Korelasi Kadar Protein C-Reaktif dengan Rasio Kolesterol Total / HDL pada Penyandang Obes di RSUP Dr M Djamil Padang

C-reactive protein is an acute-phase protein produced by the liver in response to inflammation. Dyslipidemia can trigger the inflammatory reaction in the blood vessels, causing atherosclerosis. The ratio of total cholesterol/High Density Lipoprotein (HDL) is considered as one of the sensitive predictor lipid ratio for the cardiovascular disease risk factor. Objectives: To determined the correlation of C reactive protein between cholesterol levels with total cholesterol/HDL ratio in obese people. Methods: This study was an analytical study with a cross-sectional design of 59 people who met the inclusion and exclusion criteria at the RSUP Dr. M. Djamil Padang from January to September 2019. Research subjects consisted of first degree obesity (25.0 ≤IMT <30.0 kg/m2) and second degree (≥30.0 kg/m2). C reactive protein levels were measured as high-sensitivity C-reactive protein. Total cholesterol and HDL levels were measured using automated clinical chemicals with the enzymatic colorimetric method. Data were analyzed by Pearson, significant if p <0.05. Results: The study subjects were 59 people (17 men and 22 women) with an average age was 35 (8.04) years. CRP levels in stage II obesity were slightly higher than grade I, with a mean difference between groups of 0.26 mg/L (95% CI: -1.80-1.2; p=0.74). The average ratio of total cholesterol/HDL levels in the obese group I and II was 5.13 and 4.80 (p=0.93). The correlation showed a very weak positive (r=0.12) and was statistically not significant (p=0.35). The results of the subanalysis showed relatively similar patterns between the first-degree obesity population (r=0.10; p=0.58) and second-degree (r=0.16; p=0.41). Conclusion: There is no significant correlation between protein C-reactive and total cholesterol/HDL ratio.Keywords: Obesity, C-Reactive Protein, total cholesterol/HDL rati

Perbedaan Rerata Indeks Fibrosis-4 Antara Manifestasi Klinis Berat Dan Kritis Pada Pasien COVID-19.

Latar Belakang: Coronavirus disease 2019 (COVID-19) adalah penyakit menular baru yang disebabkan SARS-CoV-2. Indeks Fibrosis-4 (FIB-4) saat ini digunakan sebagai prediktor awal menilai derajat berat dan perburukan COVID-19. Tujuan: Mengetahui perbedaan rerata indeks FIB-4 antara manifestasi klinis berat dan kritis pada pasien COVID-19. Metode: Penelitian analitik dengan rancangan potong lintang dilakukan terhadap 100 pasien COVID-19 dengan manifestasi klinis berat dan kritis di   RSUP Dr. M. Djamil Padang sejak Juli 2022 hingga Februari 2023. Indeks FIB-4  dihitung dengan rumus umur × SGOT dibagi jumlah trombosit × √SGPT. Data dianalisis dengan uji T tidak berpasangan, bermakna jika p <0,05. Hasil: Subjek penelitian sebagian besar laki-laki (62%). Rerata umur subjek penelitian 57 tahun, rentang 38-80 tahun. Rerata indeks FIB-4  seluruh subjek penelitian 4,24 (1,72-8,66). Rerata indeks FIB-4 dengan manifestasi klinis berat 2,83 dan manifestasi klinis kritis 5,65 bermakna (p=0,001). Pembahasan: Terdapat peningkatan indeks FIB-4 yang lebih tinggi pada pasien manifestasi klinis kritis dibandingkan dengan manifestasi klinis  berat, sehingga pasien dengan manifestasi klinis kritis sudah terjadi fibrosis hati. Keterbatasan pada penelitian ini adalah tidak dilakukannya fibroscan sebagai konfirmasi fibrosis hati. Simpulan:Terdapat peningkatan indeks FIB-4 yang lebih tinggi pada manifestasi klinis kritis dibandingkan dengan manifestasi klinis berat pada pasien COVID-19.

Prevalensi dan Pola Sensitivitas Antibiotik Klebsiella pneumoniae dan Escherichia coli Penghasil Extended Spectrum Beta Laktamase di RSUP Dr. M Djamil Padang

Prevalensi Escherichia coli dan Klebsiella pneumoniae penghasil Extended spectrum beta Lactamase (ESBL) meningkat dalam beberapa tahun ini. Infeksi bakteri penghasil ESBL memiliki pilihan terapi yang terbatas. Tujuan: Mengetahui prevalensi dan pola sensitivitas antibiotik dari Klebsiella pneumoniae dan Escherichia coli penghasil ESBL di RSUP Dr M Djamil Padang. Metode: Penelitian ini merupakan studi deskriptif dengan rancangan potong lintang terhadap 828 sampel mikrobiologi dengan hasil kultur positif terhadap bakteri Gram negatif pada bulan Juni 2018- Mei 2019 yang memenuhi kriteria inklusi. Identifikasi bakteri, pemeriksaan ESBL dan uji sensitivitas dilakukan dengan alat mikrobiologi otomatis dengan metode kolorimetri dan turbidimetri. Hasil: Prevalensi Klebsiella pneumoniae dan Escherichia coli penghasil ESBL di RSUP Dr M Djamill Padang  masing-masing sebanyak 70,9% dan 75,7%. Sensitivitas Klebsiella pneumoniae dan Escherichia coli penghasil ESBL adalah 96,4% dan 98,8 terhadap antibiotik meropenem, 98,9% dan 99,4% terhadap antibiotik amikasin, 53,5% dan 44,8% terhadap antibiotik sefepim, 46,2% dan 53,4% terhadap antibiotik gentamisin serta 31,5% dan 15,9% terhadap antibiotik siprofloksasin. Prevalensi Klebsiella pneumoniae dan Escherichia coli penghasil ESBL di RSUP Dr. M Djamil Padang cukup tinggi dengan rata-rata prevalensi kedua bakteri 73,2%. Simpulan: Klebsiella pneumoniae dan Escherichia coli penghasil ESBL sensitif terhadap antibiotik meropenem dan amikasin.Kata kunci: ESBL, Escherichia coli, Klebsiella pneumoniae, prevalens

Prevalensi dan Pola Sensitivitas Antibiotik Acinetobacter baumannii di RSUP. Dr. M. Djamil Padang

AbstrakTujuan: Mengetahui prevalensi dan pola sensitivitas Acinetobacter baumannii di RSUP Dr. M. Djamil Padang. Metode:  Penelitian ini adalah penelitian deskriptif retrospektif, dilakukan di Laboratorium Mikrobiologi pada bulan Januari 2020 hingga Juni 2020. Jumlah sampel penelitian sebanyak 195 yang memenuhi kriteria inklusi dan eklusi. Identifikasi bakteri dan uji sensitivitas menggunakan alat mikrobiologi otomatis (VITEK 2) dengan metode kolorimetri dan turbidimetri. Hasil:  Prevalensi Acinetobacter baumannii pada penelitian ini sebesar 14,7%. Spesimen positif terbanyak dari bangsal penyakit dalam, intensif dewasa, intensif anak dan bedah, masing-masing sebesar 46,7%, 20,5%, 7,2%, 7,2%. Sensitivitas Acinetobacter baumannii terhadap antibiotik paling tinggi adalah amikasin, trimetroprim/sulfametoksazol dan meropenem masing-masing sebesar 74,9%, 67,1%, 62,7%. Resistensi antibiotik paling tinggi didapatkan pada cefazolin, seftriakson dan siprofloksasin masing-masing sebesar 99,3%, 67,0%, 66,2%. Kesimpulan: Prevalensi infeksi Acinetobacter baumannii di RSUP Dr M Djamil 14,7% dengan antibiotik paling sensitif adalah amikasin.Kata kunci: prevalensi; resistensi; antibiotik; Acinetobacter baumannii; pola antibiotik

Hiperurisemia pada Pra Diabetes

AbstrakAsam urat (AU) merupakan produk akhir dari katabolisme adenin dan guanin yang berasal dari pemecahannukleotida purin. Urat dihasilkan oleh sel yang mengandung xanthine oxidase, terutama hepar dan usus kecil.Hiperurisemia adalah keadaan kadar asam urat dalam darah lebih dari 7,0 mg/dL.Pra diabetes adalah subjek yangmempunyai kadar glukosa plasma meningkat akan tetapi peningkatannya masih belum mencapai nilai minimaluntuk kriteria diagnosis diabetes melitus (DM). Glukosa darah puasa terganggu merupakan keadaan dimanapeningkatan kadar FPG≥100 mg/dL dan <126 mg/dL. Toleransi glukosa terganggu merupakan peningkatanglukosa plasma 2 jam setelah pembebanan 75 gram glukosa oral (≥140 mg/dL dan <200mg/dL) dengan FPG<126 mg/dL.Insulin juga berperan dalam meningkatkan reabsorpsi asam urat di tubuli proksimal ginjal. Sehinggapada keadaan hiperinsulinemia pada pra diabetes terjadi peningkatan reabsorpsi yang akan menyebabkanhiperurisemia. Transporter urat yang berada di membran apikal tubuli renal dikenal sebagai URAT-1 berperandalam reabsorpsi urat.Kata kunci: Hiperurisemia, Pra DiabetesAbstractUric acid (AU) is the end product of the catabolism of adenine and guanine nucleotides derived from thebreakdown of purines. Veins produced by cells containing xanthine oxidase, especially the liver and small intestine.Hyperuricemia is a state in the blood uric acid levels over 7.0 mg / dL.Pre-diabetes is a subject which has a plasmaglucose level will rise but the increase is still not reached the minimum value for the diagnostic criteria for diabetesmellitus (DM). Impaired fasting blood glucose is a condition in which increased levels of FPG ≥ 100 mg / dL and<126 mg / dL. Impaired glucose tolerance is an increase in plasma glucose 2 hours after 75 gram oral glucose load(≥ 140 mg / dL and <200mg/dl) with FPG <126 mg / dL.Insulin also plays a role in increasing the reabsorption ofuric acid in renal proximal tubule. So that the hyperinsulinemia in the pre-diabetic condition increases thereabsorption of which will lead to hyperuricemia. Urate transporter in the apical membrane of renal tubule known asURAT-1 plays a role in urate reabsorption.Keywords: Hyperuricemia, Pre-diabete

Atherosclerotic Biomarkers (Interleukin-6 and CD40) and Tunica Intima Thickness in Obese Rats after the Administration of Plectranthus amboinicus (Lour.) Spreng Ethanol Extract

BACKGROUND: Obesity can increase oxidative stress, thereby increasing the inflammatory markers interleukin (IL)-6. These markers are characterized by various biomarkers, such as cluster of differentiation 40 (CD40) and IL-6, and thickness of the tunica intima. AIM: This study aims to analyze the effect of the Plectranthus amboinicus (Lour.) Spreng ethanol extract on IL-6, CD40, and thickening of the tunica intima of obese rats. METHODS: The pure experimental method with complete random design consisted of several research groups: C− (negative control), C+ (positive control/cholesterol feed), positive control (cholesterol feed + CMC), T1_Chol_300 (cholesterol feed and administration of 300 mg/kg body weight [BW] P. amboinicus for 45 days), T2_Chol_600 (cholesterol feed and administration of 600 mg/kg BW P. amboinicus for 45 days), and T3_chol_900 (cholesterol feed and administration of 900 mg/kg BW P. amboinicus for 45 days). RESULTS: Results showed increased CD40 levels in the blood plasma of obese rats and decreased CD40 levels after the administration of the ethanol extract of P. amboinicus leaves. A significantly increased (p &lt; 0.05) level of lL-6 in the obese mice group and a significant decrease (p &lt; 0.05) in IL-6 after the administration of the ethanol extract of P. amboinicus leaves were observed. Tunica intima thickness significantly occurred (p &lt; 0.05) in the group of obese rats, and normal tunica intima thickness occurred in the group administered with the ethanol extract of P. amboinicus leaves. CONCLUSION: In conclusion, the ethanol extract of P. amboinicus leaves (900 mg/kg BW) had the potential to normalize obese rats

Detection of Multiple Dengue Infections by Rt-qPCR in West Sumatera, Indonesia

BACKGROUND: Dengue is a disease caused by four distinct serotypes of dengue virus (DENV 1-4). DENV serotype differs from one another by 25–40% at the amino acid level. The detection of serotype is very important due to the fact that in secondary infection with heterologous serotype often leads to life threatening, dengue hemorrhagic fever (DHF)/dengue shock syndrome (DSS); likewise, an infection caused by two serotypes or more in one individual can contribute to the severity of infection. AIMS: The aims of the study were to detect the multiple dengue serotypes infection by quantitative reverse transcription polymerase chain reaction (Q-RT-PCR) and to determine the viral load in dengue infection. MATERIALS AND METHODS: This study applied the molecular examination for determining the serotype and viral load of DENV. The data were analyzed using Student’s t-test. RESULTS: A total of 119 samples, 91 samples showed positive dengue infection after amplification. The multiple dengue infection was found in 47 samples and 44 samples with single infection. There was a significant difference between the number of viral load DENV-2 and DENV-1 infection (p = 0.000). CONCLUSION: Two or more serotypes of dengue were found to infect a patient in West Sumatra. DENV-2 serotype was found predominantly in West Sumatra (n = 36, 39.56%) in patients with single infection. The molecular detection of dengue RNA by RT-PCR is a sensitive, rapid, and simple method. The RT-PCR method can detect the multiple dengue infection in clinical samples

Upregulation of SCUBE1 in Dengue Virus Infection

BACKGROUND: Dengue is a major communicable disease in tropical areas, with an increasing prevalence every year. Thrombocytopenia is one of the commonly used laboratory parameters for predicting the severity of the disease. It is detected on day 6 or day 7 after the febrile stage, and its presence indicates that the disease has become potentially fatal. Therefore, it is necessary to identify a marker for the early recognition of dengue virus infection during the febrile stage before the detection of thrombocytopenia on day 6 to prevent severe disease outcomes. Signal peptide-CUB- (complement C1r/C1s)-EGF (epidermal growth factor)-like domain-containing protein 1 (SCUBE1) is secreted in activated platelets under inflammatory conditions and enhances platelet-platelet adhesion and agglutination. This gene was first identified in human vascular endothelium, but its biological role in platelets remains unknown. AIM: This study aims to identify SCUBE1 expression during the febrile stage of dengue virus infection and examine the correlation of its expression with thrombocytopenia occurrence on day 6. MATERIAL AND METHODS: Blood samples were collected from 17 patients infected with dengue virus on day-3 fever and from 16 healthy controls who met the inclusion and exclusion criteria for dengue virus infection according to the World Health Organization (WHO) classification for dengue virus infection. All samples were subjected to SCUBE1 gene analysis using real-time reverse transcription quantitative PCR (RT-PCR). RESULTS: The results showed that upregulation of SCUBE1 gene in infected patients (8.9 ± 3.1-fold) compared to that in healthy controls, indicating SCUBE1 involvement in dengue virus infection. Furthermore, we analysed the laboratory parameters of infected patients on day 3 and day 6, when thrombocytopenia is usually detected. Platelet count was found to be significantly decreased from day 3 until day 6 in the infected patients. Unfortunately, our results showed no correlation between SCUBE1 expression in the febrile stage and the occurrence of thrombocytopenia on day 6. CONCLUSION: The conclusion of this study is SCUBE1 might play a role in dengue virus infection but does not correlate with thrombocytopenia on day-6 fever

Effect of Irbesartan-Poloxamer-188 Solid Dispersion on Intercellular Cell Adhesion Molecule-1 and Interleukin-8 on Hypertension Rats

BACKGROUND: Based on the Biopharmaceutics Classification System (BCS) system, irbesartan is a drug that belongs to the class II BCS group which has limitations in terms of dissolution rates with low bioavailability of 26% -60%. These limitations to bioavailability can be overcome by solid dispersion with hydrophilic matrices such as Poloxamer. Irbesartan is an angiotensin receptor blocker. At present, it is widely used in dealing with hypertension due to endothelial dysfunction. AIM: This study aims to determine endothelial function blood markers can be examined, such as adhesion molecules (ICAM-1) and IL-8 pro-inflammatory cytokines. MATERIAL AND METHODS: Research on the effects of irbesartan-poloxamer-188 solid dispersion on ICAM-1 and IL-8 in hypertensive rats has been carried out. The formation of solid dispersion through dissolution method while induction of hypertension using 2.5% NaCl and prednisone 1.5 mg/Kg BB orally in 3 treatment groups, irbesartan dose was 13.5 mg/kg. The parameters observed were serum ICAM-1 and IL-8 levels. RESULTS: The result showed that the solid dispersion of irbesartan-poloxamer-188 could reduce ICAM-1 and IL-8 levels in hypertensive rats which differed significantly from the positive control group (p &lt; 0.05). CONCLUSION: This study concluded that the solid dispersion of irbesartan-poloxamer-188 effects and decreases ICAM-1 levels in the serum of hypertensive rats. Solid dispersion of irbesartan-poloxamer-188 can influence and reduce IL-8 in the serum of hypertensive rats

IDENTIFIKASI BAKTERI GRAM NEGATIF DAN UJI SENSITIVITAS ANTIBIOTIK ULKUS KAKI DIABETES DI RSUP DR. M. DJAMIL PADANG

AbstrakUlkus kaki diabetes merupakan komplikasi kronik diabetes melitus yang dapat menyebabkan terjadinya infeksi bakteri. Bakteri yang umum diisolasi dari infeksi ulkus kaki diabetes adalah Gram-positif dan Gram-negatif. Pemakaian antibiotik pada terapi ulkus kaki diabetes pada setiap rumah sakit berbeda sehingga terjadi perbedaan sensitivitas antibiotik. Tujuan: Mengidentifikasi bakteri gram negatif dan uji sensitivitas pada ulkus kaki diabetes di RSUP Dr M Djamil Padang. Metode: Penelitian deskriptif retrospektif telah dilakukan pada seluruh swab dari ulkus kaki diabetes di bangsal penyakit dalam yang dikultur menggunakan agar darah di Laboratorium Sentral RSUP Dr M Djamil periode Agustus 2015 sampai Juli 2016. Identifikasi bakteri dengan pewarnaan Gram dan tes biokimia. Uji  sensitivitas antibiotik menggunakan metode Kirby-Bauer sesuai dengan standar CLSI. Hasil: Bakteri yang ditemukan dari swab Ulkus kaki diabetes adalah Proteus sp (36%), Klebsiella sp (34%), Pseudomonas sp (21%), dan Acinetobacter sp (9%). Proteus sp sensitif terhadap meropenem (90%) dan resisten terhadap erithromycin (100%). Klebsiella  sp resisten terhadap ampicilin (94,7%) dan sensitif terhadap Meropenem (36.8%). Pseudomonas sp sensitif terhadap meropenem (83.3%) dan sebagian besar resisten terhadap antibiotik yang diuji. Acinetobacter sp sebagian besar resisten terhadap antibiotik yang diuji, hanya 40% sensitif terhadap meropenem. Simpulan: Bakteri terbanyak penyebab ulkus kaki diabetes di bangsal penyakit dalam pada periode Agustus 2015 sampai Juli 2016 adalah Proteus sp, yang sensitif terhadap meropenem dan resisten terhadap erithromycin.