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Ahmad H. Asdie Ahmad H. Asdie
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Association ofIgpertension with diabetes mellitus Ahmad H. Asdie Ahmad H. Asdie
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 24, No 01 (1992)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

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Abstract

The clinical impression of association between hypertension and diabetes mellitus has not been consistently confirmed by epidemiological studies. The variety of methodological problems in this area of research includes the choice of appropriate patients and control group, the measurement techniques used, and consideration of many possible confounding variables.Hypertension in diabetes mellitus patients contributes substantially to the increased cardiovascular morbidity and mortality, and should be actively treated as accurately as diabetes mellitus itself. The first therapeuticstep is reduction of overweight, saltintake, and stopsmoking; the omission of interfering drugs and adequate education. Prescription of diuretic drugs or alternatively of calcium antagonists, vasodilators of hydralazin or prazosin. The adds of minoxidil or cap topril to the previousdrugsshouldonlybe taken after evaluation of the overall situation. It should be kept in mind that all anti-hypertensive agents have disadvantages, some of them serious, when used for diabetic patients Key Words: diabetes mellitus - hypertension - cardiovascular mortality - anti-hypertensive treatment - overweight
The management of hyperlipidemia Ahmad H. Asdie Ahmad H. Asdie
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 23, No 03 (1991)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

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Abstract

In terest in hyperlipidemia is related to its role in atherogenesis. The connection between bloodcholesterollevels and varibus manifestations of coronary heart disease has long been apparent.However, proof that this connecton is causal has been more elusive. For particular subpopulations it has been demonstrated that lowering elevated cholesterol levels can lead to fewer coronary heart disease events; this provides strong evidence of a causal relationship which can furthermore be favourably influenced.The significant lipid element contributing of plaque formation appears to be low density lipoprotein cholesterol, but its derivation in plaques in quite complicated. Low density lipoprotein and possibly intermediate density lipoprotein, with a somewhat lower cholesterol content, are known to enter sub-in finial spaces directly and they may do so in association whit cellular migration. Locally produced endothelial-derived relaxing factor.Despite the massive study on the subject of lipids, atherogenesis and its complications, much of our therapeutic endeavour still relates to hypothesis rather than established facts based on observations in humans. Key Words: hyperlipidemia - lipoproteins diet - physical exercise - antilipidemic drugs
The genetics of diabetes mellitus Ahmad H. Asdie Ahmad H. Asdie
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 22, No 02 (1990)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

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Abstract

It is now clear that diabetes mellitus is not a disease in classical sense but is a genetically heterogeneous group of disorders which share glucose intolerance in common. Genetic heterogeneity, the concept that diabetes can have many different causes, was first suggested by the existence of rare genetic syndromes with diabetes, ethnic differences of clinical features, and genetic heterogeneity in animal models.This paper describes the background for genetic heterogeneity of diabetes mellitus which has major implications for the research and care of diabetic patients since the precise etiology, risk of complications and genetic counselling are likely to vary among these different disorder that result in diabetes.Key Words: diabetes mellitus - genetic heterogeneity - mode of inheritance - genetic counselling - antoinunune process
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 : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

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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 individual's 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.
Diagnosis dan Kelasifikasi Diabetes Mellitus Ahmad H. Asdie Ahmad H. Asdie
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 20, No 02 (1988)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

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Abstract

This paper presented the main recommendations for the definition and classification.of diabetes mellitus and of impaired glucose intolerance in non-pregnant adults.Diabetes mellitus is not a disease in the classical sense but is more probably a syndrome best characterized as a state of chronic hyperglycemia of various etiology. It may present with acute symptoms that include polyuria, polydipsia and unexplained weight loss and these can progress to life threatening ketoacidosis or hyperosmolar coma. Chronic hyperglycemia may be asymptomatic, but it has long been recognized as a predisposing factor for specific microvascular complications, namely neuropathy, retinopathy and nephropachy.Blood glucose concentration is the most common, variable used to define diabetes mellitus, but the increased blood glucose is not the sole pathological manifestation, nor has it been proved beyond doubt to be first in the pathological sequence. The limit between physiological and pathological values of blood glucose concentration is still debatable. An area of particular difficulty is the evaluation of situation that are near the physiological limit.New criteria for the diagnosis of diabetes mellitus and other catagories of glucose intolerance have been developed by National Diabetes Data Group (1979) and these have been endorsed by World Health Organization in 1980 and revised in 1985.Key Words: diabetes mellitus — target screening — chronic hyperglycemia — glucose intolerance -- hyperosmolar coma
Diabetes Mellitus dan Sulfonilurea Ahmad H. Asdie Ahmad H. Asdie
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 21, No 01 (1989)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

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Abstract

Diabetes mellitus characterized by increased blood glucose level (hyperglycemia) is currently recognized to be a heterogenous disorder. Although there has been general acceptance of the classification adopted by WHO Expert Committee on Diabetes Mellitus in 1980, the WHO Study Group revised the classification in 1985. The most important change from the previous classification is the appearance of malnutrition-related diabetes mellitus as a major subclass, ranking with IDDM (insulin-dependent diabetes mellitus) or type I diabetes mellitus and NIDDM (non-insulin- dependent diabetes mellitus) or type II diabetes mellitus.Sulfonylurea orally administered hypoglycemic agents have been used in the treatment of NIDDM for more than 30 years. Despite this fact, the mechanism responsible for hypoglycemic action of sulfonylurea agents remains controversial. Sulfonylureas are now generally thought to act by improving both the ability of pancreatic islets to secrete insulin and the response of tissues to insulin. There are two kinds of sulfonylureas, so-called first•generation sulfonylureas (tolbutamide and chlorpropamide) and second-generation sulfonylureas (glybenclamide, glyclazide, glypizide, and glyquidone), now available in Indonesia. The indications, contraindications, and guidelines for the use of these agents, as well as their mechanisms of action and the differences among them, are reviewed in this article.Key Words: classification of diabetes mellitus - sulfonylureas - hyperglycemia - malnutrition -- insulin
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 : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

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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 : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

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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
The innocent murmurs Ahmad H. Asdie Ahmad H. Asdie
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 13, No 02 (1981)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

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Abstract

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
Dengue Hemorrhagic Fever in adolescents and young adults in the Department of Internal Medicine, Gadjah Mada Ahmad H. Asdie Ahmad H. Asdie
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 5, No 02 (1973)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

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Abstract

A short history of Dengue, the etiology of Dengue Hemorrhagic Fever and the vectors are reviewed. A classification and nomenclature for diseases suspected to be of dengue or chikungunya virus etiology, as suggested by WHO is given.Six cases and two additional cases of Dengue Hemorrhagic Fever in adolescents and young adults are reported.The bone marrow findings in our cases compared with those found in the literature.The pathogenesis of Dengue Hemmorrhagic Fever is reviewed in short.
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