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"Indonesian Journal of Dentistry 2006; Edisi Khusus KPPIKG XIV: 7-11Mucous membrane pemphigoid (MMP) is an autoimmune mucocutaneous blistering disease characterized by autoantibodies to components within the basement membrane zone. The lesions may produce risk of scarring of the canthus (symblepharon), inversion of the eyelashes (entropion) and trauma to the cornea (trichiasis). We reported a case of MMP in a 56-year old female with diabetes mellitus and hypertension whose ocular involvement has lead to blindness of the right eye. The diagnosis MMP was base on the history and clinical findings in oral medicine department. Management of this patient inclueded the administration of antifungal, corticosteroid ; diaminodiphenylsulfone, nutritional supplementation. oral hygiene promotion and consultation to internal medicine specialist and opthalmologis. The improvement of oral lesions progressed well within five months. we conclude that optimal improvement can be reached by comprehesieve management with controlling systemic factors and good cooperation between medical team and patient. and patien"

"Mucous membrane pemphigoid (MMP) also known as cicatricial pemphigoid is a chronic autoimmune subepithelial blistering disease primarily affecting people over 50 years old. MMP may affect any mucosal surface which is particularly oral mucosal, conjungtiva, esophagus, or larinx is involved. MMP rarely occurs in children and adolescents, but several cases of MMP affecting 2 to 18 years old patients have been reported in previous studies. In this paper we reported a case of MMP in an eighteen year old male patient who had been diagnosed with oral mucous membrane pemphigoid by anamnesis, clinical feature, histopathology. The patient was treated with systemic corticosteroid, topical corticosteroid, oral rinse and multivitamins. Until recently corticosteroid remains as the most effective and the drug of choice to treat pemphigoid lesions. Clinicians need to pay attention in using this drug because of its potential side effect."

"Although basal cell carcinoma (BCC) is a common skin tumor, very rare cases of BCC arising from upper vermilion mucosa of lip have been reported previously. This tumor basically, originates from pillar structures and the involvement of the vermilion lip contrasts this concept so it is devoid of hair follicles and sweat glands. The exact pathogenesis of vermilion lip BCC is not clear but it has been postulated that the neoplasm originates from the pluripotential epithelial cells of the oral mucosa and epidermis. On the other hand, some authors consider their origin from ectopic sebaceous glands. Herein, we report a 34- year-old man with an asymptomatic ulcerated lesion on the upper left lip vermilion mucosa. The diagnosis of BCC was confirmed with histopathological examination after incisional biopsy of the mucosal neoplasm. After surgery of lip lesion, no recurrency was seen after 3 months follow-up the patient.

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Meskipun karsinoma sel basal (KSB) merupakan tumor kulit yang umum dijumpai, tetapi kasus-kasus KSB yang berasal dari mukosa merah bibir di bibir atas sangat jarang dilaporkan sebelumnya. Tumor ini pada dasarnya berasal dari struktur jaringan pilar dan keterlibatan bagian merah bibir sangat bertentangan dengan konsep ini sehingga struktur tersebut kekurangan folikel rambut dan kelenjar keringat. Patogenesis terjadinya KSB pada bagian merah bibir yang tepat masih belum jelas, tetapi telah dipostulasikan bahwa neoplasma tersebut berasal dari sel-sel epitel pluripoten di mukosa mulut dan epidermis. Sebaliknya, beberapa penulis memperkirakan bahwa asalnya adalah kelenjar sebasea ektopik. Di sini, kami melaporkan seorang lelaki berusia 34 tahun dengan lesi ulkus asimptomatik pada bagian merah bibir di bibir atas kiri. Diagnosis KSB dipastikan dengan pemeriksaan histopatologik setelah biopsi insisi pada mukosa neoplasma dilakukan. Setelah dilakukan pembedahan lesi bibir tersebut, tidak ditemukan kekambuhan setelah pasien dievaluasi lanjut selama 3 bulan."

"Diabetes Mellitus merupakan penyakit degeneratif yang jumlahnya terus meningkat setaip tahunnya. Individu yang menderita DM dengan gula darah yang tidak terkontrol sangat, berisiko mengalami luka ulkus diabetikum. Selain penanganan hiperglikemia dengan pemberian obat-obatan, perawatan luka ulkus diabetikum penting dilakukan untuk mencegah terjadi infeksi. Studi kasus ini bertujuan mengetahui efektifitas penggunaan antibiotik topikal pada perawatan luka ulkus diabetikum grade 1. Analisis dilakukan pada asuhan keperawatan yang diberikan di ruang rawat RSUPN Dr. Cipto Mangunkusumo. Evaluasi dilakukan dengan memonitoring proses penyembuhan luka ulkus selama perawatan. Hasil evaluasi menunjukkan bahwa proses penyembuhan luka ulkus dapat cepat mengering. Karya ilmiah ini menyarankan bahwa penggunaan antibiotik topikal sebagai alternatif jenis perawatan luka ulkus.

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Diabetes Mellitus is a degenerative disease whose numbers continue to increase every year. Individuals suffering from diabetes mellitus with uncontrolled blood sugar are at risk of developing diabetic ulcer. In addition to handling hyperglycemia by administering drugs, care for diabetic ulcer wounds is important to prevent infection. This case study aims to determine the effectiveness of using topical antibiotics in grade 1 diabetic ulcer wound care. The analysis was carried out on nursing care given in the hospital room Dr. RSUPN Cipto Mangunkusumo. Evaluation is done by monitoring the ulcer wound healing process during treatment. Evaluation results indicate that the ulcer wound healing process can dry out quickly. This scientific work suggests that the use of topical antibiotics as an alternative treatment of diabetic ulcer."

"Ketidakpatuhan terapi diabetes melitus (DM) dapat menimbulkan komplikasi kronis. Konseling dan booklet adalah bentuk edukasi yang dapat diberikan pada pasien DM tipe 2. Penelitian ini bertujuan untuk mengevaluasi efektivitas pemberian konseling dan booklet terhadap tingkat kepatuhan melalui penurunan kadar hemoglobin terglikasi (HbA1C) dan penurunan skor kuesioner Morisky Medication Adherence Scale (MMAS-8) pada pasien DM tipe 2. Penelitian merupakan pre-experimental yang dilaksanakan secara prospektif di RSUD dr. Adjidarmo pada bulan maret sampai bulan mei tahun 2014. Sampel penelitian adalah pasien DM tipe 2 berjumlah 30 orang yang masuk kriteria inklusi dan eksklusi dan diberikan intervensi konseling dan booklet. Kepatuhan diukur terhadap skor MMAS-8 dan kadar HbA1C sebelum dan sesudah 10 minggu pemberian intervensi. Skor MMAS-8 sebelum intervensi adalah sebesar 2,63±1,50, dan sesudah intervensi terjadi penurunan menjadi 0,7±1,18. Kadar HbA1C sebelum intervensi adalah sebesar 11,31±2,95, dan sesudah intervensi terjadi penurunan menjadi 8,12±2,79. Hasil pengukuran dianalisis dengan menggunakan uji Wilcoxon untuk MMAS-8 dan HbA1C. Hasil analisis menunjukkan ada perbedaan yang signifikan (p<0,001) terhadap kadar HbA1C dan skor MMAS-8 antara sebelum dan sesudah intervensi, dengan demikian penelitian ini mengindikasikan bahwa pemberian konseling dan booklet efektif meningkatkan kepatuhan pasien DM tipe 2.

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Non-compliance on diabetes mellitus medication leads to chronic complications. Counseling and booklet is a form of education that can be given to patients with type 2 diabetes. The Study aimed to evaluate the effectiveness of counseling and booklet on the level of compliance through reduced levels of glycated hemoglobin (HbA1C) and questionnaire scores of Morisky Medication Adherence Scale (MMAS-8) in patients with type 2 diabetes mellitus. This study was a pre-experimental prospectively conducted from march to may 2014 at RSUD dr. Adjidarmo. The samples were type 2 diabetic patients were 30 people who entered inclusion and exclusion criteria and given counseling intervention and booklet. Compliance is measured against the MMAS-8 scores and HbA1C levels before and after 10 weeks of administration of the intervention. MMAS-8 scores before and after intervention is 2,63±1,50 and 0,7±1,18. HbA1C levels before and after is 11,31±2,95 dan 8,12±2,79. The measurement results were analyzed using the Wilcoxon test for MMAS-8 and HbA1C. The analysis showed significant difference (p<0,001) of the value of HbA1C and MMAS-8 scores between before and after intervention, this study therefore indicates that the provision of counseling and booklet improve patient compliance with type 2 diabetes."

"ABSTRAKDiabetes Melitus Tipe 2 (DMT2) adalah masalah global yang sangat serius. Penyakit ini menyerang pada usia yang paling produktif sehingga dapat menurunkan derajat ekonomi dan mengurangi usia harapan hidup. Patogenesis DM sangat erat kaitannya dengan inflamasi, ditandai dengan peningkatan kadar sitokin proinflamasi seperti IL-6, IL-8 dan TNF. Namun, belum ada agen antiinflamasi yang terbukti berperan dalam tatalaksana DMT2. Butirat merupakan asam lemak rantai pendek yang diproduksi dari fermentasi pati resisten di lumen usus. Dalam kondisi normal butirat diserap dan digunakan sebagai sumber energi bagi sel kolonosit, hati dan otot. Butirat mampu berikatan dengan reseptor GPR41 dan GPR43 pada monosit sehingga mampu mengubah pola ekspresi sitokin, aktivasi, migrasi dan diferensiasi sel. Sehingga menarik untuk meneliti pengaruh butirat terhadap migrasi dan sitokin yang diekspresikan oleh monosit pada pasien DMT2. Kadar sitokin dihitung dari supernatan yang diambil dari kultur monosit . Sebanyak 37 subJek dibagi menjadi dua perlakuan yaitu kontrol dan dengan penambahan butirat. Monosit hari pertama diisolasi dalam gel kolagen tipe 1 untuk dilakukan uji migrasi menggunakan μ-slide chemotaxis IBIDI. Analisis gambar menggunakan software ImageJ dan Chemotaxis tool. Terdapat adanya perbedaan yang bermakna pada rasio TNF/IL 10 antara kelompok sehat dan DMT2. Butirat juga terlihat menekan produksi sitokin TNF dan meningkatkan produksi IL10. Indikator migrasi monosit seperti jarak akumulasi dan kecepatan migrasi memiliki perbedaan bermakna antara kelompok sehat dan DMT2. Butirat dapat menekan laju migrasi monosit diikuti dengan penurunan jarak dan kecepatan migrasi monosit

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ABSTRACTType 2 Diabetes Mellitus (DMT2) is a very serious global problem. This disease attacks at the most productive age so that it can reduce economic status and reduce life expectancy. The pathogenesis of DM is very closely related to inflammation. characterized by increased levels of proinflammatory cytokines such as IL-6, IL-8 and TNF. However, no anti-inflammatory agent has been proven to play a role in the management of T2DM. Butyrate is a short chain fatty acid produced from resistant starch fermentation in the intestinal lumen. In normal conditions the butyrate is absorbed and used as an energy source for colonocytes, liver and muscle cells. Butirate is able to bind to GPR41 and GPR43 receptors on monocytes so that it can change the pattern of cytokine expression, activation, migration and cell differentiation. So it is interesting to examine the effect of butyrate on migration and cytokines expressed by monocytes in T2DM patients. Cytokine levels were calculated from supernatants taken from monocyte cultures. A total of 37 subjects were divided into two treatments, namely control and with addition of butyrate. The first day monocytes were isolated in type 1 collagen gel for migration testing using the slide chemotaxis IBIDI. Image analysis using ImageJ and Chemotaxis tool software. There was a significant difference in the TNFα / IL 10 ratio between healthy groups and T2DM. Butyrate also appears to suppress TNF cytokine production and increase IL10 production. Monocyte migration indicators such as accumulation distance and migration speed have significant differences between healthy groups and T2DM. Butirat can reduce inflammation responds and the distance and speed of monocyte migration"