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The Effects of Moderate Intensity Treadmill Exercise with Gradual Increase of Speed and Inclination on VO2max in Men with Type 2 Diabetes Mellitus Mas'adah Mas'adah; Damayanti Tinduh; Nur Sulastri; Sony Wibisono Mudjanarko
Surabaya Physical Medicine and Rehabilitation Journal Vol. 3 No. 2 (2021): SPMRJ, AUGUST 2021
Publisher : Faculty of Medicine, Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/spmrj.v3i2.22589

Background: The American College of Sport Medicine (ACSM) recommends cardiorespiratory fitness training in people with diabetes mellitus (DM) for 3-7 days a week, total duration 150 minutes a week with moderate intensity using large muscle groups. Treadmill training is the best cardiorespiratory fitness training because it involves large muscle group compared to static cycle and arm crank.Aim: To determine the effect of moderate intensity treadmill exercise with gradual increase of speed and inclination on VO2max in men with T2DM.Material and Methods: Randomized group design in 22 men with T2DM, suitable with inclusion criteria was divided into 2 groups, the experimental and control group. The experimental group received moderate intensity treadmill exercise, 3 times a week with gradual increase of speed and inclination for 4 weeks. The control group underwent standard therapy. Measurement of VO2max was performed before and after program in both groups.Results: A significant increase of VO2max in the experimental group (p = 0.003). Compared to the control group, alteration of VO2max also significant among the experimental group (p = 0.000).Conclusion: Moderate intensity treadmill exercise with gradual increase on speed and inclination for 4 weeks increase VO2max in men with T2DM.

Effect of Acute Persadia Gymnastic on The Ability to Concentrate in Diabetic Patients Desi Rianti Rahmadhani; Lilik Herawati; Sony Wibisono Mudjanarko; Kristanti Wanito Wigati; Laylatul Fitriah Mukarromah; Winna Adelia Amru
Surabaya Physical Medicine and Rehabilitation Journal Vol. 4 No. 1 (2022): SPMRJ, FEBRUARY 2022
Publisher : Faculty of Medicine, Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/spmrj.v4i1.23465

Background: Diabetes Mellitus (DM) can affect the peripheral and central nervous system. It can affect cognitive function, one of which can be seen from the decrease in the concentration ability. The concentration ability can be assessed by measuring the reaction time. Reaction time is the time interval between the onset of a stimulus and the initiations of a response. One of the important treatments for DM is physical exercises. Persadia gymnastic is one example of physical exercise that is specially designed for people with DM.Aim: The purpose of this study was to identify the effect of acute Persadia gymnastic on the concentration ability of people with DM.Material and methods: This was an experimental study in type 2 DM patients. Fourteen subjects who met the inclusion criteria were analyzed and randomly grouped into the control (without performing Persadia gymnastic) and the intervention group (performing Persadia gymnastic). The subject’s reaction times were measured before and after the intervention. The mean results of the reaction time of all subjects were then compared between the control and the intervention groups using the Independent-T test and Mann-Whitney tests.Result: The analyzed data were only 7 subjects per group with a total of 14 subjects. The mean value of reaction time in the intervention group was decreased, both audio (-0.04 ± 0.85) and visual (-0.09 ± 0.56). However, there was no significant difference of the reaction time between control and intervention groups (p > 0.05).Conclusions: Many factors can affect reaction time and some still cannot be controlled in this study due to a lot of limitations. Further research is still needed to figure out the effect of persadia gymnastics on the ability to concentrate in people with Diabetes Mellitus.

Risk Factors for Lower Extremity Amputation in Diabetic Foot Ulcer Patients: A Case-Control Study Gusti Agung Ayu Ira Kencana Dewi; Sony Wibisono; I Putu Alit Pawana
JUXTA: Jurnal Ilmiah Mahasiswa Kedokteran Universitas Airlangga Vol. 11 No. 2 (2020): Jurnal Ilmiah Mahasiswa Kedokteran Universitas Airlangga
Publisher : Faculty of Medicine Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/juxta.V11I22020.83-85

Introduction: Diabetes mellitus is a metabolic syndrome that is marked by higher blood glucose. The uncontrolled high blood glucose can lead to complication, such as diabetic foot. Diabetic foot is the most reason why diabetic patients are hospitalized. Diabetic foot that cannot heal may lead to lower extremity amputation. The purpose of this study was to describe the risk factors of lower extremity amputation in diabetic foot ulcer patients.Methods: This study used a case-control study of diabetic foot patients in Dr. Soetomo General Hospital from January 2015 to December 2017. This study used the data from medical records in Inpatient Installation Department of Internal Medicine. Patients with diabetic foot ulcer and lower extremity amputation due to diabetes were included in this study. Incomplete medical records were excluded. Data of samples were divided to two groups, i.e. the amputation group and the non-amputation group with a ratio of 1:1. Risk factors of amputation that were analyzed were male, old age, and the history of ulcer/lower extremity amputation.Results: Based on the data of 36 samples, there were 11 male patients (61.1%) and 7 female patients (38.9%) who experienced lower extremity amputation. The average age of amputation group was 59.61 years old with a range of ages from 39 to 72 years old. This study found the risk factors for lower extremity amputation in diabetic foot ulcer patients was the history of ulcer/amputation due to diabetes (OR 5.0, 95% CI 1.065-23.464, p = 0.034). Conclusion: The risk factor for lower extremity amputation in diabetic foot ulcer patients was the history of ulcer/amputation due to diabetes.

Serum Receptor Activator of Nuclear Factor-κβ Ligand and Osteoprotegerin Levels and Ratio in Correlation with Bone Mineral Density Fauqa Arinil Aulia; Sri Lestari Utami; Leonita Anniwati; Sony Wibisono Mudjanarko; Ferdy Royland Marpaung
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 27, No 1 (2020)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v27i1.1627

Osteoporosis is a disorder represented by manifestations of low bone mass, decreased bone tissue, and disrupted bonemicroarchitecture. The diagnosis of osteoporosis so far has been based on fracture manifestations after minimal trauma orby detecting low Bone Mineral Density (BMD). Measurement of Receptor Activator of Nuclear Factor-κβ Ligand (RANKL)and Osteoprotegerin (OPG) levels has opened the discourse of a more specific assessment of osteoblast and osteoclastregulation. The RANKL/OPG ratio can represent resorption and bone formation more significantly when correlated withBMD features. This study aimed to analyze the correlation between serum RANKL and OPG levels and ratio with BMD. A totalof 58 post-menopausal females from 13 elderly in Integrated Community Health Care Surabaya and Sidoarjo were enrolled.Data were collected by recording age, onset of menarche, onset of menopause, and Body Mass Index (BMI). Serum RANKLand OPG levels were evaluated using sandwich ELISA from Elabscience®. The RANKL/OPG ratio was obtained from the ratiobetween measured RANKL and OPG levels in serum. The proximal femur and lumbar spine BMDs were measured usingHologic® Discovery™ QDR™ Dual-Energy X-ray Absorptiometry (DEXA). Pearson's correlation test in this study showed nosignificant correlation between BMD and RANKL levels (lumbar: p=0.203; hip: p=0.283). The insignificant result was alsoshown in the correlation between BMD and OPG levels (lumbar: p=0.412; hip: p=0.617). A significant result between lumbarBMD and RANKL/OPG ratio was only found in the osteopenia subjects (p=0.001). The RANKL/OPG ratio had a significantcorrelation only with osteopenia-BMD in post-menopausal females. Therefore, it could be used as supporting data inosteoporosis screening.

CORRELATIONS BETWEEN MEAN PLATELET VOLUME AND IMMATURE PLATELET FRACTION TO HEMOGLOBIN A1C IN PATIENTS WITH TYPE 2 DIABETES MELLITUS Dian W Astuti; Sony Wibisono; Arifoel Hajat; Sidarti Soehita
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 24, No 1 (2017)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v24i1.1148

Pasien diabetes melitus tipe 2 berkebahayaan mengalami komplikasi makro dan mikrovaskuler, yang dipengaruhi oleh kendaliglikemik. Reaktivitas trombosit berperan pada timbulnya komplikasi ini, terutama komplikasi kardiovaskuler. Tujuan penelitian iniadalah membandingkan MPV dan IPF di kendali glikemik baik dan buruk dan menentukan adanya kenasaban MPV dan IPF terhadapHbA1c. Penelitian bersifat analitik observasional dengan rancang bangun potong lintang. Sampel darah EDTA dari 43 orang pasienDM tipe 2, dikumpulkan selama Januari-Februari 2016. HbA1c diperiksa dengan Dimension RxL, sedangkan MPV dan IPF diperiksadengan Sysmex XN-1000. Rerata nilai MPV 10,36±0,84 fL, rerata nilai IPF 4,22±2,29%. Uji perbedaan nilai MPV menurut kendaliglikemik didapatkan p=0,494, uji perbedaan IPF didapatkan p=0,462. Uji kenasaban Pearson antara IPF dan MPV didapatkanr=0,877 (p<0,0001), MPV dan HbA1c didapatkan r=0,018 (p=0,907), IPF dan HbA1c didapatkan r=0,128 (p=0,414). Penelitian inimenunjukkan rerata MPV berada dalam rentang normal, sedangkan rerata IPF meningkat, namun tak terdapat perbedaan bermaknanilai MPV dan IPF di kendali glikemik baik dan buruk. MPV dan IPF pada penelitian ini tak bernasab dengan HbA1c.

A CASE REPORT: CHALLENGES IN THE MANAGEMENT OF TOXIC MULTI NODULAR THYROID IN PREGNANCY WHO HAD CRISIS THYROID Kurnia Alisaputri; Sony Wibisono
Current Internal Medicine Research and Practice Surabaya Journal Vol. 2 No. 2 (2021): CURRENT INTERNAL MEDICINE RESEARCH AND PRACTICE SURABAYA JOURNAL
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/cimrj.v2i2.26243

Managing crisis thyroid in toxic multi nodular thyroid in pregnancy is challenging. This case objective is to highlight comprehensive treatment going to safe mother & baby’s life. A woman, 43 years old in 13th week of her third pregnancy, admitted in emergency room with palpitating and vomiting as her chief complaints. Her complaints had started since she stopped taking propylthiouracyl. She used to take it since diagnosed hyperthyroid. She was diagnosed crisis hyperthyroid in pregnancy. The first main goal was to stabilize the patient, curing the precipitate factors, and assist her to have a healthy baby. She was discharged from hospital day 7th. She was routinely checked FT4 for evaluation and switch on Thyrozol during 25-26th weeks and continued it until postpartum. Her baby was delivered vaginally with normal APGAR score and growing well. Based on her experience, she agreed to have IUD to prevent unplanned pregnancy.

Comparison of Neutrophyl Lymphocyte Ratio and Nerve Conduction Study Between Male Type 2 Diabetes Mellitus With or Without Peripheral Neuropathy Complication Martha Kurnia Kusumawardani; Surdiana; I Putu Alit Pawana; Sony Wibisono
Indonesian Journal of Physical Medicine & Rehabilitation Vol 11 No 01 (2022): Indonesian Journal Of Physical Medicine and Rehabilitation
Publisher : Indonesian Journal of Physical Medicine & Rehabilitation

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36803/ijpmr.v11i01.326

ABSTRACT Background: Diabetic Peripheral Neuropathy (DPN) is one of the type 2 Diabetes Melitus (T2DM) complication, which may lead to diabetic foot ulcer and lower extremity amputation. Inflammation plays a role in the pathogenesis of this type 2 DM complication. Recent studies showed neutrophyl-lymphocyte ratio (NLR) is a potential inflammation marker. Early screening for neuropathy is an important part of the medical rehabilitation management of this condition. Material and methods: This study uses data analysis independent sample T-2 test with a significant (p<0.05). This study is a analytic observation cross-sectional study with type 2 diabetic male subjects, screened with Michigan Neuropathy Screening Instrument then divided into 2 groups, with DPN group (11 subjects) and without DPN group (7 subjects). This was followed with complete blood count laboratory testing (neutrophyl and lymphocyte level) and NCS to measure distal latency, amplitudo, and NCV of the tibial, peroneal, and suralnerve on both lower extremities. Result: There were 18 subjects in this study. Independent T-2 test showed that there was no significant difference in neutrophils (p=0.679), lymphocytes (p=0.127), and NLR (p=0.190) in the DM group without or with neuropathy. NCS showed that there were significant differences on the amplitude of the three nerves peroneal (p=0.003), tibial (p=0.017), sural (p=0.033), also in NCV of peroneal (p=0.001) and tibial (p=0.008). There were no significant differences found on the three distal latency of peroneal (p=0.074), tibial (p=0.151), sural(p=0.294), and NCV of sural (p=0.262). Conclusions: This study shows that there is no significant difference in NLR on both groups. There were significant differences in the amplitude of the three peroneal, tibial, and sural nerves and the conduction velocity of the peroneal and tibial nerves. However, there was no significant difference in the distal latency of the threeperoneal, tibial, sural, and the NCV of the sural nerves.Keywords: diabetes melitus, diabetic peripheral neuropathy, nerve conduction studies, neutrophyl-lymphocyte ratio, rehabilitation management.

Comparison of Neutrophyl Lymphocyte Ratio and Nerve Conduction Study Between Male Type 2 Diabetes Mellitus With or Without Peripheral Neuropathy Complication Martha Kurnia Kusumawardani; Surdiana; I Putu Alit Pawana; Sony Wibisono
Indonesian Journal of Physical Medicine & Rehabilitation Vol 11 No 01 (2022): Indonesian Journal Of Physical Medicine and Rehabilitation
Publisher : Indonesian Journal of Physical Medicine & Rehabilitation

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36803/ijpmr.v11i01.326

ABSTRACT Background: Diabetic Peripheral Neuropathy (DPN) is one of the type 2 Diabetes Melitus (T2DM) complication, which may lead to diabetic foot ulcer and lower extremity amputation. Inflammation plays a role in the pathogenesis of this type 2 DM complication. Recent studies showed neutrophyl-lymphocyte ratio (NLR) is a potential inflammation marker. Early screening for neuropathy is an important part of the medical rehabilitation management of this condition. Material and methods: This study uses data analysis independent sample T-2 test with a significant (p<0.05). This study is a analytic observation cross-sectional study with type 2 diabetic male subjects, screened with Michigan Neuropathy Screening Instrument then divided into 2 groups, with DPN group (11 subjects) and without DPN group (7 subjects). This was followed with complete blood count laboratory testing (neutrophyl and lymphocyte level) and NCS to measure distal latency, amplitudo, and NCV of the tibial, peroneal, and suralnerve on both lower extremities. Result: There were 18 subjects in this study. Independent T-2 test showed that there was no significant difference in neutrophils (p=0.679), lymphocytes (p=0.127), and NLR (p=0.190) in the DM group without or with neuropathy. NCS showed that there were significant differences on the amplitude of the three nerves peroneal (p=0.003), tibial (p=0.017), sural (p=0.033), also in NCV of peroneal (p=0.001) and tibial (p=0.008). There were no significant differences found on the three distal latency of peroneal (p=0.074), tibial (p=0.151), sural(p=0.294), and NCV of sural (p=0.262). Conclusions: This study shows that there is no significant difference in NLR on both groups. There were significant differences in the amplitude of the three peroneal, tibial, and sural nerves and the conduction velocity of the peroneal and tibial nerves. However, there was no significant difference in the distal latency of the threeperoneal, tibial, sural, and the NCV of the sural nerves.Keywords: diabetes melitus, diabetic peripheral neuropathy, nerve conduction studies, neutrophyl-lymphocyte ratio, rehabilitation management.

Medication Adherence in Type 2 Diabetes Mellitus Patients with Diabetic Ulcer: Systematic Literature Review: English Safira Raissa Dwi Putri; Sony Wibisono Mudjanarko; Bambang Hermanto
Indonesian Archives and Biomedical Sciences Vol 1 No 2 (2021): Indonesian Archives of Biomedical Research (InABR). 1(2): 2021
Publisher : Konsorsium Ilmu Biomedik Indonesia (KIBI)

Background: Patient non-adherence to diabetes medication can worsen the patient's condition and increase the risk of diabetes complications such as diabetic ulcers. A sufficient level of medication adherence can prevent diabetic complications. This study aimed to determine the level of medication adherence of type 2 DM patients with diabetic ulcers. Review: This research uses a systematic literature review with a PRISMA chart as a research design guideline. Researchers searched three databases, namely PubMed, Google Scholar, and ScienceDirect, using predefined keywords. The search resulted in 2,763 literatures then 11 literatures that met the criteria were taken. The number of respondents obtained amounted to 1,082 people. Characteristics of type 2 DM patients with diabetic ulcers: respondents were female, aged under 60 years, had diabetes for more than five years, used oral medication, insulin, or combination, could have normal or excess BMI, and possibly had hypertension or neuropathy. The result from systematic literature review obtained seven pieces of literature that had a low medication adherence level, two pieces of literature showed no correlation between medication adherence and the incidence of diabetic ulcers in type 2 DM patients, and two pieces of literature had a sufficient level of medication adherence. Summary: The level of medication adherence in type 2 DM patients with diabetic ulcers varies. However, more literature contains results in low medication adherence of type 2 Diabetes Mellitus patients with diabetic ulcers, so it needs to be improved in the future. Keywords: diabetic ulcer, medication adherence, type 2 diabetes mellitus

Mortality among Heart Failure Patients in the Presence of Cachexia Andrianto; Ula Nur Pramesti Karman; Sony Wibisono Mudjanarko; Meity Ardiana; Hanestya Oky Hermawan
Folia Medica Indonesiana Vol. 59 No. 1 (2023): March
Publisher : Universitas Airlangga

Highlights: Around 38.8% of heart failure patients with cachexia died during the 180-1,876-day follow-up period. Cachexia increases the risk of mortality in heart failure patients. Abstract: Despite the fact that obesity has long been recognized as a risk factor for cardiovascular disease, the mortality rate of heart failure (HF) patients with cachexia is still high. Several studies have been conducted to investigate the association between cachexia and mortality in HF patients. However, the research results vary, as do the diagnostic criteria employed to assess cachexia. This meta-analysis aimed to conclusively summarize the association between cachexia and mortality in HF patients. The data were obtained from prospective or retrospective cohort studies with full texts in English or Indonesian and keywords related to "cachexia," "heart failure," and/ or "mortality". Studies that did not assess mortality in HF patients with cachexia and had no full text accessible were omitted. A literature search was conducted through four databases (PubMed, Web of Science, Scopus, and SAGE Journals) using keywords, reference searches, and/ or other methods on April 2022 in accordance with the Preferred Reported Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Data from the selected studies were presented and analyzed using qualitative and quantitative synthesis methods. The Newcastle-Ottawa Scale (NOS) was used to assess the risk of bias in the selected cohort studies. The qualitative synthesis contained nine studies, whereas the quantitative synthesis (meta-analysis) included six studies. Cachexia was found in 16.0% of the 4,697 patients studied. During the 180-1,876-day follow-up period, 33.0% of the patients died, with a mortality rate of 38.8% among the patients with cachexia. The pooled analysis revealed cachexia to be a significant predictor of mortality in HF patients (hazard ratio (HR)=3.84; 95% CI=2.28-6.45; p<0.00001), but with significant heterogeneity (p<0.00001; I2=88%). In conclusion, cachexia worsens HF prognosis.

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