Introduction: Diabetes mellitus (DM) is a non-communicable disease that has increased from year to year. Type 2 diabetes mellitus is not caused by lack of insulin secretion, but is caused by the failure of the body's cells to respond to the hormone insulin (insulin resistance). Insulin resistance was found to be a major contributor to atherogenic dyslipidemia. Dyslipidemia in DM risks 2 to 4 times higher than non-DM. Although dyslipidemia has a great risk for people with type 2 diabetes mellitus, this conventional risk factor only explains a portion (25%) of excess cardiovascular risk in type 2 DM. Discussion: In uncontrolled type 2 DM patients, LDL oxidation occurs faster which results from an increase in chronic blood glucose levels. Glycemic control as a determinant of DM progressivity is determined through HbA1c examination. HbA1c levels are associated with blood triglyceride levels. Meanwhile, triglyceride levels are associated with total cholesterol and HDL cholesterol levels. HbA1c levels are also associated with LDL cholesterol levels. Conclusion: There is a relationship between lipid profile and the progression of type 2 diabetes mellitus. Keywords: type 2 diabetes mellitus, dyslipidemia, HbA1c, glycemic control, lipid profile
ABSTRAK Pendahuluan: Tuberkulosis (TB) merupakan infeksi oportunistik yang paling sering ditemukan pada infeksi Human Immunodeficiency Virus (HIV) dan menjadi penyebab kematian paling tinggi pada Orang Dengan HIV/AIDS (ODHA). Risiko penularan TB 26 sampai 31 kali lebih besar terjadi pada penderita HIV dibandingkan dengan orang tanpa HIV. Pasien TB-HIV cenderung memiliki hasil pemeriksaan laboratorium bakteri tahan asam (BTA) negatif dan gambaran radiologis yang tidak khas. Kedua hal tersebut menjadi kendala dalam menentukan diagnosis dan tatalaksananya. Semakin berat tingkat imunosupresi pasien TB-HIV yang ditunjukkan dengan penurunan kadar cluster of differentiation 4 (CD4), maka gambaran radiologisnya semakin tidak khas. Jumlah CD4 berhubungan dengan manifestasi klinis pasien HIV yang bisa dilihat dari gambaran radiologis, sehingga dapat digunakan dalam mempercepat penegakkan diagnosis dan tatalaksana TB-HIV. Penelitian ini bertujuan untuk mengetahui hubungan antara CD4 dengan gambaran radiologis pasien TB-HIV di Rumah Sakit PKU Muhammadiyah Surakarta. Metode: Penelitian ini menggunakan desain penelitian cross sectional dan dilakukan pada bulan November hingga Desember 2020 di Rumah Sakit PKU Muhammadiyah Surakarta. Besar subjek penelitian sebanyak 30 pasien yang diambil dengan teknik non-probability purposive sampling. Pengambilan data menggunakan data rekam medis pasien. Data dianalisis menggunakan uji Fisher. Hasil: Hasil uji Fisher didapatkan tidak terdapat hubungan antara CD4 dengan gambaran radiologis pasien TB-HIV (p=1,000). Simpulan: Tidak terdapat hubungan yang signifikan antara CD4 dengan gambaran radiologis pasien TB-HIV.
Hypertension is a chronic condition which is often found worldwide and becomes a major risk factor for cardiovascular disease. Initial antihypertensive therapy with Angiotensin Receptor Blocker can be used for patients who have intolerance to Angiotensin-Converting Enzyme Inhibitors, such as telmisartan. Telmisartan can be taken as monotherapy or in combination with other antihypertensive drugs. This study was designed to review the current update on the efficacy of telmisartan in patients with hypertension as single-dose or doubledose monotherapy or in combination therapy. Methods: We searched the PubMed, ScienceDirect, and Hindawi databases for terms related to telmisartan efficacy as single-dose or double-dose monotherapy, in combination with amlodipine or hydrochlorothiazide, and as therapy for hypertension with diabetes or for dyslipidemia patients with blood pressure and TGs or LDL cholesterol or post-meal blood sugar or fasting insulin or fasting plasma glucose. The articles matching the restriction criteria were then passed the PRISMA flowchart. The quality of the articles was tested using the GRADE method. Results: The article searches found 1033 journals, 12 articles were eligible for systematic review with high-grade result, 1 article with moderate-grade result, and 1 article with low-grade result based on the GRADE method. The review of articles on telmisartan single-dose monotherapy showed significantly reduced blood pressure (±5.61/5.15 mmHg) and 21.8 ± 5.592/16.00 ± 5.965 mmHg when used as double-dose therapy. The combination of telmisartan with amlodipine showed a highly significant effect to reduce blood pressure (−15.3 ± 11.2/−8.0 ± 8.6 mmHg) after 8 weeks, and with hydrochlorothiazide it was −31.1−18.1 mmHg in 8 weeks. For hypertension patients with diabetes, telmisartan has significantly reduced blood pressure (−24.9/−19.5 mmHg), post-meal blood sugar (−36.9 mg/dL) after 12 weeks, and FPG (−1.06 mg/dL) as well as fasting insulin (−0.818 μU/mL). Telmisartan has good tolerability for treatment with anti-cholesterol drugs. Conclusion: Telmisartan is favorable and effective for the treatment of patients with hypertension as single-dose and double-dose monotherapy, in combination with amlodipine or hydrochlorothiazide, and therapy for hypertension with diabetes or dyslipidemia patients.
ABSTRAK COVID-19 merupakan penyakit menular yang disebabkan oleh SARS-CoV-2. Penyakit ini ditetapkan sebagai pandemi karena telah menyebar sampai ke seluruh dunia. Sebagai upaya memutus rantai penyebarannya, pemerintah mengeluarkan kebijakan baru, yaitu mengganti kegiatan belajar mengajar menggunakan sistem daring. Pembelajaran daring menggunakan aplikasi zoom meetingyang padat dapat mengakibatkan kelelahan fisik maupun psikis yang disebut zoom fatigue. Namun, belum banyak masyarakat yang mengetahui bagaimana cara mencegah dan mengatasinya. Penyuluhan diadakan dalam rangka memberikan informasi kepada masyarakat mengenai cara mencegah dan mengatasi zoom fatigue di masa pandemi. Langkah yang digunakan adalah dengan memberikan materi dan pre-test dan post-test. Hal ini bertujuan untuk mengetahui pengetahuan dari peserta penyuluhan mengenai cara mencegah dan mengatasi zoom fatigue di masa pandemi. Perbandingan dari rata-rata jawaban benar pre-test 75,42% dan post-test 86,5%. Hasil yang didapat dinilai menggunakan uji normalitas dan homogenitas dan uji T berpasangan, didapatkan nilai p < 0,005. Hal ini menunjukkan adanya peningkatan pengetahuan setelah diberikannya materi oleh pemateri. Oleh karena itu, kegiatan penyuluhan ini berhasil meningkatkan pengetahuan mengenai cara mencegah dan mengatasi zoom fatigue di masa pandemi. ABSTRACT COVID-19 is an infectious disease caused by SARS-CoV-2. This disease is designated as a pandemic because it has spread throughout the world. In an effort to break the chain of distribution, the government issued a new policy, namely replacing teaching and learning activities using the online system. Online learning using the dense zoom meeting application can result in physical and psychological fatigue which is called zoom fatigue. However, not many people know how to prevent and overcome them. Counseling is held in order to provide information to the public on how to prevent and overcome zoom fatigue during the pandemic. The steps used are to provide material and pre-test and post-test. This aims to determine the knowledge of the counseling participants on how to prevent and overcome zoom fatigue during the pandemic. The comparison of the average correct answers for the pre-test was 75.42% and the post-test was 86.5%. The results obtained were assessed using normality and homogeneity tests and paired t-test, obtained p value <0.005. This shows an increase in knowledge after the material given by the presenter. Therefore, this outreach activity succeeded in increasing knowledge about how to prevent and overcome zoom fatigue during the pandemic.
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