PERBEDAAN KADAR IRISIN SERUM PADA PASIEN LANJUT USIA SARKOPENIA DENGAN DAN TANPA CHRONIC HEART FAILURE

Pendahuluan : Setiap negara di dunia mengalami pertumbuhan baik dalam jumlah maupun proporsi lanjut usia di dalam populasi. United Nations (UN) mendefinisikan lanjut usia sebagai individu yang berusia 60 tahun ke atas. Tujuan penelitian adalah untuk mengetahui perbedaan kadar irisin serum pada pasien lanjut usia sarkopenia dengan dan tanpa Chronic Heart Failure. Metode penelitian : Penelitian ini adalah suatu penelitian observasional analitik dengan pendekatan cross-sectional, yaitu variabel independen dan dependen yang diamati di waktu bersamaan. Hasil penelitian: terdapat perbedaan kadar irisin serum yang signifikan antara pasien lanjut usia sarkopenia dengan dan tanpa CHF. Setelah diuji secara statistik berdasarkan uji Mann-Whitney didapatkan perbedaan yang bermakna secara statistik p=0,000 (p<0,05). Kadar irisin serum didapatkan lebih rendah pada pasien lanjut usia sarkopenia dengan CHF dibandingkan pasien lanjut usia sarkopenia tanpa CHF. Kesimpulan : Rerata kadar irisin serum pada pasien lanjut usia sarkopenia adalah 7,641 (1,367) ng/ml. Rerata kadar irisin serum pada pasien lanjut usia sarkopenia dengan Chronic Heart Failure adalah 6,424 (0,649) ng/ml. Rerata kadar irisin serum pada pasien lanjut usia sarkopenia tanpa Chronic Heart Failure adalah 8,858 (0,546) ng/ml. Kadar irisin serum secara bermakna lebih rendah pada pasien lanjut usia sarkopenia dengan Chronic Heart Failure dibandingkan pada pasien lanjut usia sarkopenia tanpa Chronic Heart Failure

Risiko Perdarahan Saluran Cerna pada Pasien COVID-19 berdasarkan Jenis Obat Antivirus di Rumah Sakit Umum Pusat Dr. M. Djamil Padang

Coronavirus disease 2019 (COVID-19) has become a global pandemic to date. Some studies reported gastrointestinal tract (GIT) bleeding occurs in several patients hospitalized with COVID-19. Medications known to be associated with an increased risk of GIT bleeding were not associated with GIT bleeding in COVID-19 patients. Objectives: To examined the risk of gastrointestinal tract (GIT) bleeding in COVID-19 patients based on antiviral drugs at Dr. M. Djamil General Hospital Padang. Methods: A nested cohort study was conducted in Dr. M. Djamil General Hospital Padang from May until October 2021. All COVID-19 patients who received antiviral drugs with GIT bleeding with onset days 0 - 7 were included. COVID-19 was confirmed by RT-PCR swab. Data entry and analysis were conducted by computerized. Results: 30 patients were involved in this study. 43,3% COVID-19 Moderate stage and 56,7% Severe stage. 63,3% were treated with remdesivir and 36,7% were treated with favipiravir. Onset on GIT tract bleeding at day 4 (23,3%), day 5 (26.7%), day 6 (30%), and day 7 (20%). The Chi-square test to determine the factors associated with GIT bleeding in COVID-19 patients including COVID-19 severity, type of antiviral drugs, anticoagulant, and corticosteroid revealed that none of all potential factors above related to GI bleeding. Conclusion: The type of antiviral drugs was not related to GIT bleeding in COVID-19 patients.Keywords: antiviral drugs,  COVID-19, gastrointestinal tract bleedin

Diagnosis and Management of Osteosarcopenia

Osteosarcopenia is a syndrome defined as a combination of low bone density and muscle mass as well as decreased strength and/or functional capacity. Osteoporosis and sarcopenia often coexist in the elderly, leading to a significantly worse prognosis. The epidemiology of osteosarcopenia is quite limited because the term is still new. Osteosarcopenia is more common in women than men and in malnutrition. Age-related immunological changes such as hormonal imbalance, chronic inflammation, increased oxidative stress, imbalance in protein metabolism, increased fat deposition, decreased physical activity, and poor nutritional status contribute to sarcopenia. Decreased bone density in osteoporosis can occur due to an imbalance between osteoblasts and osteoclasts. The diagnosis of osteosarcopenia is made based on the presence of osteoporosis and sarcopenia. Instrument strength, assistance with walking, rising from a chair, climbing stairs, and falls (SARC–F) are recommended for assessing sarcopenia and the fracture risk assessment tool (FRAX) for the risk of osteoporotic fracture. Management of osteosarcopenia is carried out holistically, including management of osteoporosis and sarcopenia both non-pharmacologically and pharmacologically