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"ABSTRAKDuring 11 years period from January 2005 to December 2015 there were 18 adolescent and adult patients who underwent transcatheter closure of PDA using PDA Amplatzer Duct Occluder (ADO). There were 9 cases with age of 14 to 18 years and 9 cases with age of more than 18 years where the oldest case was 46 years old. Two cases were male and 16 cases were female. Prior to procedures, clinical assessment, ECG, chest x-ray and transthoracic echocardiography (TTE) were performed to confirm the diagnosis of PDA. The procedures of device implantation was performed under conscious sedation in adults and using general anesthesia in adolescents.The size of PDA ranged from 1.6 mm to 11.1 mm. Based on Kritchenko classification, the type of PDA were 15 type A1 and 3type A2. Flow ratio between pulmonary to systemic circulation was between 1.1 and 5.9. The procedure time ranged from 60-189 minutes and the fluoroscopic time 7.1-77.3 minutes. The PA pressure ranged from 22 to 63 mmHg. Immediate results after procedures as seen in angiography showed complete closure in 14 cases and smoky residual shunt or minimal residual shunts in 4 cases, which probably due to the temporary leaking through the devices. In 24 hours, complete closure was achieved in all cases (100%) and continued until 1months. At 6 month follow up, there was no residual shunts detected and also there was no significant complications, such as device embolization or recanalization. This case series suggest that transcatheter closure of PDA in adolescents and adults using Amplatzer duct occluder (ADO) is effective and has excellent resultswithout significant complication. However, long-term follow up is required to assess long term efficacy and safety."

"Snakebite is an important medical problem in India. Among their various manifestations, cerebral complications are uncommonly found in literature. Moreover, Ischemic stroke following snake bite is quite rare. Here we report a case series of two such cases that developed neurological manifestations following Russell’s viper bite. On computerized tomography (CT) scan of brain; cerebral infarcts were revealed. Their likely mechanisms are discussed in present study which include disseminated intravascular coagulation, toxin induced vasculitis and endothelial damage.

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Gigitan ular adalah masalah medis yang utama di India. Di antara berbagai manifestasinya, komplikasi serebral jarang ditemukan pada literatur. Terlebih lagi, stroke iskemik akibat gigitan ular cukup langka. Kami melaporkan serangkaian kasus dari dua kasus serupa yang mengembangkan manifestasi neurologis setelah gigitan ular viper Russell. Pada pemeriksaan CT scan menunjukkan infark serebral. Kemungkinan mekanisme penyebab kejadian yang mencakup koagulasi intravaskular diseminata, toksin yang diinduksi vaskulitis, dan kerusakan endotel akan dibahas pada artikel ini."

"Low birth weight (LBW) is defined as a birth weight of a liveborn infant of <2,500 gram. In developed countries, LBW is commonly caused by preterm birth; while in developing countries, it is mostly due to intrauterine growth retardation. The concept of developmental origins of adult diseases, particularly on late-onset diseases such as hypertension and kidney disease, implies that there is a correlation between intrauterine milieu, intrauterine growth retardation, premature birth and infant feeding. The ‘fetal origin hypothesis’ suggests that metabolic diseases are directly related to poor nutritional status in early life.There is an inverse association between LBW and later risk of hypertension. The pathomechanism that links LBW and hypertension is multifactorial including delayed nephrogenesis, genetic factors, sympathetic hyperactivity, endothel dysfunction, elastin deficiencies, insulin resistance and activation of renin-angiotension system.

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ayi berat lahir rendah (BBLR) didefinisikan sebagai bayi yang lahir dengan berat <2500 gram. Penyebab BBLR di negara maju umumnya adalah prematuritas, sedangkan di negara berkembang sebagian besar oleh karena gangguan pertumbuhan intra-uterin. Konsep perkembangan penyakit pada usia dewasa khususnya hipertensi dan penyakit ginjal dihubungkan dengan lingkungan intrauterin, gangguan pertumbuhan intrauterin, kelahiran prematur dan nutrisi janin. Hipotesis “The Fetal Origin” menyatakan bahwa penyakit metabolik secara langsung berhubungan dengan status nutrisi yang buruk pada fase awal kehidupan. Terdapat hubungan terbalik antara BBLR dengan risiko kejadian hipertensi di masa mendatang. Patomekanisme hubungan antara BBLR dan hipertensi bersifat multifaktorial yaitu hambatan nefrogenesis, faktor gen, hiperaktiifitas saraf simpatik, disfungsi endotel, defisiensi elastin, resistensi insulin dan aktivasi sistem renin angiotensin."