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"Alcoholic ketoacidosis is a common disorder in chronic alcoholic persons. The Pathogenesis is complex associated with extracellular fluid volume depletion, alcohol withdrawal, abdominal pain, and acid abnormalities. The syndrome is rapidly reversible and has a low mortality. The treatment is administration with normal saline, glucose, potassium and thiamine. We report two cases of Alcoholic Ketoacidosis, first case with classically picture of AKA and the second one AKA with Decrease consciousness and concomitant illness, pneumonia. We believe this report possibly to be the first report of AKA in Indonesia"

"Latar belakang. Gagal jantung dan aritmia merupakan penyebab kematian tersering pada penderita thalassemia R. Gangguan fungsi jantung, khususnya disfungsi diastolik merupakan komplikasi dini pada jantung akibat muatan besi berlebih (iron overload). Kadar feritin serum sampai saat ini masih secara luas digunakan sebagai parameter muatan besi berlebih (iron overload).Tujuan. Mengetahui perbedaan kadar feritin serum antara penderita thalassemia j3 dewasa yang mengalami dan tidak mengalami disfungsi diastolik ventrikel kiri, dan mengetahui besar proporsi disfungsi diastolik pada penderita thalassemia 13 dewasa.Metodologi. Penelitian ini merupakan studi potong lintang untuk melihat perbedaan kadar feritin serum (sebagai parameter iron overload) pada penderita thalassemia 13 dewasa yang mengalami disfungsi diastolik dibandingkan dengan yang tanpa disfungsi diastolik, serta untuk mendapatkan proporsi disfungsi diastolik pada penderita thalassemia 3 dewasa. Analisis terhadap variabel-variabel yang diteliti menggunakan uji-1 independen untuk mendapatkan perbedaan rerata kadar feritin serum antara kedua kelompok.Hasil. Dari penelitian ini 30 orang penderita thalassemia 13 dewasa, laki-laki 13 orang, perempuan 17 orang, didapatkan rerata usia 25,9 tahun dengan rentang usia antara 18-38 tahun. Rerata Hb sebesar (7,5g%, SB I,4g%) dengan rentang kadar Hb antara 5,2 - 9,9 g%. Rerata kadar feritin serum sebesar (5590ng1m1, SB 4614,7 nglml) dengan rentang kadar, feritin antara 296,4 - 15900 nglml. Tidak terdapat perbedaan rerata kadar feritin antara penderita yang mengalami disfungsi diastolik dibandingkan dengan yang tidak mengalami disfungsi diastolik. Proporsi disfungsi diastolik pada thalassemia 13 dewasa pada penelitian ini sebesar 70%.Kesimpulan. Tidak terdapat perbedaan rerata kadar feritin antara penderita yang mengalami disfungsi diastolik dibandingkan dengan yang tidak mengalami disfungsi diastolik. Proporsi disfungsi diastolik pada thalassemia 13 dewasa pada penelitian ini sebesar 70%.

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Background. Heart failure and aritmia is the major cause of death in 3 thalassemia major. Heart dysfunction, especially diastolic dysfunction in ji thalassemia seems to be an early involvement of the heart due to iron overload. Serum ferritin level as a parameter of iron overload still widely use for evaluation in 13 thalassemia.

Objectives. To know the mean difference of serum ferritin level between adult 13 thalassemia patients who have left ventricular diastolic dysfunction and who do not have Ieft ventricular diastolic dysfunction, and to obtain the proportion of diastolic dysfunction in adult 13 thalassemia patients.

Methods. This cross-sectional study was conducted to see the mean difference of Serum ferritin. IeVel'(as a parameter of iron overload) in adult P'thalassemia who have left ventricular diastolic dysfunction and who do not have left ventricular diastolic dysfunction and to know the proportion of diastolic dysfunction among adult 13 thalassemia. The independent t-test was used to analyze the variables to obtain the mean difference of serum ferritin level between the two groups.

Results. Thirty adult P thalassemia patients, 13 were male and 17 were female had been enrolled into this study. The age of the patients ranged from 18 to 38 years old, and the average-age was 25,9 years. The Hb level ranged from 5,2 to 9,9 g% and the mean was (7,5g%, SD 1,4g°/o). The serum ferritin level ranged from 296,4 to 15900 nglml, and the mean was (5590ng/ml, SD 4614,7 nglml). There was no significance mean difference serum ferritin level in patients who had diastolic dysfunction and those who do not have diastolic dysfunction. The proportion of diastolic dysfunction in adult 13 thalassemia patients in this study was 70%.

Conclusions. There was no significannce mean difference serum ferritin level in patients who had. diastolic dysfunction and those. who. did, not have diastolic dysfunction . The proportion of diastolic dysfunction in adult thalassemia 3 patients in this study was 70%."

"Irritable bowel syndrome (IBS) is the most common functional disorder of the gastrointestinal tract. As a result of the lack of specific diagnostic testing and absence of circumscribed biology markers of the disease, its diagnosis is based on a myriad of symptoms. The term irritable bowel syndrome was probably first coined in 1944 by Peters and Bargenf. ln 1849, Cumming described the clinical manifestations of Irritable Bowel Syndrome. Irritable bowel syndrome is defined an the basis of the recently modified Rome criteria as the presence of at least l2 weeks (not necessarily consecutive) of abdominal discomfort or pain in the preceding l2 months that cannot be explained by structural or biochemical abnormalities, and that has at least two of the following three features: pain relieved with defecation, an onset associated with a change in the frequency of bowel movements (diarrhea or constipation), or an onset associated with a change inform of stool (loose, watery, or pellet-like). The syndrome can be divided into three subcategories according to the Modmed Rome criteria ll; those with a predominant symptom of diarrhea, constipation, or constipation alternating with diarrhea. There are Several criteria for irritable bowel syndrome, one of which is the Manning criteria applied in many epidemiological and clinical studies to identify irritable bowel syndrome. However, many investigators disagree with this criteria due to a seemingly poor validity in men. In an attempt to bring order to the specialty, consensus-based approach is adopted by a group of international experts, which led to the development ofthe Rome criteria for irritable bowel syndrome (Table l). Extra-intestinal symptoms, including headache, backache, urinary and gynecologic symptoms, and fatigue, are more common in the constipation-predominant subgroup"