http://localhost:8080/xmlui/handle/123456789/11919 1231 - 1446 Thu, 09 Apr 2026 03:42:52 GMT 2026-04-09T03:42:52Z http://localhost:8080/xmlui/handle/123456789/11961 Title: Cerebral Vessel Rupture Leading to Sudden Death: Implications for Pharmacognosy Authors: Moegis, Farhad; Yudianto, Ahmad; Sumino, Renny Abstract: Sudden death is one of the situations that necessitates immediate treatment from a forensic doctor. The WHO defines sudden death as death occurring within 24 hours of the beginning of symptoms. There are three sorts of sudden death: unexpected, unwitnessed, and spontaneous. Diseases of the Central Nervous System are the third most common cause of sudden death. Ischemic stroke (blockage) and hemorrhagic stroke (bleeding) are examples of central nervous system illnesses. Hypertension (cardiovascular disease) and smoking are known risk factors for hemorrhagic stroke.In 2019, the global incidence of intracerebral hemorrhage (ICH) and subarachnoid hemorrhage (SAH) was 14.46 per 100,000 people. The case discussed in our paper is about the sudden death of a European (Ukrainian) ship captain who happened to be anchored in the waters of Gresik, East Java, who died of hemorrhagic stroke. Mon, 01 Jan 2024 00:00:00 GMT http://localhost:8080/xmlui/handle/123456789/11961 2024-01-01T00:00:00Z http://localhost:8080/xmlui/handle/123456789/11960 Title: Preeclampsia: A Cardiorenal Syndrome in Obstetric Intensive Care Unit Authors: Izwardy, Mohamad Evandiar; Fitriati, Mariza Abstract: Introduction: Cardiorenal syndrome (CRS) encompasses a spectrum of disorders involving heart and kidneys. Preeclampsia and cardiovascular disease are most likely occur via oxidative stress induced endothelial dysfunction. Case presentation: A 34-years-old woman was referred with difficulty of breathing. She had a history of preeclampsia and refractory acute kidney injury (AKI). The patient was diagnosed with severe preeclampsia, partial HELLP syndrome, acute lung edema, cardiomyopathy, CRS, anemia, hyperkalemia, hypoalbuminemia, and AKI. Discussion: CRS and preeclampsia share similar risk factors and mechanisms including pre-existing renal or cardiac disease, diabetes, chronic hypertension, hypertriglyceridemia, obesity, metabolic syndrome, or other systemic disease. She had a history of preeclampsia and refractory AKI. Cardiac dysfunction reduce arterial blood supply and impairs venous return. Renal failure leads to the retention of water and an excessive volume demand. Conclusion: Cardiovascular disorders leading to CRS and preeclampsia remain the leading cause of morbidity in pregnancy. Mon, 01 Jan 2024 00:00:00 GMT http://localhost:8080/xmlui/handle/123456789/11960 2024-01-01T00:00:00Z http://localhost:8080/xmlui/handle/123456789/11959 Title: A Successful Practice of Massive Transfusion in Traumatic Amputation of Digit I-V Manus Dextra: A Case Report Authors: Juwono, Kashi Ameta Resijiadi; Maulydia, Maulydia; Airlangga, Prananda Surya Abstract: Introduction: Massive blood is the main cause of mortality and morbidity in trauma patients, in which 6 out of 10 cases are reported to die. Case presentation: A 29-year-old man appears to have experienced an amputation of digit I-V manus dextra. Vital signs are in stable condition and the patient is also conscious (GCS of 15) with ASA PS 1. The patient underwent debridement and replantation for 18 hours. Post-first surgery, we found blood seepage in the surgical wound, which for 4 hours showed 2000 mL of blood. The patient experiences decreased consciousness (GCS of 9), hypotension (77/40 mmHg), HR of 130 ×/min, and cold extremities. The patient received resuscitation with 1000 mL of crystalloid, 500 mL of colloid, 800 mL of WB, and 400 mL of PRC transfusion. Abnormal laboratory examination revealed Hb 4.6 g/dL, albumin 1.4 g/dL, and prolongation of hemostasis function 2 times. The patient underwent reoperation and was found to have ruptured muscles and veins for which musculorraphy and venorraphy were performed for 16 hours. On the 3rd day, the patient experienced breathing difficulties (RR of 30 ×/ min and SO2 of 95%) and the chest x-ray showed lung edema. The patient was placed on a ventilator using NIV and furosemide 20 mg/8 h. The patient regained consciousness on the 7th day. Discussion: The principle of managing massive bleeding is to stop the bleeding, restore blood circulation volume, and maintain peripheral vascularization. Conclusion: Massive transfusion is a management strategy for preventing death due to hemorrhagic shock. Mon, 01 Jan 2024 00:00:00 GMT http://localhost:8080/xmlui/handle/123456789/11959 2024-01-01T00:00:00Z http://localhost:8080/xmlui/handle/123456789/11958 Title: Antiphospholipid Syndrome Patient with Libman-Sacks Endocarditis Authors: Nugraha, Andy; Awalia, Awalia; Putra, Rendra Mahardika Abstract: Antiphospholipid syndrome (APS) is a systemic autoimmune disorder characterized by recurrent arterial and venous thrombosis, often associated with complications such as pregnancy morbidity. Libman-Sacks Endocarditis (LSE), a form of nonbacterial thrombotic endocarditis, is commonly observed in APS patients. This case report presents a 29-year-old Javanese woman with APS and Libman-Sacks Endocarditis. The patient, previously diagnosed with a transient ischemic attack, was admitted to Dr. Soetomo General Hospital with progressive shortness of breath, leg swelling, and abdominal distension. Initial investigations revealed thrombocytopenia, anemia, pleural effusion, cardiomegaly, and valve abnormalities. Despite anticoagulant therapy and supportive measures, the patient’s condition worsened, and she developed signs of heart failure and neurological deficits. Blood cultures remained negative, ruling out bacterial endocarditis. Imaging studies confirmed the presence of sterile vegetations on the mitral valve, a hallmark of LSE. The patient was diagnosed with primary APS based on clinical and laboratory findings, including positive lupus anticoagulant. After 28 days of hospitalization, she was discharged in stable condition but was re-admitted two days later with neurological decline. Despite aggressive management, including corticosteroids, diuretics, and anticoagulants, the patient suffered multiple complications, including seizures and possible thrombotic stroke and eventually passed away. This case underscores the diagnostic challenges and complexity in managing APS with Libman-Sacks Endocarditis, highlighting the need for early diagnosis and comprehensive treatment. The objective of this case report is to highlight the diagnostic challenges and management complexities of APS with Libman-Sacks Endocarditis, emphasizing the importance of early recognition and comprehensive treatment to mitigate associated morbidity and mortality. LSE remains a rare but severe manifestation of APS, with potential for thromboembolic events and significant morbidity. Mon, 01 Jan 2024 00:00:00 GMT http://localhost:8080/xmlui/handle/123456789/11958 2024-01-01T00:00:00Z