bluuebunny/crossref_metadata_2025 huggingface dataset:
Pengembangan Aplikasi Seluler Kesehatan terkait Diabetes Melitus
Authors: Lukito Johan Indra
Published: July 2022

Peningkatan kualitas hidup pasien diabetes melitus (DM) membutuhkan pengelolaan komprehensif. Beberapa tantangan dihadapi baik oleh pasien maupun profesional kesehatan dalam tatalaksana DM. Penggunaan dan pengembangan aplikasi seluler kesehatan berbasis telemedicine dan teknologi informasi kesehatan diharapkan dapat membantu mengatasi tantangan ini.

Improving the quality of life of patients with diabetes mellitus (DM) requires comprehensive management. Several challenges are faced by both patients and health professionals in the management of DM. It is hoped that the use and development of mobile health applications based on telemedicine and health information technology can help overcome this challenge.
Konjungtivitis pada COVID-19
Authors: Stefanie Airina , Haryady Stefanny , Amelia Yufilia Suci
Published: July 2022

Corona Virus Disease 19 (COVID-19) pertama ditemukan di Wuhan, Cina, pada Desember 2019 dan telah menjadi ancaman kesehatan global. COVID-19 disebabkan oleh Severe Acute Respiratory Corona Virus 2 (SARS-CoV-2), ditransmisikan melalui droplet pernapasan atau kontak erat. Penelitian terbaru menyatakan bahwa konjungtiva dapat menjadi port d’entree SARS-CoV-2, dan menyebabkan gejala konjungtivitis. Jalur transmisi SARS-CoV 2 ke okuler diduga melalui inokulasi langsung dan melalui reseptor ACE2 yang diekspresikan di konjungtiva. Karakteristik konjungtivitis COVID-19 adalah sekret mukoid ataupun aqueous berlebih, sensasi tidak nyaman pada okuler seperti gatal, benda asing, atau rasa terbakar, serta hiperemis konjungtiva. Pada pemeriksaan RT PCR swab okuler ataupun nasofaring dapat positif pada 3 hingga 21 hari setelah onset gejala. Studi ini merupakan literature review. Artikel diambil dari database Google scholar, Pubmed, Lange, Elsevier, dengan kata kunci “ocular manifestation in COVID-19”, “characteristics of conjunctivitis in COVID-19”, “mechanism of COVID-19 in conjunctiva”. Artikel yang dipilih adalah jurnal yang dipublikasi sejak tanggal 1 Desember 2019 sampai 30 Oktober 2020.

 

Corona Virus Disease 19 (COVID-19) was first discovered in Wuhan, China, in 2019 and has been declared as global health emergency. COVID-19 is caused by Severe Acute Respiratory Corona Virus 2 (SARS-CoV 2) transmitted through droplet and physical contact. Studies stated that conjunctiva is a potential port of entry of SARS-CoV2, which then leads to conjunctivitis. This literature review is based on analytic study on conjunctivitis in COVID-19. The transmission route is thought from direct inoculation and expression of ACE2 receptors from conjunctiva. Most common characteristics of conjunctivitis in COVID-19 are increased conjunctival secretions both mucoid and aqueous, and ocular discomfort such as itching, foreign bodies sensations, burning, and conjunctival hyperemia. RT PCR from both ocular and nasopharyngeal swabs were detectable from days 3 to 21 after the onset of symptoms. This study is a review on published articles from December 1st 2019 to October 30th 2020, in Google Scholar, PubMed, Lange, and Elsevier; selected with keywords “ocular manifestation in COVID-19”, “characteristics of conjunctivitis in COVID-19”, “mechanism of COVID-19 in conjunctiva”. 
The Effectivity of Telerehabilitation for Post Stroke Patients
Authors: Glenis Gabrielle , Setiawan Regina Caecilia , Tambunan Tresia Fransiska Ulianna
Published: July 2022

Stroke rehabilitation is an essential component of post-stroke care and is more effective if started sooner. Stroke rehabilitation therapy aims to improve motor function, psychological well-being, cognitively, emotionally, and in terms of social well-being. Telerehabilitation allows communication between medical staff and patients and can be a suitable alternative to usual rehabilitation care in poststroke patients. This method may have potential implications for patients, especially in remote or underserved areas. Future trials are needed on telerehabilitation's feasibility, efficacy, and cost-effectiveness in other low and middle-income countries where the stroke burden is burgeoning.

 
Rehabilitasi stroke merupakan komponen penting dalam tatalaksana pasca-stroke dan lebih efektif untuk dimulai lebih awal. Tujuan terapi rehabilitasi stroke adalah untuk meningkatkan fungsi motorik, kognitif, emosional, kesejahteraan psikologis dan sosial. Telerehabilitasi memungkinkan komunikasi antara staf medis dan pasien dan dapat sebagai alternatif yang sesuai untuk perawatan rehabilitasi biasa pada pasien pasca-stroke. Metode ini mungkin memiliki implikasi potensial bagi pasien, terutama di daerah terpencil atau kurang terlayani. Penelitian masih diperlukan untuk kelayakan, kemanjuran, dan keefektifan biaya telerehabilitasi di negara berpenghasilan rendah dan menengah dengan beban stroke meningkat.
Komplikasi Sistem Saraf Pusat pada COVID-19
Authors: Esterita Tasia , Wreksoatmodjo Budi Riyantoo
Published: July 2022

Coronavirus disease-19 disebabkan oleh virus SARS-CoV-2 yang menyebabkan pandemi sejak Maret 2020. COVID-19 tidak hanya menyebabkan komplikasi pernapasan dan kardiovaskular, tetapi dapat menyebabkan komplikasi sistem saraf pusat yang juga berkontribusi terhadap mortalitas dan morbiditas. Beberapa komplikasi sistem saraf pusat pada COVID-19 adalah stroke iskemik, stroke hemoragik, meningoensefalitis, acute transverse myelitis, dan ensefalopati. Stroke iskemik pada COVID-19 disebabkan oleh beberapa mekanisme, di antaranya koagulopati, disfungsi endotel, kardioemboli, invasi virus ke sistem saraf pusat, dan terapi imunoglobulin. Stroke hemoragik dapat disebabkan oleh kerusakan endotel akibat inflamasi menyebabkan disregulasi tekanan darah yang meningkatkan risiko stroke hemoragik. Meningoensefalitis pada COVID-19 disebabkan invasi virus langsung melalui cribriform plate atau karena kerusakan endotel yang menjadi pintu masuk SARS-CoV-2 ke otak. Mielitis transversa pada COVID-19 disebabkan hiperinflamasi sistemik, molecular mimicry, dan epitope spreading. Kegagalan organ multipel pada pasien COVID-19 akibat badai sitokin dapat menyebabkan ensefalopati.

 
Coronavirus disease-19 is caused by the SARS-CoV-2 virus that has been causing a pandemic since March 2020. Besides respiratory and cardiovascular complications, COVID-19 can cause complications to central nervous system that also contribute to mortality and morbidity. Some central nervous system complications in COVID-19 are ischemic stroke, hemorrhagic stroke, meningoencephalitis, acute transverse myelitis, and encephalopathy. Ischemic stroke in COVID-19 is caused by several mechanisms, including coagulopathy, endothelial dysfunction, cardioembolism, viral invasion of the central nervous system and immunoglobulin therapy. Hemorrhagic stroke can be associated with blood pressure dysregulation caused by inflammational endothelial damage. Meningoencephalitis in COVID-19 can be caused by direct viral invasion through the cribriform plate or due to endothelial damage that facilitate SARS-CoV-2 entrance to the brain. Transverse myelitis in COVID-19 is caused by systemic hyperinflammation, molecular mimicry and epitope spreading. Multiple organ failure in COVID-19 patients due to a cytokine storm can lead to encephalopathy.
Penggunaan Steroid Sistemik pada Henoch Schonlein Purpura
Authors: Taqiyyah Masyalia Hasna
Published: July 2022

Steroid umum digunakan pada HSP mengingat efek antiinflamasinya. Namun, di lain pihak beberapa kasus HSP dapat sembuh sendiri hanya dengan terapi simtomatik ataupun suportif. Penelitian terkini menunjukkan bahwa steroid hanya bermanfaat pada beberapa kasus HSP. Penggunaan steroid harus dipertimbangkan berdasarkan indikasi dan tidak untuk setiap kasus HSP.

 
Steroids are commonly used in all cases of HSP because of its anti-inflammatory effect. However, some HSP cases are self-limiting and only necessitate symptomatic or supportive therapy. Recent research has shown that steroids are beneficial in only a few cases of HSP. Steroid should be used as indicated and considered in every case of HSP.
Tren Terapi Age-Related Macular Degeneration
Authors: Pricelda Alicia
Published: July 2022

Dahulu penyakit retina memiliki prioritas rendah dalam strategi pencegahan kebutaan di negara berkembang karena masih jarang dikenal sebagai penyebab kebutaan, peralatan belum cukup canggih, dan juga kurangnya tenaga medis sub-spesialistik penyakit retina. Seiring kemajuan ilmu pengetahuan dan teknologi, penyakit retina saat ini diketahui merupakan salah satu penyebab kebutaan utama terutama pada anak. Masih belum banyak pilihan terapi penyakit retina, tetapi pasien berhak mendapatkan diagnosis yang akurat, penjelasan yang baik, dan prognosis yang jelas. Artikel ini membahas salah satu penyakit retina yaitu age-related macular degeneration (AMD), pengobatan yang tersedia dan yang sedang dikembangkan.

Previously, retinal diseases had low priority in preventing blindness strategies in developing countries because they are rarely known as the cause of blindness, no available sophisticated diagnostic equipment, and also lack of medical personnel with sub-specialties in retinal diseases. With the advancement of science and technology, retinal disease is now currently known as one of the main causes of blindness, especially in children. Limited therapies are currently available, but patients still deserve an accurate diagnosis, good explanation, and a clear prognosis. This article discusses one of the retinal diseases : age-related macular degeneration (AMD), its existing and emerging treatments.
Indeks Subjek
Authors: - -
Published: July 2022

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Penggunaan Montelukast dalam Terapi Asma Bronkial dan Rinitis Alergi
Authors: Kristiningrum Esther
Published: July 2022

Montelukast merupakan antagonis reseptor leukotrien (LTRA) oral yang diindikasikan untuk terapi asma kronik, profilaksis bronkokonstriksi yang diinduksi latihan fisik, serta meredakan gejala rinitis alergi, baik musiman maupun sepanjang tahun. Montelukast direkomendasikan sebagai monoterapi untuk mengontrol asma, khususnya pada anak, dan sebagai terapi tambahan terhadap ICS (inhalation corticosteroid) atau alternatif terhadap penambahan LABA (long acting beta agonist). Selain itu, montelukast oral direkomendasikan pada dewasa dan anak dengan rinitis alergi musiman dan pada anak prasekolah dengan rinitis alergi sepanjang tahun.

Montelukast is an oral leukotriene receptor antagonist (LTRA) indicated for the treatment of chronic asthma, prophylaxis of exercise-induced bronchoconstriction, and for the relief of symptoms of both seasonal and perennial allergic rhinitis. LTRA is recommended as monotherapy to control asthma, especially in children, and as an adjunct therapy to ICS (inhalation corticosteroid) or an alternative to the addition of LABA (long acting beta agonist). Oral montelukast are also recommended for adults and children with seasonal allergic rhinitis and in preschool children with perennial allergic rhinitis.

 
Lung Abscess: Diagnosis and Treatment
Authors: Lawrensia Sherly
Published: July 2022

Lung abscess is a microbial infection of the lungs that results in pulmonary parenchyma necrosis. Meticulous history taking, physical examination, and prompt diagnostic workup are necessary for establishing the diagnosis. Antibiotics are the cornerstone for lung abscess’ treatment with size less than 6 cm.

Abses paru adalah infeksi mikroba pada paru yang menyebabkan nekrosis parenkim paru. Anamnesis dan pemeriksaan fisik yang teliti, serta pemeriksaan penunjang yang tepat penting untuk diagnosis. Antibiotik merupakan pilihan terapi utama untuk abses paru berukuran kurang dari 6 cm.
Acute Respiratory Distress Syndrome: Pathophysiology and Management
Authors: Hartanto Darius
Published: July 2022

Acute respiratory distress syndrome (ARDS) is a severe and fatal condition characterized by severe hypoxic respiratory failure resistant to oxygen therapy with bilateral lung infiltrates in radiological findings, first described in 1967 by Ashbaugh and colleagues. Several pathogenesis mechanisms were involved in ARDS, such as excess inflammation, endothelial permeability, epithelial permeability, and impaired alveolar fluid clearance. Kigali criteria as modified Berlin criteria typically maintain the previous criteria with removed PEEP requirement and hypoxemiaevaluated using the ratio of arterial oxygen saturation by pulse oximetry/inspiratory oxygen fraction (SpO2/FiO2). Low tidal volumes and positive end-expiratory pressure(PEEP) were needed to prevent alveolar collapse due to loss of surfactant and fluid accumulation in alveoli. The prone position was shown to have a beneficial effect on a critically ill patient. Treatment should be aimed at the underlying condition even though lung injury has occurred in many cases.

Acute respiratory distress syndrome (ARDS) adalah kondisi serius dan fatal yang ditandai dengan kegagalan pernapasan tipe hipoksia berat yang resisten terhadap terapi oksigen dengan infiltrat paru bilateral pada temuan radiologis; pertama kali ditemukan pada tahun 1967 oleh Ashbaugh dan kawan-kawan. Beberapa mekanisme patogenesis yang terlibat dalam ARDS adalah inflamasi berlebih, permeabilitas endotel, permeabilitas epitel, dan gangguan pembersihan cairan alveolar. Kriteria Kigali sebagai hasil modifikasi dari kriteria Berlin, mempertahankan kriteria sebelumnya dengan persyaratan PEEP dihilangkan dan hipoksemia dievaluasi menggunakan rasio saturasi oksigen arteri dengan oksimetri nadi/ fraksi oksigen inspirasi (SpO2/ FiO2). Volume tidal dan tekanan ekspirasi akhir positif (PEEP) rendah perlu untuk mencegah kolaps alveolar karena hilangnya surfaktan dan akumulasi cairan di alveoli. Posisi tengkurap terbukti memiliki efek menguntungkan pada pasien kritis. Pengobatan ARDS harus ditujukan untuk mengobati kondisi yang mendasarinya meskipun cedera paru telah terjadi dalam kebanyakan kasus.

 
Peranan Inotropik dan Vasopresor dalam Terapi Syok Kardiogenik
Authors: Rizka Pratama Agung , Fadil Muhammad
Published: July 2022

Syok kardiogenik merupakan keadaan darurat medis yang mengancam jiwa dengan terjadinya hipoperfusi jaringan akibat berkurangnya curah jantung. Penyebab utama syok kardiogenik yaitu infark miokard akut dengan angka mortalitas mencapai 50%. Inotropik dan vasopresor telah menjadi landasan untuk stabilisasi gangguan hemodinamik dan curah jantung pada syok kardiogenik. Beberapa penelitian dan rekomendasi terbaru mengajukan dobutamin sebagai agen inotropik dan norepinefrin dibandingkan dopamin sebagai vasopressor lini pertama untuk tatalaksana syok kardiogenik.

Cardiogenic shock is a life-threatening medical emergency because of tissue hypoperfusion due to reduced cardiac output. The main cause of cardiogenic shock is acute myocardial infarction with mortality rate reaching 50%. Inotropics and vasopressors have been the basis for stabilization of hemodynamic instability and cardiac output in cardiogenic shock. Recent studies and recommendations recommend that dobutamine and norepinephrine is preferred over dopamine as a first-line vasopressor for patients with cardiogenic shock.
Angina Prinzmetal - Diagnosis dan Tatalaksana
Authors: - Tommy
Published: July 2022

Angina Prinzmetal merupakan sindrom klinis yang dicirikan dengan nyeri dada saat istirahat disertai perubahan elektrokardiogram. Insidensi lebih tinggi pada populasi Asia dengan rentang usia di atas 50 tahun. Merokok dan penggunaan obat-obatan tertentu dapat meningkatkan risiko angina Prinzmetal. Penyakit ini jarang terdiagnosis sehingga tatalaksana belum optimal. Diagnosis berdasarkan kriteria Coronary Vasomotion Disorders International Study Group dan pemeriksaan penunjang seperti elektrokardiografi, uji provokatif, atau pencitraan intrakoroner. Tatalaksana mencakup perubahan gaya hidup, terapi farmaka, atau intervensi koroner perkutan. Prognosis mengacu pada hasil skor risiko Japanese Coronary Spasm Association, umumnya baik.

Prinzmetal’s angina is a clinical syndrome in which angina occurs at rest with transient electrocardiogram changes. The incidence is higher in the Asian population with age ranges above 50 years. Smoking and use of certain drugs can increase the risk of Prinzmetal’s angina. This disease is underdiagnosed and the treatment is not optimal. Diagnosis is based on the Coronary Vasomotion Disorders International Study Group Criteria and supporting examinations such as electrocardiography, provocative test, or intracoronary imaging. The management includes lifestyle changes, pharmacotherapy, or percutaneous coronary intervention. Prognosis refers to the Japanese Coronary Spasm Association risk score, are generally good.
Obesity and Endometrial Cancer: Mechanism and How to Deal with?
Authors: Dewi Anggraeni Tricia , Surya Raymond , Pratama Kurniawan Andrew
Published: July 2022

Obesity is strongly associated with development of endometrial cancer more than any other cancer type. The relationship between obesity and endometrial cancer risk is combination of inflammation, insulin resistance, and increased bioavailability of estrogen. Obesity can increase risk to develop endometrial cancer as exogenous estrogen has impact for tumorigenesis. The best method to reduce the risk of endometrial cancer in obese women is through progesterone medication and lifestyle intervention.

Obesitas erat kaitannya dengan terjadinya kanker endometrium lebih dari jenis kanker lainnya. Hubungan antara obesitas dan risiko kanker endometrium adalah kombinasi antara inflamasi, resistensi insulin, dan peningkatan bioavailabilitas estrogen. Obesitas dapat meningkatkan risiko terjadinya kanker endometrium karena estrogen eksogen berdampak pada tumorigenesis. Metode terbaik untuk mengurangi risiko kanker endometrium pada wanita yang obese adalah melalui pengobatan progesteron dan intervensi gaya hidup. Tricia
Prosedur Barbotase Dipandu Ultrasonografi untuk Terapi Tendinitis Kalsifik
Authors: Suryamin Ricky
Published: July 2022

Tendintis kalsifik merupakan penyakit deposisi kristal kalsium hidroksiapatit di dalam atau di sekitar tendon. Etiologinya masih belum diketahui pasti. Deposisi kristal kalsium sering terjadi pada bagian rotator cuff tendon. Gejala bervariasi tergantung fase perjalanan penyakit, dapat self-limiting. Pengobatan lini utama adalah pengobatan oral, jika kurang berhasil dapat dilakukan tindakan invasif minimal. Prosedur barbotase dipandu ultrasonografi memungkinkan panduan radiologis saat memasukkan jarum suntik untuk aspirasi kristal kalsium hidroksiapatite. Prosedur barbotase dipandu ultrasonografi memiliki banyak keuntungan dan berhasil baik.

Calcific tendinitis is a disease of crystal deposition inside or around tendon. The etiology is still not known, it is often self-limiting. Most common site for calcific tendinitis is at rotator cuff tendon. Symptoms may depend on the phase of the disease. First-line medication is oral treatment, but some patients require minimal invasive treatment. Ultrasound-guided barbotage procedure allow guidance for needle aspiration of calcium hydroxyapatite crystal. The procedure has many advantage and provide good result.

 
Tatalaksana Pasca Henti Jantung
Authors: Alvenus Willim Herick , Ketaren Infan , Supit Alice Inda
Published: July 2022

Sindrom pasca henti jantung merupakan keadaan kompleks dan kritis dengan mortalitas tinggi. Tatalaksana pasca henti jantung membutuhkan pendekatan multidisiplin meliputi stabilisasi status kardiopulmoner, penanganan penyebab, strategi neuroproteksi dini, dan pencegahan berulangnya henti jantung. Pendekatan multimodal diperlukan untuk prediksi keluaran neurologis.

Post-cardiac arrest syndrome is complex and critical condition associated with high mortality. Post-cardiac arrest management needs multidisciplinary approach including stabilization of cardiopulmonary status, managing the underlying cause, early neuroprotective strategy, and prevention of recurrent cardiac arrest. Multimodal approach is needed to predict neurological outcome.
Diagnosis dan Tatalaksana Paroxysmal Nocturnal Hemoglobinuria
Authors: - Cecile
Published: July 2022

Paroxysmal nocturnal hemoglobinuria (PNH) merupakan kelainan sel hematopoesis didapat yang menyebabkan hemolisis intravaskular dan berisiko tinggi trombosis. PNH terdiri dari PNH klasik, PNH terkait kegagalan sumsum tulang dan PNH subklinis. Diagnosis PNH dengan flow cytometry (FCM). Terapi PNH saat ini menggunakan eculizumab, ravulizumab dan transplantasi sel punca alogenik.

Paroxysmal nocturnal hemoglobinuria (PNH) is an acquired disorder of hematopoietic stem cell causing intravascular hemolysis and high risk of thrombosis. It can be differentiated into: classical PNH, PNH associated with bone marrow failure and subclinical PNH. Diagnosis is made by flow cytometry. PNH is treated with eculizumab, ravulizumab and allogenic stem cell transplantation.
Penggunaan Parasetamol pada Covid-19
Authors: Christian Yong Bernard Jonathan
Published: July 2022

Latar belakang: Parasetamol sering digunakan untuk mengobati gejala demam pada COVID-19. Banyak hipotesis yang menyebutkan hubungan kadar Glutathione (GSH) dengan derajat keparahan COVID-19, sedangkan parasetamol dapat menurunkan kadar GSH. Hingga saat ini, belum ada panduan khusus untuk dosis penggunaan obat parasetamol pada pasien COVID-19.

Background: Paracetamol is often used to treat fever symptoms in COVID-19. Many hypotheses state the relationship between Glutathione (GSH) levels and the severity of COVID-19, while paracetamol can reduce GSH levels. To date, there are no specific guidelines for the dosage of paracetamol in patients with COVID-19

 
Efektivitas N-Acetylsistein pada Pasien COVID 19
Authors: Sujana Karlina Sari , Maulida Munfika
Published: July 2022

COVID- 19 disebabkan oleh virus SARS-Cov-2 dan menyebabkan morbiditas dan mortalitas yang tinggi. COVID 19 dapat menyebabkan pneumonia, sindrom gangguan pernapasan akut, perubahan kardiovaskular, dan kegagalan multi organ, yang dianggap berasal dari mekanisma badai sitokin, respons peradangan sistemik, dan serangan sistem kekebalan. N-acetylcysteine (NAC) telah digunakan dalam klinis untuk mengobati pasien sepsis dengan kondisi kritis. NAC memiliki karakteristik antioksidan, antiinflamasi, dan modulasi kekebalan yang bermanfaat menurunkan risiko perburukan COVID-19.

COVID-19 is caused by SARS-Cov-2 virus, and is known to cause high morbidity and mortality. COVID-19 causes pneumonia, acute respiratory distress syndrome, cardiovascular changes, and multi-organ failure, correlated to cytokine storm mechanisms, systemic inflammatory responses, and immune system attacks. N-acetylcysteine (NAC) has been used in clinical practice to treat sepsis patients with critical conditions. NAC has antioxidant, anti-inflammatory, and immune modulation characteristics beneficial to reduce the risk of COVID-19 worsening.
Diagnosis dan Tatalaksana Kegawatdaruratan Hiperkalemia
Authors: Teo Gloria
Published: July 2022

Hiperkalemia ialah kadar kalium plasma/ serum yang melebihi batas atas rentang normal, yaitu ≥ 5,5 mEq/L; dapat bervariasi tergantung cutoff laboratorium dan sampel pemeriksaan. Hiperkalemia sering dijumpai di instalasi gawat darurat (IGD). Hiperkalemia berat dapat meningkatkan risiko mortalitas hingga 30%, karena menyebabkan aritmia yang mengancam nyawa, seperti fibrilasi ventrikel dan asistol. Hiperkalemia dapat disebabkan oleh perpindahan K+ intraseluler menuju ekstraselular, ekskresi inadekuat, dan intake K+ berlebih pada pasien gangguan ginjal. Tatalaksana hiperkalemia meliputi upaya menstabilkan miokard dan mencegah/ memperbaiki disritmia, redistribusi/pemindahan K+ menuju intraseluler, serta meningkatkan ekskresi K+.

Hyperkalemia is defined as a serum or plasma potassium level above the upper limits of normal range, usually ≥5,5 mEq/L; may vary depending on each laboratory cutoff and sample. Hyperkalemia is the most common electrolyte disorder in emergency department. Severe hyperkalemia may increase the mortality up to 30% due to fatal arrhythmia, such as ventricular fibrillation and asystole. Hyperkalemia might be caused by potassium shift to extracellular compartment, inadequate excretion, and increased potassium intake in patients with decreased renal function. Management of hyperkalemia include myocardial stabilization and preventing/ improving dysrhythmia, redistribution/ shifting potassium back to intracellular compartment, and increasing potassium excretion.
Pendekatan Klinis Pasien Transthyretin Cardiac Amyloidosis (ATTR-CA)
Authors: Purba Nur Adiba
Published: July 2022

Transthyretin Cardiac Amyloidosis (ATTR-CA) adalah penumpukan fragmen protein transthyretin di jaringan interstisial miokardium akibat salah lipat protein, menyebabkan kardiomiopati restriktif dan infiltratif karena penebalan dan kekakuan dinding jantung. Transthyretin sebagian besar diproduksi di hati, berbentuk tetramer dan berfungsi sebagai protein pembawa tiroksin (T4) serta holoretinol binding protein (HRP). Saat ini, pemeriksaan diagnostik metode non-invasif telah dikembangkan meskipun biopsi endomiokardium masih menjadi gold standard diagnosis. Diagnosis akurat sedini mungkin sangat berpengaruh terhadap keberhasilan serta penurunan angka morbiditas dan mortalitas.

Transthyretin Cardiac Amyloidosis (ATTR-CA) is the accumulation of transthyretin protein fragment in myocardium interstitial tissue induced by misfolded protein, lead to thickening and stiffness cardiac muscles, causing restrictive and infiltrative cardiomyopathy. Transthyretin is produced mainly in the liver as tetramer and bonded both with thyroxine (T4) and holoretinol binding protein (HRP) as carrier protein. Diagnostic test with non-invasive methods have been developed recently although endomyocardial biopsy is still the gold standard. Early targeted diagnosis has huge impact for therapy management and decreasing patient’s morbidity and mortality.
Tatalaksana Nyeri Neuropatik Perifer dengan Sediaan Patch
Authors: Wijaya Lupita
Published: July 2022

Obat-obat oral seperti antidepresan trisiklik, antikonvulsan (gabapentin dan pregabalin), dan SSRI (selective serotonin reuptake inhibitors), masih menjadi pilihan pertama yang direkomendasikan oleh pedoman internasional dan Eropa untuk terapi nyeri neuropatik. Namun, penurunan nyeri hanya sebesar 30-40% dan sering disertai efek samping sistemik. Obat topikal sediaan patch menjadi salah satu terapi alternatif.

Oral drugs like tricyclic antidepressant, anticonvulsants (gabapentin and pregabalin), and SSRI (selective serotonin reuptake inhibitors), still become first choice as recommended by international and Europe therapy guidelines for neuropathic pain. However, the regimen is effective in only about 30-40% cases and often has undesirable systemic adverse effects. Topical drugs in patch form can be one of alternative therapy for neuropathic pain.
Sindrom Rapunzel – Diagnosis dan Tatalaksana
Authors: Apriliana Hardika Putu Stephanie
Published: July 2022

Sindrom Rapunzel merupakan kondisi medis terdapatnya massa (gumpalan) rambut yang terperangkap di gaster atau sampai menuju usus halus. Gangguan psikiatri trikotilomania dan trikofagia menjadi faktor predisposisi gastric trichobezoar. Kondisi ini dominan ditemukan pada remaja perempuan. Manifestasi klinis biasanya non-spesifik berupa nyeri abdomen, mual, dan muntah. Endoskopi menjadi baku emas diagnosis. Metode endoskopi dan open surgery merupakan pilihan modalitas pengangkatan massa (trichobezoar). Pendekatan multidisiplin evaluasi psikiatri berkala sangat perlu guna mencegah berulang.

Rapunzel Syndrome is a medical condition of solid mass (accumulation) of hair in stomach and may extend to small intestine. Psychiatric disorders, such as trichotillomania and trichophagia, are two predisposition factors for gastric trichobezoar. This condition is predominantly found in young female. Clinical manifestation is usually non-specific gastrointestinal symptoms, like abdominal pain, nausea, and vomiting. Endoscopic examination is the gold standard for diagnosis. The main management is removal by endoscopy or open surgery. Multidiscipline approach including regular follow up and psychiatric evaluation is required to prevent its recurrence.
Vaksinasi SARS-CoV-2 dalam Perspektif Hukum di Indonesia
Authors: Purnomo Ika Cahyo , Suharto Gatot
Published: July 2022

Pandemi COVID-19 sampai saat ini belum menunjukkan tanda akan berakhir. Vaksin diharapkan dapat menjadi solusi; oleh karena itu, vaksinasi massal dilakukan di berbagai negara, termasuk di Indonesia. Kebijakan imunisasi massal ini menuai pro dan kontra; tidak hanya di masyarakat awam, melainkan juga di kalangan tenaga kesehatan. Penelitian efikasi vaksin, program vaksinasi wajib, pengadaan vaksin, dan efek samping vaksin adalah beberapa hal yang menjadi isu hangat. Sebagai profesional kesehatan, seorang dokter wajib mengetahui perihal vaksin SARS-CoV-2 dalam kacamata hukum positif yang berlaku di Indonesia. Tinjauan pustaka ini membahas vaksinasi SARS CoV 2 dari berbagai perspektif regulasi; sejawat dokter diharapkan dapat mengetahui dasar-dasar hukum kebijakan terkait vaksinasi SARS CoV 2 di Indonesia.

The COVID-19 pandemic has yet to show its end. Vaccines are expected to be a solution; mass vaccination is carried out in various countries, including Indonesia. This policy reaps pros and cons; not only in the general public, but also among health workers. Vaccine efficacy research, mandatory vaccination programs, vaccine procurement, and vaccine side effects have became critical issues. As a health professional, knowledge on the SARS CoV 2 vaccine in the light of Indonesia’spositive laws is mandatory. This literature review discusses SARS-CoV-2 vaccination programme from various regulatory perspectives; medical colleagues are expected to understand the legal basis of policies related to SARS-CoV-2 vaccination in Indonesia.
Soft Tissue Release for Neglected Clubfoot : One-year Clinical Outcome
Authors: Albar Husnul Fuad
Published: July 2022

Background. Neglected clubfoot is the most common congenital problem leading to locomotor disability. Eighty percent children with clubfoot deformity are born in developing world and the majority do not have access to appropriate medical care. The severity of clubfoot may be assessed with a variety of methods; i.e Pirani scoring system. This study use Pirani scoring system to evaluate the clinical outcome of neglected clubfoot patients one year after soft tissue release. Method. A study of 17 patients who underwent soft tissue release in Harapan Hospital a year before. We compare Pirani score before and one year after soft tissue release. Other data submitted are age, reason of delayed treatment, term of prosthesis, and complication after surgery. Result. The 17 patients were 10 females and 7 males; the average age was 69,06 ± 49.15 months old. Deformity in left foot was in 13 feet (59.1%) and right foot was in 9 feet (40.9%). The average total Pirani Score before soft tissue release is 5,43 ± 1,03 and one year after soft tissue release is 0,30 ± 0,40. p<0,0001 (p<0,05). This result shows significant improvement one year after soft tissue release. Conclusion. Soft tissue release for neglected clubfoot resulted in significant Pirani score improvement after one year.

Latar Belakang. Neglected clubfoot merupakan masalah kongenital yang paling sering menyebabkan disabilitas lokomotor. Tingkat keparahan clubfoot dapat ditentukan dengan beberapa metode, antara lain sistem skoring Pirani. Salah satu tatalaksana neglected clubfoot adalah soft tissue release. Studi ini mengevaluasi keluaran klinis pasien neglected clubfoot menggunakan sistem skoring Pirani satu tahun setelah soft tissue release. Metode. Studi pada 17 pasien yang telah menjalani soft tissue release satu tahun yang lalu. Skor Pirani sebelum dan satu tahun setelah soft tissue release dibandingkan. Data lain meliputi usia, alasan terlambatnya tatalaksana, prosthesis yang digunakan, serta komplikasi pasca operasi. Hasil. Rata-rata pasien berusia 69.06 ± 49.15 bulan, 10 perempuan dan 10 laki-laki. Sejumlah 13 deformitas didapatkan pada kaki kiri (59.1%), 9 deformitas pada kaki kanan (40.9%). Rata-rata skor Pirani sebelum soft tissue release adalah 5.43 ± 1.03, sedangkan rata-rata skor Pirani satu tahun setelah soft tissue release adalah 0,30 ± 0,40. Hasil ini menggambarkan peningkatan signifikan skor Pirani (p < 0.0001). Simpulan. Keluaran klinis pasien neglected clubfoot dinilai menggunakan skor Pirani meningkat signifikan satu tahun setelah soft tissue release.
Suplementasi Vitamin D pada Bayi Prematur
Authors: Corona Fidel Corona , Fitriyani Nur , - Michael
Published: July 2022

Vitamin D merupakan mikronutrien yang berperan dalam sistem imun, penyerapan kalsium dan pembentukan tulang, sehingga dibutuhkan pada segala usia. Defisiensi vitamin D pada ibu hamil sering terjadi dan berkaitan dengan infeksi neonatus, mortalitas dan morbiditas pada bayi prematur mengingat janin mendapat vitamin D sepenuhnya dari ibu. Prematuritas, nutrisi buruk dan kurangnya paparan terhadap sinar matahari dapat meningkatkan risiko defisiensi vitamin D. Kebanyakan pedoman merekomendasikan asupan vitamin D 400 hingga 1000 IU setiap hari untuk kesehatan tulang pada bayi prematur dengan perhatian khusus pada gangguan hati atau ginjal. Vitamin D dapat diberikan melalui tetes, fortifikasi ASI atau melalui susu formula. Belum ada data perlunya pemeriksaan rutin kadar 25-hidroksivitamin D.

Vitamin D is a micronutrient with a role in the immune system, calcium absorption, and bone formation. Vitamin D deficiency in pregnancy is common and associated with neonatal infection, mortality, and morbidity in premature infants as a fetus get vitamin D entirely from the mother. Short gestational age, poor nutrition, and lack of exposure to sunlight during hospitalization may contribute to an increased risk of vitamin D deficiency. Most guidelines recommend vitamin D 400 to 1000 IU daily intake for bone health in preterms with special attention in preterms with liver or kidney disorders. Vitamin D may be given via drops, breast milk fortification, or formula milk. There are no data regarding the necessity of routine testing for 25-hydroxyvitamin D levels.
Herpes Zoster Oftalmika dengan Komplikasi Uveitis Anterior
Authors: Chrisdianudya Theresia Dita , Nikita Hyasinta Arlette , Nernere Marselino Galuh Setyawan
Published: July 2022

Herpes zoster adalah penyakit infeksi akibat reaktivasi virus varisela zoster laten. Terdapat 8-56% kasus herpes zoster oftalmika dan pada sekitar 50-72% pasien zoster periokular akan terjadi gangguan mata dan kehilangan visual derajat sedang sampai berat. Kasus Laki-laki usia 16 tahun dengan lenting-lenting di sekitar dahi, kelopak mata, mata dan hidung sisi kanan disertai mata kanan nyeri, memerah, berkabut, penurunan tajam penglihatan dan kotoran mata putih kekuningan yang lengket sejak kurang lebih satu minggu. Hutchinson sign positif. Pasien memiliki riwayat cacar air tetapi tidak memiliki komorbid. Diagnosis herpes zoster oftalmika okuli dekstra dengan uveitis anterior. Tatalaksana dengan parasetamol oral 3x500 mg, acyclovir oral 5x800 mg, amoksisillin oral 3x500 mg, metilprednisolon 2x8 mg, salep mata acyclovir 5 kali sehari, salep kulit acyclovir 5 kali sehari. Simpulan Pada pasien herpes zoster oftalmika dengan penurunan tajam penglihatan perlu diwaspadai komplikasi uveitis anterior; terapi kortikosteroid dapat berhasil lebih baik.

Herpes Zoster is caused by reactivation of latent varicella zoster virus. Approximately 8- 56% from herpes zoster cases were reported with ophthalmic signs, and 50- 72% cases show moderate to severe visual loss. Case. Male, 16 y.o. with multiple vesicles surrounding right eye area, forehead, nose, with pain, redness, haziness, visual disturbance and purulent secretion in the right eye since a week ago. Hutchinson sign was positive. Patient had a history of chicken pox without other comorbidities. Diagnosis was herpes zoster ophthalmica oculi dextra with anterior uveitis. Management consist of oral paracetamol 3x500 mg, acyclovir 5x800 mg, amoxicillin 3x500 mg, methylprednisolon 2x8 mg, acyclovir eye ointment 5 times a day, acyclovir skin ointment 5 times a day. Conclusion. Herpes zoster ophthalmica with decreased visual function should be monitored for complications like uveitis anterior and managed with corticosteroid for a better outcome.

 
Efektivitas Suplementasi Vitamin D3 dalam Meningkatkan Fungsi Kognitif Lanjut Usia
Authors: Marsigit Jessica , Fitriana Ika
Published: July 2022

Latar Belakang: Demensia adalah salah satu penyakit kronik degeneratif yang hingga saat ini belum memiliki tatalaksana definitif. Beberapa suplementasi yang menjanjikan untuk meningkatkan fungsi kognitif, salah satunya adalah vitamin D3. Tujuan: Membuat telaah sistematis studi terkait suplementasi vitamin D3 dan peranannya dalam meningkatkan fungsi kognitif. Metode: Pencarian sistematis dilakukan pada tiga database yaitu PubMed, CENTRAL, dan ScienceDirect untuk memilih studi eksperimental sesuai kriteria inklusi dan eksklusi. Artikel yang terpilih kemudian ditelaah kritis dan dianalisis lebih lanjut. Hasil: Pada analisis akhir didapatkan 5 artikel untuk telaah kritis, hanya satu studi memiliki risiko bias rendah. Empat studi populasi lansia tanpa gangguan kognitif menunjukkan tidak ada perbedaan signifikan fungsi kognitif kelompok suplementasi vitamin D dibandingkan kelompok plasebo. Satu studi populasi lansia penderita Alzheimer menunjukkan peningkatan signifikan nilai total IQ setelah suplementasi vitamin D3 800 IU per hari selama 12 bulan. Simpulan: Suplementasi vitamin D3 pada lansia dengan fungsi kognitif baik tidak menghasilkan perubahan fungsi kognitif bermakna. Namun, menjaga fungsi kognitif harus dilakukan secara komprehensif, dimulai dari pola diet seimbang, aktivitas fisik, serta latihan kognitif rutin.

Background: Dementia is one of the chronic degenerative diseases which does not have a definitive therapy. Several supplements are promising to increase cognitive function, including vitamin D3. Objective: Systematic review on studies related to vitamin D3 supplementation and its role in increasing cognitive function. Method: Systematic searching was performed on three databases, which are PubMed, CENTRAL, and ScienceDirect to include experimental studies based on the inclusion and exclusion criteria. The chosen articles would be critically appraised and further analyzed. Results: Five articles were included in the final analysis to be critically appraised, only one study has low risk of bias. Four studies regarding elderlies without cognitive dysfunction showed no significant differences between group with vitamin D supplementation and placebo in terms of cognitive function. One study with Alzheimer elderlies as the population showed a significant increase in total IQ score after vitamin D3 800 IU supplementation every day for 12 months. Conclusion: Vitamin D3 supplementation for elderlies with good cognitive function showed no significant difference. Maintaining cognitive function needs a comprehensive management i.e. balanced diet, physical activity, and routine cognitive training.

 
Challenges Faced by Classroom Teachers in Distance Learning for Students with Attention Deficit Hyperactivity During COVID-19 Pandemic
Authors: Khusheim Salwa Mostafa
Published: July 2022

Remote and virtual classrooms could negatively affect the academics of students, especially in case of a child suffering from attention deficit hyperactivity disorder (ADHD). The aim of the present study was to understand the obstacles and differences between the teachers regarding their use of teaching methods, tasks and assignments, tests and evaluation methods and communication between teacher and parents of students with ADHD, during distance learning in COVID-19 pandemic. Data were collected through a questionnaire which was reviewed by some experts in the field of this study from several KSA universities. The result showed that there were statistically significant differences among responses of classroom teachers regarding all the dimensions. Furthermore, there were statistically significant differences between participants in their opinion toward all dimensions according to their specialization and years of experience which was not in the case of age and academic qualifications of the participants. Thus, it was concluded that teachers were willing to co-operate with the students having ADHD during online classes, but they face difficulties in handling them as ADHD students lacks concentration and can be distracted easily.
ECONOMIC SIGNIFIANCE AND DESIGN OF LOW AREA AND LOW
POWER MAGNITUDE COMPARATOR
Authors: SAFARYAN Karo , GALSTYAN Andranik , MANUKYAN Arman , VOSKANYAN Garnik , HARUTYUNYAN Sergo
Published: July 2022

Multibit digital comparators take up large surface and high power consumption. As they
are composed of logic gates, it is recommended to decrease the number of transistors in
the logic gates using different transistor logics. By decreasing the number of transistors,
the occupied surface and power consumption of the entire circuit will also decrease. The
identical circuit was propounded applying standard CMOS (Complementary MetalOxide-Semiconductor) technology and with a combination of PTL (Pass Transistor Logic) and DVL (Dual Value Logic) transistor logics. Due to less area and decreased number of transistors, the physical design (layout) of the whole circuit will become easier and
less time consuming from layout designer point of view, then in case of standard CMOS
technology. As an output load was used a 1fF capacitance for both circuits. Correspondingly, the propounded circuit cuts down the power consumption by 21.3%, the
delay was decreased by 28.4%, and the number of transistors was reduced by 25%. The
circuit was developed using Custom Compiler tool. All the simulations are done using
Synopsys Hspice and WaveView tools. SAED (Synopsys Armenia Educational Department) 32/28 nm technology process libraries have been used during the work.
THE RELEVANCE OF INFORMATION TECHNOLOGIES IN THE DESIGN OF
MECHANICAL SYSTEMS WITHIN THE FRAMEWORK OF MODERN
TECHNOLOGICAL PROGRESS
Authors: BOSTANJYAN Vardan , ISAYAN Zareh
Published: July 2022

One of the most relevant areas actively used in the professional sphere of life of a modern person is information technology. Mechanical engineering technologists are expected to apply current technologies and principles from machine and product design, production and material and manufacturing processes.Mechanical Engineering is one of the
broadest and one of the most popular fields of engineering.The main goals of the Information Technologies in Mechanical Engineering group is to contribute to the art of product development and to increase the permanent innovation ability of our partners, thus enabling high-valued, highly productive and dynamically acting product development.
The main purpose of this article is to study the relevance and main trends of IT integration in the technological process. In the process of writing the work, the authors used
theoretical, statistical and empirical research methods.
ECONOMIC IMPACT OF DEVELOPING OF WEB TECHNOLOGIES
Authors: MARTIROSYAN Armen , OGHLUKYAN Artur
Published: July 2022

Since the variety of technologies in 2022 is unusually large, for each developer the question arises of determining the priority direction in work. The relevance of this article is due to this need. Thus, the main purpose of this work is to consider the development of Web technologies and the industry. The article discusses a common area, in 2022, the web, since modern information technologies largely affect the daily life of any person. IT is used to create electronic markets by transferring all payments made to the information sphere, where payments can be tracked and controlled. Also, the development of information technology affects the creation of additional jobs and the retraining of existing personnel, which is directly related to the reduction of unemployment, information technology has expanded opportunities in the medical, educational, law enforcement fields, which has improved the activities of each institution. This topic became popular also since the development of web technologies, the range of professions related to the development of websites is expanding, while studying computer science and information technology in this area, the article provides a history of the development of the web industry and the stages of transformation web technologies.
SUCCESS STORIES FROM POST WAR RISK MANAGEMENT:
THE CASE OF ISRAEL
Authors: MANASERYAN Tatul
Published: July 2022

As the history of Israel's economic development shows, the small area, the small
population and the lack of rich natural resources are not an obstacle to economic growth,
the development of science and technology and the improvement of living standards. It
was facilitated by the entrepreneurial inclinations and qualities of the people, the support
of foreign countries and the Diaspora, as well as a relatively stable and healthy political
system. Despite the difficult conditions, the economy resisted the absorption of many
immigrants, ensuring the security of the state, creating a modern economic infrastructure. In particular, in the early 1990s, the number of repatriates arriving in Israel increased sharply, mainly from the former Soviet Union (see Greater Alia). In total, more than
600,000 people arrived between 1990 and 1996. In the short run, the wave of immigration led to a sharp increase in the budget expenditures for their adoption, housing and
maintenance at the initial stage, an increase in unemployment, which exceeded 10% of
the able-bodied population. However, in the mid-1990s, it became clear that factors such
as the emergence of a large number of skilled workers in the labor market and the sharp
increase in domestic demand had a positive effect that transcended temporary difficulties.
ASSESSMENT OF FISCAL POLICY IMPACT ON INCOME INEQUALITY
ELIMINATION AND POVERTY ALLEVIATION
Authors: GHANTARCHYAN Ruben , TOROSYAN Alik
Published: July 2022

The paper analyzes the impact extent of individual instruments of the monetary policy on
income inequality and poverty alleviation. Therefore, we firstly studied the stand-points
presented by various economists on income inequality and poverty, the nature of income
inequality and poverty, its consequences and the main causes. Then the move-ment of
indicators characterizing income inequality and poverty in Armenia during the last
decade were studied, the current state of those problems and the main reasons for their
drastic changes were analyzed. The article also developed two models and per-formed a
regression analysis using the Least Squares Method. First, the model assesses the impact
of monetary policy on income inequality, examines the main reasons for indi-vidual
monetary policy instruments impact. Then, through the other model, the extent of the
impact of individual instruments of monetary policy on poverty was calculated, and the
main reasons of the impact extent of individual instruments of the monetary policy were
studied.
National Goals in Foreign Policy
Authors: Wazir Irfan , Wahdat Rabani
Published: July 2022

The basis and survival of states in foreign policy depends on national goals and interests. Guaranteeing and defining national goals for states is so fundamental and important that foreign policy has no special meaning without it. States pursue their national goals and interests seriously in their foreign policy decision-making and structuring. The national goals and interests of states are subject to variability for a variety of reasons, and uniformity is unlikely. Why some of the goals that are set for almost all states as national goals are related to the self-preservation and security of states. That security is paramount to all foreign goals in terms of degree of importance for all countries. The purpose of security is the self and the purpose of self-preservation is these four phenomena: Preservation of national territory, protect your population, protecting the independence of the country, the survival of the political and economic system.