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Korelasi Antara Kadar Hemoglobin dan Gangguan Fungsi Ginjal pada Diabetes Melitus Tipe 2 di RSUP dr Mohammad Hoesin Palembang Clara Adelia Wijaya; Yulianto Kusnadi; Nyayu Fauziah Zen
Majalah Kedokteran Sriwijaya Vol 47, No 1 (2015): Majalah Kedokteran Sriwijaya
Publisher : Fakultas Kedokteran Universitas Sriwijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36706/mks.v47i1.2741

Penderita Diabetes Melitus (DM) di dunia mencapai 382 juta jiwa dan diperkirakan akan semakin meningkat dalam 25 tahun mendatang. Komplikasi kronik DM adalah gangguan fungsi ginjal dengan angka kejadian yang tinggi sebesar 20-40% yang dapat menghambat pembentukan eritropoietin sebagai pembentuk Hb dan menyebabkan anemia. Tujuan penelitian ini untuk mengetahui korelasi antara kadar hemoglobin dan gangguan fungsi ginjal pada DM tipe 2 di RSUP dr. Mohammad Hoesin Palembang. Penelitian ini merupakan penelitian observasional analitik dengan desain penelitian cross sectional yang menggunakan data sekunder berupa rekam medik tahun 2013 di Bagian Penyakit Dalam RSUP dr. Mohammad Hoesin Palembang. Populasi penelitian adalah 125 orang dan dengan purposive sampling didapati sampel 46 orang. Prevalensi anemia pada DM tipe 2 dengan gangguan fungsi ginjal adalah 80%, sebagian besar berjenis kelamin perempuan, banyak pada usia >45 tahun dan pada pasien dengan gangguan ginjal sedang. Hasil uji korelasi antara kadar Hb dan gangguan fungsi ginjal menggunakan analisis Spearman menunjukkan r = 0,353 dan p = 0,016 serta regresi linier didapatkan persamaan Hb = 8,797+ 0,03LFG (R square = 11,5%, p = 0,012). Terdapat korelasi positif dengan kekuatan korelasi yang lemah antara kadar hemoglobin dan gangguan fungsi ginjal pada DM tipe 2 yang berarti semakin rendah nilai LFG atau semakin berat gangguan fungsi ginjal, maka kadar Hb pun akan semakin rendah.

The Role of Serum Omega 3 Levels on Muscle Mass, Muscle Strength, and Physical Performance in the Elderly Community Welly Salutondok; Nur Riviati; Yulianto kusnadi; Erial Bahar; Nova Kuniati; Syamsu Indra
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 5 No. 3 (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.v5i3.220

A B S T R A C TIntroduction. Old age is related to geriatric syndrome where there are several healthproblems that often occur related to a decrease in body function and an increase inthe inflammatory process. Decrease in muscle mass, muscle strength and physicalperformance will lead to a condition of sarcopenia and frailty syndrome in the elderly.The importance of prevention so that sarcopenia does not occur in the elderly byevaluating the factors that can cause it, one of which is controlling nutritional factors(macro and micro nutrients), such as in research, namely omega-3 macronutrients.The purpose of this study was to determine the correlation between serum omega-3levels with muscle mass, muscle strength, and physical performance in the elderlycommunity at Moehammad Hoesin Hospital Palembang. Methods. This research isan observational analytic study with a cross-sectional approach which wasconducted at the Integrated Geriatric Clinic Internal Medicine RSMH Palembangfrom November 2019 to November 2020. A sample of 21 people aged> 60 years wasexamined for muscle mass, muscle strength, physical performance and omega-levels. 3 serums. All data processing and analysis in this study used SPSS version25 for Windows. Results. Of the 21 subjects, it was found that women were 19people (90.5%) and 2 men (9.5%). The mean value of muscle mass was 37.65 ± 5.7,hand grip strength was 24.04 ± 5 kg, and walking speed was 6.72 ± 1.8 seconds per6 meters. There were 11 subjects with low serum omega-3 levels of 485.25 ± 110.19mg. There was a significant relationship between serum omega-3 levels and musclemass (p = 0.041) with moderate correlation strength (r = 0.448). Conclusion: Musclemass has a significant relationship with serum omega-3 levels in the elderly withmoderate strength. Meanwhile, muscle strength and physical performance did nothave a significant relationship.

Correlation of Vitamin D Serum Levels with Muscle Mass, Muscle Strength, and Physical Performance in the Elderly Community in Mohammad Hoesin General Hospital Palembang Noveldy Calzoum Bachry; Nur Riviati; Yulianto kusnadi; Erial Bahar
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 5 No. 3 (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.v5i3.225

Background: Older people tend to have decreased activity and intake of macronutrients and micronutrients that are not in accordance with the body's needs. Research in 2017 on elderly men and women at the Center for Family Compensation (PUSAKA) in Central Jakarta showed that 80.2% of elderly people have vitamin D deficiency. Low serum levels of vitamin D in the body are the initial risk of decreased muscle mass and physical performance in old age. where there is a significant correlation between low serum vitamin D levels in the body with sarcopenia and mortality. The purpose of this study was to determine the correlation of vitamin D levels with muscle mass, muscle strength and physical performance in the elderly community at RSMH Palembang. Methods: This research is a study analytic observation with a cross-sectional approach that was carried out at the Integrated Geriatric Clinic Internal Medicine RSMH Palembang from November 2019 to November 2020. A sample of 34 people aged> 60 years were examined for muscle mass, muscle strength, physical performance and serum vitamin D levels. All processing and analysis The data in this study used SPSS version 25 for Windows. Results: From 34 subjects, it was found that there were 29 women (85.3%) and 5 men (14.7%). The mean value of muscle mass is38.76 ± 4.1 kg / m2, long runs within 6 meters 6.12± 0.9 m / sec, and hand grip strength 24.9 ± 5.2 kg. It was found that 18 (62.1%) female samples had vitamin D deficiency while 11 (37.9%) samples had vitamin D insufficiency. There was a significant correlation between muscle mass and hand grip strength with vitamin D with weak correlation strength and length of walking with vitamin D with moderate correlation strength. Conclusion: There is a significant correlation between muscle mass and grip strength and walking time of 6 meters with vitamin D.

Sepsis-Induced Diabetic Ketoacidosis (DKA) in Latent Autoimmune Diabetes in Adult (LADA) Fadel Fikri Suharto; Alwi Shahab; Yulianto Kusnadi; RM Dewi Anggraini
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 6 No. 2 (2022): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v6i2.452

Backgrounds. Latent autoimmune diabetes in adults (LADA) is a slowly progressive form of autoimmune diabetes mellitus characterized by older age at diagnosis, presence of pancreatic autoantibodies, and lack of absolute insulin requirement at diagnosis. Patients with LADA had better β-cell function than patients with classic Type 1 DM (T1DM). Overtime, LADA tends to experience rapid and progressive loss of beta cell function that requires intensive insulin therapy. This case report aims to describe a case of Diabetic Ketoacidosis (DKA) in a patient with latent autoimmune diabetes in adult (LADA) induced by sepsis (urinary tract infection/UTI). Case Presentations. A woman, 28 years-old, came to the Emergency Department (ED) RSMH Palembang with chief complaints of decreased consciousness and shortness of breath. Patient had a history of frequent urination, pain when urinating, and fever. Urinalysis examination were glycosuria, proteinuria, hematuria. Hb-A1c level was 10.7%, C-Peptide 0.11 ng/dL, Anti GAD65 qualitative positive, and Islet cell antibody (ICA) negative. Patient was diagnosed with diabetic ketoacidosis (DKA), LADA, and sepsis due to urinary tract infection (UTI). Patients were managed with DKA and sepsis management algorithm. Conclusion. Diabetic ketoacidosis (DKA) in LADA caused by sepsis is an emergency in the metabolic endocrine and diabetes fields. Prompt and appropriate management can improve outcome prognosis in this case.

The Role of Serum Omega 3 Levels on Muscle Mass, Muscle Strength, and Physical Performance in the Elderly Community Welly Salutondok; Nur Riviati; Yulianto kusnadi; Erial Bahar; Nova Kuniati; Syamsu Indra
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 5 No. 3 (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.v5i3.220

A B S T R A C TIntroduction. Old age is related to geriatric syndrome where there are several healthproblems that often occur related to a decrease in body function and an increase inthe inflammatory process. Decrease in muscle mass, muscle strength and physicalperformance will lead to a condition of sarcopenia and frailty syndrome in the elderly.The importance of prevention so that sarcopenia does not occur in the elderly byevaluating the factors that can cause it, one of which is controlling nutritional factors(macro and micro nutrients), such as in research, namely omega-3 macronutrients.The purpose of this study was to determine the correlation between serum omega-3levels with muscle mass, muscle strength, and physical performance in the elderlycommunity at Moehammad Hoesin Hospital Palembang. Methods. This research isan observational analytic study with a cross-sectional approach which wasconducted at the Integrated Geriatric Clinic Internal Medicine RSMH Palembangfrom November 2019 to November 2020. A sample of 21 people aged> 60 years wasexamined for muscle mass, muscle strength, physical performance and omega-levels. 3 serums. All data processing and analysis in this study used SPSS version25 for Windows. Results. Of the 21 subjects, it was found that women were 19people (90.5%) and 2 men (9.5%). The mean value of muscle mass was 37.65 ± 5.7,hand grip strength was 24.04 ± 5 kg, and walking speed was 6.72 ± 1.8 seconds per6 meters. There were 11 subjects with low serum omega-3 levels of 485.25 ± 110.19mg. There was a significant relationship between serum omega-3 levels and musclemass (p = 0.041) with moderate correlation strength (r = 0.448). Conclusion: Musclemass has a significant relationship with serum omega-3 levels in the elderly withmoderate strength. Meanwhile, muscle strength and physical performance did nothave a significant relationship.

Correlation of Vitamin D Serum Levels with Muscle Mass, Muscle Strength, and Physical Performance in the Elderly Community in Mohammad Hoesin General Hospital Palembang Noveldy Calzoum Bachry; Nur Riviati; Yulianto kusnadi; Erial Bahar
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 5 No. 3 (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.v5i3.225

Background: Older people tend to have decreased activity and intake of macronutrients and micronutrients that are not in accordance with the body's needs. Research in 2017 on elderly men and women at the Center for Family Compensation (PUSAKA) in Central Jakarta showed that 80.2% of elderly people have vitamin D deficiency. Low serum levels of vitamin D in the body are the initial risk of decreased muscle mass and physical performance in old age. where there is a significant correlation between low serum vitamin D levels in the body with sarcopenia and mortality. The purpose of this study was to determine the correlation of vitamin D levels with muscle mass, muscle strength and physical performance in the elderly community at RSMH Palembang. Methods: This research is a study analytic observation with a cross-sectional approach that was carried out at the Integrated Geriatric Clinic Internal Medicine RSMH Palembang from November 2019 to November 2020. A sample of 34 people aged> 60 years were examined for muscle mass, muscle strength, physical performance and serum vitamin D levels. All processing and analysis The data in this study used SPSS version 25 for Windows. Results: From 34 subjects, it was found that there were 29 women (85.3%) and 5 men (14.7%). The mean value of muscle mass is38.76 ± 4.1 kg / m2, long runs within 6 meters 6.12± 0.9 m / sec, and hand grip strength 24.9 ± 5.2 kg. It was found that 18 (62.1%) female samples had vitamin D deficiency while 11 (37.9%) samples had vitamin D insufficiency. There was a significant correlation between muscle mass and hand grip strength with vitamin D with weak correlation strength and length of walking with vitamin D with moderate correlation strength. Conclusion: There is a significant correlation between muscle mass and grip strength and walking time of 6 meters with vitamin D.

Sepsis-Induced Diabetic Ketoacidosis (DKA) in Latent Autoimmune Diabetes in Adult (LADA) Fadel Fikri Suharto; Alwi Shahab; Yulianto Kusnadi; RM Dewi Anggraini
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 6 No. 2 (2022): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v6i2.452

Backgrounds. Latent autoimmune diabetes in adults (LADA) is a slowly progressive form of autoimmune diabetes mellitus characterized by older age at diagnosis, presence of pancreatic autoantibodies, and lack of absolute insulin requirement at diagnosis. Patients with LADA had better β-cell function than patients with classic Type 1 DM (T1DM). Overtime, LADA tends to experience rapid and progressive loss of beta cell function that requires intensive insulin therapy. This case report aims to describe a case of Diabetic Ketoacidosis (DKA) in a patient with latent autoimmune diabetes in adult (LADA) induced by sepsis (urinary tract infection/UTI). Case Presentations. A woman, 28 years-old, came to the Emergency Department (ED) RSMH Palembang with chief complaints of decreased consciousness and shortness of breath. Patient had a history of frequent urination, pain when urinating, and fever. Urinalysis examination were glycosuria, proteinuria, hematuria. Hb-A1c level was 10.7%, C-Peptide 0.11 ng/dL, Anti GAD65 qualitative positive, and Islet cell antibody (ICA) negative. Patient was diagnosed with diabetic ketoacidosis (DKA), LADA, and sepsis due to urinary tract infection (UTI). Patients were managed with DKA and sepsis management algorithm. Conclusion. Diabetic ketoacidosis (DKA) in LADA caused by sepsis is an emergency in the metabolic endocrine and diabetes fields. Prompt and appropriate management can improve outcome prognosis in this case.

The Role of Podocyte Cells in Diabetic Nephropathy: A Narrative Literature Review Azhari, Fauzan; Novadian; Ian Effendi; Zulkhair Ali; Suprapti; Ratna Maila Dewi Anggraini; Yulianto Kusnadi; Alwi Shahab
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 7 No. 12 (2023): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v7i12.893

The main cells affected in diabetic nephropathy are podocytes and proximal tubular cells. One of the main functional proteins in the podocyte slit diaphragm is podocin which podocytes need to express together with several specific proteins in the correct way for their differentiation, as well as to maintain their complex anatomy. Podocytes are highly specialized epithelial cells. They line the urinary surface of the glomerular capillary bundles. Podocytes are part of the filtration barrier along with capillary endothelial cells and GBM. Podocytes ensure selective permeability of the glomerular capillary walls. Podocin is a membrane protein with a molecular weight of 42kD which is located in the foot processes, and also forms part of the SD with the nephrin protein. Urinary podocin levels more specifically indicate ongoing glomerular damage because they were significantly increased in the normoalbuminuria group compared with the control group.

Penanganan Kasus Kehamilan 32 Minggu dengan Hipertiroid Janin-Fetal Goiter Albernande, Anggy; Sutrisno, Muhammad Al Farisi; Lestari, Peby Maulina; Mafiana, Rose; Kusnadi, Yulianto; Indrayadi, Indrayadi; Aditiawati, Aditiawati
Indonesian Journal of Obstetrics & Gynecology Science Volume 7 Nomor 1 Maret 2024
Publisher : Dep/SMF Obstetri & Ginekologi Fakultas Kedokteran Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24198/obgynia.v7i1.609

Hipertiroid pada kehamilan didefinisikan sebagai peningkatan kadar free T4. Hipertiroid terjadi pada 2/1000 kehamilan yaitu hipertiroid yang tidak terkontrol selama kehamilan meningkatkan risiko krisis tiroid, kelahiran prematur, dan kematian janin. Pasien Ny. DK 21 tahun datang dengan keluhan benjolan di leher kanan sebesar telur puyuh, hamil 21 minggu, dengan hasil USG fetal goiter. Pemeriksaan fisik didapatkan keadaan umum baik, suhu 36,60C; tekanan darah: 120/80 mmHg; frek. nadi: 92x/menit; frek. nafas: 20 x/menit. Pada pemeriksaan Leopold I didapatkan tinggi fundus uteri 21 cm, teraba bagian lunak. Leopold II teraba tahanan memanjang di sisi kiri kesan punggung. Leopold III teraba bagian terbawah bulat, melenting dan keras U 5/5, kesan kepala. DJJ 159x/mnt, TBJ 1240 gram. Pada pasien dilakukan observasi dan kontrol dengan rentang 2 minggu setelah pemeriksaan. Tata laksana pada pasien ini adalah asam folat, kalsium karbonat, vitamin D, propylthiouracil, folamil, dan ferrous sulfat.Management of Cases 32 Weeks Gestational Pregnancy with Fetal Hyperthyroidism-Fetal GoiterAbstractHyperthyroidism in pregnancy is defined as an increase in free T4 levels. Hyperthyroidism occurs in 2/1000 pregnancies where uncontrolled hyperthyroidism during pregnancy increases the risk of thyroid crisis, premature birth and fetal death. Patient Mrs. 21 year old DK came with complaints of a lump in her right neck the size of a quail egg, 21 weeks pregnant, with ultrasound results of fetal goiter. Physical examination revealed good general condition, temperature 36.60C; blood pressure: 120/80 mmHg; Strange. pulse: 92x/minute; Strange. breath: 20 x/minute. On examination by Leopold I, the height of the uterine fundus was 21 cm, and the soft part was palpable. Leopold II has a longitudinal resistance on the left side of the dorsal impression. Leopold III palpable lower part round, melted and hard U 5/5, head impression. DJJ 159x/minute, TBJ 1240 grams. Patients were observed and monitored at intervals of 2 weeks after the examination. Treatment for this patient is folic acid, calcium carbonate, vitamin D, propylthiouracil, folamyl and ferrous sulfate.Key words: Hyperthyroidism, fetal goiter, propylthiouracil

Neutrophil-Lymphocyte Ratio as a Novel Biomarker for Diabetic Nephropathy in Type 2 Diabetes Mellitus Patients: A Cross-Sectional Study Pradesta, Rahnowi; Novadian; Yulianto Kusnadi; Nova Kurniati; Syarif Husin
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 3 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i3.1235

Background: Early detection of diabetic nephropathy (DN) is crucial to prevent progression to end-stage renal disease. The gold standard for diagnosing DN involves urine microalbumin testing and renal biopsy. However, the availability of these diagnostic tools is limited in many healthcare facilities across Indonesia. Consequently, there is a pressing need for an alternative examination that is readily accessible and can effectively monitor the progression of DN. Methods: This cross-sectional study was conducted at Dr. Mohammad Hoesin General Hospital, Palembang, from February 2024 to May 2024. The study aimed to investigate the correlation between neutrophil-lymphocyte ratio (NLR) and urinary albumin levels in type 2 diabetes mellitus (DM) patients. NLR, calculated from complete blood counts, has emerged as a potential inflammatory marker for various conditions. A total of 65 participants diagnosed with type 2 DM were enrolled in the study. Data analysis involved Spearman's correlation test to assess the relationship between NLR and urinary albumin levels. Results: The majority of the 65 subjects were female (58.5%). The study found that 44 subjects had normoalbuminuria, 18 had microalbuminuria, and 3 had macroalbuminuria. A significant positive correlation was observed between NLR and albuminuria levels in type 2 DM patients (r = 0.795; p < 0.01). Conclusion: The study's findings suggest that NLR is a potential cost-effective biomarker for the early detection of DN in type 2 DM patients, especially in resource-limited settings. Further large-scale studies are recommended to validate these findings and establish specific NLR thresholds for predicting DN progression.

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