Latar Belakang: Neuropati diabetika/polineuropati diabetika ditandai munculnya kehilangan fungsi saraf secara progresif. Komplikasi ini terjadi pada 50% pasien dengan DM tipe 1 dan 2. Kadar HbA1c dapat menggambarkan rata-rata kadar glukosa dalam darah selama 2-3 bulan terakhir. Pemeriksaan ini penting pengelolaan pasien DM dalam jangka panjang dan pasien DM dengan perubahan gula darah yang dramatis setiap harinya. Penelitian sebelumnya mengenai HbA1c dan neuropati masih belum jelas. Tujuan: Penelitian ini bertujuan untuk membandingkan rerata kadar HbA1c pada pasien DM dengan neuropati dan tanpa neuropati sensori motor. Metodologi: Penelitian ini adalah penelitian potong lintang. Penelitian dilakukan di RS Bethesda, Yogyakarta. Pengambilan sampel dengan metode consecutive sampling, dengan jumlah sampel sebanyak 64 sampel. Semua sampel dilakukan screening neuropati sensori motor menggunakan Diabetic Neuropathy Examination, Diabetic Neuropathy Symptom, dan Monofilament Test. Sampel terbagi menjadi 2 kelompok : DM Neuropati (DMN) dan DM Tidak Neuropati (DMTN); masing-masing kelompok terdiri dari 32 sampel. Hasil: Hasil penelitian pada 64 sampel menunjukkan bahwa kelompok DMN memiliki rerata kadar HbA1c (% ; mean ± SD) lebih tinggi dibandingkan kelompok DMTN (9,61 ± 2,60 Vs. 9,05 ± 2,35). Hasil analisis data menggunakan uji Chi-Square menunjukkan tidak terdapat hubungan bermakna antara rerata kadar HbA1c terhadap neuropati (p = 0,368). Pada penelitian ini didapatkan durasi DM menunjukkan hubungan bermakna terhadap neuropati (p = 0,006). Kesimpulan: Rerata kadar HbA1c ditemukan lebih tinggi pada pasien DM dengan neuropati sensori motor dibandingkan pada pasien DM tidak neuropati sensori motor, namun secara statistik tidak signifikan.
Metabolic syndrome is still a major problem in developing countries and it has an association with high blood pressure, blood glucose, and lipid profile abnormalities, which can cause cardiovascular disease. This indicates that it is important to provide adequate treatment, but patient compliance has effects on the outcome. Improving patients’ compliance to treatment can provide a better control of the condition. Therefore, this study aimed to determine the association between medication compliance and the therapeutic outcome of metabolic syndrome. This observational analytic study was conducted using a retrospective cohort design for one year of observation, namely April 2020-March 2021. The influence of patient compliance with therapy outcomes in terms of blood pressure, blood glucose, and lipid profile was assessed using the medication possession ratio method. This study was carried out by examining patients’ medical records from the Bethesda Lempuyangwangi Hospital as parameters for compliance, while the outcome parameters were assessed by experts. The data obtained were analyzed using Anova (homogeneous data) or Kruskal-Wallis (not homogeneous data) to determine the differences in the compliance based on patients’ characteristics. The relationship of adherence to therapeutic outcomes was analyzed using logistic bivariate. From 174 patients’ data that was observed, only 151 had a blood test. The average systolic blood pressure, total cholesterol, triglyceride, and HbA1c levels were above the standard threshold. The three levels of compliance had no significant relationship with blood pressure, HbA1c, and lipid profiles (p>0.05). The adjusted data for age and gender on adherence showed patients with low compliance, and they have a 2.08 times risk of having high triglyceride levels compared to others (p<0.05). The results indicated the patients’ low compliance to therapy, hence, health professionals must strengthen education to improve this condition.
Background Knee osteoarthritis is more frequently found in women than men. Osteoarthritis pathophysiology is based on inflammatory and degenerative process. The role of inflammation in osteoarthritic pain is varied time over time among patients. Pain perception is different between men and women. Pain in osteoarthritis patients is not only caused by inflammatory process, but also from neurogenic and psychogenic process. Objectives The objectives of this study were to recognize the difference of COX-2 expression by monocytes of synovial fluid and pain perception between men and women with knee osteoarthritis. Methods This was a cross-sectional study. Eighty patients with knee osteoarthritis based on American College of Rheumatology (ACR) criteria, from Rheumatology Clinic of Sardjito Hospital, whose age more than 50 years old and agreed to participate, were selected. Subjects underwent washing period by not consuming anti-inflammatory drugs for a week. Synovial fluids were aspirated from more painful knee. Dried smear preparations were made, and stained using immunocytochemistry method. COX-2 expressions by synovial fluid monocytes were classified into 4 grades, based on monocyte cytoplasm color. Pale monocyte cytoplasm which didn't express COX-2 were scored 0, light brown monocyte cytoplasm which expressed small amount of COX-2 were scored 1, brown monocyte cytoplasm which expressed medium amount of COX-2 were scored 2, and dark brown cytoplasm which expressed large amount of COX-2 were scored 3. The individual mean scores of COX-2 expressions were calculated from the average of 100 monocytes. Knee joint pain was assessed using Visual Analogue Scale (VAS), 0 – 100 mm score. Statistical analysis was done by Duta Wacana Christian University Statistic Center. Results There were 27 men and 53 women. Body mass index, age, and time suffering from osteoarthritis, were not different between groups. The mean ± SD of COX-2 expression scores were 1.95±0.36 in men and 1.80±0.38 in women. COX-2 expression scores were significantly higher (p=0.038) in men (median (IQR), 2.14 (0.63)) compared to women (median (IQR), 1.81 (0.62)). VAS scores were significantly higher (p=0.035) in women (mean ± SD: 56.52±22.67 mm) than men (mean ± SD: 44.33±26.43 mm). Conclusions In patients with knee osteoarthritis, women had more severe pain despite lower COX-2 enzyme expressed by synovial fluid monocytes than men. References Elboim-Gabyzon M, Rozen N, Laufer Y. Gender differences in pain perception and functional ability in subjects with knee osteoarthritis. ISRN Orthopedics. 2012;413105. doi: 10.5402/2012/43105. Neogi T, Frey-Law L, Scholz J, Niu J, Arendt-Nielsen L, Woolf C. Nevitt M, Bradley L, Felson DT. Sensitivity and sensitisation in relation to pain severity in knee osteoarthritis: trait or state? Ann Rheum Dis. 2013. doi: 10.1136/annrheumdis-2013-204191 (Abstract). Tonelli SM, Rakel BA, Cooper NA, Angstom WL, Sluka KA. Women with knee osteoarthritis have more pain and poorer function than men, but similar physical activi...
Vaccination is a very important measure for the prevention of various infections worldwide including the recent COVID-19 disease. However, until now the COVID-19 vaccine with various platforms has not been clinically tested on autoimmune inflammatory rheumatic disease (AIIRD) patients, due to caution against possible side effects and unknown efficacy. Several recent studies proved that there is increased risk of SARS-CoV-2 infection in AIIRD patients and moreover, those patients also have worse COVID-19 outcomes. Thus, patients with AIIRD should be prioritized for vaccination because they have an increased burden of infections, including COVID-19. Many studies showed that inactivated/non-live vaccine is safe for AIIRD patients and do not cause disease exacerbations. We conclude that benefits of vaccination greatly outweigh the risks of infection and therefore, COVID-19 vaccines can also be administered safely in stable AIIRD patients.
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