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Background and aims: Millions of people in Indonesia have diabetes. The cluster of metabolic abnormalities has long been identified as the risk factors for type 2 diabetes and is now commonly described as metabolic syndrome/MetS. Insulin resistance takes a key role in the process of the MetS and has even been hypothesized as its underlying cause. Clinical and epidemiologic studies also indicate that inflammatory factors might be correlated with IR. Prospective studies have proved that metabolic syndrome grows during childhood/adolescence and progresses to adulthood T2DM. The purpose of this study was to investigate relationships between metabolic syndrome components and low-grade systemic inflammation with insulin resistance in non-diabetic Indonesian adolescent male. Methods: This was a cross-sectional analysis of non-diabetic adolescent male in Indonesian population (n ¼ 128) aged between 18 and 22 years old. MetS components are based on NCEP ATP III (2004) modification for Asia Pacific population. Marker for low-grade systemic inflammation is hsCRP and insulin resistance was determined by HOMA-IR formula. Relevant measures were anthropometry, blood pressure, fasting insulin, serum glucose, lipid profiles and hsCRP. Results: Of the 128 adolescent male, we found that 16 subjects (12.5%) have central obesity; 3 subjects (2.3%) have hyperglycemia; 26 subjects (20.3%) have low HDL-c; 19 subjects (14.8%) have high triacylglycerol; 45 subjects (35.2%) have hsCRP 1.0 mg/dL; 4 subjects (3.1%) have high blood pressure and 39 subjects (30.5%) have insulin resistance. The association of MetS components with the risk of insulin resistance is central obesity and high triacylglycerol with OR of 24.4 (95%CI: 5.19e114.42) and 9.4 (95%CI: 3.09e28.68) consecutively. We also found that low-grade systemic inflammation (hsCRP 1.0 mg/dL) was strongly associated with incident of insulin resistance with OR 5.2 (95%CI: 2.31e11.64). Meanwhile, we found that high triacylglycerol level is the solely one of five MetS components which has contribution to the incident of systemic low-grade inflammation with OR 3.9 (95%CI: 1.43e10.92). Conclusion: Central obesity and high triacylglycerol level are the important MetS components associated with IR. Systemic low-grade inflammation has been associated with insulin resistance. Identification of obesity, high triacylglycerol and high hsCRP should be focused for prevention of type 2 diabetes in nondiabetic Indonesian adolescent male.

Background: There is increasing evidence that nephrolithiasis is a systemic disease, as opposed to an isolated urinary metabolic problem, after considerable links were found between nephrolithiasis and systemic diseases such as hypertension, obesity, dyslipidemia, and insulin resistance. The interplay between these four factors defines metabolic syndrome (MetS). In this review we aim to clarify the associations of MetS and its components to kidney stone incident. Methods: Online databases of EMBASE, MEDLINE, and Google Scholar were searched from January 1998 up to October 2020 to identify observational studies examining the association between metabolic syndrome components and kidney stone incident. Bayesian random-effects meta-analysis and meta-regression were performed to observe the association. Linear dose-response analysis was conducted to shape the direction of the association. Data analysis was performed using STATA, and R statistics. Results: A total of 25 potentially relevant studies (n = 934,588 participants) were eventually identified. The pooled results suggested that metabolic syndrome was associated with an increased risk of nephrolithiasis with an odds ratio (OR) of 1.769 (95% CI: 1.386 – 2.309).  The summary OR of hypertension and dyslipidemia for developing nephrolithiasis were 1.613 (95% CI: 1.213 – 2.169) and 1.586 (95% CI: 1.007 – 2.502) respectively. The presence of diabetes mellitus and obesity had an OR of 1.552 (95% CI: 1.027 – 2.344) and 1.531 (95% CI: 1.099 – 2.109) respectively. Our results revealed that the increasing number of MetS traits will increase the risk of developing nephrolithiasis, the higher the fasting plasma glucose, and body mass index, the higher the risk of kidney stones incident. Conclusions: Our results suggest that hypertension, diabetes, obesity and dyslipidemia are associated with increased risk of developing nephrolithiasis. Linear significant association between MetS components and nephrolithiasis were revealed in our study which reinforced the notion that should be considered a systemic disorder.

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Purpose: Purpose: Management of Fournier's Gangrene (FG) includes broad-spectrum antibiotics Management of Fournier's Gangrene (FG) includes broad-spectrum antibiotics with adequate surgical debridement, which should be performed within the first 24 hours with adequate surgical debridement, which should be performed within the first 24 hours of onset. However, this treatment may cause significant loss of tissue and may delay of onset. However, this treatment may cause significant loss of tissue and may delay healing with the presence of ischemia. Hyperbaric oxygen therapy (HBOT) has been healing with the presence of ischemia. Hyperbaric oxygen therapy (HBOT) has been proposed as adjunctive therapy to assist the healing process. However, its benefit is still proposed as adjunctive therapy to assist the healing process. However, its benefit is still debatable. Therefore, this systematic review and meta-analysis aimed to evaluate the debatable. Therefore, this systematic review and meta-analysis aimed to evaluate the effect of HBOT as an adjunct therapy for FG. effect of HBOT as an adjunct therapy for FG. Materials and Methods: Materials and Methods: This study complied with the Preferred Reporting Items forThis study complied with the Preferred Reporting Items for Systematic Reviews and Meta-analyses protocol to obtain studies investigating the Systematic Reviews and Meta-analyses protocol to obtain studies investigating the effect of HBOT on patients with FG. The search is systematically carried out on different effect of HBOT on patients with FG. The search is systematically carried out on different databases such as MEDLINE, Embase, and Scopus based on population, intervention, databases such as MEDLINE, Embase, and Scopus based on population, intervention, control, and outcomes criteria. A total of 10 articles were retrieved for qualitative and control, and outcomes criteria. A total of 10 articles were retrieved for qualitative and quantitative analysis. quantitative analysis. Results: Results: There was a significant difference in mortality as patients with FG who received There was a significant difference in mortality as patients with FG who received HBOT had a lower number of deaths compared to patients who received conventional HBOT had a lower number of deaths compared to patients who received conventional therapy (Odds Ratio 0.29; 95% CI 0.12 -0.69; p = 0.005). However, the mean length therapy (Odds Ratio 0.29; 95% CI 0.12 -0.69; p = 0.005). However, the mean length of stay with Mean Difference (MD) of -0.18 (95%