Hubungan Antara Intensitas Aktivitas Fisik Dan Kadar Asam Urat Serum Pada Populasi Sindrom Metabolik

Background: WHO estimated that the prevalence of metabolic syndrome was occured in 23% of male population and 12% of female population in the world. Hyperuricemia had a strong relationship with each component of metabolic syndrome. Earlier studies reported that physical activity played an important role to prevent hyperuricemia.Aim: To find out the assosiation between intensity of physical activity and serum uric acid levels in metabolic syndrome population.Methods: This study was an observational analytic study with cross-sectional design. This study was conducted in RW X, Padangsari, Banyumanik, Semarang in a population based sample aged over 40. The collected data are subject characteristics, serum uric acid levels, andintensity of physical activity. Global physical activity questionnaire (GPAQ), developed by WHO, was used to determine the intensity of physical activity. The Spearman test and chi- square test were used for the statistical analyses.Results: The data showed that 40,6% of 32 subjects with metabolic syndrome had light physical activity, 25% had moderate physical activity and 34,4% had vigorous physical activity. The examination of serum uric acid levels showed that 40,6 % of them had high serum uric acid levels. The Spearman test showed a moderate degree positive correlation between intensity of physical activity and serum uric acid levels (r=0,491; p=0,004). The chi-square test showed a significant relationship between intensity of physical activity categories and serum uric acid levels categories (p=0,023; prevalence ratio 4,17).Conclusions: There was a positive correlation with a moderate degree between intensity of physical activity and serum uric acid levels in metabolic syndrome population

Cigarette Smoke Exposure, but Not High Fat Diet, is Able to Induce Atherosclerosis in Wild-Type Rats

Background: High-fat diet (HFD) and cigarette smoke exposure (CSE) have been used to induce atherosclerosis in wild-type (WT) rats however, their effectivity remains unclear.Objective: To confirm and compare the effectivity of HFD and CSE on both the histopathology of aorta and the level of malondialdehyde (MDA) in WT rats.Methods: Thirty-six WT Wistar rats were divided into four main groups (K0, K1, K2, and K3) and four subgroups (K3A, K3B, K3C, and K3D). The negative control group (K0) was fed with regular diet. Group K1 was treated with an intravenous adrenaline followed by high-fat diet (HFD), K2 was fed with regular diet and given CSE, while K3 was treated with a combination of CSE and HFD. The serum and cardiac MDA levels were measured using ELISA. Hematoxylin eosin and oil red O staining of aorta were done for measuring of the intima-media thickness (IMT) ratio and for counting of foam cells, respectively. Results: Both serum and cardiac tissue MDA levels in either K1, K2, or K3 were significant higher (p<0.01) than that of in K0. IMT ratio in K3 was significant higher compared to other groups (p<0.01). Foam cell numbers were significant higher in K2 and K3 groups than that of in either K0 or K1 (p<0.01).Conclusion: While the HFD fails to induce atherosclerosis in WT rats for 28 days, either CSE or combination of CSE and HFD is able to induce it, and the combination is better than alone.

Hyperuricemia as a Risk Factor for Cardiovascular Diseases

Serum uric acid level above 7 mg/dl is defined as hyperuricemia, which gives rise to the monosodium urate (MSU), causing gout and urolithiasis. Hyperuricemia is an independent risk factor as well as a marker for hypertension, heart failure, atherosclerosis, atrial fibrillation, and chronic kidney disease. MSU crystals, soluble uric acid (UA), or oxidative stress derived from xanthine oxidoreductase (XOR) might be plausible explanations for the association of cardio-renovascular diseases with hyperuricemia. In macrophages, MSU activates the Nod-like receptor family, pyrin　domain containing 3(NLRP3) inflammasome, and proteolytic processing mediated by caspase-1 with enhanced interleukin (IL)-1β and IL-18 secretion. Soluble UA accumulates intracellularly through UA transporters (UAT) in vascular and atrial myocytes, causing endothelial dysfunction ad atrial electrical remodeling. XOR generates reactive oxygen species (ROS) that lead to cardiovascular diseases. Since it remains unclear whether asymptomatic hyperuricemia could be a risk factor for cardiovascular and kidney diseases, European and American guidelines do not recommend pharmacological treatment for asymptomatic patients with cardio-renovascular diseases. The Japanese guideline, on the contrary, recommends pharmacological treatment for hyperuricemia with CKD to protect renal function, and it attaches importance of the cardio-renal interaction for the treatment of asymptomatic hyperuricemia patients with hypertension and heart failure

Defisiensi vitamin D pada pasien gagal jantung kronik yang menjalani rawat inap

Latar Belakang: Gagal jantung merupakansalah satu masalah kesehatan masyarakat global dengan jumlah penderita yang diperkirakan terus mengalami peningkatan. Meskipun terdapat kemajuan dalam tata kelolanya, gagal jantung masih memiliki prognosis yang buruk. Vitamin D merupakan mikronutrien yang berpengaruh terhadap prognosis  pasien gagal jantung kronik. Saat ini belum ada data mengenai kadar vitamin D serum pada pasien gagal jantung kronik yang dirawat pada populasi Indonesia. Tujuan penelitian ini adalah untuk mengetahui kadar vitamin D serum pada pasien gagal jantung kronik yang menjalani rawat inap.Metode: Penelitian observasional pada pasien gagal jantung kronik yang dirawat di RSUP. Dr. Kariadi Semarang mulaibulan November 2017 sampaiJanuar1 2018. Pemeriksaan kadar vitamin D serum [25(OH)D] dilakukan dengan metode chemiluminescence immunoassay (CLIA).Hasil: Sebanyak 102 pasien (median usia 55 (22–65) tahun) yang terlibat, terdapat 69 sampel yang memenuhi kriteria seleksi. Median fraksi ejeksi ventrikel kiri adalah 35 (10-76)%. Median kadar vitamin D serum adalah 47.25 (14.25–143.02) nmol/L.Yang menarik,  88,4% pasien menunjukkan kadar vitamin D lebih rendah dari yang direkomendasikan. Dibandingkan dengan pasien dengan kadar vitamin D normal, pasien dengan kadar rendah tersebut lebih sering disertai denganhipertensi atau diabetes, berjenis kelamin perempuan, dan memiliki riwayat rawat inap ulang yang lebih sering.Kesimpulan: Defisiensi vitamin D serum dialami olehsebagian besar pasien gagal jantung kronik yang dirawat. Data ini menunjukkan perlunya pengukuran kadar vitamin D pada pasien gagal jantung kronik dengan hipertensi, diabetes, jenis kelamin wanita dan rawat inap ulang.Kata Kunci : Gagal jantung, defisiensi vitamin D, rawat ina

Sensitivity and Specificity of Denaturing HPLC to Detect MYBPC3 Gene Mutations in Hypertrophic Cardiomyopathy

Denaturing high-performance liquid chromatography (DHPLC), which has recently been developed as an automated method to detect mutations, is at least ten times less expensive than the direct sequencing method; however, its sensitivity and specificity for cardiac myosin-binding protein C (MYBPC3) gene mutations in hypertrophic cardiomyopathy have not been reported yet. A mutation analysis of exons 1 to 35 of MYBPC3 gene from 20 Japanese patients with hypertrophic cardiomyopathy was performed using DHPLC and direct sequencing. Compared to direct sequencing, the sensitivity and specificity of DHPLC were 87.5% and 97.42%, respectively. Its positive and negative predictive values were 41.18% and 99.74%. The positive and negative likelihood ratios were 33.95 and 0.13, and the prevalence was 2.02%. DHPLC showed high sensitivity and specificity for detecting MYBPC3 gene mutations in hypertrophic cardiomyopathy. The use of this complementary sequencing method should reduce the cost of detection of MYBPC3 gene mutations, and could be used to screen patients with hypertrophic cardiomyopathy

Degree of coronary occlusions links to the patient clinical outcome: four cases of double culprits acute ST-segment elevation myocardial infarction

Background: Double coronary culprit lesions in ST-segment elevation myocardial infarction (STEMI) is uncommon. Despite successful primary percutaneous coronary intervention (PPCI) in all culprit lesions, the clinical outcome remains unfavorable and the possible factors for the outcome are not fully understood.Cases Presentation: We reported four cases of double culprit lesions STEMI underwent PPCI. Patient A, a 62 y.o. male with extensive anterior-inferior STEMI, had total occlusion (TO) at both proximal left anterior descending (LAD) and mid right coronary artery (RCA). Patient B, a 42 y.o. male with extensive anterior-inferior STEMI, had subtotal occlusion (STO) at proximal RCA and TO at proximal LAD. Both of them had RBBB ECG pattern. Patient C, a 67 y.o. male with inferior STEMI had 90% thrombus occlusion at proximal–mid LAD and TO at proximal RCA. Patient D, a 65 y.o. male with anteroseptal STEMI, had STO at proximal LAD and 80% thrombus occlusion at mid left circumflex. The cardiomyocyte infarction biomarkers increased in all patients. Although all of them underwent successful PPCI in all of culprit lesions, they suffered from acute heart failure and two of them experienced recurrent ventricular arrhythmia episodes. One of them (patient A) died two days post PPCI. He was only patient who suffering from total occlusion in LAD and RCA with TIMI thrombus 5 and experienced a total atrioventricular block post-PPCI.Conclusion: STEMI with coronary double culprits have severe clinical outcome, regardless of the successful PCI. The degree of coronary occlusions might be linked to the patient clinical outcome.

Adiponutrin and Adiponectin Gene Variants in Indonesian Patients with Non-Alcoholic Fatty Liver Disease: a Preliminary Study

BackgroundVariants of adiponutrin (PNPLA3) and adiponectin (ADIPOQ) genes were considered to be associated with non-alcoholic fatty liver disease (NAFLD). Although the prevalence of NAFLD is increasing, there are limited numbers of studies about the association in Indonesian population.ObjectiveTo confirm whether specific variants of adiponutrin (PNPLA3) and adiponectin (ADIPOQ) genes are associated with NAFLD in Indonesian patients.MethodsData and DNA of 152 participants were obtained from a previous study in Dr. Kariadi Hospital, Semarang, Indonesia. PCR-RFLP analysis was performed for detection of PNPLA3 rs738409 and ADIPOQ rs2241767 variants. The diagnosis and severity of NAFLD were assessed according to NAFLD activity score (NAS) based on histopathology assessment of liverbiopsy.ResultsAllele G of PNPLA3rs738409 was associated with NAFLD in both bivariate (p=0.009, OR 2.52, CI 95% 1.25–5.07) and multivariate (p=0.008, OR 2.62, CI 95% 1.29%–5.32%) analysis, while ADIPOQ rs2241767 had no significant association. In NAFLD participants, both genotypes showed allele G was higher in the group of possible non-alcoholic steatohepatitis (NASH) – NASH (NAS >2) than in the simple steatosis group (NAS <2) i.e. 40.0% vs. 3.75% for the rs2241767 variant and 23.75% vs. 1.25% for the rs738409 variant, without significant association.ConclusionVariant PNPLA3 rs738409 was associated with NAFLD incidence in studied population. Among NAFLD participants, the frequency of both variants were found higher in the possible NASH – NASH group, yet needs to be confirmed with more participants and a multicenter study.Data and DNA of 152 participants were obtained from a previous study in Dr. Kariadi Hospital, Semarang, Indonesia. PCR-RFLP analysis was performed for detection of PNPLA3 rs738409 and ADIPOQ rs2241767 variants. The diagnosis and severity of NAFLD were assessed according to NAFLD activity score (NAS) based on histopathology assessment of liverbiopsy

Optimization On Subcritical Fluid Extraction Of Zingiberene

The establishment of subcritical fluid application for zingiberene extraction was studied by employing water as a green solvent. The zingiberene content was observed by using Liquid Chromatography-Mass Spectrofotometry and regarding to the independent variable of temperature, extraction time, ginger-solvent ratio and aging time. By applying subcritical water, the critical value of zingiberene content obtained was 0.036%.  This value was approached by the surface modeling of alpha for rotatability design which performed at 125 C, 20 min of extraction time, 0.08 of ginger to solvent ratio and 9 min of aging time of extraction parameters. The surface modeling was validated by plotting the observed and predicted value of zingiberene content and evidenced by the value of R-square at 0.76