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All Journal journal of internal medicine INDONESIAN JOURNAL OF BIOMEDICAL SCIENCES MNJ (Malang Neurology Journal) The Indonesian Biomedical Journal Indonesian Journal of Cardiology Journal of the Indonesian Medical Association : Majalah Kedokteran Indonesia Heart Science Journal Narra J Proceedings Book of International Conference and Exhibition on The Indonesian Medical Education and Research Institute
Anwar Santoso
Faculty of Medicine Udayana University, Denpasar
Biochemistry, Genetics & Molecular Biology Education Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

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KORELASI ANTARA BRACHIAL-ANKLE PULSE WAVE VELOCITY DAN PROFIL LIPID PADA KARYAWAN RUMAH SAKIT SANGLAH DENPASAR Arsana, Gede Putu; -, Kambayana; Santoso, Anwar; Suastika, Ketut
journal of internal medicine Vol. 8, No. 2 Mei 2007
Publisher : journal of internal medicine

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Abstract

Brachial-ankle pulse wave velocity (baPWV) is an indicator of limb arterial stiffness. Dislipidemia is a major risk factorof atherosclerosis and may worsen baPWV by increasing the blood viscosity. This study aims to study the correlations betweenbaPWV and the lipid profile among employees of Sanglah Hospital. Cross sectional analytic study was performed in Sanglahhospital. Pulse wave velocity was measured using an automatic device (Fukuda VS 1000). Lipid profile were taken as well. Datawas expressed in mean + SD, analyzed by t-test compare mean and Pearson correlation by using SPSS 13.0. There were 85patients involved, all subjects were male, age all between 40-56 (mean 47.23 + 5.16) years old. Cholesterol total, LDL-C, HDLC,and triglyceride concentrations varied subject, range (means + SD) as (205.05 + 39.40) mg/dL, (144.26 + 36.85) mg/dL,(45.94 + 8.98) mg/dL, and (151.94 + 64.56) mg/dL, respectively. BaPWV on the right limbs were between (13,31 + 2,14 ) m/sec,on the left limbs were (15,05 + 2,33 ) m/sec. Significant correlations were found between total cholesterol concentration and theleft baPWV (r = 0.222, p = 0.41), while a significant correlation were found on the right side (r = 0.234, p = 0.031). Brachialanklepulse wave velocity is positively correlation with total cholesterol concentration.
HUBUNGAN ANTARA OBESITAS SENTRAL DENGAN ADIPONEKTIN PADA PASIEN GERITARI DENGAN PENYAKIT JANTUNG KORONER Gotera, Wira; Suastika, Ketut; Santoso, Anwar; Kuswardhani, Tuty
journal of internal medicine Vol. 7, No. 2 Mei 2006
Publisher : journal of internal medicine

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Abstract

Obesity is rapidly becoming a global problem not only in developed countries but also in developing countries such asIndonesia. Visceral obesity (central obesity) is an importance risk for cardiovascular disease and recognition that adipose tissuecan be regarded as a large endocrine organ that secreted inflammatory and anti inflammatory molecules (adiponectin). This studyaims to know the correlation between central obesity and adiponectin in geriatric coronary heart disease (CHD) patients. Thisstudy was cross sectional analytic study of geriatric CHD at out and in patients in Sanglah hospital. Data are presented as groupmean ± SD and analyzed by t-test, chi-square, and Pearson correlation with SPSS 12 software. Forty five patients (35 males and10 females), 23 patient unstable angina pectoris, 14 patient acute myocardial infarction, and 8 patient stable angina pectoris wererecruited and examined. There was high prevalence of central obesity 51.1% (23 patients). Mean of log adiponectin weresignificantly difference between central obese and non central obese (1.80 ± 0.61 vs 1.09 ± 0.41 with p). Central obesity increasedrisk of hypoadiponectinemia 5 times than non central obesity (p=0.011, CI 95% 1.4-17.8). Waist circumference has negativecorrelation with log plasma adiponectin (R=-0.663, p<0.001). There was high prevalence of central obesity in geriatric coronaryheart disease patients. Central obesity increased risk of hypoadiponectinemia 5 times than non central obesity. Waistcircumference has negative correlation with plasma adiponectin. Increased of waist circumference will decrease of adiponectin(cardioprotective protein) and will increase risk of acute coronary syndrome in geriatric patients.
EFEKTIFITAS OBAT PENURUN KOLESTEROL 'STATIN' DALAM MENURUNKAN KEJADIAN KARDIOVASKULER PADA SINDROM KORONER AKUT -, Sajinadiyasa; Santoso, Anwar
journal of internal medicine Vol. 9, No. 1 Januari 2008
Publisher : journal of internal medicine

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Abstract

Acute coronary syndromes (ACS) is usually caused by atherosclerotic process in coronary artery. Clinical manifestation of ACS is unstable angina pectoris, acute miocard infarc ( non-Q-wave and Q-wave) and sudden death. ACS develop have various degrees of coronary artery occlusion. ACS is caused by rupture of plaque with a thin cap. Inflammation is also plays the pathogenesis these syndromes. Stable plaque is imfortance condition in prevent cardiac event and statin drug lowering cholesterol can made stable plaque and as antiimplammation.
HUBUNGAN ADIPONEKTIN DENGAN GAGAL JANTUNG KONGESTIF Agung Budiyasa, Dewa Gde; Santoso, Anwar
journal of internal medicine Vol. 9, No. 3 September 2008
Publisher : journal of internal medicine

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Abstract

Adipose tissue synthesis several protein involved in the regulation of insulin action and lipid metabolism. Among theprotein adipocytokines, adiponectin is the most abundant and exerts profound anti-diabetic, anti-atherogenic, and anti-inflammatoryroles. Adiponectin may contribute to the regulation of vascular hemostasis by its ability to affect several signaling pathwaysin the vessel wall and modulate excess inflammatory responses. In the heart, adiponectin serve as a regulator of cardiacinjury through modulation of pro-survival reaction, cardiac energy metabolism, and inhibition of hypertropic remodelling. Manyeffect of adiponectin in the cardiovascular system correlate with the activation of both AMPK and Cox-2.Adiponectin levels may influence the development of CHF, but the epidemiological data are somewhat complex. This isdue in part to the fact that while higher body mass indices are a risk factor for heart failure, obesity is a predictor of improveprognosis in patients with establish CHF because wasting is strongly associated with the increased risk of death in the final stageof this disease. In this regard, high adiponectin levels are a predictor of mortality in patients with heart failure. Presumably, thisparadoxical relationship exist because high body mass, hence low protein, favors survival in endstage heart failure. Therefore,further studies should examine adiponectin levels in patients with stable heart failure
GAGAL JANTUNG Mariyono, Harbanu H; Santoso, Anwar
journal of internal medicine Vol. 9, No. 1 Januari 2008
Publisher : journal of internal medicine

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Abstract

Heart failure were the end stage of all heart disease and the cause of the increasing morbidity andmortality among patient. Almost five percent from all inhospital patient were heart failure. Heart failure hasbeen defined as the failure of the heart to pump blood to systemic. It can be classify into acute, acutedecompensated and chronic heart failure. New York Heart Association, Stevenson, Forrester have madeclassification based on the clinical symptoms. All cardiac problems can ended into heart failure, thepathogenesis was very complex including renin-angiotensin-aldosteron system, neurohormonal, sympatic nervesystem, nattriuretic peptide, and others. Twelve leads ECGs, echocardiography, chest x-rays, blood chemistries,catheterisation can help us diagnose patient with heart failure. Management of heart failure consist ofmanagement of acute and chronic heart failure, non drugs management, drugs and even an invasive treament.
RELATIONSHIP BETWEEN METHYLENE TETRA HYDRO FOLATE REDUCTASE (MTHFR) GENE POLYMORPHISM AND HYPERHOMOCYSTEINEMIA IN STROKE Raka Widiana, I Gde; -, Tianing; Santoso, Anwar; Ketut Budiarsa, Gusti Ngurah
journal of internal medicine Vol. 8, No. 3 September 2007
Publisher : journal of internal medicine

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Abstract

Cardiovascular disease is a major cause of mortality in Indonesia. Hyperhomocysteinemia (hyper-hcy) isan independent cardiovascular risk factor, which may be due to methylene tetrahydrofolate reductase (MTHFR)deficiency, frequently linked to MTHFR gene mutation. This case-control study examined the relationshipbetween homocysteine (hcy), folate, and vitamin B12 plasma concentrations with C677T mutation of MTHFRgene among 20 haemorrhagic and non-haemorrhagic stroke patients aged 18-55 years, in Sanglah Hospital,Denpasar. 10 age-matched controls were selected via random sampling of 1 of 4 neighbours; all subjects wereBalinese. Hyper-hcy (X2: 5.4; PR: 1.8; 95% CI: 1.0-2.7; p=0.03), hypertension (X2: 13.12; PR 2.66; 95%CI1.41 to 5.02; p=0.00) were associated with increased risk of stroke. There were no significant correlationbetween plasma hcy levels and plasma folate and vitamin B12 levels as co-factors of hcy metabolism. Lowplasma vitamin B12, smoking, alcohol drinking, and hypertension tend to be determinant factors of hyper-hcy.This study found no mutation on 677 from C to T (C677T), however there were substitution in nucleotidesamong stroke and controls, with or without producing chances of amino acids, including: 1) G659A substitutionthat caused changing in amino acid from glutamine to glycine found in 1 stroke patients with hyper-hcy; 2)A660G substitution that cause changing in amino acid from glutamine to glycine found among all controlsubjects and among 3 stroke patients, one of whom had hyper-hcy; and 3) A661G substitution that causechanging in amino acid from lysine to glutamine found in one stroke patients with normo-hcy. Some variationswere also found in nucleotide 659 and 660, however, did not produce changing in amino acid. Whether thissubstitution is a kind of polymorphism that specific to Balinese ethnicity needs a further study to answer.
AKURASI PULSE OKSIMETRI UNTUK MENDETEKSI DILATASI VASKULAR INTRAPULMONER (DVIP) PADA PASIEN SIROSIS HATI Sujana, I Ketut; Wibawa, I Dewa Nyoman; Santoso, Anwar
journal of internal medicine Vol. 9, No. 1 Januari 2008
Publisher : journal of internal medicine

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Abstract

Hepatopulmonary syndrome (HPS) is a complication of liver cirrhotic in the lung. This clinicalsyndrome has three components; liver disease, intrapulmonary vascular dilatation (IPVD), and a defect inoxygenation. Transthoraxic echocardiography with contras enhancement (CE-TTE) is a gold standart methodbut still expensive and difficult to detect IPVD because it needs expertise. Therefore, a simple non-invasivemethod to detect IPVD would be desirable. In this study pulse oximetry was evaluated as predictor foridentification of IPVD in patient with liver cirrhotic.Objective of ythis study is to determine the diagnostic accuracy of pulse oxymetry in detection IPVDcompared with CE-TTE as a gold standart. The diagnostic test was perfomed with pulse oxyimetry in 49consecutive patient with liver cirrhotic of >17 years old without primary cardiopulmonary diseases. Oxygensaturation (SO2) was determined using a pulse oximeter in supine and upright position. The IVPD measured byCE-TTE as gold standard. Measurement of predictor and effect variables were singgle blinded which mean thedifferent examiner, each of them does not know the result of others. Sensitivity, specificity, positif predictivevalue, negative predictive value, accuracy, and likelihood ratio was calculated with computer programmed.Eight patients (16.3%) had IPVD and fourty (83.7%) without IPVD. The cut off SO2 95.5 % in supineposition can predict IPVD with sensitivity 97.6% (CI 95% 72.8;100.0), specificity 87.5% (CI95% 93.2;100.0),positif predictive value 87. 0% (CI95% 78.2;96.7) negative predictive value 100% (CI95% 72.8;100.0),accuracy 95% (CI95% 75.8;100.0), positif likelihood ratio 7.8, and negatif likelhood ratio 0.3. The cut off SO293.0 % in upright position can predict IPVD with sensitivity 100% (CI95% 94.2;100.0), specificity 87.5%(CI95% 78.2;96.7), positif predictive value 100% (CI95% 94.2;102.2), negative predictive value 97.6 %(CI95% 93.4;100.0), accuracy 97.5%(94.1;100.0), positif likelihood ratio 8, and negatif likelhood ratio 0. Thecut off slope oxygen saturation from supine to upright position ( SO2) 2.5% can predict IPVD with sensitivity100% (CI95% 97.2;100.1), specificity 95.1% (CI95% 89.1;100.0), positif predictive value 80% (CI95% 52.0;100.0), negative predictive value 100 %, accuracy 100% (97.1;100.0), positif likelihood ratio 20.4, andnegatif likelhood ratio 0. Pulse oxymetry is accurate predictor to detect of IPVD in liver cirrhotic patientwithout primary cardiopulmonary disease.
THE HIGH PLASMA RETINOL BINDING PROTEIN 4 LEVEL AS A RISK FACTOR CONSEQUENTLY OF TYPE 2 DIABETES MELLITUS OF ABDOMINAL OBESITY Budhitresna, AAG; Suastika, Ketut; Mantik Astawa, Nyoman; Santoso, Anwar
INDONESIAN JOURNAL OF BIOMEDICAL SCIENCES Vol. 5, No. 1 Januari 2011
Publisher : Udayana University

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Abstract

Abdominal obesity (Ab-Ob) related to cardiometabolic risk, that is riskfactor constellation for succeeded cardiovasculer disease and type 2 DiabetesMellitus (DM). That factors such as atherogenic dislipidemia, hypertension,hyperglycemia, protrombotic state, and proinflammation state. Type 2 DMcharacterised by insulin resistance (IR). Plasma levels of retinol binding protein 4(RBP4) that is secreted by adipocytes are increased in insulin resistance (IR) state.Experiment in mice suggest that elevated RBP4 level cause IR. Although theunderlying mechanism is not clearly understood, RBP4 considered playimportance role consequently of type 2 DM in Ab-Ob.This research was carried out to determine the role of high plasma RBP4level as a risk factor consequently of type 2 DM in Ab-Ob. The research wasconducted by cross sectional analytic in 81 patients with Ab-Ob and case controlstudy with matching on 33 patients with Ab-Ob type 2 DM as cases and 33patients with Ab-Ob non type 2 DM as control. The plasma of TNF-?, sTNFR1,and RBP4 levels was measured by ELISA. IR status of the patients wasdetermined by HOMA-IR, whereas the ?-cell function was determined byHOMA-B. Ab-Ob was defined by using criteria for Asian peoples (male WC ? 90cm; female WC ? 80 cm). The result of 81 patients with Ab-Ob showed that bothplasma of TNF-? and sTNFR1 levels were significant positive correlated withplasma RBP4 level (coeficient correlation r = 0,294; p = 0,008 dan r = 0,458; p =<0,001 respectively). In addition, the plasma of RBP4 level significantly positivecorrelation with HOMA-IR (r = 0,450; p = 0,000) and significantly negativecorrelation with HOMA-B (r = -0,564; p = <0,001). In the matched case-controlstudy, it was shown that mean plasma of RBP4 level of type 2 DM group (76,08 ±16,84 ?g/ml) statistically higher than that without type 2 DM group (41,13 ±14,75 ?g/ml) (p = <0,001). The odds ratio higher plasma of RBP4 level was 5,426(CI 95%; 1,343 – 21, 928) statistically significant for increases risk type 2 DM (p= < 0,05). It has been proven that RBP4 was a dominant and consisten risk factor(66.9%, p = < 0.001) which influenced the incidence of type 2 DM in Ab-Ob. It can be concluded that high plasma of RBP4 level have a greater risk tosuffered from type 2 DM compared to low plasma of RBP4 in Ab-Ob. The highplasma of RBP4 level is most dominant and consistent risk factor consequently oftype 2 DM. These mechanism could behind the association between high plasmaof RBP4 level and type 2 DM.
ASSOCIATION OF HBA1C AND NEUTROPHIL LYMPHOCYTE RATIO WITH NORMAL-TENSION GLAUCOMA IN METABOLIC SYNDROME AND OBSTRUCTIVE SLEEP APNEA RISK PATIENTS Prayitnaningsih, Seskoati; Asrory, Virna Dwi Oktariana; Nusanti, Synthia; Listyaningsih, Erlin; Siswanto, Bambang Budi; Santoso, Anwar
MNJ (Malang Neurology Journal) Vol. 7 No. 2 (2021): July
Publisher : PERDOSSI (Perhimpunan Dokter Spesialis Saraf Indonesia Cabang Malang) - Indonesian Neurological Association Branch of Malang cooperated with Neurology Residency Program, Faculty of Medicine Brawijaya University, Malang, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mnj.2021.007.02.14

Abstract

Background: Normal-Tension_Glaucoma (NTG) is an eye disease and characterize with low intraocular pressure (IOP) levels. In population-based settings, the diagnose of glaucoma is based on the IOP levels of 21 mmHg, and its usually delayed. A recent study HbA1c levels could lead to IOP changes. Obstructive Sleep Apnea (OSA) result oxidative stress that results an altered function of neutrophil in patients with NTG. Objective: To_evaluate the association of HbA1c, Netrophil-to-Lymphocyte Ratio_(NLR) toward NTG as its novel early detection.Methods: This study divided into two groups consisted of Metabolic Syndrome ( MS) + OSA without eye disorder as control (15 subjects) and MS + OSA + NTG patients (14 subjects). IDF criteria was used to established MS, and risk of OSA determined by STOP-BANG Questionnaire. The diagnosis of NTG was confirmed by normal IOP measured by Tonopen. Mean Defect (MD) of visual field evaluated by Automated Humphrey Perimetry, Retinal Nerve Fiber Layer (RNFL) established by OCT. HbA1c measured by ELISA and NLR by flowcytometry. Statistical analysis consisted of comparison and correlation testResults: The ratio of CD was significantly higher in NTG patients (0.54 ± 0.13) compared to control (0.26 ± 0.07; p<0.001). MD was also higher in subjects with NTG (6.80 ± 3.90) compared to control (4.97 ± 2.28; p=0.134). Mean RNFL was lower in subjects with NTG (87.95 ± 28.29) compared to control (95.07 ± 26.66; p=0.035). Positive correlation between HbA1C-MD (r = 0.456, p = 0.013) and NLR-RNFL thinning (r = 0.525, p = 0.003) was existed in Metabolic Syndrome (MS) patients.Conclusion: Patients with MS and OSA risk have an increased risk of NTG. A novel association between Hba1C levels, NLR and NTG was also identified.
Triglyceride Glucose Index as a Predictor of 30-Day Readmission and 6 Months Mortality After Hospitalization in Acute Decompensated Heart Failure Rezeki, Arindya; Widyantoro, Bambang; Rossimarina, Vienna; Dwiputra, Bambang; Danny, Siska Suridanda; Sukmawan, Renan; Santoso, Anwar
Jurnal Kardiologi Indonesia Vol 44 No 2 (2023): Indonesian Journal of Cardiology: April - June 2023
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.1380

Abstract

Background: Acute decompensated heart failure (ADHF) is a cardiovascular disease with high mortality and readmission rates. Currently, insulin resistance has been reported to predict prognosis of ADHF patients. Triglyceride glucose index (TyG) has now been proposed as an independent predictor of cardiovascular risk and a simple marker of insulin resistance. However, the association between TyG and 30-days readmission and 6 months mortality after hospitalization remains unclear. Objective: To investigate TyG as a predictor of 30-day readmission and 6 months mortality after hospitalization in ADHF patients. Methods: The study was conducted in a retrospective cohort. Data were taken from medical records based on the admission of patients who met the inclusion criteria from January 2018 – November 2021. The clinical outcomes were 30-days readmission and 6 months mortality. The data were analyzed by multivariate analysis and the survival rate of the subjects. Results: This study included 467 subjects, with 158 subjects have clinical outcomes. The readmission rate is 29% (135 subjects), and 6 month mortality after hospitalization is 5% (23 subjects). Multivariate analysis showed that the factors associated with 30-days readmission were hypertension (p 0.03, HR 1.547, CI 95% 1.044 – 2.291), systolic blood pressure > 140 mmHg on admission (p< 0.001, HR 0.441, CI 95% 0.296 – 0.658), triglyceride ³ 150 mg/dL (p 0.012, HR 1.812, CI 95% 1.139 – 2.881), and TyG index (p <0.001, OR 4.594, CI 95% 2.717 – 7.767). Independent factors for 6 months mortality were only no diuretic medication (p 0.02, HR 6.015, CI 95% 1.975 – 18.320). Conclusion: Triglyceride glucose index can predict 30-days readmission, but does not associated with 6-months mortality in ADHF patients.
Co-Authors AAG Budhitresna Adam, Erika Ambari, Ade Meidian Aria Kekalih Asrory, Virna Dwi Oktariana Badai Bhatara Tiksnadi Bambang Budi Siswanto Bambang Widyantoro Basuni Radi Bayushi Eka Putra Budi Rahmat Busro, Pribadi W. Christy, Kelly Desandri, Dwita Rian Dewa Gde Agung Budiyasa Dicky Armein Hanafy Dicky Fakhri Dwiputra, Bambang Dwiputra, Bambang Erwinanto, Erwinanto Gede Kambayana Gede Putu Arsana Harahap, Alida R. Harahap, Alida Rosita Harbanu H Mariyono Hermanto, Dony Yugo I Dewa Nyoman Wibawa I Gde Raka Widiana I Gede Ketut Sajinadiyasa I Gusti Ngurah Ketut Budiarsa I Ketut Suastika I Ketut Sujana I NYOMAN MANTIK ASTAWA Irawan Yusuf Katsukawa, Hajime Liastuti, Lies Dina Listyaningsih, Erlin Marita Kaniawati Michael Caesario Mukti, Aryo A.P. Nusanti, Synthia Oktarina, Virna Dwi Pintaningrum, Yusra Poh, Kian K. Pritazahra, Armalya Purba, Salomo Putra, Magma Purnawan R. A.T. Kuswardhani Renan Sukmawan Rezeki, Arindya Rif'ati, Lutfah Rossimaria, Vienna Rossimarina, Vienna Samsuridjal Djauzi Seskoati Prayitnaningsih Simbolon, Jessica Putri Natalia Siska Suridanda Danny Sunanto Ng Sunu Budhi Raharjo Syakib Bakri Syntia Nusanti Tambunan, Tresia Fransiska Ulianna Tambunan, Tresia FU. Teuku Heriansyah, Teuku Tianing - Triangto, Kevin Wicaksono, Sony Hilal Wienta Diarsvitri Wira Gotera Yoga Yuniadi ZAHRA, RITA