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Journal : Universa Medicina

Type IV collagen as marker of fibrosis in nonalcoholic liver disease Alvina, Alvina
Universa Medicina Vol 29, No 2 (2010)
Publisher : Faculty of Medicine, Trisakti University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2010.v29.114-122

Abstract

Currently nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH) are medical problems associated with the increasing prevalence of diabetes mellitus, obesity, hypertension and hypertriglyceridemia, usually designated as the metabolic syndrome associated with insulin resistance. One study demonstrated an increase in NAFLD prevalence of around 17-33% and in NASH prevalence of 5.7-16.5%. NAFLD comprises a range of mild to severe conditions, from simple steatosis to steatohepatitis, hepatic fibrosis and cirrhosis. The diagnosis of hepatic fibrosis is important for prognosis, stratification for treatment, and monitoring of treatment efficacy. Ultrasonography (USG) is a simple method for detecting fatty infiltrates in the liver. USG has a sensitivity of 82-89% and a specificity of 93%, but cannot differentiate between hepatic steatosis and fibrosis. The gold standard for evaluation of hepatic fibrosis is liver biopsy, which however is a painful and invasive procedure. Currently determination of serum type IV collagen has been suggested as an alternative to liver biopsy among the non-invasive methods for evaluation of hepatic fibrosis, as its serum concentration is closely correlated with advanced hepatic fibrosis in NASH. Type IV collagen is one of the components of basement membrane and its serum concentration is indicative of degradation of the extracellular matrix.
Hepatic enzyme concentrations as indicators of nonalcoholic fatty liver disease Alvina, Alvina
Universa Medicina Vol 28, No 3 (2009)
Publisher : Faculty of Medicine, Trisakti University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2009.v28.139-145

Abstract

Nonalcoholic fatty liver disease (NAFLD) has emerged as a world-wide problem because it runs an asymptomatic course, ultimately leading to cirrhosis of the liver and portal hypertension, resulting in death. The prevalence of the disease accounts for 3-24% of the population in several countries. Generally there are increased concentrations of hepatic enzymes as markers of liver damage, such as serum glutamic oxaloacetic transaminase (SGOT), serum glutamic pyruvic transaminase (SGPT) and gamma glutamyl transferase (GGT). The aim of the present study was to determine the concentrations of hepatic enzymes as markers of NAFLD. The study design was cross-sectional, involving 90 subjects meeting the inclusion and exclusion criteria. The degree of severity NAFLD was determined by ultrasonography and the concentrations of SGOT, SGPT and GGT by automated clinical chemistry analyzer. The results indicated that there were 32 subjects with mild NAFLD (35.6%), 35 subjects with moderate NAFLD (38.9%) and 23 subjects with severe NAFLD (25.6%). There was a significant difference in degree of NAFLD by gender (p<0.05), where severe NAFLD was more frequent in males than in females. Concentrations of SGOT, SGPT and GGT were significantly different between degrees of NAFLD (p<0.05). The conclusion is that SGOT, SGPT and GGT concentrations are indicators of degree of NAFLD.
Idiopathic thrombocytopenic purpura: laboratory diagnosis and management Alvina, Alvina
Universa Medicina Vol 30, No 2 (2011)
Publisher : Faculty of Medicine, Trisakti University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2011.v30.126-134

Abstract

Idiopathic thrombocytopenic purpura (ITP) or immune thrombocytopenic purpura is a disease characterized by low platelet count (<150,000/ìL) caused by autoantibody-mediated platelet destruction and the absence of other causes of thrombocytopenia. Acute primary ITP is more common in children 2-6 years of age, with similar incidence between males and females, while the chronic form is usually encountered in adults with median age of 40-45 years. The clinical signs of ITP are purpura, ecchymosis, petechiae and gastrointestinal tract bleeding, gingival bleeding, epistaxis, and urinary tract bleeding. Spontaneous mucosal, intracranial, and gastrointestinal hemorrhage may occur at platelet counts of <10000/ìL. To date, the diagnosis of ITP is still arrived at by exclusion, i.e. by elimination of other causes of thrombocytopenia. The diagnosis of ITP also requires a medical history (anamnesis), physical examination, platelet count, and examination of a peripheral blood smear. The latter examination in ITP shows low numbers of normal-sized platelets, occasionally also giant platelets, while erythrocytes and leukocytes have a normal morphology. The bone marrow is usually normal or shows increased megakaryocytes. Assessment of antithrombocyte antibody may assist in establishing the diagnosis of ITP. Management of ITP is based on platelet count and severity of bleeding. Treatment is aimed at interfering with antibodies that damage the platelets, by inhibiting the functions of macrophage Fcã receptors and decreasing the production of antiplatelet antibodies. Thrombopoietin (TPO) receptor agonists including eltrombopag and romiplostim have offered an important new option in treating ITP.
Heavy mental workload increase poor sleep quality in informal garment workers Merijanti, Lie T; Pusparini, Pusparini; Meiyanti, Meiyanti; Alvina, Alvina; Sudharma, Novia I; Tjahjadi, Muljadi
Universa Medicina Vol 38, No 3 (2019)
Publisher : Faculty of Medicine, Trisakti University

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (687.632 KB) | DOI: 10.18051/UnivMed.2019.v38.202-208

Abstract

Background Sleep is needed by the human body so that the performance of body remains optimal when the body is awake, especially during work. Informal workers often work without clear regulations, with inadequate equipment and poor work environment, and pay little attention to occupational health and safety factors. The existence of large work demands with unclear work system arrangements will certainly result in a mental workload in these workers. The objective of this study was to determine the relationship between mental workload and sleep patterns of workers in the informal garment sector. MethodsA cross-sectional study involving 225 informal garment workers was conducted between December 2018 and May 2019. Data collection included respondents’ demographics, job characteristics, measurement of mental burden and disturbances in sleep patterns. The sleep pattern used the PSQI (Pittsburgh Sleep Quality Index) instrument and the mental burden used the Rating Scale Mental Effort (RSME). A multiple linear regression analysis was used to analyze the data. ResultsThe mean sleep quality was 5.40 ± 2.54. Multiple linear regression test found that mental workload correlated significantly with sleep quality of workers (β=0.016, p=0.012).ConclusionThis study demonstrated that heavy mental workload decreases the quality of sleep in informal garment workers. A good work system management is required so that workers are assigned that portion of the task that is commensurate with their capacity.