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All Journal Sriwijaya Journal of Internal Medicine Sriwijaya Journal of Otorhinolaryngology
Ayesh Mahmood
Department of Palliative Therapy, Nukus Private Hospital, Nukus, Uzbekistan
Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Nursing Public Health

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Glycated Hemoglobin (HbA1c) as a Predictor of Periodontal Disease Progression in Patients with Type 2 Diabetes: A Longitudinal Study in Surabaya, Indonesia Alexander Mulya; Muhammad Ashraf; Muhammad Yoshandi; Ayesh Mahmood; Daphne Marshall
Sriwijaya Journal of Internal Medicine Vol. 3 No. 1 (2025): Sriwijaya Journal of Internal Medicine
Publisher : Phlox Institute: Indonesian Medical Research Organization

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59345/sjim.v2i2.178

Abstract

Introduction: Periodontal disease is a prevalent complication of type 2 diabetes mellitus (T2DM), and poor glycemic control is a known risk factor. This longitudinal study aimed to investigate the predictive value of glycated hemoglobin (HbA1c) for periodontal disease progression in a cohort of T2DM patients in Surabaya, Indonesia. Methods: A prospective cohort study was conducted at private hospital, Surabaya, Indonesia, from January 2021 to January 2023. 180 patients with T2DM and pre-existing chronic periodontitis were enrolled. Periodontal parameters, including probing pocket depth (PPD), clinical attachment loss (CAL), bleeding on probing (BOP), and plaque index (PI), were assessed at baseline, 12 months, and 24 months. HbA1c was measured at each visit. Multivariate linear regression and mixed-effects models were used to analyze the association between HbA1c and changes in periodontal parameters over time, adjusting for potential confounders. Results: The mean age of participants was 58.5 ± 8.2 years, and 55% were female. Baseline mean HbA1c was 8.2 ± 1.5%. After adjusting for age, gender, smoking status, diabetes duration, and baseline periodontal parameters, higher baseline HbA1c was significantly associated with greater increases in PPD (β = 0.15 mm per 1% HbA1c increase, 95% CI: 0.08-0.22, p < 0.001) and CAL (β = 0.18 mm per 1% HbA1c increase, 95% CI: 0.10-0.26, p < 0.001) over 24 months. Furthermore, sustained elevation of HbA1c (average HbA1c over 24 months) was a stronger predictor of periodontal disease progression than baseline HbA1c alone. A significant interaction between HbA1c and time was observed (p < 0.001), indicating that the effect of HbA1c on periodontal parameters increased over time. Conclusion: HbA1c is a significant independent predictor of periodontal disease progression in patients with T2DM. Sustained glycemic control is crucial for preventing and managing periodontal complications in this population. These findings highlight the importance of interdisciplinary collaboration between internists and dentists in the comprehensive care of T2DM patients.
Incidence, Mortality, Sex Differences, and Demographic Projections for Six Selected Head and Neck Cancer Site Groups in Indonesia: A Secondary Analysis of GLOBOCAN 2024 Modeled Estimates Lisye Tiur Simanjuntak; Ayesh Mahmood
Sriwijaya Journal of Otorhinolaryngology Vol. 4 No. 1 (2026): Sriwijaya Journal of Otorhinolaryngology
Publisher : Phlox Institute: Indonesian Medical Research Organization

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59345/sjorl.v4i1.317

Abstract

Background: Nationally representative data on the heterogeneous malignancies managed in head and neck oncology remain limited in Indonesia. Objective: To estimate incidence, mortality, sex differences, and demographic change for six selected head and neck cancer site groups in Indonesia. Methods: We performed a descriptive secondary analysis of GLOBOCAN 2024 aggregate modeled estimates (version 08 July 2026). The definition included lip and oral cavity (C00–C06), salivary glands (C07–C08), oropharynx (C09–C10), nasopharynx (C11), hypopharynx (C12–C13), and larynx (C32). Counts and age-standardized rates were aggregated across mutually exclusive sites. Indonesia was compared descriptively with four reference populations. Constant-rate Cancer Tomorrow projections and two definitional sensitivity analyses were evaluated. Source uncertainty distributions were unavailable; therefore, confidence intervals were not constructed. Results: An estimated 28,226 cases and 16,025 deaths occurred in 2024; summed ASIR and ASMR were 8.91 and 5.06 per 100,000. Nasopharyngeal cancer contributed 16,064 cases (56.9%) and 8,718 deaths (54.4%). Male rates exceeded female rates: ASIR 13.19 versus 5.18 and ASMR 7.73 versus 2.77. With 2024 rates held constant, annual cases increased to 46,895 (+66.1%) and deaths to 27,900 (+74.1%) by 2050. All 21 validation checks passed. Conclusion: Indonesia's selected head and neck cancer burden is dominated by nasopharyngeal cancer and higher male rates. These modeled estimates support prevention, registry strengthening, and planning hypotheses but do not measure stage, utilization, treatment need, survival, cost, or causal effects.
Co-Authors Alexander Mulya Daphne Marshall Lisye Tiur Simanjuntak Muhammad Ashraf Muhammad Yoshandi