Liong Boy Kurniawan

BMI and Waist Circumference Have Positive Correlation With Mitochondrial DNA Copy Number in Young Adult Male

Received: February 28, 2018 Revised: April 19, 2018 Accepted: May 10, 2018 Abstract: Background: Abdominal obesity is associated with metabolic and cardiovascular diseases. Mitochondrial dysfunction is often related to metabolic disorder commonly found in abdominal obesity. Mitochondrial DNA (mtDNA) copy number is a biomarker which can be used to reflect the activity of mitochondria. Abdominal obesity is more commonly found in males compared to females and the incidence is growing in young adult male, therefore we investigated the relationship of mtDNA copy number and anthropometric and metabolic biomarkers in young adult male.

Body Mass, Total Body Fat Percentage, and Visceral Fat Level Predict Insulin Resistance Better Than Waist Circumference and Body Mass Index in Healthy Young Male Adults in Indonesia

The incidence of obesity which leads to insulin resistance (IR) and metabolic disorder is increasing in developing countries, including Indonesia. Male adults have a higher risk of abdominal obesity than females. This is associated with cardiometabolic disorders. Several anthropometric measurements have been proposed to predict IR. The aim of this study was to investigate whether body mass, body mass index (BMI), waist circumference (WC), body fat percentage (BF) or visceral fat level (VF) could become a better predictor of IR in healthy young male adults. A total of 140 healthy young male adults ranging from 18–25 years were recruited in the study. Insulin resistance was measured by calculating their Homeostatic Model Assessment for Insulin Resistance (HOMA-IR). Subjects with a HOMA-IR value ≥75th percentile, with cut off 3.75, were defined as IR. Anthropometric measurements including body weight, BMI, and WC were performed, whereas BF and VC were measured using bioelectrical impedance analysis (BIA). IR had a strong correlation with body weight, BMI, WC, BF, and VF. In the area under the curve of body mass, BF and VF were slightly greater than WC and BMI. Anthropometric measurements correlated strongly with IR but body weight, BF, VF had a stronger correlation than WC and BMI in healthy young male adults.

DIAGNOSIS TIROID (Diagnosis of Thyroid)

Thyroid disease often causes unspecific or mild symptoms, so laboratory tests are needed to confirm the functional diagnosis of the thyroid disorder. The laboratory tests which are important to establish the diagnosis of thyroid disorder include: total and free thyroid hormones, its related (thyroid) hormone binding proteins and auto antibodies. The thyroid hormone tests are mostly measured with competitive or sandwich immunoassays and each method can be interfered by several factors. Some drugs may increase or decrease the thyroid functional tests and several factors such as: underlying diseases, age, pregnancy, occurrence of heterophil antibody and auto antibodies may also interfere the thyroid tests results. The interpretation of an unusual combination from thyroid stimulating hormone such as free thyroxin and tri-iodothyronine results needs confirmation of underlying condition for establishing the right diagnosis. This review is aimed to evaluate several factors which may influence the thyroid tests and interpretation.

PNEUMATIC TUBE TERHADAP DARAH RUTIN DAN LAKTAT DEHIDROGENASE

The transportation of laboratorial samples with pneumatic tube system spends less time than when were handled by courier. Pneumatic tube system produces minor vibrations on sample due to the velocity changes during transportation and may cause changes on the blood cells and haemolysis. The aim of this study is to know the effect of sample transportation with pneumatic tube on blood cells and its effect on hemolysis. A cross sectional study was performed at Dr. Wahidin Sudirohusodo Hospital, Makassar in July 2013. Routine blood, electrolyte and LDH were tested in 12 out-patients. The researchers collected two (2) samples, for each EDTA tube (routine blood tests) and serum (electrolyte and LDH). The samples were transported using pneumatic tube and the paired samples were sent by courier. The result then were analyzed with Paired T-Test. There were no significant difference of routine blood test results between samples sent by pneumatic tube and courier except RDW. RDW were higher in samples which were sent by pneumatic tube compared to those brought by the courier (18.72±2.70% vs 17.83±2.36%, p=0.007). The electrolyte levels sent by both methods there were no significant difference, but the LDH levels were higher in samples sent by pneumatic tube (472.08±100.44 U/L vs 331.25±94.19 U/L, p=0.000). Based on this study, in common can be concluded that the pneumatic tube system does not effect on the routine blood test results, except on RDW and does not cause changes due to haemolysis (on electrolyte) except the LDH levels elevates. So based on this study, it is recommended to send samples for LDH test only by courier.

ANALYSIS OF MEAN PLATELET VOLUME AS A MARKER FOR MYOCARDIAL INFARCTION AND NON-MYOCARDIAL INFARCTION IN ACUTE CORONARY SYNDROME

Sindrom Koroner Akut (SKA) merupakan manifestasi akut dari plak aterosklerosis pembuluh darah koroner yang koyak atau pecah. Platelet berperan penting pada patogenesis aterosklerosis dan SKA. Nilai MPV yang tinggi mencerminkan ukuran platelet yang lebih besar dan lebih reaktif. Penelitian ini merupakan penelitian retrospektif potong lintang di Rumah Sakit Dr. Wahidin Sudirohusodo Makassar dengan mengambil data pasien dengan diagnosa SKA (STEMI, NSTEMI dan UAP). Sampel SKA kemudian dibagi menjadi kelompok Infark Miokard (STEMI dan NSTEMI) dan non-Infark Miokard (UAP). Nilai platelet dan MPV diambil dari hasil pemeriksaan darah rutin pertama sejak pasien masuk Instalasi Gawat Darurat RSUP Dr. Wahidin Sudirohusodo. Nilai platelet dan MPV dibandingkan berdasarkan kelompok SKA. Sebanyak 251 data pasien SKA Infark Miokard dan non-Infark Miokard diperoleh masing-masing 191 data pasien Infark Miokard dan 60 data pasien non-Infark Miokard. Hasil uji statistik Mann-Whitney tidak didapatkan perbedaan bermakna nilai platelet antara pasien SKA Infark Miokard dan non-Infark Miokard (263,4 ± 93,2 vs 285,2 ± 98,7; p=0,215). Namun didapatkan perbedaan bermakna nilai MPV antara pasien SKA Infark Miokard dan non-Infark Miokard (8,3 ± 1,13 vs 7,9 ± 1,2; p=0,013). Hasil penelitian didapatkan nilai MPV di SKA Infark Miokard lebih tinggi daripada SKA non-Infark Miokard. Peneliti menyarankan penggunaan MPV sebagai tolok ukur yang berkemampuan dalam membantu penegakan diagnosa infark miokard.

VERY SEVERE HYPERTRIGLYCERIDEMIA IN SUSPECTED FAMILIAL CHYLOMICRONEMIA INFANT

Seorang bayi perempuan berusia 6 bulan, masuk rumah sakit dengan keluhan utama muntah dialami sejak satu hari sebelum masuk rumah sakit dengan kekerapan lebih dari sepuluh kali dalam sehari dan demam dialami sejak 6 jam sebelum masuk rumah sakit. Pasien ini lahir prematur secara sectio secarea dengan berat badan lahir 1,5 kg. Serum pasien lipemik seperti susu. Kadar kolesterol total serum pasien 477 mg/dL, trigliserida 4370 mg/dL (hipertrigliseridemia sangat berat), LDL direk 135 mg/dL, HDL 5 mg/dL dan kadar hemoglobinnya 8,0 gr/dL. Pasien ini mendapatkan cairan intravena, antibiotik dan transfusi darah akibat anemia yang diderita. Di kasus ini, hipertrigliseridemia sangat berat diduga terkait dengan kilomikronemia familial. Penapisan profil lipid dari orang tua bayi dan keluarga lainnya sangat penting dilakukan untuk menegakkan diagnosis.

CREATINE KINASE RELATED TO THE MORTALITY IN MYOCARDIAL INFARCTION (Creatine Kinase terhadap Angka Kematian di Infark Miokard)

Creatine Kinase (CK) merupakan salah satu uji yang sering diperiksakan untuk mendiagnosis infark miokard akut. Peningkatan enzim ini menunjukkan ada nekrosis sel otot meskipun tidak khas di otot jantung. Kenaikan tingkat CK di infark miokard akut menggambarkan luas serta beratnya penyakit dan dihubungkan dengan peningkatan angka kematian pasien. Untuk mengetahui tingkat CK di pasien infark miokard akut saat masuk rumah sakit dan menilai pengaruhnya terhadap angka kematian pasien selama perawatan di rumah sakit. Penelitian ini merupakan kajian potong lintang dengan mengambil data sekunder dari rekam medik 62 pasien infark miokard akut yang dirawat di Unit Perawatan Jantung Intensif Rumah Sakit Dr. Wahidin Sudirohusodo Makassar masa waktu bulan Juli 2010 hingga Juni 2011. Kadar CK yang diteliti diperoleh saat pasien masuk rumah sakit. Uji statistic dilakukan dengan uji Mann Whitney, T Test dan Chi-Kuadrat. Rerata kadar CK di pasien infark miokard akut yang tetap hidup dan meninggal selama perawatan adalah 507,38+749,62 U/L dan 1995,39+2290,06 U/L (p=0,002). Perbedaan tingkat angka kematian yang bermakna ditemukan antar kuartil CK (p=0,021). Kebahayaan relatif angka kematian pada kuartil keempat (4) sebesar 13 kali dibandingkan dengan kuartil kesatu (1) (selang kepercayaan 95%, 2,07-81,5; p=0,006), kuartil ketiga (3) sebesar 4,8 kali dibandingkan dengan kuartil kesatu (1) (selang kepercayaan 95%, 1,07-21,45; p=0,04) dan kuartil kedua (2) sebesar 3 kali dibandingkan dengan kuartil kesatu (1) (selang kepercayaan 95%, 0,68-13,3; p=0,148).Didasari telitian ini, ditemukan perbedaan bermakna kadar CK ditemukan saat masuk rumah sakit di pasien infark miokard akut yang tetap hidup maupun yang meninggal selama perawatan. Semakin tinggi kadar CK saat pasien masuk rumah sakit semakin tinggi tingkat angka kematiannya.

Hubungan antara Kadar Creatine Kinase-MB dengan Mortalitas Pasien Infark Miokard Akut Selama Perawatan di RS. Dr. Wahidin Sudirohusodo, Makasar

Abstract Increase of CK-MB level is associated with myocardial infarction size and severity. The aim of this study is to evaluate the correlation between the admission CK-MB level of acute myocardial patients and the in-hospital mortality. Secondary data of 60 acute myocardial infarction patients hospitalized in Intensive Cardiac Care Unit of Dr.Wahidin Sudirohusodo Hospital Makassar from June 2010 to July 2011 were taken. Admission CK-MB levels between the period of 3 hours to 1 week after onset were then analyzed. The mean of admission CK-MB level in the in-hospital survived and non survived acute myocardial infarction patients were 89.52+121.59 U/l and 202.88+192.75 U/l respectively (Mann Whitney Test, p=0.005). There were significant mortality rate difference among all CK-MB quartiles with mortality rate 13.3%, 6.7%, 40% and 46.7 % in 1st, 2nd, 3rd, and 4th quartile respectively (Chi Square Test, p=0.031) but the odds ratio of mortality between quartiles were not different.. There was significant difference of admission CK-MB levels in the in-hospital survived and non survived acute myocardial infarction. Keywords : CK-MB, myocardial infarction, mortality Abstrak Peningkatan kadar CK-MB pada infark miokard akut menunjukkan luas dan parahnya penyakit. Penelitian ini bertujuan untuk menilai hubungan antara kadar CK-MB pada pasien infark miokard akut saat masuk rumah sakit dan mortalitas pasien selama perawatan di rumah sakit.. Data sekunder diambil dari rekam medis 60 pasien infark miokard akut yang dirawat di Unit Perawatan Jantung Intensif Rumah Sakit Dr. Wahidin Sudirohusodo, Makassar periode Juli 2010 hingga Juni 2011. Kadar CK-MB diperoleh saat masuk rumah sakit antara 3 jam hingga 1 minggu setelah onset. Rerata kadar CK-MB pada penderita infark miokard akut yang survive dan meninggal selama perawatan adalah 89,52+121,59 U/l dan 202,88+192,75U/l (Uji Mann Whitney, p=0,005). Ditemukan perbedaan tingkat mortalitas yang bermakna antar kuartil CK-MB masing-masing 13,3%, 6,7%, 40% dan 46,7% pada kuartil 1, 2, 3 dan 4 berturut-turut ( Uji Chi Square, p=0,031) tetapi risiko mortalitas antar kuartil tidak berbeda bermakna. Ditemukan perbedaan bermakna kadar CK-MB pada pasien yang survive maupun yang meninggal selama perawatan. Kata kunci : CK-MB, infark miokard, mortalitas