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All Journal The Indonesian Biomedical Journal Indonesian Journal of Medicine
Siswanto, Febby Gunawan
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Biochemistry, Genetics & Molecular Biology Medicine & Pharmacology Public Health

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Comparison of The Effectiveness of Remifentanyl versus Fentanyl in Pediatric Undergoing Methotrexate Therapy Purwoko, Purwoko; Putro, Bambang Novianto; Pamungkas, Ferdy; Siswanto, Febby Gunawan
Indonesian Journal of Medicine Vol. 7 No. 1 (2022)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Abstract

Background: Anesthesia procedure is routinely performed for some painful pediatric oncologic procedures such as lumbar puncture (LP) and bone marrow examination (BME).  Several studies mentioned that fentanyl and remifentanyl are often used as anesthetic agent of this procedure, but none of them compare the recovery time of both agent. This study aims to compare the recovery time of fentanyl and remifentanyl in pediatric patients undergoing methoterexate therapy.Subjects and Method: This was a double-blind randomized controlled trial on 36 patients who underwent intratechal methotrexate chemoterapy under general anesthesia anesthesia in pediatric intervention room of Moewardi General Hospital Surakarta that met inclusion criteria. The dependent variable was recovery time and the independent variable were fentanyl and remifentanyl. The samples were divided into 2, Fentanyl (F) and Remifentanyl (R) group. Recovery time was recorded after the procedure until the subject reached Pediatric Glasgow Comma Scale (PGCS) of 15. Statistical analysis was Mann Whitney U Test using SPSS 25 for Windows.Results: The mean recovery time of F group was 373.39 ± 29.48 seconds, while R group was 124.67±11.55 seconds. There was a significant difference in recovery time between patients in the Fentanyl group and the Remifentanyl group (p= 0.000).Conclusion: Remifentanyl recovery time was significantly faster than with fentanyl in pediatric patients undergoing intrathecal methotrexate chemotherapy.Keywords: Fentanyl, Methotrexate, Outpatient anesthesia, Recovery time, RemifentanylCorrespondence: Ferdy Pamungkas. Anesthesiology Department, Moewardi General Hospital, Surakarta. Jalan Kolonel Sutarto 132 Jebres, Kecamatan Jebres, Surakarta City 57126. Central Java, Indonesia. dr.ferdypamungkas@gmail.com. +6281230269501.Indonesian Journal of Medicine (2022), 07(01): 115-121https://doi.org/10.26911/theijmed.2022.07.01.12
Vitamin D and Magnesium Combination Lowers High-Sensitivity C-Reactive Protein, Interleukin-12, Renin, and Carotid Vessel in Diabetic Rats Rahayu, Rachmi Fauziah; Zahrah, Fathimah Afifah; Anugrah, Tessa Septian; Yudhani, Ratih Dewi; Yueniwati, Yuyun; Irawan, Amelia Tjandra; Kusumaningrum, Sulistyani; Fauzi, Adam; Wasita, Brian; Wiyono, Nanang; Muthaminah, Muthaminah; Sholikah, Tri Agusti; Wardhani, Lusi Oka; Suyatmi, Suyatmi; Yarso, Kristanto Yuli; Pesik, Riza Novierta; Siswanto, Febby Gunawan
The Indonesian Biomedical Journal Vol 18, No 2 (2026)
Publisher : The Prodia Education and Research Institute (PERI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18585/inabj.v18i2.4061

Abstract

BACKGROUND: Diabetes mellitus induces oxidative stress, inflammation, and endothelial dysfunction, accelerating atherosclerosis development marked by elevated high-sensitivity C-reactive protein (hs-CRP) and interleukin-12 (IL-12). Diabetes often causes significant vascular changes, which can be represented by carotid tunica intima thickening and elevated renin level. Metformin, which remains as the standard therapy, has limited vascular effects. Vitamin D and magnesium exhibit vasoprotective and anti-inflammatory properties; however, their combined effects on diabetic vascular injury remain unclear. This study evaluated the effects of vitamin D and magnesium combination on serum hs-CRP, IL-12, renin, and carotid tunica intima thickness in diabetic rats.METHODS: Wistar rats were diabetic-induced by 45 mg/kg streptozotocin and 110 mg/kg nicotinamide. Following the induction, the rats were subsequently assigned to receive no treatment, metformin, or a combination of vitamin D and magnesium. Healthy rats were also included as control. Blood sample was collected after 21 days of treatment. Serum hs-CRP, IL-12, and renin were measured using enzyme-linked immunosorbent assay (ELISA), while the carotid tunica intima thickness was assessed by Doppler ultrasound.RESULTS: Diabetic rats showed significant increases hs-CRP, IL-12, renin level, and intima thickness (p<0.001) compared to control. Both metformin and combination of Vitamin D and magnesium reduced these parameters, with combination of Vitamin D and magnesium showing the greatest improvement. Carotid intima thickness in the combination of Vitamin D and magnesium group was comparable to normal controls, indicating marked vascular protection.CONCLUSION: Vitamin D and magnesium combination provided superior glycemic, anti-inflammatory, and vascular protective effects compared to metformin alone. This adjunctive strategy might have potential in preventing vascular complications in diabetes.KEYWORDS: diabetes mellitus, oxidative stress, endothelial dysfunction, hs-CRP, IL-12, atherosclerosis
Co-Authors Adam Fauzi Anugrah, Tessa Septian Brian Wasita Irawan, Amelia Tjandra Kusumaningrum, Sulistyani Muthaminah, Muthaminah Nanang Wiyono Pamungkas, Ferdy Purwoko Purwoko Putro, Bambang Novianto Rachmi Fauziah Rahayu Ratih Dewi Yudhani Riza Novierta Pesik Sholikah, Tri Agusti Suyatmi Suyatmi Wardhani, Lusi Oka Yarso, Kristanto Yuli Yuyun Yueniwati Zahrah, Fathimah Afifah