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All Journal Journal of the Medical Sciences (Berkala Ilmu Kedokteran)
Raden Bowo Pramono
Division Of Endocrinology And Metabolic, Department Of Internal Medicine, Faculty Of Medicine, Public Health, And Nursing, Universitas Gadjah Mada/Dr. Sardjito General Hospital Yogyakarta, Indonesia.
Immunology & microbiology Neuroscience

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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.
Effects of valsartan compared with telmisartan in reducing insulin resistance on type 2 diabetes mellitus (T2DM) patients with hypertension Hemi Sinorita; Luthfan Budi Purnomo; R.Bowo Pramono
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 53, No 2 (2021)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (199.179 KB) | DOI: 10.19106/JMedSci005302202102

Abstract

Insulin resistance is a major risk factor for patients with type 2 diabetesmellitus (T2DM). Telmisartan and valsartan are angiotensin II type I receptorblockers (ARBs) that are often used in patients with metabolic syndrome andT2DM. This study aimed to compare the effect of valsartan and telmisartan inreducing insulin resistance on T2DM with hypertension. Patients of T2DM wereopen-label screened at the Endocrinology Policlinic, Department of InternalMedicine, Dr. Sardjito General Hospital, Yogyakarta, and then randomized intotwo groups. The first group received valsartan 80 mg per day up to 160 mg perday, the second group received telmisartan 40 mg per day up to 80 mg per dayin addition with life-style modifying and diabetes therapy. Homeostasis modelassessment of insulin resistance (HOMA-IR), triglyceride and HDL cholesterollevels of patients were measured before and after receiving telmisartan andvalsartan for 12 weeks. A total of forty-nine outpatients were involved in thisstudy comprised of 25 female patients (51%) and 24 male patients (49%) with27 patients (55.1%) received telmisartan and 22 patients (44.9%) receivedvalsartan as the hypertension therapy. No significantl difference were observedbetween telmisartan group compared with valsartan group in HOMA-IR (14.01± 16.39 vs. 5.31 ± 3.51; p=0.053), triglyceride levels (165.71 ± 94.70 vs 144.41 ±48.33 mg/dL; p=0.620), HDL-C level (48.57 ± 9.78 vs 49.24 vs 49.24 ± 12.56 mg/dL;p=0.999). In conclusion, telmisartan demonstrated no difference compared tovalsartan in reducing insulin resistance on T2DM patients with hypertension.
Co-Authors Hemi Sinorita Hemi Sinorita Luthfan Budi Purnomo Mohammad Robikhul Ikhsan Susanti, Vina Yanti