Brama Ihsan Sazli
Endocrine, Metabolic And Diabetes Division, Department Of Internal Medicine, Faculty Of Medicine, Universitas Sumatera Utara, Medan, Indonesia

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Effect of Lifestyle Modification with Metformin on Serum Chemerin Concentration of Metabolic Syndrome Subjects Dharma Lindarto; Brama Ihsan Sazli
Journal of Endocrinology, Tropical Medicine, and Infectious Disease (JETROMI) Vol. 1 No. 1 (2019): Journal of Endocrinology, Tropical Medicine, and Infectiouse Disease (JETROMI)
Publisher : TALENTA Publisher, Universitas Sumatera Utara

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (313.702 KB) | DOI: 10.32734/jetromi.v1i1.1110

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Chemerin is adipokine that plays an important role in macrophage infiltration into adipose tissue and may contribute to inflammation development and insulin resistance. This study aimed to determine the effect of lifestyle modification with and without metformin on chemerin in metabolic syndrome. Forty-five metabolic syndrome subjects (IDF-2005) were randomly assigned to one of the two groups: placebo group (n=22) and metformin group (n=23). Both groups underwent a 12-week lifestyle modification (diet and moderate aerobic-exercise). Only 40 participants (placebo group n=20 and metformin group n=20) completed the survey whereas 5 participants dropped out of the study. After their lifestyle was modified, body weight, BMI, WC, and chemerin decreased significantly (p<0.001) in both groups. Moreover, there was a significant difference between both groups in body weight, BMI, and WC (p<0.05) but not for chemerin. Thus, lifestyle modification with metformin improved BW, BMI, WC on metabolic syndrome, and there was no decrease significantly of chemerin between placebo and metformin groups. Further investigations should be done to confirm the effect of lifestyle modification and metformin on chemerin after an extended follow-up period.
The Relationship Between Adma and Anthropometric, Glucose, Lipid, and Inflammatory Parameters in Obese Dharma Lindarto; Brama Ihsan Sazli
Journal of Endocrinology, Tropical Medicine, and Infectious Disease (JETROMI) Vol. 1 No. 1 (2019): Journal of Endocrinology, Tropical Medicine, and Infectiouse Disease (JETROMI)
Publisher : TALENTA Publisher, Universitas Sumatera Utara

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (292.51 KB) | DOI: 10.32734/jetromi.v1i1.1111

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Asymmetric dimethylarginine (ADMA) is an endogenous inhibitor of nitric oxideproduction and involved in various pathological processes, especially processes involvingcardiovascular risk. The purpose of this study was to analyze the correlation betweenADMA and anthropometric, glucose, lipid, and inflammatory parameters. The study wasanalyzed by a cross-sectional study of 45 obese subjects at H. Adam Malik Hospital. Bloodtests were carried out after 8-10 hours of fasting against cardiovascular risk: anthropometry(body weight, BMI, and WC), glucose (FPS, PPS, HbA1C, Fasting Insulin, and HOMA-IR), lipid (LDL-C, HDL-C, TG, and sd-LDL), and inflammation (ApoB and hs-CRP)parameters. The results showed of the 45 subjects, the average age was 41.69 ± 5.69 yearsold, and the average BMI was 33.09 ± 5.05 (Obesity I). ADMA was also found to becorrelated significantly with FPG, HBA1c, and TG parameters [r=-0.506, p=0.001; r=-0.334, p=0.013, dan r = -0.315. p=0.017, respectively]. In obesity, ADMA correlatedsignificantly with cardiovascular risk parameters: FPG, HbA1C, and TG.
Pituitary Macroadenoma with Apoplexy in an Adult: A Case Report Nasution, Fakhri Amin; Sazli, Brama Ihsan
Journal of Endocrinology, Tropical Medicine, and Infectious Disease (JETROMI) Vol. 2 No. 4 (2020): Journal of Endocrinology, Tropical Medicine, and Infectiouse Disease (JETROMI)
Publisher : TALENTA Publisher, Universitas Sumatera Utara

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (857.679 KB) | DOI: 10.32734/jetromi.v2i4.4909

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Abstract: Pituitary adenomas are the most common type and benign tumours arising from hormone expressing cells in the anterior pituitary gland. They account for 10% to 15% of all intracranial masses. Pituitary adenomas present clinically in three ways: syndromes of hormone hypersecretion or deficiency; neurologic manifestations from mass effect of an expanding gland; or an incidental finding on imaging done for an unrelated issue. A 49-years old man, was reffered to the hospital with symptoms of chronic headache and blurred vision. General physical examination revealed no abnormalities. History of previous illness and medication were unremarkable. MRI brain showed hyperintense lesion in suprasellar/selllar area. Hormone assay reciprocally revealed hypocortisolism and hyperprolactinemia. Abstrak: Adenoma hipofisis merupakan tumor jinak tersering dari sel penghasil hormon di kelenjar hipofisis anterior, berkisar 10%-15% dari seluruh massa intrakranial. Adenoma hipofisis secara klinis bermanifestasi dalam tiga cara: sindrom hipersekresi atau defisiensi hormon; manifestasi neurologis dari efek massa yang membesar; atau temuan secara tidak sengaja pada modalitas pencitraan. Seorang laki-laki berumur 49 tahun dirujuk ke rumah sakit dengan kkeluhan sakit kepala kronik dan pandangan kabur. Pemeriksaan fisik secara umum dalam batas normal. Riwayat penyakit sebelumnya atau pengobatan juga tidak spesifik. MRI otak menunjukkan lesi hiperintens pada area suprasellar/sellar. Temuan pemeriksaan hormon juga sejalan menunjukkan hipokortisolisme dan hiperprolaktinemia.
Pituitary Macroadenoma Manifesting As Acromegaly: A Case Report Dian Primadia Putri; Sazli, Brama Ihsan
Journal of Endocrinology, Tropical Medicine, and Infectious Disease (JETROMI) Vol. 3 No. 1 (2021): Journal of Endocrinology, Tropical Medicine, and Infectiouse Disease (JETROMI)
Publisher : TALENTA Publisher, Universitas Sumatera Utara

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (558.432 KB) | DOI: 10.32734/jetromi.v3i1.5482

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Background: Acromegaly is an uncommon clinical disorder driven by high serum levels of growth hormone (GH) and insulin-like growth factor 1 (IGF-1). Over 99% of patients with acromegaly harbor a GH emitting pituitary adenoma. Pituitary tumors represent about 15% of essential intracranial neoplasms. Case presentation: A 38 years old woman, was referred to the H. Adam Malik central public hospital on December 15th, 2020, with chief complaints of enlarged fingers and toes. The patient complained that the patient's fingers and toes were getting bigger in the past 2 years. The brain MRI was performed showed intrasella spherical intensity lesions measuring ± 2.3x1.5x2 cm with the impression of macroadenoma. The patient later diagnosed with acromegaly due to pituitary macroadenoma. Therefore the patient was treated with administration of sandostatin injection, novorapid 6-6-6 IU SC, then 0-0-12 IU SC, 3x1 salt capsules. The patient is also consulted to the neurosurgery department for surgical management plans and a consulted to the Ophthalmology Department. Conclusion: We report an instance of acromegaly suspected because of pituitary macroadenoma in a patient with unmistakable clinical highlights, with comprehensive management.
The Correlation Between Grade of Non-Alcoholic Fatty Liver Disease and Lipid Profile in Type 2 Diabetes Mellitus Siregar, Hafiz Syaifullah; Brama Ihsan Sazli
Journal of Endocrinology, Tropical Medicine, and Infectious Disease (JETROMI) Vol. 4 No. 1 (2022): Journal of Endocrinology, Tropical Medicine, and Infectious Disease (JETROMI)
Publisher : TALENTA Publisher, Universitas Sumatera Utara

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32734/jetromi.v4i1.8488

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Background. Non-alcoholic fatty liver disease (NAFLD) is a form of metabolic liver disease in which fat changes (steatosis) are associated with lobular inflammation, hepatocyte injury, polymorphs, or liver fibrosis. The study aimed to assess the relationship between NAFLD grades and lipid profiles in T2DM.Method. The design of the study was cross-sectional with the dependent variable being the grade of NAFLD and the independent variable being profile lipid. The sample of this study was NAFLD sufferers who met the inclusion criteria and were taken on a consecutive sampling basis. Diagnosis of NAFLD from anamnesis and physical, examination. Laboratory and abdominal ultrasound (Sonata SG 30 Ultrasound). Stages of NAFLD are divided into Degree I, Degree II, and Degree III. Lipid profile examination is carried out using a spectrophotometer tool colorimetric enzymatic method.Result. All patients are T2DM, consisting of Grade 1: 32 (40%), Grade II: 29 (36%), and Grade III: 19 (23%) patients. There was a significant difference between TC, TG, and LDL-C (p < 0.01) in the three grades of NAFLD. There is a significant correlation between NAFLD grade with TC and LDL-C (p < 0.05).Conclusion. In T2DM, there is a significant correlation between NAFLD grades and TC and LDL-C, and there was a significant difference between TC, TG, and LDL-C in the three grades of NAFLD.
Correlation between Low-Density Lipoprotein Cholesterol and Certain Lipid Profiles in The Treatment of Bay Leaf Extract (Syzgium Polyanthum (Wight) Walp) to Dyslipidemia Patients Nasution, Melati Silvanni; Brama Ihsan Sazli; Santi Syafril
Journal of Endocrinology, Tropical Medicine, and Infectious Disease (JETROMI) Vol. 5 No. 2 (2023): Journal of Endocrinology, Tropical Medicine, and Infectious Disease (JETROMI)
Publisher : TALENTA Publisher, Universitas Sumatera Utara

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32734/jetromi.v5i2.12244

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Background: The use of herbal medicine has long been practiced throughout the world, and the production and processing of herbal medicines are constantly being improved to treat various diseases. The aim of this study was to assess the correlation between low density lipoprotein cholesterol and certain lipid profiles in the treatment of bay leaf extract (syzgium polyanthum (wight) walp) to dyslipidemia patients. Method: We recruit dyslipidemia patients, and the search project was given an explanation and asked to give written consent (informed consent) to participate in the research. Then anamnes is carried out and examination:measurement of BMI, measurement of weist circumference, after being satisfied for 10-12 hours, the patient then took blood samples by the laboratory, to examine hs-CRP levels, lipid profiles (total cholesterol, LDL cholesterol, HDL cholesterol and triglycerides), routine blood, kidney function (ureum, creatinine). Blood samples is taken before and after 30 days study. Bay leaf extract 150 mg is taken two times perday . Result: Subjects who participate of the study were 15 peoples as a treatment group and ages 47.47±11,507 years old. There is signifikant differences in cholesterol total, LDL-C and Apo=B (all, p < 0,01). There is a correlation between LDL-C and Total Cholesrerol, Triglyceride, FPG and Apo-B (all, p < 0.05). Conclusion: In this study, bay leaf administration 2x150 mg for 30 days, improved lipid profiles of total cholesterol, LDL, and ApoB in dyslipidemic patients. Bay leaf extract administration has the potential to prevent and improve cardiovascular disease in dyslipidemic patients
Demography and Clinical Characteristic COVID-19 with Diabetes Mellitus at the Universitas Sumatera Utara Hospital Mikhael Kurnia S.J. Situmorang; Brama Ihsan Sazli
Journal of Endocrinology, Tropical Medicine, and Infectious Disease (JETROMI) Vol. 4 No. 3 (2022): Journal of Endocrinology, Tropical Medicine, and Infectious Disease (JETROMI)
Publisher : TALENTA Publisher, Universitas Sumatera Utara

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32734/jetromi.v4i3.12709

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Background: COVID-19 is a disease caused by a virus called SARS-CoV-2. COVID-19 can infect almost all age groups, however, the elderly and those with co-morbidities such as diabetes mellitus can get worse complications from COVID-19. The study aims to find out the demographics and clinical characteristics of COVID-19 patients with diabetes mellitus treated at the Universitas Sumatera Utara Hospital. Method. This research is a descriptive study using retrospective data. The data used is secondary data taken from medical records. The number of samples that met the inclusion criteria was 37 people. Results. The majority of patients were dominated by the age group of 46-65 years (56.8%) and males (54.1%). The predominating clinical characteristics of COVID-19 with diabetes mellitus are cough (70.3%), shortness of breath (59.5%), and fever 51.4%. There was an increase in the laboratory results of COVID-19 patients with diabetes mellitus on blood sugar levels at admission, HbA1c, urea, creatinine, SGOT, SGPT, and d-dimer levels. The most treatment results were recovered by as many as 24 people (64.9%). Conclusion. The majority of patients are in the age group of 46-65 years and are male. The most common clinical characteristic is cough and there is an increase in laboratory results in patients
The Association Between Stress Hyperglycemia Ratio (SHR) and Cardiovascular Event in Acute Coronary Syndrome Patients at Adam Malik Hospital Siregar, Anisafitri; Nasution, Melati Silvanni; Sazli, Brama Ihsan
Journal of Endocrinology, Tropical Medicine, and Infectious Disease (JETROMI) Vol. 7 No. 2 (2025): Journal of Endocrinology, Tropical Medicine, and Infectious Disease (JETROMI)
Publisher : TALENTA Publisher, Universitas Sumatera Utara

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32734/jetromi.v7i2.19443

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Introduction: Acute hyperglycemia in patients with acute coronary syndrome (ACS) has been associated with major adverse cardiovascular events (MACE). The stress hyperglycemia ratio (SHR) is considered a potential marker for predicting MACE in ACS patients. This study aims to evaluate the relationship between SHR and MACE among ACS patients at Adam Malik Hospital, Medan. Methods: This study employed a retrospective analytic design by collecting data from the medical records of ACS patients treated at Adam Malik Hospital, Medan, during 2022–2023. Inclusion criteria included: confirmed ACS patients (who underwent coronary angiography), while exclusion criteria were: patients with an E-GFR <30 ml/min and those with malignancies, liver diseases, hematological disorders, or infections (sepsis). The chi-square test was used to evaluate the relationship between variables, with a p-value <0.05 considered statistically significant. Results: A total of 100 ACS patients met the study criteria, with an average age of 59 ± 10.3 years, and 78% were male. The mean SHR among the study subjects was 1.09 ± 0.36. MACE was recorded in 64% of patients, including heart failure in 44%, rehospitalization in 12%, stroke in 9%, and mortality in 31%. SHR was found to have a significant relationship with overall MACE (p <0.001) and heart failure events (p = 0.001). However, no association was found between SHR and stroke, rehospitalization, mortality, or 3-point MACE (p >0.05). Conclusion: SHR has a significant relationship with MACE but not with 3-point MACE.
HYDROGEL-BASED WOUND DRESSING IN THE TREATMENT OF DIABETIC FOOT ULCERS: A NARRATIVE REVIEW Sembiring, Faisal Rozi; Sazli, Brama Ihsan
Journal of Endocrinology, Tropical Medicine, and Infectious Disease (JETROMI) Vol. 6 No. 4 (2024): Journal of Endocrinology, Tropical Medicine, and Infectious Disease (JETROMI)
Publisher : TALENTA Publisher, Universitas Sumatera Utara

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32734/jetromi.v6i4.17208

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ABSTRACTBackground: The aim of this case study is to determine the effectiveness of hydrogel-based wound dressing (HBWD) in the treatment of diabetic foot ulcer (DFU) in diabetic patients.Methods: Method in this case study is evidence-based case report. The clinical question used: Are HBWDs effective in the treatment of DFU, especially in the limited-resources healthcare facilities? To answer this question, we search the evidence from PubMed, Cochrane Database, Semantic Scholar, and Google Scholar with various keywords based on the clinical question. The studies were selected based on pre-determined inclusion and exclusion criterias and were critically appraised.Results: Four randomized controlled trials (RCTs) that met the inclusion and exclusion criterias were found. There are no significant difference in reduction of ulcer area (RUA) rate or complete wound closure (CWC) rate in all RCTs. When compared to control or non-hydrogel group, three studies reported some favoring aspect in HBWD group, such as less inflammatory signs and faster CWC mean time. Conclusion: HBWDs are recommended in the treatment of DFU because they are widely available, cost-effective, and relatively easy to use.