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Lubis DA, Subekti I, Yunir E, Irawan C, Hestiantoro A, Lestari SW, Kekalih A, Pasaribu MMB, Syafril S. Proportion of Hypogonadism in Transfusion-Dependent Thalassemia Patients and Its Contributing Factors. Acta Med Indones 2024; 56:13-19. [PMID: 38561881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
BACKGROUND Beta thalassemia is a lifelong disease involving malformed red blood cells (RBC). One of the disease's complications is hypogonadism, in which adults tend to exhibit regression in sexual characteristics, experience sexual dysfunction, and therefore have a lower quality of life. Around 3-10% of the Indonesian population carries the beta-thalassemia gene. This study aimed to see the proportions of hypogonadism in transfusion-dependent thalassemia patients and its contributing factors. METHODS This is a cross-sectional study involving 60 male patients admitted to three Indonesian general hospitals from July 2022 to July 2023. All patients were diagnosed with beta-thalassemia via chromatography hemoglobin analysis. We performed a single-time physical examination and laboratory examinations to determine FSH, LH, and free testosterone levels. The correlation between Hb and sexual hormone levels was analyzed using Spearman's rank correlation coefficient. ROC curve analysis was conducted afterward. All statistical analysis was done in SPSS version 29. RESULTS 31 out of 60 thalassemia patients had hypogonadism. Pre-transfusion Hb count was found to be linearly correlated with FSH (r = 0.388, p = 0.049), LH (r = 0.338, p = 0.008), and free testosterone (r = 0.255, p = 0.049). ROC analysis indicated that pre-transfusion Hb was viable as a predictor for hypogonadism (AUC = 0.655, 65.5% sensitivity, 67.7% specificity). CONCLUSION We confirmed the role of pre-transfusion Hb count as a potential predictor for hypogonadism due to the tissue hypoxia mechanism and transfusion-related iron overload in TDT patients. Decreased Hb is linearly correlated with FSH, LH, and testosterone levels. Decreased Hb also downregulates these factors.
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Affiliation(s)
- Dian Anindita Lubis
- 1. Doctoral Program in Medical Sciences, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia. 2. Division of Endocrinology Metabolic, Department of Internal Medicine, Faculty of Medicine Universitas Sumatera Utara, Medan, Indonesia.
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Sazli BI, Lindarto D, Hasan R, Putra A, Pranoto A, Sembiring RJ, Ilyas S, Syafril S. Secretome of Hypoxia-Preconditioned Mesenchymal Stem Cells Enhance Angiogenesis in Diabetic Rats with Peripheral Artery Disease. Med Arch 2023; 77:90-96. [PMID: 37260802 PMCID: PMC10227841 DOI: 10.5455/medarh.2023.77.90-96] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 03/24/2023] [Indexed: 09/29/2023] Open
Abstract
Background Lower limb peripheral artery disease (PAD) is the main risk of diabetes mellitus which result to high mortality rate. Approximately, 50% of patients who receive several treatments have passed away or lost limbs at a year's follow-up. Secretome of hypoxia mesenchymal stem cells (S-MSCs) contains several active soluble molecules from hypoxia MSCs (H-MSCs) that capable inducing anti-inflammatory and vascular regeneration in PAD. Objective In this study, we investigated the therapeutic potential of S-MSCs in improving dynamic function and angiogenesis of PAD diabetic rats. Methods The PAD was established by the incision from the groin to the inner thigh and distal ligation of femoral arteries in rats with diabetes. Rats were administered with 200 µL and 400 µL S-MSCs that successfully filtrated using tangential flow filtration (TFF) system based on various molecular weight cut-off categories intravenously. ELISA assay was used to analyze the cytokines and growth factors contained in S-MSCs. Tarlov score were examined at day 1, 3, 5, 7, 10 and 14. The rats were sacrificed at day 14 and muscle tissues were collected for immunohistochemistry (IHC) and gene expression analysis. Results ELISA assay showed that S-MSCs provides abundant level of VEGF, PDGF, bFGF, IL-10 and TGFβ. In vivo administration of S-MSCs remarkably enhanced the Tarlov score. S-MSCs improved angiogenesis through enhancing VEGF gene expression and significantly increasing CD31 positive area in muscle tissue of PAD diabetic rats. Conclusion Our findings suggest that S-MSCs could improves dynamic function and angiogenesis in PAD diabetic rats.
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Affiliation(s)
- Brama Ihsan Sazli
- Philosophy Doctor in Medicine Program, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
- Department of Internal Medicine, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
| | - Dharma Lindarto
- Philosophy Doctor in Medicine Program, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
- Department of Internal Medicine, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
| | - Refli Hasan
- Philosophy Doctor in Medicine Program, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
- Department of Internal Medicine, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
| | - Agung Putra
- Stem Cell and Cancer Research, Faculty of Medicine, Universitas Islam Sultan Agung, Semarang, Indonesia
- Department of Postgraduate Biomedical Science, Faculty of Medicine, Universitas Islam Sultan Agung, Semarang, Indonesia
| | - Agung Pranoto
- Department of Internal Medicine, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
| | - Rosita Juwita Sembiring
- Philosophy Doctor in Medicine Program, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
| | - Syafruddin Ilyas
- Department of Biology, Faculty of Mathematics and Natural Sciences, Universitas Sumatera Utara, Medan, Indonesia
| | - Santi Syafril
- Department of Internal Medicine, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
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Boy E, Lelo A, Tarigan AP, Machrina Y, Yusni Y, Harahap J, Sembiring RJ, Syafril S, Rusip G, Freeman CA. Salat Dhuha Improves Haemodynamic: A Randomized Controlled Study. Open Access Maced J Med Sci 2021. [DOI: 10.3889/oamjms.2021.7666] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND: The prevalence of hypertension increases with age, more than 1 in every two elderly have hypertension, dominated by women. The primary prevention of hypertension is a worldwide public health concern. Salat Dhuha is a moderate-intensity physical activity. Salat with a two-movement cycle (rakaat) demonstrated improved hemodynamic in adults.
AIM: Our study purpose was to asses the effects of 2 and 8 rakaats of Salat Dhuha in improving systolic and diastolic blood pressure and heart rate in healthy elderly women.
METHODS: Elderly women in the Senior Care Residence (aged 60–74 years) participated in a 6-week controlled study. We completed a formal physical, clinical, and blood assessments before admission. Participants with a history of hypertension were excluded from the study. The participants were randomized into 2 groups, i.e., “8 rakaats group” (n = 13) and “2 rakaats group” (n = 13) of Salat Dhuha. Two participants dropped out from the present study. At baseline and at the end of 6 weeks study period, blood pressure and heart rate were recorded. All data obtained were statistically analyzed.
RESULTS: Both groups demonstrated the benefits of Salat Dhuha in improving hemodynamic parameters (systolic and diastolic blood pressure and heart rate). However, the reduction of systolic blood pressure in the “2 rakaats group” (2.16 mmHg) was less than in the “8 rakaats group” (5.50 mmHg), the reduction of diastolic blood pressure in the “2 rakaats group” (0.75 mmHg) was less than the “8 rakaats group” (2.41 mmHg) and the reduction of heart rate in “2 rakaats group” (2.08 bpm) was less than the “8 rakaats group” (6.08 bpm). All differences were statistically significant (p < 0.05).
CONCLUSION: This study demonstrated that the Salat Dhuha has a significant potential in improving hemodynamic parameters for elderly women which the more frequent rakaat will give more benefit than less frequent rakaat.
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Zulfa Z, Mardia AI, Handayani S, Syafril S, Gatot D. Comparison of Protein-C levels in diabetes melitus type 2 patients with and without ulcers at Haji Adam Malik Hospital Medan Indonesia May-July 2017. Bali Med J 2019. [DOI: 10.15562/bmj.v8i3.913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Introduction People with diabetes mellitus (DM) have an increased risk for thrombosis compared with non-diabetic patients. Several studies showed contradicting in data on levels of protein C in people with type 2 DM and diabetic ulcers.Methods This is a descriptive and analytical cross-sectional study on protein C concentration of patients with type 2 DM with and without foot ulcers. The control group was the type 2 DM patients without foot ulcers, whereas the case group was the type 2 DM patients with a rigid diabetic foot ulcer based on the Wagner criteria. Blood samples are then taken after 8 to 10 hours of fasting to check for protein C concentration and hemostasis examination including platelet count, prothrombin time (PT), activated partial thromboplastin time (aPTT), thrombin time (TT), fibrinogen levels, and D-dimers.Results Of a total of 20 samples, there was no statistically significant difference in protein C levels of diabetic foot ulcers with hypercoagulation compared with no diabetic foot ulcers with hypocoagulation and no significant correlation between grade diabetic foot ulcers and protein C concentration.
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Zulfahmi Z, Mardia AI, Handayani S, Syafril S, Gatot D. Comparison of antithrombin III levels in type 2 diabetes mellitus patients with and without ulcers at Haji Adam Malik Hospital Medan Indonesia from may to july 2017. Bali Med J 2019. [DOI: 10.15562/bmj.v8i2.914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Hartuti S, Nasution A, Syafril S. The Effect of Drug-Related Problems on Blood Glucose Level in the Treatment of Patients with Type 2 Diabetes Mellitus. Open Access Maced J Med Sci 2019; 7:1798-1802. [PMID: 31316661 PMCID: PMC6614271 DOI: 10.3889/oamjms.2019.290] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Revised: 06/10/2019] [Accepted: 06/11/2019] [Indexed: 02/01/2023] Open
Abstract
AIM The study aimed to investigate the effect of drug-related problems (DRPs) on changes in blood glucose level (BGL) in the treatment of type 2 diabetes mellitus (T2DM) patients. METHODS This three-month prospective cross-sectional study was conducted to patients of T2DM with complications hospitalised in Haji Adam Malik (HAM) Hospital, Medan, Indonesia period from July to October 2018. DRPs were identified and classified by using Cipolle DRP classification and trustable literature. The data obtained were analysed by Chi-Square test (p < 0.05 implied that there was a significant relationship). RESULTS This study involved 81 T2DM patients, 52 (64.2%) of the patients were male, and 29 (35.8%) of them were female. Most (30.9%) of patients were at the age of 51-60 years. Combination of rapid-acting and long-acting insulin was the most frequently provided antidiabetic drugs (69.1%). There were 68 DRPs experienced by 32 (39.5%) of the patients. Percentage of DRP experienced by the 32 patients by number: 1 DRP, 53.1; 2 DRPs, 28.1; 3 DRPs, 3.1; 4 DRPs, 3.1; 5 DRPs, 3.1; 7 DRPs, 9.3. This study showed that 27.2% and 12.3 % of the patients had hyperglycemia and hypoglycemia, respectively. There was no significant relationship between BGL and indication without drug therapy (p = 0.064), ineffective provided drug (p = 0.079), and there was a significant relationship between BGL and irrational dose (p = 0.000). Furthermore, there was a significant relationship between hypoglycemia and adverse drug reaction (p = 0.000). CONCLUSION DRPs are common among T2DM patients and still required the attention and appropriate actions of healthcare providers.
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Affiliation(s)
- Silvy Hartuti
- Department of Pharmacology, Faculty of Pharmacy, Universitas Sumatera Utara, Medan 20155, Indonesia
| | - Azizah Nasution
- Department of Pharmacology, Faculty of Pharmacy, Universitas Sumatera Utara, Medan 20155, Indonesia
| | - Santi Syafril
- Department of Internal Medicine, Faculty of Medicine, Universitas Sumatera Utara, H. Adam Malik General Hospital, Medan, Indonesia
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Syafril S, Lindarto D, Lelo A, Sembiring RJ, Saragih A. Correlations between Insulin Receptor Substrate-1 with Phosphoinositide 3-Kinase and P38 Mitogen-Activated Protein Kinase Levels after Treatment of Diabetic Rats with Puguntano ( Curanga Fel-Terrae [Merr.]) Leaf Extract. Open Access Maced J Med Sci 2019; 7:1247-1251. [PMID: 31110564 PMCID: PMC6514355 DOI: 10.3889/oamjms.2019.218] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Revised: 04/21/2019] [Accepted: 04/22/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Defects in post-receptor insulin signalling are the major cause of insulin resistance in type 2 diabetes mellitus (T2DM). AIM This study aimed to investigate the correlations between insulin receptor substrate (IRS)-1 with phosphoinositide 3-kinase (PI3K) and p38 mitogen-activated protein kinase (MAPK) levels after puguntano (Curanga fel-terrae [Merr.]) leaf extract treatment in a rat model of T2DM. METHODS A combination of high-fat diet-feeding (HFD) and multiple low dose intraperitoneal injections of streptozotocin was used to induced T2DM in 48 Wistar rats, which were then randomly divided into control and treatment groups (n = 24 per group). Puguntano leaf extract was administered to the treatment group once daily (200 mg/kg.bw) for 10 days. IRS-1, PI3K and p38 MAPK levels were measured in skeletal muscle using sandwich ELISAs in control group after becoming T2DM and in the treatment group after 10 days of puguntano treatment. Data were analysed using the Wilcoxon test and Spearman's correlation. RESULTS IRS-1, PI3K and p38 MAPK levels were significantly higher in the treatment group than in the control group. There were also significant positive correlations between IRS-1 with PI3K and p38 MAPK levels (r = 0.375, p = 0.035; r = 0.552, p = 0.003; respectively) after the treatment. CONCLUSION This study demonstrated significant positive correlations between IRS-1 with PI3K and p38 MAPK levels after puguntano leaf extract treatment of T2DM rats.
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Affiliation(s)
- Santi Syafril
- Department of Internal Medicine, Faculty of Medicine, Universitas Sumatera Utara, H. Adam Malik General Hospital, Medan, Indonesia
| | - Dharma Lindarto
- Department of Internal Medicine, Faculty of Medicine, Universitas Sumatera Utara, H. Adam Malik General Hospital, Medan, Indonesia
| | - Aznan Lelo
- Department of Pharmacology and Therapeutics, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
| | - Rosita Juwita Sembiring
- Department of Clinical Pathology, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
| | - Awaluddin Saragih
- Department of Biological Pharmacy, Faculty of Pharmacy, Universitas Sumatera Utara, Medan, Indonesia
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Syafril S, Lindarto D, Lelo A, Sembiring RJ, Manaf A, Putra IB, Hasibuan PAZ, Mutiara E. The Effect of Puguntano Leaf Extract ( Curanga Fel - Terrae Merr.) On P38 Mapk Levels and Glut-4 Expression in Type 2 Diabetic Rat Muscle. Open Access Maced J Med Sci 2019; 7:521-525. [PMID: 30894905 PMCID: PMC6420951 DOI: 10.3889/oamjms.2019.165] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Revised: 02/13/2019] [Accepted: 02/18/2019] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Puguntano (Curanga feel-terrae Merr.) contains flavonoids, saponins, tannins, and steroids/ terpenoids which improved post-receptor insulin signalling in rats model of type 2 diabetes mellitus (T2DM). AIM This study aimed to determine the effect of puguntano leaf extract on p38 mitogen-activated protein kinase (MAPK) levels and glucose transporter-4 (GLUT-4) expression in diabetic rats muscle. METHODS Forty-eight male Wistar rats had T2DM induced using a combination of feeding a high-fat diet for 5 weeks and multiple intraperitoneal injections of low-dose streptozotocin (30 mg/kg). The diabetic rats were randomly divided into control and treatment groups, and 200 mg/kg/day puguntano extract was administered orally for 10 days to treatment group. Subsequently, p38 MAPK levels were measured by Sandwich Elisa and plasma membrane GLUT-4 expression was evaluated by Immunohistochemistry in their gastrocnemius muscles. RESULTS There were significantly higher p38 MAPK levels and GLUT-4 expression in the treatment group than in the control group. CONCLUSION These data suggest that a puguntano leaf extract can improve post-receptor insulin signalling by enhancing p38 MAPK levels and GLUT-4 expression in a rat model of T2DM.
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Affiliation(s)
- Santi Syafril
- Department of Internal Medicine, Faculty of Medicine, Universitas Sumatera Utara, H. Adam Malik General Hospital, Medan, Indonesia
| | - Dharma Lindarto
- Department of Internal Medicine, Faculty of Medicine, Universitas Sumatera Utara, H. Adam Malik General Hospital, Medan, Indonesia
| | - Aznan Lelo
- Department of Pharmacology and Therapeutic, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
| | - Rosita Juwita Sembiring
- Department of Clinical Pathology, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
| | - Asman Manaf
- Department of Internal Medicine, Faculty of Medicine, Universitas Andalas, Dr M. Djamil General Hospital, Padang, Indonesia
| | - Imam Budi Putra
- Department Dermatovenereology, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
| | | | - Erna Mutiara
- Department of Biostatistics, Faculty of Public Health, University of Sumatera Utara, Medan, Indonesia
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Lindarto D, Shierly, Syafril S. Neck Circumference in Overweight/Obese Subjects who Visited the Binjai Supermall in Indonesia. Open Access Maced J Med Sci 2016; 4:319-323. [PMID: 27703549 PMCID: PMC5042609 DOI: 10.3889/oamjms.2016.072] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2016] [Revised: 06/25/2016] [Accepted: 06/26/2016] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Neck circumference (NC) is a simple screening measure for identifying overweight and obesity, it reflects upper-body fat distribution and central obesity. AIM To determine whether a single measure of NC might be used to identify overweight/obesity. MATERIAL AND METHODS An observational, analytical, cross-sectional study was done. The subjects consisted of all consecutive subjects who visited Binjai Supermall (North Sumatera Province, Indonesia) between 23rd and 29th September 2015 and agreed to participate in the study. NC, weight, height, body mass index (BMI), and waist circumference (WC) were measured. Overweight and obesity were defined as BMIs of 23.0-24.9 and ≥ 25 kg/m2, respectively. RESULTS In total, 1554 subjects participated. Of these, 1238 (79.7%) were overweight/obese. NC correlated significantly with weight, height, BMI, and WC. Receiver operating characteristic (ROC) analysis showed that for all men and women, the area under the curve of overweight/obesity for NC was 0.83 and 0.79, respectively. The best NC cutoff points for males and females that indicated overweight/obesity were ≥ 37 cm (sensitivity, 78.3% and specificity, 75.5%) and ≥ 33.5 cm (sensitivity, 76.6% and specificity, 66.7%), respectively. CONCLUSION The NC cutoffs that were identified may be useful for screening for overweight/obesity and related co-morbidities.
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Affiliation(s)
- Dharma Lindarto
- Department of Internal Medicine, Faculty of Medicine, North Sumatra University - H. Adam Malik Hospital, Jalan Bunga Lau No 17, Medan 20136, Indonesia
| | - Shierly
- Department of Internal Medicine, Faculty of Medicine, North Sumatra University - H. Adam Malik Hospital, Jalan Bunga Lau No 17, Medan 20136, Indonesia
| | - Santi Syafril
- Department of Internal Medicine, Faculty of Medicine, North Sumatra University - H. Adam Malik Hospital, Jalan Bunga Lau No 17, Medan 20136, Indonesia
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