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The Effect of Vitamin D Supplementation on the Increase in CD4 count of HIV/AIDS Patients Receiving Antiretroviral Therapy Mega Permata; Harun Hudari; Mediarty; Taufik Indrajaya
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 5 No. 1 (2021): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32539/bsm.v5i1.186

Introduction. Vitamin D plays a role in health overall, but hypovitaminosis D stilloccurs throughout the world. HIV/AIDS patients are prone to suffer fromhypovitaminosis D because of the infection itself and the side effects of antiretroviraltherapy. Various effort have been tried to improve the immune status of HIV/AIDSpatients, one of them is by adding vitamin D. Vitamin D acts as an antiinflammatoryso that it can prevent apoptosis of CD4 T cells and increase CD4 cell count.Methods. This is a randomized control trial add on a study that aims to determinethe effect of vitamin D to increase in CD4 counts of HIV / AIDS patients who havereceived antiretroviral drugs. Subjects were HIV / AIDS patients who had receivedantiretroviral drugs. A total of 20 subjects were divided randomly into two groups;one group received vitamin D (calcitriol 0.5 mcg per day) for eight weeks, and theother group that received a placebo. Each group was measured of CD4 cell countbefore and after treatment. Results. There was a significant increase in the CD4 cellcount of the vitamin D group (p = 0.046), but not in the CD4 cell count of bothgroups (p = 0.985). The comparison of mean CD4 cell counts between groups beforetreatment was not significantly different (p = 0.057), but after treatment, it becamesignificantly different (p = 0.040). Conclusion. Vitamin D has been successful inincreasing CD4 cell count in the vitamin D group, and it is recommended to giveHIV / AIDS patients to increase CD4 cell count.

Relationship between Interleukin 6 Serum Levels and Degree of Depression in Systemic Lupus Erythematosus Patients Internal Disease in Dr. Moh Hoesin Palembang Shinta Suharno; Eddy Mart Salim; Ali Apriansyah; Taufik Indrajaya; Zen Ahmad; Erial Bahar
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 5 No. 3 (2021): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32539/bsm.v5i3.224

Introduction. Systemic Lupus Erythematosus (LES) is a chronic autoimmune inflammatory disease affecting many organ systems with varied clinical manifestations, disease course and prognosis. One of the clinical manifestations that can occur is depression as much as 25%. In LES patients, there is an increase in proinflammatory cytokines, one of which is IL-6, which is often associated with contributing to the pathophysiology of depression. The purpose of this study was to determine the relationship between serum IL-6 levels and the degree of depression in LES patients at RSUP DR. Mohammad Hoesin Palembang. Methods. Analytic observational study in the form of correlation test with cross sectional design which was conducted in the Internal Medicine room RSUP DR. Mohammad Hoesin Palembang from May 2019 to March 2020. The number of study subjects was 40 samples who were LES patients with depression who had been calculated using the BDI (Beck's Depression Inventory). All subjects were examined for serum IL-6 levels and evaluated for factors that influence it. Results. There were 40 study subjects aged 18-56 years. The median degree of depression was 16 with a range of values from 10 to 40. There were 17 people (42.5%) with mild depression degree, 14 people (35%) moderate depression, and 9 people (22.5%) major depression. In LES activities, there were 5 people (12.5%) with light LES activities, 20 people (50%) with moderate LES activities, and 15 people (37.5%) with heavy LES activities. The mean serum IL-6 level was 11.57 pg / mL with a value range of 1.1-50pg / mL. There was a significant correlation between the degree of depression and LES activity (p = 0.004; r = 0.444) and between serum IL-6 levels and the degree of depression (p = 0.025; r = 0.169). However, there was no significant correlation between serum IL-6 levels and LES activity (p = 0.057; r = 0.304). Conclusion. There is a relationship between serum IL-6 levels and the degree of depression in LES patients at Dr. Moh. Hoesin Palembang with a very weak correlation.

Anatomical and Hemodynamic Evaluation of Mitral Stenosis Patients with Echocardiography Muhammad Mukti; Erwin Sukandi; Ali Ghanie; Taufik Indrajaya; Syamsu Indra
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 5 No. 12 (2021): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32539/bsm.v5i4.378

Mitral stenosis (MS) is the most common valvular heart disease encountered in developing countries. The cause of MS is almost always chronic rheumatic heart disease. Echocardiography is the single most important diagnostic tool in the evaluation of MS. The objectives are to confirm the etiology, to assess the severity of stenosis, to recommend the type and timing of intervention, to assess other valvular lesions, presence of thrombus, and vegetation. According to current guidelines and recommendations for clinical practice, the severity of MS should not be defined by a single value but rather be assessed by a multimodality approach that determines valve areas, mean Doppler gradients, and pulmonary arterial pressures. The European Society of Echocardiography/American Society of Echocardiography (EAE/ASE) recommendations of measurement method for clinical practice were categorized into three level of recommendations. Mitral valve area (MVA) can be assessed by planimetry using either 2D or 3D imaging, pressure half-time (PTH), the continuity equation, and the proximal isovelocity surface area (PISA) method. These result echocardiographic examinations can increase the accuracy and appropriate management with a good prognosis.

Role of Fibroblast Growth Factor-23 in Coronary Slow Flow Phenomenon Pathogenesis Welly Oktaviandani; Taufik Indrajaya; Ali Ghanie; Erwin Sukandi
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 5 No. 12 (2021): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32539/bsm.v5i4.379

The phenomenon of angina chest pain without significant epicardial coronary artery stenosis, but accompanied by a slowdown in coronary blood flow is often found in patients with symptoms of acute coronary syndrome who undergoing invasive coronary angiography. This phenomenon of slow coronary blood flow is then called the coronary slow flow phenomenon (CSFP). The pathogenesis mechanism of CSFP remains unclear. The pathogenesis of CSFP is thought to be multifactorial. Endothelial dysfunction, small vessel disease, inflammation, renin system angiotensin aldosterone, atherosclerosis are thought to be involved in the pathogenesis of CSFP. Cardiovascular disease incidence and death were associated with elevated levels of Fibroblast growth factor-23 (FGF-23). High levels of FGF-23 can lead to formation of blood vessel calcification, left ventricular hypertrophy, arterial stiffness, endothelial dysfunction, increased inflammatory markers and elevated levels of angiotensin II. It is suspected that FGF-23 has a role in this event other than as a regulator of bone and mineral metabolism. This literature review aims to determine the relationship between fibroblast growth factor-23 and the pathophysiology of CSFP. Based on the broad role of FGF-23, it is possible that FGF-23 is involved in the pathogenesis of CSFP.

The Association between Urinary Tissue Inhibitor Metalloproteinase 2 (TIMP-2) and Insulin-like Growth Factor Binding Protein 7 (IGFBP-7) and Renal Recovery in Acute Kidney Injury Emilia; Zulkhair Ali; Ian Effendi; Novadian; Suprapti; Mediarty; Taufik Indrajaya; Mgs. Irsan Saleh
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 5 No. 4 (2021): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32539/bsm.v5i4.386

Background. Acute kidney injury (AKI) is a common and serious medical condition associated with significant increases in morbidity, mortality, cost of care and non recovery of kidney function that leads to progression to chronic kidney disease. Cell cycle arrest is implicated in the pathogenesis and repair process following AKI. The urinary cell-cycle arrest markers tissue inhibitor of metalloproteinase-2 (TIMP-2) and insulin-like growth factor binding protein 7 (IGFBP-7) have been utilized to predict the risk of AKI in many studies from specific population with good performance. However, their use in predicting recovery is still lacking. The aim of this study was to determine the association between two novel AKI biomarkers, urinary TIMP2 and IGFBP7 and renal recovery after 7 days of treatment in AKI patients at Dr. Mohammad Hoesin Hospital Palembang. Method. This was a prospective cohort study conducted in dr. Mohammad Hoesin Hospital Palembang from January 2021 until March 2021. Subjects enrolled in this study were patients whom diagnosed AKI based on KDIGO 2012 criteria. Urine samples were collected upon patients’ enrollment within 24 hours of AKI diagnosis. We utilized Sandwich Enzyme Linked Immunosorbant Assay (ELISA) method to detect urinary TIMP-2 and IGFBP-7 levels. The primary outcome is recovery from AKI after 7 days of treatment. Chi square test is used to analyze the association between urinary TIMP-2 and IGFBP-7 levels and renal recovery. Results. There were 70 subjects, only 22 of them were recovered after 7 days (31%). Median of urinary TIMP-2 and IGFBP-7 was 0,0047(0,0001-0,1439) [(ng/ml)2/1000]. There was significant association between urinary TIMP2 and IGFBP7 and renal recovery (p=0,027; OR 3,19; 95% CI 1,116-9,128). Conclusion. There was significant association between urinary TIMP2 and IGFBP7 and renal recovery in AKI patients.

Accuracy of Cell-Free DNA (cfDNA) in Colorectal Cancer Diagnosis Anjab Akmal Sya’roni; Suyata; Imam Supriyanto; Vidi Orba Busro; Ayus Astoni; Mediarty Shahrir; Taufik Indrajaya; Erial Bahar
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 5 No. 11 (2021): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32539/bsm.v5i11.422

Background: Colorectal cancer is the third most common type of cancer following lung and breast cancer with the second most common cause of cancer-related death globally. Delayed diagnosis due to limited source and modality to perform early diagnosis lead to advanced-stage condition which contributes to higher morbidities and mortalities. Recent diagnosis of colorectal cancer depends on biopsy of suspected tissues, either obtained surgically or per colonoscopy. Colorectal cancer detection through cell-free DNA measurement allowing small-size cancer being detected even in early stage. cfDNA originated from derivates of increased and abnormality apoptosis-necrosis pathway from cancer lesion, therefore can be managed as specific tumor marker. Methods: Diagnostic test was performed at the Gastroentero Hepatology Outpatient Unit and Internal Medicine Inpatient Unit of Dr. Mohammad Hoesin General Hospital Palembang from March to June 2021. Data processing and analysis using SPSS version 26.0 for Windows. Results: Among 50 subjects included, 39 subjects (78%) are diagnosed with colorectal cancer, whereas 11 subjects (22%) as control. The median of cfDNA result is 59,71 ng/mL with 92,3% sensitivity, 90,9% specificity, 95,2% positive predictive value, 82,3% negative predictive value, and 92,4% accuracy rate. Combination the measurement of cfDNA, CEA, and CA19-9 appears to have better AUC instead of single measurement. Conclusion: The study reveals that cell-free DNA (cfDNA) demonstrated a very promising accuracy rate in diagnosing colorectal cancer.

Coronary Microvascular Dysfunction Doharjo Manullang; Imran Soleh; Rukiah Chodilawati; Syamsu Indra; Ferry Usnizar; Erwin Sukandi; Taufik Indrajaya; Ali Ghanie
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 5 No. 12 (2021): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32539/bsm.v5i12.428

Coronary microvascular dysfunction (DMK) is a condition of patients who are accompanied by complaints of chest pain where the results of coronary angiography examination are normal and this is almost 49% with 60% of patients diagnosed with DMK. Another study said that about 40% of patients with DMK showed coronary flow reserve (CFR <2) of about 40% and the WISE study (Women's Ischaemia Syndrome Evaluation) showed that about 47% of patients with chest pain had normal coronary arteries. DMK can be divided into 4 groups; DMK with no coronary arterial disease (CAD) obstruction and myocardial disease, DMK with myocardial disease where this occurs due to remodeling of intramural coronary arteries, DMK with CAD (coronary arterial disease) or acute myocardial infarction with or without ST segment, iatrogenic typhoid DMK occurs after coronary recanalization caused by vasoconstriction and distal embolization. The mechanism of action of DMK can be caused by several factors, namely endothelial dysfunction, smooth muscle dysfunction, decreased diastolic perfusion time, damage to blood vessels and damage to the vascular and microvascular remodeling. And to enforce this DMK, there are several tests carried out in diagnosing the disease, some of which are invasive and non-invasive so that by enforcing the diagnosis of this disease, treatment for DMK can be done immediately and optimally.

The Effect of Vitamin D Supplementation on the Increase in CD4 count of HIV/AIDS Patients Receiving Antiretroviral Therapy Mega Permata; Harun Hudari; Mediarty; Taufik Indrajaya
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 5 No. 1 (2021): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32539/bsm.v5i1.186

Introduction. Vitamin D plays a role in health overall, but hypovitaminosis D stilloccurs throughout the world. HIV/AIDS patients are prone to suffer fromhypovitaminosis D because of the infection itself and the side effects of antiretroviraltherapy. Various effort have been tried to improve the immune status of HIV/AIDSpatients, one of them is by adding vitamin D. Vitamin D acts as an antiinflammatoryso that it can prevent apoptosis of CD4 T cells and increase CD4 cell count.Methods. This is a randomized control trial add on a study that aims to determinethe effect of vitamin D to increase in CD4 counts of HIV / AIDS patients who havereceived antiretroviral drugs. Subjects were HIV / AIDS patients who had receivedantiretroviral drugs. A total of 20 subjects were divided randomly into two groups;one group received vitamin D (calcitriol 0.5 mcg per day) for eight weeks, and theother group that received a placebo. Each group was measured of CD4 cell countbefore and after treatment. Results. There was a significant increase in the CD4 cellcount of the vitamin D group (p = 0.046), but not in the CD4 cell count of bothgroups (p = 0.985). The comparison of mean CD4 cell counts between groups beforetreatment was not significantly different (p = 0.057), but after treatment, it becamesignificantly different (p = 0.040). Conclusion. Vitamin D has been successful inincreasing CD4 cell count in the vitamin D group, and it is recommended to giveHIV / AIDS patients to increase CD4 cell count.

Relationship between Interleukin 6 Serum Levels and Degree of Depression in Systemic Lupus Erythematosus Patients Internal Disease in Dr. Moh Hoesin Palembang Shinta Suharno; Eddy Mart Salim; Ali Apriansyah; Taufik Indrajaya; Zen Ahmad; Erial Bahar
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 5 No. 3 (2021): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32539/bsm.v5i3.224

Introduction. Systemic Lupus Erythematosus (LES) is a chronic autoimmune inflammatory disease affecting many organ systems with varied clinical manifestations, disease course and prognosis. One of the clinical manifestations that can occur is depression as much as 25%. In LES patients, there is an increase in proinflammatory cytokines, one of which is IL-6, which is often associated with contributing to the pathophysiology of depression. The purpose of this study was to determine the relationship between serum IL-6 levels and the degree of depression in LES patients at RSUP DR. Mohammad Hoesin Palembang. Methods. Analytic observational study in the form of correlation test with cross sectional design which was conducted in the Internal Medicine room RSUP DR. Mohammad Hoesin Palembang from May 2019 to March 2020. The number of study subjects was 40 samples who were LES patients with depression who had been calculated using the BDI (Beck's Depression Inventory). All subjects were examined for serum IL-6 levels and evaluated for factors that influence it. Results. There were 40 study subjects aged 18-56 years. The median degree of depression was 16 with a range of values from 10 to 40. There were 17 people (42.5%) with mild depression degree, 14 people (35%) moderate depression, and 9 people (22.5%) major depression. In LES activities, there were 5 people (12.5%) with light LES activities, 20 people (50%) with moderate LES activities, and 15 people (37.5%) with heavy LES activities. The mean serum IL-6 level was 11.57 pg / mL with a value range of 1.1-50pg / mL. There was a significant correlation between the degree of depression and LES activity (p = 0.004; r = 0.444) and between serum IL-6 levels and the degree of depression (p = 0.025; r = 0.169). However, there was no significant correlation between serum IL-6 levels and LES activity (p = 0.057; r = 0.304). Conclusion. There is a relationship between serum IL-6 levels and the degree of depression in LES patients at Dr. Moh. Hoesin Palembang with a very weak correlation.

Anatomical and Hemodynamic Evaluation of Mitral Stenosis Patients with Echocardiography Muhammad Mukti; Erwin Sukandi; Ali Ghanie; Taufik Indrajaya; Syamsu Indra
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 5 No. 12 (2021): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32539/bsm.v5i4.378

Mitral stenosis (MS) is the most common valvular heart disease encountered in developing countries. The cause of MS is almost always chronic rheumatic heart disease. Echocardiography is the single most important diagnostic tool in the evaluation of MS. The objectives are to confirm the etiology, to assess the severity of stenosis, to recommend the type and timing of intervention, to assess other valvular lesions, presence of thrombus, and vegetation. According to current guidelines and recommendations for clinical practice, the severity of MS should not be defined by a single value but rather be assessed by a multimodality approach that determines valve areas, mean Doppler gradients, and pulmonary arterial pressures. The European Society of Echocardiography/American Society of Echocardiography (EAE/ASE) recommendations of measurement method for clinical practice were categorized into three level of recommendations. Mitral valve area (MVA) can be assessed by planimetry using either 2D or 3D imaging, pressure half-time (PTH), the continuity equation, and the proximal isovelocity surface area (PISA) method. These result echocardiographic examinations can increase the accuracy and appropriate management with a good prognosis.

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