Background: Chemotherapy with fluorouracil, adriamycin, and cyclophosphamide (FAC) regimen in breast cancer patients may cause myocardial injury and necrosis, thereby attenuating global and regional longitudinal strain (GLS and RLS). It is unclear whether the first chemotherapy cycle would cause GLS and RLS reduction and which segment would be most affected by the chemotherapy. The purpose of the study was to investigate the effect of the first chemotherapy cycle on GLS and RLS reduction.Methods: This was a prospective single-center cohort study of patients with breast cancer who underwent the first chemotherapy cycle with a FAC regiment. The GLS and RLS were measured using speckle tracking echocardiography and left ventricular ejection fraction (LVEF) measured with Simpson's biplane. The echocardiography was performed before and 3 weeks after the first chemotherapy cycle. We compared the value of GLS, RLS, and LVEF before and after chemotherapy using paired t-test analysis.Results: Thirty-six breast cancer patients were enrolled in the study. The GLS and RLS were reduced significantly at 3 weeks compared to baseline. The RLS of the basal anteroseptal, basal anterolateral, mid anterolateral, mid inferolateral, and all apical segments declined significantly from baseline. The largest RLS decline was detected in the apicoanterior segment. The post-chemotherapy GLS but not LVEF was significantly lower than that before treatment. Conclusion:The GLS and RLS of patients who underwent first cycle chemotherapy with FAC declined significantly than that before treatment, especially at the apicoanterior segment. LVEF was not altered after first cycle chemotherapy.

Background: Triglycerides (TG) as a risk factor for coronary artery disease (CAD) is still a matter of controversy but when used as a single ratio with high density lipoprotein (HDL) the predictive value for CAD is better. The TG/HDL ratio is also associated with the presence of small dense LDL (sdLDL) in the body. SdLDL is a more atherogenic LDL subfraction and has been proven to be associated with CAD progression.Aims: This study aims to find the correlation between the TG/HDL ratio and the degree of coronary lesion severity based on the Gensini score in stable non diabetic angina pectoris patients.Methods: This study was a cross sectional study conducted at Dr. Hasan Sadikin Hospital and Hasna Medika Palimanan Hospital. Subjects were non diabetic stable angina pectoris patients ≥18 years old who underwent elective coronary angiography. Blood collection for TG and HDL examination was performed after coronary angiography. Gensini scoring system was used to assess the severity of coronary lesions. The relationship between the TG/HDL ratio and the Gensini score was analyzed using multiple linear regression tests against confounding variables.Results: This study involved 60 patients with stable angina pectoris with a mean age of 60±8 years. The mean TG/HDL ratio is 2.56 ± 1.04. The average Gensini score was 51 ± 36. The TG/HDL ratio was significantly associated with the Gensini score (R = 0.637; p <0.001). Analysis of confounding variables showed age, hypertension, and metabolic syndrome had a weak correlation with Gensini score (r values of 0.321, 0.270, and 0.333, p <0.05, respectively), while those correlating with TG/HDL ratios were men, hypertension, and metabolic syndrome (r values of 0.290, 0.287, and 0.362, p <0.05, respectively).Conclusion: TG/HDL ratio was significantly positively correlated significantly with the severity of coronary lesions based on Gensini score in non diabetic stable angina pectoris patients.

No abstract

At the Cikalong hydropower plant there are 3 power transformers with a voltage rating of 6.3/77 kV, because of their long life, it is necessary to analyze the condition of the transformer oil. One way to determine the level of fault gas contained in transformer oil is the DGA (Dissolved Gas Analysis) test. DGA will extract the gas to find out indications of disturbance based on the interpretation of the dissolved gases data, namely the Total Dissolved Combustible Gas (TDCG), Key Gas, Roger's Ratio, Doernenberg's Ratio and Duval's Triangle methods. This method is in order to determine the condition of the transformer oil is normal or not, measure the breakdown voltage value and calculate the correlation value between operating hours and the amount of power production. The results of the DGA analysis on transformer units 1, 2, and 3 of the Cikalong hydropower sub-unit show the TDCG value in condition 1, which includes all transformers in good condition. The value of the correlation coefficient between hours of operation and the number of kWh production with TDCG is 0.267 and 0.297, respectively, which indicates the relationship between these variables is a weak relationship (standard value is close to 1).

Pasien yang menjalani operasi Bedah Pintas Koroner (BPK) atau coronary artery bypass grafting (CABG) memiliki risiko terjadinya komplikasi pasca operasi yang berakibat pada hari rawat yang lama bahkan kematian. Intervensi berupa rehabilitasi jantung fase I diperlukan untuk membantu mempercepat proses pemulihan pasca operasi serta mencegah terjadinya komplikasi pasca operasi BPK. Meskipun penelitian terkait rehabilitasi jantung sudah banyak dilakukan, namun perlu dilakukan telaah lebih lanjut dari artikel penelitian mengenai intervensi yang dapat dilakukan dalam program rehabilitasi jantung yang aman dan mudah dilakukan pada pasien pasca operasi BPK. Tujuan penelitian ini adalah untuk melihat intervensi yang aman dan efektif dilakukan dalam rehabilitasi jantung fase I pada pasien yang menjalani operasi BPK. Studi literatur ini dibuat dengan melakukan analisis terhadap atikel-artikel ilmiah minimal penelitian retrospektif yang dipublikasi tahun 2008 sampai 2018 dan berbahasa Inggris. Data didapat dari database meliputi Google Scholar, PubMed, DOAJ, dan Proquest dengan kata kunci cardiac rehabilitation phase I, coronary artery bypass grafting, early ambulation, early mobilization, education pre operative, dan physical exercise.  Hasil studi literatur ini didapatkan 13 artikel yang sesuai dengan kriteria inklusi dan eksklusi. Hasil telaah ditemukan bahwa pelaksanaan rehabilitasi jantung fase I pada pasien yang menjalani operasi BPK dimulai dari fase praoperasi dan dilanjutkan pasca operasi sampai pasien akan pulang. Intervensi rehabilitasi jantung fase I, baik pre maupun pasca operasi, terdiri dari edukasi dan konseling, latihan/ aktivitas fisik, latihan bernapas, latihan batuk efektif, inspiratory muscle training, fisioterapi dada, dan respiratory muscle stretch gymnastics. Oleh karena itu, hasil telaah literatur ini dapat menjadi dasar dalam menentukan standar prosedur operasional terhadap pelaksanaan rehabilitasi jantung fase I untuk rumah sakit yang menyediakan pelayanan operasi BPK. Kata Kunci: cardiac rehabilitation phase I, coronary artery bypass grafting, early ambulation, early mobilization.  Abstract Cardiac rehabilitation phase I in patient undergoing coronary artery bypass grafting surgery. A patient undergoing coronary artery bypass grafting CABG surgery has a risk of post operative complication, which can cause prolonged length of stay and even mortality. The patient necessarily needs to do intervention cardiac rehabilitation phase I to help the recovery process after surgery and prevent post operative complications. The articles related to cardiac rehabilitation have been carried out. However, it is necessary to review research articles about the effective and safe intervention of cardiac rehabilitation phase I for patients undergoing CABG surgery. The aim of this study was to explore the effective and safe intervention of cardiac rehabilitation phase I. This literature review was conducted by analyzing articles including randomized control trial until retrospective design which published between 2008 to 2018 with English language articles. Data was searched through Google Scholar, PubMed, DOAJ, and Proquest. The keyword was early ambulation, coronary artery bypass grafting, preoperative education, physical exercise, early mobilization, and cardiac rehabilitation phase I or inpatient cardiac rehabilitation. The finding in this literature review was 13 articles corresponding with the inclusion and exclusion criteria. The result of this study found that the intervention in cardiac rehabilitation phase I in patient who undergoing coronary artery bypass grafting surgery was started from preoperative and continued postoperative phases until the patient will leave the hospital. Interventions in cardiac rehabilitation phase I consisted of education and counseling, physical exercise/ activity, breathing exercises, effective cough exercises, inspiratory muscle training, chest physiotherapy, and respiratory muscle stretch gymnastics. Therefore, the result of this literature review can be the basis to determine standard operational procedure for the implementation of the cardiac rehabilitation phase I for the hospitals that provide CABG surgery.  Keywords: cardiac rehabilitation phase I, coronary artery bypass grafting, early ambulation, early mobilization

Background Breast cancer survivors potentially develop cardiotoxicity after FAC regiment administration. Carvedilol may provide antioxidant, antiapoptotic, and myocyte-calcium regulation effects in chemotherapy. This study aimed to evaluate cardioprotective effects of Carvedilol towards preventing subclinical left ventricular dysfunction (SLVD) in breast cancer patients following FAC chemotherapy. Methods The study was a prospective open-label and Quasi-Experimental. We divided the patients receiving the FAC chemotherapy from September 2018 until May 2019 into intervention (IG) and control groups (CG). The IG received Carvedilol 6.25 mg b.i.d. up titrated every three weeks until the tolerated dose. We evaluated the left ventricular GLS changes and the incidence of SLVD (GLS reduction ≥15% and GLS &gt;-18%) at 24 weeks after the FAC regimen initiation. Result Eighty-one women were enrolled in the study; 31 of them were the IG. There were no significant GLS changes during and after FAC completion in the IG, while the CG showed contradictive. At the end of follow-up, the delta GLS reduction was lower in the IG 0.7 (95% CI – 0.60,3.60) than the CG 3.00 (95% CI – 2.16,4.19), p = 0.035. The GLS percentage reduction showed similar results with 3.6% and 14.29% in the IG and CG respectively with p = 0.05. The incidence rate of SLVD (GLS reduction ≥15% and GLS &gt;-18%) in IG was lower; 41.9% and 25.8%, while in the CG was 58% and 48%. Conclusion Carvedilol may have a cardioprotective effect by preventing the GLS reduction and reducing the incidence of SLVD in women with breast cancer after a complete cycle of FAC regimen.

No abstract

Pasien yang menjalani operasi Bedah Pintas Koroner (BPK) atau coronary artery bypass grafting (CABG) memiliki risiko terjadinya komplikasi pasca operasi yang berakibat pada hari rawat yang lama bahkan kematian. Intervensi berupa rehabilitasi jantung fase I diperlukan untuk membantu mempercepat proses pemulihan pasca operasi serta mencegah terjadinya komplikasi pasca operasi BPK. Meskipun penelitian terkait rehabilitasi jantung sudah banyak dilakukan, namun perlu dilakukan telaah lebih lanjut dari artikel penelitian mengenai intervensi yang dapat dilakukan dalam program rehabilitasi jantung yang aman dan mudah dilakukan pada pasien pasca operasi BPK. Tujuan penelitian ini adalah untuk melihat intervensi yang aman dan efektif dilakukan dalam rehabilitasi jantung fase I pada pasien yang menjalani operasi BPK. Studi literatur ini dibuat dengan melakukan analisis terhadap atikel-artikel ilmiah minimal penelitian retrospektif yang dipublikasi tahun 2008 sampai 2018 dan berbahasa Inggris. Data didapat dari database meliputi Google Scholar, PubMed, DOAJ, dan Proquest dengan kata kunci cardiac rehabilitation phase I, coronary artery bypass grafting, early ambulation, early mobilization, education pre operative, dan physical exercise.  Hasil studi literatur ini didapatkan 13 artikel yang sesuai dengan kriteria inklusi dan eksklusi. Hasil telaah ditemukan bahwa pelaksanaan rehabilitasi jantung fase I pada pasien yang menjalani operasi BPK dimulai dari fase praoperasi dan dilanjutkan pasca operasi sampai pasien akan pulang. Intervensi rehabilitasi jantung fase I, baik pre maupun pasca operasi, terdiri dari edukasi dan konseling, latihan/ aktivitas fisik, latihan bernapas, latihan batuk efektif, inspiratory muscle training, fisioterapi dada, dan respiratory muscle stretch gymnastics. Oleh karena itu, hasil telaah literatur ini dapat menjadi dasar dalam menentukan standar prosedur operasional terhadap pelaksanaan rehabilitasi jantung fase I untuk rumah sakit yang menyediakan pelayanan operasi BPK. Kata Kunci: cardiac rehabilitation phase I, coronary artery bypass grafting, early ambulation, early mobilization.  Abstract Cardiac rehabilitation phase I in patient undergoing coronary artery bypass grafting surgery. A patient undergoing coronary artery bypass grafting CABG surgery has a risk of post operative complication, which can cause prolonged length of stay and even mortality. The patient necessarily needs to do intervention cardiac rehabilitation phase I to help the recovery process after surgery and prevent post operative complications. The articles related to cardiac rehabilitation have been carried out. However, it is necessary to review research articles about the effective and safe intervention of cardiac rehabilitation phase I for patients undergoing CABG surgery. The aim of this study was to explore the effective and safe intervention of cardiac rehabilitation phase I. This literature review was conducted by analyzing articles including randomized control trial until retrospective design which published between 2008 to 2018 with English language articles. Data was searched through Google Scholar, PubMed, DOAJ, and Proquest. The keyword was early ambulation, coronary artery bypass grafting, preoperative education, physical exercise, early mobilization, and cardiac rehabilitation phase I or inpatient cardiac rehabilitation. The finding in this literature review was 13 articles corresponding with the inclusion and exclusion criteria. The result of this study found that the intervention in cardiac rehabilitation phase I in patient who undergoing coronary artery bypass grafting surgery was started from preoperative and continued postoperative phases until the patient will leave the hospital. Interventions in cardiac rehabilitation phase I consisted of education and counseling, physical exercise/ activity, breathing exercises, effective cough exercises, inspiratory muscle training, chest physiotherapy, and respiratory muscle stretch gymnastics. Therefore, the result of this literature review can be the basis to determine standard operational procedure for the implementation of the cardiac rehabilitation phase I for the hospitals that provide CABG surgery.  Keywords: cardiac rehabilitation phase I, coronary artery bypass grafting, early ambulation, early mobilization