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EFEKTIVITAS SUPLEMENTASI VITAMIN D TERHADAP SKOR BECK DEPRESSION INVENTORY PADA PASIEN ACQUIRED IMMUNODEFICIENCY SYNDROME DI POLIKLINIK VCT RSUP DR MOHAMMAD HOESIN PALEMBANG Ridzqie Dibyantari; Muhammad Ali Apriansyah; Mediarty Syahrir; Erial Bahar
JURNAL KEDOKTERAN DAN KESEHATAN Vol 8, No 2 (2021)
Publisher : Fakultas Kedokteran Universitas Sriwijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32539/V8I2.12063

Depresi merupakan gangguan psikosomatik tersering pada pasien terinfeksi HIV dan mengganggu kualitas hidup penderita secara bermakna. Hipovitaminosis D sering terjadi pada pasien AIDS dan kadar vitamin D berkorelasi negatif dengan tingkat depresi. Namun, sampai saat ini belum ada penelitian mengenai efektivitas suplementasi vitamin D terhadap tingkat depresi penderita AIDS. Penelitian ini dilakukan untuk menganalisis pengaruh penambahan vitamin D terhadap perubahan tingkat depresi penderita AIDS. Penelitian uji klinis acak tersamar ganda melibatkan penderita AIDS dengan skor BDI ? 10 di Poliklinik VCT RSMH Palembang sejak April 2019 sampai dengan Februari 2020 menggunakan nonprobability consecutive sampling. Sampel dirandomisasi untuk mendapat vitamin D (calitriol 0,5 mcg per hari) atau plasebo selama 8 minggu. Uji T berpasangan digunakan untuk menilai perubahan tingkat depresi. Dari 37 subjek, terdapat 26 orang laki-laki dan 11 orang perempuan dengan skor BDI awal kelompok perlakuan 19,95±9,88 dan kelompok plasebo 20,44±8,86. Setelah 8 minggu penelitian, didapatkan skor BDI kelompok perlakuan 6,63±6,16 dan kelompok plasebo 11,94±7,14. Uji T berpasangan menunjukkan perbedaan bermaka pada tingkat depresi antara kelompok perlakuan dan plasebo (p=0,000). Suplementasi vitamin D secara bermakna memperbaiki skor BDI pada penderita AIDS.

PERBEDAAN INDEKS TROMBOSIT ANTARA PASIEN KANKER KOLOREKTAL NONMETASTASIS DAN METASTASIS DI RSMH PALEMBANG Eva Syahriana; Mediarty Mediarty; Erial Bahar; Subandrate Subandrate
JURNAL KEDOKTERAN DAN KESEHATAN Vol 8, No 2 (2021)
Publisher : Fakultas Kedokteran Universitas Sriwijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32539/V8I2.13432

Kanker kolorektal masih menjadi permasalahan kesehatan di dunia. Hal ini karena progresivitas kanker berkaitan dengan prognosis dan angka kematian. Salah satu faktor yang berhubungan dengan progresivitas dan metastasis pada kanker kolorektal adalah indeks trombosit. Penelitian ini bertujuan untuk mengetahui perbedaan indeks trombosit antara pasien kanker kolorektal nonmetastasis dan metastasis. Penelitian ini adalah penelitian analitik komparatif dengan pendekatan case-control. Subyek penelitian adalah pasien kanker kolorektal di Poliklinik Hematologi dan Onkologi Medik Penyakit Dalam dan di bangsal rawat inap Penyakit Dalam RSMH Palembang mulai Januari – Juli 2020. Sampel berupa darah yang diambil dari vena mediana cubiti. Indeks trombosit (jumlah trombosit, MPV dan PDW) diperiksa menggunakan automated hematology analyzer di Laboratorium Patologi Klinik RSMH Palembang. Data dianalisis menggunakan uji T tidak berpasangan. Hasil penelitian menunjukkan kadar trombosit (484,1±185,1/µL) lebih tinggi pada kelompok kanker kolorektal dengan metastasis dibandingkan kelompok nonmetastasis (361,9±97,9/µL) dengan nilai p=0,000. Kadar MPV (8,9±0,7 fl) dan PDW (9,1±1,4%) lebih rendah pada kelompok kanker kolorektal dengan metastasis dibandingkan kelompok nonmetastasis (masing-masing 9,5±0,8 fl dan 10,6±2,2%) dengan nilai p=0,000. Pada penelitian ini, ada perbedaan indeks trombosit antara pasien kanker kolorektal dengan metastasis dan kanker kolorektal nonmetastasis.

Efficacy of Alpha Lipoic Acid Supplementation In Chemotherapy-Induced Peripheral Neuropathy Mediarty Syahrir; Yenny Dian Andayani; Norman Djamaludin; Erty Sundarita Maksudin; Putri Farissa Muharramah; Kgs. M. Rosyidi; Hasnawi Haddani; Erial Bahar
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 5 No. 1 (2021): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32539/bsm.v5i1.162

Background. Chemotherapy-induced peripheral neuropathy is a side effect of several chemotherapy drugs and a significant cause of chronic pain in cancer patients, which affects patients' long-term quality of life. The neurotoxic chemotherapy agents most reported to cause neuropathic pains are platinum and taxane. This study aimed to determine the efficacy of alpha-lipoic acid supplementation in chemotherapy patients. Methods. This study used a randomized, double-blind clinical trial in the oncology haematology clinic in the Department of Internal Medicine at Mohammad Hoesin General Hospital Palembang from November 2018 to July 2019. Samples were taken from patients who met the inclusion criteria and signed informed consent forms to join the study. This studyused SPSS version 22.0 for Windows to analyze the data. Results. This research studied 30 subjects who were divided into alpha lipoic acid groups and placebo groups with 15 samples each. The alpha-lipoic acid group showed a significant decline in the Toronto Clinical Scoring System (TCSS) after treatment (p = 0.000) compared to the placebo group (p = 0.164). Conclusions. Treatment with a 600 mg single dose each day of alpha-lipoic acid for 12 weeks effectively improved patients condition significantly.

The Effect of Vitamin D Supplementation on the Increase in CD4 count of HIV/AIDS Patients Receiving Antiretroviral Therapy Mega Permata; Harun Hudari; Mediarty; Taufik Indrajaya
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 5 No. 1 (2021): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32539/bsm.v5i1.186

Introduction. Vitamin D plays a role in health overall, but hypovitaminosis D stilloccurs throughout the world. HIV/AIDS patients are prone to suffer fromhypovitaminosis D because of the infection itself and the side effects of antiretroviraltherapy. Various effort have been tried to improve the immune status of HIV/AIDSpatients, one of them is by adding vitamin D. Vitamin D acts as an antiinflammatoryso that it can prevent apoptosis of CD4 T cells and increase CD4 cell count.Methods. This is a randomized control trial add on a study that aims to determinethe effect of vitamin D to increase in CD4 counts of HIV / AIDS patients who havereceived antiretroviral drugs. Subjects were HIV / AIDS patients who had receivedantiretroviral drugs. A total of 20 subjects were divided randomly into two groups;one group received vitamin D (calcitriol 0.5 mcg per day) for eight weeks, and theother group that received a placebo. Each group was measured of CD4 cell countbefore and after treatment. Results. There was a significant increase in the CD4 cellcount of the vitamin D group (p = 0.046), but not in the CD4 cell count of bothgroups (p = 0.985). The comparison of mean CD4 cell counts between groups beforetreatment was not significantly different (p = 0.057), but after treatment, it becamesignificantly different (p = 0.040). Conclusion. Vitamin D has been successful inincreasing CD4 cell count in the vitamin D group, and it is recommended to giveHIV / AIDS patients to increase CD4 cell count.

Cancer Progression : Focus on Platelet Erty Sundarita; Mediarty
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 5 No. 2 (2021): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32539/bsm.v5i2.197

Platelets are an important component in the process of hemostasis and coagulation. It’snow known that high platelets count closely related to poor prognosis of patients withcancer, due to their role in the hematogenous spread of cancer cells. Platelet can beactivated by cancer cells into tumor educated platelet and then cause thrombosis throughtumor induced platelet aggregation. Platelet also protect cancer cells in the blood circulationfrom natural killer cells and help the transition of cancer cells from epithelial tomesenchymal and vice versa, resulting in the process of metastasis. In the next stage ofmetastasis, platelets trigger extravasation of cancer cells from primary cancer and helpadhesion of cancer cells to distant organs.

Correlation between Lgr5 Expression and 5-FU based Chemotherapy Response in Stage IV Colorectal Cancer Patients Kgs. M. Rosyidi; Mediarty Syahrir; Suly Auline Rusminan; Legiran
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 5 No. 10 (2021): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32539/bsm.v5i10.358

Background. Colorectal cancer is the third commonest malignancy and the second leading cause of cancer death in the world. 5-Fluorouracyl-based chemotherapy is the primary treatment modality for colorectal cancer. Cancer stem cells are known to be responsible for chemotherapy resistance. Lgr5 is a colorectal cancer stem cell marker that is the target gene for Wnt signaling. Lgr5 potentiates the Wnt signaling pathway through inhibition of a regulator that inhibits Wnt signaling. Lgr5 overexpression is associated with a worse prognosis and chemotherapy resistance. This study was aimed to investigate the correlation between Lgr5 expression and 5-FU-based chemotherapy response in stage IV colorectal cancer patients at Dr. Mohammad Hoesin Hospital Palembang.Methods. This study used a correlative analysis study with a retrospective design using secondary data from medical records and paraffin blocks of stage IV colorectal cancer patients who received 5-FU-based chemotherapy from September 2018 to September 2020. The number of samples was 30 subjects consisting of 22 cases of negative responses and eight positive responses. All samples were stained with Lgr5 immunohistochemistry. Data analysis used the contingency coefficient correlation test.Results. Of the 30 research subjects, 20 subjects (66.7%) had high Lgr5 expression and ten subjects (33.3%) with low Lgr5 expression. Correlation analysis using the contingency coefficient test showed a weak correlation between Lgr5 expression and 5-FU based chemotherapy response with a positive direction, which means the higher the Lgr5 expression, the less response to chemotherapy.Conclusion. There is a weak correlation between Lgr5 expression and 5-FU based chemotherapy response in stage IV colorectal cancer patients at dr.Mohammad Hoesin Hospital Palembang.

The Association between Urinary Tissue Inhibitor Metalloproteinase 2 (TIMP-2) and Insulin-like Growth Factor Binding Protein 7 (IGFBP-7) and Renal Recovery in Acute Kidney Injury Emilia; Zulkhair Ali; Ian Effendi; Novadian; Suprapti; Mediarty; Taufik Indrajaya; Mgs. Irsan Saleh
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 5 No. 4 (2021): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32539/bsm.v5i4.386

Background. Acute kidney injury (AKI) is a common and serious medical condition associated with significant increases in morbidity, mortality, cost of care and non recovery of kidney function that leads to progression to chronic kidney disease. Cell cycle arrest is implicated in the pathogenesis and repair process following AKI. The urinary cell-cycle arrest markers tissue inhibitor of metalloproteinase-2 (TIMP-2) and insulin-like growth factor binding protein 7 (IGFBP-7) have been utilized to predict the risk of AKI in many studies from specific population with good performance. However, their use in predicting recovery is still lacking. The aim of this study was to determine the association between two novel AKI biomarkers, urinary TIMP2 and IGFBP7 and renal recovery after 7 days of treatment in AKI patients at Dr. Mohammad Hoesin Hospital Palembang. Method. This was a prospective cohort study conducted in dr. Mohammad Hoesin Hospital Palembang from January 2021 until March 2021. Subjects enrolled in this study were patients whom diagnosed AKI based on KDIGO 2012 criteria. Urine samples were collected upon patients’ enrollment within 24 hours of AKI diagnosis. We utilized Sandwich Enzyme Linked Immunosorbant Assay (ELISA) method to detect urinary TIMP-2 and IGFBP-7 levels. The primary outcome is recovery from AKI after 7 days of treatment. Chi square test is used to analyze the association between urinary TIMP-2 and IGFBP-7 levels and renal recovery. Results. There were 70 subjects, only 22 of them were recovered after 7 days (31%). Median of urinary TIMP-2 and IGFBP-7 was 0,0047(0,0001-0,1439) [(ng/ml)2/1000]. There was significant association between urinary TIMP2 and IGFBP7 and renal recovery (p=0,027; OR 3,19; 95% CI 1,116-9,128). Conclusion. There was significant association between urinary TIMP2 and IGFBP7 and renal recovery in AKI patients.

Accuracy of Cell-Free DNA (cfDNA) in Colorectal Cancer Diagnosis Anjab Akmal Sya’roni; Suyata; Imam Supriyanto; Vidi Orba Busro; Ayus Astoni; Mediarty Shahrir; Taufik Indrajaya; Erial Bahar
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 5 No. 11 (2021): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32539/bsm.v5i11.422

Background: Colorectal cancer is the third most common type of cancer following lung and breast cancer with the second most common cause of cancer-related death globally. Delayed diagnosis due to limited source and modality to perform early diagnosis lead to advanced-stage condition which contributes to higher morbidities and mortalities. Recent diagnosis of colorectal cancer depends on biopsy of suspected tissues, either obtained surgically or per colonoscopy. Colorectal cancer detection through cell-free DNA measurement allowing small-size cancer being detected even in early stage. cfDNA originated from derivates of increased and abnormality apoptosis-necrosis pathway from cancer lesion, therefore can be managed as specific tumor marker. Methods: Diagnostic test was performed at the Gastroentero Hepatology Outpatient Unit and Internal Medicine Inpatient Unit of Dr. Mohammad Hoesin General Hospital Palembang from March to June 2021. Data processing and analysis using SPSS version 26.0 for Windows. Results: Among 50 subjects included, 39 subjects (78%) are diagnosed with colorectal cancer, whereas 11 subjects (22%) as control. The median of cfDNA result is 59,71 ng/mL with 92,3% sensitivity, 90,9% specificity, 95,2% positive predictive value, 82,3% negative predictive value, and 92,4% accuracy rate. Combination the measurement of cfDNA, CEA, and CA19-9 appears to have better AUC instead of single measurement. Conclusion: The study reveals that cell-free DNA (cfDNA) demonstrated a very promising accuracy rate in diagnosing colorectal cancer.

Efficacy of Alpha Lipoic Acid Supplementation In Chemotherapy-Induced Peripheral Neuropathy Mediarty Syahrir; Yenny Dian Andayani; Norman Djamaludin; Erty Sundarita Maksudin; Putri Farissa Muharramah; Kgs. M. Rosyidi; Hasnawi Haddani; Erial Bahar
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 5 No. 1 (2021): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32539/bsm.v5i1.162

Background. Chemotherapy-induced peripheral neuropathy is a side effect of several chemotherapy drugs and a significant cause of chronic pain in cancer patients, which affects patients' long-term quality of life. The neurotoxic chemotherapy agents most reported to cause neuropathic pains are platinum and taxane. This study aimed to determine the efficacy of alpha-lipoic acid supplementation in chemotherapy patients. Methods. This study used a randomized, double-blind clinical trial in the oncology haematology clinic in the Department of Internal Medicine at Mohammad Hoesin General Hospital Palembang from November 2018 to July 2019. Samples were taken from patients who met the inclusion criteria and signed informed consent forms to join the study. This studyused SPSS version 22.0 for Windows to analyze the data. Results. This research studied 30 subjects who were divided into alpha lipoic acid groups and placebo groups with 15 samples each. The alpha-lipoic acid group showed a significant decline in the Toronto Clinical Scoring System (TCSS) after treatment (p = 0.000) compared to the placebo group (p = 0.164). Conclusions. Treatment with a 600 mg single dose each day of alpha-lipoic acid for 12 weeks effectively improved patients condition significantly.

The Effect of Vitamin D Supplementation on the Increase in CD4 count of HIV/AIDS Patients Receiving Antiretroviral Therapy Mega Permata; Harun Hudari; Mediarty; Taufik Indrajaya
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 5 No. 1 (2021): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32539/bsm.v5i1.186

Introduction. Vitamin D plays a role in health overall, but hypovitaminosis D stilloccurs throughout the world. HIV/AIDS patients are prone to suffer fromhypovitaminosis D because of the infection itself and the side effects of antiretroviraltherapy. Various effort have been tried to improve the immune status of HIV/AIDSpatients, one of them is by adding vitamin D. Vitamin D acts as an antiinflammatoryso that it can prevent apoptosis of CD4 T cells and increase CD4 cell count.Methods. This is a randomized control trial add on a study that aims to determinethe effect of vitamin D to increase in CD4 counts of HIV / AIDS patients who havereceived antiretroviral drugs. Subjects were HIV / AIDS patients who had receivedantiretroviral drugs. A total of 20 subjects were divided randomly into two groups;one group received vitamin D (calcitriol 0.5 mcg per day) for eight weeks, and theother group that received a placebo. Each group was measured of CD4 cell countbefore and after treatment. Results. There was a significant increase in the CD4 cellcount of the vitamin D group (p = 0.046), but not in the CD4 cell count of bothgroups (p = 0.985). The comparison of mean CD4 cell counts between groups beforetreatment was not significantly different (p = 0.057), but after treatment, it becamesignificantly different (p = 0.040). Conclusion. Vitamin D has been successful inincreasing CD4 cell count in the vitamin D group, and it is recommended to giveHIV / AIDS patients to increase CD4 cell count.

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