Diabetes mellitus is a chronic progressive disease affecting the metabolic hormonal system and its prevalence in the elderly population is high. Depression is one of the psychiatric disorders in diabetic patients in particular during the coronavirus disease 2019 (COVID- 19) pandemic. People with depression are more susceptible to leading an unhealthy lifestyle; therefore, depression and diabetes have a negative influence on life quality and aggravate complications and symptoms. The aim of this study was to determine the association between depression and hemoglobin A1c (HbA1c) levels in elderly with type 2 diabetes mellitus patients. A cross-sectional study was conducted where a total of 42 diabetic patients from the Puskesmas Belakang Padang, Batam of Indonesia was recruited. The HbA1c level, the main determinant of optimum glycemic control, was measured using ion-exchange high-performance liquid chromatography while the level of depression was assessed using Geriatric Depression Scale-15 (GDS-15). The association between depression and HbA1c levels was analyzed using the chi-squared test. Our study found that that 69% of the elderly with diabetes experienced a depression, classified as mild (40.5%), moderate (21.4%) and severe (7.1%). There were 61.9% of the subjects had poor HbA1c control. Our data suggested that the depression level was associated with HbA1c (p=0.002). In conclusion, there is a significant association between depression and HbA1c levels in the elderly with type 2 diabetes mellitus.
Peritoneal fibrosis is the final process of progressive changes in the peritoneal membrane due to chronic inflammation and infection. It is one of the main causes of discontinuation of peritoneal dialysis (PD), apart from peritonitis and cardiovascular complications. Over time, morphological changes occur in the peritoneal membranes of patients who use PD. Of those are mesothelial-to-mesenchymal transition (MMT), neoangiogenesis, sub-mesothelial fibrosis, and hyalinizing vasculopathy. Several key molecules are involved in the complex pathophysiology of peritoneal fibrosis, including advanced glycosylation end products (AGEs), transforming growth factor beta (TGF-β), and vascular endothelial growth factor (VEGF). This narrative review will first discuss the physiology of the peritoneum and PD. Next, the multifaceted pathophysiology of peritoneal fibrosis, including the effects of hyperglycemia and diabetes mellitus on the peritoneal membrane, and the promising biomarkers of peritoneal fibrosis will be reviewed. Finally, the current and future management of peritoneal fibrosis will be discussed, including the potential benefits of new-generation glucose-lowering medications to prevent or slow down the progression of peritoneal fibrosis.
Purpose: Interprofessional education (IPE) is defined as a practice of collaboration between two or more students from different health profession programs in which the students study with and about, and learn from, each other. IPE is an educational method that trains students to perform in terms of good communication and teamwork which will be useful for the implementation of interprofessional collaboration (IPC) at health-care facilities. The aim of this study is to identify the perceptions of medicine and health profession students on IPE at
The adaptation process of the learning system, the hospital environment, and the high risk of COVID-19 infection can be stressors for anxiety in clinical clerkship. Through the brain-gut–axis, the interaction of psychological factors, such as anxiety, can trigger symptoms related to functional dyspepsia. This study aimed to determine the relationship between anxiety levels and functional dyspepsia during the COVID-19 pandemic among clinical clerkship students. This research was conducted on clinical clerkship students/young doctors in 2021. This was an observational analytic study with a cross-sectional approach and involved 131 respondents. The hamilton anxiety rating scale (HARS) questionnaire was utilized to quantify the level of anxiety, while functional dyspepsia was measured based on Rome IV criteria. The data were analyzed by the Lambda (λ) coefficient of correlation test. This study revealed a significant relationship between anxiety level and functional dyspepsia during the COVID-19 pandemic.
Diabetes is defined as a chronic hyperglycemia which should be countered by the effective, safe and readily available hypoglycemic agents. Herbal is among alternatives that has been used by society for years but lacks of documented evidences. Tinospora crispa (TC) is enriched by phytochemicals which potentially reduce blood glucose thus is useful for diabetic patients. This study aimed to investigate the potency of TC inreducing blood sugar and body weight. It involved 30 healthy rats divided into 5 groups namely: normal control, normal fed with TC extract, diabetic, TC-treated diabetic (dose 500 mg/kg w/w), and vitamin E-traeted diabetic rats (60 IU). The body weight and fasting blood glucose were measured each week for 1 month. The administration of TC extract 500 mg/kg (w/w) helps to maintain body weight in diabetic rats and reduce the fasting blood glucose. TC is highly potent as hypoglycemic agents therefore needed to be explored further.
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