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"ABSTRAKBackground: hypoglycemia is a major adverse event of insulin therapy for diabetes mellitus patients. The study was conducted to evaluate the incidence of hypoglycemia among insulin treated patients with type 1 diabetes mellitus (T1DM) or type 2 diabetes mellitus (T2DM) in the Indonesian cohort. Methods: this Indonesian cohort study consisted of retrospective and prospective evaluation of hypoglycemic episodes, using International Operations Hypoglycemia Assessment Tool (IO HAT) in 374 patients with diabetes (T1DM; n=17 or T2DM; n=357). The patients of ≥18 years of age and treated with insulin for >12 months were selected for this study (ClinicalTrials.gov number: NCT02306681). Results: a total of 374 patients were enrolled in this study and completed SAQ1. All patients with T1DM (17 [100%]), and 347 (97.2%) patients with T2DM completed SAQ2. Almost all the patients in the 4-week prospective period reported at least one hypoglycemic event (T1DM 100%, T2DM 99.4%) and the incidence rate of any hypoglycemia was 67.5 events per patient-year (PPY) and 25.7 events PPY for T1DM and T2DM patients, respectively. Among patients with T1DM and T2DM, 5.9% and 36.4%, respectively, did not know what hypoglycemia was at baseline, also high proportion of patients had impaired hypoglycemic awareness in the study (82.4% and 62.7%, respectively). Conclusion: overall, high proportion of patients reported hypoglycemic events in the prospective period indicating under reporting during the retrospective period due to recall bias. Therefore, there is a need for patient education program to improve the awareness of hypoglycemia in diabetes patient in Indonesia."

"Resistensi insulin adalah penurunan kemampuan jaringan (otot, hati, dan jaringan adiposa) untuk merespon insulin yang bersirkulasi secara normal dalam darah yang berisiko berkembang menjadi penyakit diabetes melitus tipe 2. Rasio tinggi asupan asam lemak omega-6/omega-3 diduga berperan dalam menurunkan sensitivitas insulin. Penelitian ini bertujuan untuk mengetahui hubungan antara rasio asupan omega-6/omega-3 dan HOMA-IR pada perempuan usia reproduktif. Studi potong lintang ini dilakukan di Jakarta, pada bulan Juli sampai Oktober 2021. Pengambilan sampel menggunakan metode consecutive sampling dan diperoleh 79 subjek perempuan yang memenuhi kriteria penelitian. Pengumpulan data dilakukan melalui wawancara 24-hours food recall sebanyak 3 kali, pengukuran antropometri untuk menilai status gizi, dan pengambilan serum untuk mengukur kadar glukosa darah puasa dan insulin. Rerata asupan omega-6 pada subjek adalah 9.43 ± 3.69 gram/hari, median asupan omega-3 pada subjek adalah 0.79 (0.23–3.53) gram/hari, dan rerata rasio asupan omega-6/omega-3 adalah 12.32 ± 4.32. Rerata HOMA-IR pada subjek adalah 3.04 ± 1.24. Terdapat korelasi positif lemah antara rasio asupan omega-6/omega-3 dan HOMA-IR, namun tidak signifikan (r=0.161, p=0.157). Ditemukan hubungan signifikan antara DHA dan HOMA-IR setelah mengontrol faktor perancu (p=0.014). Tidak ada hubungan antara rasio asupan asam lemak omega-6/omega-3 dan HOMA-IR pada perempuan usia reproduktif. Namun, ditemukan hubungan antara asupan DHA dan HOMA-IR yang menunjukkan bahwa peningkatan asupan asam lemak tidak jenuh dapat mencegah terjadinya resistensi insulin.

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Insulin resistance is a decrease in the ability of tissues (muscle, liver, and adipose tissue) to respond to insulin that circulates normally in the blood which is at risk of developing type 2 diabetes mellitus. A high ratio of omega-6/omega-3 fatty acid intake is thought to play a role in reducing insulin sensitivity. This study aims to determine the association between the ratio of omega-6/omega-3 intake and HOMA-IR in reproductive-aged women. This cross-sectional study was conducted in Jakarta, from July to October 2021. Sampling used the consecutive sampling method and obtained 79 women subjects who met the research criteria. Data was collected through 24-hour food recall interviews 3 times, anthropometric measurements to assess nutritional status, and serum sampling to measure fasting blood glucose and insulin levels. The mean omega-6 intake in the subjects was 9.43 ± 3.69 grams/day, the median omega-3 intake in the subjects was 0.79 (0.23–3.53) grams/day, and the mean ratio of omega-6/omega-3 intake was 12.32 ± 4.32. The mean HOMA-IR in the subjects was 3.04 ± 1.24. There was weak positive correlation between the ratio of omega-6/omega-3 intake and HOMA-IR, but not significant (r=0.161, p=0.157). A significant relationship was found between DHA and HOMA-IR after adjusted confounding factors (p=0.014). There was no association between the ratio of omega-6/omega-3 fatty acid intake and HOMA-IR in reproductive-aged women. However, it was found that there was a assocation between DHA intake and HOMA-IR which indicated that increasing intake of unsaturated fatty acids could prevent insulin resistance"

"ABSTRAKPenelitian mengenai hubungan inulin dan fruktooligosakarida FOS terhadap kadar gula darah masih terbatas dan hasilnya kontradiktif. Penelitian ini merupakan penelitian potong lintang untuk menilai hubungan antara asupan serat total, inulin, dan FOS dengan kadar Hemoglobin A1cpada wanita Suku Minangkabau dan Sunda. Dilakukan penilaian asupan terhadap 298 wanita menggunakan semi quantitative food frequency questionnaire. Analisis data menggunakan uji regresi linier ganda. Median serat, inulin, dan FOS lebih tinggibermakna pada wanita Sunda dibandingkan Minangkabau.Median kadar HbA1ctidak berbeda bermakna antara kedua suku. Setelah dilakukan penyesuaian terhadap faktor pengganggu, asupan serat ?=-0,011, p=0,211 , inulin ?=-0,019, p=0,733 , dan FOS ?=-0,092, p=0,357 tidak berhubungan dengan kadar HbA1cpada wanita Suku Minangkabau dan wanita Sunda.

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ABSTRACTInulin and Fructooligosaccharide FOS are recently known to have effect on lowering blood glucose, but this finding was still multivocal. A cross sectional study was conducted to assess the relationship between dietary fiber, inulin, and FOS intake with hemoglobin A1c HbA1c level in Minangkabau and Sundanese women. A total of 298 women were selected. Fiber, inulin and FOS intake was assessed using semi quantitative food frequency questionaire. Data was analyzed using multiple linear regression. Median of dietary fiber, inulin, and FOS are signfificantly higher in Sundanese than in Minangkabau women. Median of HbA1c level was not stastically different between two ethnics. After adjustment with potential confouders, there was no relationship between total dietary fiber 0,011, p 0,211 , inulin 0,019, p 0,733 , dan FOS 0,092, p 0,357 intake with HbA1c level in Minangkabau and Sundanese women. "

"Latar Belakang: Penyakit ginjal diabetik (PGD) merupakan salah satu penyebab terbanyak penyakit ginjal kronik tahap akhir. Podositopati sebagai gambaran dini PGD dapat ditandai oleh adanya protein spesifik podosit (nefrin dan podosin) di urin. Asymmetric dimethylarginine (ADMA) merupakan penanda disfungsi endotel yang diketahui meningkat pada hiperglikemia serta berhubungan dengan albuminuria dan progresivitas kerusakan ginjal. Mekanisme terjadinya gangguan ginjal akibat disfungsi endotel belum sepenuhnya diketahui. Tujuan: Penelitian ini bertujuan untuk mengetahui korelasi ADMA plasma dengan kadar nefrin, podosin, dan rasio podosin nefrin (RPN) urin pada pasien PGD. Metode: Studi potong lintang dilakukan terhadap pasien PGD pada dua rumah sakit di Jakarta sepanjang periode April sampai Juni 2023. Dilakukan pengumpulan data karakteristik subjek, riwayat penyakit dan pengobatan, serta data laboratorium yang relevan. Pemeriksaan ADMA dilakukan dengan metode liquid chromatography dari darah, sedangkan nefrin dan podosin dilakukan dengan metode ELISA dari urin. Uji korelasi dilakukan untuk menilai hubungan ADMA dengan nefrin, podosin, dan RPN. Regresi linier dilakukan untuk menilai pengaruh variabel perancu terhadap hubungan tersebut. Hasil: Dari data 41 subjek yang dianalisis ditemukan rerata ADMA 70,2 (SD 17,2) ng/mL, median nefrin 65 (RIK 20-283) ng/mL, dan median podosin 0,505 (RIK 0,433-0,622) ng/mL. Ditemukan korelasi bermakna antara ADMA dengan nefrin (r=0,353; p=0,024) dan korelasi bermakna antara ADMA dengan RPN (r=–0,360; p=0,021). Tidak ditemukan korelasi bermakna antara ADMA dengan podosin (r=0,133; p=0,409). Analisis multivariat menunjukkan indeks massa tubuh sebagai faktor perancu. Simpulan: Terdapat korelasi positif lemah antara ADMA dengan nefrin urin dan korelasi negatif lemah antara ADMA dengan RPN urin pada pasien PGD. Tidak ditemukan korelasi antara ADMA dengan podosin urin.

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Background: Diabetic kidney disease (DKD) is the leading cause of end-stage kidney disease, and podocytopathy is an early manifestation of DKD characterized by the urinary excretion of podocyte-specific proteins, such as nephrin and podocin. Asymmetric dimethylarginine (ADMA), a biomarker of endothelial dysfunction, is associated with progressive kidney dysfunction. However, the mechanism of endothelial dysfunction in DKD progression is unclear. Objectives: The aim of this study was to investigate the correlations of ADMA levels with nephrin, podocin, and the podocin nephrin ratio (PNR) in DKD patients. Methods: A cross-sectional study of 41 DKD outpatients was performed in two hospitals in Jakarta from April to June 2023. The collected data included the subjects’ characteristics, histories of disease and medication, and relevant laboratory data. Serum ADMA was measured using liquid chromatography, while urinary podocin and nephrin were measured using the enzyme-linked immunosorbent assay (ELISA) method. A correlation analysis was performed to evaluate the correlation of ADMA with nephrin, podocin, and PNR. Regression analysis was performed to determine confounding factors. Results: The mean value of ADMA was 70.2 (SD 17.2) ng/mL, the median for nephrin was 65 (20-283 ng/mL), and the median of podocin was 0.505 (0.433-0.622) ng/mL. ADMA correlated significantly with nephrin (r = 0.353, p = 0.024) and PNR (r = -0.360, p = 0.021), but no correlation was found between ADMA and podocin (r = 0.133, p = 0.409). The multivariate analysis showed that body mass index was a confounding factor. Conclusion: This study revealed weak positive correlations between ADMA and urinary nephrin, and weak negative correlations between ADMA and PNR in DKD patients. No correlation was found between ADMA and urinary podocin.

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"Latar Belakang: Panjang interval QTc dipengaruhi oleh berbagai faktor, salah satunya oleh inflamasi. Pada pasien COVID-19 sering terjadi badai sitokin sehingga menyebabkan peningkatan signifikan dari sitokin inflamasi, termasuk interleukin 6. Peningkatan interleukin 6 menyebabkan perubahan pada kanal ion kardiomiosit sehingga menyebabkan pemanjangan interval QTc yang berisiko aritmia.Tujuan: Mengetahui korelasi dengan melihat beda rerata kadar interleukin 6 dan panjang interval QTc, nilai titik potong kadar interleukin 6 terhadap panjang interval QTc > 500 ms dan kekuatan kadar interleukin 6 dalam menilai risiko aritmia ventrikular.Metode: Penelitian ini menggunakan desain studi potong lintang dengan mengambil data sekunder rekam medik pasien COVID-19 yang menjalani rawat inap di RSCM Kiara sejak November 2020 hingga Maret 2021. Pada penelitian ini dilakukan analisis bivariat menggunakan uji Spearman. Selanjutnya dilakukan analisis terhadap beda rerata kadar interleukin 6 pada kelompok subyek dengan panjang interval QTc > 500 ms dan kelompok subyek dengan panjang interval QTc normal. Dilakukan analisis dengan Receiver Operating Curve (ROC) untuk melihat Area under curve (AUC) dan menentukan titik potong kadar interleukin 6 terhadap panjang interval QTc > 500 ms.Hasil: Pada penelitian ini didapatkan korelasi kadar interleukin 6 dan panjang interval QTc (r=0,72). Median kadar interleukin 6 pada kelompok subyek dengan interval QTc > 500 ms yaitu 99,36 pg/ml sedangkan pada kelompok subyek dengan interval QTc normal yaitu 19,51 pg/mL. Didapatkan AUC=0,852 untuk menentukan titik potong kadar interleukin 6 terhadap panjang interval QTc > 500 ms dengan nilai 59 pg/ml, dengan sensitivitas 80,6% dan spesifisitas 80%. Kejadian aritmia ventrikular tidak ditemukan sehingga tidak dapat dilakukan analisis untuk menilai kekuatan kadar interleukin 6 untuk menentukan risiko aritmia ventrikular.Kesimpulan: Terdapat korelasi kadar interleukin 6 dan panjang interval QTc dengan beda rerata kadar interleukin 6 pada subyek dengan interval QTc > 500 ms 5 kali lebih besar dibandingkan kelompok subyek dengan panjang interval QTc normal. Kadar interleukin 6 59 pg/mL ditentukan sebagai nilai titik potong terhadap panjang interval QTc > 500 ms.

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Background: The length of the QTc interval is influenced by various factors, one of which is inflammation. In COVID-19 patients, cytokine storms often occur, causing a significant increase in inflammatory cytokines, including interleukin 6. An increase in interleukin 6 can cause changes in the ion channels of cardiomyocytes, which can lead to prolonged QTc interval which is at risk of arrhythmias.

Objective: Knowing the correlation by looking at the differences in interleukin 6 levels and the length of the QTc interval, the cut-off value of interleukin 6 levels to the length of the QTc interval > 500 ms and the strength of interleukin 6 levels in assessing the risk of ventricular arrhythmias.

Method: This study used a cross-sectional study design by taking secondary data from the medical records of COVID-19 patients who were hospitalized at RSCM Kiara from November 2020 to March 2021. In this study, a bivariate analysis was carried out using the Spearman test. Furthermore, an analysis of the mean difference in interleukin 6 levels was carried out in the subject group with a QTc interval length> 500 ms and the subject group with a normal QTc interval length. Analyzes were performed using the Receiver Operating Curve (ROC) to see the area under curve (AUC) and determine the interleukin 6 cutoff point for the QTc interval length> 500 ms.

Result: The correlation between interleukin 6 levels and the length of the QTc interval (r=0.72) was found. The median level of interleukin 6 in the group of subjects with a QTc interval > 500 ms was 99.36 pg/ml while in the group of subjects with a normal QTc interval it was 19.51 pg/mL. AUC = 0.852 was obtained to determine the cut-off point for interleukin 6 levels to the QTc interval length > 500 ms with a value of 59 pg/ml, with a sensitivity of 80.6% and specificity of 80%. The incidence of ventricular arrhythmias was not found so that an analysis could not be performed to assess the power of interleukin 6 levels to determine the risk of ventricular arrhythmias.

Conclusion: There is a correlation between levels of interleukin 6 and the length of the QTc interval. The mean difference of interleukin 6 levels in subjects with QTc intervals> 500 ms was 5 times greater than those in groups of subjects with normal QTc interval lengths. The level of interleukin 6 59 pg / mL was determined as the cutoff value for the QTc interval length> 500 ms."

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Latar Belakang: Penyakit Ginjal Kronik (PGK) adalah kondisi serius dengan morbiditas dan mortalitas tinggi, ditandai oleh kerusakan ginjal selama lebih dari tiga bulan. Hemodialisis adalah tatalaksana umum untuk PGK lanjut, yang dijalani oleh 19,33% pasien di Indonesia. Risiko Penyakit Kardiovaskular (PKV) pada PGK stadium 4-5 mencapai 50%, dengan 40% kematian terkait PKV. Padahal sebanyak 12,5% pasien CKD ditemukan pada pasien yang sudah memiliki penyakit kardiovaskular. Maka biomarker seperti Pentraxin-3 (PTX3) penting untuk diagnosis dan prognosis, terutama karena telah ditemukan lebih efektif daripada C-Reactive Protein (CRP) dan biomarker inflamasi lain. PTX3 juga bersifat kardioprotektif dan dapat memprediksi kejadian Major Adverse Cardiovascular Events (MACE) tetapi belum pernah ada penelitian yang memprediksi MACE pada pasien PGK. Penelitian ini termasuk dalam penelitian CARE-CKD di Rumah Sakit Cipto Mangunkusumo (RSCM) dan menganalisis kemampuan PTX3 dalam memprediksi MACE pada pasien PGK.

Tujuan: Mengetahui kadar, nilai potong, dan kemampuan PTX3 dalam memprediksi MACE pada pasien PGK yang menjalani HD di RSCM, dengan kalibrasi dan diskriminasi baik setelah dikontrol faktor jenis kelamin, usia, IMT dan infeksi.

Metode: Penelitian ini menggunakan desain kohort retrospektif. Data sekunder dari pasien PGK yang menjalani hemodialisis dianalisis untuk melihat hubungan kadar PTX3 dengan kejadian MACE selama satu tahun. Analisis statistik menggunakan SPSS versi 26.

Hasil:

Pada 74 pasien PGK yang menjalani HD di RSCM, kadar PTX–3 median adalah 0,9 ng/mL. Dari mereka, 11 pasien mengalami MACE dengan PTX–3 median 1,324 ng/mL. Analisis ROC menunjukkan AUC 0,630. PTX–3 dapat memprediksi MACE, dengan cut-off 1,317 ng/mL.

Simpulan: Pentraxin 3 dapat menjadi prediktor MACE pada pasien PGK yang menjalani HD yang baik setelah dikontrol oleh variable perancu.

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Background: Chronic Kidney Disease (CKD) is a serious condition with high morbidity and mortality, characterized by kidney damage for over three months. Hemodialysis is a common treatment for advanced CKD, undertaken by 19.33% of patients in Indonesia. The risk of Cardiovascular Disease (CVD) in CKD stages 4-5 reaches 50%, with 40% of deaths related to CVD. Therefore, biomarkers like Pentraxin-3 (PTX3) are crucial for diagnosis and prognosis, as PTX3 has been found to be more effective than C-Reactive Protein (CRP) and other inflammatory biomarkers. PTX3 also has cardioprotective properties and can predict Major Adverse Cardiovascular Events (MACE), though no studies have yet predicted MACE in CKD patients. This research is part of the CARE-CKD study at Cipto Mangunkusumo Hospital and will analyze PTX3's ability to predict MACE in CKD patients.

Objective: To determine the levels, cut-off value, and predictive ability of PTX3 for Major Adverse Cardiovascular Events (MACE) in Chronic Kidney Disease (CKD) patients undergoing hemodialysis at Cipto Mangunkusumo Hospital, with good calibration and discrimination after controlling for gender, age, BMI, and infection factors.

Methods: This study utilized a retrospective cohort design. Secondary data from CKD patients undergoing hemodialysis were analyzed to examine the relationship between PTX3 levels and MACE occurrences over one year. Statistical analysis was conducted using SPSS version 26.

Results: In 74 CKD patients undergoing HD at Cipto Mangunkusumo Hospital, the median PTX-3 level was 0.9 ng/mL. Among them, 11 patients experienced MACE with a median PTX-3 level of 1.324 ng/mL. ROC analysis indicated an AUC of 0.630. PTX-3 can predict MACE, with a cut-off of 1.317 ng/mL.

Conclusions: Pentraxin 3 could be a predictor of MACE in CKD patients undergoing HD after calibration of confounding factors."

"Latar Belakang: Pada ODHA didapatkan peningkatan inflamasi dan stres oksidatif. Puasa Ramadan dapat memperbaiki inflamasi dan stres oksidatif, namun penelitian pada ODHA yang mendapat antiretroviral belum pernah dilakukan. Tujuan: Mengetahui pengaruh puasa Ramadan terhadap high sensitivity Creactive protein (hs-CRP) dan status antioksidan total (SAT) pada ODHA yang mengonsumsi antiretroviral. Metode: Penelitian ini merupakan penelitian prospektif pada 29 orang ODHA dengan ARV yang berpuasa dan 29 yang tidak berpuasa. Kriteria inklusi yaitu pria, 20-40 tahun, mendapat ARV lini 1 minimal 6 bulan, serta tidak dalam fase inisiasi pengobatan untuk infeksi oportunistik. Pasien yang mendapat steroid atau imunosupresan lain atau pasien dengan adherens minum ARV kurang dari 95% dieksklusi. Pemeriksaan kadar hs-CRP dan SAT dilakukan sebelum dan saat puasa Ramadan (setelah 14 hari puasa). Hasil: Karakteristik baseline usia, hitung CD4, HIV-RNA, kombinasi ARV, status hepatitis B dan C, serta kadar hs-CRP tidak berbeda antara kelompok berpuasa dengan kontrol. Setelah dua minggu, terdapat penurunan signifikan hs-CRP pada kelompok yang berpuasa dibandingkan kontrol (p=0,004). Median perubahan hs-CRP pada kelompok puasa adalah -0,41 (IQR -1; 0,1) mg/L, sedangkan pada kelompok kontrol adalah 0,2 (IQR -0,3; 1,5) mg/L. Konsumsi polyunsaturated fatty acid, berat badan, jumlah rokok, dan jumlah jam tidur per hari menurun selama puasa Ramadan (berturut-turut p=0,029; p<0,001; p<0,001; dan p<0,001). Tidak ditemukan perbedaan bermakna perubahan SAT antara kelompok yang berpuasa dengan kontrol (p=0,405). Median perubahan SAT pada kelompok puasa adalah 0,05 (IQR -0,03; 0,12) mmol/L, sedangkan pada kelompok kontrol adalah 0,04 (IQR -0,13; 0,36) mmol/L. Simpulan: Puasa Ramadan menurunkan kadar hs-CRP pada ODHA yang mengosumsi antiretroviral. Puasa Ramadan belum meningkatkan kadar SAT pada ODHA yang mengonsumsi antiretroviral.

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Background: Inflamation and oxidative stress were increased among HIV patients. Studies had showed Ramadan fasting could improve inflammation and oxidative stress, but not one of them had been conducted in HIV patients receiving antiretroviral therapy.

Aim: to know the effect of Ramadan fasting on hs-CRP level and total antioxidant status among HIV patients on highly active antiretroviral therapy.

Methods: A prospective cohort study comparing 29 HIV-infected patients on stable ART doing Ramadan fasting versus 29 non-fasting patients. Inclusion criteria were male, 20-40 years old, receiving first line ART for at least six months, and not on initial phase of opportunistic infection?s treatment. Patients who consumed steroid or other immunosuppressant or patients with poor ART adherence were excluded. Level of hs-CRP was obtained before and during Ramadan after at least 14 days fasting.

Results: Baseline age, CD4 cell count, HIV-RNA, ART combination, hepatitis B and hepatitis C status, and hs-CRP level were similar for both fasting and control groups. After 2 weeks, a significant hs-CRP decrease was found in fasting group compared to non-fasting one (p=0.004). Median difference of hs-CRP in fasting group was -0.41 (IQR -1 and 0.1) mg/L, while in control group the median difference was 0.2 (IQR -0.3 and 1.5) mg/L. Polyunsaturated fatty acid consumption, body weight, amount of cigarette smoking, and total sleep hours per day were decreased significantly during Ramadan fasting (p=0.029; p<0.001, p<0.001, p<0.001 respectively). There was no statistically significant changes in total antioxidant status between the two groups (p=0.405). Median total antioxidant status changes in fasting group was 0.05 (IQR -0.03;0.12) mmol/L. Median total antioxidant status changes in control group was 0.04 (IQR -0.13; 0.36) mmol/L.

Conclusion: Ramadan fasting decreased hs-CRP level among HIV patients on antiretroviral therapy. Ramadan fasting had not increased total antioxidant status among HIV patients on antiretroviral therapy."

"Diabetes Melitus merupakan penyakit kronik yang dapat dikendalikan, hal ini menjadi bagian penting untuk memperlambat terjadinya komplikasi. Upaya pengendalian dapat berjalan efektif bila dilandasi oleh tingginya Awareness Diabetisi akan penyakitnya termasuk dalam monitoring kadar glukosa, alat monitoring gula darah yang ada dimasyarakat saat ini masih membutuhkan sampel darah menjadi masalah tersendiri bagi Diabetisi. Penelitian ini bertujuan untuk meningkatkan Disease Awareness Diabetisi melalui pengembangan model konsep pengelolaan diri Model SOFIANI dengan bantuan alat pendeteksi kadar glukosa darah non-invasif. Penelitian ini terdiri dari 3 tahap, tahap 1 pengembangan model kondep pengelolaan diri, tahap 2 pengembangan alat pendeteksi kadar glukosa darah non-invasif, dan tahap 3 uji coba model dengan desain eksperimen yang melibatkan 59 responden pada tahap 3, pada tahap 2 melibatkan 344 responden. Analisis data menggunakan paired t test dan general linier model repetead measure. Hasil analisis diperoleh data terdapat peningkatan skor Diabetes Self Cara Management, penurunan tingkat stres dan kadar HbA1c pada kelompok intervensi pada variabel outcome, sedangkan pada variabel intermediate terlihat penurunan kadar glukosa darah puasa yang efektif sejak minggu 6, peningkatan waktu melakukan aktifitas dan kepatuhan dalam menggunakan terapi. Kesimpulan Model SOFIANI dapat meningkatkan disease awareness dengan indikator variabel outcome dan intermediate. Saran manajemen keperawatan memberikan kebijakan agar model SOFIANI ini dapat digunakan untuk terlaksananya asuhan yang berkesinambungan Continuity of care.

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Diabetes mellitus is a chronic disease which can be controllable, and that is being an important part to delay the complication. Control efforts, which, guided by a higher awareness of the patients, can run effectively. Especially the patient 39 s awareness of disease prognosis and blood glucose monitoring. Blood sugar monitoring devices which exist in the community still need a blood sample, in the examination process, and this is being a problem for people with diabetes.

The purpose of this study was to increase the disease awareness among diabetic patients through the concept of self management model SOFIANI equipped with the non invasive blood glucose monitoring tool. This study consisted of the three following steps 1 the development modelofself management concept, 2 the development of non invasive blood glucose detector, and 3 the experimental design for the testing model. A total of 344 respondents was involved in the second stage of this study, while a total of 59 respondents participated in the third stage of this study. Paired t test and General Linear Model with repeated measurement were used for data analysis.

The results of this study were to identified the increaseof diabetes self care management DSCM score, the decrease of stress and HbA1c levels among intervention group, especially for outcome variables.While in the intermediate variables the effectively decrease of blood glucose started from weeks 6, the increasing amount of time for exercise and the adherence towards therapy. Conclusion SOFIANI Model can increase disease awareness with the outcome and intermediate variables as an indicator. This model might be considered by nursing management in the hospital to be implemented to create the continuity of nursing care."

"Latar Belakang: Kekakuan arteri merupakan prediktor morbiditas dan mortalitas kardiovaskular pasien menjalani dialisis. Beberapa studi yang membandingkan kekakuan arteri antara pasien yang menjalani hemodialisis dengan continuos ambulatory peritoneal dialysis CAPD masih kontroversi. Pelaksanaan hemodialisis yang dilakukan dua kali seminggu di Indonesia akan meningkalkan kekakuan arteri.Tujuan: Membandingkan kekakuan arteri antara pasien menjalani yang CAPD dengan hemodialisis dua kali seminggu.Metode: Studi komperatif membandingkan kekakuan arteri pasien yang menjalani CAPD dengan hemodialisis. Penelitian ini terdiri dari 30 subjek CAPD dan 30 subjek hemodialisis selanjutnya dilakukan pemeriksaan kekakuan arteri menggunakan SphygmoCor. Hasil: Karakteristik subjek yang menjalani CAPD dan hemodialisis tidak terdapat perbedaan pada usia, jenis kelamin, tekanan darah, lama menjalani dialisis dan diabetes melitus. Kadar fosfat subjek yang menjalani CAPD 5,09 1,83 mg/dL lebih rendah dibandingkan hemodialisis 6,07 1,83 mg/dL dan bermakna secara stastistik p = 0,046. Subjek yang menjalani CAPD mempunyai PWV 8,04 1,54 m/s lebih rendah dibandingkan hemodialisis 9,05 1,98 m/s dan bermakna secara stastistik p = 0,03.Simpulan: Pasien yang menjalani CAPD mempunyai kekakuan arteri yang lebih rendah dibandingkan hemodialisis dua kali seminggu.

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Background: Arterial stiffness is a predictor of cardiovascular morbidity and mortality in dialysis patients. Several studies comparing arterial stiffness among patients undergoing continuous ambulatory peritoneal dialiyis CAPD and hemodialysis are still controversial. In, Indonesia hemodialysis is still performed twice a week that can cause the arterial stiffness higher than CAPD.Objective: This study is aimed to compare arterial stiffness between CAPD and hemodialysis that performed twice a week patients. Method: The comparative study between CAPD and hemodialysis patients. This study consisted of 30 CAPD and 30 hemodialysis patients. The examination of arterial stiffness used SphygmoCor. Result: The CAPD and hemodialysis patients were no different in age, sex, blood pressure, dialysis duration and diabetes mellitus. Phosphate levels in CAPD 5.09 1.83 mg/dL were lower than hemodialysis patients 6.07 1.83 mg/dL and stastically significant p = 0.046. CAPD patients have lower PWV 8.04 1.54 m/s than hemodialysis 9.05 1.98 m/s and stastically significant p = 0.03. Conclusion: The CAPD patients have lower arterial stiffness than hemodialysis patients that performed twice a week."

"Latar belakang: Penyakit kardiovaskular sangat umum ditemukan dan berakibat fatal pada pasien dengan usia lanjut. Disfungsi sistolik ventrikel kiri yang asimptomatik atau subklinis sering kali mendahului penyakit ini. Deteksi dini terhadap disfungsi sistolik ventrikel kiri dapat mengurangi morbiditas dan mortalitas akibat penyakit kardiovaskular. Salah satu metode deteksi dini adalah dengan penilaian global longitudinal strain (GLS). Tujuan: Tujuan dari penelitian ini adalah untuk mengetahui nilai rerata GLS pada pasien usia lanjut dengan frailty maupun non frailty dan mengetahui faktor-faktor yang berhubungan.Metode: Penelitian potong lintang dilakukan pada pasien usia lanjut diatas 60 tahun di poliklinik geriatri dan kardiologi Ilmu Penyakit Dalam RSCM. Data diperoleh dari wawancara, rekam medik dan pemeriksaan ekokardiografi transtorakal. Variabel penelitian berupa usia, frailty, hipertensi, penyakit jantung koroner, dislipidemia, dan diabetes melitus dianalisis sebagai determinan penurunan GLS. Analisis univariat terhadap masing-masing variabel. Analisis bivariat menggunakan uji chi kuadrat dengan tingkat signifikan p<0,25 dan interval kepercayaan (IK) sebesar 95%. Analisis multivariat menggunakan uji regresi logistik.Hasil: Sebanyak 194 subjek yang memenuhi kriteria pemilihan diikutkan dalam penelitian, rerata usia 66 tahun dengan 118 (60,8%) di antaranya perempuan. Penelitian ini mendapatkan beberapa determinan yang memiliki nilai p<0,25 yaitu frailty, hipertensi, dislipidemia, dan diabetes melitus dengan hasil analisis multivariat, frailty memiliki OR sebesar 2,002 (95% IK 1,042-3,925), dan diabetes melitus memiliki OR sebesar 2,278 (95% IK 1,033-5,025).Simpulan : Nilai median GLS pada usia lanjut secara umum adalah sebesar -21,6% (minimal -5,3% sampai dengan maksimal -29,9%). Faktor yang mempengaruhi penurunan GLS adalah frailty dan diabetes melitus.

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Background: Cardiovascular disease is very common and can be fatal in elderly patients. It is often preceded by asymptomatic or subclinical left ventricular systolic dysfunction (LVSD). Early detection of LVSD can reduce morbidity and mortality due to cardiovascular disease. One method used in the early detection of LVSD is an assessment of global longitudinal strain (GLS).Objective: To determine the mean value of GLS and GLS-related factors.Methods: This cross-sectional study was conducted among elderly patients aged > 60 years in the geriatric and cardiology polyclinic, Internal Medicine, CMH Hospital. Data were obtained from interviews, medical records, and transthoracic echocardiography examination. The variables of age, frailty, hypertension, coronary artery disease, dyslipidemia, and diabetes mellitus were analyzed as the determinants of a decrease in GLS. Univariate analysis was conducted for each variable. Bivariate analysis was conducted using the chi-square test with a significance level of p<0.25 and confidence interval (CI) of 95%, and multivariate analysis used a logistic regression test.Results: A total of 194 patients were admitted according to the study criteria, with a mean age of 66 years. The proportion of women was 60.8%. The study revealed that the determinants with p<0.25 are frailty, hypertension, dyslipidemia, and diabetes mellitus, with multivariate analysis frailty having an OR of 2.002 (95% CI 1.042-3.925) and diabetes mellitus having an OR of 2.278 (95% CI 1.033-5.025).Conclusions : The median value of GLS in elderly is -21,6% (minimum value -5,3% and maximum value 29,9%). The factors that influence the decrease of GLS are frailty and diabetes mellitus."