Patent Foramen Ovale Closure Procedure

Patent foramen ovale is strongly associated with cryptogenic stroke. Variousclinical trials has shown the association between cryptogenic stroke andincidence of undelrying patent foramen ovale, these trials also shown thedecrease of cryptogenic stroke incidence with the treatment of patentforamen ovale Lesion. In the absence of absolute contraindications, patientswith patent foramen ovale are advised to undergo closure. Preproceduralexaminations such as trans esophageal echocardiography and pretreatmentwith anticoagulants are required to prevent peri and postprocedural adverseevents. Currently, patent foramen ovale Closure can be done through apercutaneous access with minimal risk. Treatment of patent foramen ovalecan help decrease future incidences of stroke

Penghambat GPIIb/IIIa pada Intervensi Koroner Perkutan Primer: Kapan dan Dimana?

Prosedur Intervensi Koroner Perkutan Primer (IKPP) merupakan prosedur pilihan pada pasien STEMI dengan awitan kurang dari 12 jam. Tetapi banyak hal yang masih belum terjawab di antaranya pada pasien dengan awitan dini (2 atau 3 jam) apakah pihannya langsung dirujuk ke RS dengan fasilitas IKPP tetapi dengan konsekuensi adanya keterlambatan atau langsung diberikan trombolitik. Masalah kedua adalah jenis terapi yang diberikan saat transportasi ke rumah sakit rujukan apakah antitrombin heparin, bivalirudin, penghambat GP IIb/IIIa atau trombolitik? Masalah ketiga adalah IKPP tidak selalu berhasil memberi reperfusi. Masalah lain adalah keberhasilan angiografis yang tidak disertai bukti reperfusi yang diharapkan pada pemeriksaan dengan modalitas imajing

ANALISIS FRAMING BERITA DAHLAN ISKAN DALAM KASUS KORUPSI PEMBANGUNAN 21 GARDU LISTRIK DI JPNN.COM

Pernyataan yang disampaikan kepala kejaksaan tinggi dki jakarta m. Adi toegarisman telah menetapkan dahlan iskan sebagai tersangka kasus korupsi pembangunan 21 gardu listrik pada 5 juni 2015 merupaka hal yang menjadi perhatian khalayak dan wartawan dalam meliput dan mengkaji kasus tersebut. Dalam penelitian ini penulis ingin mengetahui bagaimana jpnn.com membingkai berita dahlan iskan dalam kasus korupsi pembangunan 21 gardu listrik induk jawa, bali, dan nusa tenggara barat (ntb) edisi bulan juni, juli dan agustus 2015 ditinjau dari teori framing yang dikemukakan oleh pan dan kosicki. Pan dan kosicki merumuskan framing ke dalam empat dimensi struktur, yaitu: pertama sintaksis bagaimana cara wartawan menyusun fakta, kedua skrip bagaimana cara wartawan mengisahkan fakta, ketiga tematik bagaimana wartawan menulis fakta, keempat retoris bagaimana wartawan menekankan fakta. Penulis mengumpulkan enam berita, kemudian data dianalisa dengan merujuk pada konsep analisis framing. Selanjutnya data disajikan dalam bentuk deskriptif kualitatif, yaitu dengan menggambarkan dan menjelaskan bagaimana sebuah media tersebut memframing berita dahlan iskan dalam kasus korupsi pembangunan 21 gardu listrik. Hasil penelitian memperlihatkan jpnn.com tidak banyak melakukan penerbitan berita terkait kasus korupsi dahlan iskan, pada bulan juni terdapat tiga berita, bulan juli dua berita, dan bulan agustus satu berita, dalam kurun waktu satu bulan dapat dirata-ratakan hanya dua berita saja yang diterbitkan. Untuk kasus tindak pidana korupsi, merugikan keuangan negara atau perekonomian negara dan menghambat pembangunan nasional dengan hukuman penjara seumur hidup atau paling singkat penjara empat tahun, jpnn.com terlalu sedikit memberitakan pada portalnya. Analisis dari kelengkapan berita seperti foto, grafis, jpnn.com cukup memberikan kelengkapan berita dan jpnn.com memandang kasus korupsi yang menimpa dahlan iskan terdapat kesalahpahaman dalam penetapannya sebagai tersangka korupsi. Setiap berita tidak selalu pada headline melainkan subourdinate headline. Kata Kunci : Framing, Media, Dahlan Iskan

Intervensi Koroner Perkutan Primer

Penyakit Kardiovaskular masih merupakan pembunuh nomor satu di Indonesia maupun di dunia. Dari data di Amerika setiap tahun 1,2 juta orang mengalami infark miokard dan kira-kira sepertiganya merupakan infark miokard dengan ST elevasi. Dari seluruh orang yang mengalami infark miokard di Amerika, 25-35% nya meninggal sebelum mendapat perawatan, sebagian besar karena Fibrilasi Ventrikel. Pada kelompok yang mendapat perawatan, angka kematian turun dari 11.2% di tahun 1990 menjadi 9.4% di tahun 1999. Hal tersebut dikarena-kan adanya tindakan reperfusi pada Infark dengan ST elevasi, baik dengan fibrinolitik maupun Intervensi Koroner Perkutan ( IKPP ). Dari analisa National Registry of Myocardia Infarction angka kematian di rumah sakit pada pasien yang mendapat reperfusi adalah sekitar 5.7%, jauh lebih rendah dibandingkan dengan pasien yang tidak mendapat reperfusi walau-pun sebenarnya kandidat yaitu 14.8

Association of Fibrinogen Level and Index of Microcirculatory Resistance In Acute ST-Segment Elevation Myocardial Infarction Patient Undergoing Primary Percutaneus Coronary Intervention

Background: Primary percutaneus coronary intervention (PPCI) is a first of choice to return patients blood flow and perfusion with ST-segment elevation myocardial infarction (STEMI), however reperfusion in macrocirculation level is not always accompanied by a sufficient microcirculation reflow due to Microvascular Obstruction (MVO). Previous study demonstrated thathigh fibrinogen concentration may affect rheological parameters of the blood and play an important role in the pathomechanism of myocardial non-reperfusion phenomenon following successful mechanical recanalisation of the infarct-related coronary artery. Another study show eda more compact, lysis-resistant fibrin network in no reflow group, but without significant relation to fibrinogen level. However, there is a lack of data regarding fibrinogen and MVO. The aim of this study is to evaluate association between fibrinogen and MVO by index of microcirculatory resistance (IMR). Methods. 55 STEMI patients undergoing primary PCI were consecutively included. The fibrinogen was evaluated using clauss method and IMR was done right after PPCI to evaluate MVO. Results. From fifty-five patients included in the study, there were 87,3% men, with mean age 53,18.9 years old, and smoker show the biggest proportion compare with risk factor for coronary artery disease. All the patient undergo primary percutaneus coronary intervention with mean door-to-ballon time of 89.04+37.114 minute and ischemia time of 458,69+170,709 minute. Mean IMR was 55,2 + 47,454 and mean fibrinogen level was 350,8+103,19. From the scaterred plot fibrinogen prone to had a weak negative correlation with IMR and statistically non-significant(r = -0,137; p=0,319). Conclusion. There is no correlation between fibrinogen level and IMR value in STEMIpatients undergoing PPC

Comparison of Percutaneous Coronary Intervention versus Coronary Artery Bypass Grafting for Unprotected Left Main Coronary Artery Disease at National Cardiovascular Centre Harapan Kita

Background. Despite many studies had been done comparing the outcome of Percutaneous Coronary Intervention (PCI) versus Coronary Artery By-pass Grafting (CABG) in Unprotected Left Main Coronary Artery Disease (ULMCAD), there is none such study in Indonesia. Aim. To compare the outcome of PCI versus CABG in ULMCAD patients at National Cardiovascular Centre Harapan Kita (NCCHK) Jakarta. Methods. A retrospective cohort study was done including 137 ULMCAD NCCHK patients who underwent PCI (n = 67) or CABG (n = 70) from July 2008 until March 2010. One-year Major Adverse Cardio Cerebrovascular Event (MACCE) outcome as defined by death, myocardial infarction (MI), stroke, and target vessel revascularization (TVR), were evaluated using Chi-square analysis, while Kaplan-Meier and Cox regression analysis were used to examine the survival curve of the mentioned intervention. Results. One-year risk of composite MACCE (death, stroke, and TVR) (hazard ratio (HR): 1.267; 95% confidence interval (CI): 0.567 2.829, p = 0.564), and the risk of death (HR: 1.080; 95% CI: 0.405 2.878, p = 0.878) were not significantly different for patients undergoing PCI versus CABG. Proportion of stroke was significantly higher in the CABG group (8.6% vs 0.0%; p = 0.014), while proportion of TVR was significantly higher in the PCI group (13.4% vs 0.0%; p = 0.001). No MI event was documented in both groups. Conclusion. During one-year follow up, PCI showed similar rate of composite MACCE and death, but higher TVR as compared to CABG in ULMCAD patients. Meanwhile CABG showed higher stroke rate as compare to PCI

AUGMENTED REALITY MEASUREMENT SEDERHANA MENGGUNAKAN OS ANDROID (ARealSure)

Aplikasi pengukuran telah banyak digunakan di sistem IOS maupun android. Namun, aplikasi pengukuran berbasis android tidak sebaik dengan aplikasi pengukuran berbasis sistem IOS. Beberapa orang masih meragukan keakuratan aplikasi ini karena terkadang hasil pengukuran tidak akurat dan masih banyak eror atau bug. Tujuan dari kegiatan ini adalah untuk mengembangkan aplikasi pengukuran berbasis android dengan tingkat keakuratan 90%. Apikasi pengukuran ini menerapkan AR (Augmented Reality). Proses pembuatan aplikasi menggunakan software android studio, library dan ARcore. Untuk Bahasa pemrograman yang digunakan yaitu Java Output. Pertimbangan menggunakan perangkat tersebut aplikasi pengukuran untuk smartphone berbasis Android dapat mengukur atau mengetahui dimensi benda bangun datar dan bangun ruang dengan satuan cm dan hasil pengukuran yang akurat. Kata Kunci: Augmented Reality, Android, Aplikasi, Pengukuran, Akur

Analisis Kemampuan Guru dalam Menanamkan Kemampuan Pemahaman Konsep dan Mengembangkan Kemampuan Pemecahan Masalah terhadap Hasil Belajar Siswa

This study aims to determine the category of mathematics teacher's ability to build the ability to understand concepts and instill mathematical problem solving abilities on student learning outcomes. This research was conducted at SMA Negeri 1 Alasa, and the sample was taken randomly as many as 272 students. The research instrument used a questionnaire, and data analysis used descriptive analysis. Based on the results of the analysis it can be concluded that the ability of mathematics teachers to build understanding of concepts and instill mathematical problem solving abilities on student learning outcomes in the moderate category

Percutaneous Intra Arterial Thrombolysis on Peri-coronary Angiography Ischemic Stroke: Initial Experience in National Cardiac Center Harapan Kita

Background. Ischemic stroke is a rare but well-known complication of cardiac-catheter interventions attributable mostly to embolism. Peri-coronary angiography stroke, represents a unique opportunity for im-mediate stroke interventional therapy with intravenous, catheter based intra-arterial thrombolysis (IAT) or combined therapy using recombinant tissue plasminogen activator (rtPA). Intra-arterial thrombolysis is an option for treatment of selected patients who have major stroke of < 6 hours duration due to occlusion of the Media Cerebral artery(MCA) and who are not otherwise candidates for intravenous rtPA (Class I, Level of Evidence B, AHA guidelines). Objective.To review the first experience of percutaneous intra-arterial thrombolysis(PIAT) as a management of acute ischemic stroke due to complication of coronary angiography procedure. Summary. We present 3 cases of acute ischemic stroke which happened during coronary angiography procedures. All of them (NIHSS 30, 20 and 34) were treated immediately with intra-arterial thrombolysis (IAT) recom-binant tissue Plasminogen Activator (rtPA) and had a very good outcome with no residual of stroke (NIHSS 0). Although it has been stated clearly in the AHA guidelines for the early management of adult with ischemic stroke, up until now the procedure of IAT or (intra-venous thrombolysis) IVT upon acute ischemic stroke is not established yet in standard operational procedure of National Cardiovascular Center Harapan Kita (NCCHK) Jakarta, which perhaps makes the physicians hesitate on performing these procedures due to legal aspects, while in the other hand the risks of acute ischemic stroke remain the potential threats on every single coronary angiography or any intensive catheter based procedures