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Papers by Ryan Intan

Cor et Vasa

Analyzovat souvislost mezi podáním reversinu a zvýšenou plasticitou buněk DFAT schopných dělení n... more Analyzovat souvislost mezi podáním reversinu a zvýšenou plasticitou buněk DFAT schopných dělení na různé typy buněk. Metoda: Vykultivované buňky DFAT byly rozděleny do čtyř skupin podle dávky reversinu: na kontrolní (bez reversinu) skupinu a na skupiny s aplikací reversinu v dávkách 10 nM, 20 nM a 40 nM. Každá skupina prochází několika stadii vývoje před další diferenciací na kardiomyocyty (identifi kované expresí cTnT), buňky hladké svaloviny (vascular smooth muscle cells, VSMC) (označené expresí afta-SMA) a buňky cévního endotelu (identifi kované expresí CD31). Výsledek: V každé skupině buněk DFAT s aplikací reversinu byly nalezeny statisticky významné rozdíly v expresi cTnT, alfa-SMA a CD31 (p = 0,003; resp. < 0,001 a < 0,001). Post hoc analýza s použitím Tukeyova testu prokázala, že pouze ve skupině s reversinem v dávce 10 nM došlo ke statisticky významnému rozdílu oproti kontrolní skupině (p = 0,002) v expresi cTnT a ve skupinách s reversinem v dávkách 10 nM a 20 nM k rozdílu v expresi alfa-SMA a CD31 (p = 0,028, resp. p < 0,001). Závěry: Tato studie prokázala vztah mezi dávkou reversinu a zvýšenou plasticitou buněk DFAT schopných diferenciace na kardiomyocyty (cTnT), VSMC (alfa-SMA) a buňky cévního endotelu (CD31).

Pregnancy Hypertension: An International Journal of Women's Cardiovascular Health, 2015

resistance (TPR) = [DBP + (SBP À DBP)/3]/CO. Results: We could not show any significant differenc... more resistance (TPR) = [DBP + (SBP À DBP)/3]/CO. Results: We could not show any significant difference in systolic (111 ± 11 vs 117 ± 14 mmHg) or in diastolic blood pressure (70 ± 2 vs 75 ± 2 mmHg, P = 0.16) between the groups at 11 year follow-up.However there was a significant difference in the night/day SBP and DBP ratios (0.81 ± 0.06 vs 0.76 ± 0.05, and 0.88 ± 0.04 vs 0.84 ± 0.04; both p < 0.05).There were no significant differences in LV and RV dimensions, systolic function or global LV strain.Indices of diastolic LV function, left and right atrial size or NT-pro-BNP levels did not differ between our study groups.EA/ELV was 0.53 (0.45-0.6) in PE and 0.52 (0.48-0.61) in controls, p = 0.60.None of the VAC variables differed between the groups. Conclusion: We could not demonstrate alterations in systolic or diastolic left or right ventricular function, or in ventriculo-arterial interaction in women 11 years after a pregnancy complicated by PE, despite sensitive echocardiographic techniques. Pre-existing risk factors may be more important for future cardiovascular complications than myocardial and vascular damage apparent during pregnancy in women with PE.

Medicinski glasnik : official publication of the Medical Association of Zenica-Doboj Canton, Bosnia and Herzegovina, Aug 1, 2022

Annals of Medicine and Surgery

Background Endothelial dysfunction (ED) is thought to be a risk predictor of acute coronary syndr... more Background Endothelial dysfunction (ED) is thought to be a risk predictor of acute coronary syndrome (ACS) outcome. Our aim is to analyse the ED by brachial artery flow-mediated dilatation (FMD) as a predictor of major adverse cardiac event (MACE) in ACS patients. Method This is a prospective cohort study with consecutive sampling for ACS in a hospital at Indonesia in April – May 2021. 69 patients met the inclusion were examined for brachial artery FMD with value

Supplemental material, sj-pdf-1-ejo-10.1177_11206721211006583 for Recurrent keratoconjunctivitis ... more Supplemental material, sj-pdf-1-ejo-10.1177_11206721211006583 for Recurrent keratoconjunctivitis as the sole manifestation of COVID-19 infection: A case report by Satria Audi Hutama, Firas Farisi Alkaff, Ryan Enast Intan, Citra Dewi Maharani, Luki Indriaswati and Ismi Zuhria in European Journal of Ophthalmology

Medical Science Monitor, 2022

None declared Conflict of interest: None declared Background: This was a retrospective study cond... more None declared Conflict of interest: None declared Background: This was a retrospective study conducted at a rural referral center in East Java, Indonesia, to evaluate the association between the platelet-to-lymphocyte ratio (PLR) on hospital admission and the incidence of new symptomatic heart failure (HF) within 6 months in patients with acute coronary syndrome (ACS). Material/Methods: The study population consisted of all ACS patients who were hospitalized between 1 January and 31 December 2018 at a non-percutaneous coronary intervention-capable secondary referral hospital and came for a routine follow-up until 6 months afterwards. The diagnosis of new symptomatic HF was based on International Classification of Diseases 10 th revision code I50.9. Results: From 126 hospitalized patients, 92 patients were included in the analysis. The incidence rate of new symptomatic HF at 6 months was 70.65%. High PLR upon initial admission was significantly associated with new symptomatic HF incidence (odds ratio=1.70, P<0.001). PLR was also able to discriminate new symptomatic HF incidence at 6 months with area under the curve of 0.83 (P=0.001). Multivariate Cox regression analysis showed that PLR was an independent predictor for new symptomatic HF incidence (hazard ratio=4.5, P=0.001). Conclusions: In a rural center in Indonesia, the PLR was independently correlated with the onset of new symptomatic HF in patients with ACS 6 months after hospital admission. The PLR may be a supplementary biomarker for clinical outcomes in patients with ACS for use in resource-limited regions.

European Journal of Ophthalmology, 2021

Introduction: Ocular symptoms are uncommon manifestations of coronavirus disease 2019 (COVID-19) ... more Introduction: Ocular symptoms are uncommon manifestations of coronavirus disease 2019 (COVID-19) infection. Earlier study reported that dry eye, blurred vision, foreign body sensation, tearing, itching, conjunctival secretion, conjunctival congestion, ocular pain, and photophobia are among the ocular symptoms that could be found in COVID-19 patients. However, there are only a few reports available regarding corneal involvement in this disease. Here we report a case of keratoconjunctivitis as the only symptom of COVID-19 infection. Case description: A 27-year-old man who worked as an obstetrics and gynecology resident came to the outpatient clinic with the chief complaints of eye discomfort, foreign body sensation, conjunctival hyperemia, lacrimation, and photophobia in his right eye for the past 3 weeks. Fluorescence test showed a small corneal lesion. The patient was then diagnosed with keratoconjunctivitis. A week after the treatment, all symptoms were resolved. A month later, the...

Open Access Macedonian Journal of Medical Sciences, 2020

BACKGROUND: National prevalence of hypertension in Indonesia is increasing in the past few years.... more BACKGROUND: National prevalence of hypertension in Indonesia is increasing in the past few years. One of the reasons is because of the weaknesses in health systems, particularly at the primary care level. To resolve this issue, Indonesian government launched a chronic disease care program (PROLANIS) designed to be done at primary health care with the aim to control hypertension. Wates primary health care routinely conducts the program from April 2018. AIM: This study aims to evaluate the effectivity of PROLANIS in controlling hypertension and its comorbidities at Wates primary health care. METHODS: This study was an observational retrospective cohort study using secondary data from PROLANIS report at Wates primary health care in Mojokerto city, Indonesia. The study population was hypertensive patients that voluntarily joined the program on April 2018 and routinely attend evaluation follow-up every 6 months. Follow-up evaluation including blood pressure (BP), body mass index (BMI), t...

Preeclampsia is still the leading cause of maternal mortality in developing countries, including ... more Preeclampsia is still the leading cause of maternal mortality in developing countries, including Indonesia. However, there is a discrepancy between national and regional data regarding the cause of maternal death in Indonesia. National data shows that peripartum hemorrhage is the main cause of maternal death, while data from East Java region shows that the leading cause is preeclampsia. Thus, we believe that there is still lack of understanding about preeclampsia in East Java region. This study aims to scrutinize the characteristic of pregnant women with preeclampsia in East Java, Indonesia. This study was a matched case-control study conducted from June to October 2018 at secondary referral government hospitals. Variables analyzed in this study were demographic characteristic, pregnancy history, preeclampsia risk factors, and infant outcomes. Logistic regression was used to analyze preeclampsia risk factor. There were 67 preeclamptic women as case group and 67 women with normal pre...

Frontiers in Cardiovascular Medicine, 2021

Background: To date, there is no reference for a 6-min walk test distance (6-MWD) immediately aft... more Background: To date, there is no reference for a 6-min walk test distance (6-MWD) immediately after cardiac surgery. Therefore, this study aimed to identify the determinants and to generate equations for prediction reference for 6-MWD in patients immediately after cardiac surgery.Methods: This is a cross-sectional study of the 6-min walk test (6-MWT) prior to participation in the cardiac rehabilitation (CR) program of patients after coronary artery bypass surgery (CABG) or valve surgery. The 6-MWT were carried out in a gymnasium prior to the CR program immediately after the cardiac surgery. Available demographic and clinical data of patients were analyzed to identify the clinical determinants of 6-MWD.Results: This study obtained and analyzed the data of 1,509 patients after CABG and 632 patients after valve surgery. The 6-MWD of all patients was 321.5 ± 73.2 m (60–577). The distance was longer in the valve surgery group than that of patients in the CABG group (327.75 ± 70.5 vs. 313...

Background: In developing countries, even electrocardiography (ECG) hasnt been used widely in mos... more Background: In developing countries, even electrocardiography (ECG) hasnt been used widely in most health-care centers. The ability of physicians to refer to chronic kidney disease (CKD) patients for ECG, often collide with several barriers and costs. Therefore, we need to formulate the simplest and most efficient model to predict when CKD patients need to be referred due to potential ECG abnormalities. Objective: The aim of this study was to develop several clinical and laboratory parameters as a predictor of any ECG abnormalities. Materials and Methods: A retrospective cross-sectional study design held at Dr. Soetomo General Academic Hospital, Surabaya, Indonesia. Subjects were hospitalized patients with CKD between 1 January to 31 December 2019. 198 CKD patients (101 males) were enrolled for the study. All patients had demographic information, detailed clinical profile, resting 12-lead ECG recording, complete blood count, serum electrolyte and renal function test profile during a...

Article history: Received 28 July 2019 Received in revised form 10 October 2019 Accepted 18 Octob... more Article history: Received 28 July 2019 Received in revised form 10 October 2019 Accepted 18 October 2019 Available online 31 October 2019

American Journal of Case Reports, 2020

Unusual clinical course Background: Triangular QRS-ST-T waveform (TW) electrocardiography pattern... more Unusual clinical course Background: Triangular QRS-ST-T waveform (TW) electrocardiography pattern has been found to be associated with poor prognosis in patients with ST-segment elevation myocardial infarction (STEMI). It identifies a subset of patients at high risk of both ventricular fibrillation and cardiogenic shock, with high in-hospital mortality. Therefore, aggressive treatment is needed in patients presenting with this electrocardiography pattern. However, this pattern is rarely present in non-ischemic cardiac diseases. Case Report: We report the case of a 50-year-old man who came to our emergency room with a chief complaint of gastrointestinal problems and partial bowel obstruction. After failure of initial conservative treatment, laparotomy was planned. Just before the surgery, the patient felt a non-specific chest discomfort and showed ST-segment elevation on ECG and slight elevation of cardiac enzyme. He was then treated for STEMI with an intravenous thrombolytic. However, the degree of ST-segment elevation further increased and showed a TW pattern. Transthoracic echocardiography revealed a moderate pericardial effusion with normal ejection fraction and a normokinetic left ventricle; hence, a diagnosis of acute myopericarditis was made. After treatment with low-dose steroid and colchicine, his symptoms improved, the electrocardiography pattern returned to normal, and the gastrointestinal symptoms resolved. Conclusions: To the best of our knowledge, this is the first case report of an acute myopericarditis presenting with a TW electrocardiography pattern. Myopericarditis should always be considered in the differential diagnosis of acute chest pain and ST segment electrocardiography changes, including TW pattern. The use of echocardiography can help determine the diagnosis of myopericarditis.

The Egyptian Heart Journal, 2020

Background Wellens’ syndrome is known to be associated with left anterior descending artery occlu... more Background Wellens’ syndrome is known to be associated with left anterior descending artery occlusion that could lead to an extensive anterior wall myocardial infarction. Thus, emergency cardiac catheterization is needed. However, during coronavirus disease 2019 (COVID-19) pandemic, it is recommended for hemodynamically stable acute coronary syndrome patients with COVID-19 infection to be treated conservatively in an isolated hospital ward. Case presentation We report an 85-year-old patient with chief complaints of typical, squeezing chest pain in the past 4 h. The patient had a high fever, dyspnea, sore throat, and fatigue for 3 days. He had previously come into contact with COVID-19 positive relatives. The patient was hemodynamically stable and pulmonary auscultation revealed coarse rales in the entire lung. Electrocardiography (ECG) evaluation during the pain episode showed non-specific ST-T changes in lead V2-V5. After sublingual nitrate was administered, ECG evaluation during t...

BMJ Case Reports, 2021

ST-elevation myocardial infarction (STEMI) is one of the medical emergencies in cardiology with h... more ST-elevation myocardial infarction (STEMI) is one of the medical emergencies in cardiology with high morbidity and mortality rate which requires rapid response. In elderly patients, its presenting symptoms may be atypical which may cause the diagnosis of MI to be delayed or missed. Therefore, ST-segment elevation on ECG has become the main instrument for initial diagnosis. However, there are a variety of conditions mimicking the ECG changes of STEMI. We report a case of 70-year-old patient with acute peritonitis and pneumoperitoneum secondary to gastric perforation with dynamic ECG changes mimicking anteroseptal STEMI. After the surgery, the ECG dynamically reverted to normal. He was then discharged after 4 days without any remaining symptoms. Misinterpretation of ECG findings may lead to unnecessary aggressive intervention, costly management strategies and delay in appropriate treatment.

Biomolecular and Health Science Journal, 2019

Pericarditis is a common disorder that might present in various settings, including primary-care ... more Pericarditis is a common disorder that might present in various settings, including primary-care and emergency department. However, the clinical features in some cases did not match with the written theory, which could lead to a misdiagnosis. A 46-year-old man presented to the emergency room with progressive tightness chest pain, epigastric pain, nausea, and vomiting in the past 2 days. Based on the clinical, electrocardiograph (ECG), and laboratory evaluation, the patient was diagnosed with unstable angina pectoris and treated accordingly but did not showed an improvement. Clinical re-examination and echocardiography evaluation showed a pathognomonic finding of pericarditis feature. Combination therapy of colchicine and ibuprofen was given for 3 weeks. One-month follow-up evaluation showed normal ECG and echocardiography result without any remaining symptoms. Acute pericarditis does not always show typical finding. Therefore, clinician must always aware with other differential diag...

American Journal of Case Reports, 2019

Rare disease Background: Pulmonary artery aneurysm (PAA) is a rare disease in cardiovascular syst... more Rare disease Background: Pulmonary artery aneurysm (PAA) is a rare disease in cardiovascular system. This disease is difficult to diagnose and less often considered due to its non-specific clinical manifestations. Until now there are no clear guidelines about its optimal management because of the small number of reported cases. Case Report: We report a 56-year-old male with chief complain of atypical bilateral chest pain and shortness of breath. Initial electrocardiogram (ECG) and laboratory evaluation showed no sign of ischemic heart disease. After the patient was stabilized, he was evaluated using chest x-ray, transthoracic echocardiography (TTE), and multi slice computed tomography (MSCT). The patient was then diagnosed with PAA secondary to suspicion of pulmonary hypertension (PH) with chronic obstructive pulmonary disease and heart failure. Conservative treatment was chosen because of the limited resources for surgery and patient's refusal to be referred. The treatment aims to lower the pulmonary artery pressure while monitoring the aneurysm. His 6-month follow-up evaluation showed an improvement in pulmonary artery pressure and persistent of the PAA without any increasement of the diameter. Conclusions: PAA is a rare disease that is difficult to diagnose because of its non-specific nature. Persistent atypical chest pain can be an early symptom of PAA, thus clinicans should be aware in a high-risk patient suffered persistent chest pain, despite normal ECG and laboratory findings. TTE and MSCT evaluation are reliable for diagnosing PH and PAA. With conservative treatment and routine follow-up, patient with PAA secondary to PH could be managed well.