Aim : This research is to evaluate the hs-CRP level comparison between CKD stages in Dr. Soetomo General Hospital Surabaya.Methods: An analytic observational cross-sectional study, evaluating the differences of hs-CRP level between CKD stages in 72 patients (mean age 55.49±7.62 years, the ratio between male:female was 1:1.48, mean BMI 24.18±3.64 kg/m2, 36.11% diabetics, 43.05% on ACEI/ARB, 29.16% on statin), recruited from Nephrology Outpatient Clinic, Dr Soetomo General Hospital, Surabaya, from January to May 2014. The stages were stratified according to the MDRD formula.Results: The mean hs-CRP of CKD stage 3 was 2.29±2.86, stage 4 was 2.48 ± 2.19, and non-dialysis stage 5 was 2.09 ± 2.54. The analysis using Kruskal-Wallis test showed no significant differences among patients with CKD stage 3, stage 4, and non-dialysis stage 5 (median 1.25 vs 1.80 vs 1.05 mg/L; p=0.430). No significant differences of the serum hs-CRP level were detected between diabetics and non diabetics in stage 3, 4, and non-dialysis stage 5 (p=0.673 vs 0.666 vs 0.138); between patients with and without ACEI/ARB treatment (p=0.610 vs 0.649 vs 0.671); and between patients with and without statin treatment (p=0.852 vs 0.341 vs 0.309).Conclusion: The elevation of serum hs-CRP level can not indicate the decline of kidney function, but it still needs further investigations.
Gastroesophageal reflux disease (GERD) is a global health problem in which the prevalence is increasing over periods. This disease is a significant cause of disorders in the upper gastrointestinal tract with very complex pathogenesis. Oxidative stress (OS) due to gastric acid reflux plays a role in the inflammatory response of the esophageal epithelium. Several OS markers have been widely studied and are thought to affect the severity degree of the esophageal mucosa. However, there has been no research on total oxidant status (TOS), total antioxidant status (TAS), and OS index (OSI) in the adult with GERD; hence the aim of this review was to determine the association between TOS, serum TAS, and OSI with the GERD degree. A literature review was conducted by searching articles related to the TOS, TAS, OSI, and its correlation with GERD degree on an online database, particularly Pubmed and Google scholar. We conclude that TAS and OSI might influence the severity of GERD; however, further clinical study is needed to prove this theory.
Hepatitis B virus infection is a major global health problem in the world and particularly in Indonesia. It can cause chronic infection and puts people at high risk of death from cirrhosis and liver cancer. In this case, we will show about the problems that may occur while we manage a patient. A 55 years old man with chronic hepatitis B has been treated with Telbivudin 600 mg for 8 years and and then stop for 2 years (The HBsAg has been non reactive, HBeAg has been seroconversion from positive to negative, and HBV DNA has been not detected since 2014 until January 2016). In 2018, patients undergo surgery to remove nodules in the liver. After that, there were transaminase and bilirubin elevation, and then HBsAg become reactive again. After giving combination therapy of Telbivudin 600 mg with Entecavir 0.5 mg and metyl prednisolone 8 mg (per os, three times a day) for 1 months, the transaminase became decrease, but the bilirubine was still high. The patient was reported to have died in February 2019 after being hospitalized in a hospital outside Java, so we could not know or investigasted the cause of his mortality.
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