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All Journal International Journal of Electrical and Computer Engineering The Indonesian Biomedical Journal Jurnal Epidemiologi Kesehatan Komunitas Indonesian Journal of Global Health research Narra J Indonesia Journal of Physical Medicine and Rehabilitation Indonesia Journal Physical Medicine and Rehabilitation The Indonesian Journal of Community and Occupational Medicine Journal of Endocrinology, Tropical Medicine, and Infectious Disease (JETROMI) Jurnal Penyakit Dalam Indonesia Jurnal Kefarmasian Indonesia Proceeding International Health Conference Indonesian Journal of Endocrinology Metabolism and Diabetes (InaJEMD) Kesmas: Jurnal Kesehatan Masyarakat Nasional (National Public Health Journal)
Em Yunir, Em
Department Of Internal Medicine, Faculty Of Medicine, Universitas Indonesia, Jakarta
Biochemistry, Genetics & Molecular Biology Chemistry Computer Science & IT Decision Sciences, Operations Research & Management Education Electrical & Electronics Engineering Health Professions Immunology & microbiology Languange, Linguistic, Communication & Media Medicine & Pharmacology Neuroscience Nursing Physics Public Health

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Effect of Ankle Pumping Exercise to Ankle Brachial Index in Type 2 Diabetes Mellitus Patients with Ulcer Tjie Haming Setiadi; Widjajalaksmi; Elida Ilyas; Em Yunir; Arini Setiawati
Indonesian Journal of Physical Medicine & Rehabilitation Vol 1 No 1 (2012): Indonesian Journal Of Physical Medicine and Rehabilitation
Publisher : Indonesian Journal of Physical Medicine & Rehabilitation

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (219.954 KB) | DOI: 10.36803/ijpmr.v1i1.186

Abstract

Objectives: To analyze the effect of ankle pumping exercise and other factors such as gender, age, duration of Diabetic Mellitus, nutritional status, history of smoking, hypercholesterolemia, ulcer degreeand HbA1c to Ankle Brachial Index (ABI) in type 2 Diabetes Mellitus patients with diabetic ulcer.Methods: The quasi experimental design study with consecutive sampling and one-­week interval of intervention was conducted in this study. Analysis of changes in pre-­post test ABI used paired t-­testwhile other factors were measured with multiple regression.Results: Ankle pumping effect to right foot after exercise as 0.048 while ABI 0,017 on left foot and ABI 0.038 after exercise on both feet. It was not a statistically significant increase on both feet (p>0.05). The relations of multifactors to ABI : Gender 0.47(p 0.829), age 51.32 (p 0.743), duration of DM 83.16(p 0.490), BMI 21.82 (p 0.452), history of smoking 0.47 (p 0.769), hypercholesterolemia 0.11 (p 0.195), degree of ulcer 3.74 (p 0.635), HbA1c 0.89 (p 0.798).Conclusions: There is statistically no effect of ankle pumping exercise to ABI. We also did not find an effect of gender, age, and duration of DM, nutritional status, history of smoking, history of hypercholesterolemia, ulcer grade and HbA1c to increase of ABI in diabetic subjects with foot ulcer after ankle pumping exercise. Nevertheless, we found a sufficiently noted increase of systolic blood pressure of Dorsal Pedis Artery and Posterior Tibia Artery after ankle pumping exercise in type 2 DM subjects although this not statistically significant.Keywords : Diabetes Mellitus, diabetic ulcer ankle pumping, ankle-­brachial index.
Effect of Ankle Pumping Exercise to Ankle Brachial Index in Type 2 Diabetes Mellitus Patients with Ulcer Tjie Haming Setiadi; Widjajalaksmi; Elida Ilyas; Em Yunir; Arini Setiawati
Indonesian Journal of Physical Medicine & Rehabilitation Vol 1 No 1 (2012): Indonesian Journal Of Physical Medicine and Rehabilitation
Publisher : Indonesian Journal of Physical Medicine & Rehabilitation

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (219.954 KB) | DOI: 10.36803/ijpmr.v1i1.186

Abstract

Objectives: To analyze the effect of ankle pumping exercise and other factors such as gender, age, duration of Diabetic Mellitus, nutritional status, history of smoking, hypercholesterolemia, ulcer degreeand HbA1c to Ankle Brachial Index (ABI) in type 2 Diabetes Mellitus patients with diabetic ulcer.Methods: The quasi experimental design study with consecutive sampling and one-­week interval of intervention was conducted in this study. Analysis of changes in pre-­post test ABI used paired t-­testwhile other factors were measured with multiple regression.Results: Ankle pumping effect to right foot after exercise as 0.048 while ABI 0,017 on left foot and ABI 0.038 after exercise on both feet. It was not a statistically significant increase on both feet (p>0.05). The relations of multifactors to ABI : Gender 0.47(p 0.829), age 51.32 (p 0.743), duration of DM 83.16(p 0.490), BMI 21.82 (p 0.452), history of smoking 0.47 (p 0.769), hypercholesterolemia 0.11 (p 0.195), degree of ulcer 3.74 (p 0.635), HbA1c 0.89 (p 0.798).Conclusions: There is statistically no effect of ankle pumping exercise to ABI. We also did not find an effect of gender, age, and duration of DM, nutritional status, history of smoking, history of hypercholesterolemia, ulcer grade and HbA1c to increase of ABI in diabetic subjects with foot ulcer after ankle pumping exercise. Nevertheless, we found a sufficiently noted increase of systolic blood pressure of Dorsal Pedis Artery and Posterior Tibia Artery after ankle pumping exercise in type 2 DM subjects although this not statistically significant.Keywords : Diabetes Mellitus, diabetic ulcer ankle pumping, ankle-­brachial index.
Hyaluronic Acid Accelerates VEGF and PDGF Release from Advance Platelet Rich Fibrin in Diabetic Foot Ulcer Ronald Winardi Kartika; Idrus Alwi; Franciscus Dhyanagiri Suyatna; Ferry Sandra; Em Yunir; Sarwono Waspadji; Suzzana Immanuel; Todung Silalahi; Saleha Sungkar; Jusuf Rachmat; Saptawati Bardosono; Mirta Hediyati Reksodiputro
The Indonesian Biomedical Journal Vol 13, No 3 (2021)
Publisher : The Prodia Education and Research Institute (PERI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18585/inabj.v13i3.1523

Abstract

BACKGROUND: Hyaluronic acid (HA) is an essential component of extracellular matrix and mediates signaling in wound healing. HA could induce growth factor release from Advanced Platelet Rich Fibrin (A-PRF), including Vascular Endothelial Growth Factor (VEGF) and Platelet-derived Growth Factor (PDGF). However, concentrations of the released-VEGF and PDGF have not been clearly disclosed. Therefore, current study was conducted to measure the release of these growth factors in HA + A-PRF gel of diabetic foot ulcer (DFU) subjects.METHODS: Twenty DFU subjects were included in the study and treated with A-PRF or HA+A-PRF. A-PRF was derived from autologous peripheral blood and processed with low-speed centrifugation. HA was added with a ratio of 1:0.6. A-PRF or HA + A-PRF was applied topically on DFU. Upper tips of A-PRF or HA + A-PRF gels were collected on day 0, 3 and 7 for measurements of VEGF and PDGF concentrations with Enzyme-linked Immune-sorbent Assay (ELISA) methods.RESULTS: On day-3, both VEGF and PDGF concentrations of HA + A-PRF group were significantly higher than the VEGF (p=0.000) and PDGF (p=0.019) concentrations of A-PRF group. The VEGF and PDGF concentrations were continuously and significantly increased on day-7 of HA + A-PRF group, compared to the VEGF (p=0.000) and PDGF (p=0.004) concentrations of A-PRF group.CONCLUSION: Combination HA+A-PRF induces VEGF and PDGF release from A-PRF. A mixture of A-PRF and HA could be more effective than A-PRF alone for treatment of DFU.KEYWORDS: hyaluronic acid, advanced platelet rich fibrin, PRF, growth factor, VEGF, PDGF, diabetic foot ulcer
Advance-Platelet Rich Fibrin and Hyaluronic Acid Combination Improves Interleukin-6 and Granulation Index in Diabetic Foot Ulcer Patients Ronald Winardi Kartika; Idrus Alwi; Franciscus Dhyanagiri Suyatna; Em Yunir; Sarwono Waspadji; Suzanna Immanuel; Todung Silalahi; Saleha Sungkar; Jusuf Rachmat; Saptawati Bardosono; Mirta Hediyati Reksodiputro
The Indonesian Biomedical Journal Vol 13, No 2 (2021)
Publisher : The Prodia Education and Research Institute (PERI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18585/inabj.v13i2.1501

Abstract

BACKGROUND: Diabetic foot ulcer (DFU) is the most common and threatening complication of Diabetes Mellitus (DM). Ideal wound dressing for DFU management should relieve symptoms, provide wound protection, and encourage healing. Advanced-Platelet Rich Fibrin (A-PRF) and Hyaluronic Acid (HA) have been proven to improve wound healing process. This study was aimed to demonstrate the ability of combination of A-PRF and HA in reducing inflammation and improving DFU tissue healing.METHODS: Twenty DFU subjects were involved in this study, and divided into two groups based on the topical fibrin gel treatment: A-PRF + HA group and A-PRF only group. A-PRF was obtained by peripheral blood centrifugation. A-PRF + HA was prepared by homogening A-PRF and AH with a ratio of 1:0.6. Interleukin-6 (IL-6) level, granulation index (GI), numeric pain score (NPS), and inflammation clinical symptoms (ICS) were assessed on day-0, 3, 7 and 14.RESULTS: Wound swabs’ IL-6 level on day-7 was found to be significantly lower in A-PRF + HA compared to A-PRF alone (p=0.041). The IL-6 level reduction also found to be significant higher either in wound swabs (day 0-7, p=0.015) or fibrin gel (day 0-3, p=0.049; day 0-7, p=0.034). A-PRF + HA treatment significantly increased the GI even since day-3 (p=0.043), with lower NPS (p<0.001), and ICS score.CONCLUSION: The combination of A-PRF and HA increases the GI in DFU healing by reducing the inflammation state which will induce the angiogenesis process, as well as reducing pain in DFU subjects better than A-PRF alone.KEYWORDS: inflammation, interleukin-6, wound healing, angiogenesis, proliferation 
Development and characterization of an automated portable wound irrigation device for diabetic ulcers Muhammad Hanif Nadhif; Hanif Assyarify; Muhammad Irsyad; Em Yunir; Tri Juli Edi Tarigan; Angela Sarumpaet; Eni Iswati
International Journal of Electrical and Computer Engineering (IJECE) Vol 12, No 5: October 2022
Publisher : Institute of Advanced Engineering and Science

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.11591/ijece.v12i5.pp4746-4755

Abstract

Patients with diabetes mellitus may experience peripheral neuropathy and extremity system impairment, which may lead to ulceration if the treatments are delayed. Diabetic ulcers, unfortunately, are chronic, which require proper treatments, including debridement and bacterial removal using an irrigation device. To date, commercial irrigation devices included pulsed-lavage, bulb syringe, and gravity bags. Unfortunately, the devices have limitations in terms of portability, measurability, controllability, and disposability. To tackle the limitations, this study aims to design, fabricate, and characterize an automated portable wound irrigation device (Apdice), which is controllable non-disposable, and portable. The device was designed and fabricated using a lightweight construction, a rechargeable battery, and non-disposable materials to support the portability and non-disposable means. Meanwhile, the proportional-derivative-integral controller with its peripheral components were featured to enable controllability. Furthermore, the device was also tested regarding the contamination using a particle counter, and appeared to be contamination free. In short, Apdice showed a robust technological performance. However, it is also worth the try to test the contamination test against biological agents to guarantee the biocompatibility of the device.
Peripheral Arterial disease and Cardiovascular Mortality in Type-2 Diabetes Mellitus Esa, Dekta Filantropi; Prahasary, Adelia Nova; Tahapary, Dicky L.; Yunir, Em
Jurnal Penyakit Dalam Indonesia Vol. 6, No. 2
Publisher : UI Scholars Hub

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Abstract

Peripheral arterial disease (PAD) is one of the macrovascular complications of type 2 diabetes mellitus (T2DM), which increases the risk of cardiovascular mortality. Ankle-brachial index (ABI) is one of the simple and widely available tool to diagnose PAD. The authors aim to find out the cardiovascular mortality in T2DM patient with PAD. Bundo et al. study found HR 2.45 (95% CI: 0.84 to 7.17). Mostaza et al. study reported HR 1.64 (95% CI: 0.64 to 4.49). Aboyans et al. study declared HR 2.21 (95% CI: 1.16 to 4.22). Mohammedi K et al. claimed HR 1.35 (95% CI: 1.15 to 1.60). Quiles et al. found HR 6.61 (95% CI: 2.47 to 17.72). Mueller et al. study reported RR 3,53 (95% CI: 1.80 to 6.91). Mueller et al. study reported RR 4,06 ( 95% CI: 2.67 to 6.18). In conclusion, the mortality risk in T2DM patients with PAD is higher compared to those without PAD. Moreover, an ankle-brachial index can be used as an independent stratification tool to predict the risk of cardiovascular mortality
The Role of Clinical Sign and The Added Value of Procalcitonin in Determining The Existance of Infection in The Treated Diabetic Foot Ulcer Aswar, Andra; Yunir, Em; Karuniawati, Anis; Harimurti, Kuntjoro
Jurnal Penyakit Dalam Indonesia Vol. 5, No. 2
Publisher : UI Scholars Hub

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Abstract

Determinant Factors and Added Value of Osteoprotegerin (OPG) to Detect Carotid Intima-Media Thickness (CIMT) in Type 2 Diabetes Mellitus Patient Tedjasaputra, Shirly Elisa; Yunir, Em; Wijaya, Ika Prasetya; Setiati, Siti
Jurnal Penyakit Dalam Indonesia Vol. 5, No. 2
Publisher : UI Scholars Hub

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Hubungan Albumin Serum Awal Perawatan dengan Perbaikan Klinis Infeksi Ulkus Kaki Diabetik di Rumah Sakit di Jakarta Kurniawan, Hendra Dwi; Yunir, Em; Nugroho, Pringgodigdo
Jurnal Penyakit Dalam Indonesia Vol. 2, No. 1
Publisher : UI Scholars Hub

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Latar Belakang: Ulkus kaki diabetik terinfeksi merupakan kasus DM yang paling banyak dirawat di RS, berhubungan dengan morbiditas, mortalitas, biaya yang tinggi dan bersifat multifaktorial. Salah satu faktor yang berpengaruh adalah albumin. Belum ada penelitian yang secara langsung menghubungkan konsentrasi albumin serum awal perawatan dengan perbaikan klinis infeksi ulkus kaki diabetik. Belum ada batasan mengenai konsentrasi albumin yang dapat mempengaruhi perbaikan klinis infeksi ulkus kaki diabetik. Penelitian ini bertujuan Mendapatkan data mengenai konsentrasi albumin serum awal perawatan dan hubungannya dengan perbaikan klinis infeksi ulkus kaki diabetik. Metode: Penelitian dengan desain kohort prospektif terhadap 71 pasien diabetes dengan ulkus kaki terinfeksi yang dirawat inap di RSUPNCM, RSPADGS atau RSP pada kurun waktu April-Agustus 2014. Diagnosis dan klasifikasi ulkus kaki diabetik terinfeksi menggunakan kriteria IDSA. Data klinis dan albumin serum diambil dalam 24 jam pertama perawatan dan diikuti dalam 21 hari perawatan dengan terapi standar untuk dilihat perbaikan klinis infeksi ulkus kaki diabetik. Perbedaan rerata konsentrasi albumin antara subjek yang mengalami perbaikan klinis infeksi dan yang tidak, diuji dengan uji t tidak berpasangan dengan batas kemaknaan p
Non-Operative Management of Diabetic Foot Osteomyelitis: ACase Report Yunir, Em; Aziza, Yully Astika Nugrahayning
Jurnal Penyakit Dalam Indonesia Vol. 8, No. 2
Publisher : UI Scholars Hub

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Diabetic foot osteomyelitis is an advanced complication of diabetic foot infection which can increase the risk of amputation. This report discusses a case of a 50-year-old female with a wound on the thumb of her left foot that became more swollen with a bluish red color within one month. The patient delayed her treatment due to the COVID-19 pandemic. She has had diabetes and hypertension for 20 years which is uncontrolled. Physical examination showed a sausage toe digiti 1 left pedis with wound 4 x 2 cm with purulent discharge, Probe to Bone (PTB) positive. Laboratory and x-ray examination showed leukocytosis, increased erythrocyte sedimentation rate (ESR) and c-reactive protein (CRP), glucose level 415 mg/dL, and HbA1c 13.1%, with destruction and fragmentation in first toe bone of the left foot. Because she refused minor surgery, the wound was treated regularly by removing infected bone fragments and giving intravenous (IV) antibiotics for four weeks. For glucose level control, continuous IV insulin was given with subcutaneous basal-bolus insulin, then continued by outpatient care with oral antibiotics. After seven weeks, manifestations of infection improved, the wound area was reduced, and antibiotics were discontinued, but wound care was continued. Metabolic control along with long-term antibiotics and wound care for diabetic foot osteomyelitis can be used as an alternative to surgery
Co-Authors A.A. Ketut Agung Cahyawan W Achmad Rudijanto Adeputri Tanesha Idhayu Aditya Wardhana Adna, Rury Maharani Agnes Stephanie Harahap Alvita Dewi S Amalina, Nida Amilya Agustina Andra Aswar, Andra Angela Sarumpaet Anggono, Rendi F. Anis Karuniawati Ardani, Yanuar Arini Setiawati Arshita Auliana Asir, Taufik Rizkian Astrid Sulistomo Aulia Rizka, Aulia Aziza, Yully Astika Nugrahayning Banun Saptaningsih, Agusdini Ceva W. Pitoyo Cleopas Martin Rumende Cosphiadi Irawan Dante S Harbuwono, Dante S Dante S. Harbuwono Dharmeizar Dharmeizar Diah Martina, Diah Dian Anindita Lubis Dian R. Sawitri, Dian R. Dono Antono E. Mudjaddid A. Siswanto Deddy N.W.Achadiono Hamzah Shatri Edwin Halim Eka Ginanjar Eka Susanto Elida Ilyas Endy Novianto, Endy Eni Iswati Erni Juwita Nelwan, Erni Juwita Erwin Danil Julian Esa, Dekta Filantropi Evy Yunihastuti Febriyanti febriyanti febriyanti Ferry Sandra Findy Prasetyawati, Findy Fitrianingsih Fitrianingsih Franciscus D. Suyatna Gurmeet Singh Hanif Assyarify Harahap, Agnes S. Hardigaloeh, Amanda Trixie Hari Hendarto Harry Isbagio Hendra Dwi Kurniawan, Hendra Dwi Henry Ratno Diono Silalahi, Henry Ratno Diono Heri Wibowo Idrus Alwi Idrus Alwi Ika Prasetya Wijaya Ikhwan Rinaldi Imam Subekti Indrapriyatna, Ahmad Syafruddin Ira Laurentika Irman Firmansyah Joedo Prihartono Juli Edi Tarigan, Tri Jusuf Rachmat Jusuf Rachmat Katarina, Matilda Khomimah Khomimah, Khomimah Kumala, Poppy Kumalawati, July Kuntjoro Harimurti Laurentius A Pramono, Laurentius A Laurentius A. Pramono Leonard Nainggolan Levina Chandra Khoe Lubis, Dian Anindita Lugyanti Sukrisman Luhuna, Muslimah Mandang, Veny VV Marbun, Maruhum Bonar Hasiholan Marcellus Simadibrata Masrul Masyur, Muhtaruddin Mirta Hediyati Reksodiputro Mirta Hediyati Reksodiputro Mudjiran Mudjiran Muhammad Hanif Nadhif Muhammad Irsyad Murdani Abdullah Najirman Najirman, Najirman Noorwati Sutandyo Prahasary, Adelia Nova Pringgodigdo Nugroho, Pringgodigdo Puteri, Happy HS Rahmad Mulyadi Rani Sauriasari, Rani Rasco Sandy Sihombing, Rasco Sandy Ratna Djuwita Reyhan Eddy Yunus Ricardo, William Rima Semiarty Robert Shinto Robert Sinto Ronald Winardi Kartika Rudi Putranto Rustam, Musfardi Saleha Sungkar Saptawati Bardosono Saptawati Bardosono Saraswati, Made R Sarwono Waspadji Sarwono Waspadji Sarwono Waspadji Sarwono, Sugeng J. Setyo Widi Nugroho Siti Setiati Siti Taqwa Fitria Lubis, Siti Taqwa Fitria Stella Ilone Sukamto Koesnoe Suzanna Immanuel Suzzana Immanuel Tahapary, Dicky Tahapary, Dicky L. Taufik Agung Tedjasaputra, Shirly Elisa Teguh Harjono Karjadi, Teguh Harjono Tjhin Wiguna Tjie Haming Setiadi Todung Silalahi Todung Silalahi Tri J.E. Tarigan Tri Juli Edi Tarigan Veronica, Raja Merlinda Widjajalaksmi Wijaya, Indra Yulia, Dwi