Ivan Chandra Sulamanda
Universitas Sam Ratulangi

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PERBANDINGAN NILAI AGREGASI TROMBOSIT PADA PASIEN DIABETES MELLITUS TIPE 2 DENGAN DISLIPIDEMIA DAN NORMOLIPIDEMIA DI RSUP PROF. DR. R. D. KANDOU MANADO Sulamanda, Ivan Chandra
e-Biomedik Vol 2, No 1 (2014): eBiomedik
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/ebm.v2i1.4389

Abstract

Abstract: Insulin resistance occurs in patients with type 2 diabetes mellitus, which stimulates lipolysis in adipose tissue resulting in increasing of free fatty acid and dyslipidemia. Dyslipidemia is associated with platelet reactivity and thrombogenic potency. Examination of platelet aggregation aims to detect abnormalities of platelet function. This study aimed to see comparison of platelet aggregation value in patients with type 2 diabetes with dyslipidemia and with patients who have normal blood lipid level. The Methods of this study used an observational analytic, using comparative hypothesis testing. This study were conducted on 30 diabetes mellitus patients, in which 15 of them have dyslipidemia and the other 15 has normal lipid level. These patients were registered at Poliklinik Endokrin Metabolik RSUP Prof. Dr. R. D. Kandou Manado. Blood samples of patients were processed in Laboratorium Prokita Malalayang Manado. The Results of this research was T test showed that there are significant differences of the platelet aggregation value with ADP 10 µm agonist between patients with type 2 diabetes with dyslipidemia and with patients who have normal blood lipid level (p=0.019). Mann-Whitney test showed that there are significant differences of the platelet aggregation value with ADP 5 µm agonist between patients with type 2 diabetes with dyslipidemia and with patients who have normal blood lipid level (p=0.006). Most patients studied in this study are at an older age (86.7%), with an equal number of men and women. Conclusion: There are significant differences of the platelet aggregation value between patients with type 2 diabetes with dyslipidemia and with patients who have normal blood lipid level, whether using ADP 10 µm agonist or ADP 5 µm agonist. Keywords: Platelet aggregation, type 2 diabetes mellitus, dyslipidemia     Abstrak: Pada pasien diabetes mellitus tipe 2 terjadi resistensi insulin sehingga merangsang lipolisis di jaringan adiposa yang meningkatkan asam lemak bebas dan menimbulkan dislipidemia. Dislipidemia sering dikaitkan dengan peningkatan aktivitas platelet dan potensi trombogenik. Pemeriksaan agregasi trombosit bertujuan untuk mendeteksi abnormalitas fungsi trombosit. Penelitian ini bertujuan untuk melihat perbandingan nilai agregasi trombosit pada pasien diabetes mellitus tipe 2 dengan dislipidemia dan normolipidemia. Metode penelitian ini menggunakan observasional analitik dengan menggunakan metode uji hipotesis komparatif. Subjek dalam penelitian ini berjumlah 30 orang, 15 orang pasien diabetes mellitus tipe 2 dengan dislipidemia dan 15 orang pasien diabetes mellitus tipe 2 dengan normolipidemia yang terdaftar di Poliklinik Endokrin Metabolik RSUP Prof. Dr. R. D. Kandou Manado. Pemeriksaan sampel darah pasien dilakukan di Laboratorium Prokita Malalayang Manado. Hasil pada penelitian ini adalah uji T menunjukkan bahwa terdapat perbedaan yang signifikan antara nilai agregasi trombosit dengan agonist ADP 10 µm pada pasien diabetes mellitus tipe 2 dengan dislipidemia dan normolipidemia (p = 0,019). Uji Mann-Whitney menunjukkan bahwa juga terdapat perbedaan yang signifikan antara nilai agregasi trombosit dengan agonist ADP 5 µm pada pasien diabetes mellitus tipe 2 dengan dislipidemia dan normolipidemia (p = 0,006). Karakteristik terbanyak pada pasien diabetes mellitus tipe 2 terdapat pada usia tua (86,7%) dengan jenis kelamin baik laki - laki maupun perempuan sama banyak (50%). Simpulan: Terdapat perbedaan signifikan antara nilai agregasi trombosit pada pasien diabetes mellitus tipe 2 dengan dislipidemia dan normolipidemia baik menggunakan agonist ADP 10 µm maupun ADP 5 µm.Kata Kunci: Agregasi trombosit, diabetes mellitus tipe 2, dislipidemia  
A Case Report Intravitreal Anti VEGF Bevacizumab on Patient with Hypertension Retinopathy and Exudative Retinal Detachment: Poster Presentation - Case Report - Resident Sulamanda, Ivan Chandra; Watania, Dyana Theresia
Majalah Oftalmologi Indonesia Vol 49 No S2 (2023): Supplement Edition
Publisher : The Indonesian Ophthalmologists Association (IOA, Perhimpunan Dokter Spesialis Mata Indonesia (Perdami))

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35749/kt4xr912

Abstract

Introduction : To present a case of intravitreal anti VEGF bevacizumab function on patient with hypertension retinopathy and exudative retinal detachment. Case Illustration : A 29 years old man presented with chief complaint blurry vision with visual acuity 1/60 on both eyes. History of hypertension sinced one year ago and already got hemodialisa treatment twice a week sinced 6 months ago. Ophthalmic examination showed decreased vision on both eyes and posterior segment both eyes we can find macular star and papil edema. Patient had diagnosed with hypertension retinopathy scheie 4 and exudative retinal detachment both eyes. Discussion : Hypertension will cause blood vessels to become damage in the form of sclerosis, thickening of blood vessel walls, and plasma leakage. Hypertension retinopathy acts as predictor of systemic morbidity and mortality due to organ target damage. Regulating systemic disease like blood pressure to become normal will improve clinical signs of hypertension retinopathy. Administration of anti-VEGF intravitreal injection therapy like bevacizumab can improve permeability of blood vessels in retina and decreased volume of exudate in retina. Visual acuity for this patient will improve to become 4/60 for both eyes. Conclusion : Uncontrolled hypertension can lead to organ target damage, which one of that was eyes. Hypertension retinopathy can make complications like exudative retinal detachment if the blood pressure still uncontrolled. Management of exudative retinal detachment caused by hypertension retinopathy was giving intravitreal anti VEGF injection in eyes to repair breakdown of blood retinal barrier, and the blood pressure must be well controlled to maintain permeability of blood retinal barrier.