Acute adrenal insufficiency (AI) is a life-threatening condition. While Addison's disease (AD) is rare, in developing countries, tuberculosis (TB) still remains as the primary cause in 7 to 20% of cases. Urinary TB is also the third most common form of extrapulmonary disease. We report a case of 37-year-old male who presented with weakness, anorexia, weight loss, dysuria, flank pain and low grade fever. Examination revealed hypotension, hyperpigmentation, hyponatremia, hypoglycemia and low serum cortisol. He was diagnosed to have adrenal crisis due to Addison's disease and extrapulmonary TB manifesting as urinary tract infection (UTI). He was treated with corticosteroids and anti-TB medications. Urologic reconstructive surgery was subsequently planned..
Abstract. Bayesian statistics proposes an approach that is very flexible in the number of samples and distribution of data. Bayesian Mixture Model (BMM) is a Bayesian approach for multimodal models. Diabetes Mellitus (DM) is more commonly known in the Indonesian community as sweet pee. This disease is one type of chronic non-communicable diseases but it is very dangerous to humans because of the effects of other diseases complications caused. WHO reports in 2013 showed DM disease was ranked 6th in the world as the leading causes of human death. In Indonesia, DM disease continues to increase over time. These research would be studied patterns and would be built the BMM models of the DM data through simulation studies where the simulation data built on cases of blood sugar levels of DM patients in RSUD Saiful Anwar Malang. The results have been successfully demonstrated pattern of distribution of the DM data which has a normal mixture distribution. The BMM models have succeed to accommodate the real condition of the DM data based on the data driven concept. IntroductionWhen a set of real data observed have a very small amount and a multimodal distribution then it is necessary need specially handling. The Bayesian statistics proposes an approach that is very flexible in the number of samples and distribution of data. These approach is based directly on the posterior distribution of the data. Therefore Bayesian approach can accommodate the real condition of the data based on the data driven concept and [5]). Bayesian Mixture Model (BMM) is one model that uses a Bayesian approach for multimodal models and its parameter models is seen as random variables in the model parameter space [6].Various studies have previously been carried out by BMM modeling. The modeling of BMM for the DM data in Surabaya is the research that has been done by [7] and the research of [8] has been conducted for the DM data in Malang by BMMA modeling. Some of the BMM research in the other field, among others [9] and [10]. Modeling of cases is very important in order to know the exact model and can be used for decision making in accordance with the cases observed [11].
Prevalensi wanita dengan diagnosis Diabetes Mellitus (DM) meningkat sepanjang tahunnya termasuk dalam kehamilan. Kami laporkan kasus seorang wanita 36 tahun dengan persalinan anak pertama yang dikonsultasikan dengan peningkatan gula darah sesudah persalinan. Dari hasil anamnesa dan pemeriksaan fisik tidak didapatkan riwayat DM pada pasien dan keluarga yang dapat menjadi penyebab keterlambatan diagnosis DM pada kehamilan. Anamnesis, observasi dan hasil pemeriksaan laboratorium mengindikasikan potensi DM yang dimulai sebelum kehamilan namun tidak dikonfirmasi melalui skrining pemeriksaan gula darah pada kehamilan. Bayi yang dilahirkan mempunyai berat badan normal namun sempat mengalami hipoglikemia. Pasien diberikan terapi injeksi insulin basal dimulai pada dosis 6 iu dan dinaikkan bertahap menjadi 8 iu dan 10 iu, sesuai dengan hasil evaluasi hingga tujuan terapi tercapai. Kasus ini menunjukkan pentingnya penggalian riwayat dengan teliti dan skrining DM dalam kehamilan pada mereka yang berisiko untuk mencegah komplikasi pada janin maupun ibu. Kata Kunci: Diabetes mellitus, kehamilan, komplikasiÂ
Background: Diabetes mellitus is a metabolic disorder whose prevalence increases globally. Medical nutrition therapy (MNT) is one of the DM management pillars to control blood glucose. Local Indonesian brown rice is proven to contain high fiber and magnesium levels thus could improve obesity, fasting blood glucose, and HbA1c This study aims to prove the benefits of brown rice on anthropometric parameters and blood glucose control.Design and methods: Respondents were overweight women older than 40 years with type 2 diabetes who were given three main meals and three snacks six days a week for 12 weeks. Anthropometric and blood glucose control data were collected before and after the intervention. Diet and intake data before the intervention were obtained through a semi quantitate food frequency questionnaire. Intake data during the intervention were recorded using the 24-hour food record and analyzed using modified NutriSurvey 2007 software.Results: Brown rice intervention significantly reduced body weight, BMI, body fat percentage, and abdominal circumference (P <0.05), also in fasting blood glucose (FBG), 2-h postprandial blood glucose (PBG), and HbA1c (P <0.05). From the Pearson's test results, an increase in fiber intake correlated with a decrease in BMI and abdominal circumference (P = 0.03; r = -0.511 and P = 0.006; r = -0.619, respectively). Meanwhile, magnesium intake and changes in BMI showed a negative correlation.Conclusions: The substitution of brown rice as a staple food for 12 weeks improves anthropometric parameters and blood glucose control in respondents with type 2 diabetes.
A hazard to global health is being posed by diabetes mellitus (DM). Macrovascular and microvascular abnormalities in blood vessels are one type of DM complication that might happen. In most cases, blood arteries, the brain, and the heart are affected by macrovascular problems. Obesity is well-known to have a substantial significant risk factor for coronary heart disease on its own (CHD). As a result, many persons with DM have a 2 to 4 times higher risk of dying from CHD than those without DM. In fact, different goal parameters (such glucose management, blood pressure, cholesterol status, or body composition) can improve with exercise training to varying degrees in each patient; here is where cardiovascular rehabilitation can help. To attain the best results, the type and intensity of exercise training must be tailored to the unique characteristics of each patient. The clinician's challenge is to teach the patient the skills necessary to maintain lifestyle modifications and to explain the relationship between exercise and blood sugar, BG goal ranges, and the types and amounts of activity that can be done safely.
Pendahuluan. Ekstrak teh hijau (senyawa polifenol/katekin) terbukti secara in vitro memiliki kemampuan sebagai antioksidan. Aktivitas fisik submaksimal merupakan salah satu penyebab peningkatan radikal bebas. Peningkatan radikal bebas dapat dideteksi dengan peningkatan MDA yaitu produk akhir dari peroksidasi lemak. Penelitian ini dilakukan untuk mengetahui efek suplementasi antioksidan ekstrak teh hijau terhadap radikal bebas yang ditimbulkan oleh aktivitas fisik submaksimal dengan mengukur kadar MDA plasma. Metode. Uji double blind control trial dilakukan pada 20 orang mahasiswa Fakultas Ilmu Olahraga Universitas Negeri Malang dengan aktivitas fisik submaksimal yaitu lari 1.500 m dalam 12 menit menggunakan mesin treadmill. Subjek terbagi atas dua kelompok: kelompok ekstrak teh hijau (250 mg) dan kontrol (plasebo). Suplemen diberikan satu kapsul per hari selama 14 hari sebelum aktivitas fisik submaksimal. Kadar MDA plasma diambil sebelum aktivitas submaksimal, serta 2 jam dan 48 jam setelah aktivitas fisik submaksimal. Analisis hasil penelitian menggunakan uji ANOVA dan post hoc dengan Tukey. Penelitian telah dinilai layak secara etik oleh tim Komisi Etik Penelitian Kesehatan Fakultas Kedokteran Universitas Brawijaya. Hasil. Pada kelompok kontrol, rerata kadar MDA plasma kondisi basal, 2 jam dan 48 jam setelah aktivitas fisik submaksimal secara berturut-turut yaitu 52,43 nmol/ml (simpang baku [SB] 12,52 nmol/ml), 55,57 nmol/ml (SB 13,84 nmol/ml), dan 63,86 nmol/ml (SB 12,17 nmol/ml). Namun demikian, peningkatan tersebut tidak bermakna secara statistik (p=0,158). Pada kelompok perlakuan, terdapat penurunan kadar MDA plasma yang bermakna saat 48 jam setelah aktivitas fisik submaksimal dari kondisi basal dengan rerata kadar MDA pada basal dan 48 jam setelah aktivitas fisik submaksimal secara berturut-turut yaitu 36,14 nmol/ml (SB 5,88 nmol/ml) dan 19,86 nmol/ml (SB 8,92 nmol/ml) (p<0,001). Hasil analisis menunjukkan adanya perbedaan bermakna kadar MDA plasma antara kedua kelompok saat basal, serta 2 jam dan 48 jam setelah aktivitas fisik submaksimal dengan nilai p secara berturut-turut yaitu 0,012; <0,001, dan <0,001. Simpulan. Ekstrak teh hijau dapat menurunkan kadar MDA plasma basal, 2 jam, dan 48 jam setelah aktivitas fisik submaksimal.
Diabetes melitus merupakan penyakit yang banyak ditemui sehari-hari, akan tetapi memiliki manifestasi klinis yang tidak lazim. Salah satu manifestasinya adalah sindroma hemichorea-hemiballismus, spektrum gerakan involunter yang berlangsung terus-menerus tanpa pola dan melibatkan satu sisi tubuh akibat hiperglikemia non-ketotik pada diabetes yang tidak terkontrol. Dilaporkan dua kasus pasien diabetes dengan hiperglikemia non-ketotik yang mengalami sindrom hemichorea-hemiballismus. Kasus pertama-wanita 57 tahun mengalami gerakan involunter, repetitif, dan tidak berirama di lengan dan tungkai kanan, disertai kedutan di wajah kanan selama dua minggu. Pasien tersebut memiliki riwayat diabetes melitus tidak terkontrol. Kasus kedua-laki-laki 60 tahun dengan kejang umum tonik-klonik. Pasien mengalami gerakan involunter pada lengan kanan selama empat hari dan riwayat diabetes sebelumnya tidak diketahui. Terapi diazepam intravena tidak memberikan respons terhadap kejang. Gambaran CT scan kepala pada kedua pasien menunjukkan lesi hiperdens pada ganglia basalis yang diduga disebabkan oleh hiperglikemia non-ketotik, akan tetapi lesi hiperdens pada pasien kedua tampak lebih luas. Gerakan involunter membaik setelah target glukosa darah tercapai dengan rehidrasi dan insulin intravena kontinyu. Respons klinis pada kasus hemichorea-hemiballismus di atas bersifat reversibel meskipun gambaran lesi hiperdens dapat bertahan selama berbulan-bulan.
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