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All Journal Acta Interna : The Journal of Internal Medicine Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Jurnal Farmasi Klinik Indonesia Majalah Farmaseutik
Mohammad Robikhul Ikhsan
Division Of Endocrinology, Department Of Internal Medicine, Faculty Of Medicine, Public Health, And Nursing, Universitas Gadjah Mada/Dr. Sardjito General Hospital, Yogyakarta, Indonesia
Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience

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Kontrol Glikemik dan Prevalensi Gagal Ginjal Kronik pada Pasien Diabetes Melitus Tipe 2 di Puskesmas Wilayah Provinsi DIY Tahun 2015 Ningrum, Vitarani Dwi Ananda; Ikawati, Zullies; Sadewa, Ahmad Hamim; Ikhsan, Mohammad Robikhul
Indonesian Journal of Clinical Pharmacy Vol 6, No 2 (2017)
Publisher : Indonesian Journal of Clinical Pharmacy

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (621.312 KB) | DOI: 10.15416/ijcp.2017.6.2.78

Abstract

Pengendalian glikemik yang baik pada diabetes melitus tipe 2 (DMT2) terbukti dapat mencegah penyakit komplikasi akibat DMT2. Puskesmas sebagai sarana pelayanan kesehatan primer merupakan garda terdepan yang diharapkan dapat memberikan pelayanan pengelolaan DMT2 dengan baik untuk mencegah penyakit komplikasi seperti penyakit gagal ginjal kronik (GGK). Kejadian GGK yang seringkali tanpa gejala spesifik serta keterbatasan pemeriksaan diagnostik di puskesmas menyebabkan keterlambatan diagnosa GGK maupun pengelolaan terapi yang sub-optimal. Penelitian ini bertujuan menganalisis kontrol glikemik dan kejadian GGK pada pasien DMT2 di puskesmas serta faktor pasien yang memengaruhi kontrol glikemik dan kejadian GGK. Penelitian potong-lintang pada 6 puskesmas di Yogyakarta tahun 2015 ini melibatkan pasien DMT2 dewasa tanpa riwayat gagal hati kronik. Parameter kontrol glikemik menggunakan Glukosa-Darah-Puasa (GDP), Glycated-Albumin (GA), atau hemoglobin terglikasi (HbA1C), sedangkan nilai eLFG digunakan sebagai dasar klasifikasi GGK. Sebanyak 101 pasien dengan rata-rata usia 50,75±6,73 tahun terlibat dalam penelitian. Kontrol glikemik kategori baik ditemukan hanya pada 13,86% pasien, sedangkan 12,87% pasien mengalami GGK. Tidak ada faktor pasien yang memengaruhi kontrol glikemik. Sementara itu, usia dan durasi DMT2 berkorelasi dengan kejadian GGK (p<0,01). Berdasarkan penelitian ini, kontrol glikemik yang buruk dapat meningkatkan kemungkinan kejadian GGK sebesar 63,64%. Oleh karena itu, diperlukan strategi pengelolaan DMT2 maupun pencegahan GGK yang lebih baik termasuk penyediaan fasilitas pemeriksaan yang memadai untuk meminimalkan kejadian clinical inertia di puskesmas.
Predictive factors for recurrence in patients with Graves’ Disease following treatment with methimazole Mohammad Robikhul Ikhsan; Raden Bowo Pramono; Hemi Sinorita; Vina Yanti Susanti
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 53, No 3 (2021)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (190.332 KB) | DOI: 10.19106/JMedSci005303202102

Abstract

Graves’ disease (GD) contributes for 60–80% of all hyperthyroidism. Methimazoleis the first line drug and most commonly used as antithyroid drug (ATD). However,the relapse rate following ATD therapy is 40–50%. The aimed of this studywas to evaluate long-term ATD treatments and to identify prognostic factorsthat contribute to GD recurrence. A total of 46 GD patients who referred to theEndocrinology Clinic, Dr. Sardjito General Hospital, Yogyakarta between January2016 and December 2018 with thyrotropin receptor antibody (TRAb) tested andtreated with methimazole were included in this study. Size of goiter was measuredbased on WHO grading system and eye syndrome based on NOSPEC score system.Patients were classified into recurrence and remission groups based on TRAbevaluation at 12 month following treatment. Result of thyroid hormone level (FT4)and subject characteristic as predictive factors observed at 3-, 6- and 12-month post-treatment were compared and analyzed.Among 46 patient involved in this study, 23patients demonstrated remission of hyperthyroidism based on TRAb evaluation at12-month. The size of thyroid at onset of disease in 30 (65%) patients was grade 2 orabove (p<0.05). Free FT4 levels at the end of observation (12 month) was 1.9±0.6 ng/dL in recurrent and 1.4±0.5 ng/dL in remission group (p<0.05). TRAb levels at earlyof study was higher in the recurrent group (p<0.05). Logistic regression analysisdemonstrated that thyroid size, FT4 level, and TRAb at diagnosis were associatedwith recurrencies. In conclusion, GD patients with large thyroids size, high TRAblevels, and high FT4 level at the onset of disease tended to fail to respond to ATD andwere associated with recurrence incidence.
Thyrotropin Receptor Antibody as a Risk Factor for the Occurrence and Severity of Graves' Ophthalmopathy Ikhsan, Mohammad Robikhul; Kertia, Nyoman; Supanji, Supanji; Rianto, Bambang Udji Djoko
Acta Interna The Journal of Internal Medicine Vol 12, No 1 (2023): Acta Interna The Journal of Internal Medicine
Publisher : Faculty of Medicine Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/actainterna.98158

Abstract

Background. Graves' disease (GD) is an autoimmune disorder known to be the most common cause of hyperthyroidism. Thyrotropin receptor antibody (TRAb) might be involved in the occurrence and the disease process of Graves’ ophthalmopathy (GO).Objectives. This study aimed to evaluate whether TRAb levels are associated with the occurrence and severity of GO based on the clinical severity of The European Group on Graves' Orbitopathy (EUGOGO).Methods. A case-control study of 44 patients with newly diagnosed Graves’ disease (22 with GO compared to 22 without GO). Diagnosis of GO was made according to Bartley and Gorman’s criteria. Level of thyrotropin receptor antibody was tested with electrochemiluminescence immunoassay (ECLIA) method. Assessment of the clinical severity of GO was documented with EUGOGO scores.Results. Baseline characteristics were similar between 22 patients with GO compared to 22 patients non-GO group. Thyrotropin receptor antibody (TRAb) significantly increased in the GO group (11.223±7.116 IU/L) when compared to non-GO (6.720±3.442 IU/L; P=0.035). Multiple logistic regression analysis shows that 1 IU/L increase of TRAb has a 1.610-fold higher risk for developing GO. In the GO group, there is correlation between TRAb and the severity of GO-based on EUGOGO (r =0.794, P<0.001).Conclusion. Thyrotropin receptors antibody is a risk factor for the occurrence and severity of GO-based on EUGOGO.
Kajian Literatur: Faktor Risiko Glucocorticoid-induced Diabetes Mellitus (GIDM) pada pasien SLE Pramana, Facetha Intan; Andayani, Tri Murti; Ikhsan, Mohammad Robikhul
Majalah Farmaseutik Vol 21, No 2 (2025)
Publisher : Faculty of Pharmacy, Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/farmaseutik.v21i2.96652

Abstract

Glukokortikoid telah digunakan untuk pengobatan banyak penyakit inflamasi dan autoimun salah satunya adalah Systemic Lupus Erythemasous (SLE). Berbagai efek samping glukokortikoid telah diketahui, termasuk infeksi, osteoporosis, gangguan kejiwaan, cedera saluran cerna, katarak, hipertensi, arteriosklerosis, dan sebagainya. Di antara efek samping ini, hiperglikemia merupakan efek sistemik yang lazim dari pengobatan glukokortikoid. Kondisi hiperglikemik yang persisten akan berkembang menjadi diabetes melitus. Kajian literatur ini bertujuan untuk mengetahui faktor-faktor yang mempengaruhi terjadinya Glucocorticoid induced Diabetes Mellitus (GIDM) pada pasien SLE. Pencarian literatur pada studi ini dilakukan dengan database PubMed, DOAJ dan Sciencedirect yang diterbitkan 10 tahun terakhir. Ditemukan sebanyak 639 artikel dan 5 artikel yang memenuhi kriteria peneliti.  Total 5 jurnal yang diperoleh, seluruh jurnal membahas faktor risiko dosis, 2 diantaranya membahas faktor usia, 2 jurnal membahas faktor gangguan ginjal, 3 diantaranya membahas faktor komorbid hipertensi dan hiperlipid, dan 1 diantaranya membahas faktor ras. Secara keseluruhan jurnal, didapatkan kesimpulan bahwa usia lebih tua, penurunan fungsi ginjal, dosis, komorbid hipertensi dan hiperlipidemia, dan ras merupakan faktor risiko terjadinya GIDM pada pasien SLE.
Co-Authors Ahmad Hamim Sadewa Bambang Udji Djoko Rianto Hemi Sinorita Nyoman Kertia Pramana, Facetha Intan Raden Bowo Pramono Supanji, Supanji Susanti, Vina Yanti Tri Murti Andayani Vitarani Dwi Ananda Ningrum