Small Dense Low-Density Lipoprotein (sdLDL) and the ApoB/ApoA-I ratio has greater atherogenic potential and is a better marker to predict atherosclerotic blood vessel disease. The purpose of this study was to determine the relationship between the sdLDL and ApoB/ApoA-I ratio to assess the prevalence risk of Peripheral Arterial Disease (PAD) in hypertensive patients. A cross-sectional observational analytic study was performed in 51 hypertension patients with age> 18 years old in Dr. Moewardi Hospital Surakarta from May until June 2018. Patients have measured ABI scores, BMI, blood pressure, lipid profile, ApoB, and ApoA levels. Data were statistically analyzed was using bivariate analysis and multivariate analysis. P-value <0.05 was statistically significant. The prevalence of PAD was 54.90%. Bivariate analysis of age variables (PR: 3.15; 95%Cl: 1.128-8.811; p=0.005), sdLDL (PR: 2; 95%Cl: 0.997-4.013; p=0.03), the ratio of ApoB/ApoA-I (PR: 5.786; 95%Cl: 0.899-37.224; p=0.007), and smoking (PR: 1.896; 95%Cl: 1.210-2.971; p=0.015) was significantly related with PAD. After adjustment of age, smoking, and dyslipidemia variables using multivariate logistic regression analysis, PAD was still related with sdLDL (PR: 10.55; 95%CI: 1.80-61.73; p=0.009), age (PR: 11. 61; 95%CI: 1.83-61.73; p=0.009), and smoking (PR: 11.96; 95%CI: 1.71-83.81; p= 0.013). sdLDL and ApoB/ApoA-I ratio were related to PAD. However, sdLDL, age, and smoking are independent variables of PAD in hypertension patients.
Preeliminary : Pituitary gigantism is a condition caused by the excessive secretion of growth hormone (GH). Growth Hormone is also the most common pituitary hormone deficient in pituitary disease. Chordoma is a bone primary tumor that grows slowly and rarely found. Hypothyroidism is a pathological condition due to thyroid hormone deficiency. Symptoms of hypogonadism is non-specific including libido disorders, erectile dysfunction and decreased muscle mass and no hair growth in the head or body. Case : A 24-year-old man came with a knee-jerk complaint. Physical examination obtained increased growth of statural and body parts as well as loss of body hair. Laboratory investigation revealed pancytopenia, increased prolactin; decreased GH, IGF-1 and testosterone; increased TSH, decreased FT3 and FT4. Head MRI demonstrated the presence of mass in the clivus.Discussion : In this case, the patient presents with clinical gigantism. However, laboratory examination shows decreased GH and IGF-1 which may be due to the suppressive effect of mass on the clivus bone to the pituitary. The suspicion of hypothyroid found alone or due to mass in the clivus bone still requires further examination. Hypogonadism can result from supression on the pituitary. Pancytopenia can be caused by deficiency of GH or from hypothyroidism.Conclusion : Gigantism may occurred with deficiency GH and IGF-1 due to suppressed pituitary caused by chordoma.
Background: Type 2 diabetes mellitus (DM) is a metabolic disorder characterized by hyperglycemia. Metabolic syndrome (MS) is a complex metabolic disorder like hyperglycemia, obesity, dyslipidemia, and hypertension. Vitamin D controls genes associated with regulation of insulin and renin production. The aim of this study was to analyze the relation between total levels of 25-hydroxyvitamin D [25(OH)D] and the incidence of MS in type 2 DM patients.Methods: This case control study was conducted from October to November 2018 in Dr Moewardi Hospital Surakarta in 84 people with type 2 diabetes mellitus. All subjects were 34-75 years old. The research data were analyzed with a 2x2 test table to determine the odd ratio (OR) of each study variable, then multivariate analysis with logistic regression then continued.Results: The mean total level of 25(OH)D is 18.01 ± 6.10 ng/dl. Bivariate and multivariate OR analysis showed that poor glycemic control with the incidence of MS (OR: 11.154; 95% Cl: 3.933-31.631; p = 0.001); female sex (OR : 1.788; 95% Cl: 0.750-4.261; p = 0.188); age < 50 year (OR: 1.644; 95% Cl: 0.614-4.404; p = 0.321); and total 25(OH)D deficiency (OR: 1.250; 95% Cl: 0.317-2.022; p = 0.637).Conclusion: total 25(OH)D level is not associated with the incidence of MS in the type 2 DM patients. Further study was needed using by healthy group control to explain the role of vitamin D in type 2 DMKeywords: type 2 DM, metabolic syndrome, 25(OH)D
Diabetes Mellitus (DM) is a chronic disease caused by pancreas the inability to produce insulin or ineffectively insulin use.Fracture risk in type 2 DM patients increases even though the bone density is normal. This study aimed to examine thecorrelation of osteopontin (OPN) and alkaline phosphatase (ALP) in type 2 DM patients. An observational analytical studywas conducted in 73 type 2 DM patients in Dr. Moewardi Hospital, Surakarta from October to November 2018. The subjectswere examined for blood pressure, fasting blood glucose, two hours postprandial blood glucose, HbA1c, OPN, and ALPlevels. P-value <0.05 was statistically significant with a 95% confidence interval. Poorly controlled type 2 DM had higher OPNlevels than well-controlled (20.5±2.8 vs. 14.8±3.1 ng/mL, p <0.001). The ALP concentration was also higher in poorlycontrolled type 2 DM patients (79.9±31.7 vs. 61.1±25 U/L, p=0.003). The levels of OPN and ALP were significantly correlatedin type 2 diabetes (r=0.273; p=0.020) and in well-controlled patients (r=0.353; p=0.047) but no correlation was found inpoorly controlled type 2 DM patients (r= -0.073; p= 0.652). In this study, a significant correlation was found between OPNand ALP in patients with type 2 DM and well-controlled. Further study involving healthy controls and bone ALPmeasurement is needed.
The Acquired Immune Deficiency Syndrome (AIDS) is the presence of symptoms caused by Human Immunodeficiency Virus (HIV)which belongs to human retroviruses (retroviridae). Thrombocytopenia is a common finding in patients with HIV infection. HIV infectionmay induce thrombocytopenia through immune and non-immune mechanisms, autoimmune combination and inhibition of plateletproduction. The aim of this study is to analyze the correlation between thrombocyte and CD4 count in HIV/AIDS patients. This studyuses a cross sectional design with a total of 17 patients. The subject of this study is HIV/AIDS patients who came to and examined atVCT clinic, dr. Moewardi Hospital Surakarta. To analyze this result the researchers used Spearman (r) correlation with p<0.05, andconfidence interval 95%. Patients’ median age was 30 (21–49) years, 11 (64.7%) men and 6 (35.3%) women. The subjects with AIDSwere 11 (64.7%), and HIV were 6 (35.3%) patients. The duration of antiretroviral (ARV) was 7.5 (4–20) months in 10 subjects.The median of thrombocyte count was 203 (143–327)×103/μL, CD4 absolute 207 (5.0–734)/μL, and CD4 (% lymphocytes) 13.0(2.0–29.0)%. The thrombocyte count was not correlated with CD4 absolute (r=0.456; p=0.066) and CD4% (r=0.218; p=0.400). InHIV patients, low platelet counts will be the result of a host of problems and complications that are associated with the progressive HIVinfection or its management.
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