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All Journal JBIO: jurnal biosains (the journal of biosciences) Jurnal Kedokteran Syiah Kuala Majalah Kedokteran Bandung Dentika Dental Journal Jurnal Farmasi Klinik Indonesia The Indonesian Biomedical Journal Universa Medicina Majalah Kedokteran Nusantara The Journal Of Medical School Buletin Farmatera Sumatera Medical Journal Indonesian Journal of Clinical Pathology and Medical Laboratory (IJCPML) AVERROUS: Jurnal Kedokteran dan Kesehatan Malikussaleh Al-Iqra Medical Journal : Jurnal Berkala Ilmiah Kedokteran Narra J Cermin Dunia Kedokteran Journal of Endocrinology, Tropical Medicine, and Infectious Disease (JETROMI) The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy The Journal of Society Medicine (JSOCMED) Indonesian Journal of Endocrinology Metabolism and Diabetes (InaJEMD)
dharma Lindarto, dharma
Department Of Internal Medicine, Faculty Medicine, Universitas Sumatera Utara, Medan, Indonesia
Agriculture, Biological Sciences & Forestry Biochemistry, Genetics & Molecular Biology Dentistry Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Nursing Public Health

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Effect of Puguntano Extract (Curanga Fel-Terrae Merr.) on hs-CRP Level in Newly Diagnosed Type 2 Diabetes Mellitus Patient Hartono Apriliasta Purba; Santi Syafril; Dharma Lindarto
The Indonesian Biomedical Journal Vol 10, No 1 (2018)
Publisher : The Prodia Education and Research Institute (PERI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18585/inabj.v10i1.362

Abstract

BACKGROUND: Inflammation is one of the factors that associated with insulin resistance which causes type 2 diabetes mellitus (T2DM). Inflammation can be measured by using high sensitivity C-reactive protein (hs-CRP), a quantitative measurement of CRP concentration. Puguntano is a plant that traditionally used for antidiabetic treatment found in North Sumatera. The objective of this study is to know the effect of Puguntano extract on hs-CRP level in newly diagnosed T2DM patient.METHODS: The study was a randomized controlled clinical trial on 24 newly diagnosed T2DM patients. Subjects were divided into 2 groups. The first group was given Puguntano extract with starting doses at 100 mg daily, then the dose was increased in titration up to a maximum dose of 2x100 mg daily depending on blood sugar level monitoring. Meanwhile, the other group (which serves as a control group) was given metformin with starting doses at 500 mg daily, then the dose was increased in titration up to a maximum dose of 3x500 mg per day depending on blood sugar level monitoring. The hs-CRP and HbA1c are assessed at the baseline and after 12 weeks of treatment.RESULTS: The hs-CRP level was decreased in Puguntano group by 1.41 (-7.54-0.52) (p=0.06) and decrease by 0.58 (-7.86-33.41) (p=0.695) in metformin group. There was no difference in hs-CRP level between the two groups (p=0.630).CONCLUSION: Puguntano extract showed the effect of lowering HbA1C and hs-CRP level in T2DM patients, although it was not statistically significant.KEYWORDS: type 2 diabetes mellitus, hs-CRP, puguntano
Comparison of Tumor Necrosis Factor-α Level in Coronary Artery Disease and Coronary Slow Flow of Thrombolysis in Myocardial Infarction Muhammad Diah; Rahmawati Rahmawati; Aznan Lelo; Zulfikri Muhktar; Dharma Lindarto; Ferry Sandra
The Indonesian Biomedical Journal Vol 11, No 3 (2019)
Publisher : The Prodia Education and Research Institute (PERI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18585/inabj.v11i3.826

Abstract

BACKGROUND: Tumor necrosis factor (TNF)-α, an important primary pro-inflammatory cytokine, has a crucial role in the pathogenesis of atherosclerosis. Since the pathophysiological mechanism of coronary slow flow (CSF) is not fully understood, we investigated the level of TNF-α in coronary artery disease (CAD), CSF and healthy subjects.METHODS: This study was conducted in cross-sectional design involving 16 CAD, 18 CSF and 18 healthy subjects. Coronary angiography was recorded at the left anterior oblique, cranial, right anterior oblique, caudal, and horizontal positions. The flow in coronary arteries of the subjects were assessed using Thrombolysis in the Myocardial Infarction (TIMI) frame count method. Peripheral blood-derived serum was collected and level of TNF-α was determined by using highly sensitive enzymelinked immunosorbent assay (ELISA).RESULTS: No significant difference in level of TNF-α in CAD, CSF and healthy subjects (2.72±2.64 pg/mL, 1.88±0.8 pg/mL, 1.64±0.35 pg/mL, respectively) (p=0.087). In addition, there was no correlation between the concentration of TNF-α and TIMI frame count (r<0.2, p>0.05).CONCLUSION: There was no significant difference of TNF-α level in CAD, CSF and healthy subjects. In addition, there was no correlation between the TNF-α level with TIMI frame count as well. Nevertheless, further clinical studies with more subjects are needed.KEYWORDS: TNF-alpha, coronary artery disease, coronary slow flow 
Elevated uric acid level decreases glycated hemoglobin in type 2 diabetes mellitus Muhammad Fahmi Hidayat; Santi Syafril; Dharma Lindarto
Universa Medicina Vol. 33 No. 3 (2014)
Publisher : Faculty of Medicine, Universitas Trisakti

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2014.v33.199-204

Abstract

BackgroundType 2 diabetes mellitus is a heterogeneous disease which is characterized by variable degrees of insulin resistance and impaired insulin secretion. Uric acid has been identified as a marker for a number of metabolic and hemodynamic abnormalities. In diabetic patients, there is biochemical interaction between serum glucose and purine metabolism, with increased excretion of uric acid during hyperglycemia and glycosuria. The objective of this study was to evaluate the correlation of serum uric acid levels with glycated hemoglobin (HbA1c) and blood glucose levels in type 2 diabetes patients.MethodsA cross sectional study from May until July 2014 had been done in 82 type 2 diabetes patients. Serum was analyzed for uric acid, fasting and 2-hour post prandial blood glucose and lipid profile. Spearman correlation test was used to assess associations of HbA1c, fasting and post prandial blood glucose with serum uric acid levels.ResultsThere was a negative correlation of HbA1c with serum uric acid levels (r=-0.407; p=0.000) and of fasting and post prandial blood glucose with serum uric acid levels (r=-0.338; p=0.002 and r=-0.318; p=0.004, respectively).ConclusionsSerum uric acid level was associated with HbA1c, fasting and post prandial blood glucose suggesting a significant role of serum uric acid in the deterioration of glucose toleration.
Mean platelet volume increases in proliferative retinopathy among diabetes mellitus subjects Mardiya Sari; Dharma Lindarto; Dairion Gatot
Universa Medicina Vol. 33 No. 1 (2014)
Publisher : Faculty of Medicine, Universitas Trisakti

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2014.v33.43-48

Abstract

BACKGROUND Mean platelet volume (MPV) shows the average size of platelets in the circulation and can be used to assess the activity of platelets. Increased of MPV can be sign of atherotrombosis and can be used to assess the risk of vascular complications such as retinopathy diabetic (RD). The aim of this study was to determine correlation between glycated haemoglobin (HbA1c), MPV with degree of retinopathy in diabetes mellitus (DM) patients. METHODS A cross sectional study from June until July 2013 was conducted involving 77 DM subjects. Anamnesis, laboratory examination and funduscopy had been done in all subjects. One way ANOVA was used to assess the differences between MPV with other parameters to the degree of retinopathy and continued with Bonferroni test to assess the differences between the degree of retinopathy with the parameters that significantly different in one way ANOVA. RESULTS One way ANOVA showed significance difference of mean MPV between normal funduscopy group compared than proliferative diabetic retinopathy (PDR) group (9.57 ± 0.63 fl vs 10.45 ± 0.51 fl, p=0.044). PDR group were older (p=0.001), longer suffered from DM (p=0.001) and hypertension (p=0.011). Bonferroni test showed no significance difference of mean MPV between normal funduscopy versus non-proliferative diabetic retinopathy (NPDR) group (p=0.290) and NPDR versus PDR (p=0.409). CONCLUSION There was a significance differences between MPV with the degree of retinopathy. Platelets may play a role in the pathogenesis of vascular complications and that MPV can be used as simple parameter to assess the vascular events in DM.
Renal cortex echogenicity increases degree of retinopathy in diabetes mellitus Indah Maulidawati; Abdurrahim Rasyid Lubis; Dharma Lindarto
Universa Medicina Vol. 35 No. 1 (2016)
Publisher : Faculty of Medicine, Universitas Trisakti

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2016.v35.19-25

Abstract

BackgroundThe number of people with diabetes mellitus (DM) is increasing due to population growth, aging, and increasing prevalence of obesity. Diabetic retinopathy and diabetic nephropathy are two main complications of DM. Some studies suggest a correlation between diabetic nephropathy and diabetic retinopathy. However, other studies found that renal cortex echogenicity is associated with chronicity of kidney disease and renal histopathology. The aim of this study was to determine whether there is a correlation between renal cortex echogenicity as determined by renal ultrasonography and degree of retinopathy as determined by funduscopy in subjects with DM.MethodsA cross sectional study was conducted on 41 DM subjects from September to November 2014. Data obtained by anamnesis, physical examination, and examination of ureum, creatinine, urinalysis, glycated hemoglobin (HbA1c), renal and urinary tract ultrasonography and funduscopy, were collected from all subjects. Blood samples were taken from the median cubital vein for biochemical measurements using COBAS automated analyzers. Normality of data distribution was tested using the Shapiro-Wilk test. To determine the relationship between variables the Spearman correlation test was used. ResultsUsing the Spearman correlation test, a strongly significant correlation was found between degree of renal cortex echogenicity and degree of retinopathy (r=0.773; p=0.0001). A significant relationship was also found for the degree of retinopathy with age (r=0.317; p=0.044), duration of diabetes mellitus (r=0.639; p=0.0001) and HbA1c (r=0.681; p=0.001).ConclusionThis study found that renal cortex echogenicity increased the degree of diabetic retinopathy in diabetic subjects. Renal ultrasonography for patients with type 2 DM has a great role in diagnosing and grading diabetic retinopathy.
RERATA VOLUME TROMBOSIT DAN AGGREGASI TROMBOSIT DI DIABETES MELITUS TIPE 2 (Mean Platelet Volume and Platelet Aggregation in Diabetes Mellitus Type 2) Malayana Rahmita Nasution; Adi Koesoema Aman; Dharma Lindarto
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 21, No 3 (2015)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v21i3.1283

Abstract

Diabetes mellitus patients often have hypercoagulable blood, as evidenced by the increased coagulation, impaired fibrinolysis,endothelial dysfunction and platelet hyperactivity. Hyperactive platelet is the major determinant of pro thrombotic state in DM. Byassessing the MPV and platelet aggregation, which is a marker of platelet activity, in patients with type 2 DM, it is expected to help theprediction of acute events. This research is aimed to know the differences of MPV and the aggregation of platelet between poor glycemiccontrol as well as good the control group in type 2 DM patients. This study was conducted in cross sectional method using 22 people withgood glycemic control and 28 people with poor one (glycemic control) from June to August 2013. Fasting blood samples were analyzedfor CBC, HbA1c, TG and platelet aggregation. MPV and platelet aggregation value were compared between groups using independentt-test. Based on this study, there is no significant difference in MPV and platelet aggregation between groups (p=0.598, p=0.464 (1 μM),p=0.868 (2 μM), p=0.984 (5 μM), p=0.401 (10 μM)). Mean Platelet Volume (MPV) correlate significantly with platelet aggregationat 1 μM and 5μM ADP concentration in good glycemic control group (r=0.591; p=0.004 at 1 μM ADP and r=0.521; p=0.013 at 5 μMADP). Mean platelet volume correlate significantly with the platelet aggregation at 2 μM ADP and the concentration in poor glycemiccontrol group (r=0.405; p=0.033). There are no significant differences in MPV and platelet aggregation between groups, but there is asignificant correlation between them (MPV and platelet aggregation) in the good glycemic control of the type 2 DM group.
HUBUNGAN PEMBENTUKAN BIOFILM OLEH BAKTERI GRAM NEGATIF DENGAN RESISTENSI ANTIBIOTIK PADA WANITA DIABETES MELITUS TIPE 2 Juwita Sahputri; Dharma Lindarto; Ratna Akbari Ganie
AVERROUS: Jurnal Kedokteran dan Kesehatan Malikussaleh Averrous, Vol. 4: No. 1 (Mei, 2018)
Publisher : Fakultas Kedokteran Universitas Malikussaleh

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.29103/averrous.v4i1.804

Abstract

Diabetes melitus (DM) memiliki efek jangka panjang terhadap sistem genitourinari yang menjadi faktor predisposisi terjadinya infeksi saluran kemih (ISK) pada pasien wanita dan umumnya bersifat asimtomatik. Bakteri gram negatif merupakan mikroorganisme penyebab tersering yang dapat membentuk biofilm sehingga sering menyebabkan resistensi antibiotik. Penelitian ini bertujuan untuk membuktikan hubungan antara pembentukan biofilm bakteri gram negatif dengan resistensi antibiotik pada wanita diabetes melitus tipe 2 (DMT2). Menggunakan desain penelitian cross sectional dengan teknik total sampling. Jumlah sampel penelitian adalah 45 orang wanita DMT2 anggota Program Pengendalian Penyakit Kronis (PROLANIS). Pada semua responden dilakukan kultur urin porsi tengah, uji sensitivitas dan pemeriksaan biofilm terhadap isolat bakteri yang teridentifikasi.  Hasil kultur urin menunjukkan bakteriuria signifikan 14 (31%) responden. Identifikasi koloni menunjukkan bakteri penyebab ISK antara lain Escherichia coli (35,7%), Klebsiella pneumoniae (35,7%), Enterobacter sp (21,5%) dan Citrobacter sp (7,1%). Uji sensitivitas dijumpai 8 (57%) isolat resisten terhadap antibiotik, yaitu 2 (14,2%) isolat terhadap ciprofloksasin dan 6 (42,8%) isolat terhadap TMP-SMX. Bakteri gram negatif yang diisolasi 100% mampu membentuk biofilm dengan kategori weak. Berdasarkan analisis bivariat dengan uji Rank Spearman correlation dapat disimpulkan bahwa terdapatnya hubungan yang sangat lemah antara pembentukan biofilm oleh bakteri gram negatif dengan resistensi antibiotik ciprofloksasin dan TMP-SMX.
AGREGASI TROMBOSIT DAN MEAN PLATELET VOLUME DENGAN SINDROM METABOLIK TERKAIT KEGEMUKAN Nindia Sugih Arto; Adi Koesoema Aman; Dharma Lindarto
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 21, No 2 (2015)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v21i2.1095

Abstract

The hyperactivity of platelet had been seen in patients with metabolic syndrome which can be caused by several factors, such as:insulin resistance, obesity, dyslipidemia and hypertension. The hyperactivity of platelet leads to its aggregation that can be increased therisk of cardiovascular disease. This study is aimed to know the platelet aggregation and mean platelet volume in patients with metabolicsyndrome and obesity by determination 30 patients were choosen for this cross sectional study, those whom attended to the laboratoryand policlinic at H. Adam Malik Medan Hospital, between May 2013 until August 2013. The diagnosis used of metabolic syndromecriteria established by the International Diabetic Federation 2005. From the 30 patients with 15 metabolic syndrome and 15 obesity,four patients were excluded because of their tryglyceride were more than 200 mg/dL. There is no significant differences between theplatelet aggregation with the agonist adenosin difosfat (ADP) in patient with metabolic syndrome and obesity. And there is no significantdifferences of the mean platelet volume values between the metabolic syndrome (9.6±0.93) and the obesity group (9.73±0.74), with pvalue 0.846. Based on this study there is no significant differences between the platelet aggregation and the Mean Platelet Volume values(MPV) in the metabolic syndrome and the obese group
Pengaruh modifikasi pola hidup medis dengan atau tanpa metformin terhadap kadar asymmetrical dimethyl arginine (ADMA) pada penderita obesitas Sari Harahap; Dharma Lindarto
Majalah Kedokteran Nusantara The Journal Of Medical School Vol 45, No 2 (2012): The Journal of Medical School
Publisher : Fakultas Kedokteran USU

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Abstract

Introduction : Obesity, accumulation of excessive adipose tissue, is a risk factor of cardiovascular diseases. Human adipocytesproduce asymmetrical dimethyl arginine (ADMA), an inhibitor nitric oxide synthase which has important role in endotheldysfunction, and express the full enzymatic machinery responsible for ADMA metabolism. Lifestyle modification and metforminhave lowering body weight and ADMA level effects. This study intends to find out whether lifestyle modification with metforminin obese subjects can make the improvement of ADMA level better.Method : A randomized double blind clinical trial held in 12 weeks on 40 obese subjects having lifestyle modification with andwithout metformin. Antropometric parametres and ADMA level were measured before and after intervention.Results : After intervention, there were decreasement in ADMA level, body weight, waist circumfrence and body mass indexin both group. Mean of ADMA, weight, waist circumfrence, and body mass index reduction in metformin versus placebo groupwere .0235 (SD 0.12) ug/l vs 0.03 (SD 0.1) ug/l (P=0.726), 3.88 (SD 1.23) kg vs 2.36 (SD 1.12) kg (P = 0.0001), 6.39 (SD 0.99)cm vs 5.75 (SD 1.71) cm (P = 0.0001), and 1.76 (SD 0.85) kg/m2 vs 1.08 (SD 0.61) kg/m2 (P = 0.0001).Conclusion : In obese subjects, lifestyle modification in 12 weeks could improve some antropometric parametres but extrametformin did not improve the ADMA level significantly.Keywords : obesity; lifestyle modification; metformin; ADMA
Pengaruh modifikasi pola hidup dengan atau tanpa metformin terhadap kadar C-reactive protein pada penderita obesitas Muhammad Budiman; Mardianto dr; Dharma Lindarto
Majalah Kedokteran Nusantara The Journal Of Medical School Vol 45, No 3 (2012): The Journal of Medical School
Publisher : Fakultas Kedokteran USU

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Abstract

Background : Obesity is a multifactorial disease caused by accumulation of excessive adipose tissue that can cause metabolic syndrome and increase cardiovascular event. Adipose tissue secretes adipokine that induces the formation of CRP. Metformin as an antidiabetic agent has anti inflammatory effect.Aim of the study : Find out whether combination of medical life style and metformin in obesity subjects can improve CRP level. Method : This study was a clinical trial held for 12 weeks on obesity subjects which divided in to two groups. Group was subjects with medical life style without metformin and group was subjects with combinationof medical life style and metformin. Results : After 12 weeks of intervention in group without metformin (n= 19) there was significant improvement in body weight 78.01 (SD 11.33) compared to 75.68 (SD 11.02), P= 0.0001); waist circumference 95.47 (SD 7.12) compared to 90.07 (SD 7.63), P = 0.001; body mass index 32.35 (SD 4.13) compared to 31.26 (SD 4.15), P = 0.0001; and hs-CRP 3.03 (SD 2.20) compared to 3.22 (SD 2.40), P = 0.445. While metformin group (n= 19) the body weight was 76.07 (SD 13.06) compared to 72.33 (SD 12.97), P = 0.0001; waist circumference 93.97 (SD 9.70) compared to 87.80 (SD 9.42), P = 0.0001; body mass index 32.49 (SD 4.88) compared to 30.70 (SD 4.72), P= 0.0001; and hs-CRP 3.02 (SD 2.25) compared to 2.63 (SD 1.93), P = 0.292. There was significant difference in body weight and body mass index.Conclusion : Implementation of medical life style in 12 weeks improved spesific antropometric parameter and metformin complementation did not improve the CRP level significantly in obesity subjects.Keywords : obesity; lifestyle; modification; metformin; CRPBackground : Obesity is a multifactorial disease caused by accumulation of excessive adipose tissue that can cause metabolic syndrome and increase cardiovascular event. Adipose tissue secretes adipokine that induces the formation of CRP. Metformin as an antidiabetic agent has anti inflammatory effect.Aim of the study : Find out whether combination of medical life style and metformin in obesity subjects can improve CRP level. Method : This study was a clinical trial held for 12 weeks on obesity subjects which divided in to two groups. Group was subjects with medical life style without metformin and group was subjects with combinationof medical life style and metformin. Results : After 12 weeks of intervention in group without metformin (n= 19) there was significant improvement in body weight 78.01 (SD 11.33) compared to 75.68 (SD 11.02), P= 0.0001); waist circumference 95.47 (SD 7.12) compared to 90.07 (SD 7.63), P = 0.001; body mass index 32.35 (SD 4.13) compared to 31.26 (SD 4.15), P = 0.0001; and hs-CRP 3.03 (SD 2.20) compared to 3.22 (SD 2.40), P = 0.445. While metformin group (n= 19) the body weight was 76.07 (SD 13.06) compared to 72.33 (SD 12.97), P = 0.0001; waist circumference 93.97 (SD 9.70) compared to 87.80 (SD 9.42), P = 0.0001; body mass index 32.49 (SD 4.88) compared to 30.70 (SD 4.72), P= 0.0001; and hs-CRP 3.02 (SD 2.25) compared to 2.63 (SD 1.93), P = 0.292. There was significant difference in body weight and body mass index.Conclusion : Implementation of medical life style in 12 weeks improved spesific antropometric parameter and metformin complementation did not improve the CRP level significantly in obesity subjects.Keywords : obesity; lifestyle; modification; metformin; CRP
Co-Authors Abdurrahim Rasyid Lubis Achmad Rudijanto Adi Koesoema Aman Awaluddin Saragih Awaluddin Saragih Aznan Lelo Brama Ihsan Sazli Dairion Gatot, Dairion Darmadi Darmadi Dasopang, Eva S. Daulay, Milahayati Dhini Sylvana Dian Anindita Lubis Efi Ramadhan Eva S. Dasopang Farik Zarmal Ferry Sandra Ginting, Fransiscus Gontar Alamsyah Siregar Hartono Apriliasta Purba Herniza Yusdani Ihsan, Brama Imelda Rey Imelda Rey Indah Maulidawati Irmayani Irmayani Juwita Sahputri Kembaren, Tambar Kumala, Poppy Malayana Rahmita Nasution Mardianto dr Mardianto Mardianto Mardiya Sari Masrul Lubis Melati Silvanni Nasution Muhammad Budiman Muhammad Diah Muhammad Fahmi Hidayat Muzasti, Riri A. Nasution, Melati Silvanni Nindia Sugih Arto Ozar Sanuddin Pertiwi, Vani Gita Priska Krinanta Ginting Purba, Ambrocious Puteri, Happy Helene Sulung Rahmawati Rahmawati Ratna Akbari Ganie Ratna Akbari Ganie, Ratna Akbari Sahputri, Juwita Santi Syafril Santi Syafril Santi Syafril Santi Syafril Santi Syafril Santi Syafril Santi Syafril Santi Syafril, Santi Sari Harahap Siahaan, Billy Stinggo Sinaga, Bintang YM Sitepu, Annisa Nidya Rahmatika SN, Sigit Anugerah Putra SN Sondang Pintauli Stephen Udjung Suherdy Suherdy Sumadio Hadisahputra Sumantri, Imam Bagus Sylvana, Dhini Theresia, Lydia Tjokorda Gde Dalem Pemayun Urip Harahap Widya Deli Satuti Wismandari Wisnu Yetty Machrina Yulindaa, Wina Zulfikri Muhktar