Gout sering dialami oleh orang dewasa disebabkan terlalu banyak mengkonsumsi makanan tinggi purin. Air rebusan seledri yang mengandung apiin dan apigenin dipercaya dapat menurunkan kadar asam urat secara alami tanpa menimbulkan efek samping. Selain itu, kemudahan dalam mendapatkan dan mengaplikasikan seledri menjadikan seledri obat alternatif tradisional dalam penurunan kadar asam urat. Penelitian ini bertujuan untuk mengetahui pengaruh pemberian air rebusan seledri (Apium graveolens L.) terhadap kadar asam urat pada penderita gout di wilayah kerja Unit Pelayanan Kesehatan (UPK) Puskesmas Rasau Jaya. Penelitian ini menggunakan rancangan quasi eksperiment dengan rancangan non-equivalent pre-test and post-test control group design. Metode pengambilan sampel dengan purposive sampling berjumlah 64 responden yang dibagi menjadi dua kelompok. Analisa menggunakan uji Independent t-test. Hasil kadar asam urat pada kelompok intervensi didapatkan p value=0.002, sedangkan kadar asam urat pada kelompok kontrol didapatkan p value=0.496. Perbandingan antara kelompok kontrol dan intervensi memiliki nilai signifikansi p value 0.001. Hasil penelitian menujukkan bahwa terdapat pengaruh pemberian air rebusan seledri (Apium graveolens L.) terhadap kadar asam urat pada penderita gout di Rasau Jaya, sehingga pemberian air rebusan seledri (apium graveolens L.) ini dapat diaplikasikan sebagai intervensi mandiri keperawatan dalam menangani masalah asam urat.
Background Based on our previous pilot study, systemic inflammatory response syndrome is more common in off-pump compared to on-pump coronary artery bypass. Therefore, we conducted a clinical trial of dexamethasone in patients undergoing off-pump coronary artery bypass. Methods Sixty consecutive patients undergoing off-pump coronary artery bypass were enrolled from August 2018 to January 2019 and randomized to a dexamethasone or placebo group of 30 each. Clinical outcomes were analyzed. Results There was a lower incidence of major adverse cardiac events in the dexamethasone group compared to the placebo group (17% versus 43%, p = 0.024). Clinical outcomes in the dexamethasone group were better than those in the placebo group, in terms of duration of mechanical ventilation ( p = 0.029), intensive care unit stay ( p = 0.028), hospital stay ( p = 0.04), and vasoactive-inotropic score ( p = 0.045). There were significant differences in inflammatory markers between the two groups: interleukin-6 ( p = 0.0001), procalcitonin ( p = 0.0001), and C-reactive protein ( p = 0.0001) were lower in the dexamethasone group. There was a significant association between the incidence of major adverse cardiac events and both interleukin-6 ( p = 0.005) and procalcitonin ( p = 0.007). Conclusion Preoperative dexamethasone in patients undergoing off-pump coronary artery bypass is effective in improving clinical outcomes and controlling the postoperative inflammatory reaction.
Antiplatelet has been the cornerstones management of acute coronary syndrome. However, numbers of patients on these agents had episodes of adverse cardiovascular events. A 65-year-old woman post cardiac coronary bypass surgery on dual antiplatelet therapy, Aspirin, and Clopidogrel underwent several episodes of thrombotic events despite good adhered to thedailyantiplatelet regimen.These recurrent events had led to clinical suspicious of antiplatelet resistance. Platelet function test was performed which indicates a poor platelet response to Clopidogrel. Clopidogrelwas discontinued and Ticagrelor was prescribed together with Aspirin. During two months of follow up, there is no episode of chest discomfort.
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