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All Journal Acta Interna : The Journal of Internal Medicine Journal of the Medical Sciences (Berkala Ilmu Kedokteran) CoMPHI Journal : Community Medicine and Public Health of Indonesia Journal Indonesian Journal of Biomedicine and Clinical Sciences
Susanti, Vina Yanti
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Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Nursing Public Health

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Journal : Acta Interna : The Journal of Internal Medicine

 1 
Comparison of the Effectiveness of Subcutaneous Insulin Injection between Upper Arm and Abdominal Sites in Type II Diabetes Mellitus Patients with Normal and Above Normal Body Mass Index Khairina, Ana; Ihsan, Mohammad Robikhul; Susanti, Vina Yanti
Acta Interna The Journal of Internal Medicine Vol 11, No 1 (2021): Acta Interna The Journal of Internal Medicine
Publisher : Faculty of Medicine Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/actainterna.94630

Abstract

Background. Type II Diabetes Mellitus (DM) has high morbidity and mortality. One of DM therapy is insulin. Insulin effectiveness is affected by the injection site and the thickness of the fat in the injection site. Several studies on the effectiveness of insulin injection sites have been conducted, but the results still vary.Objective. To determine the difference in the effectiveness of subcutaneous insulin injections between the upper arm and abdominal sites on changes in capillary glucose levels in type II diabetes mellitus patients with normal and above-normal body mass index (BMI).Methods. The research design used a quasi-experimental repeated measure design. The research subjects were patients diagnosed with type II DM, age ≥ 40 years, hospitalized in the ward of Dr. Sardjito Hospital Yogyakarta. The effectiveness of insulin injection is described by the difference between 2-hours postprandial glucose (2hPPG) minus fasting blood glucose (FBG) (Δ2hPPG-FBG). Δ2hPPG-FBG was taken on the site of the upper arm and abdomen. Patients were classified based on normal and above normal BMI. Statistical analysis was performed using paired T-tests.Result. There were 14 patients with normal BMI and 11 patients with above normal BMI. Paired T-test showed a significant difference in Δ2hPPG-FBG between the upper arm and abdominal sites in normal BMI patients (p=0.028) with a mean of Δ2hPPG-FBG for the upper arm site of 26,14±38.18 mg/dL, and a mean of Δ2hPPG-FBG of the abdominal site -0.64±50,62 mg/dL. Paired T-test showed no significant difference in Δ2hPPG-FBG between the upper arm and abdominal sites in patients with an above-normal BMI (p = 0.239).Conclusion. The effectiveness of subcutaneous insulin injection in the abdominal site was better than in the upper arm site in patients with normal BMI. There was no difference in the effectiveness of subcutaneous insulin injection between the upper arm and abdominal sites in patients with an above-normal BMI.
The Relationship of Thyroid Stimulating Hormone Receptor Antibody (TRAb) Levels to Activity and Clinical Severity of Graves' Ophthalmopathy in RSUP Dr. Sardjito Putra, Kharisma Wibawa Nurdin Putra; Ikhsan, M. Robikhul; Susanti, Vina Yanti
Acta Interna The Journal of Internal Medicine Vol 12, No 2 (2023): Acta Interna The Journal of Internal Medicine
Publisher : Faculty of Medicine Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/actainterna.98252

Abstract

Background: Graves' disease (GD) is an autoimmune disease that is the most common cause of hyperthyroidism. Thyroid stimulating hormone receptor antibody (TRAb) is a specific biomarker for diagnosing GD. Graves' ophthalmopathy (GO) is the most common extrathyroid manifestation in Graves'. Each GO was assessed for activity and clinical severity for treatment.Objectives: To determine the relationship between TRAb levels and GO clinical activity in Clinical Activity Score (CAS) classification and clinical severity of The European Group on Graves' Orbitopathy (EUGOGO).Methods:  This is a cross-sectional study, conducted from January to August 2021 at RSUP Dr. Sardjito Yogyakarta. 30 newly diagnosed Graves' patients or previously diagnosed with Graves' presented symptoms of hyperthyroidism were included. The patients had TRAb levels > 1.75 IU/L, and diagnosed with Graves' ophthalmopathy based on clinical criteria according to Bartley and Gorman and has not received steroid injections. Serum TRAb examination by electrochemiluminescence immunoassay (ECLIA) method. Clinical activity are assessed with CAS, while severity are assessed with EUGOGO criteria. The data are analyzed using Spearman correlation, multivariate analysis with linear regression and logistic regression.Results: 30 study subjects mean age 35.43 years, female dominant (80%), median GD duration of 13 months. Median TRAb 8.15 IU/L, median CAS score 2 with 46.3% active. Mild severity 40% and moderate-severe 60%. Correlation of TRAb with CAS (r=0.576, p=0.001), EUGOGO (r=0.535, p=0.002). Multivariate analysis of TRAb with CAS (B= 0.076, p=0.01) while EUGOGO (OR=1.198, p=0.045)Conclusion: TRAb is positively correlated with activity and clinical severity of OG.
Co-Authors Adhikara, Imam Manggalya Akbar, Adrianus Anggraeni, Vita Yanti Fadhilah, Farah Handajani, Fitri Ihsan, Mohammad Robikhul Ikhsan, M. Robikhul Khairina, Ana Leo, Benedreky Nugroho, Dhite Bayu Putra, Kharisma Wibawa Nurdin Putra Vita Yanti Anggraeni