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All Journal Majalah Kedokteran Bandung Medical Journal of Indonesia Jurnal Farmasi Klinik Indonesia Majalah Kedokteran Nusantara The Journal Of Medical School Sumatera Medical Journal AVERROUS: Jurnal Kedokteran dan Kesehatan Malikussaleh

dharma Lindarto, dharma

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Author-ID : 563292

Dentistry Health Professions Immunology & microbiology Medicine & Pharmacology Nursing Public Health

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Articles

Polifarmasi dan Interaksi Obat Pasien Usia Lanjut Rawat Jalan dengan Penyakit Metabolik Dasopang, Eva S.; Harahap, Urip; Lindarto, Dharma
Indonesian Journal of Clinical Pharmacy Vol 4, No 4 (2015)
Publisher : Indonesian Journal of Clinical Pharmacy

Penyakit metabolik merupakan penyakit yang berkaitan dengan peningkatan usia seperti hipertensi, diabetes melitus, dislipidemia, dan obesitas. Penyakit-penyakit tersebut ditangani dengan terapi obat yang sifatnya polifarmasi sehingga dapat menyebabkan risiko terjadi interaksi obat-obat. Penelitian ini dilakukan secara restropektif dengan menggunakan rekam medis pasien usia lanjut dengan penyakit metabolik yang di rawat jalan di Rumah Sakit Umum Pusat Haji Adam Malik Medan. Sebanyak 328 sampel yang termasuk ke dalam kriteria inklusi diperoleh data bahwa jumlah interaksi obat-obat yang terjadi cukup tinggi sebesar 78,96%. Pola mekanisme yang terbanyak adalah farmakokinetik (63,6%) dengan tingkat keparahan yang terbanyak adalah moderat (69,8%). Penelitian ini menunjukan adanya korelasi antara jumlah interaksi dengan jumlah obat (r= 0,728; p= 0,0001), dan jumlah interaksi dengan jumlah diagnosis (r= 0,264; p= 0,0001).Kata kunci: Interaksi obat, penyakit metabolik, polifarmasiPolipharmacy and Drug Interactions in Elderly Patients with Metabolic DiseasesMetabolic disease is a disease that is associated with increasing age such as hypertension, diabetes mellitus, dyslipidemia and obesity. Such diseases are treated with polypharmacy therapy that can cause increased risk of drug interactions. This study was conducted using a restropective method using the medical records of elderly patients with metabolic diseases in outpatient unit of H. Adam Malik General Hospital Medan. A total of 328 samples were included in the inclusion criteria data showed that the numberof drug-drug interactions that occur quite high at 78.96%. The pattern of drug interaction mechanism that most frequently occur is pharmacokinetic (63.6%) and the highest severity was moderate (69.8%). This study shown a correlation between the number of interactions with a number of drugs (r= 0.728; p=0.0001), and the number of interactions with a number of diagnoses (r= 0.264; p= 0.0001).Keywords: Drug-interactions, metabolic-disease, polypharmacy

Efektifitas Kombinasi Ekstrak Sambiloto (Andrographis paniculata (burm.f.) nees) dan Daun Salam (Syzygium polyanthum (wight) walp) terhadap Kadar hs-CRP pada Pasien Dislipidemia Yulindaa, Wina; Lindarto, Dharma; Syafril, Santi
Majalah Kedokteran Nusantara The Journal Of Medical School Vol 50, No 3 (2017): The Journal of Medical School
Publisher : Fakultas Kedokteran USU

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Introduction Dyslipidemia is risk factor of cardiovascular disease and significantly correlated with increased hs-CRP concentration. Simvastatin, a sintetic antidyslipidemic drug, decreases hs- CRP concentration. But long term use of sintetic drug may cause side effects, so that phytopharmaca is preferably to be consumed. Combination sambiloto extract and salam could decrease proinflammatory cytokines, cholesterol, and triglyceride. Aim of this study was to compare the effect of combination sambiloto extract and salam with simvastatin on hs-CRP concentration in dyslipidemic patientsMethods This clinical trial use prospective design. Treated group (n = 15) and control group (n = 15) were selected by double blind random sampling. Before and after 30 days therapy, blood sample was taken. Data was analysed with SPSS, p < 0.05 was considered significant.Results There was significant decrease of hs-CRP before and after 30 days therapy in treated group ((3.02 Â± 3.13 vs 1.67 + 1.37) mg/dL; p = 0.005); meanwhile insignificant decrease was there in control group ((2.78 Â± 1.97 vs 2.25 Â± 2.32) mg/dL; p = 0.285). hs-CRP decrease of treated group was bigger than in control group, but statistically insignificant ((1.35 Â± 2.37 vs 0.53 Â± 1.96) mg/dL; p = 0.089 mg/dL).Conclusion Combination sambiloto extract (Andrographis paniculata) and salam (Syzygium polyanthum) 2 x 150 mg for 30 days decreased hs-CRP concentration lower than simvastatin 1 x 20 mg, but statistically insignificant.Keywords : hs-CRP, Andrographis paniculata and Syzygium polyanthum, dyslipidemia

DiabCare Asia 2012: diabetes management, control, and complications in patients with type 2 diabetes in Indonesia Cholil, Achmad Rudijanto; Lindarto, Dharma; Pemayun, Tjokorda Gde Dalem; Wisnu, Wismandari; Kumala, Poppy; Puteri, Happy Helene Sulung
Medical Journal of Indonesia Vol 28, No 1 (2019): March
Publisher : Faculty of Medicine Universitas Indonesia

BACKGROUND Indonesia was a part of the most recent edition of DiabCare Asia held in 2008. DiabCare Asia 2012 is modeled after a similar project to provide the latest information to facilitate healthcare policymaking in this area.METHODS This was an observational, non-interventional, cross-sectional study of patients with type 2 diabetes mellitus from primary, secondary, and tertiary care centers in Indonesia. Patient data collected included demography, medical history complications, eye and foot examinations, diabetes management, and most recent laboratory investigations. Blood samples were collected from all patients for the analysis of glycated hemoglobin (HbA1c).RESULTS A total of 1,967 patients participated in the study, with a mean (SD) age of 58.4 (9.5) years and a median (range) duration of diabetes 6.0 (0.1−47.0) years. The percentage of patients with HbA1c <7.0% was 30.8% and the mean (SD) HbA1c level was 8.3 (2.2%). The proportion of patients using insulin was 34.7% with a mean (SD) total daily dose of 37.9 (24.1) IU. The most common diabetes-related complications were peripheral neuropathy (59.1%), erectile dysfunction (32.4%), and eye complications (29.1%).CONCLUSIONS Glycemic and metabolic control remain unsatisfactory in type 2 diabetes patients in Indonesia. Efforts are needed to optimize control and prevent complications in these patients.

Chronic Effect Various Type of Exercises to Fasting Blood Glucose and Insulin Resistance Machrina, Yetty; Purba, Ambrocious; Lindarto, Dharma; Daulay, Milahayati
Sumatera Medical Journal Vol. 2 No. 2 (2019): Sumatera Medical Journal (SUMEJ)
Publisher : Talenta Publisher

Exercise is non-pharmacological management for Diabetes Mellitus (DM) type-2. Previous study found that both eerobic and interval training improved insulin resistance. The aim of this study was to analyze the chronic effect various type of exercises to fasting blood glucose (FBG) and insulin resistance in DM type-2 model rats. It was an experimental study, twenty male Wistar rats, age 8 weeks, weight 150-180 gram as the object. Rats were given high fed diet for 4 weeks then injected streptozocin dose 30 mg/kgBB in citrate buffer pH 4.5 i.p, and 45 mg/kgBB at the following week. Groups were divided into i.e moderate continous training (MCT), severe continous training (SCT), slow interval training (SIT), and fast interval training (FIT). All groups were treated with ran on the treadmill three times a week for 8 weeks. Fasting blood glucose and fasting insulin were checked before and after intervention. Insulin resistance was determined by calculating HOMA-IR. Data analized with paired t-test (p<0,05). The results shown that all group significantly decreased fasting blood glucose and insulin resistance (p <0,05) after eight weeks exercise except insulin resistance in MCT group. Fasting blood glucose and insulin resistence post-test was found lowest in SIT groups in this study. In conclucions chronic effect of aerobic continous and aerobic interval in various intensity can decrease fasting blood glucose and insulin resistance in DM type-2 rat model. Slow interval training was the best exercise model to decrease insulin resistance.

Pengaruh Puguntano terhadap HOMA-IR Pada Pasien Diabetes Melitus yang Baru Didiagnosis Siahaan, Billy Stinggo; Lindarto, Dharma
Majalah Kedokteran Bandung Vol 49, No 2 (2017)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Resistensi insulin sangat penting pada diabetes melitus sebagai prediktor yang kuat terhadap perkembangan diabetes melitus dan target terapi saat hiperglikemia sudah terjadi. HOMA-IR merupakan suatu metode yang telah tervalidasi dalam menilai resistensi insulin pada pasien diabetes melitus. Puguntano suatu tanaman budidaya yang terdapat di Sumatra Utara diketahui memiliki efek antidiabetes. Sampel diambil dari tahun 2015-2016 di Rumah Sakit Haji Adam Malik Medan. Studi ini mencoba menilai pengaruh puguntano sebagai tanaman budidaya di Sumatera Utara terhadap resistensi insulin pada pasien Diabetes Melitus tipe 2. Untuk mengetahui pengaruh pemberian serbuk puguntano terhadap HOMA-IR pada pasien DM tipe 2 yang baru didiagnosis. Dilakukan uji klinis terbuka dengan desain paralel selama 12 minggu pada 24 pasien (12 pasien dan 12 kontrol) Diabetes Mellitus tipe 2 yang baru terdiagnosaÂ yang dibagi dalam 2 grup masing-masing diberikan puguntano dan metformin selama 12 minggu. HOMA-IR dan HbA1c diperiksa pada awal dan akhir pengobatan (minggu ke 12). Didapatkan penurunan HOMA-IR rata-rata pada grup puguntano 1,71 (Â±2,29) (p=0,034). Tidak didapatkan perbedaan penurunan HOMA-IR rata-rata antara kedua grup puguntano vs metformin 1.71 (Â±2,29) vs 0,80 (Â±1,47) (p=0,402). Didapatkan penurunan nilai HOMA-IR dengan pemberian puguntano pada penderita Diabetes Mellitus tipe 2 yang baru didiagnosis. Simpulan, efek puguntano dalam mengontrol gula darah terutama dalam perannya memperbaiki sensitifitas insulin tidak jauh berbeda dengan metformin yang telah menjadi obat standar dalam pengobatan lini pertama diabetes melitus tipe 2. [MKB. 2017;49(2):67â€“72]Â Kata kunci: Diabetes melitus, HOMA-IR, puguntanoÂ Â Effect of Puguntano on HOMA-IR in Newly Diagnosed Type 2 Diabetes MellitusÂ Insulin resistance is important not only as a powerful predictor of future development of type 2 diabetes mellitus but also as a therapeutic target once hyperglycemia is present. HOMA-IR is a method for assessing insulin resistance that has been validated worldwide. Puguntano is one of the traditional plants found in North Sumatera that has been recognized for its anti-diabetic effect. Samples were taken from 2015â€“2016 at H. Adam Malik General Hospital Medan. This study tried to assess the effect of puguntano as a traditional plant in North Sumatera on insulin resistance in type 2 diabetes melitus patients and aimed to determine the effect of puguntano treatment on HOMA-IR in newly diagnosed type 2 diabetes mellitus patients. This was a randomized open clinical trial on 24 newly diagnosed type 2 diabetes mellitus patients (12 patients and 12 controls) divided into 2 groups who were assigned to receiveÂ puguntano or Metformin for 12 weeks. HOMA-IR and Hba1c were determined at baseline and at the end of 12 weeks. In puguntano group, the mean decrease of HOMA-IR was 1.71 (Â± 2.29) (p=0.034). There was no difference in terms of the mean decrease of HOMA-IR between the puguntano and Metformin group, which was 1.71 (Â±2.29) vs 0.80 (Â±1.47) (p=0.402). There was a decrease mean of HOMA-IR level with puguntano treatment in newly diagnosed type 2 diabetes mellitus patients which was statistically significant. In conclusions, the effect of puguntano in controlling blood sugar especially in its role of improving insulin sensitivity is not much different from metformin which has become a standard drug in the first-line treatment of type 2 diabetes mellitus. [MKB. 2017;49(2):67â€“72]Â Key words: Diabetes mellitus, HOMA-IR, puguntano

HUBUNGAN PEMBENTUKAN BIOFILM OLEH BAKTERI GRAM NEGATIF DENGAN RESISTENSI ANTIBIOTIK PADA WANITA DIABETES MELITUS TIPE 2 Sahputri, Juwita; Lindarto, Dharma; Ganie, Ratna Akbari
AVERROUS: Jurnal Kedokteran dan Kesehatan Malikussaleh Averrous, Vol. 4: No. 1 (Mei, 2018)
Publisher : Fakultas Kedokteran Universitas Malikussaleh

Diabetes melitus (DM) memiliki efek jangka panjang terhadap sistem genitourinari yang menjadi faktor predisposisi terjadinya infeksi saluran kemih (ISK) pada pasien wanita dan umumnya bersifat asimtomatik. Bakteri gram negatif merupakan mikroorganisme penyebab tersering yang dapat membentuk biofilm sehingga sering menyebabkan resistensi antibiotik. Penelitian ini bertujuan untuk membuktikan hubungan antara pembentukan biofilm bakteri gram negatif dengan resistensi antibiotik pada wanita diabetes melitus tipe 2 (DMT2). Menggunakan desain penelitian cross sectional dengan teknik total sampling. Jumlah sampel penelitian adalah 45 orang wanita DMT2 anggota Program Pengendalian Penyakit Kronis (PROLANIS). Pada semua responden dilakukan kultur urin porsi tengah, uji sensitivitas dan pemeriksaan biofilm terhadap isolat bakteri yang teridentifikasi. Hasil kultur urin menunjukkan bakteriuria signifikan 14 (31%) responden. Identifikasi koloni menunjukkan bakteri penyebab ISK antara lain Escherichia coli (35,7%), Klebsiella pneumoniae (35,7%), Enterobacter sp (21,5%) dan Citrobacter sp (7,1%). Uji sensitivitas dijumpai 8 (57%) isolat resisten terhadap antibiotik, yaitu 2 (14,2%) isolat terhadap ciprofloksasin dan 6 (42,8%) isolat terhadap TMP-SMX. Bakteri gram negatif yang diisolasi 100% mampu membentuk biofilm dengan kategori weak. Berdasarkan analisis bivariat dengan uji Rank Spearman correlation dapat disimpulkan bahwa terdapatnya hubungan yang sangat lemah antara pembentukan biofilm oleh bakteri gram negatif dengan resistensi antibiotik ciprofloksasin dan TMP-SMX.

Co-Authors Achmad Rudijanto Dasopang, Eva S. Daulay, Milahayati Kumala, Poppy Purba, Ambrocious Puteri, Happy Helene Sulung Ratna Akbari Ganie, Ratna Akbari Sahputri, Juwita Santi Syafril, Santi Siahaan, Billy Stinggo Tjokorda Gde Dalem Pemayun Urip Harahap Wismandari Wisnu Yetty Machrina Yulindaa, Wina

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