Bambang Wirjatmadi

The effect of adding zinc to vitamin A on IGF-1, bone age and linear growth in stunted children

A randomized, double-blind, placebo controlled trial of a single dose of 200,000 I.U. of vitamin A with daily zinc supplementation was conducted with children in Mojo village, Surabaya City. Children aged 48 to 60 months were randomized to receive a single dose of 200,000 I.U. of vitamin A plus zinc sulfate (n=12) or a single dose of 200,000 I.U. of vitamin A (n=12) plus placebo six days a week for six months. Children were evaluated weekly for nutrient intake and for IGF-1, C-reactive protein levels, gamma globulin levels, serum zinc, serum retinol, bone age and the index height for age at six months. At the end of the study, there was a significant increase in the serum retinol level (p<0.03), serum zinc level (p<0.03), IGF-1 hormone (p<0.04) and Z-score height for age (p<0.001), bone age (p<0.01), and gamma globulin level (p<0.04) and a significant decrease in the amount of infection/inflammation measured by CRP level (p<0.001). There was also a significant correlation between CRP level and height for age (p<0.01), and between gamma level and height for age (p<0.01). These results suggest that combined vitamin A and zinc supplementation reduces the risk of infection and increases linear growth among children, and thus may play a key role in controlling infection and stunted growth for children under five years old.

Level of Zinc, Retinol, Blood Macrophages, T- Lymphocytes andImmunoglobulin G in Children with Tuberculosis and Non Tuberculosis

Tuberculosis remains a major cause of morbidity and mortality in children in the world, but still lack of priority in overcomes them. Every year estimated 9 million new tuberculosis cases with 1 million of whom are children aged <15 years and 2 million of them died. Nutrients which are very influential on a childs immune system are fat, protein, vitamin A and zinc. The presence of zinc in the body greatly affects the immune function so it plays an important role in the prevention of infectious diseases, including tuberculosis. The purpose of this study is to determine differences in serum zinc levels, serum retinol levels, levels of blood macrophages, T-lymphocytes and IgG between children with tuberculosis with healthy children or non- tuberculosis. This study is a comparative observational study with cross sectional study design. The sampling technique of this study was simple random sampling. This study was conducted at RSUD Sidoarjo with each 11 children in tuberculosis and non-tuberculosis group as a sample. At the end of this study, it discovered that there are significant differences levels of zinc serum (p=0.003), retinol serum (p=0.018), blood macrophages (p=0.001), T-lymphocytes (p=0.001) and IgG (p=0.006) between tuberculosis and non-tuberculosis group. The levels of zinc, retinol and IgG on children with tuberculosis were lower than nontuberculosis children, but T-lymphocytes on children with tuberculosis were higher than non-tuberculosis children. It suggested for giving zinc and vitamin A regularly and appropriate dosing in children with tuberculosis where it is useful to improve the durability of the body and can improve the childs appetite.

Selenium Intake in Hypertensive and Normotensive Post-Menopausal Indonesian Women.

The Indonesian Ministry of Health has predicted that the national prevalence of hypertension in Indonesia may reach 26.5% in 2013. Increasing age, stress, lack of physical activity, obesity and passive smoking are known to be risk factors of hypertension. In women over 50 y, hormonal changes that occur post-menopause may also increase the risk of hypertension and other vascular diseases. Antioxidant precursors, such as selenium, however, are known to provide protection against the development of several oxidative stress-related diseases, including hypertension. To prove the hypothesis, we compared the levels of consumption of selenium in hypertensive and normotensive post-menopausal women. An observational comparative study with cross-sectional design was conducted in groups of post-menopausal women with hypertension and those who are normotensive. Structured interviews and food recall of 2×24 h were used to determine the level of consumption, and the Depression, Anxiety and Stress Scale (DASS) questionnaire was used to measure the level of stress. The result suggests a significant difference in the levels of selenium intake between the normotensive and hypertensive groups (p=0.008). Furthermore, the passive smoking and stress levels of the hypertensive group were significantly higher than those of the normotensive group. These result support the hypothesis that selenium may play a protective role in vascular disease.

The Effect of Adding Zinc To Zinc And Retinol Serum Levels At Postpartum In the Malnutrition Pregnant Women in Third Trimester

Zinc deficiency in pregnant women has been associated with various conditions in babies born, one of whom was an infant with low birth weight. Effect of zinc supplementation in pregnant women may increase serum zinc levels and highdoses vitamin A supplementation may increase serum retinol levels. The aim of this study is to examine the effect of zinc supplementation in the malnutrition pregnant women in third trimester to zinc and retinol serum levels when the mother had postpartum. The population in this study was all pregnant women in third trimester on study sites. Respondents were malnutrition pregnant women in third trimester with upper arm circumference less than 23,5cm (n=32). Data collected through questionnaire, blood sampling and laboratory tests. Samples were taken from the population with inclusion criteria. They were then placed into groups using random allocation. At the end of the study, there was a significant difference in serum zinc levels (p<0,000) and no significant difference in serum retinol levels (p<0,624) in the trial group. Serum zinc levels increase after supplementation, but serum retinol levels decrease. These results suggest that zinc supplementation can increase serum zinc levels but needed adequate protein intake to increase serum retinol levels.

Effect of Zinc and High-Dose Vitamin A Supplementation to Retinol and Zinc Levels of Breast Milk in the Malnutrition Pregnant Women in Third Trimester

Zinc and high-dose vitamin A supplementation in the malnutrition pregnant women in third trimester could increase retinol and zinc levels in breast milk. This research applied an experimental design of double blind randomized tests (pre-test and post-test) on two groups (trial and control groups) to analyze the effect of zinc and high-dose vitamin A supplementation. Variables of interest were measured two times, pre-test and post-test. Data were collected through questionnaire-based interviews, laboratory tests of blood samples and breast milk. Based on the inclusion criteria, 32 malnutrition pregnant women were selected as samples. The sample was randomly assigned to two groups, trial and control groups. Based on t-tests, the effects of supplementation were analyzed. The results showed that there was no significant differences of zinc (p < 0.386) and retinol levels (p < 0.948) of breast milk between pre and post-tests within control group and trial group. The conclusion is there was no difference on zinc and retinol levels of breast milk between the control and trial groups. These results suggested that zinc and high-dose vitamin A supplementation has no effect to retinol and zinc levels of breast milk in the control and trial groups.

Chromium and Zinc Level of Patients with Type 2 Diabetes and Non-Diabetes

Type 2 diabetes mellitus and its complications have become a serious public health problem and an important cause of morbidity, mortality and disability in worldwide. Type 2 diabetes caused by insulin resistance together with insulin deficiency, occurs in adulthood. Micro mineral that contribute to the occurrence of diabetes mellitus are chromium and zinc. This study aimed to determine differences level of chromium and zinc between patients with type 2 diabetes and non-diabetic in Hajj General Hospital, Surabaya. This research is an observational study with cross sectional approach. The study was conducted in internal disease poly of Hajj General Hospital, Surabaya on June to July 2014 using simple random sampling as sampling method. Sample sizes are 30 people, consisting of 15 patients with type 2 diabetes and 15 non-diabetic patients. Blood tests performed in the laboratory and interview was conducted using a questionnaire. Bivariate analysis using Independent Sample T-test. The results showed no significant difference of chromium (p<0.201) and zinc level (p<0.431) between type 2 diabetes group with non-diabetic. Average level of chromium and zinc in type 2 diabetic patients is lower than the non-diabetic.

Effect of Zinc Capsules To Physical Size of Born Babies in Malnutrition Pregnancy Women during Third Trimester in Bojonegoro, East Java Province

Malnutrition is not only harm the physical and mental of mother, but also threatens safety of the fetus. Mothers who insisted pregnant with malnutrition status are at 2-3 times larger risk of giving birth to low birth weight babies than mothers with good nutritional status. This study is an experimental research with pretest-posttest control group design. The purpose of this study is to analyze the effect of zinc capsule to the physical size of born babies in malnutrition pregnant women during third trimester in Bojonegoro Regency, East Java province. The data was collection through questionnaire, food recall, food frequency, monitoring card, anthropometry, blood sampling, and laboratory tests. The population was pregnant women who living in 27 different locations in Bojonegoro Regency. The samples were 32 malnutrition pregnant women during their third trimester who registered in 6 health clinics. The sampling technique is done by simple random sampling. Samples are divided into two groups, the treatment group (n=16) and the control group (n=16). The results of this study showed there was a significant difference between treatment and control group regarding the weight (p<0.000), length (p<0.000), and head circumference (p<0.029) of the born babies. These results suggest that zinc supplementation has positive effect on the physical size of the birth.

The Effect of Zinc and Lysine Supplementation on Infection Rate and CD4 Count In Elderly

Elderly people tend to have higher susceptibility of infections because immune dysfunction, especially cell-mediated immune system which is related to zinc deficiency. Lysine can support zinc role to boost up the cell-mediated immune system which can be determined by CD4 count. The objective of this study is to determine the effect of zinc and lysine supplementation on infection rate and CD4 count in elderly. A randomized, double-blind, placebo-controlled trial was conducted in a senior center in Surabaya using 24 healthy elderly subjects of both sexes aged 62 to 90 years. They were divided into two experimental groups and one control group. They were given zinc 20 mg per day; or zinc 20 mg and lysine 500 mg per day; or placebo for 2 months. Infection rate during supplementation period was documented. Albumin level, serum zinc level and CD4 count were measured before and after supplementation. The data was analyzed using one way Anova and paired T-test with p < 0.05. Compared to control group, infection rate was lower in zinc group and zinc + lysine group (p < 0.065). Zinc + lysine supplementation increased serum zinc level significantly (p < 0,012) and had better effect compared to zinc supplementation alone. Zinc + lysine supplementation also increased CD4 count (p < 0,784) and had better effect compared to zinc supplementation alone. Zinc + lysine supplementation did not increase albumin level which was already in the normal level. Zinc + lysine supplementation can reduce infection rate in elderly by increasing zinc level and CD4 count.