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All Journal Acta Interna : The Journal of Internal Medicine Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Indonesian Journal of Endocrinology Metabolism and Diabetes (InaJEMD)

Hemi Sinorita

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Author-ID : 381427

Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

Published : 8 Documents Claim Missing Document

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Articles

The Effect of Telmisartan and Metformin on Insulin Resistance in Metabolic Syndrome Patients with Insulin Therapy oktariani, Siswi; Pramono, Raden Bowo; Sinorita, Hemi
Acta Interna The JOurnal of Internal Medicine Vol 4, No 1 (2014): Acta Interna The Journal Of Internal Medicine
Publisher : Acta Interna The JOurnal of Internal Medicine

Show Abstract | Download Original | Original Source | Check in Google Scholar

ABSTRACTBackground: Recommendations for therapy insulin resistance are metformin and thiazolidindion. Sideeffects of thiazolidindion due to peripheral edema occurs to 2-5% and increased 5-15% when combinedwith insulin therapy. Telmisartan, an angiotensin receptor blocker, has anti-hypertensive effects and improveinsulin resistance. Telmisartan effect on peroxisome proliferator activated receptor Î³ agonist and has the samestructure of the group thiazolidindion, pioglitazone. The research objective was to determine the effectsof telmisartan and metformin on insulin resistance in metabolic syndrome patients with insulin therapy.Methods: This study used a before-after design. The study was conducted in the internal medicine clinic of theendocrinology department of Dr. Sardjito Hospital Yogyakarta. Subjects were patients who met the diagnosis of metabolic syndrome based on the IDF 2005, hypertension and received insulin therapy. Subjects given metforminand telmisartan therapy for 12 weeks. Subjects examined HOMA IR before and after treatment. The averagedecrease in HOMA IR was tested by paired t-test or Wilcoxon test. P value <0.05 was considered signifi cant.Result: The total sample were 27 subjects. Data analysis was performed on 11 subjects. Fasting bloodglucose before and after treatment was signifi cantly decreased (p<0.001) whereas the fasting insulin levelsincreased. HOMA IR was signifi cantly decreased after treatment {p = 0.004 (5.79 â 20.26), CI 95%}.Conclusion: this study found insulin resistance decreased signifi cantly in patients with the metabolicsyndrome of insulin therapy who received metformin and telmisartan.Keywords : metabolic syndrome, insulin therapy, metformin, telmisartan, HOMA IR

The Effect of Telmisartan and Metformin on Insulin Resistance in Metabolic Syndrome Patients with Insulin Therapy Oktariani, Siswi; Pramono, Raden Bowo; Sinorita, Hemi
Acta Interna The Journal of Internal Medicine Vol 4, No 1 (2014): Acta Interna The Journal Of Internal Medicine
Publisher : Acta Interna The Journal of Internal Medicine

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (177.968 KB)

ABSTRACTBackground: Recommendations for therapy insulin resistance are metformin and thiazolidindion. Side effects of thiazolidindion due to peripheral edema occurs to 2-5% and increased 5-15% when combined with insulin therapy. Telmisartan, an angiotensin receptor blocker, has anti-hypertensive effects and improve insulin resistance. Telmisartan effect on peroxisome proliferator activated receptor Î³ agonist and has the same structure of the group thiazolidindion, pioglitazone. The research objective was to determine the effects of telmisartan and metformin on insulin resistance in metabolic syndrome patients with insulin therapy.Methods: This study used a before-after design. The study was conducted in the internal medicine clinic of the endocrinology department of Dr. Sardjito Hospital Yogyakarta. Subjects were patients who met the diagnosis of metabolic syndrome based on the IDF 2005, hypertension and receive insulin therapy. Subjects given metformin and telmisartan therapy for 12 weeks. Subjects examined HOMA IR before and after treatment. The average decrease in HOMA IR was tested by paired t test or Wilcoxon test. P value <0.05 was considered signifi cant.Result: The total sample were 27 subjects. Data analysis was performed on 11 subjects. Fasting blood glucose before and after treatment was signifi cantly decreased (p<0.001) whereas the fasting insulin levels increased. HOMA IR was signifi cantly decreased after treatment {p = 0.004 (5.79 â 20.26), CI 95%}.Conclusion: this study found insulin resistance decreased signifi cantly in patients with the metabolic syndrome of insulin therapy who received metformin and telmisartan.Keywords : metabolic syndrome, insulin therapy, metformin, telmisartan, HOMA IR

Low level of plasma VEGF-A and C allele of -2578*C/A polymorphism in the VEGF-A gene are risk factors of diabetic foot ulcer in Javanese ethnic Rahayu, Ika; Sinorita, Hemi; Timotius, Kris Herawan; Sadewa, Ahmad Hamim
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 53, No 2 (2021)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Diabetes mellitus (DM) is caused by abnormal insulin secretion, impairedinsulin action, or both. Approximately 12-25% of type 2 diabetes mellitus(T2DM) patients will develop diabetic foot ulcers (DFU). Vascular endothelialgrowth factor (VEGF) is a group of platelet-derived growth factors (PDGF)which have a potential role in angiogenesis. Low levels of VEGF-A can causeinsufficient angiogenesis leading to wound healing inhibition. The 2578*C/Apolymorphism of VEGF-A gene has been reported as a candidate markerfor the DFU development. However, the variant role in the development ofDFU in Javanese ethnic needs to be clarified. This study was conducted tocompare VEGF-A levels and the -2578*C/A polymorphism of the VEGF geneamong diabetic patients with and without DFU in Javanese ethnic. In thiscase-control study, the T2DM individuals with DFU as case group (n=19) andwithout DFU as control group (n=41) were recruited. The VEGF-A levelsweredetermined by ELISA. The ARMS-PCR technique was applied to investigate thepresence of -2578*C/A polymorphism of the VEGF gene. Data were analyzedwith independent t, Mann-Whitney, Chi-square, and Kruskal-Wallis tests withsignificance level of p<0.05. The median of plasma VEGF-A level was significantlydifferent between case and control groups (p=0.001). The genotype frequencyof -2578*C/A polymorphism of VEGF gene was no difference between case andcontrol groups. However, individuals with C allele have a higher risk factor todevelop DFU than A allele (CC+CA vs AA;p=0.042; OR=2.5). The plasma VEGF-Alevels were lower in T2DM subjects with DFU than those without DFU. Inconclusion,individuals with C allele of -2578*C/A polymorphism of VEGF geneare more susceptible to have DFU than individuals with A allele in Javaneseethnic with T2DM.

The Effect of Telmisartan and Metformin on Insulin Resistance in Metabolic Syndrome Patients with Insulin Therapy Siswi Oktariani; Raden Bowo Pramono; Hemi Sinorita
Acta Interna The Journal of Internal Medicine Vol 4, No 1 (2014): Acta Interna The Journal Of Internal Medicine
Publisher : Faculty of Medicine Universitas Gadjah Mada

ABSTRACTBackground: Recommendations for therapy insulin resistance are metformin and thiazolidindion. Side effects of thiazolidindion due to peripheral edema occurs to 2-5% and increased 5-15% when combined with insulin therapy. Telmisartan, an angiotensin receptor blocker, has anti-hypertensive effects and improve insulin resistance. Telmisartan effect on peroxisome proliferator activated receptor γ agonist and has the same structure of the group thiazolidindion, pioglitazone. The research objective was to determine the effects of telmisartan and metformin on insulin resistance in metabolic syndrome patients with insulin therapy.Methods: This study used a before-after design. The study was conducted in the internal medicine clinic of the endocrinology department of Dr. Sardjito Hospital Yogyakarta. Subjects were patients who met the diagnosis of metabolic syndrome based on the IDF 2005, hypertension and receive insulin therapy. Subjects given metformin and telmisartan therapy for 12 weeks. Subjects examined HOMA IR before and after treatment. The average decrease in HOMA IR was tested by paired t test or Wilcoxon test. P value <0.05 was considered signifi cant.Result: The total sample were 27 subjects. Data analysis was performed on 11 subjects. Fasting blood glucose before and after treatment was signifi cantly decreased (p<0.001) whereas the fasting insulin levels increased. HOMA IR was signifi cantly decreased after treatment {p = 0.004 (5.79 – 20.26), CI 95%}.Conclusion: this study found insulin resistance decreased signifi cantly in patients with the metabolic syndrome of insulin therapy who received metformin and telmisartan.Keywords : metabolic syndrome, insulin therapy, metformin, telmisartan, HOMA IR

The Difference Plasma Levels of Endotelin-1 in Type 2 Diabetes Mellitus Women with and without Hypertension Enita Rahmawati Kurniatmaja; Hemi Sinorita; Lutfan Budi Purnomo
Acta Interna The Journal of Internal Medicine Vol 5, No 1 (2015): Acta Interna The Journal of Internal Medicine
Publisher : Faculty of Medicine Universitas Gadjah Mada

Background. Diabetes and hypertension are related to each other and have a strong pre-disposition on the incidence of atherosclerosis. The incidence of hypertension 2 times greater in patients with DM than non DM. Endothelial dysfunction underlies these events. Endothelial markers, endothelin-1 is known to affect blood pressure.Aim. The aim of this study is to determine the difference plasma levels of endothelin-1 in type 2 diabetes mellitus in women with and without hypertension.Methods. The cross sectional design was conducted on women with type 2 diabetes mellitus with and without hypertension at metabolic and endocrinology clinic, Dr. Sardjito General Hospital Yogyakarta from July 2010 until the sample met the criterias. Subjects were divided into two groups, type 2 DM woman with hypertension groups and without hypertension. ELISA sandwich’s method was used to measure plasma levels of endothelin-1. Characteristics of the study are presented in the form of mean Kurniaatmaja et al.Results. In this research, the plasma levels of endothelin-1 in in type 2 diabetes mellitus in women with hypertension (n=32) and without hypertension (n=32) respectively 19.17±7.53 ng/ml and 13.75±6.19 ng/dl, and this difference was stastistically signifi cant with p= 0.003 CI 95% -8.87 to -1.97.Conclusion. Plasma levels of endothelin-1 in type 2 diabetes woman with hypertension higher than without hypertension.

Health measurement profile of older adults in Sleman District, Yogyakarta: its correlation with low-grade chronic inflammation in hypertension Adyarini, Dwita Dyah; Rohmah, Siti Nur Rohmah; Sattwika, Prenali Dwisthi; Handayaningsih, Anastasia Evi; Probosuseno, Probosuseno; Sinorita, Hemi
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 55, No 4 (2023)
Publisher : Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19106/JMedSci005504202307

The older adult often experiences a low-grade chronic inflammation that commonly manifests in various conditions without infection, including hypertension. The serum neutrophil-to-lymphocyte ratio (NLR) and hyperuricemia are important markers for various diseases including hypertension. Older adult accounts for 17.33% of the total population of Yogyakarta Special Province, which is the highest compared to other provinces. The study aimed to evaluate the relationship between NLR and hyperuricemia with hypertension among adult patients in Sleman District, Yogyakarta, Indonesia. It was a community-based cross-sectional nested study involving 90 older adults aged ≥70 y.o. living around of the Sleman Health and Demographic Surveillance System (HDSS). Data of demographic and health characteristics of the subjects were collected. Independent t test, and Mann Whitney test were used to analyze mean differences between normotensive and hypertensive groups. Multivariate analysis with logistic regression was used to analyze correlation between all variables. The results showed 59 respondents (65%) suffered from hypertension and 31 (35%) respondents had normal and pre-hypertension. No significantly different in almost of the subject characteristics between the normotensive and the hypertensive groups was observed (p>0.05). However, significantly different between the normotensive group and the hypertensive group was observed in the history of hypertension, blood pressure/BP, mean arterial pressure/MAP, abdominal circumstance/AC, fasting blood glucose/FBG, triglyceride, and hemoglobin (p<0.05). No significantly different in the NLR and HsCRP levels of the normotensive group compared to the hypertensive groups were observed (p>0.05). However, the uric acid level of the hypertensive group [5.6 (2.9-9.4 mg/dL)] was significantly higher than that the normotensive group [4.7 (2.9-8.0 mg/dL)] (p=0.042), although it was no significantly relationship with hypertension (p>0.05). In conclusion, there is no relationship between NLR, HsCRP and uric acid with hypertension among middle old and oldest old in Sleman District.

The Association Between Physical Activity and Monocyte-HDL Ratio in Diabetes Mellitus Patients Who Have Exceed Life Expectancy in Yogyakarta Province Setiawan, Gibran Ilham; Probosuseno, Probosuseno; Sinorita, Hemi
Acta Interna The Journal of Internal Medicine Vol 13, No 1 (2024): Acta Interna The Journal of Internal Medicine
Publisher : Faculty of Medicine Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/actainterna.101284

Background: The elderly population is expected to double in the upcoming three decades, due to increase in life expectancy. The province of DIY has the highest life expectancy in Indonesia (73.13 years and 76.67 years for men and women). Physical activity can reduce insulin resistance, improve lipid metabolism and reduce levels of inflammation in diabetes mellitus (DM). Physical activity can increase life expectancy. Many factors affect life expectancy, one of which is physical activity. This study investigated the association between physical activity and monocyte to HDL ratio (MHR) in diabetes mellitus patients who had exceeded their life expectancy in Yogyakarta.Method: This cross-sectional study was conducted in September 2022-April 2023 and using purposive sampling. Participants who meet the criteria and consent were asked to fast at least 8 hours, then be interviewed by a physical activity questionnaire and checked complete blood tests, fasting blood glucose and HDL cholesterol. The association between physical activity and MHR then analyzed using SPSS.Result: There were 50 participants with median age 78 (74-91) years. The mean score of physical activity is 100.28±7.96. Mean MHR is 0.0147±0.005. There is a significant relationship with weak correlation between physical activity and MHR (p 0.034, r -0.301), weak correlation between MHR and body mass index (BMI) (p 0.015, r 0.343), obesity (p 0.019, r 0.331) central obesity (p 0.032, r 0.303) and smoking (p 0.039, r 0.293). Multivariate analysis was performed, there is a significant relationship with weak correlation between physical activity and MHR (p 0.033, r -0.297).Conclusion: There is a negative correlation with weak strength between physical activity and MHR in patients with diabetes mellitus who have reached the life expectancy of province of DIY.

Unexpected Histological Finding of Diffuse Large B-Cell Lymphoma in a Patient with Long-standing Goiter and Hashimoto's Thyroiditis: A Case Report Dhinar Kemas Ariawidjaja; Mohammad Robikhul Ikhsan; Hemi Sinorita; Raden Bowo Pramono; Vina Yanti Susanti; Rayhani Erika Putri
‎ InaJEMD - Indonesian Journal of Endocrinology Metabolic and Diabetes Vol. 2 No. 2 (2025): InaJEMD Vol. 2, No. 2
Publisher : PP PERKENI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.66266/inajemd.v2i2.59

Primary thyroid lymphoma (PTL) is an uncommon malignancy, comprising less than 5% of all thyroid cancers. Hashimoto's thyroiditis (HT) is the most significant risk factor, increasing the risk of developing PTL by 40 to 80 times. Diffuse large B-cell lymphoma (DLBCL) is the most prevalent and aggressive histological subtype, accounting for over 50% of PTL cases. The diagnosis is challenging, as the clinical and sonographic features of PTL can mimic benign thyroiditis. A 60-year-old female with a three-year history of a progressively enlarging goiter and worsening compressive symptoms presented for surgical evaluation. Initial investigations revealed severe hypothyroidism and ultrasound findings of a nodular goiter with features of thyroiditis (TI-RADS 3). She underwent a total thyroidectomy for symptomatic relief. Postoperative histopathology unexpectedly revealed a DLBCL, confirmed by CD20 positivity, coexisting with a background of classic HT. The patient was subsequently treated with six cycles of R-CHOP (Rituximab, Cyclophosphamide, Doxorubicin, Vincristine, and Prednisone) chemoimmunotherapy and achieved a complete clinical and radiological response. This case underscores the diagnostic challenge PTL presents, particularly in patients with preexisting HT. A high index of suspicion is crucial for clinicians managing HT patients who present with a rapidly enlarging goiter or worsening compressive symptoms. While fine-needle aspiration has limitations, definitive diagnosis often requires a core needle or excisional biopsy to differentiate neoplastic infiltration from the benign lymphocytic infiltrate of HT.

Co-Authors Adyarini, Dwita Dyah Ahmad Hamim Sadewa Dhinar Kemas Ariawidjaja Enita Rahmawati Kurniatmaja Handayaningsih, Anastasia Evi Ika Puspitasari Ika Rahayu Kris Herawan Timotius Kurniatmaja, Enita Rahmawati Lutfan Budi Purnomo Lutfan Budi Purnomo, Lutfan Budi Martalena Br Purba, Martalena Br Mohammad Robikhul Ikhsan Prenali Dwisthi Sattwika Probosuseno Probosuseno, Probosuseno Raden Bowo Pramono Rahayu, Endah Sri Rayhani Erika Putri Rizka Humardewayanti Asdie Rohmah, Siti Nur Rohmah Setiawan, Gibran Ilham Siswi oktariani Sumarningsih, Pebriati Titik Rahayu Tri Hartati, Tri Vina Yanti Susanti

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