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Correlation between Risk Stratification of Complications and Types of Antihyperglycemia Drugs with Incidence of Acute Diabetic Complications in Patients with Diabetes Mellitus during Ramadan Fasting Sasiarini, Laksmi; Simatupang, Charisma Dian; Arsana, Putu Moda
Clinical and Research Journal in Internal Medicine Vol 1, No 2 (2020): New: The Second Issue is Coming!
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.crjim.2020.001.02.3

Abstract

Ramadan fasting for Diabetes Mellitus (DM) patients can lead to acute complications such as hypoglycemia, hyperglycemia, diabetic ketoacidosis (DKA) and thrombosis. Risk stratification predicts fasting safety of DM patients. Dose and timing of antihyperglycemia drugs adjusted during Ramadan fasting. Aim: To know the correlation between the risk stratification of Ramadan fasting and type of antihyperglycemia drugs with the incidence of acute complications in DM patients undergoing Ramadan fasting. Methods: DM patients in Endocrinology Clinic, dr. Saiful Anwar, General Hospital Malang who intend to fast during Ramadan classified in IDF-DAR risk stratification, conduct blood glucose monitoring and filled out a daily logbook during fasting. Results: Thirty-seven subjects were included in the study, only 1 patient with type-1 DM. Average fasting time is 18 days. Acute complications found higher in very high-risk group (5/6) compared to mild/moderate (2/13) and high-risk group (7/18) (p=0.009). Acute complications found higher in group with OAD and insulin combination regiment (2/4) compared to OAD (9/24) or insulin group (3/9) (p= 0. 731). One subject in very high-risk group suffered from acute coronary syndrome. Relationship between risk stratification and the incidence of hypoglycemia (p=0.040) and hyperglycemia (p=0.031) was significant. Relative risk in the very high-risk group was 2.538 compared to mild/moderate risk RR (95% CI)= 0.77 (0.62-0.96). Conclusions: There is a correlations between risk stratification and acute complications in DM patients undergoing Ramadan fasting. No relationship between type of antihyperglycemia drugs with acute complications of Ramadan fasting.
Expression of Testicular Estrogen Receptor Alpha in Rats Exposed to Subchronic Inhalation Exposure of Transfluthrin Kartikasari, Nanik Triana; Arsana, Putu Moda; Soeatmadji, Djoko Wahono
Clinical and Research Journal in Internal Medicine Vol 1, No 1 (2020): New: The First Volume of Clinical and Research Journal in Internal Medicine
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.crjim.2020.001.01.3

Abstract

Endocrine Disrupting compounds (EDCs) are exogenous materials that can interfere with the functions of the endocrine system. Research has demonstrated that pyrethroid compounds affect endocrine function. Transfluthrin belongs to the pyrethroid group that is widely used. These compounds could interact with estrogen receptor α and may increase the expression of estrogen receptor α in rat testis. Aim: to determine the effect of subchronic inhaled transfluthrin exposure on the expression of estrogen receptor α (ERα). Method: we used 35 adult male Wistar rats as experimental animals, which were randomly divided into 5 groups (n=7 per group): negative control group (rats without treatment), solvent control group (rats exposed to n-hexane solvent), and three treatment groups of subchronic inhaled transfluthrin: 0.1 mg/ml (treatment 1),  0.2 mg/ml (treatment 2) and 0.4 mg/ml (treatment 3), treated for 60 days. The immunohistochemical (IHC) staining was used to assess the expression of ERα. Result: there was a tendency for an increase in ERα expression with the addition of a transfluthrin dose. ER α in negative control group, solvent control group, treatment 1 group, treatment 2 group, and treatment 3 group was 16.75 ± 5.01 %; 16.64 ± 13.00 %; 19.31 ± 6.52 %; 25.63 ± 7.08 %, and 28.79 ± 20.31 %; p>0.05, respectively. There was a weak positive correlation between the dose of transfluthrin with ERα expression (r = 0.38, p = 0.025). Conclusion: subchronic inhalation exposure of transfluthrin in rats showed a tendency to increased the expression of ERα (dose-dependent). There is a weak positive correlation between the dose of transfluthrin with ERα expression.                                                                                            
Clinical Response of Convalescent Plasma Therapy in COVID-19 Patients in Dr. Saiful Anwar General Hospital Burhan, Niniek Budiarti; Brahmantyo, Herwindo Pudjo; Hermanto, Djoko Heri; Arsana, Putu Moda
Jurnal Kedokteran Brawijaya Vol 31, No 4 (2021)
Publisher : Fakultas Kedokteran Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jkb.2021.031.04.5

Abstract

The use of convalescent plasma has been beneficial for more than a century to treat various infections.  The lack of effective treatment currently available for COVID-19 has reemerged the use of convalescent plasma as a potential therapeutic option. This is an observational descriptive study in 13 COVID-19 patient who got convalescent Plasma. Consist of 11 (84%) male patient, 2 (16%) female patient. Divided into two groups based on severity, and outcome. 38% patient included in severe disesase and 62% patient in critically Ill condition. 30% patient who got convalescent plasma deceased, and 70% had a resolve condition.
Comparison of Lipid Profiles in Patients with Type 2 Diabetes Mellitus with Good Glycemic Control and Poor Glycemic Control in RSUD Dr. Saiful Anwar Malang Yudha, Nyoman Satvika Dharma; Arsana, Putu Moda; Rosandi, Rulli
Jurnal Penyakit Dalam Indonesia Vol. 8, No. 4
Publisher : UI Scholars Hub

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Abstract

Introduction. Diabetes mellitus (DM) is a group of metabolic diseases characterized by hyperglycemia due to insulin resistance, deficiency of insulin action, or both with a prevalence of 8.5% in Indonesia. Evidence regarding the relationship between HbA1c and lipid profile in type 2 DM is currently contradictory, therefore a study was conducted to examine the relationship between glycemic control and lipid profile for DM patients.Methods. This survey research was conducted at the outpatient endocrine clinic Dr. Saiful Anwar Malang Hospital in 2014-2019 with a total of 1,308 patients. Patients were then classified into type 2 DM patients with good (HbA1c < 7%, n = 291) and poor glycemic control (HbA1c > 7%, n = 1017).Results. There were lower levels of total cholesterol (183.9 (SD 38.7) mg/dl vs. 198.6 (SD 44.8) mg/dl; p < 0.001), triglycerides (144.2 (SD 67.5) mg/dl vs. 172.9 (SD 112) mg/dl; p < 0.001), and low-density lipoprotein (LDL-C) (119.2 (SD 32.1) mg/dl vs. 131 (SD 35.4) mg/dl; p < 0.001) in type 2 DM patients with good glycemic control compared to poor glycemic control group. There was no significant difference in high-density lipoprotein (HDL-C) levels between the two groups (47.7 (SD 13.4) mg/dl vs. 47.5 (SD 12.7) mg/dl; p = 0.89). There was a significant correlation between total cholesterol levels (r = 0.232; p < 0.001), triglycerides (r = 0.223; p < 0.001), and LDL-C (r = 0.20; p < 0.001) with HbA1c levels.173Jurnal Penyakit Dalam Indonesia | Vol. 8, No. 4 | Desember 2021|Perbandingan Profil Lipid pada Pasien Diabetes Melitus Tipe 2 dengan Kontrol Glikemik yang Terkendali dan Kontrol Glikemik yang Tidak Terkendali di RSUD Dr. Saiful Anwar Malang Conclusion. Type 2 DM patients with good glycemic control had significantly lower total cholesterol, triglycerides, and LDL-C levels compared to type 2 DM patients with poor glycemic control.
Correlation of Ramadan Fasting with HbA1C and Lipid ProfileLevel Changes in The Risk Stratification of Complications inDiabetes Mellitus Patients Bramantya, Rinadhi Reza; Arsana, Putu Moda; Sasiarini, Laksmi
Jurnal Penyakit Dalam Indonesia Vol. 8, No. 1
Publisher : UI Scholars Hub

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Abstract

Introduction. Diabetic patients will still do Ramadan fasting, which could affect the levels of HbA1C and lipid change after Ramadan. This study aimed to identify the correlation between fasting of Ramadan risk stratification with HbA1C and lipid levels diabetic patients who run the fast of Ramadan. Methods. This was a survey research using pre - post test. Study was conducted among diabetes patients who meet the criteria: carry out routine controls before and after Ramadan fasting at dr. Saiful Anwar Malang Hospital, filling in the required data, and underwent examination laboratory. Patients were grouped into moderate, high, and very high-risk stratification. Then we analyzed the HbA1C and fat levels before (pre) and after (post) Ramadan fasting in each risk group. Results. There were 25 subjects included in this study. There was a decrease in HbA1C level in all subjects from 7.93% (SD 2.3) to 7.86% (SD 1.9) after Ramadan fasting (p = 0.563), only the moderate risk group increased by 0,37% (SB 0.27). In all subjects, total cholesterol levels increased from 196.4 (SD 48.7) mg/dl to 205.0 (SB 70.8) mg/dl (p = 0.397), with the highest change found in the very high-risk group with an increase 30,7 (SD 125.0) mg/dl. There was a decrease in HDL levels from 55.6 (SD 31.3) mg/dl to 47.8 (SD 10.5) mg/dl (p = 0.782), and the highest decrease occurred in the very high - risk group (27.7 (SD 66,9) mg / dl). There was an increase in the LDL from 115.9 (SD 45.8) mg/dl to 130.4 (SD 41.9) mg/dl (p = 0.133) which the highest increase found in the very high-risk group (55.0 (SD 74.7) mg/dl). Only triglycerides showed an improvement from 190.7 (SD 105.2) mg/dl to 188.8 (SD 79.6) mg/dl (p = 0.084), increasement only occur in the high risk group (13.2 (SD 213.4) mg/dl). Conclusion. There was a decrease in HbA1C levels, but the value of the statistics was not significant. There was a negative effect of fasting Ramadan against blood-fat levels, except for improvements in the levels of triglycerides though statistically not significant
The Effect of Green Tea Extract Supplementation on PlasmaMalondialdehyde (MDA) in Human with Sub-Maximal PhysicalActivity, Double-Blind and Placebo-Controlled Trials Arsana, Putu Moda; Sasiarini, Laksmi; Nugraha, Bayu Eka
Jurnal Penyakit Dalam Indonesia Vol. 6, No. 1
Publisher : UI Scholars Hub

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Abstract

Introduction. Green Tea extract has been proven in vitro to have the ability as an antioxidant. Submaximal physical activity causes an increase in free radicals. The increase of MDA can detect the increase of free radicals. This study aimed to determine the effects of green tea extract supplementation against free radicals in submaximal physical activity by measuring plasma MDA. Methods. This double-blind controlled trial study was performed in 20 students of faculty of sports science with submaximal physical activity in the form of 1,500 meters running in 12 minutes using a treadmill. Subjects were divided into two groups: green tea extract group (250 mg) and the control group (placebo). Supplement/placebo was given as one caps a day for fourteen days before submaximal physical activity. The plasma MDA was taken before, 2 hours after, and 48 hours after the submaximal physical activity. Analysis of the results used ANOVA and post hoc Tukey. The study has been assessed by 24 | Jurnal Penyakit Dalam Indonesia | Vol. 6, No. 1 | Maret 2019 Putu Moda Arsana, Laksmi Sasiarini, Bayu Eka Nugraha Medical Research Ethical Committee at Medical Faculty of Universitas Brawijaya. Results. In the control group, the mean value of plasma MDA levels in basal conditions, 2 hours and 48 hours after submaximal physical activity were 52.43 nmol/ml (standard deviation [SD] 12.52 nmol/ml), 55.57 nmol/ml (SD 13.84 nmol/ml), and 63.86 nmol/ml (SD 12.17 nmol/ml), respectively. However, this result was not statistically significant (p = 0.158). In the treatment group, the mean value of plasma MDA level at 48 hours after submaximal physical activity was significantly decreased compared to basal condition with mean value in basal and 48 hours after submaximal physical activity were 36.14 nmol/ ml (SD 5.88 nmol/ml) and 19.86 nmol/ml (SD 8.92 nmol/ml), respectively (p <0.001). Further analysis showed a significant difference in plasma MDA levels between the two groups at basal, 2 hours, and 48 hours after submaximal physical activity (p values were 0.012; <0.001, and <0.001 respectively). Conclusion. Green tea extract can decrease the plasma level of MDA at basal, 2 hours, and 48 hours after submaximal physical activity.