AbstrakHipertensi seringkali menjadi kondisi komorbid yang menyertai diabetes melitus tipe 2. Diabetes melitus, hipertensi dan peningkatan LDL kolesterol merupakan keadaan yang sering dijumpai saling berkaitan. Tujuan penelitian ini adalah untuk melihat perbedaan kadar LDL kolesterol penderita diabetes melitus tipe 2 dengan dan tanpa hipertensi. Penelitian ini menggunakan desain cross sectional comparatif. Pengumpulan data dilakukan dengan observasi data rekam medis pasien diabetes melitus tipe 2 dengan dan tanpa hipertensi tahun 2011 di RS. Dr. M.Djamil Padang. Analisis statistik menggunakan uji chi-square dan uji t-berpasangan. Hasil penelitian menemukan kadar LDL kolesterol pada pasien diabetes melitus tipe 2 dengan hipertensi (137,56±41,43 mg/dl) lebih tinggi dibandingkan tanpa hipertensi (94,39±35,36 mg/dl). Uji chi-square menunjukkkan adanya hubungan yang bermakna antara peningkatan kadar LDL kolesterol dengan kejadian hipertensi (p<0,05). Uji t-berpasangan menunjukkan bahwa adanya perbedaan bermakna kadar LDL kolesterol antara kelompok pasien diabetes melitus dengan hipertensi dan tanpa hipertensi (p<0,05). Penelitian ini menyimpulkan adanya perbedaan yang bermakna kadar LDL kolesterol pada pasien diabetes melitus tipe 2 dengan hipertensi dan tanpa hipertensi di RS. Dr. M. Djamil Padang. Kata kunci: LDL kolesterol, diabetes melitus tipe 2, hipertensi AbstractHypertension is often a comorbid conditions that accompany diabetes mellitus type 2. Diabetes mellitus, hypertension and increased LDL cholesterol is a condition that is often be found related one another. The objective of this study was to determine difference LDL cholesterol level among diabetes melitus type 2 with hypertension and without hypertension.This research used cross-sectional comparatif design. The data was collected through observation of the patient's medical records diabetes mellitus type 2 with hypertension and without hypertension in 2011 at the hospital Dr. M. Djamil Padang. The statistical analysis used was chi-square test and paired-T test. The results found that the levels of LDL cholesterol in patients with diabetes mellitus type 2 with hypertension (137,56±41,43) was higher than without hypertension (94,39±35,36). Chi square test was found that a significant correlation between elevates levels of LDL cholesterol to the incidence of hypertension (p<0,05). Paired-t test showed that there were significant differences of LDL cholesterol levels between groups of diabetes mellitus type 2 with hypertension and diabetes mellitus type 2 without hypertension (p<0,05).This research conclude that there are differences in the levels of LDL cholesterol in patients with diabetes melitus type 2 with hypertension and without hypertension in the hospital Dr. M. Djamil Padang in 2011.

AIM:This study was conducted to identify malondialdehyde (MDA) serum level, nerve growth factor (NGF) serum level, diabetic peripheral neuropathy score and the correlation between MDA and NGF serum level with diabetic peripheral neuropathy score.METHODS:A cross-sectional study was conducted to observe diabetic patients in the internal medicine department in Dr M. Djamil Hospital, Padang, Indonesia. The MDA serum level was measured using Beuge method with thiobarbituric acid. The NGF serum level was analysed using ELISA method. Diabetic peripheral neuropathy score was defined when history score in Michigan Neuropathy Screening Instrument (MNSI) ≥ 7 and physical assessment score in MNSI > 2.RESULTS:Thirty subjects with diabetes has diabetic peripheral neuropathy score 3.53 (± 0.91), MDA serum level 2.16 (± 2.89) nmol/ml, and NGF serum level 10.56 (± 2.89) pg/dl. There were significant correlations between the MDA serum level and the diabetic peripheral neuropathy score (r = 0.364, p = 0.048), and between the NGF serum level with the diabetic peripheral neuropathy score (r = -0.59, p = 0.001).CONCLUSION:There are high MDA serum level and low NGF serum level in patients with diabetic peripheral neuropathy. Low NGF serum level plays a bigger role than high MDA serum level in diabetic peripheral neuropathy.

Abstrak Sindrom Ovarium Polikistik (SOPK) merupakan kelainan endokrin dan metabolik pada wanita usia reproduksi. SOPK merupakan kumpulan gejala dari amenore, oligomenore, infertilitas, obesitas, hirsutisme, acne, alopesia, dan akantosis nigrikan. Resistensi insulin diyakini sebagai salah satu penyebab tersering dari SOPK melalui berbagai mekanisme. Tujuan penelitian ini adalah untuk mengetahui hubungan resistensi insulindengan gambaran klinis SOPK. Penelitian ini dilakukan pada pasien SOPK dengan menggunakan studi cross sectional dengan pendekatan retrospektif, yaitu mengumpulkan kejadian masa lalu dari tahun 2009 - 2011, jumlah sampel 105 orang. Analisis statistik yang digunakan adalah uji chi-square. Hasil penelitian didapatkan 33,3% penderita SOPK mengalami resistensi insulin. Berdasarkan gambaran klinis 35,23% amenore, 64,77% oligomenore, 72,04% infertilitas, 50,5% obesitas, 0,95% hirsutisme, acne 20%, alopesia dan akantosis nigrikan0%. Dari 33,3% SOPK dengan resistensi insulin 40% amenore, 60% oligomenore, 71,9% infertilitas, 77,14% obesitas, dan 0% hirsutisme. Berdasarkan hasil uji statistik ditemukan hubungan bermakna antara resistensi insulin dengan obesitas (p<0,05) dan tidak ditemukan hubungan bermakna antara resistensi insulin dengan infertilitas, hirsutisme, dan acne (p>0,05).Kata Kunci: SOPK, resistensi insulin, gambaran klinisAbstract Polycystic Ovary Syndrome (PCOS) is an endocrine and metabolic disorders that is common in reproductive-aged women. PCOS is a group of symptoms, such as amenorrhea, oligomenorrhea, infertility, obesity, hirsutism, acne, alopecia, and achanthosis nigricans. Insulin resistance is believed to be one of the most common causes of PCOS through a various mechanisms. The objective of this study was to find out the relationship between insulin resistance and clinical manifestation of PCOS. This research was done in patients with PCOS using cross sectional study with retrospective approach. Data was collected from 2009-2011, with the sample of 105 patients. This research used statistical analysis, that was chi square test. This research found that  33.3% patients of PCOS have insulin resistance. Based on clinical manifestation found that 35.23% amenorrhea, 64.77% oligomenorrhea, 72.04% infertility, 50.5% obesity, 0.95% hirsutism, 20% acne, 0% alopecia and achanthosis nigricans. From 33.3% PCOS with insulin resistance, 40% amenorrhea, 60%  oligomenorrhea, 71.9% infertility, 77.14% obesity, and 0% hirsutism. The results showed that there is a significant relationship between insulin resistance and obesity (p<0.05) and no significant reslationship between insulin resistance and infertility, hirsutism, and acne (p>0.05).Keyword: PCOS, insulin resistance, clinical manifestation

The most common cause of hyperthyroidism is Graves' disease. TRH and TSH are hormonal factors that modulate and control thyroid function in Graves' disease. In the immunological aspect, Graves' disease is played by the role of T-reg, IL-4, and anti-TPO. Graves' disease treatment goal is to inhibit thyroid hormone secretion by administering thionamide. The evaluation of this treatment is its hormonal and immunological aspects. To describe the effect of thionamide on serum TRH, TSH, IL-4, T-reg, and anti-TPO levels in Graves' disease. This study is a clinical trial study in 25 study participants. All study participants were given thionamide, namely PTU 300mg for three months and blood samples were taken for laboratory tests. Serum TRH, TSH, IL-4, T-reg FOXP3, and anti-TPO levels were examined by ELISA. The mean levels at the beginning and after three months of therapy are: serum TRH 92.589pg/mL and 115.944pg/mL; serum TSH 0.041mU/L and 0.223mU/L; serum IL-4 19.759pg/mL and 23.040pg/mL; T-reg FOXP3 gene polymorphism 0.621ng/mL and 0.518 ng/mL; serum anti-TPO 2697.539pg/mL and 2604.710pg/mL. Increased levels of serum TRH and TSH levels were statistically significant. The change in serum IL-4, T-reg FOXP3 gene polymorphism, and anti-TPO levels were not statistically significant. The administration of thionamide in Graves' disease for three months will significantly decrease Wayne index and serum FT4 levels, increase serum TRH and TSH levels.

Objective: This study aimed to reveal differences in levels of survivin and Raf-1 kinase in prediabetes, controlled Type 2 diabetes mellitus (T2DM), uncontrolled T2DM, and their relationship with hemoglobin A1c (HbA1c) levels and serum triglyceride levels.Methods: This study was an observational study with a cross-sectional design. The study involved 60 people with T2DM who visited the endocrine and metabolic clinic and 30 prediabetes patients. The variables were survivin levels and Raf-1 kinase enzymes that examined using enzyme-linked immunosorbent assay techniques. HbA1c values are measured by high-performance liquid chromatography and triglyceride levels measured by enzymatic method.Results: Average levels of Raf-1 kinase were significantly higher in the prediabetes group, controlled T2DM, and uncontrolled T2DM (11.6±1.4 pg mL, 9.9±1.1 pg/mL, and 9.1±1.5 pg/mL). Survivin was significantly higher in the prediabetes group, controlled T2DM, and uncontrolled T2DM (5.4±0.4 pg mL, 5.0±0.2 pg/mL, and 4.7±0.1 pg/mL). There was no correlation between HbA1c with Raf-1 kinase levels (R=−0.215, p=0.250), but there was a correlation between HbA1c with serum survivin levels (R=−0.6, *p<0.05). There was a correlation between the levels of triglycerides with survivin but not with Raf-1 kinase (R=−0.267, *p=0.039).Conclusion: Survivin and Raf-1 kinase levels are lower in uncontrolled T2DM. This explained the role of survivin and Raf-1 kinase against enhancement of pancreatic beta-cell apoptosis in patients with T2DM.

The objectives of this study are to find the percentage of depressive symptoms and the most appeared clinical manifestation of depressive symptoms. A total of 2016 patient with type 2 diabetes from M Djamil General Hospital had fulfilled the questionnaire we administered. Demographic and clinical data were determined from the patient's medical records. Depressive symptoms defined by The Center for Epidemiologic Studies Depression Scale-Revised (CESD-R) score of 16 or higher. CESD-R consisted of nine symptoms group and a 20-item questionnaire. These symptoms groups in patients with depressive symptoms will be counted. Patients with depressive symptoms were grouped based on a type of diabetic medication they consumed (diet only, oral antidiabetic, and insulin) and diabetic complication. From 2016 patients participated in this study, we found 235 (11.7%) patients were having depressive symptoms. The most appeared clinical manifestation in 235 patients with depressive symptoms is fatigue (88.08%), loss of interest (52.34%), sadness (41.7%), poor concentration (40.42%), and agitation (23.83%). There are more depressive symptoms in patients consuming oral antidiabetic drug than patients using insulin and diet only (70.2 vs. 28.1 vs 1.7%). More depressive symptoms are also found in patients with diabetic nephropathy than patients with diabetic neuropathy and heart disease (52.8 vs. 27.7 vs. 19.6%). These findings showed that there are many depressive symptoms in patients with T2DM, and some of most appeared clinical manifestation in depressive symptoms should be considered.

Abstrak Pendahuluan: Peripheral Arterial Disease (PAD) adalah penyumbatan pada arteri perifer akibat proses atherosklerosis atau proses inflamasi yang menyebabkan lumen arteri menyempit (stenosis), atau pembentukantrombus. Tempat tersering terjadinya PAD adalah daerah tungkai bawah dan jarang ditemukan pada jari tangan.Metode: Laporan kasus. Hasil: Telah dilaporkan suatu kasus iskemia jari tangan yang jarang ditemui di klinik, merupakan suatu PAD. Pembahasan: Selain adanya faktor risiko konvensional seperti diabetes melitus dan keganasan untuk terjadinya trombosis, juga didapatkan suatu kelainan herediter berupa defisiensi antikoagulan yaitu defisiensi protein S, sekalipun protein C dalam batas normal yang secara bersama-sama diduga mempermudah terjadinya trombosis pada arteri perifer. Kata kunci: Diabetes, Iskemia, Peripheral arterial disease, Protein S, Trombosis Abstract Introduction: Peripheral Arterial Disease (PAD) is occlusion in peripheral artery caused by atherosclerosis or inflammation process that make stenosis in artery, or thrombus formation. High incidence of PAD occur in lower extremity, and rarely in hand and finger. Method: Case report. Result: Has been reported hand ischaemia that rarely found in hand and finger. Discussion: Despite conventional risk factor for thrombosis like diabetes mellitus and malignancy, hereditary disorder of anticoagulant factor deficiency played the same role, like protein S deficiency,eventhough protein C in normal limit. These risk factors made thrombosis at peripheral arteri easier to occur.Keywords:  Diabetes, Ischaemia, Peripheral arterial disease, Protein S, Thrombosis

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