ABSTRACT Background: Obesity is a major risk factor for the onset of insulin resistance and type 2 diabetes mellitus (T2DM) caused by chronic inflammation of the islets of langerhans. Sleeve gastrectomy (SG) procedure increases particular hormone which stimulates insulin sensitivity. Mesenchymal stem cells (MSCs) can also exhibit potential immunomodulatory properties through their paracrine effects, however the mechanism regarding combination of them could not be adequately explained.  Aim: In this study, we explore the potential of sleeve gastrectomy followed by injection of MSCs in type 2 diabetic rats with obesity in improving insulin resistance. Methods: This study used a pre and post control group design with 18 rats that divided into 3 groups: control (C), sleeve gastrectomy (SG), sleeve gastrectomy + MSCs (SG+M). On day 10, the level of IL-6, IL-10 and HOMA-IR were evaluated using ELISA. Results:  This study showed a significant decrease of IL-6 level in all treatment groups on day 10, in which SG+M group showed optimum inhibition. This result was in line with the optimum increase of IL-10 in SG+M group. Moreover, our study also revealed the optimum decrease of HOMA-IR in SG+M group on day 10. Conclusion: Combination of SG and MSCs can optimally improve insulin resistance by modulating proinflammatory milieu though inhibiting IL-6 level and upregulating IL-10 level in obese type 2 diabetes mellitus rat model.

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The social function of Islamic banking is an essential factor in the existence of Islamic banking, and research is still lacking. This study aims to analyze the trend of the social function of Islamic banking, its reporting conformity with accounting standards, and its effect on the financial performance of Islamic banking. The population of this study is Islamic Commercial Banks (ICB) registered with the Financial Services Authority (FSA) from 2014-2019. The sampling technique used purposive sampling and obtained 59 samples. The method of analysis used descriptive analysis and multiple linear regressions. The results show that fines and non-halal income still dominate the social function instrument. Social functions such as zakat, infaq, alms, and waqf tend to be low. Social reports in the form of sources and uses of zakat funds are sufficient. Reports on sources and uses of benevolent funds are also in the sufficient category, but the percentage value is lower. Internal zakat positively affects the performance of Islamic banking as measured by Return on Assets (ROA) and Operating Expenses on Operating Income (BOPO). Other variables do not affect the performance of Islamic banking as measured by ROA, BOPO, and Non-Performing Financing (NPF). This research theoretically confirms that internal zakat can encourage the growth of Islamic banking. Islamic banking must pay attention to social functions, especially zakat, an order from Islam.

Background: Diabetes mellitus is one of the health problems that is growing rapidly today. In Asia, majority of the population are non-obese with Type 2 Diabetes Mellitus (T2DM). Two main defects of T2DM, insulin resistance and impaired insulin secretion due to reduced pancreatic β cells. Persistent metabolic stress due to hyperglycemic conditions, causes inflammation of the islets of Langerhans. Interleukin-1β (IL-1β) signaling is the most frequent pathway inducing β cell dysfunction. The bariatric Sleeve Gastrectomy (SG) procedure increases particular hormone which stimulates β cell growth and pancreatic insulin production. Aside from the role as a blood glucose regulator, insulin also plays a role in anti-inflammatory modulation. Omentoplasty can be used to wrap organ or tissue structures. The Omentum has unique biological functions, including promote tissue regeneration and anti-inflammatory effect. The study evaluates the effect of Sleeve Gastrectomy and pancreas Omentoplasty procedures on β cell insulin expression and Interleukin-1β (IL-1β) serum levels in non-obese diabetes mellitus subjects.Methods: Experimental study with "post-test control group design" on 27 rats with Diabetes Mellitus was divided into 3 groups: K (control), P1 (Sleeve Gastrectomy), P2 (Sleeve Gastrectomy + Omentoplasty). 10 days after procedure, we evaluated the insulin expression of β cells using monoclonal antibody anti-insulin stain and IL-1β serum levels using rat IL-1β Enzyme-Linked Immunosorbent Assay (ELISA) kit. Statistical analysis with Kruskal Wallis and Mann Whitney test. Correlation test with Spearman.Results: β cell insulin expression increased in P2 (p=0.020), compared to control. While the IL-1β serum levels reduced significantly in all groups (p<0.001) compared to control. Moderate negative correlation (r = -0.476) between β cell insulin expression and IL-1β serum levels.Conclusion: Sleeve gastrectomy and omentoplasty increased β cell insulin expression and decreased IL-1 β serum levels in non-obese rats with diabetes mellitus.

Musculoskeletal disorders are often found in various types of work, including surgeons. Standing working position is immobile and rigid when performing surgical operations. The equipment used is less ergonomic which is the main parameter. The surgeon profession belongs to the category of the high-risk profession and has the potential to experience musculoskeletal disorders. Surgeons who suffer musculoskeletal disorders sense disease start from mild-to-severe due to the muscles receiving static loads frequently in the long-term. The emergence of musculoskeletal disorders can be caused by working environment conditions and standing position while working, causing injury to joints, vertebral discs, nerves, cartilage, tendons, and muscles. This paper describes in extensive the potential for reducing musculoskeletal problems with the use of a chairless chair for surgeons in carrying out operations. Musculoskeletal problems in surgery and the use of chairless chairs have been further explored to close the existing research gap.

Background: Obesity can trigger inflammation or inflammatory disease, which is one of the main features of adipose tissue dysfunction. Adipose secretes several different peptides called adipocytokines, which can induce several pro-inflammatory cytokines such as IL-6, TNF-α, and IL-1. Omentoplasty pancreas dan sleeve gastrectomy is a surgical technique that can treat overweight and metabolic syndrome in obesity and type II DM. This study aims to determine the effect of pancreatic omentoplasty on weight loss and improvement of triglyceride and interleukin-1 levels in rats obesity with type II diabetes mellitus performed sleeve gastrectomy. Methods: This study is an experimental study in vivo. Eighteen rats participated in this study and were grouped into the control group (KI) and the KII and KIII treatment groups. Triglyceride levels were assessed using the spectrophotometric method, and IL-1 levels were assessed using the ELISA method. Data analysis was carried out using SPSS univariate and bivariate. Results: The KII and KIII treatment groups experienced a decrease in body weight, triglyceride levels, and Interleukin-1 levels of rats after the treatment intervention, p<0.05. The KIII treatment group showed the most significant reduction in body weight, triglyceride levels, and Interleukin-1 levels compared to the KII treatment. Conclusion: Pancreatic omentoplasty is effective in reducing body weight, reducing triglyceride levels, and reducing IL-1 levels in obese rats with type II diabetes mellitus undergoing sleeve gastrectomy surgery.

Colorectal cancer (CRC) is the development of cancer from the colon or rectum. There are two kinds of surgery which are laparotomy and laparoscopy. This course of action had a significant effect on the length of stay, surgical site infection, and intraperitoneal adhesion. The purpose of this study is to find out the comparison between laparotomy and colorectal cancer laparoscopy with the length of stay, surgical site infection and intraperitoneal adhesion. The researcher used a cross sectional design. The sample for this study was taken from the medical record data of colorectal cancer patients in Dr. Kariadi Semarang from 2013 to 2018. The data were collected using purposive sampling technique. There were 57 samples that included inclusion and exclusion criteria with 28 details of laparoscopy and 29 samples of laparotomy. Numeric-scale data were tested for normality of data by Kolmogorov-Smirnov and found abnormal data using the Mann Whitney test. Nominal scale data were processed using the non-parametric Chi-Square test and it significant if p<0.05. There is a difference in length of stay and frequency of occurrence of surgical site infections and intraperitoneal adhesion between laparotomy and laparoscopy.

Introduction: Gastrointestinal stromal tumor (GIST) is a rare neoplasm representing 80% of gastrointestinal neoplasms. Laparoscopic resection is only recommended for GIST less than 2 cm and 5 cm for laparoscopic wedge resection. Thus, a large GIST is recommended to complete resection through laparotomy. A large GIST of the gastric fundus can be found in patients, which coincides with an upper right abdominal quadrant pain caused by cholecystolithiasis. A suggested laparotomy for tumor resection and cholecystectomy may result in poor recovery in the postoperative period. Therefore, one approach surgery with minimally invasive laparoscopic partial gastrectomy using Endoflex stapler and cholecystectomy was performed to achieve the optimal outcome.Case Presentation: A 43-year-old male had a major complaint of hematemesis and melena for one month and colicky pain in the right upper quadrant of the abdomen with increased intensity in the last two months. Contrast-enhanced abdominal MSCT revealed a solid 4.6 x 4 x 5.6 cm exophytic mass on the gastric fundus, added with 0.5 cm gall bladder stone. Laparoscopic partial gastrectomy and cholecystectomy were performed in a single minimal invasive surgical procedure. The post-operative period was uneventful. The patient experienced minimum pain, early mobilization, and better diet tolerance. He was discharged on day four after the surgery. Besides, the histopathologic result revealed a malignant mesenchymal tumor according to GIST with a tumor-free margin of resection.Conclusions: Single approach surgery with minimal laparoscopic partial gastrectomy and cholecystectomy has provided optimal outcomes for patients with large GIST and cholecystolithiasis.