Assalamualaikum Wr.WbPraise and gratitude we pray the presence of Allah SWT for all His grace and guidance so we can still work to help in the fields of education and humanity. With greetings and prayers we praise the prophet Rahmatan lil alamin Rasulullah Muhammad SAW who has brought us from the realm of darkness to a realm full of knowledge. In the fourth year it was held during the Covid 19 pandemic, 4th Aceh Surgery Update International Conference in 2021 will be held virtually on February 26-28, with theme Current Update on Covid 19; Clinical and Surgery. This virtual science event will be attended by international and national speakers who have expertise in the field of surgery and the latest information regarding Covid 19 from the Indonesia government. This scientific event felt very special with the presence of the Bali Medical Journal indexed by SCOPUS and Web of Science in scientific publications for all topics presented, both in symposium and free paper sessions.I would like to welcome all experts who are willing to attend to be native speaker at this scientific even. I would like to thank all the committees and sponsors who have helped make this scientific webinar a success. Finally, I am also welcome all the participants and delegated, really hope you all get valuable scientific experiences in extra ordinary city of Banda Aceh. Sincerelly Yours,Yopie Afriandi Habibie, MD, Sp. BTKV (K)-D, FIHA, FICS, FACSChairman
Introduction: Chronic limb-threatening ischemia (CLTI), a manifestation of peripheral arterial disease (PAD) that is characterized by chronic ischemic pain in the foot, inadequate tissue perfusion at rest more than 2 weeks, non-healing wounds, or gangrene that is attributable to objectively proven arterial occlusive disease. Endovascular surgery has played an important rules for revascularization in limb saving.Case description: 57-years-old man came to the Zainoel Abidin General Hospital emergency room, with a chief complaint of ischemic pain at the right foot since 3 months ago, and being extremely progressive for 10 days. He has no history of smoking and 10-year history of controlled type 2 diabetes mellitus. On the physical examination revealed a stable hemodynamic, an unhealed wound in the right lower limb as well as an open wound size 10cm x 6cm x 4cm. He has palpable femoral pulses but not distal pulses. Peripheral CT angiography obtained a total occlusion at the right anterior tibialis artery (ATA), and no flows at the right dorsalis pedis artery (DPA). Performed a revascularization procedure with endovascular therapy using 3 mm balloon angioplasty with good results along the ATA and DPA. The patient was discharged on the 4th day after surgery. Clinical Evaluation after 2 months showed improvement on pain, good ulcer healing and ready for skin grafting.Conclusion: The goal of treatment for CLTI is to relieve pain, heal wounds, and preserve a functional limb, with a cornerstone of treatment is timely arterial revascularization Endovascular surgery in one of the best revascularization techniques for CLTI.
Abstract. Blunt thoracic trauma highest incidence is in adult, 20% to 50 % of the trauma cause death. Injuries to the vascular structures of the thoracic outlet, especially left subclavian artery, are rare and typically accompanied by massive hemorrhage. Close observation of vital sign and serial chest x-ray are very important. We describe an unusual presentation of a patient who suffered traumatic rupture ofleft subclavian artery. No clinical presentation of supraclavicular hematoma, unilateral absence of radial artery pulse and mediastinal widening in chest x-ray was found, but there is a massive hemothorax. Left posterolateral thoracotomy was performed, the source of bleeding was found in the apex of the lung, suspected a rupture of the left subclavian artery. The procedure continued with median sternotomy extended to left supraclavicular incision, a rupture was found in the left subclavian artery, 1,5 cm proximal to aortic arch. Primary repair was done with a good result. Key Words : Blunt thoracic trauma, massive hemothorax, left subclavian artery rupture
Hypoxia-inducible factor-1 alpha (HIF-1α) is a transcription factor that plays a crucial role in cellular responses to hypoxia, such as in the development of intimal hyperplasia, a common complication in arteriovenous fistula (AVF) creation. While the application of umbilical cord mesenchymal stem cells (UC-MSCs) has shown promise in various regenerative medicine applications, including tissue repair and angiogenesis, the effect of UC-MSCs on HIF-1α level in the AVF has not been tested. Therefore, the aim of this study was to evaluate the effect of UC-MSCs administration on HIF-1α levels in the AVF animal model. An experimental study was conducted on 28 local male rabbits (Lepus domestica) using a post-test-only design. The rabbits were divided randomly into four groups: normal rabbit group (negative control), placebo-treated AVF rabbit group (positive control), AVF rabbits treated with in-situ UC-MSCs injection (one dose, 106 UC-MSCs/kg body weight), and AVF rabbits treated with intravenous UC-MSCs (one dose, 106 UC-MSCs/kg body weight (BW). HIF-1α level was measured using ELISA method after 28 days post- treatment. All data were analyzed using the one-way analysis of variance (ANOVA) and continued with the Duncan’s post-hoc test. The data indicated that the levels of HIF-1α were different among all four groups (p<0.001). The post-hoc analysis revealed that the HIF-1α levels in both UC-MSC treated groups were significantly lower compared to untreated AVF rabbits(p<0.05). This study suggests that UC-MSCs could be a promising therapy to prevent and reduce intimal hyperplasia in AVF.
The dataset is comprised of survey season 3 data collected in Kapuas Hulu (West Kalimantan). Data included here are from household surveys with female heads of households and include socio-demographic information, information on health, agricultural practices, food source information, asset ownership, dietary intake based on 24-hour dietary recall of mother-child pairs, and anthropometric measurement (weight and height for the mother-child pairs).
Introduction: Fever, systemic embolism, and intra-cardiac masses are all symptoms of Infective Endocarditis (IE) and Cardiac Myxoma (CM)1. As a result, despite proper imaging studies, these diseases are frequently misdiagnosed one for the other.2 Case description: A 23-years-old female patient was admitted to emergency department of Zainoel Abidin General Hospital with acute onset right lower extremity pain for the last few hours and presented roth spots of the retina. The next day after admission, she presented fever. The patient denied having chronic disease, drug abuse, and thrombotic history. Tooth decay were found. Transthoracic Echocardiography (TTE) were obtained due to concern of infective endocarditis. Head CT-scan revealed cardioembolic cerebral stroke. TTE showed ejection fraction 56%, severe mitral regurgitation, and a mobile mass size 3.1x2.4 cm in mitral valve, attached to anterior mitral leaflet. The patient underwent thrombectomy, stroke therapy, dental tooth decay treatment, and lower limb rehabilitation at that moment, before having Mitral Valve Replacement (MVR) surgery. Six months afterward MVR surgery was done, rather than vegetation, we found a 50cc cardiac myxoma in anterior mitral valve leaflet. A 27mm bioprosthetic valve was installed. The patient was recovered quickly and she was able to discharge from hospital in the next 7 days after procedure without any further issue. Conclusion: In order to effectively manage the patients, it is crucial to distinguish between IE and cardiac myxoma. The mainstay of treatment for cardiac myxoma cases is surgery, which has an excellent prognosis. To evaluate for recurrence, long-term follow-up is frequently required.
Link of Video Abstract: https://youtu.be/2uoN5ciMk14 Umbilical cord mesenchymal stem cells have been shown to reduce neointimal hyperplasia in animal models. However, current studies about therapeutic use to reduce neointimal hyperplasia mainly utilized bone-marrow and adipose tissue-derived mesenchymal stem cells and lack of in vivo testing from umbilical cord mesenchymal stem cells. Herein, we explore the potential of the therapeutic use of umbilical cord-derived mesenchymal stem cells to reduce neointimal hyperplasia in patients with arteriovenous fistula. Studies were identified from Scopus, Pubmed, and Google Scholar published between 2000 and 2022. The inclusion criteria for the articles were: (1) written in English, (2) focused on the use of mesenchymal stem cells (MSCs) for the treatment of neointimal hyperplasia, and (3) animal-controlled studies. Exosome-derived from mesenchymal stem cell studies were excluded. A total of 9 articles were included. Overall, the available evidence suggests that UC-MSCs may be a promising therapeutic option for reducing neointimal hyperplasia in arteriovenous fistula (AVF) patients. However, more research is needed to confirm these findings and to determine the optimal dosing and administration for their use in clinical practice. Additionally, further studies are required to fully understand the standardization in isolating and characterizing UC-MSCs and their effects on neointimal hyperplasia.
Gagal jantung kongestif adalah kumpulan gejala yang kompleks yaitu napas pendek yang tipikal saat istirahat atau saat melakukan aktivitas disertai/tidak kelelahan, tanda retensi cairan berupa edema pulmoner atau edema perifer, dan adanya bukti dari gangguan struktural maupun fungsional jantung. Pasien gagal jantung kongestif mengalami penurunan fungsi sistolik berdasarkan fraksi ejeksi dan penurunan kapasitas fungsional. Tujuan dari penelitian ini untuk mengetahui hubungan antara fungsi sistolik ventrikel kiri dengan kapasitas fungsional pasien gagal jantung kongestif di poliklinik jantung RSUDZA. Penelitian ini merupakan penelitian analitik observasional dengan pendekatan cross-sectional dan telah dilakukan pada 14 September-31 Oktober 2016 dengan jumlah responden 44 orang yang diambil dengan teknik consecutive sampling. Hasil analisis bivariat dengan uji Chi-Square menunjukkan terdapat hubungan yang signifikan antara fungsi sistolik ventrikel kiri dengan kapasitas fungsional (p<0,001) pasien gagal jantung kongestif di Poliklinik Jantung RSUDZA. Congestive heart failure is a complex collection of symptoms that typically are short of breath at rest or while doing activities with / no fatigue, fluid retention pins in the form of pulmonary edema or peripheral edema, and no evidence of structural or functional cardiac disorder. Congestive heart failure patients experienced a decrease in systolic function by ejection fraction and decreased functional capacity. The purpose of this study was to determine the relationship between left ventricular systolic function with the functional capacity of patients with congestive heart failure in cardiac clinic RSUDZA. This research is an observational analytic research with cross-sectional and was carried out on 14 September – 31 October 2016, with the number of respondents 44 people who were taken with consecutive sampling technique. The results of the bivariate analysis with Chi-square test showed a significant relationship between left ventricular systolic function with functional capacity (p <0.001) in patients with congestive heart failure Heart Clinic RSUDZA.
