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Peran Melanocortin Receptor (MCR) Tipe 3 Sebagai Faktor Protektif Pada Pneumonia Geriatri : Studi Literatur Wahyudi, Dicky; Mukhtar, Diniwati; Aditama, Tjandra Yoga; Marsiati, Himmi
Jurnal Ilmu Kedokteran dan Kesehatan Vol 11, No 12 (2024): Volume 11 Nomor 12
Publisher : Prodi Kedokteran Fakultas Kedokteran Universitas Malahayati

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/jikk.v11i12.17608

Abstract

Usia lanjut menjadi salah satu faktor risiko paling penting untuk pneumonia. Pada kelompok lanjut usia yang menderita pneumonia, tanda-tanda klinis seringkali tidak khas, dan terdapat risiko lebih besar untuk mengalami kegagalan organ (pernapasan, ginjal atau jantung), kehilangan fungsi yang lebih besar dan, akibatnya, prognosis yang lebih buruk. Hal ini didasari oleh adanya mikroaspirasi patogen yang akan menginduksi pertahanan host. Sejumlah modulator peradangan endogen termasuk melanokortin terbukti dapat menghambat proses inflamasi dan membantu mencegah kerusakan jaringan. Peptida melanokortin telah terbukti menurunkan regulasi aktivasi nukleus faktor-kappa beta dan akibatnya sintesis sitokin pada fase awal akan menginduksi protein anti-inflamasi. Diketahui keberadaan reseptor MC3R pada makrofag alveolar menunjukkan aktif secara fungsional. MC3R terutama terlibat dalam efek imunomodulator. Aktivasi MC3R tidak hanya mengurangi produksi mediator pro-inflamasi, namun dapat mengatur diferensiasi sel serta kemotaksis leukosit. Melanokortin saat ini dapat ditambahkan ke sebagian besar mediator pro-resolusi melalui kemampuannya untuk meningkatkan fagositosis dan eferositosis. Namun, sejauh ini belum ada data terkait MC3R pada pasien pneumonia geriatri. Diperkirakan sifat MC3R akan menentukan fungsi lain/sifat biologis melanokortin dalam aspek resolusi inflamasi pada kasus pneumonia geriatrik
Alpha Klotho: Peran Biomolekuler dan Potensinya Sebagai Biomarker Luaran Klinis Dalam Pneumonia Geriatri Wahyudi, Dicky; Mukhtar, Diniwati; Aditama, Tjandra Yoga; Marsiati, Himmi
Jurnal Medika Malahayati Vol 8, No 4 (2024): Volume 8 Nomor 4
Publisher : Universitas Malahayati

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/jmm.v8i4.18882

Abstract

Pada populasi geriatri, pneumonia menjadi lebih berisiko karena dikaitkan dengan perubahan fisiologis yang mengakibatkan penurunan fungsi paru, berkurangnya regenerasi, remodeling saluran napas, melemahnya respons imun bawaan dan adaptif, peningkatan kerentanan hingga adanya kemungkinan komorbid yang mempersulit pemulihan. Salah satu protein sitoprotektif yang esensial dalam mencegah kerusakan paru adalah α-klotho. α-Klotho utamanya diproduksi pada ginjal merupakan salah satu hormon endokrin yang sangat penting untuk pemeliharaan dan perlindungan jaringan. α-Klotho berperan dalam mencegah penuaan, memperlambat tingkat degenerasi multi-organ prematur, menurunkan stres oksidatif, dan menekan kerusakan jaringan yang diperantarai oleh inflamasi. Efek tersebut diperoleh melaui inhibisi pada jalur transforming growth factor β (TGF-β), insulin-like growth factor 1 (IGF-1), Wnt dan NF-κB. Ekspresi α-klotho menurun seiring bertambahnya usia. Penurunan ekspresi α-klotho pada paru dikaitkan dengan peningkatan stres oksidatif, inflamasi, dan apoptosis serta penurunan fungsi pembersihan mukosiliar dan peningkatan laju pelebaran alveolus. Hingga saat ini belum ada penelitian khusus yang meneliti ekspresi ɑ-klotho pada pneumonia geriatri. Namun, penelitian terbaru mengungkap potensi protein ini sebagai biomarker. Ditemukan bahwa kadar ɑ-klotho memiliki hubungan negatif yang signifikan terhadap berbagai biomarker inflamasi akut yang merupakan komponen penting dalam patogenesis pneumonia. Potensi α-klotho sebagai modulator respon inflamasi menunjukkan kemungkinan untuk digunakan sebagai biomarker yang mewakili kondisi pneumonia pada populasi lanjut usia dalam memprediksi luaran klinis.
PENGARUH STRES OKSIDATIF PADA GINJAL TERHADAP KADAR KLOTHO Endah Purnamasari; Endang Purwaningsih; Diniwati Mukhtar; Astuti Giantini
Medika Alkhairaat: Jurnal Penelitian Kedokteran dan Kesehatan Vol 6 No 3 (2024): Desember
Publisher : Fakultas Kedokteran Universitas Alkhairaat

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.31970/ma.v6i3.218

Abstract

Pada stres oksidatif terjadi peningkatan produksi reactive oxygen species (ROS) dan penurunan antioksidan. Akumulasi ROS dan ketidakseimbangan redoks menyebabkan disregulasi dan atau oksidasi protein, asam nukleat, karbohidrat, dan lipid yang semuanya berkontribusi terhadap apoptosis dan nekrosis sel. Stres oksidatif pada ginjal dapat menyebabkan disregulasi yang berlanjut menjadi kerusakan sel tubulus ginjal, terlibat dalam patofisiologi kerusakan ginjal akut maupun kronis, serta bertanggungjawab terhadap progresifitas penyakit ginjal. Klotho adalah protein transmembran single-pass yang diekspresikan terutama di tubulus distal dan sedikit di tubulus proksimal ginjal. Setelah dipecah oleh protease, Klotho dapat ditemukan di dalam darah dan urin. Klotho mempunyai peran perlindungan yang potensial melalui mekanisme anti inflamasi, aktivasi autofagi, meredam stress oksidatif, dan melindungi fungsi mitokondria. Bila sel tubulus ginjal mengalami stres oksidatif, maka kadar Klotho di darah dan urin menurun secara signifikan.
PERITONITIS BAKTERIAL SPONTAN DAN PENGARUH PENGHAMBAT POMPA PROTON PADA PENDERITIA SIROSIS HATI Lelosutan, Syafruddin; Sakura Muhammad Tola; Intan Keumala Dewi; Endah Purnamasari; Diniwati Mukhtar; Muhammad Samsul Mustofa; Himmi Marsiati
Medika Alkhairaat: Jurnal Penelitian Kedokteran dan Kesehatan Vol 6 No 3 (2024): Desember
Publisher : Fakultas Kedokteran Universitas Alkhairaat

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.31970/ma.v6i3.224

Abstract

Abstract. Spontaneous bacterial peritonitis (SBP) is an acute infection of ascitic fluid in the abdominal cavity (ACAF - ascitic fluid that accumulates in the abdominal cavity) in patients with portal hypertension who experience ascites and is a serious complication of internal medical emergencies in patients with Liver cirrhosis (SH) and nephrotic syndrome (SN). A pathophysiological condition that may be contaminating, such as contamination of dialysate fluid in patients with chronic renal failure (CKD) who receive peritoneal dialysis (PD) or that stimulates the transmission of germs, such as long-term use of proton pump inhibitors (PPI) in SH sufferers, could be an infectious etiology. The pathophysiology of SBP in SH is an inoculation of bacteria in the form of intestinal organisms in ACAF which most likely (> 90%) comes from bacterial contamination due to transmission of germs from the gastrointestinal tract in the presence of enteric microorganism endotoxin which is a direct transmural migration (DTM) of hollow and solid organ bacteria. stomach (gastrointestinal system / esophago-gastro-duodenalis, small and large intestines and pancreatic-hepato-biliary system / pancreas, liver, gallbladder and its ducts); known as enteric bacterial translocation (EBT). Understanding the pathophysiological process of SBP is generally not paid much attention by clinical practitioners, let alone understanding what types of germs are in ascitic fluid. This can be seen from the rare critical assessment (culture and cytology) of the existing ascitic fluid, perhaps even thinking about the presence or absence of ascites at the start of a case of liver cirrhosis (SH). General results show that SH patients who receive PPI therapy appear to experience SBP more often than those who do not receive PPI therapy in their treatment. This review aims to be a critical review of the use of PPIs in liver cirrhosis sufferers to warn of the risk of germ migration from the gastrointestinal tract to ascitic fluid which might cause SBP. Study and understand the literature relating to the management of SBP and the risks of using PPIs in liver cirrhosis sufferers. Gain an understanding of the risks of using PPIs in liver cirrhosis sufferers.
The Comparative Effects of Almond and Peanut on Adipose Tissue Profile and Blood Sugar Levels in Rats: A Review from an Islamic Perspective prastina sari, Putri Agnia; Mukhtar, Diniwati; Ainur Rahmah, Nunung; Astiwara, Endy Muhammad
Junior Medical Journal Vol. 3 No. 1 (2024): September 2024
Publisher : Fakultas Kedokteran Universitas YARSI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33476/jmj.v3i1.4690

Abstract

Type 2 diabetes and cardiovascular disease are associated with high blood sugar and poor lipid profiles. Almonds and peanuts have the potential to reduce these risks. This study aims to evaluate the effects of these two nuts on blood sugar levels and lipid profiles, within the Islamic perspective of halal and thayyib foods. An experimental study was conducted with 4 groups: standard feed (K1), high-fat feed (K2), almond feed (K3), and peanut feed (K4) over 4 weeks. Blood sugar measurements were taken using the GOD-PAP method, and histopathological analysis of adipose tissue was performed using Hematoxylin-Eosin (HE) staining. The results showed that both almonds and peanuts significantly (P<0.05) increased blood sugar levels. When compared to the high-fat feed group, the nut groups were more effective in inhibiting this increase. However, changes in blood sugar levels and lipid profiles were not statistically significant (P>0.05). From the study results, it can be concluded that there are differences in blood sugar and lipid profiles after the consumption of almonds and peanuts, although not significant. The consumption of halal and thayyib foods is recommended in Islam.
Dietary almonds and peanuts improve metabolic health and reduce oxidative stress in wistar rats Mukhtar, Diniwati; Rahmah, Nunung Ainur; Royhan, Aan; Yusnidar, Amirah
Science Midwifery Vol 13 No 1 (2025): April: Health Sciences and related fields
Publisher : Institute of Computer Science (IOCS)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35335/midwifery.v13i1.1856

Abstract

Metabolic syndrome characterized by insulin resistance, atherogenic dyslipidemia, and hypertension, is a significant health concern often associated with obesity and Diabetes Mellitus. Regular consumption of nuts has been suggested to mitigate some of these conditions. This study investigates the effects of almond and peanut consumption on oxidative stress, plasma lipids, body weight, glucose, and blood pressure in Wistar rats. Wistar rats were divided into four dietary groups: standard diet (ST), high-fat diet (HF), high-fat diet with almonds (HFA), and high-fat diet with peanuts (HFP). The treatment lasted for 8 weeks, during which body weight was monitored weekly. Blood pressure measurements and retro-orbital blood samples were collected before and after the treatment. Superoxide dismutase (SOD) and malondialdehyde (MDA) levels were measured using ELISA and TBARS methods. Blood lipid profiles and glucose levels were analyzed using enzymatic methods. Statistical tests used the oAnova followed by Posthoc LSD. The HF group exhibited significant increases in body weight, blood glucose, cholesterol, triglycerides, MDA, and blood pressure, with reduced SOD levels. Conversely, the HFA and HFP groups showed moderated increases in these parameters compared to the HF group. Both nut-supplemented groups had significantly lower MDA levels and higher SOD activity, indicating reduced oxidative stress and enhanced antioxidative defenses. Almonds and peanuts can reduce body fat, improve lipid profiles, and stabilize blood glucose levels, suggesting their potential role in promoting metabolic health and reducing cardiovascular risk. Further research should explore the long-term benefits and the specific bioactive compounds responsible for these effects.
Hubungan Tingkat Stres terhadap Aktivitas Fisik pada Mahasiswa Fakultas Kedokteran Universitas YARSI Angkata 2021/2022 dan Tinjauannya Menurut Pandangan Islam Melia Puji Pratami; Mukhtar, Diniwati; Arsyad, Muhammad
Junior Medical Journal Vol. 3 No. 2 (2024): October 2024
Publisher : Fakultas Kedokteran Universitas YARSI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33476/jmj.v3i2.4347

Abstract

Pendahuluan: Stres di definisikan sebagai respon tubuh yang diakibatkan karena adanya tuntutan dari luar diri individu yang melebihi kemampuan dalam memenuhi tuntutan untuk mengatasi dan menyelesaikan suatu masalah. Aktivitas fisik merupakan serangkaian gerak yang teratur untuk memelihara gerak dan meningkatkan kemampuan gerak. Melakukan aktivitas fisik dengan tujuan mengembangkan aspek jasmani maupun rohani dapat berdampak positif bagi orang yang melakukannya yaitu guna meningkatkan daya tahan tubuh demi meningkatkan aktivitas keimanan, dan mengurangi resiko stres. Sehingga dengan melakukan penelitian, maka seorang muslim mengetahui suatu kebenaran ilmu Allah SWT dan manfaatnya bisa berguna bagi orang lain. Tujuan: Tujuan dari penelitian ini adalah untuk mengetahui hubungan tingkat stres terhadap aktivitas fisik pada mahasiswa kedokteran Universitas Yarsi Angkatan 2021 dan 2022. Metodologi: Penelitian ini menggunakan jenis penelitian deskriptif analisis dengan metode cross sectional. Populasi dalam penelitian ini adalah mahasiswa fakultas Kedokteran Universitas Yarsi. Analisis data yang dilakukan dengan analisis univariat dan analisis bivariat. Hasil: Hasil uji univariat menunjukkan terdapat 5 orang (6,7%) mengalami stres ringan, 64 orang (85,3%) mengalami stres sedang, serta 6 orang (8%) mengalami stres berat. Serta terdapat terdapat 30 orang (40%) melakukan aktivitas fisik ringan, 39 orang (52%) melakukan aktivitas fisik sedang, serta 6 orang (8%) melakukan aktivitas fisik berat. Simpulan: Hasil uji chi-square dengan hasil p-value 0,147 (> 0,05) yang menyatakan bahwa hubungan antara tingkat stres terhadap aktivitas fisik tidak terdapat perbedaan yang signifikan.
Interaction of Oral Microbiota and Type 1 Diabetes Mellitus in Children: A Narrative Review Maharsi, Eri Dian; Sudarmono, Pratiwi Pudjilestari; Mukhtar, Diniwati; Fadilah , Fadilah
Eduvest - Journal of Universal Studies Vol. 5 No. 5 (2025): Eduvest - Journal of Universal Studies
Publisher : Green Publisher Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59188/eduvest.v5i5.51180

Abstract

Type 1 diabetes mellitus (DM T1) is a chronic autoimmune disease that is common in children and adolescents, characterized by damage to cells β pancreas that leads to absolute insulin deficiency. This condition contributes to metabolic disorders, immune dysfunction, and an imbalance of the body's microbiota, including the oral microbiota. The oral cavity as one of the important microbiota ecosystems, plays a central role in maintaining local and systemic health. In children with T1 DM, oral dysbiosis is often found and is associated with an increased risk of periodontal disease and caries. This literature review aims to understand the interaction between oral microbiota and T1 DM in children, by highlighting changes in microbiota composition, their impact on oral and systemic health, and the potential for microbiota-based therapeutic interventions. Discussion. Commensal microbes in the oral cavity play a role in maintaining the homeostasis of the oral environment. However, in the DM T1 condition, there is an increase in pathogenic bacteria such as Porphyromonas gingivalis, Prevotella intermedia (P. Intermedia) and Fusobacterium nucleatum that trigger periodontal inflammation and the release of pro-inflammatory cytokines (IL-1β, TNF-α, IL-6). This can worsen the regulation of glucose metabolism and increase susceptibility to infection. An overview of clinical manifestations due to dysbiosis that occur in the form of gingivitis, periodontitis, xerostomia, oral candidiasis, and delayed wound healing. Conclusions, The reciprocal interactions between the oral microbiota and T1 DM reflect the complex relationship between dysbiosis, inflammation, and immune dysregulation.
Faktor Risiko Kematian Pasien Covid-19 Periode September 2021 - 2022 di RS Yarsi dengan Komorbid Diabetes Melitus Serta Tinjauannya Menurut Pandangan Islam Putra Pangraizan, Farel; Mukhtar, Diniwati; Ainur Rahmah, Nunung; Ma'sum, Ali
Junior Medical Journal Vol. 3 No. 3 (2025): Maret 2025
Publisher : Fakultas Kedokteran Universitas YARSI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33476/jmj.v3i3.4409

Abstract

KATA KUNCI COVID-19, Diabetes Melitus, Komorbid, Kematian, Faktor Risiko ABSTRAK Penelitian ini dilakukan untuk mengetahui fakor resiko kematian pasien covid 19 periode september 2021-2022 di RS yarsi dengan komorbid diabetes melitus serta tinjauannya menurut pandangan islam. Penelitian ini menggunakan metode kuantitatif dengan desain penelitian kohort retrospektif. Sampel penelitian diambil secara total sampling. Data dikumpulkan melalui data sekunder menggunakan data rekam medis. Pada penelitian ini terdapat 10 Sampel. Analisis dilakukan menggunakan uji Chi Square: Hasil analisis menunjukkan tidak terdapat hubungan yang signifikan antara usia dan jenis kelamin terhadap kematian pasien covid-19 dengaan komorbid diabetes melitus dan komorbid lain karena nilai signifikansi tersebut memiliki nilai yang lebih besar dari 0,05, sehingga H0 diterima.Dalam pandangan islam, kematian dan penyakit dapat dibagi menjadi dua yaitu fisik dan non-fisik. Dalam kasus penelitian ini covid-19 sendiri masuk kedalam penyakit medis atau dalam pandangan islam masuk kedalam penyakit fisik yaitu penyakit badan, penyakit yang tampak dan dapat kita rasakan. KEYWORDS COVID-19, Geriatric, Comorbid, Death, Factor Risks ABSTRACT This research was conducted to determine the risk factors for death of Covid 19 patients for the period September 2021-2022 at Yarsi Hospital with comorbid diabetes mellitus and its review according to Islamic views. This research uses quantitative methods with a retrospective cohort research design. The research sample was taken by total sampling. Data was collected through secondary data using medical record data. In this study there were 10 samples. The analysis was carried out using the Chi Square test: The results of the analysis showed that there was no significant relationship between age and gender on the death of Covid-19 patients with comorbid diabetes mellitus and other comorbidities because the significance value had a value greater than 0.05, so H0 was accepted .In the Islamic view, death and disease can be divided into two, namely physical and non-physical. In the case of this research, Covid-19 itself is a medical disease or in the Islamic view it is a physical disease, namely a bodily disease, a disease that we can see and feel.
Molecular Biomarkers in Pneumonia: Therapeutic Potential of Traditional Plant Medicine Awairaro, Tirsa Persila; Mukhtar, Diniwati; Budiman, Dicky; Marsiati, Himmi
Indonesian Journal of Global Health Research Vol 7 No 5 (2025): Indonesian Journal of Global Health Research
Publisher : GLOBAL HEALTH SCIENCE GROUP

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37287/ijghr.v7i5.6671

Abstract

Pneumonia causes 2.56 million global deaths annually, with current therapies limited by antimicrobial resistance and adverse effects. Traditional medicinal plants offer multi-target potential through anti-inflammatory, antioxidant, and immunomodulatory mechanisms. This review synthesizes knowledge on molecular biomarkers in pneumonia pathogenesis and evaluates therapeutic potential of medicinal plants, particularly Coleus amboinicus. A comprehensive literature search was conducted across PubMed/MEDLINE, Scopus, and Web of Science covering publications from January 2000 to June 2025. Inclusion criteria encompassed studies investigating molecular biomarkers, pneumonia therapeutic pathways, or medicinal plants with respiratory therapeutic properties. Narrative synthesis was employed due to study heterogeneity. Of 1,247 articles identified, 10 studies met inclusion criteria and were utilized in the analysis. Key inflammatory biomarkers included IL-6, TNF-α, and IL-1β, increasing from 5.05 mg/dL (controls) to 25.30 mg/dL in bacterial pneumonia. Neutrophil extracellular trap (NET) formation emerged as a central mechanism (47.36% of protein targets). Coleus amboinicus demonstrated 139 bioactive compounds with broad-spectrum antimicrobial activity and antioxidant properties (DPPH EC₅₀ 32.67-152.8 µg/mL). Traditional medicinal plants, particularly Coleus amboinicus, modulate key molecular pathways in pneumonia through sophisticated multi-target mechanisms, supporting integration of biomarker-guided approaches in contemporary respiratory care.
Co-Authors Aan Royhan Aan Royhan Aan Royhan Aan Royhan Ainur Rahmah, Nunung Alqudsi, Hade Irhas Amsaka, Azha Azzuna Anisya Fitriah Astalia Maisya Adhitama Astiwara, Endy M Astiwara, Endy Muhammad Astuti Giantini Awairaro, Tirsa Persila Budiman, Dicky Dian Noor Aristi Dicky Wahyudi Dita Safira Dita Safira Salsabila Endah purnamasari Endang Purwaningsih Endy Muhammad Astiwara Endy Muhammad Istiwara Fadilah , Fadilah Farah Zahida Fatimah Eliana Taufik Febri Irwansyah Ferlianti, Rika Fitriani, Hasna L. Haddad, Desi Ariyani Hasna Luthfiah Hasna Luthfiah Fitriani Hasna Luthfiah Fitriani Himmi Marsiati Himmi Marsiati Himmi Marsiati Hutabarat, Andrea Ivana Allicia Intan Keumala Dewi Irfan Syarif, Irfan Karina A Ridwan Karina Ajeng Ridwan Lelosutan, Syafruddin Lena Fitriyana Linda Weni Linda Weni M Arsyad Ma'sum, Ali Maharsi, Eri Dian Manik, Sabarina Elfrida Marsiati, Himmi Melasari Marantika Melia Puji Pratami Muhammad Arsyad Muhammad Iqbal Thamrin Muhammad Samsul Mustofa Muhammad Samsul Mustofa Mustofa, M Samsul Naila Nur Fauziah Novia Suci Ramadhanti Nunung Ainur Rahmah Nursabur, Bistamy Muhammad Nurwijayanti Pd, Fanny Ratnasari prastina sari, Putri Agnia Puspita, Switania Putri Putra Pangraizan, Farel Q Qomariyah Qomariyah Qomariyah Qomariyah Sachrowardi Retno Noviar Dhani Ridwan, Karina A. D. A. Ridwan, Karina Ajeng Sakura Muhammad Tola Siti Helmyati Sri Wuryanti Sudarmono, Pratiwi Pudjilestari Susmiarsih Panjiasih, Tri Taufik, Fatimah Eliana Tjandra Yoga Aditama Tw, Afrizal Wan Nedra Widiastari, Erina Febriani Yulia Suciati Yusnidar, Amirah