BACKGROUND Indonesia was a part of the most recent edition of DiabCare Asia held in 2008. DiabCare Asia 2012 is modeled after a similar project to provide the latest information to facilitate healthcare policymaking in this area.METHODS This was an observational, non-interventional, cross-sectional study of patients with type 2 diabetes mellitus from primary, secondary, and tertiary care centers in Indonesia. Patient data collected included demography, medical history complications, eye and foot examinations, diabetes management, and most recent laboratory investigations. Blood samples were collected from all patients for the analysis of glycated hemoglobin (HbA1c).RESULTS A total of 1,967 patients participated in the study, with a mean (SD) age of 58.4 (9.5) years and a median (range) duration of diabetes 6.0 (0.1−47.0) years. The percentage of patients with HbA1c <7.0% was 30.8% and the mean (SD) HbA1c level was 8.3 (2.2%). The proportion of patients using insulin was 34.7% with a mean (SD) total daily dose of 37.9 (24.1) IU. The most common diabetes-related complications were peripheral neuropathy (59.1%), erectile dysfunction (32.4%), and eye complications (29.1%).CONCLUSIONS Glycemic and metabolic control remain unsatisfactory in type 2 diabetes patients in Indonesia. Efforts are needed to optimize control and prevent complications in these patients.
BACKGROUND:Neck circumference (NC) is a simple screening measure for identifying overweight and obesity, it reflects upper-body fat distribution and central obesity.AIM:To determine whether a single measure of NC might be used to identify overweight/obesity.MATERIAL AND METHODS:An observational, analytical, cross-sectional study was done. The subjects consisted of all consecutive subjects who visited Binjai Supermall (North Sumatera Province, Indonesia) between 23rd and 29th September 2015 and agreed to participate in the study. NC, weight, height, body mass index (BMI), and waist circumference (WC) were measured. Overweight and obesity were defined as BMIs of 23.0–24.9 and ≥ 25 kg/m2, respectively.RESULTS:In total, 1554 subjects participated. Of these, 1238 (79.7%) were overweight/obese. NC correlated significantly with weight, height, BMI, and WC. Receiver operating characteristic (ROC) analysis showed that for all men and women, the area under the curve of overweight/obesity for NC was 0.83 and 0.79, respectively. The best NC cutoff points for males and females that indicated overweight/obesity were ≥ 37 cm (sensitivity, 78.3% and specificity, 75.5%) and ≥ 33.5 cm (sensitivity, 76.6% and specificity, 66.7%), respectively.CONCLUSION:The NC cutoffs that were identified may be useful for screening for overweight/obesity and related co-morbidities.
Introduction: Immunomodulation properties of mesenchymal stem cells have attracted tremendous attention that eventually could regress liver fibrosis process. Aim: The study aims to demonstrate the immunomodulation activities of Umbilical cord-derived Mesenchymal stem cells (UC-MSCs) affecting interleukin-10 (IL-10) and hyaluronic acid (HA) secretion post intraperitoneal injection of CCl 4 , potent hepatotoxin, induced liver fibrosis among experimental rats. Methods: There were 18 Sprague-Dawley (SD) rats divided into three treatment groups (G1 sham group, G2 untreated liver fibrosis group, and G3 UC-MSCs treated-group) and isolated in Stem Cell and Cancer Research Facility, Semarang, Indonesia. Blood examination was conducted after 3 and 14 days of UC-MSCs transplantation using sandwich based ELISA followed by the histopathological analysis of rat liver tissue. ANOVA and posthoc LSD tests were determined the significance against all groups based on their quantitative measurement. Results: UC-MSCs have been successfully extracted and isolated as well as positive with osteogenic differentiation (Alizarin dye). In further analysis, there were significant mean differences among all groups through the ANOVA test, both IL-10 and HA secretion, concurrent with low-grade liver fibrosis in G3. IL-10 elevates during the early phase of UC-MSCs transplantation, and HA significantly reduced on the 14th day of transplantation, it characterizes the liver fibrosis that has been attenuated. Conclusion: The transplantation of UC-MSCs has given an opportunity for the treatment of a wide range of chronic liver diseases through the immunomodulation properties via its paracrine effects that regulate specific cytokine to suppress fibrosis development.
AbstrakPenyakit metabolik merupakan penyakit yang berkaitan dengan peningkatan usia seperti hipertensi, diabetes melitus, dislipidemia, dan obesitas. Penyakit-penyakit tersebut ditangani dengan terapi obat yang sifatnya polifarmasi sehingga dapat menyebabkan risiko terjadi interaksi obat-obat. Penelitian ini dilakukan secara restropektif dengan menggunakan rekam medis pasien usia lanjut dengan penyakit metabolik yang di rawat jalan di Rumah Sakit Umum Pusat Haji Adam Malik Medan. Sebanyak 328 sampel yang termasuk ke dalam kriteria inklusi diperoleh data bahwa jumlah interaksi obat-obat yang terjadi cukup tinggi sebesar 78,96%. Pola mekanisme yang terbanyak adalah farmakokinetik (63,6%) dengan tingkat keparahan yang terbanyak adalah moderat (69,8%). Penelitian ini menunjukan adanya korelasi antara jumlah interaksi dengan jumlah obat (r= 0,728; p= 0,0001), dan jumlah interaksi dengan jumlah diagnosis (r= 0,264; p= 0,0001). Kata kunci: Interaksi obat, penyakit metabolik, polifarmasi Polipharmacy and Drug Interactions in Elderly Patients with Metabolic Diseases AbstractMetabolic disease is a disease that is associated with increasing age such as hypertension, diabetes mellitus, dyslipidemia and obesity. Such diseases are treated with polypharmacy therapy that can cause increased risk of drug interactions. This study was conducted using a restropective method using the medical records of elderly patients with metabolic diseases in outpatient unit of H. Adam Malik General Hospital Medan. A total of 328 samples were included in the inclusion criteria data showed that the number of drug-drug interactions that occur quite high at 78.96%. The pattern of drug interaction mechanism that most frequently occur is pharmacokinetic (63.6%) and the highest severity was moderate (69.8%). This study shown a correlation between the number of interactions with a number of drugs (r= 0.728; p= 0.0001), and the number of interactions with a number of diagnoses (r= 0.264; p= 0.0001).
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