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All Journal Open Access Indonesian Journal of Medical Reviews Plexus Medical Journal
Suharto Wijanarko
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Health Professions Medicine & Pharmacology Public Health

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Neutrophil-Lymphocyte Ratio as a Predictor of Ulcer Severity in Type 2 Diabetes Prima Budi Prayogi; Prima Kharisma Hayuningrat; Suharto Wijanarko; Hari Wujoso
Open Access Indonesian Journal of Medical Reviews Vol. 5 No. 3 (2025): Open Access Indonesian Journal of Medical Reviews
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/oaijmr.v5i3.718

Abstract

Type 2 diabetes mellitus (T2DM) is a chronic metabolic disorder with increasing global prevalence, frequently complicated by foot ulcers. These ulcers present a significant burden, often leading to amputation and increased mortality. The neutrophil-lymphocyte ratio (NLR), a readily available marker of systemic inflammation, has emerged as a potential prognostic indicator in various diseases. This study investigated the correlation between NLR and the severity of foot ulcers in patients with T2DM. A retrospective, cross-sectional study was conducted, analyzing data from 60 patients with T2DM and foot ulcers admitted to Dr. Moewardi General Hospital, Surakarta, between January 1st, 2022, and December 31st, 2023. NLR was calculated from routine complete blood counts. Ulcer severity was graded using the Meggitt-Wagner classification. Statistical analysis included Spearman's rank correlation and Kruskal-Wallis tests. Our study found a significant correlation observed between NLR and ulcer severity (ρ = 0.524, p < 0.001), with NLR values increasing with ulcer grade. Amputation was significantly associated with ulcer severity (p=0.009). In conclusion, NLR is a valuable and readily available biomarker for assessing the severity of foot ulcers in patients with T2DM. Elevated NLR is associated with more severe ulcers and a higher likelihood of amputation. Incorporating the assessment of NLR into the routine evaluation of patients with diabetic foot ulcers can aid in risk stratification and guide clinical management.
Reconstruction of Multiple Renal Arteries in Live Donor Kidney Transplantation: Moewardi Hospital Experience Muhammad Hilmy Labibi; Syaeful Agung Wibowo; Husein, Ali; Wibisono; Bimanggono Hernowo Murti; Suharto Wijanarko; Tusarawardaya , Setya Anton; Rodjani, Arry; Rasyid, Nur; Susanto , Agung; Putro , Prasetyo Sarwono
Plexus Medical Journal Vol. 4 No. 4 (2025): Agustus
Publisher : Fakultas Kedokteran, Universitas Sebelas Maret

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20961/plexus.v4i4.2292

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Background: Kidney transplant is the procedure for end stage renal disease (ESRD). This treatment has longer survival advantage than dialysis. Anatomical variations in the renal vasculature like multiple renal arteries, may increase surgical difficulties and influence postoperative outcomes. Case Presentation: We report a 46-year-old female living donor with two renal arteries on the left side of kidney. The recipient was her 25-year-old daughter with end stage renal disease due to systemic lupus erythematosus. A left open donor nephrectomy was completed without complications. The two renal graft arteries were side-to-side anastomosed each other, then an end-to-side anastomosis to the external iliac artery. The kidney achieved rapid reperfusion and returned to function immediately. Doppler ultrasound examination showed the normal perfusion. The creatinine level was 1.2 mg/dL on second day postoperative and stable at 0.8 mg/dL during a three-month follow-up. Conclusion: This case highlights the feasibility of transplanting a kidney from a donor with multiple renal arteries, emphasizing the critical role of comprehensive preoperative evaluation and meticulous surgical planning in achieving optimal outcomes.
Adiposity-Induced Voiding Dysfunction: Unraveling the Association Between Overweight Status and Symptom Severity in Non-Retentive Benign Prostatic Hyperplasia Iman Hakim Wicaksana; Setya Anton Tusarawardaya; Suharto Wijanarko; Wibisono; Amru Sungkar
Open Access Indonesian Journal of Medical Reviews Vol. 6 No. 1 (2025): Open Access Indonesian Journal of Medical Reviews
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/oaijmr.v6i1.845

Abstract

Benign prostatic hyperplasia (BPH) has historically been viewed through a prostato-centric lens, attributing lower urinary tract symptoms (LUTS) primarily to prostatic volume and mechanical obstruction. However, this model fails to account for the substantial symptom burden observed in patients without significant retention or massive enlargement. Emerging evidence suggests that systemic metabolic dysregulation, particularly adiposity, plays a crucial role in the pathophysiology of LUTS. This study aims to evaluate the association between Overweight status and the subjective severity of LUTS in a specific cohort of non-retentive BPH patients, thereby isolating metabolic contributors from acute mechanical failure. We conducted an observational analytic cross-sectional study at the Urology Polyclinic of RSUD Dr. Moewardi, Surakarta, Indonesia, from June 2024 to January 2025. The study enrolled 110 men diagnosed with BPH who met strict criteria for non-retentive status (post-void residual <150 mL, no indwelling catheter). Participants were stratified into normal BMI (<25 kg/m²) and Overweight (≥25 kg/m²) groups. Symptom severity was quantified using the International Prostate Symptom Score (IPSS). Data were analyzed using the Mann-Whitney U test and Chi-square analysis. The cohort comprised 72 (65.5%) normal-weight and 38 (34.5%) overweight patients. A statistically significant disparity in symptom severity was observed. The overweight group exhibited a significantly higher mean IPSS (17.87 ± 5.18) compared to the normal group (11.54 ± 4.71) (p<0.001). Notably, 44.7% of overweight patients presented with severe LUTS, compared to only 5.6% of normal-weight patients. Conversely, 90.9% of patients with mild symptoms belonged to the normal-weight group. In conclusion, overweight status is significantly associated with increased LUTS severity in non-retentive BPH patients. The findings suggest that adiposity exacerbates voiding dysfunction through systemic inflammatory, hormonal, and autonomic pathways independent of urinary retention. These results advocate for the integration of weight management as a core therapeutic strategy in BPH care.
Co-Authors Amru Sungkar Arry Rodjani Bimanggono Hernowo Murti Hari Wujoso Husein, Ali Iman Hakim Wicaksana Muhammad Hilmy Labibi Nur Rasyid Prima Budi Prayogi Prima Kharisma Hayuningrat Putro , Prasetyo Sarwono Setya Anton Tusarawardaya Susanto , Agung Syaeful Agung Wibowo Tusarawardaya , Setya Anton Wibisono