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All Journal International Journal of Public Health Science (IJPHS) Jurnal Gizi dan Pangan BALI MEDICAL JOURNAL (BMJ) journal of internal medicine INDONESIAN JOURNAL OF BIOMEDICAL SCIENCES E-Jurnal Medika Udayana Jurnal Veteriner Journal of Biomedicine and Translational Research WMJ (Warmadewa Medical Journal) The Indonesian Biomedical Journal Public Health of Indonesia Molecular and Cellular Biomedical Sciences (MCBS) JURNAL PENDIDIKAN JASMANI DAN OLAHRAGA Pharmasipha Jurnal Penyakit Dalam Udayana Jurnal Pendidikan dan Konseling Jurnal Cahaya Mandalika International Journal of Industrial Engineering and Engineering Management Journal of Global Pharma Technology Seminar Ilmiah Nasional Teknologi, Sains, dan Sosial Humaniora (SINTESA) Jurnal Kedokteran Hewan
I Made Bakta
Universitas Bali Internasional
Agriculture, Biological Sciences & Forestry Humanities Biochemistry, Genetics & Molecular Biology Computer Science & IT Dentistry Education Health Professions Immunology & microbiology Industrial & Manufacturing Engineering Languange, Linguistic, Communication & Media Mathematics Medicine & Pharmacology Neuroscience Public Health Social Sciences Veterinary Other

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Journal : INDONESIAN JOURNAL OF BIOMEDICAL SCIENCES

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SUBTIPE HIV-1 DI BEBERAPA DAERAH DI INDONESIA DAN PERANNYA SEBAGAI PETUNJUK DINAMIKA EPIDEMI HIV Parwati Merati, Tuti; Ryan, Claire; Turnbul, Shannon; Wirawan, DN; Otto, Brad; Bakta, I Made
INDONESIAN JOURNAL OF BIOMEDICAL SCIENCES Vol. 2, No. 2 Mei 2008
Publisher : Udayana University

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Abstract

Subtipe HIV-1 dapat ditentukan dengan melakukan analisis sekuens nukleotida dari gen selubung luar HIV-1, dengan mengekstrak DNA proviral dari sampel pasien, dan memakainya dalam PCR khusus untuk envelope HIV-1. Kemudian ini di sekuens dan dianalisis dengan memakai rujukan sekuens dari bank gen LANL (Los Alamos National Library) untuk menentukan subtipe. Distribusi geografi subtipe HIV-1 bersifat dinamis. Sampai sekarang terdapat 9 subtipe HIV dan 34 circulating recombinant forms (CRFs). Penelitian terdahulu mendapatkan ada dua subtipe HIV-1 yang beredar di Indonesia, Subtipe B dan CRF01_AE. Dengan mengetahui subtipe HIV-1 dapat membantu penelusuran arah epidemi dan memberikan informasi untuk merencanakan pencegahan HIV demikian juga memberikan informasi yang diperlukan dalam pembuatan vaksin. Oleh karena itu sangat penting dilakukan penelitian mengenai subtipe HIV di Indonesia.Rancangan penelitian adalah cross-sectional analytic yang dilakukan di Klinik Pelayanan AIDS di Denpasar, Bali dan Panti Rehabilitasi Narkoba di Bogor, Jawa Barat. Responden adalah odha dewasa yang memenuhi kriteria inklusi (odha dewasa dan bersedia ikut dalam penelitian) dan responden dipilih secara non probability sampling sampai memenuhi jumlah sampel yang dibutuhkan. Dengan memakai rumus 16.4 Sastroasmoro S. and Ismael S. (2002), jumlah sampel minimal dihitung sebesar 65. Untuk hipotesis 1, melihat perbedaan Subtipe HIV-1 dengan cara transmisi virus, analisis data menggunakan uji statistik Chi-Square. Untuk hipotesis 2, membandingkan Subtipe HIV-1 dengan derajat penyakit, analisis data menggunakan uji statistik Fisher’s Exact test, sedangkan untuk analisis data epidemiologi kasus dikerjakan secara deskriptif. Hasil disajikan dalam bentuk tabel, gambar pohon phylogenetic dan narasi.Dari penelitian ini didapatkan empat jenis subtipe di Indonesia, yaitu Subtipe B, CRF01_AE, C dan G (A/G). Semua pengguna narkotika suntik (penasun) terinfeksi oleh Subtipe CRF01_AE, dan hubungan ini terbukti secara statistic bermakna (Chi-square test with continuity correction value 7,951 p = 0,005) (Tabel 5.3.1). Subtipe HIV-1 tidak berhubungan secara bermakna dengan derajat penyakit, akan tetapi terdapat kecenderungan CRF01_AE mempunyai lebih banyak kasus dengan derajat penyakit berat dibandingkan dengan NonCRF01_AE. Prevalensi kasus dengan performance yang terganggu pada CRF01_AE adalah 30,3% sedangkan pada Non CRF01_AE 14,3%. Perbedaan ini secara statistic tidak bermakna (Fisher’s-Exact test p = 0,3445 (Tabel 5.11). Dari analisis Phylogenetic didapatkan bahwa transmisi HIV pada populasi risiko tinggi di Indonesia bersifat dinamis, dan epidemi yang terjadi tidak terpisah diantara populasi dengan faktor risiko yang berbeda.Kesimpulan dari penelitian adalah: CRF01_AE merupakan subtipe yang paling banyak didapatkan dan tersebar disebagian besar wilayah. CRF01_AE didapatkan pada populasi penasun, heteroseksual, penjaja seks komersial dan pelanggannya. Karena prevalensi HIV pada penasun sangat tinggi, baik di Bali maupun daerah lainnya di Indonesia (50%), maka ada kemungkinan penasun merupakan episentrum epidemi HIV di Bali dan beberapa daerah di Indonesia, yang akan menyebar ke populasi umum melalui kelompok heteroseksual risiko tinggi yaitu PSK dan pelanggannya. Sedangkan Subtipe B, C dan G (AG) terdapat baik pada homoseks dan heteroseks, namun tidak ada penasun. Data tersebut didukung oleh gambaran pohon phylogenetic (Gambar 5.3). Pemakaian DBS dalam penelitian ini cukup praktis dan aman, walaupun keberhasilannya masih rendah (44,9%). Sekarang sudah ada kertas saring yang lebih baik dan sesuai untuk dipakai pada penelitian yang akan datang.Saran dari penelitian ini adalah, dalam program harm reduction bagi penasun hendaknya juga menekankan pemakaian kondom secara konsisten dengan pasangan seksualnya. Disamping itu disarankan perlunya melakukan pemeriksaan subtipe HIV secara periodik karena distribusi subtipe HIV bersifat dinamis.
HIGH SERUM CONCENTRATION OF INTERLEUKINE-6 AND RANK-LIGAND AS RISK FACTORS FOR OSTEOPOROSIS IN ESTROGEN DEFICIENCY POST-MENOPAUSAL WOMEN Siki Kawiyana, Ketut; Surya, Gusti Putu; Bakta, Made; Roeshadi, Djoko
INDONESIAN JOURNAL OF BIOMEDICAL SCIENCES Vol. 3, No. 2 Juli 2009
Publisher : Udayana University

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Abstract

Osteoporosis in post-menopausal women is not merely due to deficient estrogenhormone production. The development of osteoporosis is due to increased boneresorption by osteoclasts. The osteoclast’s number and activity is controlled by activatingfactors such as IL-6 and RANK-L. The objective of this study was to determine that highIL-6 and RANK-L serum concentrations are risks for osteoporosis in estrogen deficientpost-menopausal women. The serum concentration of ß-CrossLaps (CTx) was measuredto determine bone resorption rate. This is an observational analytical study using case andcontrol design conducted at Sanglah General Hospital of Denpasar. The sample size wascalculated using the paired case-control study formula. There were 41 osteoporotic and41 non-osteoporotic (control) estrogen deficient post-menopausal women involved in thestudy.Data were analyzed by using the t-paired and McNemar tests. Mean serumconcentration of IL-6 among the osteoporotic women was significantly higher ascompared to that of the controls (3.47±1.75 pg/ml vs 2.51±1.13 pg/ml, p = 0.001). Meanserum concentration of RANK-L among the osteoporotic women was also significantlyhigher as compared to that of the controls (320.66±122.44ng/ml vs 249.94±82.41 ng/ml,p = 0.002). To qualify as risk factors for osteoporosis, the cut-off point for IL-6 was 2.17pg/ml (OR = 4, CI 95%: 1.23-14.24; p = 0.032); the cut-off point for RANK-L was275.165 ng/ml (OR = 8, CI 95%: 1.84-34.79; p = 0.001). Analysis of both high serumconcentration of IL-6 and RANK-L was associated with an odd ratio of 9 (CI 95%: 4,27-18,96, p=0,000). CTx concentration in the osteoporotic women was significantly higherthan in the controls (0.60±0.22ng/ml vs 0.46±0.16ng/ml, p = 0.004).We found that the high IL-6 and RANK-L serum concentrations were risk factorsin estrogen deficient post-menopausal women. CTx being a marker for osteoclastic boneresorption activity, increased in concentration higher in osteoporotic than in nonosteoporoticwomen. The high serum concentrations of IL-6 and RANK-L could be usedas predictors for osteoporosis in estrogen deficient post-menopausal women.
EFFECT OF ORAL IRON TABLET ADMINISTRATION ON SERUM FERITIN AND HEMOGLOBIN CONCENTRATION OF PRE-PREGNANT WOMEN WITH MILD IRON DEFICIENCY ANEMIA IN BALI Seri Ani, Luh; Bakta, I Made; Suryadhi, INT; Agus Bagiada, IN
INDONESIAN JOURNAL OF BIOMEDICAL SCIENCES Vol. 1, No. 3 Desember 2007
Publisher : Udayana University

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Abstract

Iron deficiency anemia (IDA) is still to be a problem of pregnant women healthrelated to its high prevalence and its negative effects on health. Prevention efforts by ironsuplementation in pregnant woman have not reducing IDA problem in pregnant women yet. This failure is probably due to the assumption that IDA have been seen pre-pregnant. Totest this hypothesis, a quasi experimental study was conducted by randomized pre and posttest control group design. Sample were collected by multistage sampling random technicconsist of 47 women in treated group and 52 in control group. Both group were serumferritin and hemoglobin value test untill 3 time, pre-pregnant, early pregnant and duringpregnant. Iron tablet was administrated to treated group from the beginning of pre-pregnantperiod, continued until the first 3 months of pregnancy, while in control group iron tabletwas only given during the first 3 months of pregnancy. T-group result shown that meanserum ferritin and hemoglobin concentration at pregnant women on treated group(33,45±14,12 ?g/dL dan 12,25±1,20 g/dl) more high than control group (19,65±8,99 ?g/dLdan 10,91±0,67 g/dl), p<0,05. Mean difference serum ferritin and hemoglobinconcentration at pregnant women is 13,8 ?g/dL dan 1,34 g/dl (p<0,05). Benefid analysisresult shown that iron suplementation since pre-pregnant more benefid than ironsuplementation during pregnant (BCR >1). Based on these results, it can be concluded thatiron supplementation to IDA women starting from pre-pregnant period results in a bettereffect compare to oral iron supplementation during pregnancy only.
The Lactate/Pyruvate Ratio of Metabolic Modulation using Glucose Insulin Kalium and Lactate Solution and their Effect on Functional Mechanical Recovery of the Isolated Perfused Heart Suranadi, I Wayan; Bakta, Made; Arhya, I Nyoman; Leverve, Xavier
INDONESIAN JOURNAL OF BIOMEDICAL SCIENCES Vol. 3, No. 1 Januari 2009
Publisher : Udayana University

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Abstract

Metabolic modulation with Glucose Insulin Kalium (GIK) solution has beenreally well known in their capacity to improve post ischemic heart function. In this regardGIK intervention on post operative Coronary Artery Bypass Graft (CABG) can improveheart function recovery on reperfusion period (Goldhaber dan Weiss, 1992; Atwell et al.,1997). Post operative CABG intervention with GIK will produce a beneficial effect onthe elevation of heart energy to prevent ionic homeostasis disturbance and reactiveoxygen species (ROS) production that become the basis of reperfusion injury (Silvermandan Stern, 1994; Cross et al., 1995; Taegtmeyer et al., 1997; Opie, 1999; Lazar, 2002;Doenst et al., 2003; Trence et al., 2003).Many efforts have been made to clarify how exactly GIK works to improve postischemic heart function as in CABG. This is crucially done in order to be able to modifythe solution concerned. Although this solution has been clearly proved to improve postischemic heart function, it is not totally free from its adverse effect. Its main side effect isthat it can provoke hyperglycemic state, which contrasts with the tight glucose control incontinuously normal range for the patients who are critically ill.In this study lactate and pyruvate level in the coronary effluent were measuredfrom the isolated heart directly perfused with GIK and lactate. It was shown that thepreischemic lactate level was low and then clearly elevated as soon as the reperfusiontook place due to anaerobic metabolism. In accordance with reperfusion time lactate leveldecreased gradually. In relation with pyruvate level, this substrate evolution looked likethe appearance of lactate but its value was lower if compared with lactate.The recovery in functional mechanical activity of the post ischemic heart seems tobe much more related to the pattern of the evolution of logarithmic lactate/pyruvate ratio(L/P ratio). Logarithmic value of L/P ratio in GIK group increased since the earlyreperfusion period (+40%, p < 0.05), followed by improvement in recovery ofmechanical activity in this group which was significantly higher if compared with thecontrol group. Similar fashion was found in lactate group in regard to the evolution of thelogarithmic value of L/P ratio in this group, where its value was significantly highercompared with the control group. The logarithmic evolution pattern on L/P ratio for thisgroup increased along the reperfusion time (+34% p < 0.05).From the present study, it can be concluded that the recovery of functionalmechanical activity of the post ischemic heart perfused with GIK is through modificationon cellular lactate metabolism.
THE ROLE OF INTENSIVE INSULIN THERAPY ON SUPEROXIDE DISMUTASE (SOD), TUMOR NECROSIS FACTOR-? (TNF-?), AND INTERLEUKIN-6 (IL-6) ON HYPERGLYCEMIA IN CRITICALLY ILL PATIENTS Wiryana, Made; Suastika, Ketut; Bagianto, Hari; Bakta, Made
INDONESIAN JOURNAL OF BIOMEDICAL SCIENCES Vol. 4, No. 1 Januari 2010
Publisher : Udayana University

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Abstract

Hyperglycemia and insulin resistance are common in critically ill patientsin the ICU, although they have not previously had diabetes. It has been reportedthat pronounced hyperglycemia may lead to complications in such patients, andcause the reactive oxygen species (ROS) production, although controlled trial dataare still lacking. The current debatable issue, focusing on whether the intensiveinsulin therapy, aimed at normalizing blood glucose, may improvepatients’prognosis. Then, the debate is mainly about the time to start the therapy,and target of blood glucose level. Therefore, this research is mainly designed andaimed at knowing the difference between intensive insulin therapy andconventional insulin therapy on the increase of superoxide dismutase (SOD),decrease of cytokine production (TNF-? and IL-6), increase of albumin level, andevent of SIRSThis study was carried out in a randomly pre and post-test control groupdesign, involving 40 adult patients being nursed through the ICU Sanglah hospitalDenpasar. They were randomly assigned to receive intensive insulin therapy, inwhich blood glucose was decreased and maintained at the level between 80-110mg/dl, or conventional insulin therapy in which the insulin was infused only if theblood glucose level exceeded 215 mg/dl, decreased and maintained then at thelevel between 180-200 mg/dl.The result of the study showed that there was (1) significant increase ofSOD mean level (370. 70 vs 98.50 U/gHb, p=0.001); (2) no significant decreaseof TNF-? mean level; (3) significant decrease of IL-6 mean level (10.26 vs 2.25;p=0.023); (4) significant increase of albumin mean level ( 0.62 vs 0.22); (5)significant decrease of SIRS (10 % vs 40 %, p=0.000) on intensive insulin therapygroup compared to conventional insulin therapy group. It can be concluded thatintensive insulin therapy could maintain blood glucose level between 80 – 110mg/dl, increase SOD level, decrease IL-6 level, increase albumin level, anddecrease SIRS on hyperglycemia in critically ill ICU patients.
PERBANDINGAN EFEK SUPLEMEN BESI PRA-HAMIL DAN SELAMA KEHAMILAN DALAM UPAYA MENURUNKAN ANEMIA DEFISIENSI BESI PADA WANITA HAMIL DENGAN ANEMIA RINGAN DI BALI Seri Ani, Luh; Bakta, I Made; Suryadhi, INT; Agus Bagiada, I N
INDONESIAN JOURNAL OF BIOMEDICAL SCIENCES Vol. 1, No. 3 Desember 2007
Publisher : Udayana University

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Abstract

Anemia defisiensi besi (ADB) masih merupakan masalah kesehatan wanita hamilterkait dengan tingginya prevalensi dan efek negatifnya terhadap kesehatan. Upayapencegahan telah dilakukan dengan pemberian tablet besi selama kehamilan. Akan tetapihasilnya belum memuaskan. Kegagalan ini mungkin diakibatkan oleh rendahnya bahkankosongnya cadangan besi tubuh sewaktu pra-hamil, terutama di negara sedangberkembang. Oleh karena itu, suplemen besi yang hanya diberikan waktu kehamilantidak cukup untuk mencegah terjadinya ADB. Oleh karena itu, dilakukan a quasiexperimental study pada 99 pasangan baru yang belum hamil yang terdiri atas 47 groupperlakuan dan 52 sebagai group kontrol. Tablet besi (200 mg ferrous sulfate) diberikansejak periode sebelum hamil pada group perlakuan yang dilanjutkan sampai dengan 3bulan kehamilan. Sementara, pada group kontrol diberikan tablet besi dimulai hanya padakehamilan trimester pertama. ADB didasarkan atas konsentrasi hemoglobin dan serumferitin sesuai dengan criteria WHO dan keuntungan pemberian tablet besi didasarkan atasteknik BCR. Pada penelitian ini didapatkan bahwa pemberian tablet besi pada pra-hamildapat menurunkan prevalensi ADB lebih tinggi dibandingkan dengan pemberian tabletbesi yang dimulai saat kehamilan (0% vs 38.46%, p<0.05). Perbedaan yang signifikanjuga pada rerata serum feritin pada akhir pengamatan yaitu 33.45±14.12 ?g/dL padagroup perlakuan dan 19.65±8.99 ?g/dL pada group kontrol. Sementara itu, kadarhemoglobin adalah 12.25±1.20 g/dL pada group perlakuan dan 10.91±0.67 g/dL padagroup kontrol (p<0.05). Analisis menunjukkan bahwa pemberian tablet besi yang dimulaisaat pra-hamil adalah lebih menguntungkan dibandingkan dengan pemberian tablet besimulai hanya pada kehamilan (BCR >1). Tidak terdapat perbedaan bermakna pada efeksamping dan kepatuhan pada group perlakuan dan kontrol. Berdasarkan hasil-hasil inidapatlah disimpulkan bahwa pemberian tablet besi yang dimulai masa pra-hamil adalahlebih baik dibandingkan dengan pemberian tablet besi yang diberikan hanya pada saatkehamilan. Program ini sangat mungkin diterapkan pada masyarakat karenakepatuhannya adalah baik.
THE ROLE OF INTENSIVE INSULIN THERAPY ON SUPEROXIDE DISMUTASE (SOD), TUMOR NECROSIS FACTOR-? (TNF-?), AND INTERLEUKIN-6 (IL-6) ON HYPERGLYCEMIA IN CRITICALLY ILL PATIENTS Wiryana, Made; Suastika, Ketut; Bagianto, Hari; Bakta, Made
INDONESIAN JOURNAL OF BIOMEDICAL SCIENCES Vol. 3, No. 1 Januari 2009
Publisher : Udayana University

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (217.01 KB)

Abstract

Hyperglycemia and insulin resistance are common in critically ill patientsin the ICU, although they have not previously had diabetes. It has been reportedthat pronounced hyperglycemia may lead to complications in such patients, andcause the reactive oxygen species (ROS) production, although controlled trial dataare still lacking. The current debatable issue, focusing on whether the intensiveinsulin therapy, aimed at normalizing blood glucose, may improvepatients’prognosis. Then, the debate is mainly about the time to start the therapy,and target of blood glucose level. Therefore, this research is mainly designed andaimed at knowing the difference between intensive insulin therapy andconventional insulin therapy on the increase of superoxide dismutase (SOD),decrease of cytokine production (TNF-? and IL-6), increase of albumin level, andevent of SIRSThis study was carried out in a randomly pre and post-test control groupdesign, involving 40 adult patients being nursed through the ICU Sanglah hospitalDenpasar. They were randomly assigned to receive intensive insulin therapy, inwhich blood glucose was decreased and maintained at the level between 80-110mg/dl, or conventional insulin therapy in which the insulin was infused only if theblood glucose level exceeded 215 mg/dl, decreased and maintained then at thelevel between 180-200 mg/dl.The result of the study showed that there was (1) significant increase ofSOD mean level (370. 70 vs 98.50 U/gHb, p=0.001); (2) no significant decreaseof TNF-? mean level; (3) significant decrease of IL-6 mean level (10.26 vs 2.25;p=0.023); (4) significant increase of albumin mean level ( 0.62 vs 0.22); (5)significant decrease of SIRS (10 % vs 40 %, p=0.000) on intensive insulin therapygroup compared to conventional insulin therapy group. It can be concluded thatintensive insulin therapy could maintain blood glucose level between 80 – 110mg/dl, increase SOD level, decrease IL-6 level, increase albumin level, anddecrease SIRS on hyperglycemia in critically ill ICU patients.
SENSITIVITY AND SPECIFICITY OF ELISA TEST USING 30 KDA RECOMBINANT ANTIGEN TO DETECT Toxoplasma gondii INFECTION IN PIG WITH MICE BIOASSAY AS A GOLD STANDARD Nyoman Adi Suratma1????, I Made Bakta2, I Made Damriyasa3 Adi Suratma, Nyoman; Bakta, I Made; Damriyasa, I Made
INDONESIAN JOURNAL OF BIOMEDICAL SCIENCES Vol. 3, No. 1 Januari 2009
Publisher : Udayana University

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Abstract

Toxoplasmosis is a zoonotic disease caused by the protozoa Toxoplasma gondii.Primary infection in pregnant women can cause abortion, neonatal death or abnormalityof fetus. Accurate diagnosis is needed to prevent infection especially related to thepresence of cyst in the tissuesThe aim of this research was to study sensitivity and specificity of ELISAmethod with 30 kDa protein antigen to detect T.gondii infection in pig with micebioassay as gold standard.. Samples were 171 pigs slaughtered at pig slaughter house inDarmasaba BadungThe result showed that sensitivity of ELISA method was 100% and 90,7% inspecificity.Research about sensitivity using ELISA test to predict cysts presence in tissuewere needed in the future.
INTERLEUKIN -2 ( IL-2 ) AND GAMMA INTERFERON ( IFN ? ) OF LYMPHOCYTE CULTURE SUPERNATANT IN IRON DEFICIENCY ANEMIA PATIENTS WITH INFECTION Suega, Ketut; Bakta, I M; Sudewa D., AAG; Suata, Ketut
INDONESIAN JOURNAL OF BIOMEDICAL SCIENCES Vol. 4, No. 1 Januari 2010
Publisher : Udayana University

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Abstract

Iron is an essential nutrient for every living cells because of it role as molecule fortransport of oxygen, as well as DNA synthesis through synthesis of ribonucleotidereductase. Iron deficiency anemia patients, especially pregnant women and children aremore susceptible to infection because of deterioration of their immune response. This wassupported by findings of decreased in phagocytic activities of white blood cells and Tcelllymphocyte proliferation impairment. Iron deficiency anemia (IDA) patients alsoaffect working capacities hence diminishing working outcomes. Although the underlyingmechanism of immune defect in iron deficiency anemia is not clearly understood,multifactor events considered play their contributing roles such as abnormality ofribonucleotide reductase enzym, impairment of T-cell proliferation and activities, alteredcytokine production of IL-2 and IFN?.The study was done to asses the relationship of IL-2 and gamma IFN withinfection in IDA patients on lymphocyte culture supernatant of IDA patients. Study wasconducted on cross-sectional analytic design. Sixty-four iron deficiency anemia patientstreated in Sanglah General Teaching Hospital were recruited, and 31 (48.4%) out of 64IDA patients were man and 33 (51.6%) women, have been selected for the study. Thisstudy found 17 (26.7%) IDA patients with infection, aged 38 ± 14.48 years and 47(73.3%) IDA patients without infection, with age average of 40.5 ± 14.4 years. Allvariables of data characteristics examined did not indicate any statistical significantdifference between group of IDA patients with infection and those without infection. Theaverage level of hemoglobin between the two groups did not differ statistically. Similarresult was obtained if samples were differentiated into severe (Hb< 7g/dl) and mildanemia. The study also revealed that there were no differences of cytokine level observedbetween older and younger age (upper and below 44.5 years) in IDA patients withinfection and without infection. Furthermore, no differences of cytokine level were foundbased on gender between IDA male 10.9 (8.60 – 12,65) (pg/l) patients and IDA femalepatients 10.6 (7.50 – 13.43) (pg/l) with Z -0.490, p =0.624. Nevertheless, significantdifferences were noted between supernatant of IL-2 and IFN? in IDA patients withinfection when compared to IDA patients without infection (Z= - 2.509, p= 0.012 forsupernatant IL-2; and Z= -2.569, p= 0.010 for supernatant IFN?).The study conclusion is that level of IL-2 and IFN? from lymphocyte culturesupernatant of patient suffered from IDA with infection is significantly lower whencompared to IDA patient without infection. It therefore summarized that lower level ofIL-2 and gamma IFN in patients suffered from iron deficiency impaired their immune response to certain infections therefore this findings support the theory that IDA patientsmore susceptible to get infected.
RISKS FOR PERIPHERAL ARTERIAL DISEASE IN THE ELDERLY WITH TYPE 2 DIABETES MELLITUS : Their Correlation with High Sensitivity C-reactive Protein and Ankle-Brachial Index Ayu Tuty Kuswardhani, Raden; Wita, Wayan; Bakta, Made; Santosa, Anwar
INDONESIAN JOURNAL OF BIOMEDICAL SCIENCES Vol. 3, No. 2 Juli 2009
Publisher : Udayana University

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Abstract

The Indonesian elderly population has been projected to increase up to about four-fold inthree decades (1990-2020). As a consequence of this population trend, the increased prevalence ofdegenerative diseases would be inevitable; this would include the prevalence of peripheral arterialdisease.This study aims to identify the correlation of diverse risk factors, either traditional or nontraditional,with the ankle-brachial index scores, and the correlation of novel non-traditional riskfactor, e.i. high sensitive C-reactive protein with the prevalence of perioheral arterial disease in theelderly, age 60-80 years old, with type 2 diabetes mellitus.Among the 146 elderly patients with type 2 diabetes mellitus, and based on measurement ofthe ABI score, approximately 30.9% of them had PAD. Some traditional and non-traditional riskfactors having a significant correlation with the ankle-brachial index score, were age (r = -0.396, p <0.001 for right ABI; r = -0.509, p < 0.001 for left ABI), supine systolic blood pressure (r= -0.268, p =0.012 for right ABI; r = -0.267, p = 0.013 for left ABI), 2-hour post-prandial blood glucose (r= -0.252, p = 0.018 for right ABI), and hsCRP (r = -0.280, p = 0.011 for right ABI; r = -0.402, p <0.001 for left ABI); whereas other risk factors like obesity based on waist circumference and BMI,non-supine systolic blood pressure, fasting blood glucose, HbA1C, duration of diabetes, plasma lipidsdid not show statistically significant different odd ratios. After linear regression test for risk factorshaving significant correlations with ABI, age and hsCRP were found to influence the ABI scores.Based on a case-control study, risk factors which, to some extent, had statistically significant valuesas risk factors, include older age (? 70 years old; OR = 7.737 [CI = 2.515-23.805]; p < 0.001),relatively high supine diastolic blood pressure (? 90 mmHg; OR = 6.882 [CI = 0.789-60.060]; p =0.048), and high concentration of hsCRP (> 3 mg/L; OR = 4.420 [CI = 1.287-15.181]; p = 0.013).Among these statistically significant risk factors, after logistic regression test analysis, only the age ofthe patient appeared to have significant influence on the prevalence of PAD.In conclusion, this study demonstrates a negative correlation between hsCRP and ABI score;and high levels of hsCRP appeared to be a risk factor for PAD. The age of the patient, however,appeared to be the strongest risk factor for PAD.
Co-Authors - Murtiananingsih, - - Saimi, - A. A. Mas-Putrawati AAG Sudewa D. Adi Purwa Hita, I Putu Gede Alma Lystia Savitri Mahayasa Ambrosius Purba Anisa Hanum Anwar Santosa Ariati, N.N. Arundina Sanyoto Astawa N. M., Astawa N. Astawa P., Astawa Brad Otto Budha K. Claire Ryan Daniel Womsiwor Dewa Nyoman Wirawan Dewa Nyoman Wirawan, Dewa Nyoman Dharmayuda, Tjokorda Gede Dhiancinantyan Windydaca Brata Putri Djoko Roeshadi Duarsa, Dyah Paramita Dwidjayanti, Ni Kadek Candra Dyah Kanya Wati Dyah Pradnya P.D., Dyah Pradnya Dyah Pradnya Paramitha Duarsa Dyah Pradnya Paramitha Duarsa, Dyah Pradnya Paramitha Dyah Pradnyaparamita D, Dyah Pradnyaparamita Ekaputra Ekaputra, Ekaputra Gusti Putu Surya H. S. Habiba Muhiddin, H. S. Habiba Hari Bagianto I Dewa Made Sukrama I Dewa Nyoman Wirawan I Dewa Putu Sutjana I Ketut Agus Somia I Ketut Suastika I Ketut Suyasa I Made Ady Wirawan I Made Damriyasa I Made Duwi Sumohadi I Made Jawi I Made Jawi I Made Sudarmaja I Made Susila Utama I N Agus Bagiada I NYOMAN ADI SURATMA I Nyoman Arhya I Nyoman Budi Hartawan I Nyoman Mangku Karmaya I NYOMAN MANTIK ASTAWA I Nyoman Sutarsa I Putu Budi Wibawa I Putu Gede Adiatmika I Putu Suiraoka I Putu Wantera I Wayan Losen Adnyan I Wayan Losen Adnyana I Wayan Putu Sutirta Yasa I Wayan Suranadi I Wayan Wita Ida Bagus Gede Suparyatha Ida Bagus Komang Ardana Ida Bagus Putra Manuaba Ida Bagus Subanada IN Agus Bagiada IN Bagiada INT Suryadhi INT Suryadhi J. A. Pangkahila Karjono M, Karjono Ketut Siki Kawiyana Ketut Suata Ketut Suega Ketut Suega Ketut Suryana Ketut Tuti Parwati Merati Kusuma, Anak Agung Ngurah Jaya Lesmana, Cokorda Agung Bagus Jaya Levi Anatolia Losen Adnyan Ludirdja, Evan Pratama LUH MERTASARI . Luh Seri Ani Made Jawi Made Krisna Adi Jaya Made Wiryana Manuaba, I.B.P Mirandinha Fortuna Sarmento Madeira, Angie N Adiputra N. Adiputra N. K. Niti Susila, N. K. Ni Made Andrinia Ratih Sri Indarswari Ni Nyoman Yunita Kusuma Bakta Ni Putu Aryati Suryaningsih Nita Fitria P. Astawa Purnamawati, Susy R. A.T. Kuswardhani Rena, Ni Made Renny A Rena, Ni Made Renny Anggreni Renny A Rena Rudi Wisaksana Santosa, I Gusti Ngurah Putra Eka Satoto D., Satoto Sawitri, Anak Agung Sagung Shannon Turnbul Sri Maliawan Sumohadi, I Made Duwi Suryadi N. T., Suryadi N. Sutajaya, I.M. Sutema, Ida Ayu Manik Partha Tirtayasa, K. Tjok Darmayuda Tjok Gde Darmayuda Tjokorda Gde Agung Senapathi Tjokorda Gde Bagus Mahadewa Tjokorda Gde Dharmayuda Tjokorda Gde Dharmayuda Tuti Parwati Merati W. A., W. Winarto, Daniel Wiryana M., Wiryana Wulansari Manuaba, Ida Ayu Ratih Xavier Leverve Yenny Kandarini