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All Journal journal of internal medicine Jurnal Kedokteran dan Kesehatan : Publikasi Ilmiah Fakultas Kedokteran Universitas Sriwijaya
Anak Agung Gde Budhiarta
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Biochemistry, Genetics & Molecular Biology Medicine & Pharmacology Neuroscience Public Health

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PENATALAKSANAAN PASIEN DIABETES MELITUS DI POLIKLINIK RUMAH SAKIT SANGLAH DENPASAR Adnyana, Losen; -, Hensen; Gde Budhiarta, Anak Agung
journal of internal medicine Vol. 7, No. 3 September 2006
Publisher : journal of internal medicine

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Abstract

A cross-sectional study was conducted from March until May 2003 among 100 diabetic patients, registered inDiabetic Clinic, Department of Internal Medicine Sanglah Hospital for management of diabetes for more than 12months. Primary objective was to evaluate diabetes control, diabetes management and late complications status in thediabetic population managed by Diabetic Clinic as urban health care clinics. The subjects were 65% men and 35%women with mean of age 59.4 years and known having diabetes since 1-5 years (mean 2.1 years). Samples consist of4% type-1 diabetes; 95% type-2 diabetes and 1% gestational diabetes. Antidiabetic medication were sulfonylurea67%; metformin 55%; insulin 26% and others (glucosidase inhibitors, thiazolidenedione and others) were 0%.According to the level of AIC, lipid profile and blood pressure, 40% (AIC < 6.5%); 50% (HDL-chol >-45 mg/dl);27.0% (LDL-cho! < 100 mg/dl); 67.6% (triglyceride < 150 mg/dl) and 23% (blood pressure < 130/80 mmHg) werecategorized as good diabetic controls. Large proportion of poor diabetic controls partly may be due to low proportionof education days received on diabetes in the past year (57% have only I education day and 32% with zero educationday). This condition also impact on lifestyle modification where 63% not regularly and 14% never follow the diet and50% never . exercise. Also 12% still smoker and 4% sti 11 consume alcohol on a regu lar basis. Micral test to detectmicroalbuminuria as an early I phase of diabetic nephropathy were not commonly used (7%), and dipstick to detectmakroalbuminuria (99%). Blood test for serum creatinin showed 89% with serum creatinin <2 mg/dl and 11% withserum creatinin >2 mg/dl. Another chronic complication were neuropathy (10.1%); cataract (10.4%); backgroundretinopathy (8.6%), healed ulcer (3%), stroke (2%), leg amputation (1%), absence of foot pulse (1%), acuteulcer/gangrene (1%), myocard infard/CABG/angioplasty (1%).
PERAN SISTEM FlBRINOL1S1S PADA BERBAGAI PROSES FISIOLOGIS DAN PATOLOGIS Gde Budhiarta, Anak Agung
journal of internal medicine Vol. 7, No. 3 September 2006
Publisher : journal of internal medicine

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Plasminogen can be converted to plasmin either by t-PA or u-PA. A dual role for these pathways isnow well established where t-PA is involved in fibrin homeostasis and u-PA is primarily involved in cellmigration and tissue remodelling. Using this mechanism thrombolytic terapy of myocardial infarction andsome other thromboembolic diseases have been introduced. Thrombolytic therapy could be improved byearlier and accelerated treatment, the used of plasminogen activator with increased thrombolytic potencysuch as reteplase, tenetecplase and staphylokinase and the use of more specific and potent anticoagulant andantiplatelet agents. Increased activity of matrix metalloproteinases (MMPs) has been implicated innumerous disease processes, including tumor growth and metastases, arthritis, and periodontal disease. It isnow becoming increasingly clear that extracelluler matrix degradation by M M Ps is also involved in thepathogenesis of cardiovascular disease, including atherosclerosis, restenosis, dilated cardiomyapathi,andmyocardial infarction. Administration of synthetic MMP inhibitor in experimental animal models of; thesecardiovascular disease significantly inhibits the progression of respectivelyatherosclerotic lesion formation,neointima formation, left ventricular remodeling, pump dysfunction, and infarc healing.
HUBUNGAN RESISTENSI INSULIN DENGAN KADAR NITRIC OXIDE PADA OBESITAS ABDOMINAL Cahjono, Heru; Gde Budhiarta, Anak Agung
journal of internal medicine Vol. 8, No. 1 Januari 2007
Publisher : journal of internal medicine

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Numerous studies that confirmed the important link between central obesity and endothelial dysfunction (ED) is furthersupported by the concept that insulin sensitivity is partly determined by the ability of endothelium to produce nitric oxide (NO).In this condition, HOMA-IR, the model which is a convenient means of evaluating insulin resistance has thus far been related toED. Nitric oxide plays important physiological roles in the endothelium, where free radical NO is synthesized from the aminoacid l-arginine by endothelial constitutive NO synthase (eNOS) and released. Endothelium-derived NO is a potent vasodilator aswell as an inhibitor of platelet aggregation and adhesion, and is associated with the development of cardiovascular disease (CVD)in the presence of endothelial dysfunction (ED), which plays an early and prominent role in atherosclerotic plaque formation. Weraised the question as to whether insulin resistance in the abdominal obesity group had association with NO levels contribute toaffect endothelial dysfuntion. Cross sectional study had been conducted during January until March 2007. The study involved 67employees at Sanglah Hospital with abdominal obesity using criteria for Asian people (male WC 90 cm; female WC 80 cm).Serum concentrations of NO metabolites were evaluated through the measurement of metabolic end products, ie, nitrite andnitrate, using enzymatic catalysis coupled with Griess reaction, Serum concentration of insulin was measured by immunoassaymethod. Plasma glucose, cholesterol, HDL-cholesterol, LDL-cholesterol and triglicerydes were determined by enzymatic procedureafter overnight fast. The study involved 45 female and 25 male subjects, 23-56 years of age. Insulin resistance had associationwith waist circumference (r=0,511; p <0,01) and there was no association between insulin resistance and NO titer (r=0,054;p<0,664) but after adjusted with ESR 20-30 mm/h r=-0,486; p<0,048. However, serum concentrations of NO did not have associationwith component of metabolic syndrome and neither did insulin resistance. The present data indicate there is no associationbetween insulin resistance and NO levels except for ESR 20-30 mm/h. This possibility is due to low grade chronic inflammationrole on the pathogenesis of endothelial dysfunction in obesity
Oral Administration of Caesalpinia bonducella Seeds Ethanolic Extract Decreased Post Prandial Blood Glucose Level and Prevented the Reduction of Fasting Insulin Level of Diabetic Male Albino Rats (Rattus norvegicus) Veny Larasati; Wimpie Pangkahila; Anak Agung Gde Budhiarta
JURNAL KEDOKTERAN DAN KESEHATAN Vol 3, No 2 (2016)
Publisher : Fakultas Kedokteran Universitas Sriwijaya

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Caesalpinia bonducella contain flavonoid, tanin, saponin which has antidiabetic activity.  The aim of this study was to determine that the Caesalpinia bonducella seed extract orally reduces post-prandial blood glucose level and prevent the reduction of fasting insulin level in diabetic male albino rats (Rattus norvegicus). This study was a true experimental with pre-test post-test control group design using 24 male albino rats.  All samples were induced with streptozotocin which caused the destruction of ? cell and nicotinamide which protected the ? cell from destructions of that the pancreatic ?-cell was not destructed entirely. The selected samples were divided into three groups: the control negative group was given distilled water (P0), the control positive group was given glibenclamide (P1), and the treatment group was given ethanolic extracts of Caesalpinia bonducella seed 500mg/kg body weight (P2).  Blood glucose and plasma insulin measurements were taken after 14 days of treatment. The result showed that the post-prandial blood glucose level of treatment group (P2) was decreased significantly, from 232,63±10,31 mg/dl to 185,50±16,00 mg/dl (P<0.001) whereas in P0 group, post-prandial blood glucose level was rising significantly from 223,75±17.03 mg/dl to 267,25±17,56 mg/dl (p<0.001). In P1 group, the reduction of post-prandial blood glucose level was bigger compare to P2 group, which was from 228,50±11,55 mg/dl to 115,88±10,23 mg/dl (p<0.001).  Post test fasting insulin level of P2 group was significantly different compare to other group (p<0.05). The administration of Caesalpinia bonducella seed extract increased the fasting insulin level although did not significant statistically (p>0.05) whereas the other group showed the reduction of fasting insulin level (p<0.05). It can be concluded that the administration of Caesalpinia bonducella seed extract orally reduced post-prandial blood glucose level and prevent reduction of fasting plasma insulin level in diabetic male albino rats.
Co-Authors Hensen - Heru Cahjono I Wayan Losen Adnyana Larasati, Veny Wimpie I Pangkahila