The Indonesian Biomedical Journal

17-22

Authors: Djanggan Sargowo, Olivia Handayani

BACKGROUND: The association between elevated triglycerides and cardiovascular risk has been extensively studied. The elevated level of triglycerides occurs through abnormalities in hepatic very low-density lipoprotein (VLDL) production and intestinal chylomicron synthesis, dysfunctional lipoprotein lipase (LPL)-mediated lipolysis or impaired remnant clearance. CONTENT: Hypertriglyceridemia (HTG) commonly leads to a reduction in high-density lipoprotein (HDL) and increase in atherogenic small dense low-density lipoprotein (LDL) cholesterol, called the atherogenic dyslipidemia (AD). Triglycerides may also stimulate atherogenesis by mechanisms, such excessive release of free fatty acids, and production of pro-inflammatory cytokines, fibrinogen, coagulation factors and impairment of fibrinolysis. Genetic studies strongly support hypertriglyceridemia (HTG) and high concentration of triglyceride-rich lipoprotein (TRL) as causal risk factors for cardiovascular disease. Therefore, lipid management is crucial in reducing cardiovascular risk. Combination of lipid lowering drug therapy may be needed to achieve both LDL and non-HDL cholesterols treatment goal for cardiovascular disease prevention in patients with elevated triglyceride levels, particularly those with triglyceride ≥500 mg/dL. SUMMARY: LDL and non-HDL cholesterol can be a promising target therapy in HTG. Additional clinical outcomes data are needed to provide a more evidence-based rationale for clinical lipid management of hypertriglyceridemic patients.

29-34

Authors: Idar Mappangara, Magma Purnawan Putra, Khalid Saleh

BACKGROUND: Many studies showed the association between peripheral artery disease (PAD) and coronary artery disease (CAD). The anklebrachial index (ABI) was a simple, noninvasive, and not expensive test that showed high sensitivity and specificity in the diagnosis of PAD. Previous studies showed PAD correlation with the number of coronary artery lesions and higher complexity of the lesions. These correlations might contribute to worse cardiovascular outcomes, especially acute coronary syndrome (ACS) cases. Aim of this study is to evaluate the correlation abnormal ABI with the risk of ACS patients to have multivessel coronary artery lesions. METHODS: This was a retrospective analytical casec ontrol study. The data were taken from Dr. Wahidin Sudirohusodo Hospital medical records from November 2015 to February 2016. The inclusion criteria were (>18 years old) patients with ACS who had underwent ABI examination and coronary angiography. RESULTS: The prevalence of patients with ST-elevation myocardial infarction (STEMI) was lower than non-ST elevation ACS (NSTE-ACS). The prevalence of patients with abnormal ABI was 43.3% and patients with multivessel CAD was 65%. Male patients dominated the ACS population with 73.3%, about half of patients were smoking, and 86.7% had dyslipidemia. Patients with abnormal ABI and multivessel disease had greater number than patients with normal ABI (p=0.025). Analysis with binary logistic regression model showed abnormal ABI (odd ratio [OR] 4.83; p=0.021) and male sex (OR 19.35; p=0.010) were associated with greater risk of multivessel CAD. CONCLUSION: An abnormal ABI is associated with greater risk of multivessel CAD in ACS patients.

43-8

Authors: Octaviani, Agus Rahardjo, Untung Alifianto, Setya Anton

BACKGROUND: Peritoneal adhesion is a side effect of abdominal surgery that often occurs. Many efforts were made in abdominal surgery to prevent or minimize the occurrence of this adhesion. One way to reduce the risk of bowel adhesions is through washing peritoneum method, so the differences in the use of washing solution on the incidence of adhesions after laparotomy surgery need to be investigated. The objective of this study is to determine differences in the effect of using sterile water and normal saline for washing irrigation to peritoneal adhesions after laparotomy in white rats. METHODS: This was an experimental study. Thirty-two sample of white rats were divided into two groups, group A and Group B, each group consists of 16 rats. Group A got washing using normal saline and group B got washing using sterile water for irrigation in laparotomy procedure to assess the peritoneal adhesion microscopically after relaparotomy. RESULTS: This study was conducted in April-May 2016. The founding of peritoneal adhesion after laparotomy in white rats using sterile water for irrigation in grade 1 were seven samples, grade 2 were five samples and grade 3 were four samples. Meanwhile, the founding of peritoneum adhesion after laparotomy using normal saline grade 1 are two samples, grade 2 are five samples, and grade 3 are nine samples. Statistically, significant differences were found (p<0.05). CONCLUSION: Some risk factors can lead to adhesion, such as trauma surgery, tissue ischemia, infection blood and foreign body irritating. Intraperitoneal irrigation with sterile water for irrigation is better than the use of normal saline in preventing peritoneal adhesion.