen because of the limited resources for surgery and patient's refusal to be referred. The treatment aims to lower the pulmonary artery pressure while monitoring the aneurysm. His 6-month follow-up evaluation showed an improvement in pulmonary artery pressure and persistent of the PAA without any increasement of the diameter. CONCLUSIONS PAA is a rare disease that is difficult to diagnose because of its non-specific nature. Persistent atypical chest pain can be an early symptom of PAA, thus clinicans should be aware in a high-risk patient suffered persistent chest pain, despite normal ECG and laboratory findings. TTE and MSCT evaluation are reliable for diagnosing PH and PAA. With conservative treatment and routine follow-up, patient with PAA secondary to PH could be managed well.
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Affiliation(s)
| | - Fani Suslina Hasibuan
- Department of Cardiology and Vascular Medicine, Dr. Koesma General Hospital, Tuban, Indonesia
| | | | | | - Firas Farisi Alkaff
- Department of Pharmacology, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
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Imawan DK, Oesman WS, Yuseran H, Mustokoweni S, Kania N, Harsono AAH, Alkaff FF. Recurrent Cervical Sarcoma Botryoides in a 3-Year-Old Female: Approach in a Limited Resource Setting. Am J Case Rep 2019; 20:838-843. [PMID: 31197128 PMCID: PMC6587646 DOI: 10.12659/ajcr.915608] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Sarcoma botryoides, known as embryonal rhabdomyosarcoma (ERMS), is a malignant tumor which arises from embryonic muscle cells. The incidence of ERMS in the uterine cervix rarely occurs at a very young age. With sufficient resources, management of this disease is not difficult. However, in limited resources settings, such as in Indonesia, the situation is more challenging. This case report aims to highlight the difficulties encountered in diagnosing and treating patients with sarcoma botryoides. CASE REPORT A 3-year-old female patient came the outpatient clinic of our hospital with a protruding mass from her vagina resembling a bunch of grapes which easily bled. She underwent surgery to remove the mass. After the procedure, she did not return to the hospital for the recommended adjuvant chemotherapy treatment due to limited funds. Three months later, she came to the outpatient clinic with the same complaint, despite smaller size. Due to limited resources, we only evaluated the metastasis using chest x-ray and did not perform intra-operative biopsy. In the second surgery, a wide excision with 1-2 cm margin was performed, followed by adjuvant chemotherapy for 6 series. We achieved a satisfactory outcome in this case, and 18 months after the surgery, the patient was still in remission. CONCLUSIONS Sarcoma botryoides is a rare malignancy. The effective treatment for sarcoma botryoides is wide excision with safe margin of 1-2 cm, followed by 6-12 cycles of vincristine, actinomycin D, and cyclophosphamide (VAC) regiment as an adjuvant chemotherapy. A family's understanding of the treatment plan is important to achieve desired outcomes. Even with limited resources, this malignancy can still be properly treated.
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Affiliation(s)
- Dwi Krisna Imawan
- Department of Obstetrics and Gynecology, Faculty of Medicine Universitas Airlangga, Dr. Soetomo General Hospital, Surabaya, Indonesia
| | - Wita Saraswati Oesman
- Department of Obstetrics and Gynecology, Faculty of Medicine Universitas Airlangga, Dr. Soetomo General Hospital, Surabaya, Indonesia
| | - Hariadi Yuseran
- Department of Obstetrics and Gynecology, Faculty of Medicine Universitas Lambung Mangkurat, Ulin General Hospital, Banjarmasin, Indonesia
| | - Sjahjenny Mustokoweni
- Department of Anatomical Pathology, Faculty of Medicine Universitas Airlangga, Dr. Soetomo General Hospital, Surabaya, Indonesia
| | - Nia Kania
- Department of Anatomical Pathology, Faculty of Medicine Universitas Lambung Mangkurat, Ulin General Hospital, Banjarmasin, Indonesia
| | | | - Firas Farisi Alkaff
- Department of Pharmacology, Faculty of Medicine Universitas Airlangga, Surabaya, Indonesia
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Sampurna M, Angelika D, Utomo MT, Wijaya NA, Budiono B, Alkaff FF, Irawan R, Etika R. Effect of enteral glutamine supplementation for low-birth-weight infants on weight gain patterns and levels of fecal secretory immunoglobulin A. Turk Arch Pediatr 2019; 53:231-237. [PMID: 30872925 DOI: 10.5152/turkpediatriars.2018.6834] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2018] [Accepted: 10/08/2018] [Indexed: 11/22/2022]
Abstract
Aim Glutamine is needed for optimal cell growth and for the immune system, especially in the enterocytes of gut mucosal immune responses. Low birth weight makes infants susceptible to glutamine depletion because nutrition is limited in the first week of life. To determine the effect of enteral glutamine supplementation on weight gain patterns and fecal secretory immunoglobulin A. Material and Methods This study is a double-blind, randomized controlled trial. Infants were randomly assigned to the glutamine group and placebo group. The glutamine group was supplemented with glutamine 400 mg/kg/day for 14 days, and placebo group received glucose 400 mg/kg/day for 14 days. The infants were observed for 30 days. Return-to-birth-weight, weight gain velocity, and fecal secretory immunoglobulin A levels were monitored during the study. Results Thirty-seven low-birth-weight infants were randomly assigned to the glutamine and placebo groups. The glutamine group had a shorter return-to-birth-weight time than the placebo group (8.1±0.9 vs. 11.0±1.6 days) and faster weight gain velocity (20.0±1.8 vs. 15.5±2.2 g/kg/day) (p<0.001). Secretory immunoglobulin A levels after glutamine supplementation were higher than in the placebo group (0.456±0.057 vs. 0.376±0.035 mg/g) (p<0.001). Levels of secretory immunoglobulin A after treatment in each group were increased. However, there was a significant difference before and after supplementation between the glutamine and placebo groups (0.247±0.024 vs. 0.140±0.016 mg/g) (p<0.001). Conclusion Enteral glutamine supplementation in low-birth-weight infants accelerates return to birth weight, increases the weight gain velocity, and the levels of fecal secretory immunoglobulin A.
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Affiliation(s)
- Mahendra Sampurna
- Department of Pediatrics, Airlangga University School of Medicine, Surabaya, Indonesia
| | - Dina Angelika
- Department of Pediatrics, Airlangga University School of Medicine, Surabaya, Indonesia
| | - Martono Tri Utomo
- Department of Pediatrics, Airlangga University School of Medicine, Surabaya, Indonesia
| | - Nur Aisiyah Wijaya
- Department of Pediatrics, Airlangga University School of Medicine, Surabaya, Indonesia
| | - Budiono Budiono
- Department of Public Health, Airlangga University School of Medicine, Surabaya, Indonesia
| | | | - Roedi Irawan
- Department of Pediatrics, Airlangga University School of Medicine, Surabaya, Indonesia
| | - Risa Etika
- Department of Pediatrics, Airlangga University School of Medicine, Surabaya, Indonesia
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Akbar MIA, Alkaff FF, Harsono AAH, Imawan DK, Klahan Y, Nugraha RA, Octora TN, Jonatan M. Serum Calcium and 25-Hydroxy Vitamin D Level in Normal and Early Onset Pre-eclamptic Pregnant Women: A Study from Indonesia. J Clin Diagn Res 2019. [DOI: 10.7860/jcdr/2019/39924.12667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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