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Effect of Glycemic Parameters on Mortality of Type 2 Diabetes Mellitus Patients with COVID-19 Infection in Haji Adam Malik Hospital Medan Pangaribuan, Jessica Patricia; Syafril, Santi; Lubis, Dian Anindita; Isnanta, Rahmad; Rey, Imelda
Journal of Society Medicine Vol. 2 No. 8 (2023): August
Publisher : CoinReads Media Prima

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47353/jsocmed.v2i8.81

Introduction: Diabetes Mellitus Type 2 (DM T2) is a major health problem, especially in people in developing countries. DM T2 is the most frequently reported comorbid disease in patients with COVID-19. The relationship between DM T2 and poorer outcome in COVID-19 infection is thought to be because hyperglycemia and chronic inflammation impair control of viremia and inflammation by weakening the immune response. This research aim to determine the effect of glycemic parameters on the mortality of DM T2 patients with COVID-19. Method: This research is a descriptive analytic study with a retrospective design which was carried out at the H. Adam Malik General Hospital in Medan. The data obtained was analyzed statistically and said to be statistically significant if p <0.05. Results: Based on the results of the study, there were significant differences in the values of inflammatory markers such as leukocytes, neutrophils, NLR, PCT, LDH, D-dimer, ferritin, SGOT, urea and creatinine in the severity of COVID-19 patients and there were significant differences in the mean fasting blood sugar, blood sugar 2PP, in moderate, severe and critical COVID-19 patients. Conclusion: Glycemic parameters in patients who died were worse than patients who recovered, although the statistical results were not significantly different.

A Case Report of a Giant Pheochromocytoma Lubis, Dian Anindita; Harahap, Agnes Stephanie; Em Yunir
Journal of Endocrinology, Tropical Medicine, and Infectious Disease (JETROMI) Vol. 2 No. 1 (2020): Journal of Endocrinology, Tropical Medicine, and Infectiouse Disease (JETROMI)
Publisher : TALENTA Publisher, Universitas Sumatera Utara

Pheochromocytoma is a rare catecholamine secreting tumor that are usually arise from adrenal medulla and produces signs and symptoms of excessive catecholamine secretion from tumor. A 32 years old female presented to the hospital, with dyspeptic symptoms. She had fluctuative hypertension, palpitation and sweating. Abdominal ultrasonography showed a right adrenal mass, and computed tomography of the adrenal glands confirmed a right adrenal mass. However, clinical biochemistry tests specific for pheochromocytoma was not performed. Laparoscopic right adrenalectomy was done and the adrenal tumor was excised. Histopathology and immunohistochemistry confirmed the diagnosis of adrenal pheochromocytoma; the tumor cells being positive for chromogranin, synaptophysin, S-100 protein, and inhibin. Following the surgery, the patient did well and showed full recovery at follow-up after 1 month.

The Differences of TNF-Î± Levels and BMI in Diabetic Patients with Pulmonary Tuberculosis After Intensive Phase of Tuberculosis Treatment Lydia, Wika; Nasution, Melati Silvanni; lubis, Dian Anindita; Muhammad Aron Pase
Journal of Endocrinology, Tropical Medicine, and Infectious Disease (JETROMI) Vol. 2 No. 2 (2020): Journal of Endocrinology, Tropical Medicine, and Infectiouse Disease (JETROMI)
Publisher : TALENTA Publisher, Universitas Sumatera Utara

Abstract. Introduction. Diabetes Melitus (DM) can cause complications, such as pulmonary tuberculosis (TB). Metabolic disorders are thought to be related to Tumor Necrosis Factor-Î± (TNF-Î±) metabolism, adipocytokines secreted by macrophages, which inhibit insulin transduction, has anti-mycobacterial activity, however, also negatively affect pathological TB process. This study aims to determine differences in TNF-Î± levels and Body Mass Index (BMI) in DM with pulmonary TB after intensive phase of antituberculosis treatment. Method. This prospective comparative analytical study with one-group pretest-posttest design, conducted during August 2019-September 2019 in outpatient of Type 2 DM with pulmonary TB at USU Hospital, Madani Medan Hospital, Teladan Health Center and Laboratory of Haji Adam Malik Medan after approval from the Health Research Ethics Commission. Data were analyzed after normality test, then mean difference and correlation test by using the SPPS program where p <0.05 was considered significant. Results. This study showed an increase BMI, and decrease of fasting blood glucose, 2-hour post-prandial blood glucose, HbA1C and TNFÎ± levels before and after intensive phase of antituberculosis treatment (p = 0,000; p = 0,000; p = 0,000; p = 0,000). Conclusion. There was a significant increase of BMI and decrease of TNFÎ± level after intensive phase of antituberculosis treatment.

Cardiometabolic Profile Screening as an Early Detection of Cardiometabolic Risk Sarastri, Yuke; Raynaldo, Abdul Halim; Ilyas, Kamal Kharrazi; lubis, Dian Anindita
Journal of Endocrinology, Tropical Medicine, and Infectious Disease (JETROMI) Vol. 4 No. 2 (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.v4i2.9156

Background:Â Cardiometabolic risk profile is a set of interconnected risk factors, namely abdominal obesity, hypertension, dyslipidemia, hyperglycemia, and hyperinsulinemia, and causes global death. This study was conducted to obtain data on cardiometabolic profiles of people who participated in the Commemoration of World Hypertension Day 2021 at RSUP H Adam Malik Medan Method:Â This research is a descriptive study with a cross-sectional research design peoples namely by looking at the description of the cardiometabolic profile. The sample is an affordable population that meets the inclusion criteria, people with age >18 years old. Variables of blood pressure, waist circumference, blood sugar levels, and total cholesterol levels are numerical variables. Blood pressure examination is measured using a sphygmomanometer and expressed in mmHg units. The measurement of the abdominal circumference is carried out by examining the size of the abdominal circumference obtained using a tape measure in cm. Blood sugar levels are obtained from the results of measuring blood sugar levels during laboratory examination of blood in mg/dl units. Cholesterol levels are obtained from the results of measuring total cholesterol levels from blood laboratory examinations in mg/dl.Â Results:Â All subjects in this study (n= 100) are 42 men and 58 women with normal waist circumference, and education level strata -1, only 9% of the subjects had high blood sugar levels, and 41% of subjects were classified as central obesity 9% of subjects. Most patients (91%) with normal postprandial glucose and high total cholesterol 66%. Conclusion:Â In this study, most of the cardiometabolic risks of patients are overweight/obesity and dyslipidemia

Correlation between Leptin and Free Testosterone Levels in Transfusion-Dependent Thalassemia Male Patients Lubis, Dian Anindita; Karina Sugih Arto; Heny Syahrini
Journal of Endocrinology, Tropical Medicine, and Infectious Disease (JETROMI) Vol. 5 No. 1 (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.v5i1.12159

Background: Male hypogonadism is a clinical disorder of low testosterone and spermatozoa due to impaired production that can occur at one or more levels in the hypothalamic-pituitary-gonadal (HPG) axis. Apart from iron accumulation, hypogonadism can also occur due to other mechanisms in thalassemia patients, such as the influence of adipose tissue and leptin. The study aimed to assess the relationship between leptin with free testosterone levels and BMI in transfusion-dependent thalassemia. Method: The research design chosen was analytic cross-sectional. The study was conducted at the adult thalassemia polyclinic of Cipto Mangunkusumo General Hospital and Fatmawati General Hospital, during the period July - December 2022. The samples used were male transfusion-dependent thalassemia patients aged over 18 years who were under control at the Thalassemia Polyclinic during the study period. The diagnosis of Thalassemia had been previously established by high-performance liquid chromatography (HPLC) or microcapillary examination. Result: Most patients were major ÃŸ thalassemia (87.8%), while HbE ÃŸ thalassemia was only 12.1%. Age distribution was with a median of 23 years (minimum-maximum 18-42 years). The clinical symptoms of hypogonadism were erectile dysfunction and decreased libido (12.1% and 9%, respectively). From body mass index examination were underweight 18 (54,5%), normal weight 13 (39,5%), overweight 1 (3%), and obese 1 (3%). Of the 33 transfusion-dependent thalassemia patients, 95% did not reach puberty according to their age (Tanner stage V). Conclusion: There is an association significantly between leptin levels with free testosterone and body mass index in transfusion-dependent thalassemia men.

The Association Between Lipid Profiles and Atherogenic Index with Diabetic Foot Severity According to the Wagner-Meggitt Classification at Adam Malik Hospital Wilonna, Almira; Pase, M Aron; Lubis, Dian Anindita
Journal of Endocrinology, Tropical Medicine, and Infectious Disease (JETROMI) Vol. 7 No. 1 (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.v7i1.18383

ABSTRACTIntroduction: Diabetic foot is a serious complication that leads to ulcers and amputations. Identifying risk factors, such as lipid profiles and atherogenic indices is crucial for prevention and treatment for cardiovascular disease and peripheral arterial disease. This study aims to investigate the relationship between lipid profiles and atherogenic indices with the severity of diabetic foot, categorized by the Wagner-Meggitt classification, at Adam Malik Hospital. Methods: This analytical observational study with cross-sectional design was conducted at Adam Malik Hospital, involving 70 diabetic foot patients. Data were collected from medical records, focusing on lipid profiles. Atherogenic indices were calculated as ratios: TC/HDL, TG/HDL, and LDL/HDL. The severity of diabetic foot was measured using the Wagner-Meggitt classification. Statistical analysis included Chi-square and Spearman's rho tests. Results: Of the 70 patients, most were aged 51-60 (41.4%), male (60%), and had normal BMI (57.1%). There was a significant correlation between diabetic foot severity and triglyceride levels (p=0.0002, r=0.358) as well as the TC/HDL ratio (p=0.02, r=-0.277). However, no significant relationships were found for total cholesterol (p=0.533), HDL (p=0.254), LDL (p=0.533), the TG/HDL ratio (p=0.158), or the LDL/HDL ratio (p=0.92). Discussion: In this study, 60% of the participants were male. The findings align with previous studies, demonstrating a correlation between elevated triglycerides and lipid profile abnormalities with the severity of diabetic foot ulcers. Conclusion: Triglycerides and the total cholesterol/HDL ratio are significantly associated with the severity of diabetic foot based on the Wagner-Meggitt classification. Keywords: diabetic foot; lipid profile; atherogenic index; Wagner-Meggitt

Hubungan Visceral Adiposity Index dengan Neuropati Diabetik Perifer pada Pasien Diabetes Melitus Tipe 2 Sanusi, Muhammad Arif; Lubis, Dian Anindita; Syafril, Santi
Jurnal Penyakit Dalam Indonesia
Publisher : UI Scholars Hub

Show Abstract | Download Original | Original Source | Check in Google Scholar

Introduction. Type 2 diabetes mellitus (T2DM) is the leading metabolic disease in Indonesia. Diabetic peripheral neuropathy (DPN), a major complication of T2DM, was associated with insulin resistance and adipose dysfunction. Visceral adiposity index (VAI) is a tool to measure visceral fat as the indicator of adipose dysfunction and insulin sensitivity. The association between VAI and DPN has not been widely researched, especially in Indonesia. This study aims to assess the association between them. Methods. This was a cross-sectional study conducted on adult patients (aged ≥18 years) with T2DM at H. Adam Malik General Hospital, Medan, from December 2024 to March 2025. DPN was assessed using the Michigan Neuropathy Screening Instrument (MNSI), consisting of a questionnaire (MNSI A) and physical examination (MNSI B). VAI was calculated using waist circumference, body mass index (BMI), triglyceride level, and high-density lipoprotein (HDL) cholesterol level. A bivariate analysis was conducted to compare mean VAI values between patients with and without DPN and to assess correlations between VAI and MNSI scores. Results. From a total of 80 subjects, the average age was 56 years (SD 9), and the majority were female (56.3%). The median VAI value in the DPN group was 2.863 (0.401–11.665), slightly higher than in the non-DPN group, which was 2.549 (0.781–17.414), but the difference was not statistically significant (p=0.34). No statistically significant correlation was found between VAI and MNSI A score (r=0.092; p=0.42) or MNSI B score (r=0.12; p=0.31). Conclusion. There was no significant association between VAI and DPN in patients with T2DM.

Role of Malondialdehyde Levels in The Occurrence of Hypogonadism in Transfusiondependent Thalassemia Male Patients Lubis, Dian Anindita; Nasution, Melati Silvanni; Lubis, Heny Syahrini; Pohan, Hafiza Humayra Prabisma
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.v6i4.16485

Male hypogonadism is a clinical syndrome resulting from the failure of the testes to produce adequate testosterone. Thalassemia major is an autosomal recessive disorder characterized by the absence or severe deficiency of the synthesis of the ÃŸ-globulin chain of hemoglobin that causes severe anemia requiring lifelong transfusions. Chronic blood transfusion in patients with ÃŸ-thalassemia leads to the accumulation of transfusion-associated iron in the tissues. Iron accumulation in the testes and pituitary gland generally leads to a state of hypogonadism. In patients undergoing repeated transfusions, there can be increased oxidative stress which can be assessed by examining malondialdehyde (MDA) levels. Increased oxidative stress can also affect a person's reproductive process through damage to pituitary tissue and LH hormones, which ultimately results in a decrease in a person's testosterone levels. Our aim is to see the correlation between malondialdehyde levels and free testosterone in male patients with transfusion-dependent thalassemia. This study used a cross-sectional design conducted at the Thalassemia polyclinic of RSCM and Fatmawati from January to March 2023. The study samples were transfusion-dependent thalassemia patients who met the acceptance criteria of the study subjects. Each patient underwent venous blood collection and was examined for serum ferritin levels, transferrin saturation, FSH levels, LH levels, free testosterone levels and MDA. The data obtained will be recorded and processed using the SPSS 20 program. Forty-one male subjects with transfusion-dependent thalassemia had a median free testosterone of 14.53 pg/mL (minimum-maximum 0.1-35.78). Twelve subjects (29%) of them had low testosterone levels. The median MDA level was 2.22 uM (0.18-2.61). There was no significant correlation between free testosterone and MDA (r=-0.18, p=0.261). There were high MDA levels in men with transfusion-dependent thalassemia. High MDA levels had no correlation with free testosterone in men with transfusion-dependent thalassemia.

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