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Ahmad H. Asdie Ahmad H. Asdie
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Penatalaksanaan Diabetes Mellitus pada Orang Dewasa Ahmad H. Asdie, Ahmad H. Asdie
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 20, No 03 (1988)
Publisher : Universitas Gadjah Mada

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Abstract

The aim of the diabetic treatment is to restore glucose intolerance to normal. There are abundant evidence that chronic hyperglycemia, from whatever cause, leads to chronic complications, such as angiopa thy, retinopathy, nephropathy and neuropathy. Prophylactic treatment should include good diabetic control and avoidance of other factors involving pathogenesis of atherosclerosis, e. obesity, smoking and hypertension. To achieve this aim, all diabetics, regardless of their age or the severity of their diabetes, must take an active role in managing their disease, and they must have adequate information about the importance of dietary management and must be instructed in suitable diet planning. Diet remains the cornerstone of the treatment of diabetes in adults. Meal-schedule, caloric intake and the composition of the diet must be a relative constant, against which is computed the necessary medication and the individuals exercise habits.Education of diabetic patients and their families should begin at the time of diagnosis. In long term diabetes education, the basic concepts of management should be reviewed together with patients during clinic visits at stated interval.Ketonuria usually means that insulin will be necessary.Key Word: diabetes mellitus — home glucose monitoring — dietary management — glocuse intolerance — diabetic education.
The innocent murmurs Ahmad H. Asdie, Ahmad H. Asdie
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 13, No 02 (1981)
Publisher : Universitas Gadjah Mada

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In this article the innocent murmur includes only those murmurs that are associated with no known abnormality, either structural or physiologic. The term "functional murmur" and "physiologic murmur" are avoided, because they may include even murmurs resulting from dilatadon of valves, heart chamber, and vessels or are associated with acceleration of the circulation.The innocent murmurs are common and are often misinterpreted. Misinterpretation of innocent murmurs may lead to anxiety on the part of both physician and patient, to a prolonged period of unnecessary restriction of physical activity, and perhaps to permanent cardiac neurosis. They may also lead to exclusion of healthy young people from athletic activities, flying, and military service, or to the use of unnecessary prophylactic penicillin. The distinction between an organic murmur and an innocent murmur is enlargement, no history of rheumatic fever; absence of cyanosis, clubbing, and congestive heart failure.KeyWords: innocent murmur - functional murmur- physiologic murmur - venous hum
Patogenesis Diabetes Mellitus Tidak Bergantung Insulin (Non-/fain/in Dependent Diabetes Mellitus) Ahmad H. Asdie, Ahmad H. Asdie
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 21, No 03 (1989)
Publisher : Universitas Gadjah Mada

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Abstract

The paper described a Short review of mechanism of glucose intolerance in most non-innilin dependent diabetics which is now clear that is not caused by defect in insulin secretion.alone. Genetic predisposition, impaired glucose-mediated insulin secretion, excessive basal hepatiC gluciase production (HGP) and cellular resistance to insulin action have been docuthented in NIDDM:The increase in basal HGP is the primary factor responsible for fasting hyperglycemia, where as both insulin resistance in peripheral tissues and relative defective insulin secretion contribute to the impaired glucose disposal following oral or intravenous glucose administration. Both receptor and post-receptor defects contribute to the insulin resistance observed in non-insulin dependent diabetic patients.The heterogeneity of NIDDM may present as insulin "resistant or insulin sensitive variety:Key Words: NIDDM -- insulin secretion --hepatic glucose produCtion -- insulin resistance type -- insulin sensitive type,
Clinical experience with Clonidine in the treatment of hypertension Ahmad H. Asdie, Ahmad H. Asdie
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 13, No 04 (1981)
Publisher : Universitas Gadjah Mada

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Abstract

In this article we reported our experience with Clonidine in treating hypertensive patients in the Department of Internal Medicine, Gadjah Mada University Hospital, Pugeran, Yogyakarta. 25 patients suffering from severe or moderate hypertension of 13 females and 10 males were included in the study. The treatment began with a small dose of 0.075 mg bid. This dose if necessary was increased every 3-7 days. In some patients diuretics were added.Side effects and effect of treatment on the blood pressure are described and discussed.Key Words: hypertension - clooidine - diuretics - renal failure - antihypertensive drugs
Role of insulin resistance and hyperinsulinemia in cardiovascular disease Ahmad H. Asdie, Ahmad H. Asdie
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 25, No 03 (1993)
Publisher : Universitas Gadjah Mada

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Abstract

Resi,stance to insulin-stimulated glucose uptake is present in the great majority of patients with impaired glucose tolerance or type 2 diabetes mellitus, in first degree relatives of patients with type 2 diabetes mellitus, as well as in approximately 25% of non-obese individuals with normal oral glucose tolerance. Deterioration of glucose tolerance can be prevented if beta cell is able to produce more insulin resulting hyperinsulinemia.The association between hypertension and diabetes mellitus is well recognized. Several reasons for the coexistence of these disorders have been postulated, i.e. as part of aging process, diabetes causes macrovascular and microvascular disease, renovascular stenosis which is enhanced by the development of hypertension. Insulin causes renal sodium reabsorption, stimulates the sympathetic nervous system, increases intracellular calcium, and is a vascular growth factor.Insulin resistance, hyperinsulinemia, impaired glucose tolerance, increased plasma triglyceride, and decreased HDL-cholesterol concentration have been shown to be associated with increased risk of coronary heart disease. Based upon these considerations, it raised the possibility that insulin resistance and hyperinsulinemia are involved in the etiology and clinical course of three major related disease; the type 2 diabetes mellitus, hypertension, and coronary heart disease.Key Words: hyperinsulinemia insulin resistance cardiovascular disease glucose homeostasis aging
The Role of Lipids in Atherogenesis Ahmad H. Asdie Ahmad H. Asdie
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 26, No 02 (1994)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

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Abstract

Hiperkolesterolemia, hipertensi, diabetes dan merokok telah lama diakui sebagai faktor risiko utama penyakit jantung koroner. Komponen utama bercak aterosklerotik adalah timbunan lipid, terutama ester kolesterol dan kolesterol, proliferasi dan perubahan sel otot polos intima arteri. Timbunan lipid dalam intima arteri terutama berasal dari low-density lipoprotein (LDL) yang telah termodifikasi dalam darah. Hal ini terjadi sebelum proliferasi otot polos intima timbul. Walaupun hubungan kausal antara hiperkolesterolemia dan penyakit jantung koroner sudah lama diterima para pakar, namun mengenai peran trigliserida dan jenis lipoprotein lainnya (high density lipoprotein, HDL) masih belum didapatkan kesepakatan. Dalam makalah ini dibahas pecan lipid dalam proses aterogenesis.Disimpulkan bahwa kelainan lipid yang berupa peninggian kolesterol (dan LDL) dan trigliserida (VLDL, terutama VLDL-sisa), dan.penurunan HDL merupakan faktor risiko bebas aterogenesis. Faktor hormonal ikut berperan dalam proses aterogenesis, dan diduga melalui efek hormon terhadap metabolisme lipid.Key Words : atherosclerosis - lipid - lipoprotein - apolipoprotein - coronary heart disease
Role of insulin resistance and hyperinsulinemia in cardiovascular disease Ahmad H. Asdie Ahmad H. Asdie
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 25, No 03 (1993)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

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Abstract

Resi,stance to insulin-stimulated glucose uptake is present in the great majority of patients with impaired glucose tolerance or type 2 diabetes mellitus, in first degree relatives of patients with type 2 diabetes mellitus, as well as in approximately 25% of non-obese individuals with normal oral glucose tolerance. Deterioration of glucose tolerance can be prevented if beta cell is able to produce more insulin resulting hyperinsulinemia.The association between hypertension and diabetes mellitus is well recognized. Several reasons for the coexistence of these disorders have been postulated, i.e. as part of aging process, diabetes causes macrovascular and microvascular disease, renovascular stenosis which is enhanced by the development of hypertension. Insulin causes renal sodium reabsorption, stimulates the sympathetic nervous system, increases intracellular calcium, and is a vascular growth factor.Insulin resistance, hyperinsulinemia, impaired glucose tolerance, increased plasma triglyceride, and decreased HDL-cholesterol concentration have been shown to be associated with increased risk of coronary heart disease. Based upon these considerations, it raised the possibility that insulin resistance and hyperinsulinemia are involved in the etiology and clinical course of three major related disease; the type 2 diabetes mellitus, hypertension, and coronary heart disease.Key Words: hyperinsulinemia insulin resistance cardiovascular disease glucose homeostasis aging
Hypothyroidism in patient with Graves disease treated with antithyroid agent: A case report Ahmad H. Asdie Ahmad H. Asdie
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 25, No 02 (1993)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

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Abstract

The paper presented a case of hypothyroidism in patient with Graves disease after have long been treated with antithyroid agent. The cause of hypothyroidism in this case might be (1) the effect of anti-thyroid agent, (2) natural history of Graves disease as a result of autoimmune mechanism, and (3) coincidental presentation of Graves disease and condition causes hypothyroidism (hashitoxicosis).A 39 year old woman, household , admitted to Sardjito Hospital because of general fatigue and facial edema. She was previously treated as Graves disease with PTU (propylthiouracil) 100 mg 3 times 100 mg/day for 2 years. Because of allergic reaction against PTU, the drug was replaced by Neomercazol®. One year later the patient complaining body weight (BW) gain, with the laboratory investigation showed T3 = 0.78 µg/d1 (N: 0.6-1.9); T4 = 2436 µg/d1 (N: 45-100). Six months before admission she has not taken any drugs. On admission, BW 60 kg, other vital signs were in normal limits, palpebral edema, T3 = 0.3 itg/d1; Ta = 2.0 jig/d1; Total cholesterol 329 mg/dl; LDL-cholesterol 238 mg/dl; triglycerides 298 mg/d1; Anti-thyroglobulin 1/1280 (N: negative); anti-microsomal negative; other laboratory results revealed normal values. She was diagnosed as hypothyroidism post treatment of Graves disease. She was treated with Thyrax® 1 tablet daily, and one year later she was in a normal condition.All patients with Graves disease should be followed up regularly eventhough the clinical condition already subsided, since other autoimmune disease may coincidentally present.Key Words: hypothyroidism Graves disease hashitoxicosis antithyroid agents autoimmune disease
Management of myocardial infarction and the post-infarction patient Ahmad H. Asdie Ahmad H. Asdie
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 24, No 02 (1992)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

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Abstract

Acute myocardial infarction is the most common form of premature death in the industrial world. Its early recognition and active intervention are becoming important in the light of recent advances, particularly the use of streptokinase shortly after the onset of the infarct. Cardiopulmonary resuscitation (CPR) is important both inside and outside the hospital. General practitioners should be confident in performing both basic life support and advanced cardiac life support since the potential needs for resuscitation is becoming great.In semi-rural areas where the general practitioner is usually the first to be called for assistance, the use of advanced resuscitation and life support does save lives. The defibrillator is an essential piece of equipment for monitoring, diagnosis, management and treatment in these cases.Following myocardial infarction the family physician has a major role to play in rehabilitation and tertiary prevention by prescribing beta-blockers, starting within two weeks of the infarct.Key Words: myocardial infarction - premature death - CPR - streptokinase - defibrillator
Insulin receptor and insulin resistance in type -2 diabetes Ahmad H. Asdie Ahmad H. Asdie
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 24, No 02 (1992)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

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Abstract

Resistance to the glucoregulatory effects of insulin is well-documented in type -2, non-insulindependent diabetes. Two separate factors may contribute in the pathogenesis, namely the obesity-related and the non-obesity-related.Obesity-related insulin resistance is associated with hyperinsulinemia, reduced numbers of insulin receptors on target cells. The mechanism by which the insulin receptor number is decreaSed is not clearly understood. This phenomenon is called "down regulation". If the defect in glucose transport can not be overcome at any insulin concentration, insulin unresponsiveness is present. This is caused by unidentified abnormalities distal to the receptor, "postreceptor defect".In non-obesity-related, a-cell dysfunction, secretion of abnormal insulin, failure to convert proinsulin to insulin, or hormonal antagonist to insulin, is thought to be responsible for the resistance.Key Words: type -2 diabetes mellitus - insulin receptor - insulin resistance - insulin antagonist - obesity-related and non-obesity-related factors
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