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"ABSTRAKLatar Belakang. Sindrom Brugada diketahui menjadi penyebab dari setidaknya 4 dari seluruh kematian mendadak dan 20 dari kematian mendadak pada struktur jantung normal. Saat ini, hanya pola EKG Sindrom Brugada tipe 1 yang bersifat diagnostik sedangkan pola tipe 2 dan 3 tidak diagnostik. Sudut > 580 memiliki nilai diagnosis yang baik pada populasi dengan EKG pola Brugada tipe 2 dan 3. Penelitian ini bertujuan untuk mengetahui apakah parameter tersebut mempunyai hubungan dengan kejadian aritmia pada pasien Sindrom Brugada tipe 2 dan 3.Metode. Studi kasus kontrol ini dilakukan terhadap 29 subjek dengan EKG pola Brugada tipe 2 dan 3 di RS Pusat Jantung dan Pembuluh Darah Harapan Kita RSPJDHK dari periode November 2013 - 2017. Tiga belas subjek dengan riwayat kejadian aritmia menjadi kelompok kasus dan 16 subjek tanpa kejadian aritmia menjadi kelompok kontrol. Data primer yang diambil antara lain riwayat henti jantung mendadak, TV/FV yang terdokumentasi, riwayat sinkop dengan kecurigaan etiologi aritmia dan riwayat pada keluarga serta interogasi data defibrillator kardioverter implan DKI pada subjek yang terpasang DKI. Data sekunder berupa data EKG yang kemudian dilakukan pengukuran sudut pada sadapan prekordial kanan oleh 2 penilai lalu dilakukan analisis statistik.Hasil. Pengukuran sudut oleh 2 penilai tidak terdapat perbedaan bermakna dengan nilai Cronbach rsquo;s Alpha 0,93. Analisa statistik menunjukkan tidak didapatkan perbedaan proporsi yang bermakna antara sudut > 58o terhadap kejadian aritmia pada kedua kelompok kasus dan kontrol. Dilakukan analisis korelasi, terlihat korelasi positif antara sudut r=0,50, p 58o dengan kejadian aritmia pada Sindrom Brugada. Terlihat korelasi positif antara sudut dengan kejadian aritmia namun hal ini masih diperlukan studi lebih lanjut.Kata kunci : sudut , sindrom Brugada.

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ABSTRACTBrugada syndrome is known to be the cause of at least 4 of all sudden deaths and 20 of sudden deaths in structurally normal hearts. To this day, only type 1 Brugada Syndrome ECG pattern is diagnostic, while type 2 and 3 are not. A angle ge 58o has a good diagnostic value in population with Brugada ECG pattern type 2 and 3. This study aims to evaluate whether this parameter is associated with arrhythmic events in patients with Brugada Syndrome type 2 and 3.Methods. This case control study is carried out towards 29 subjects with Brugada ECG pattern type 2 and 3 in National Cardiovascular Center Harapan Kita NCCHK from November 2013 until November 2017. Thirteen subjects with history of arrhythmic events make up the case group while 16 subjects without arrhythmic events make up the control group. Primary data acquired was history of sudden cardiac arrest, documented VT VF, history of syncope suspected of arrhythmic origin and family history, and also interrogation data from implantable cardioverter defibrillator ICD in subjects with ICD. Secondary data were ECG data, from which angle was measured in the right precordial leads by two observers, and then statistical analysis was carried out.Results. From angle measurement by two observers, there was not a significant difference with Cronbach rsquo s Alpha of 0,93. Statistical analysis showed no significant association between a angle ge 58o and arrhythmic events. Correlation analysis was carried out, and a positive correlation was shown r 0,50, p"

"LATAR BELAKANG: Anti Mullerian Hormon (AMH) adalah anggota dari golongan Transforming Growth Factor-β yang berperan dalam pengaturan folikuligenesis pada reproduksi wanita. Peningkatan kadar AMH 2 sampai 3 kali dijumpai pada pasien SOPK (Sindrom Ovarium Polikistik) daripada wanita dengan ovulasi normal. Pada penelitian ini dideteksi varian sekuen disepanjang daerah promoter gen AMH. Adanya variasi promoter gen AMH diduga mempengaruhi proses transkripsi gen AMH yang selanjutnya berimplikasi pada pembentukan protein AMH. Apabila terjadi gangguan pada pembentukan protein AMH maka akan berpengaruh terhadap kadar protein tersebut di dalam darah. BAHAN DAN CARA KERJA: Sampel penelitian ini berjumlah 114 pasien yang terdiri dari 60 pasien SOPK dan 54 pasien non SOPK (Kontrol). Kadar AMH dan Jumlah folikel antral didapatkan dari data rekam medik pasien Klinik IVF Yasmin, RSCM Kencana Jakarta. Analisis molekuler dan genotyping dilakukan dengan teknik PCR dan sekuensing kemudian dilanjutkan dengan analisis bioinformatika. HASIL : Dari penelitian ini ditemukan 60 titik varian mutasi promoter gen AMH. Jenis varian mutasi terbesar yang ditemukan adalah -674 G/A (100 %), -245 C/CT (88,2 %), dan -444 A/G (17,9 %) dari seluruh sampel. Berdasarkan hasil uji Wilcoxon Signed Ranks, pada kelompok SOPK ditemukan jumlah mutasi yang terjadi berpengaruh secara bermakna terhadap kadar AMH dan jumlah folikel antral (p<0,05). Pada kelompok kontrol ditemukan bahwa jumlah mutasi tidak berpengaruh secara bermakna terhadap kadar AMH (p>0,05), tetapi berpengaruh secara bermakna terhadap jumlah folikel antral (p<0.05). Ditemukan 60 titik varian pada promoter gen AMH. Jumlah mutasi pada promoter gen AMH berpengaruh terhadap kadar AMH dan jumlah folikel antral pada SOPK. Mutasi pada titik -674 G/A merupakan titik mutasi baru yang belum pernah dilaporkan oleh NCBI, ditemukan pada seluruh subyek penelitian baik kelompok SOPK maupun non SOPK.

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INTRODUCTION : Anti-Mullerian Hormone (AMH) is a member of the Transforming Growth Factor-β group which plays an important role in the regulation of the female reproductive folliculogenesis. A 2-3 fold increase in AMH levels was found in patients with PCOS (Polycystic Ovary Syndrome) compared to women with normal ovulation. This study detected sequence variants in the AMH gene promoter region. The AMH gene promoter variation is thought to affect AMH gene transcription process implicated in the formation of proteins. In the event of disruption in the formation of these AMH proteins, the levels of these proteins in the blood will be affected. The purpose of this study was to detect variants of AMH gene promoter sequences.

MATERIALS AND METHODS: The sample size was 114 patients consisting of 60 PCOS patients and 54 non-PCOS patients as control. The AMH levels and anthral follicle number obtained from the patients? medical records of the Yasmin IVF Clinic, RSCM Kencana Hospital, Jakarta. Molecular analysis and genotyping were performed by PCR and sequencing was followed by bioinformatics analysis.

RESULTS: There were 60 point mutations in the AMH gene promoter variants. The highest variant types of mutations found was -674 G/A (100%), followed by -245 C/CT (88.2%), and -444 A/G (17.9%) in the entire sample. Based on the results of the Wilcoxon Signed Rank test, the number of mutations in the PCOS group were significant to effect the serum AMH level and the anthral follicle number (p<0.05). In the control group, the number of mutations had no significant effect on the levels of AMH (p>0.05), but significantly affected the number of anthral follicles (P<0.05). There were 60 point variances in the AMH gene promoter. The number of mutations in the gene promoter affected serum AMH levels and the number of anthral follicles in PCOS. A new point mutation was found in all subjects at position -674 G/A, which have not been reported by the NCBI."

"Latar belakang: Alopesia androgenetik (AAG) merupakan penyebab kebotakan rambut yang paling sering ditemui dan mengganggu kualitas hidup. Meskipun AAG tidak mengancam nyawa, namun berbagai studi menunjukkan bahwa AAG tidak hanya dianggap sebagai penyakit kulit/estetik semata namun berkaitan dengan kondisi-kondisi sistemik, salah satunya adalah sindrom metabolik (SM). Beberapa studi menunjukkan juga bahwa pola kebotakan pada AAG memiliki risiko yang berbeda terhadap penyakit tertentu. Penelitian ini bertujuan hubungan antara pola kebotakan AAG tipe verteks dan tipe frontal terhadap SM. Metode: Penelitian ini menggunakan desain studi potong lintang yang dilakukan terhadap 24 laki-laki dengan AAG tipe verteks dan 24 laki-laki dengan AAG tipe frontal. Dilakukan anamnesis dan pemeriksaan fisik untuk menegakkan diagnosis AAG berdasarkan skala Norwood-Hamilton, serta dilakukan pengambilan foto, pemeriksaan trikoskopi, TrichoScan® pada masing-masing subjek penelitian. Sindrom metabolik ditegakkan berdasarkan kriteria National Cholesterol Education Program (NCEP) Adult Treatment Panel (ATP) III melalui pemeriksaan fisik dan laboratorium darah vena. Hasil: Prevalensi SM pada kelompok AAG tipe verteks adalah sebesar 37,5%, sedangkan pada tipe frontal sebesar 20,8%. Tidak didapatkan hubungan antara SM dengan AAG tipe verteks ataupun tipe frontal (p = 0,341). Pada kelompok AAG tipe verteks didapatkan prevalensi hipertensi yang lebih tinggi secara bermakna dibandingkan kelompok AAG tipe frontal (p = 0,043). Tidak ada perbedaan bermakna gambaran trikoskopi ataupun TrichoScan® antara AAG tipe verteks dan tipe frontal. Kesimpulan: Prevalensi SM pada kelompok AAG tipe verteks lebih besar dibandingkan pada kelompok AAG tipe frontal. Tidak ada hubungan bermakna antara pola kebotakan AAG dengan SM. Tidak ada hubungan bermakna gambaran trikoskopi dan TrichoScan® antara kelompok AAG tipe verteks dengan tipe frontal.

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Background: Androgenetic alopecia (AAG) is the most common cause of hair loss, impacting quality of life. Although AAG is not life-threatening, various studies indicate that it is not merely a cosmetic skin condition but is associated with specific systemic conditions, including metabolic syndrome (MS). Some studies also suggest that the pattern of baldness in AAG poses varying risks for specific diseases. This research aims to explore the relationship between AAG vertex and frontal patterns of baldness and metabolic syndrome.

Methods: This study adopts a cross-sectional design involving 24 males with vertex AAG and 24 males with frontal AAG. Anamnesis and physical examinations were conducted to diagnose AAG using the Norwood-Hamilton scale. Each subject underwent photography, trichoscopy, and TrichoScan®, examination. Metabolic syndrome diagnosis followed the National Cholesterol Education Program (NCEP) Adult Treatment Panel III (ATP III) criteria through physical examination and venous blood laboratory tests.

Results: The prevalence of metabolic syndrome in the AAG vertex group is 37.5%, whereas in the frontal group, it is 20.8%. No significant relationship was found between metabolic syndrome and AAG vertex or frontal types (p = 0.341). The AAG vertex group showed a significantly higher prevalence of hypertension than the frontal group (p = 0.043). There were no significant differences in trichoscopy or TrichoScan®¸ findings between AAG vertex and frontal types.

Conclusion: The prevalence of metabolic syndrome is higher in the AAG vertex group compared to the AAG frontal group. There is no significant association between metabolic syndrome and the pattern of AAG baldness. Additionally, there is no significant difference in trichoscopy and TrichoScan®¸ findings between AAG vertex and frontal groups."

"Carpal Tunnel Syndrome occurs when the median nerve, which runs from the forearm into the hand, suffers pressure or is squeezed in the wrist. The resultsmay be pain, weakness, or numbness in the hand and wrist, radiating up to the arm. This study aimed to examine the risk factors i.e age, sex, work periodand repetitive movements toward Carpal Tunnel Syndrome complaints among food-packing workers in Karanganyar. The study was conducted in October toDecember 2014 that used analytic observational design with cross sectional study. Samples were 50 of 67 food-packing workers in Jaten Karanganyar industrialarea as taken by using simple random sampling technique. Data were analyzed using chi square and multivariate logistic regression. Results showedthat age and sex had significant relation with Carpal Tunnel Syndrome and age was the most influential factor 24 times to increased risk of Carpal TunnelSyndrome (p value = 0.057, Exp.  = 24.965).Carpal Tunnel Syndrome terjadi ketika saraf median, yang membentang dari lengan bawah ke tangan, mengalami tekanan atau terpuntir di pergelangantangan. Hasilnya mungkin sakit, kelemahan atau mati rasa di tangan dan pergelangan tangan, yang memancar ke lengan tangan. Penelitian ini bertujuan untukmengkaji faktor risiko usia, jenis kelamin, masa kerja dan gerakan repetitif terhadap keluhan Carpal Tunnel Syndrome pada pekerja pengepakan makanandi Karanganyar. Penelitian ini dilaksanakan pada bulan Oktober – Desember 2014 menggunakan desain observasional analitik dengan penelitian potong lintang.Sampel terdiri dari 50 orang dari total 67 pekerja pengepak makanan di kawasan industri Jaten Karanganyar yang diambil dengan menggunakan tekniksimple random sampling. Data penelitian diolah menggunakan uji kai kuadrat dan regresi logistik multivariat. Hasil penelitian menunjukkan bahwa usia danjenis kelamin signifikan berhubungan dengan keluhan Carpal Tunnel Syndrome, dan usia merupakan faktor yang paling berpengaruh 24 kali lipat untukmeningkatkan risiko terjadinya Carpal Tunnel Syndrome (nilai p = 0.057, Exp.  = 24.965)."

"Sindrom metabolik merupakan sekumpulan faktor risiko yang meningkatkan peluang kemunculan penyakit kardiovaskular.  Sindrom tersebut muncul akibat interaksi faktor lingkungan dan faktor genetik. Beberapa penelitian menemukan bahwa single nucleotide polymorphisms (SNPs) pada gen Transcription Factor 7-Like 2 (TCF7L2) merupakan variasi yang paling berpengaruh terhadap kemunculan sindrom metabolik. Namun, studi pada SNP rs290487 dan rs290481 belum banyak dilakukan. Penelitian ini bertujuan untuk mengetahui asosiasi alel risiko rs290487 dan rs290481 dengan sindrom metabolik pada populasi Bali. Studi ini menggunakan 565 sampel (321 sampel laki-laki dan 244 sampel perempuan) yang berasal dari empat desa di Provinsi Bali. Keberadaan SNP dideteksi menggunakan teknik amplification refractory mutation system polymerase chain reaction (ARMS PCR) dengan primer yang telah didesain khusus. Analisis asosiasi SNP rs290487 dan rs290481 dilakukan menggunakan uji regresi logistik ordinal. Hasil analisis menunjukkan MAF (alel T) SNP rs290487 dan rs290481 masing-masing sebesar 0,56 dan 0,53. Alel C pada masing-masing SNP merupakan alel risiko bagi peningkatan kadar gula darah puasa (GDP) dan kemunculan sindrom metabolik pada sampel perempuan di populasi Bali. Selain itu, analisis haplotype yang dilakukan menemukan bahwa haplotype TTT dari rs290487, rs290481, dan rs7903146, berasosiasi dengan peningkatan TG (p = 0,011) dan kemunculan sindrom metabolik (p = 0,003)

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Metabolic syndrome (MetS) is a cluster of risk factors that raises risk of cardiovascular disease. MetS can occur due to an interaction between environmental and genetic factors. Several studies have shown that single nucleotide polymorphisms (SNPs) of Transcription Factor 7-Like 2 (TCF7L2) gene are significantly associated with MetS. Nevertheless, studies on SNP rs290487 and rs290481 have not yet been explored widely. This study aimed to investigate the association of rs290487 and rs290481 risk alleles with MetS in Balinese population. A total of 565 archive samples (321 males and 244 females) from four villages in Bali province were included in this study. All subjects were genotyped using amplification refractory mutation system polymerase chain reaction (ARMS PCR) method with specifically designed primers. Association between rs290487 and rs290481 with MetS were analyzed using ordinal logistic regression test. The results showed that MAF of rs290487 and rs290481 are 0,56 and 0,53, respectively. C-allele of both SNPs were risk alleles for elevated fasting plasma glucose (FPG) level and development of MetS in Balinese women. Furthermore, haplotype TTT of rs290487, rs290481, and rs7903146, were significantly associated with elevated TG level (p = 0,011) and development of MetS (p = 0,003)."

"ABSTRAK Latar Belakang: Kematian pada Penyakit Jantung Koroner (PJK) terutama akibat tindakan revaskularisasi yang tertunda atau lesi koroner kompleks yang biasanyalebih buruk pada populasi pasien PGK. Skor Modified ACEF merupakan sebuahperangkat yang memiliki peran penting dalam prognosis mortalitas PJK. SkormACEF belum pernah digunakan untuk mengevaluasi kompleksitas lesi koroner.Informasi tersebut berguna dalam menentukan prioritas tindakan angiografikoroner. Tujuan: Mendapatkan nilai diagnostik dan titik potong skor mACEF sebagaiprediktor kompleksitas lesi koroner pada pasien PGK stadium 3 dan 4 yangmengalami sindrom koroner akut (SKA). Metode: Penelitian ini merupakan uji diagnostik secara retrospektif terhadap 179subjek PGK stadium 3 dan 4 yang mengalami SKA yang dirawat di ICCU RSCMtahun 2012 hingga 2014. Analisis titik potong skor mACEF dilakukan denganmenggunakan Receiver Operating Characteristic (ROC) curves dengan intervalkepercayaan (IK) sebesar 95%. Akurasi diagnostik skor mACEF dinilai dengancara menghitung sensitivitas, spesifisitas, RKP, dan RKN. Hasil: Titik potong skor mACEF yang optimal adalah 2,288 dengan sensitivitas90,9%, spesifisitas 63,7%, RKP 2,5, RKN 0,14 dan prevalens 55,3%. Kesimpulan: Titik potong yang optimal skor mACEF pada populasi pasien PGKstadium 3 dan 4 yang mengalami SKA adalah 2,288. Akurasi diagnostik skor mACEF dinilai baik.ABSTRACT Background: Cardiovascular disease is one of the main causes of death mainlydue to delayed revascularization or complex coronary lesions which are usuallyworse in CKD patients. Modified ACEF (mACEF) score is well established indetermining cardiovascular mortality of patients undergoing revascularizationtherapy and has never been used to evaluate the complexity of coronary lesionsbefore. mACEF score?s potential as a diagnostic tool needs to be evaluated to helpstratify patients eligible for coronary angiography. Aim: To evaluate mACEF score?s diagnostic value and cut-off point as apredictor of coronary lesion complexity in patients with CKD stages 3 and 4 withACS. Methods: This study is a diagnostic test conducted retrospectively involving 179subjects with CKD stages 3 and 4 with ACS admitted to ICCU RSCM from 2012to 2014. Cut-off analysis was performed using ROC curve with confidenceintervals (CI) of 95% and diagnostic accuracy of mACEF was analyzed togenerate sensitivity, specificity, LR+, and LR-. Result: The optimal cut-off point for mACEF score was 2,288 with sensitivity of90,9%, specificity 63,7%, LR+ 2,5, LR- 0,14, and prevalence of 55,3%. Conclusion: mACEF score has a good diagnostic accuracy in subjects with CKD stage 3 and 4 with ACS with optimal cut-off point of 2,288, respectively.;Background: Cardiovascular disease is one of the main causes of death mainlydue to delayed revascularization or complex coronary lesions which are usuallyworse in CKD patients. Modified ACEF (mACEF) score is well established indetermining cardiovascular mortality of patients undergoing revascularizationtherapy and has never been used to evaluate the complexity of coronary lesionsbefore. mACEF score?s potential as a diagnostic tool needs to be evaluated to helpstratify patients eligible for coronary angiography. Aim: To evaluate mACEF score?s diagnostic value and cut-off point as apredictor of coronary lesion complexity in patients with CKD stages 3 and 4 withACS. Methods: This study is a diagnostic test conducted retrospectively involving 179subjects with CKD stages 3 and 4 with ACS admitted to ICCU RSCM from 2012to 2014. Cut-off analysis was performed using ROC curve with confidenceintervals (CI) of 95% and diagnostic accuracy of mACEF was analyzed togenerate sensitivity, specificity, LR+, and LR-. Result: The optimal cut-off point for mACEF score was 2,288 with sensitivity of90,9%, specificity 63,7%, LR+ 2,5, LR- 0,14, and prevalence of 55,3%. Conclusion: mACEF score has a good diagnostic accuracy in subjects with CKD stage 3 and 4 with ACS with optimal cut-off point of 2,288, respectively.;Background: Cardiovascular disease is one of the main causes of death mainlydue to delayed revascularization or complex coronary lesions which are usuallyworse in CKD patients. Modified ACEF (mACEF) score is well established indetermining cardiovascular mortality of patients undergoing revascularizationtherapy and has never been used to evaluate the complexity of coronary lesionsbefore. mACEF score?s potential as a diagnostic tool needs to be evaluated to helpstratify patients eligible for coronary angiography. Aim: To evaluate mACEF score?s diagnostic value and cut-off point as apredictor of coronary lesion complexity in patients with CKD stages 3 and 4 withACS. Methods: This study is a diagnostic test conducted retrospectively involving 179subjects with CKD stages 3 and 4 with ACS admitted to ICCU RSCM from 2012to 2014. Cut-off analysis was performed using ROC curve with confidenceintervals (CI) of 95% and diagnostic accuracy of mACEF was analyzed togenerate sensitivity, specificity, LR+, and LR-. Result: The optimal cut-off point for mACEF score was 2,288 with sensitivity of90,9%, specificity 63,7%, LR+ 2,5, LR- 0,14, and prevalence of 55,3%. Conclusion: mACEF score has a good diagnostic accuracy in subjects with CKD stage 3 and 4 with ACS with optimal cut-off point of 2,288, respectively.;Background: Cardiovascular disease is one of the main causes of death mainlydue to delayed revascularization or complex coronary lesions which are usuallyworse in CKD patients. Modified ACEF (mACEF) score is well established indetermining cardiovascular mortality of patients undergoing revascularizationtherapy and has never been used to evaluate the complexity of coronary lesionsbefore. mACEF score?s potential as a diagnostic tool needs to be evaluated to helpstratify patients eligible for coronary angiography. Aim: To evaluate mACEF score?s diagnostic value and cut-off point as apredictor of coronary lesion complexity in patients with CKD stages 3 and 4 withACS. Methods: This study is a diagnostic test conducted retrospectively involving 179subjects with CKD stages 3 and 4 with ACS admitted to ICCU RSCM from 2012to 2014. Cut-off analysis was performed using ROC curve with confidenceintervals (CI) of 95% and diagnostic accuracy of mACEF was analyzed togenerate sensitivity, specificity, LR+, and LR-. Result: The optimal cut-off point for mACEF score was 2,288 with sensitivity of90,9%, specificity 63,7%, LR+ 2,5, LR- 0,14, and prevalence of 55,3%. Conclusion: mACEF score has a good diagnostic accuracy in subjects with CKD stage 3 and 4 with ACS with optimal cut-off point of 2,288, respectively."

"Lesi psoriasis pada kulit kepala, wajah, lipatan, kelamin, telapak tangan/kaki, dan kuku sering terlambat terdiagnosis, sulit diterapi, dan menyebabkan disabilitas. Predileksi ini disebut sebagai area yang sulit diobati (hard-to-treat /HTT). Meski lesi pada area HTT umumnya kecil, namun berisiko komorbiditas. Sindrom metabolik (SM) merupakan komorbiditas utama psoriasis. Keparahan psoriasis dinilai dengan Psoriasis Area Severity Index(PASI). Tujuan penelitian ini untuk mengetahui hubungan antara derajat keparahan psoriasis yang memiliki lesi HTT dengan kejadian SM. Penelitian ini merupakan studi observasional analitik dengan disain potong lintang secara multicenter. Dari 84 SP, sebanyak 42 orang memiliki skor PASI<10 (derajat ringan-sedang) dan 42 orang dengan skor PASI >10 (derajat berat). Prevalensi SM ditemukan sebesar 64,3%. Pasien psoriasis HTT derajat berat berisiko 3,6 kali lebih besar untuk mengalami SM dibandingkan dengan derajat ringan-sedang (78,6% vs 50%, OR 3,667; IK 95% 1,413-9,514; p=0,006). Terdapat perbedaan kejadian hipertensi (p=0,028), penurunan kadar high density lipoprotein/HDL (p=0,01), rerata kadar gula darah puasa (p=0,018), dan trigliserida (p=0,044) antara kedua kelompok. Prevalensi SM pada psoriasis HTT derajat berat lebih besar dan secara statistik bermakna dibandingkan dengan derajat ringan-sedang. Proporsi kriteria SM dari yang terbesar secara berturutan adalah obesitas sentral, penurunan kadar HDL, hipertensi, hiperglikemia, dan hipertrigliseridemia. 

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Psoriatic lesions on the scalp, face, intertriginous, genitals, palms, soles, and nails (hard-to-treat/HTT areas) are often delay diagnosed, hard to treat, and cause disability. Despite the small surface of HTT areas, it has risks of comorbidities. Metabolic syndrome (MS) is one of the main comorbidities of psoriasis. The severity of psoriasis was measured by Psoriasis Area Severity Index (PASI). This study aims to assess the association of psoriasis severity that has HTT lesions with the prevalence of SM. It is an analytic observational, multicenter study with a cross-sectional design. From 84 patients, 42 had a PASI score <10 (mild-moderate) and 42 had a PASI score >10 (severe). The prevalence of SM is 64.3%. Patients with severe HTT psoriasis were 3,6 times more likely to have SM compare to mild-moderate group (78.6% vs 50%, OR 3.667; 95% CI 1.413-9.514; p=0.006). The incidence of hypertension (p=0.028), decreased in high density lipoprotein/HDL (p=0.01), mean fasting blood sugar (p=0.018), and triglycerides levels (p=0.044) between two groups were significantly different. Severe HTT psoriasis has higher prevalence of MS and statistically significant compared to mild-moderate group. The highest proportion of SM criteria respectively are central obesity, low levels of HDL, hypertension, hyperglycemia, and hypertriglyceridemia."

"Sindrom metabolik atau sindrom X merupakan kondisi yang berpotensi meningkatkan risiko seseorang mengalami penyakit tidak menular. Berdasarkan data Riskesdas 2013, prevalensi sindrom metabolik di Indonesia mencapai 39% dan lebih banyak terjadi pada wanita. Gaya hidup berpotensi mempengaruhi terjadinya sindrom metabolik. Namun, penelitian terdahulu tentang hubungan gaya hidup yang meliputi aktivitas fisik, pola makan dan merokok terhadap sindrom metabolik menunjukkan hasil yang beragam. Selain itu, belum ada penelitian tentang sindrom metabolik spesifik pada populasi wanita di Indonesia. Penelitian ini bertujuan untuk mengetahui hubungan gaya hidup dengan kejadian sindrom metabolik pada wanita usia ≥15 tahun di Indonesia. Desain studi yang digunakan adalah cross-sectional dengan sumber data dari Riskesdas 2018. Hasil penelitian menunjukkan prevalensi sindrom metabolik pada wanita usia ≥15 tahun di Indonesia sebesar 37,6%. Umur berhubungan signifikan dengan kejadian sindrom metabolik pada wanita (PR=1,711; 95% CI=1,640-1,785; nilai P=0,001). Dalam penelitian ini, aktivitas fisik, merokok, konsumsi makanan manis, minuman manis, makanan berlemak, soft drink, buah, dan sayur tidak terbukti berhubungan secara statistik dengan sindrom metabolik. Karena tingginya prevalensi sindrom metabolik pada wanita di Indonesia, perlu untuk meningkatkan program skrining, seperti pengukuran lingkar perut, tekanan darah, dan gula darah secara rutin. Selain itu, perlu untuk menerapkan gaya hidup sehat bagi wanita untuk mencegah terjadinya sindrom metabolik.

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Metabolic syndrome or syndrome X is a condition that can increase a person's risk of developing non-communicable diseases. Based on Riskesdas 2013 data, the prevalence of metabolic syndrome in Indonesia reaches 39% and is more prevalent in women. Lifestyle has the potential to influence the incidence of metabolic syndrome. However, previous research on the relationship between lifestyle including physical activity, diet and smoking on metabolic syndrome has shown mixed results. In addition, there has been no research on specific metabolic syndrome in women in Indonesia. This study aims to determine the relationship between lifestyle and the incidence of metabolic syndrome in women aged ≥15 years in Indonesia. The study design used was cross-sectional with data sources from Riskesdas 2018.

The results showed that the prevalence of metabolic syndrome in women aged ≥15 years in Indonesia was 37.6%. Age is significantly associated with the incidence of metabolic syndrome in women (PR=1.711; 95% CI=1.640-1.785; P=0.001). In this study, physical activity, smoking, consumption of sweet foods, sweet drinks, fatty foods, soft drinks, fruit and vegetables were not statistically proven to be associated with metabolic syndrome. Due to the high prevalence of metabolic syndrome among women in Indonesia, it is necessary to improve screening programs, such as routine measurements of abdominal circumference, blood pressure and blood sugar. In addition, it is necessary to adopt a healthy lifestyle for women to prevent metabolic syndrome."

"Sindrom koroner akut (SKA) merupakan salah satu kegawatan kardiovaskular diInstalasi Gawat Darurat (IGD). Tatalaksana SKA yang ada saat ini membutuhkan waktuminimal 3 jam untuk menentukan apakah pasien dirawat atau dipulangkan, hal ini akanberdampak pada kepadatan IGD dan pemborosan biaya perawatan. European Society ofCardiology merekomendasikan algoritma 0/1 jam pada pasien dengan gambaran EKGnon elevasi segmen ST (NEST) dengan menggunakan high sensitive troponin T (hscTnT)dalam menegakkan atau penapisan infark miokard akut non elevasi segmen ST(IMA-NEST). Penelitian ini bertujuan untuk membandingkan nilai diagnostik hs-cTnTjam ke-1 dan jam ke-3 pada terduga SKA non elevasi segmen ST dengan awitan nyeridada kurang dari 6 jam. Desain penelitian potong lintang. Sebanyak 100 subjekpenelitian yang diambil secara konsekutif sampling. Sensitivitas, spesifisitas, nilaiprediksi positif, dan nilai prediksi negatif kadar hs-cTnT 0/1 jam secara berurutanadalah 93,75%, 98,81%, 93,75%, 98,81%, sementara sensitivitas, spesifisitas, nilaiprediksi positif, dan nilai prediksi negatif kadar hs-cTnT 0/3 jam secara berurutanadalah 87,50%, 96,81%, 93,33% 97,65%. Pemeriksaan hs-cTnT 0/1 jam dapatdipergunakan dalam rule in dan rule out terduga IMA-NEST dengan awitan nyeri dadakurang dari 6 jam.

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Acute coronary syndrome (ACS) is one of the cardiovascular events in an EmergencyInstallation (ED). The patients management of ACS required at least 3 hours todetermined whether the patient hospitalized or outpatient, these would increased EDscrowded and high cost treatment. The European Society of Cardiology recommended a0/1 hour algorithm in patients with ECG showed non ST segment elevationusing highsensitive troponin T (hs-cTnT) parameter to rule in or rule out non ST segmentelevation myocard infarct (NSTEMI).We aimed to compare diagnostic values of hscTnTat the 1st and 3rd hour in NSTEMI with chest pain onset less than 6 hours. Studydesign was cross sectional. A total of 100 subjects enrolled by consecutive samplingmethod. Sensitivity, specificity, positive predictive value, and negative predictive valueof hs-cTnT 0/1 hours were 93.75%, 98.81%, 93.75%, 98.81%, while sensitivity,specificity, positive predictive value, and the negative predictive value of hs-cTnT 0/3hours were 87.50%, 96.81%, 93.33%, 97.65%. Hs-cTnT 0/1 hour test can be used inrule in and rule out suspect NSTEMI with the chest pain onset less than 6 hours."