Background: Patients with coronary heart disease (CHD) who have received standard therapy to the fullest, are still at risk for further cardiovascular events. This is likely because the standard therapy fails to inhibit some inflammatory pathways and platelet aggregation which implies the disease. This study aimed to determine the effect of colchicine on reducing levels of high sensitive c-reactive protein (HsCRP) and mean platelet volume (MPV) in patients with Acute Myocardial Infarction (IMA) in the Intensive Cardiovascular Unit (ICVCU) Dr. Moewardi Hospital, Surakarta. Subjects and Method: Experimental study was conducted with pre and post design. The study was conducted from November 1 to December 31, 2016. A sample of 32 patients with Acute Myocardial Infarction was divided into two groups. The control group was given a placebo and the treatment group was given colchicine 0.5 mg orally for 5 days. Statistical analysis was done using two mean different tests with dependent t-test or Mann-Whitney and two mean analysis paired using independent t test or Wilcoxon. Results:The HsCRP delta level in colchicine group (mean = 3.82; SD = 2.20) was higher than control group (mean = 0.57; SD = 3.12) and it was statistically significant (p<0.001). The delta MPV levels in colchicine group (mean = 2.01; SD = 1.16) were higher than control group (mean = 0.64; SD = 0.83) and it was statistically significant (p = 0.001). Conclusions:The administration of 0.5 mg colchicine by oral for 5 days was associated with levels of HsCRP and MPV among IMA patients.
Abstract. Agustina N, Hutauruk TJW, Sulistyaningrum N, Yudhanto SM, Liza N, Kusumaningrum L, Sugiyarto, Yasa A, Saensouk S, Naim DMD, Setyawan AD. 2022. Diversity of the medicinal plant in homegarden of local communities in the coastal area of Prigi Bay, Trenggalek, East Java, Indonesia. Biodiversitas 23: 6302-6312. Homegarden is a part of the agroforestry system that is essential in a food security program. It also reflects the social and traditional practices in certain areas that define the composition of plants. One common plant that grows in a homegarden area is herbal medicine. The knowledge about medicinal plants in society is essential to ensure the sustainability of this local wisdom to be passed through the subsequent generations. This research aimed to examine the diversity of medicinal plants planted in homegarden in Tasikmadu, Prigi, and Karanggandu Villages, Watulimo Sub-district, East Java, Indonesia. The research used a field survey of plant inventory and a semi-structured interview to gather ethnobotanical information. A total of 60 respondents were obtained by purposive sampling, with residents with homegardens preferred to be interviewed. The discussion results showed that 32 families of 59 medicinal plant species found in the study areas are consumed for medicinal purposes. Zingiberaceae is referred to as the highest family consumed by the respondents. Leaves and rhizomes are the most commonly utilized part, while decoction is the most popular preparation method. This study revealed that people aged 46-55 have the highest knowledge of medicinal plants. At the same time, women are considered to know more about herbal medicine compared to men.
Background Coronavirus Disease 2019 (COVID-19) resulted considerable morbidity and mortality worldwide since December 2019. In the other hand, Brugada syndrome had higher risk of sudden cardiac death. Although it was manifested with an electrocardiographic (EGC) abnormalities, the patients with Brugada syndrome were often healthy and unaware of their genetic predisposition. Case Summary A 59 years old man without significant medical history was reported a day of fever, productive cough, and shortness of breath. He did not complain any chest pain, palpitation, and episode of syncope. The patient had no family history of sudden cardiac death. On presentation, he was febrile (39,5°C), tachycardia (110 beats/ min), and tachypnea (28 breath/ min). Laboratory findings of the patient were elevated High-sensitivity C-reactive protein (hs-CRP), with normal electrolyte level, and troponin. The Polymerase chain reaction (PCR) test for COVID-19 performed with the positive result. The chest radiograph showed multifocal bilateral interstitial with a normal cardiac silhouette. The ECG revealed Brugada type 2 ECG pattern. A bedside echocardiogram demonstrated with the normal result. His condition continued to improve and the ECG demonstrated complete resolution of the initial Brugada ECG pattern. Discussion COVID-19 infection has been described as unmasking Brugada pattern. The most frequently reported symptoms of COVID-19 was fever. Brugada syndrome was a genetic disorder, that was most commonly involving SCN5A gene, which encoded the cardiac sodium channel. Fever caused blockade of sodium channel was being well described provocative trigger that might incite arrhythmia in patient with Brugada syndrome.
Background: Release of cytokines in sepsis can cause left heart failure and left ventricular systolic dysfunction (LVSD). In sepsis, there is a releasing of Procalcitonin (PCT) and tumor necrosis factor-α (TNF-α) because of the stimulation of cytokine pro inflammation effected by activated NF-kB. This study aimed to examine PCT as a predictor of LVSD in sepsis, value of Area Under the curve (AUC), sensitivity, specificity, cut off point, and probability of PCT and TNF-α as a predictor of LVSD, and then to identify the best diagnostic predictor of LVSD. Subjects and Method: This was a cross-sectional study. A sample of 71 sepsis patients aged >18 years old admitted to the intensive care unit (ICU) from November 2016 to March 2017was selected for this study. The dependent variable was left ventricle ejection fraction (LVEF). The independent variables were PCT and TNF-α. LVEF and diastolyc function were measured by transthoracicechocardiography. Data on PCT and TNF-α level were obtained from medical record. Results: As many as 22 patients had mild sepsis (30.9%), 40 patients had severe sepsis (56.4%), and 9 patients had septic shock (12.7%). The AUC value of PCT level was 0.81 (95% CI 0.71-0.91; p<0.001). Optimal cut off point was ≥7.88 ng/mL and Diagnostic Odd Ratio (DOR) was 5.55. The AUC value of TNF-α level was 0.73 (95% CI 0.60-0.86; p= 0.002). Optimal cut off point was ≥7.36 pg/ml and DOR was 5.03. Multivariate analysis was resulted that PCT was the best predictor of LVSD (AUC 0.70), and TNF-α (0.69). The combination of PCT + TNFα would increase diagnostic value with AUC 0.77. Conclusion:PCT was a better predictor of LVSD than TNF-α. This finding is significant, since it will enable clinicians to easily diagnose LVSD by measuring PCT. The combination of PCT and TNFα was the best efficient diagnostic predictor of LVSD.
EFFECTS OF N-ACETYLCYSTEIN ON HSCRP LEVEL IN ACUTE MYOCARDIAL INFARCTION PATIENTS RECEIVING FIBRINOLYTIC THERAPY Savithri Indriani1, Ahmad Yasa1, Trisulo Wasyanto1 1Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Sebelas Maret, RS Dr. Moewardi, Surakarta, Indonesia Background: Worldwide, coronary heart disease (CHD) is a leading cause of death. Inflammation in CHD and acute myocardial infarction (AMI) is a trigger due to the formation of atheroma plaques in the coronary arteries. N-Acetylcysteine (NAC) can prevent inflammation, remodeling and left ventricular dysfunction, interstitial fibrosis, and improve survival. Objective: To determine the effect of NAC on hsCRP levels in patients with acute myocardial infarction who received fibrinolytic therapy. Methods: This study was an experimental study with pre and post, single blind and randomization methods on the effect of NAC on hsCRP levels compared to controls carried out in July - August 2018 on the incidence of ST Elevation Myocardial Infarction (STEMI) came to Dr Moewardi Hospital and get fibrinolytic therapy. Results: A total of 33 patients were included in this study, there were 15 patients (mean age 58.80 ± 8.54 years) of the control group and 18 patients (mean age 55.45 ± 9.92 years) the treatment group receiving additional therapy of NAC evervescent 600 mg three times a day for three days . This study showed that hsCRP levels after intervention in the control and treatment groups were significantly different with p = 0.001. The level of hsCRP in the control group after administration of NAC had a median of 114.50 mg / L (18.60 - 300.00) while in the treatment group had a median of 18.75 mg / L (5.50 - 102.90). Conclusion: The addition of NAC 600 mg of therapy three times daily for 3 days can reduce hsCRP levels in patients with STEMI receiving fibrinolytic therapy compared to patients with acute myocardial infarction with ST segment elevation who did not receive additional NAC therapy. Keywords: hsCRP, N-Acetylcysteine, acute myocardial infarction . PENGARUH N-ACETYLCYSTEIN TERHADAP HSCRP PADA PASIEN INFARK MIOKARD AKUT DENGAN ELEVASI SEGMEN ST YANG MENDAPAT TERAPI FIBRINOLITIK Savithri Indriani1, Ahmad Yasa1, Trisulo Wasyanto1 Departemen Ilmu Penyakit Jantung dan Pembuluh Darah, Fakultas Kedokteran Universitas Sebelas Maret, RS Dr. Moewardi, Surakarta, Indonesia Latar Belakang: Di seluruh dunia, penyakit jantung koroner (PJK) merupakan penyebab utama kematian. Inflamasi pada PJK dan infark miokard akut (IMA) merupakan pemicu akibat terbentuknya plak ateroma pada arteri koroner. N-Acetylcysteine (NAC) dapat mencegah inflamasi, remodeling dan disfungsi ventrikel kiri, fibrosis interstisial, dan meningkatkan survival. Tujuan: Untuk mengetahui pengaruh NAC terhadap kadar hsCRP pada pasien infark miokard akut yang mendapatkan terapi fibrinolitik. Metode: Penelitian ini merupakan penelitian eksperimental dengan metode pre dan post, single blind dan randomisasi mengenai pengaruh NAC terhadap kadar hsCRP dibandingkan dengan kontrol yang dilakukan pada bulan Juli - Agustus 2018 terhadap paien Infark Miokard Akut dengan Elevasi Segmen ST (IMA-EST) yang datang ke Rumah Sakit Dr Moewardi dan mendapat terapi fibrinolitik. Hasil: Sebanyak 33 pasien diikutsertakan pada penelitian ini, terdapat 15 pasien (rerata usia 58.80±8.54 tahun) kelompok kontrol dan 18 pasien (rerata usia 55.45±9.92 tahun) kelompok perlakuan yang mendapat terapi tambahan NAC evervescent 600 mg tiga kali sehari selama tiga hari. Penelitian ini menunjukkan bahwa kadar hsCRP sesudah dilakukan intervensi pada kelompok kontrol dan perlakuan berbeda bermakna dengan nilai p = 0.001. Kadar hsCRP pada kelompok kontrol sesudah pemberian NAC memiliki median 114.50 mg/L(18.60 – 300.00) sedangkan pada kelompok perlakuan memiliki median 18.75 mg/L(5.50 – 102.90). Kesimpulan: Pemberian terapi tambahan NAC 600 mg tiga kali sehari selama 3 hari dapat menurunkan kadar hsCRP pada pasien infark miokard akut dengan elevasi segmen ST yang mendapat terapi fibrinolitik dibanding pasien infark miokard akut dengan elevasi segmen ST yang tidak mendapat terapi tambahan NAC. Kata Kunci: hsCRP, N-Acetylcysteine, infark miokard akut
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