Rheumatic heart disease (rheumatic heart disease) is an acquired heart disease which is a heart valve disorder that persists due to previous acute rheumatic fever, mainly affecting the mitral valve (75%), the aorta (25%), rarely affecting the tricuspid valve, and never affecting the valves lungs. A 52-year-old male patient, domiciled in Mutiara (Alue Awe) Lhokseumawe City, Indonesia. Come for outpatient treatment at Polyclinic of Cut Meutia Hospital. Patients are who routinely go to the polyclinic every month to take medicine. The patient complains of left chest pain, shortness of breath, heart palpitations, cough, tired easily during activities, especially during strenuous activities. History of Diabetes Mellitus is denied, history of hypertension (+). The patient admitted that he was diagnosed with rheumatic heart disease at the age of 19 years. The patient has been undergoing treatment for 33 years by routinely complete checks related to his heart every year and regularly taking medication at the polyclinic every month. The patient admitted at junior high school age he often experienced attacks of fever that went up and down accompanied by pain in the throat. Physical examination found: Compos Mentis (E4V5M6), BP:140/40 mmHg, HR : 92x/i, RR: 23x/i, T; 37.1°C, SpO2 : 95%. Chest examination showed vesicular breath sounds, Rhonki (-), Wheezing (-), Diastolic murmur (+).Echocardiography showed an EF of 70%. AR Severe, MR Moderate. AML Prolapse, Calcification (+), LV Dilatation, LVH Eccentric

Mata kering merupakan suatu kondisi ketidaknyamanan dalam pengelihatan penderita yang disebabkan karena kekurangan kelembaban, lubrikasi dalam mata. Sindrom mata kering adalah penyakit multifaktorial dari air mata dan permukaan mata yang menghasilkan gejala tidak nyaman pada mata, gangguan visual, dan ketidakstabilan selaput air mata yang berpotensi merusak permukaan mata secara perlahan. Gejala awal pasien akan mengeluh mata gatal, mata seperti berpasir, silau, dan penglihatan kabur, gejala sekresi mucus berlebih, sukar menggerakkan kelopak mata, mata kering, dan terdapat erosi kornea yang merupakan komplikasi lanjut. Pada stadium awal sindrom mata kering mungkin tidak berbahaya, namun pada fase lanjut dapat menimbulkan kerusakan bola mata. Penalaksanaan sindrom mata kering dapat berupa Self-Care at home seperti humidifier, Hot Compres, eye exercise, dan dapat berupa medical treatment seperti obat pelumas mata (lubrikan). Pada awal perjalanan sindrom mata kering, penglihatan sedikit terganggu. Pada kasus lanjut dapat timbul ulkus pada kornea, penipisan kornea, dan perforasi. Kadang-kadang terjadi infeksi bakteri sekunder, dan berakibat parut dan vaskularisasi pada kornea, yang sangat menurunkan penglihatan dan bahkan sampai menimbulkan kebutaan.

Rheumatic heart disease (RHD) is an acquired heart disease with heart valve disorder that persists due to previous acute rheumatic fever, mainly affecting the mitral valve (75%), the aorta (25%), rarely affecting the tricuspid valve, and never affecting the valves lungs. A 52-year-old male patient, domiciled in Mutiara (Alue Awe) Lhokseumawe City, Indonesia. Come for outpatient treatment at Polyclinic of Cut Meutia Hospital. Patients are who routinely go to the polyclinic every month to take medicine. The patient complains of left chest pain, shortness of breath, heart palpitations, cough, tired easily during activities, especially during strenuous activities. History of Diabetes Mellitus is denied, history of hypertension (+). The patient admitted that he was diagnosed with rheumatic heart disease at the age of 19 years. The patient has been undergoing treatment for 33 years by routinely complete checks related to his heart every year and regularly taking medication at the polyclinic every month. The patient admitted at junior high school age he often experienced attacks of fever that went up and down accompanied by pain in the throat. Physical examination found: Compos Mentis (E4V5M6), BP:140/40 mmHg, HR : 92x/i, RR: 23x/i, T; 37.1°C, SpO2 : 95%. Chest examination showed vesicular breath sounds, Rhonki (-), Wheezing (-), Diastolic murmur (+).Echocardiography showed an EF of 70%. AR Severe, MR Moderate. AML Prolapse, Calcification (+), LV Dilatation, LVH Eccentric