Articles
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Elevated uric acid level decreases glycated hemoglobin in type 2 diabetes mellitus
Muhammad Fahmi Hidayat;
Santi Syafril;
Dharma Lindarto
Universa Medicina Vol. 33 No. 3 (2014)
Publisher : Faculty of Medicine, Universitas Trisakti
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DOI: 10.18051/UnivMed.2014.v33.199-204
BackgroundType 2 diabetes mellitus is a heterogeneous disease which is characterized by variable degrees of insulin resistance and impaired insulin secretion. Uric acid has been identified as a marker for a number of metabolic and hemodynamic abnormalities. In diabetic patients, there is biochemical interaction between serum glucose and purine metabolism, with increased excretion of uric acid during hyperglycemia and glycosuria. The objective of this study was to evaluate the correlation of serum uric acid levels with glycated hemoglobin (HbA1c) and blood glucose levels in type 2 diabetes patients.MethodsA cross sectional study from May until July 2014 had been done in 82 type 2 diabetes patients. Serum was analyzed for uric acid, fasting and 2-hour post prandial blood glucose and lipid profile. Spearman correlation test was used to assess associations of HbA1c, fasting and post prandial blood glucose with serum uric acid levels.ResultsThere was a negative correlation of HbA1c with serum uric acid levels (r=-0.407; p=0.000) and of fasting and post prandial blood glucose with serum uric acid levels (r=-0.338; p=0.002 and r=-0.318; p=0.004, respectively).ConclusionsSerum uric acid level was associated with HbA1c, fasting and post prandial blood glucose suggesting a significant role of serum uric acid in the deterioration of glucose toleration.
Imminent threat of antibiotic resistance and the importance of diagnostic and antibiotic stewardship
Yusuf, Erlangga
Universa Medicina Vol 36, No 3 (2017)
Publisher : Faculty of Medicine, Trisakti University
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DOI: 10.18051/UnivMed.2017.v36.157-159
Antibiotic is one of the hallmarks of modern medicine. Antibiotics have saved many lives that was unthinkable prior to the discovery of antibiotic. Yet, antibiotic use is associated with the danger of resistance of bacteria. Resistance of bacteria to antibiotics means simply that antibiotics cannot be used to treat infection, that a simple skin and soft tissue infection may lead to death. Already in 1945, when Alexander Flemming received his Nobel Prize in 1945 for his part in the discovery of penicillin, he delivered a speech where he warned about this danger 1. In his speech, he mentioned the problem of underdosage of antibiotics. As the time passed by, we know that the problem is not only related to underdosage but also to other aspects of inappropriate use of antibiotics such as unnecessary use (for example when the infection is due to a virus), and extended duration of antibiotics 2.
Musculoskeletal pain and posture decrease step length in young adults
Rachmawati, Maria Regina;
Samara, Diana;
Tjhin, Purnamawati;
Wartono, Magdalena;
Bastian, Yefta
Universa Medicina Vol 28, No 2 (2009)
Publisher : Faculty of Medicine, Trisakti University
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DOI: 10.18051/UnivMed.2009.v28.92-99
Pain of the musculoskeletal system, especially low back pain, is one of the most frequent problems with a high risk of disability. The aim of this research study was to determine the existence of an association between low back pain on one hand, posture and step length on the other. This cross-sectional study was conducted on 77 healthy young adult subjects. Step length was measured with the Biodex Gait Trainer 2 (230 VAC). The study results indicate that 62.3% of the young adult subjects had suffered from low back pain. There was no significant association between gender and pain. In male subjects no significant association was found between pain on one hand and mean difference in step length and posture on the other. However, in female subjects with abnormal posture, there was a highly significant difference in left step length between subjects with back pain and those without (p=0.007). The results of a multiple regression analysis indicate that posture has the greatest influence on left step length (B=4.135; 95% Confidence Interval 0.292-7.977). It is recommended that in the examination of low back pain an assessment be made of posture, step length and difference in step lengths.
Serum 8-isoprostane increased in pre-eclampsia
Pramono, Besari Adi;
Kristanto, Herman
Universa Medicina Vol 31, No 1 (2012)
Publisher : Faculty of Medicine, Trisakti University
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DOI: 10.18051/UnivMed.2012.v31.43-51
Background The main causes of maternal mortality in Indonesia are pre-eclampsia, hemorrhage, and infection. Oxidative stress has a primary role in pre-eclampsia and one of its parameters is 8-isoprostane serum level. The objective of this study is to measure 8-isoprostane and to analyze the relationship between 8-isoprostane level and birth weight in pre-eclampsia.Methods A cross-sectional study involving 23 pre-eclampsia and 29 normotensive pregnant women with normal or cesarean delivery at Dr. Kariadi Hospital Semarang from January to May 2011. Collected maternal blood samples were assessed for 8-Isoprostane levels by means of a specific ELISA kit. Neonatal birth weight was measured immediately after delivery by means of calibrated baby scales. Differences in 8-isoprostane levels between pre-eclampsia and normotensive women were assessed using independent t-test for normal distributed data, and the Mann-Whitney test for non-normally distributed data. ResultsMean 8-isoprostane level was significantly higher in women with pre-eclampsia than in normotensive women (62.52 ± 12.19 pg/mL vs 28.64 ± 8.81 pg/mL) (p<0.05). Low birth weight was twice as frequent in pre-eclampsia than in normotensives. There was no correlation between 8-isoprostane serum level and neonatal birth weight in pre-eclampsia.Conclusion The level of 8-isoprostane was higher in pre-eclampsia than in normotensives. It is recommended to conduct further studies to determine whether 8-isoprostane may be used as a predictive marker of pre-eclampsia.
Paradoxical sleep deprivation decreases serum testosterone and Leydig cells in male rats
Fitranto Arjadi;
Sri Kadarsih Soejono;
Mulyono Pangestu
Universa Medicina Vol. 33 No. 1 (2014)
Publisher : Faculty of Medicine, Universitas Trisakti
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DOI: 10.18051/UnivMed.2014.v33.27-35
BACKGROUND Chronic stress increases glucocorticoid levels and accelerates reduction in Leydig cells functions and numbers. Chronic stress models in the working place comprise sleep deprivation, sedentary stress, and physical stress. The aim of this study was to evaluate the effect of various work stress models, such as stress from paradoxical sleep deprivation (PSD), immobilization, and footshock, on serum testosterone levels and number of Leydig cells in male albino rats. METHODS This study was of experimental randomized post-test only with control group design using 24 male Wistar albino rats (Rattus norvegicus). The sample was divided into 4 groups: K1 (control), K2 (PSD), K3 (immobilization) and K4 (footshock), receiving treatment for 25 days. Measured parameters were serum testosterone level and Leydig cell number. Analysis of variance (ANOVA) was used for statistical analysis, followed by post hoc LSD. RESULTS Mean serum testosterone levels (0.07 ± 0.08 ng/ml) and Leydig cell numbers (4.22 ± l0.96) were lowest in the PSD stress model. Serum testosterone levels differed significantly between controls and PSD group (p=0.014), while there was a significant difference in numbers of Leydig cells between footshock stress and PSD (p=0.011) and between the three stress groups and controls (p=0.006). CONCLUSION This study demonstrated that PSD, immobilization and footshock stress significantly decreased serum testosterone levels and number of Leydig cells in male albino rats (Rattus norvegicus). The mechanism by which PSD affects serum testosterone is still unclear.
Hormonal contraception increases risk of breast tumor based on clinical breast examination among adult women
Darjoko, Sulistyowati Tuminah;
Sapardin, Aprildah Nur
Universa Medicina Vol 36, No 2 (2017)
Publisher : Faculty of Medicine, Trisakti University
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DOI: 10.18051/UnivMed.2017.v36.138-149
BackgroundIn Indonesia, cancer prevalence according to the Basic Health Research 2013 was 1.4 per 1000 inhabitants and the most common cancer in hospitalized patients in 2010 was breast cancer (28.7%). Hormonal contraception (HC) use increases the breast cancer risk, even though HC has been used by 210 million women in the world. We aimed to define the association of HC with breast tumors based on clinical breast examination (CBE).MethodsA case-control design using secondary data from the baseline of the Cohort Study on the Risk Factors of Non-Communicable Disease (RFNCD) in 2011-2012 in 5 villages in Central Bogor District, Bogor City. Samples consisted of 152 cases and 152 controls. Cases comprised palpable tumors in one or both breasts CBE (+). Controls had no tumors in both breasts /CBE(-). Data were analyzed by logistic regression.ResultsOdds Ratio (OR) of CBE + was 1.83 (95% CI: 1.11-3.04; p=0.019) for HC user and 1.62 (95% CI: 1.01-2.60; p=0.044) for blood total cholesterol level <200 mg/dL. OR of group CBE(+) was 1.01 (current smoking) and 0.49 (former smoking) compared with nonsmoking (p=0.082); OR was also 1.21 for subjects with one child and 1.77 for those without children, compared with those who had ³2 children (p=0.454).Conclusion Hormonal contraception use increases breast tumor risk 1.8-fold after controlling for total cholesterol, smoking status and parity. With the several limitations of this advanced analysis, investigations focused on types and duration of HC use are still necessary.
Low vitamin C intake increases risk of pre-eclampsia in high pesticide exposure area
Masrikhiyah, Rifatul;
Suhartono, Suhartono;
Kartasurya, Martha Irene
Universa Medicina Vol 35, No 2 (2016)
Publisher : Faculty of Medicine, Trisakti University
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DOI: 10.18051/UnivMed.2016.v35.128-134
BackgroundPre-eclampsia is the largest direct cause (42%) of maternal mortality death in Brebes district in 2013. The cause of pre-eclampsia is not known with certainty, oxidative stress being one of its causes. The aim of this study was to determine macro- and micronutrient intakes that do not correspond to the needs, as pre-eclampsia risk factors in post-partum women. MethodsThe research was an observational study of case control design. Study subjects were 20-35 year-old post partum women consisting of 55 cases (pre-eclampsia) and 55 controls (non-pre-eclampsia). Nutrient intakes were measured using semi-quantitative food frequency questionnaires and data on levels of pesticide exposure, body mass index (BMI), mid-upper arm circumference (MUAC) and education were collected from structured interviews. Data was analyzed by chi-square tests and multiple logistic regression. ResultsThere was no difference in age and MUAC between the cases and controls. Low vitamin C intake (OR: 20.93; 95% CI: 2.72 – 161.36), high polyunsaturated fatty acid intake (OR: 10.50; 95% CI: 2.47 – 44.57), and low vitamin E intake (OR: 8.57; 95% CI: 2.07 – 35.46) were pre-eclampsia risk factors after controled for pesticide exposure, BMI and education. Low vitamin C intake played the most important role in the incidence of preeclampsia.ConclusionLow vitamin C intake played the most important role toward pre-eclampsia. Greater caution is needed when issuing recommendations regarding the consumption of vitamin supplements in pregnancy, as high doses of some vitamins may be deleterious.
Magnetic resonance cholangiopancreatography: practical experience in 30 subjects
Nurman, A
Universa Medicina Vol 27, No 4 (2008)
Publisher : Faculty of Medicine, Trisakti University
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DOI: 10.18051/UnivMed.2008.v27.150-156
Magnetic resonance cholangiopancreatography (MRCP) is a noninvasive method of imaging the biliary and pancreatic ducts. No special patient preparation is   required but the usual contraindications to MR scanning apply. The diagnostic performance of MRCP in most biliary tract diseases is similar to that of more invasive techniques of direct cholangiography such as endoscopic retrograde cholangiopancreatography (ERCP). The objectives of this study were to          investigate the diagnostic efficacy of MRCP in patients with abdominal pain with lesser likelihood of having choledochal stone and to determine whether use of MRCP could eliminate the need for purely diagnostic endoscopic retrograde cholangio-pancreatography (ERCP). A total of 30 patients with suspected biliopancreatic pathology from several hospital was studied retrospectiely between January 2007 and December 2008 in Jakarta. The sensitivity and specificity of MRCP was 92.59% (95% Confidence Interval, 74.25 - 98.71%) and 66.67% (95% Confidence Interval, 12.53 – 98.23%), respectively. The positive predictive value of MRCP for all biliary pathology was 96.15% (95% Confidence Interval, 78.42 – 99.79%) The negative predictive value of MRCP was 50.00% (95% Confidence Interval, 9.19 – 90.81%). MRCP seems to be effective in diagnosing patients with abdominal pain with lesser likelihood of having choledochal stone.
Analgesic activity of ethanolic extract of Manihot esculenta Crantz leaves in mice
Miladiyah, Isnatin
Universa Medicina Vol 30, No 1 (2011)
Publisher : Faculty of Medicine, Trisakti University
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DOI: 10.18051/UnivMed.2011.v30.3-10
Cassava (Manihot esculenta Crantz) leaves have long been used as a vegetable in many countries and empirically as a febrifuge. The aim of the present study was to evaluate the analgesic activity of an ethanolic extract of cassava leaves in mice. Thirty Balb/c mice (20-30 g, 2-3 months old) were randomly divided into 6 groups. Group I was given distilled water 1 mL as negative control, group II paracetamol 65 mg/kgBW as positive control, and group III-VI received an ethanolic extract of cassava leaves in 4 doses, i.e. 12.8 mg/kgBW, 25.6 mg/kgBW, 51.3 mg/kgBW, and 102.6 mg/kgBW, respectively. All interventions were administered as a single dose by oral route on a given day. Acetic acid 0.6% (w/v) was used as a pain inductor. Analgesic activity was measured by counting the percentage of writhing movements as a measure of the analgesic effect produced by each intervention. Data were analyzed with one-way Anova to compare analgesic activity between treatment groups. The results showed that groups treated with ethanolic extract of cassava leaves at dosages of 12.8 mg/kgBW, 25.6 mg/kgBW, 51.3 mg/kgBW, and 102.6 mg/kgBW had an analgesic activity of 59.2%; 73.9%; 62.1%; and 55.9%, respectively. On statistical analysis there were significant differences (p=0.00) between these treatments compared to the negative control, but no significant differences (p>0.05) with the positive control (paracetamol). It may be concluded that the analgesic effect of an ethanolic extract of cassava (Manihot esculenta Crantz) leaves in mice was of similar potency as paracetamol.
Geraniin supplementation increases human keratinocyte proliferation in serum-free culture
Indra Kusuma;
Restu Syamsul Hadi
Universa Medicina Vol. 32 No. 1 (2013)
Publisher : Faculty of Medicine, Universitas Trisakti
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DOI: 10.18051/UnivMed.2013.v32.3 - 10
BACKGROUND Various products used in cellular therapy utilize tissue culture techniques requiring keratinocyte culture. An efficient and clinically acceptable keratinocyte culture system requires supplements with mitogenic activity. Geraniin is a phytochemical with the potential as a supplement for expansion culture of keratinocytes. The objective of the present study was to verify the mitogenic activity of geraniin on human keratinocytes. METHODS This was an experimental study using two samples of human foreskin obtained by circumcision of a male child. Epidermal keratinocytes were isolated from the foreskin samples and were divided into paired groups, comprising intervention and control groups. The intervention groups were cultured with geraniin supplementation, whereas the control groups with standard supplements, without the addition of geraniin. Mitochondrial activity of the cells was evaluated by means of the 3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyl-tetrazolium-bromide (MTT) proliferation assay. Absorbance values in each of the groups was measured at 450 nm. Data analysis was performed with the paired t-test. RESULTS Geraniin supplementation significantly increased the keratinocyte proliferation rates at dosages of 0.8 to 3.1 μM. An increase of 57% in the proliferation rate was obtained at a dosage of 1.6 μM, while at a dosage of 12.5 μM toxic effects were starting to appear. Geraniin presumably causes increased cellular energy status, resulting in increased proliferation rates. CONCLUSION The findings in this study provide evidence in support of the utilization of geraniin as a supplement for expansion culture of keratinocytes. Further studies may presumably identify the molecules acting as geraniin receptors and the intracellular mechanisms underlying the increase in proliferation rates.