Suplementasi Folate, Kadar Homocysteine, Nitric Oxide dan Petanda Retinopati Diabetik Studi pada Tikus Sprague Dawley Diabetes

Folate supplementation homocysteine, nitric oxide levels and marker for diabetic retinopathy: Study on Sprague Dawley diabetic ratsIntroduction: Diabetic retinopathy (DR) is the leading cause of blindness among diabetes mellitus (DM) patients. Hyperhomocysteinemia (HHcy) is reported to increase the risk for DM complications, however, the underlying mechanism is still unclear. Retina is particularly vulnerable to oxidative stress due to a high demand for oxygen. Hyperglycemia stimulates retinal oxidative stress and increases Nitric Oxide (NO). NO contributes to the regulation of retinal blood vessel function and the occurrence of retinopathy. The administration of folic acid (FA) 0.65 mg/day on HHcy subject, decrease serum Hcy by 42%. This study was aimed to analyze the effect of folate administration on Hcy, NO levels and markers of DR (VEGF serum).Methods: An experimental study using a randomized controlled group pretest posttest design was conducted in UGM Yogyakarta. The total of 40 male Sprague Dawley rats were divided into 5 groups: negative control and the other four group were induced with Streptozotocin 40 mg/kgBW intraperitoneal. Intervention group were given FA 2, 4, 8 ppm through a nasogastric tube for 30 days. Before and after intervention, serum Hcy, NO and VEGF were assessed, and Wilcoxon tests were used to measure the difference ofit.Result: Administration of 8 ppm FA significantly decreased serum Hcy (p=0.043), NO levels (p=0.043) but not for markers of DR.Conclusion: Folic acid supplementation of 8 ppm gives benefits to diabetic rats

POLA KLINIK TUBERKULOSIS EKSTRA PARU DI RSUP Dr. KARIADI SEMARANG PERIODE JULI 2013- AGUSTUS 2014

Backgrounds : Extrapulmonary Tuberculosis (TB) is an infectious disease caused by the bacteria Mycobacterium tuberculosis mostly attacks the organs out of the lungs. According to the WHO in the year 2012 the number of cases of extrapulmonary TB were 17.420 cases of all TB 331.424. Diagnosis of extrapulmonary TB is very difficult to be established, it means needs strong clinical symptoms to eliminate another diagnose. Accuracy of diagnosis highly dependent on the method of examination materials collection, the availability of diagnostic tools, such as anatomical pathology, microbiology, and radiology. The purpose of this study was to determine the clinical pattern of Extrapulmonary tuberculosis were treated in the department of Internal Medicine Ward dr. Kariadi Semarang Methods: The study design was a retrospective descriptive study, using 68 medical records of hospitalized patients in the Internal Medicine Ward period July2013- August 2014 as the sample. The data was described in the form of tables and figures. Results : Number of patients with extrapulmonary TB total of 68 patients, larger proportion is male 64,7% and most age group that 18-28 years. According the location of infection, it is more common at tuberculosis of pleurisy TB 30,9%. Most of clinical symptom are cough for pleurisy TB and limfadenitis TB, back pain for Bone TB, abdominal pain for peritonitis TB and headache for meningitis TB. Most of clinical signs are dyspneu fot pleurisy TB, Swelling of lymph nodes for limfadenitis TB, motor weakness for bone TB, muscle tension for peritonitis TB and loss of consciousness for meningitis TB. Extra-pulmonary TB cases with microbiology examination was found as many as 72,5% cases. Biopsy 67,6%, radiology 85,3%, and hematology 69,1%. A majority complication of pleurisy TB is fibrosis, abscess for limfadenitis tb, paraplegy for bone TB, acites for peritonitis TB, and hydrocephalus for meningitis TB. For length of stay patients is over 2 weeks and with treatment outcome 76,5% recovered. Conclusions: Proper diagnosis, adequate treatment can be decreased prevalence of extrapulmonary TB Keywords: Extrapulmonary TB, Description of Extrapulmonary TB

Sindrom Polikistik Ovarium dan Suspek Maturity-Onset Diabetes of The Young

Pendahuluan : Polycistic ovarium syndrom (PCOS) merupakan kelainan endokrin dan metabolik, ditandai adanya anovulasi kronik dan/atau hiperandrogenisme, disfungsi ovum dan polikistik ovarium. Etiologi PCOS belum jelas, bisa disebabkan secara genetik ataupun diabetes tipe 1 dan 2. Maturity-onset diabetes of the young (MODY) merupakan jenis diabetes genetik yang jarang dikenali dan sering terdiagnosis sebagai diabetes mellitus tipe 1 atau tipe 2. Kasus : Wanita 32 tahun dengan riwayat siklus haid panjang sejak menarche, semakin memanjang jika stress (rentang 40-120 hari) dengan lama haid 5-7 hari. Sejak 7 tahun yang lalu mendapatkan terapi pil KB (ethinyl estradiol) dan metformin. Pemeriksaan fisik : hirsutisme minimal, hasil ultrasonografi: gambaran ovarium polikistik. Hasil laboratorium : peningkatan kadar Anti Mullerian Hormone (AMH), kadar LSH, FSH dan estradiol normal. Didapatkan pula penurunan kadar insulin dan C peptide dengan kadar glukosa, HbA1C dan profil lipid normal. Pembahasan : Polycistic ovarium syndrome ditegakkan dengan adanya kondisi hirsustime minimal, gambaran poliklinik pada USG dan peningkatan kadar AMH serum. Gambaran USG menunjukkan banyaknya ovum tetapi tidak matang (polikistik). sedangkan peningkatan kadar AMH menunjukkan banyaknya ovum premordial yang mulai matang tetapi tidak menjadi folikel de graff (matang). Kadar insulin dan C peptide yang menurun tanpa ada peningkatan kadar glukosa dan Hb1Ac menunjukkan adanya gangguan produksi insulin. Kadar glukosa, Hb1Ac serta profil lipid normal dapat terjadi akibat pola makan dan aktivitas oleh tubuh yang baik serta konsumsi metformin secara teratur pada pasien. Kecurigaan disfungsi produksi insulin pada saat dewasa menudukung diagnosis MODY pada pasien. Simpulan : Hasil pemeriksaan fisik dan laboratorium mendukung diagnosis PCOS, hasil parameter laboratorium diabetes dan onset terjadinya diabetes mengarah kecurigaan MODY. Perlu pemeriksaan lanjutan genetik untuk mengetahui diagnosis secara tepat. Kata kunci : polycistic ovarii syndrom, Maturity-onset diabetes of the youn

Homocystein Levels and Lipid Profile on Non-DM and DM Individuals with and without Cardiovascular Complications

Background: Homocysteine is suspected to increase the risk of diabetes mellitus (DM) complications and is associated with CV disease. While dyslipidemia and DM are risk factors for death due to CV disease, studies on relationship between homocysteine and glycemic control were inconsistent. Objective: To analyze the difference of Hcy level and lipid profile on nonDM (Group I), DM with CV (II) and without CV (III). Methods: This crosssectional study was conducted in Dr. Kariadi Hospital Semarang from April to October 2016. Samples were recruited consecutively, of which group I consists of 26 persons, group II (30) and III (30). All of the samples aged 30-75 years old, with long DM duration of more than 5 years. Fasting and 2 hours PP blood glucose, lipid profile was analyzed with auto analyzer, while Hcy was analyzed with ELISA. Data were analyzed using independent t test. Significance is expressed at p <0.05. Results: A significant difference on Hcy level was found between group I and III (p=0.000), but not between group I and II or II and III. No significant difference was observed on total cholesterol (TC) and LDLC in all groups. Significant differences were found on HDLC level between group I and II (p=0.009); II and III (p=0.000); I and III (p=0.033). Triglyceride level on group I was significantly different compared to group II and III (p=0.030 and 0.013 respectively), but was not significantly different compared to group II and III. Conclusion: The highest Hcy level, the lowest HDL-C and the highest triglyceride level were found in DM patients with cardiovascular complication. Keywords: DM, Homocysteine, Lipid Profile, CH