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EFFECT OF RICH RESISTANT STARCH SNACK ON MCP-1 PROMOTER METHYLATION AND TRIGLYCERIDES LEVELS IN TYPE 2 DIABETES MELLITUS

Fadlilah, Synta Haqqul, Sunarti, ., Farmawati, Arta

Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 50, No 2 (2018)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

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Abstract

Type 2 diabetes mellitus (T2DM) is closely related to inflammation. One of inflammation marker in T2DM is monocyte chemoattractant protein-1 (MCP-1). Previous research suggests that MCP-1 promoter methylation correlated significantly with plasma triglycerides levels (TG) in T2DM. Some studies state that TG levels in T2DM can be controlled through consumption of diets containing resistant starch. This study aimed to investigate the effect of high resistant starch snack on MCP-1 promoter methylation and triglycerides levels in type 2 diabetes mellitus. This study was a cross-over trial. A total of 19 T2DM subjects have been selected with the criteria of fasting blood glucose levels (GDP)>126 mg/dL, aged 40-60 years, and duration of DM at least 1 year. Subject consume snack as much as 32 g/day with the resistant starch content are 4.25 g for 4 weeks. Data collection and blood retrieval was doing before and after the intervention. The analysis of MCP-1 promoter methylation was performed by methylated specific-PCR (MS-PCR) using DNA samples extracted from mononuclear cells, whereas TG levels analysis performed by the enzymatic colorimetric method (DiaSys Kit) using blood plasma. Statistic analysis was performed by Fisher Exact test for methylation data, paired t-test and unpaired t test for TG levels, and Spearman correlation test for the correlation between variabels (p<0.05). Methylation result showed that frequency of “methylated” (52.6%) and “unmethylated” (47.4%) status before and after intervention were same, so there was no significant difference (p>0.05). Plasma triglyceride levels after intervention decreased, but not significant statistically. The correlation between MCP-1 promoter methylation and plasma triglyceride levels was significant. This study concludes that the giving of rich resistant starch snacks intervention does not affect MCP-1 promoter methylation changes significantly. This intervention can lead to decrease plasma triglyceride levels subjects, but not statistically significant.  

Systematic Review: Pre-Stroke Use of Angiotensin Receptor Blockers and Stroke Outcomes

Dewi, Ivana Purnama, Kusmanto, Virandra B., Dewi, Kristin Purnama, Pinzon, Rizaldy

Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 50, No 2 (2018)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

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Abstract

Background: Hypertension is the major risk factor and the most important modifiable risk factor for stroke. Angiotensin Receptor Blockers (ARB) are widely used in patient at high risk of cardiocerebrovascular events. The objective of this literature review was to determine the efficacy of pre-stroke use of ARB on stroke outcomes.Methods: Major medical databases (PubMed, MEDLINE, Clinical Key, Cochrane Library, EMBASE) were systematically searched using keyword: “hypertension”, “ARB”, “stroke”, and “outcome”. The search were limited to clinical trials published within the last 10 years, written in English, with full-text availability. We used GRADE Working Group to measure the quality of evidence.Results: Four clinical studies, three retrospective studies and one nationwide population-based cohort study met our inclusion criteria with total of 102.644 patients for analysis. The scientific quality of the studies varied from poor (1 study), moderate (1 study), and high quality (2 studies). Generally, the subjects of the studies were acute ischemic stroke patients. Three studies showed pre-stroke use of ARB were significantly associated with better stroke outcomes. Only one study found different result whereas pre-stroke use of ARB did not appear to affect stroke outcomes. Outcome of the studies was explored according to morbidity (severity and functional status upon discharge) and mortality (30-days mortality or in-hospital mortality). Several limitations were present, including non-random treatment assignment, retrospective study design, and lack of data for longitudinal medication exposure in observational studies.Conclusions: This systematic review shows evidence that there is possible benefit of pre-stroke ARB treatment in relation to better ischemic stroke outcomes. However, further studies with better research method quality are still needed. The efficacy of ARB treatment in relation to other type of stroke outcomes also needs to be furtherly examined.Keywords: ARB, pre-stroke, benefit, prognosis Makalah ini dipresentasikan dalam Poster Session 11th Scientific Meeting of Indonesian Society of Hypertension, 24-26 February 2017

Precocious puberty in McCune-Albright syndrome: a case report

Lestari, Rianti Puji, Sutomo, Retno, Julia, Madarina

Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 50, No 3 (2018)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

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Abstract

McCune-Albright syndrome (MAS) is a rare disease characterized by a triad of fibrous dysplasia, cafe-au-lait spots and peripheral precocious puberty. We reported a 5-year-8-month old girl with MAS who has been followed-up for 2 years and 8 months. She was referred to pediatric endocrinology clinic in our hospital for vaginal bleeding at age of 2 years 11 months. She had peripheral precocious puberty, i.e. increased estrogen level associated with very low gonadotropins, and cafe-au-lait spots on her face and was diagnosed as MAS. The patient was treated with estrogen receptor blocker (tamoxifen). She had no menses during the 2 years and 8 months of tamoxifen treatment. Her growth rate and bone maturation were also in normal ranges. However, at the end of tamoxifen treatment she had an episode of vaginal bleeding so that we had to change to other treatment modalities.

Cervical cancer screening coverage in urban and rural areas in Southeast Sulawesi: its determinants

Saimin, Juminten, Wicaksono, Satrio, Ashaeryanto, .

Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 50, No 3 (2018)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

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Abstract

Cervical cancer is a woman’s health problem that is still widespread throughout the world, especially in developing countries such as Indonesia. The high incidence of cervical cancer is related with early detection program. Visual inspection of acetic acid (VIA) is used as an alternative screening method because it is easier, cheaper and its effectiveness is not much different from the Pap test. There are differences on coverage of VIA test in urban and rural areas. This study aimed to identify determinants of cervical cancer screening coverage in urban and rural areas. The study was a cross sectional study. Total of 372 women who did the VIA test in urban areas of Kendari and rural areas of South Konawe in January to June 2016 were included in this study. Coverage of cervical cancer screening was examined in relation to the level of education, knowledge, distance of health facilities and family support. The data was analyzed using Chi-square test with a significance value p < 0.05. The majority of respondents were the age groupof 31-40 years old, low parity, and first intercourse at ≥ 17 years old. There were significant difference of education level (p=0.000), knowledge (p=0.000) and distance of health facilitiesin urban and rural areas (p=0.000). There was no significant differences between family support in urban and rural areas (p=0.224). In conclusions, education level, knowledge, and distance of health facilities are determinants of cervical cancer screening coverage in urban and rural areas in Southeast Sulawesi.

CORRELATION LEVELS OF SPECIFIC RUBELLA IMMUNOGLOBULIN G WITH RESPONSE EVOKED BRAINSTEM AUDIOMETRY EXAMINATION ON CONFIRMED CONGENITAL RUBELLA SYNDROME PATIENTS

Rianto, Bambang Udji Djoko, Pratomo, Akmaluddin Agung, Prasetyo, Ashadi

Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 50, No 4 (2018)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

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Abstract

ABSTRACTCongenital Rubella Syndrome is a health problem that can cause deaf child. Diagnose based on clinical manifestation, specific Rubella Immunoglobulin M and G examination. The aim of this study was to determine the correlation between the levels of specific Immunoglobulin G to Rubella and the results of the Brainstem Evoked Response Audiometry wave V in patients with Congenital Rubella Syndrome. The study design was a cross sectional study. The subjects were Congenital Rubella Syndrome child at Dr. Sardjito General Hospital Yogyakarta from 2011 to December 2016. The inclusion criteria were: 1) aged less than 24 months. 2) wave V of Brainstem Evoked Response Audiometry examination has been identified. Exclusion criteria were incomplete data. Based on α: 5%, β: 20% and coefficient correlation estimation 0.04, minimal sample size were 47 subjects. All of subjects was underwent specific Immunoglobulin Rubella test. Statistical analysis by using Spearman`s correlation test. Total samples were 47 patients. Wave V at the level <25 dB were found in 2 patients (4.3%), 26-40 dB results in 3 (6.4%) patients, 41-60 dB in 1 (2.1%) patient, 61-80dB was found in 9 (19.1%) patients and> 81 db in 32 (68.1%) patients. Linearity test result between Immunoglobulin G level (4-400 IU/ml) and wave V, there is a significant positive linear correlation relationship (p <0,05; R: 0.432). In conclusion there is a positive correlation between specific Rubella Immunoglobulin G level and Brainstem Evoked Response Audiometry test results.

THE ROLE OF ISOFLAVON IN REDUCING BLOOD GLUCOSE LEVELS

Prasetyastuti, .

Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 50, No 4 (2018)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

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Abstract

Plants provide excellent sources of medicinal compounds. Over 5000 flavonoids have been isolated and identified from plant sources. Flavonoids are polyphenolic compounds mainly recognized as pigments which produce the colors found in flowers, fruit and leaves. Dietary polyphenols are commonly found in plants and are abundant in fruit, vegetables, chocolate, and nuts. These polyphenols also found in beverages including tea, coffee, wine, and soy milk. Flavonoids are known to lower glucose levels, decrease cholesterol and triglycerides, and increase liver enzyme levels most likely by stimulating pancreatic insulin release. By activating cell-signaling pathways involved in controlling blood glucose levels, flavonoids aid in carbohydrate digestion, and adipose deposition. Flavonoids containing isoflavones, flavanols, flavanones, flavonols, flavones, and anthocyanins have been studied from clinic study until pre clinic study. However, not all of the studies conducted had adequate results. Isoflavone is one of the potential flavonoids that still can be explored for future research. Research on isoflavone supplementation in animals and humans in reducing blood glucose levels is still limited. Short-term supplementation did not improve blood glucose levels in postmenopausal women, while other studies suggest that the long-term isoflavone supplementation can reduce postmenopausal blood glucose levels. These findings found that isoflavone is a component of flavonoids that have potency in reducing blood glucose levels.Keyword: flavonoid, isoflavone, blood glucose level, G-6-Pase enzyme, PEPCK enzyme

Correlation between micro-RNA-21 expression and Inflammation Cytokine in Rabbits Implanted with Bare Metal Stent with the Incidence of Neo Intimal Hyperplasia

Hariawan, Hariadi, Soesatyo, Marsetyawan HNE, Munawar, Muhammad, Ghozali, Ahmad

Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 50, No 4 (2018)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

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Abstract

 Background: In stent restenosis after stenting in vascular occurs secondary to the accumulation of smooth muscle cell and extracellular matrix. This condition is a major complication caused by the occurrence of neointimal hyperplasia (NIH). Aim: To prove the role of miRNA-21 as a risk predictor of the NIH  event in aorta rabbits animal model who underwent BM type stent implantation and to know the miRNA-21 role in IL-6 and IL-8 expressions.Methods: This study is quasy experimental, had been done in Cath Laboratory Sardjito General Hospital Yogyakarta. Stent implantation with observe intravascular ultrasonography. Blood vessel which is already deployed by stent will be taken as sample for pathologic examination. Rabbit blood samples were collected on  day 0, 7, and 28. Quantification expression has been done with qPCR and Elisa approach. Results: These 10 rabbits divided into two groups in which one group as control (without stent deployment, 4 models) and another group as intervention (with BM type stent deployment, 6 models). The increase in expression of miRNA-21 on the day 7 and day 28 in the intervention group compared to the control group. NIH are increase from control group and in intervention group on day 7, and 28 are from mild grade to moderate, and severe respectively. Also an  increasing levels of IL-6 and IL-8 from day 7 to day 28. Conclusion: This study shows there is an increase of miRNA-21 expression on day 7 and NIH  rise from the mild to moderate. Furthermore, on day 28, that increase of miRNA-21 expression and NIH  rise from to moderate to severe. The increase of miRNA-21 is also shown on day 7 and day 28 with increase of IL-6 and IL-8 value.

The role of Malassezia sp, sebum level and Trans Epidermal Water Loss (TEWL) toward the dandruff severity between hijab and non hijab wearing subjects

Etnawati, Kristiana, Siswati, Agnes Sri, Pudjiati, Satiti Retno

Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 50, No 3 (2018)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

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Abstract

Dandruff is a common symptom in adolescence, which possibly due to increasing ofMalassezia sp. colonization, sebum level as well as skin hydration. Wearing hijab ispredicted to increase the humidity and sebum level lead to increase the number ofMalassezia sp. and dandruff severity. A case-control study was conducted on 19 femalewith dandruff who wear hijab and 19 female with dandruff who do not wear hijab, agebetween 18 and 27 years old. The dandruff severity was defined clinically using ascoring system (0-100), only subjects with minimum score of 28 will be included in thisstudy. The sebum and trans epidermal water loss (TEWL) levels were measured withSebumeter and Tewameter from Courage Khazaka. The Malassezia sp. was examinedusing microscopic examination of the squama and culture in the Saboraud medium.There were no significant differences found between hijab and non-hijab groups fordandruff severity. No difference found between two groups for sebum level, Malasseziasp. number microscopically, and Malassezia sp. colonization. Only TEWL level in hijabgroup that was found to be higher than non-hijab group. Wearing hijab does not increasethe dandruff severity, sebum level and colonization number of Malassezia sp. Wearinghijab is found to increase the TEWL level.

Effect of tonsillectomy with or without adenoidectomy on formant sound frequency

Rianto, Bambang Udji Djoko, Jenny, ., Indrasari, Sagung Rai

Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 50, No 3 (2018)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

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Abstract

ABSTRACT Vocal tract resonance characteristics are reflected by formant frequencies which determined by the size and shape of the vocal tract. Tonsillectomy may cause changes in the structure of the oral cavity as a resonator in the speech process. The aim of this study is to determine the effect of tonsillectomy on formant sound frequency. This study used a pre-test and post-test only design experimental. The study underwent in the Otorhinolaryngology Department between August up to November 2012. Inclusion criteria were: 1) chronic tonsillitis, 2) tonsil size was T3-T4, 3) age up to 5 years. The exclusion criteria were craniofacial abnormality and neurological disorders. All patients performed a sound analysis by recording vowel / a /, / e /, / i /, / o /, and / u / in 1 day before and 4 weeks after surgery. The sample consisted of 24 (60%) women and 16 (40%) men. The T3-T3 tonsil size were 25 (62.5%) samples and the lowest than T3-T4/T4-T3 were 6 (15%) samples. Based on paired T test there was a statistically significant increase of all F1 vowels (p <0.05), except for / i / (p> 0,05) and decrease of F2 / e / and F3 / u / (p >0,05). Based on these results it can be concluded that tonsillectomy affects the F1 mean difference almost in all vowel except the vowels / i /, F2 & F3.

The effects of furosemide on kidney damage in acute kidney injury rat models

Afifah, Afifah, Ngatidjan, ., Arfian, Nur

Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 50, No 3 (2018)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

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Abstract

The most frequent cause of acute kidney injury (AKI) is ischemia reperfusion injuriesthat causes inflammation. Furosemide is still used in AKI’s therapy. The advantages anddisadvantages of furosemide in AKI remain controversial. The aim of the study was toinvestigate the effect of furosemide on kidney damage in AKI rat models. Twenty-fivemale (2-3 months old) Sprague-Dawley rats were divided into 5 groups; sham operation(SO, n=5), ischemic-reperfusion (IR, n=5), IR+furosemide 3.6 mg/kgBW (IR+F1,n=5), IR+furosemide 7.2 mg/kgBW (IR+F2, n=5), and IR+furosemide 14.4 mg/kgBW(IR+F3, n=5). Abdominal surgery was performed under ketamine anesthesia to produceischemic reperfusion (IR) by mean of renal artery clamping for 45 min. Urine output,serum creatinine level, tubular injury score, and TLR4 gene expression were examinedto investigate kidney damage. Periodic acid-schiff (PAS) staining was measured toexamine kidney tubular injury. Data were analyzed using One-Way ANOVA and Kruskal-Wallis test with significance level of p<0.05. AKI rat models which were given 3.6 and7.2 mg/kgBW of furosemide (0.014±0.001 mL/min; and 0.012±0.007) showed higher(p>0.05) creatinine clearance compared to IR (0.009±0.003) while administration of 14.4mg/kgBW furosemide (0.009±0.004) denoted equal creatinine clearance to IR (p>0,05).Kidney tubular injury score of 3.6 mg/kgBW furosemide (2.89±0.13) was lower (p>0.05)than IR (3.26±0.19) whereas 7.2 mg/kgBW and 14.4 mg/kgBW furosemide (3.55±0.26;3.83±0.19) were higher (p<0.05) than IR. Administration of 3.6 mg/kgBW furosemide(0.99±0.08) indicated lower (p<0.05) TLR4 gene expression than IR (1.20±0.08) whilst7.2 mg/kgBW furosemide (1.23±0.13) was not-significantly higher (p>0.05) and 14.4 mg/kgBW furosemide (1.63±0.12) was significantly higher (p<0.05) than IR. In conclusion,administration of 3.6 mg/kgBW furosemide reduces kidney damage in AKI rat modelswhile higher dosages (7.2 mg/kgBW and 14.4 mg/kgBW) increase kidney damage.

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