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Lipid Profile in Confirmed Covid-19 Patients with Type 2 Diabetes Mellitus At Haji Adam Malik General Hospital Medan from March 2020 to December 2021 Sitepu, Annisa Nidya Rahmatika; Lindarto, Dharma; Nasution, Melati Silvanni
Journal of Society Medicine Vol. 2 No. 3 (2023): March
Publisher : CoinReads Media Prima

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47353/jsocmed.v2i3.37

Introduction: Diabetes can cause secondary hyperlipidemia. In COVID-19, dyslipidemia is thought to be the result of biological and pathological processes triggered by SARS-CoV-2. Altered lipid profiles have been reported since the beginning of the COVID-19 pandemic, where the alteration of lipid profile and the severity of SARS-CoV-2 infection were positively correlated. This study aims to analyze the lipid profile in confirmed COVID-19 patients with T2DM at H. Adam Malik General Hospital Medan. Method: This was a descriptive study with a cross-sectional design using a total sampling technique by collecting secondary data on inpatients with confirmed COVID-19 with T2DM at H. Adam Malik General Hospital from 2020 to 2021 which was then analyzed using the SPSS version 25 application. Results: Of the 372 subjects, the most common sex was male (57.3%), 193 people had a BMI of 18.5 - 24.9kg/m2 (51.9%), the mean overall age was 57.5 ± 10.4 years, and the median length of stay was 8 days. The most common comorbid was hypertension (n=189, 50.8%), 176 people had severe COVID-19 (47.3%), and 225 patients were discharged (60.5%). Based on laboratory data, 327 people had dyslipidemia (87.9%), 31 people had mild acute liver impairments (8.3%), the average of HbA1c was 9.0±2.5%, the average fasting blood glucose was 221.7±122.2 mg/L, the average 2 hours post-prandial blood glucose was 261.7±125.8 mg/L, an average of total cholesterol was 151.2±52.2 mg/L, an average of triglycerides was 147.5±99.1 mg/L, an average of HDL was 33.1±14.6 mg/L, an average of LDL was 97.4±44.5 mg/L, the median of ALT was 25 μ/L, and an average of AST was 30.45±27.42 μ/L. Conclusion: Total cholesterol, triglyceride, and LDL were lower in T2DM patients with a critical illness of COVID-19 and patients who died.

The Differences of TNF-α 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-α (TNF-α) 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-α 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 TNFα 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 TNFα level after intensive phase of antituberculosis treatment.

Correlation Between Duration Of Protease Inhibitor Therapy With Insulin Resistance In HIV Patients Nasution, M. Arif Habibi; Nasution, Melati Silvanni; Dian Anindita Lubis
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 Metabolic diseases related to Human Immunodeficiency Virus (HIV) caused an increase in the workload of health services. Prevalence of HIV infection in Indonesian provinces varied considerably, ranging from less than 0.1% to 4%. Several studies have analyzed the correlation between insulin resistance and the usage of antiretroviral drugs, especially protease inhibitors. The main mechanism that responsible for insulin resistance is related to glucose transporter inhibition (GLUT4). This study objective is to assess the correlation between prolonged administration of protease inhibitors and insulin resistance in patients with that have diagnosed with HIV. Method. This research is an observational research using a cross-sectional design. The study was carried at the POSYANSUS Polyclinic at H. Adam Malik General Hospital in August - December 2019. The study sample were 34 HIV-treated patients receiving protease inhibitor ARV therapy. The study was analysed using chi square. Results. The characteristics of the study subjects had the most frequent age range at the age of 34 - 49 years (54.3%), men (71.4%) and women (28.6%). The longest use of antiretroviral drugs is most in the 6-12 months group (60%). Insulin resistance number in this study was 13 people (37.1%). The average HOMA-IR value of the study subjects was 2 (0.8-16.5), fasting blood sugar levels were 86 (70-283) mg / dl, fasting insulin levels were 9.1 (4.1-79.4) (µU / ml)., urea levels of 20.88 ± 9.7 mg / dl and creatinine levels of 0.81 ± 0.15 mg / dl. There was a significant correlation between the duration of ARV treatment with insulin resistance (p = 0.018; OR 7.65) Conclusion. There is a significant correlation between the duration of ARV treatment with insulin resistance. The longer Protease Inhibitor was used, the bigger insulin resistance.

Osteogenesis Imperfecta : A Case Report Hastopraja, Ressy; Nasution, Melati Silvanni
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.v4i2.8915

ABSTRACT Background: Osteogenesis imperfecta (OI) comprises a heterogeneous group of diseases characterized by susceptibility to bone fractures with variable severity and, in most cases, with presumed or proven defects in collagen type I biosynthesis and an estimated prevalence of 1/15,000 births. Management is multidisciplinary involving mainly surgery, physiotherapy, and rehabilitation Case Presentation: A young woman the age of 19 years old came to the Endocrine Polyclinic of H. Adam Malik Hospital, with a complaint of a fracture of the arm and left thigh for 4 years due to a slip. Since a small age, there was difficulty walking due to the twisted bones of the limbs, and surgery was performed. The conclusion of X-ray of right and left femur bones according to the description of osteogenesis imperfecta accompanied by a picture of fracture and osteomalasia and the conclusion of the whole body scan: pathological picture in the bones can be caused by osteogenesis imperfecta. Conclusion: A young woman the age of 19 years old has been reported may have OI type 1, management is multidisciplinary involving mainly surgery, physiotherapy, and rehabilitation.

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

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

Relationship Between Micronutrient Ferritin, Vitamin D, And Calcium With The Severity Of Diabetic Foot Based On The Wagner-Meggitt Criteria At Adam Malik Hospital Amalia Puspita Dewi; Mardianto; Nasution, Melati Silvanni
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

Background: Diabetic foot is a significant complication for Type 2 Diabetes Mellitusâ€™s (T2DM) patients. Previous studies have linked diabetic foot to micronutrients such as ferritin, vitamin D, and calcium, but there have been no follow-up studies in Medan. Objective: This study aimed to analyze the relationship between levels of ferritin, vitamin D, and calcium with the severity of diabetic foot, as measured by the Wagner-Meggit criteria, in T2DM patients at Adam Malik Hospital. Method: A cross-sectional study with 48 T2DM patients at Adam Malik Hospital from December 2022 to December 2023. Micronutrient levels were measured, and the severity of diabetic foot was assessed using the Wagner-Meggitt classification. Result: The majority of participants (64.6%) were female. High ferritin levels were observed in 91.6% of patients, while 93.75% had low levels of calcium and vitamin D. Bivariate analysis revealed no significant correlations between ferritin, corrected calcium, or vitamin D levels and Wagner grades 2-5 (p=0.515, p=0.646, p=0.377, respectively). Non-parametric correlation analysis showed significant relationships between corrected calcium (p=0.022) and vitamin D (p=0.027) with Wagner grades. Discussion: Among the 48 subjects, bivariate testing found that ferritin levels above 150 ng/ml were not linked to diabetic foot severity. Low calcium levels (below 8.5 ng/dl) were significantly associated with increased severity of diabetic foot (p < 0.03). 93.75% of participants had low vitamin D levels, which also correlated significantly with foot severity (p=0.027). Conclusion: The study concluded that calcium and vitamin D levels correlate with the severity of diabetic foot, whereas ferritin levels do not.

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

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.

Determinants of Frailty Status in Elderly Patients with Permanent Pacemakers at Adam Malik Hospital, Medan Irawan, Raja Alfian; Ariestine, Dina Aprilia; Lubis, Anggia Chairuddin; Sungkar, Taufik; Nasution, Melati Silvanni
Journal of Society Medicine Vol. 4 No. 8 (2025): August
Publisher : CoinReads Media Prima

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.71197/jsocmed.v4i8.229

Introduction: Frailty is highly prevalent among elderly patients following permanent pacemaker implantation, with rates exceeding 70%. The Comprehensive Geriatric Assessment (CGA) evaluates frailty through domains such as nutrition (Mini Nutritional Assessment, MNA), comorbidities (Charlson Comorbidity Index, CCI), functional status (Barthel Index), cognition (Mini Mental State Examination, MMSE), mood (Geriatric Depression Scale, GDS), quality of life, polypharmacy, and pacemaker implantation duration, alongside sociodemographic factors like age and sex. Identifying factors influencing frailty is essential for optimizing outcomes and quality of life in this population. Methods: This cross-sectional study included patients aged ≥60 years with permanent pacemakers attending the Arrhythmia Clinic at Adam Malik Hospital, Medan, from October to December 2024. Frailty was assessed using the CGA. Bivariate analyses employed Fisher’s exact test and chi-square tests to evaluate associations between frailty scores and variables including MNA, CCI, Barthel Index, MMSE, GDS, quality of life, polypharmacy, implantation duration, age, and sex. Multivariate logistic regression was used to identify significant predictors of frailty. Results: Of 62 participants, 62.9% were aged 60–74 years. Bivariate analysis revealed that 58.1% of malnourished patients (per MNA) were frail (p<0.008), and 94.1% of those on polypharmacy regimens were frail (p<0.001). Multivariate analysis identified polypharmacy as the only significant predictor of frailty (OR 14.0; 95% CI 2.186–89.675). Conclusion: Nutritional status and polypharmacy are associated with frailty in elderly pacemaker patients, with polypharmacy showing a significant independent effect. Targeted interventions addressing polypharmacy may improve frailty outcomes in this population.

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