Efficacy of Vitamin-D Supplement on Thyroid Profile in Children with Graves’ Disease

BACKGROUND: Many studies have shown low Vitamin-D level as a risk factor for autoimmune diseases, especially multiple sclerosis and thyroid disease. Graves’ disease (GD) is an autoimmune disease caused by autoantibodies that stimulate thyroid-stimulating hormone (TSH) receptors by increasing thyroid hormone synthesis and secretion. Several studies report that many patients with autoimmune thyroid disease including GD have low Vitamin-D status. AIM: The objective of the study was to evaluate the effect of Vitamin-D supplement on GD patients on improvement in thyroid hormone levels. METHODS: Open random clinical trial was conducted in GD patients to determine changes in thyroid hormone to achieving normal levels between those receiving methimazole plus Vitamin-D supplementation compared with those who only received methimazole. Patients were checked for TSH receptor antibody, thyroid profile and Vitamin-D level before treatment and rechecked for thyroid profile and Vitamin-D level 3 months after treatment. t-test used to compare the drug efficacy (p < 0.05) in two groups. RESULTS: From 25 children with GD accompanied by Vitamin-D deficiency with an average value of Vitamin-D was 16 ng/mL. GD children who receive methimazole with Vitamin-D supplement had elevated TSH levels in the 3rd month of therapy that was significantly different compared to GD children who received methimazole only (p = 0.00), and the increase of TSH was also followed by an increase in Vitamin-D levels. CONCLUSION: All children with GD had Vitamin D deficiency, and the addition of Vitamin-D supplement to GD therapy would improve TSH faster than children who did not receive Vitamin-D supplement

Gambaran Indeks Eritrosit pada Pasien Penyakit Ginjal Kronik yang Menjalani Hemodialisis di RSUP H. Adam Malik Medan

Chronic Kidney Disease (CKD) will cause anemia which can lead to death. CKD patients undergoing hemodialysis therapy can also experience anemia. Therefore, it is necessary to check the erythrocyte index consisting of Mean Corpuscular Volume (MCV), Mean Corpuscular Hemoglobin (MCH), and Mean Corpuscular Hemoglobin Concentration (MCHC) to determine the type of anemia so that appropriate therapy can be given. Objectives: To determined the description of the erythrocyte index in CKD patients undergoing hemodialysis at H. Adam Malik General Hospital Medan. Methods: This research used the descriptive observational method with a cross-sectional design. The study population was all CKD patients who underwent hemodialysis at the Adam Malik General Hospital Medan period July 2018 until June  2019 according to inclusion and exclusion criteria (total sampling) using medical record data. Results: From 149 study samples, 92 people (61.7%) were male, 57 people were female (38.3%), more in the age range of 55-64 years, hemoglobin (Hb) on average in low grades (98.9% men, 94.7% women), and erythrocyte index (MCV, MCH, MCHC) averages in the normal range. Conclusion: The description of patients with chronic kidney disease undergoing hemodialysis at H. Adam Malik General Hospital in July 2018 - June 2019, in general, is normochromic normocytic anemia.Keywords:  CKD, erythrocyte index, Hb, hemodialysi

Education regarding relationship of nutritional status to short stature and level of intelligence to parents of elementary school students

Short stature is a health problem with long-term implications to the future of the children. Short stature condition in children below five years old, known as stunting, may cause cognitive, psychomotor impairment and interfere with productivity on adult period. Main concern in short stature is due to insufficient of dietary intake in long-term period. Parents’ role in the prevention of short stature is important, therefore, performing education to parents is a crucial task to the government, universities and communities to be done continuously. The objective of this educational counseling was to educate the parents so they would be able to comprehend the relationship of nutritional status to short stature, especially in children below five years old, and level of intelligence in order to prevent the condition of short stature in the future. This activity was held in conjunction with community service program Pengabdian Kepada Masyarakat Dosen Wajib Mengabdi Universitas Sumatera Utara (USU) 2019, by the lecturer team of Faculty of Medicine USU in elementary school Yayasan Pendidikan Al-Washliyah Tanjung Rejo, Medan. Educational counseling materials were modules and leaflets distributed to the parents. To evaluate the educational counseling, questionnaires were disposed prior to and after the lecture. The target audience was the parents of elementary school students, amount of 48 people. The results showed mean difference questionnaires’ score of 0.97 (SD 1.76) with 95%CI=0.46-1.49 and p value=0.001 (p<0.05). There was significant difference of parental knowledge to educational counseling material prior to and after the counseling. Concluded, parental knowledge regarding relationship of nutritional status to short stature and level of intelligence is significantly increased through the educational counseling

OVERVIEW OF KNOWLEDGE, ATTITUDE AND BEHAVIOUR LEVEL AMONG MEDICAL STUDENTS OF UNIVERSITAS SUMATERA UTARA TOWARDS Lactobacillus casei strain Shirota IN PROBIOTIC DRINK

Introduction. Probiotics are widely used in health research because it is considered to be beneficial for human health. Lactobacillus casei strain Shirota is one of the lactic acid bacteria which mostly found in commercial drink. This bactery can improve gut’s immunity towards pathogen by producing bacteriocin which is able to lower the pH in the gut. However it was found inappropriate probiotic product storaging, inappropriate way of consuming probiotic drink and the mixing of probiotic drink with other drinks randomly could disrupt the viability of probiotic bacteria which would reduce the benefits of the probiotic drink. Aim. The aim of this study is to observe the knowledge, attitude and behaviour level from students of faculty of medicine Universitas Sumatera Utara towards Lactobacillus casei strain Shirota in probiotic drink. Method. This is a descriptive research with cross sectional approach. The research is collecting primary data using questionnaire about knowledge, attitude and behaviour level towards Lactobacillus casei strain Shirota in probiotic drinks. Result. From 152 respondents who met all the criteria, there are 48,7% respondents have good knowledge level, 45,4% sufficient and 5,9% deficient. Moreover, there are 22,4% respondents have good attitude level, 47,4% sufficient and 30,3% deficient. Also, there are 77% respondents have good behaviour level, 21% sufficient and 2,0% deficient. Conclusion. Majority of respondents have good knowledge level, sufficient attitude level and good behaviour level towards Lactobacillus casei strain Shirota