Nurul Ratna Mutu Manikam
Department Of Nutrition, Faculty Of Medicine, Universitas Indonesia – Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia

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EFFECTS OF VITAMIN D ADMINISTRATION FOR WOUND HEALING IN PATIENTS WITH DIABETIC FOOT ULCERS: EVIDENCE BASED CASE REPORT Badralany, Felianty; Nurul Ratna Mutu Manikam
IJCNP : INDONESIAN JOURNAL OF CLINICAL NUTRITION PHYSICIAN Vol 6 No 1 (2023): IJCNP (INDONESIAN JOURNAL OF CLINICAL NUTRITION PHYSICIAN)
Publisher : Perhimpunan Dokter Gizi Klinik Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.54773/ijcnp.v6i1.191

Abstract

Diabetes mellitus can cause microvascular and macrovascular complications. Diabetic foot ulcer is the complications that often occur in DM patients, which is as much as 10%-25%. In Indonesia, the incidence of diabetic foot ulcers is 12% and DM patients can be at risk of diabetic foot ulcers as much as 55.4%. The mortality rate that occurs as a result of diabetic foot ulcers can reach around 15-30%. Patients who have diabetic foot ulcers significantly decreased vitamin D levels. This study aims to determine the effectiveness of vitamin D supplementation for wound healing in diabetic foot ulcers.
Urinary PYD/Creatinine Ratio Has Negative Correlation to Serum 25(OH)D and Positive Correlation to Chronic Lead Exposure Index Hajar, Siti Sarah; Mudjihartini, Ninik; Manikam, Nurul Ratna Mutu; Mulyana, Mulyana; Mansyur, Muchtaruddin
The Indonesian Biomedical Journal Vol 16, No 4 (2024)
Publisher : The Prodia Education and Research Institute (PERI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18585/inabj.v16i4.3174

Abstract

BACKGROUND: The burden of disease due to lead exposure continues to increase. Lead interferes with 25(OH)D hydroxylation and calcium transport, increasing osteoclastic activity and bone resorption. Pyridinoline crosslinks (PYD), as an indicator of bone damage, can be seen earlier compared to imaging changes. Therefore, it is necessary to determine the correlation between serum 25(OH)D levels and the urinary PYD/creatinine ratio in workers exposed to lead, since up to now, there are only limited studies related to it.METHODS: This cross-sectional study involved 104 workers exposed to lead, selected from parents whose children had blood lead levels above 10 µg/dL. Questionnaires and physical examination were performed to obtain characteristic data from subjects. Data regarding blood lead levels, serum 25(OH)D levels, urinary PYD levels, and urinary creatinine levels were also obtained from various laboratory methods.RESULTS: Most subjects (86.5%) had inadequate serum 25(OH)D. Median blood lead levels was 6.3 (1.2-35.5) µg/dL, chronic lead exposure index was 35.3 (1.2-535.8) years µg/dL, serum 25(OH)D levels was 22 (8-52) ng/mL, and urinary PYD/creatinine ratio was 5.3 (3.6-28.1)×10-6. There was a significant negative correlation between serum 25(OH)D levels and urinary PYD/creatinine ratio in workers exposed to lead. There was also a significant positive correlation between chronic lead exposure index and the urinary PYD/creatinine ratio.CONCLUSION: Since urinary PYD/creatinine ratio is correlated with serum chronic lead exposure index and serum 25(OH)D levels, it suggests that pyridinoline might be a potential biomarker to detect bone metabolism disorder due to the chronic lead exposure. Vitamin D adequacy is also an important factor in preventing bone metabolism disorder amidst chronic lead exposure.KEYWORDS: 25(OH)D, bone resorption, pyridinoline, lead, worker
Known facts: iron deficiency in Indonesia Manikam, Nurul Ratna Mutu
World Nutrition Journal Vol. 5 No. S1 (2021): Special Issue : The role and importance of iron
Publisher : Indonesian Nutrition Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25220/WNJ.V05.S1.0001

Abstract

More than half cases of anemia are due to iron deficiency. Anemia is a major and global public health problem that affects maternal and child mortality, child cognitive development and eventually productivity. Infancy, adolescence, and pregnancy are particularly at risk. Indonesia is a low middle country with the prevalence of anemia as high as 48.9% in pregnant women and 38.5% in children under 5 years old. It is even higher among adolescents aged 12-18 years, especially in rural areas. Low income and level of education seem to also contribute to iron deficiency. Indonesia government aims to prevent anemia in young and pregnant women by providing iron pills. Still, the etiology of anemia in Indonesia is various and many elements are preventing Indonesia women to consume pills and/or iron-rich foods. We aim to review the prevalence, risk factors associated with iron deficiency especially among women of reproductive age in Indonesia, including the socio-determinant influence on iron deficiency. We will also discuss the management of iron deficiency in Indonesia in comparison with international guideline to identify the potential gaps.