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"ABSTRAKSindrom metabolik MetS adalah kumpulan faktor yang kompleks dan saling berhubungan, yang meningkatkan risiko penyakit jantung dan diabetes mellitus tipe 2. Resistensi insulin dan obesitas sentral dianggap sebagai penyebab utama dari sindrom metabolik, sehingga penurunan resistensi insulin menjadi tujuan klinis yang penting saat ini. Beberapa studi menyimpulkan bahwa akupunktur dapat meningkatkan sensitivitas insulin, karena itu efektif untuk mengatasi gangguan metabolik Uji klinis acak tersamar tunggal dengan pembanding dilakukan pada 50 penderita sindrom metabolik yang dibagi secara acak ke dalam dua kelompok, kelompok elektroakupunktur dan medikamentosa n = 25 serta kelompok elektroakupunktur sham dan medikamentosa n=25 . Elektroakupunktur dilakukan 2 kali seminggu sebanyak 10 kali tindakan di titik CV12 Zhongwan, CV4 Guanyuan, ST25 Tianshu, ST36 Zusanli, ST40 Fenglong, SP6 Sanyinjiao, dan MA-IC3 Endokrin. Dilakukan pemeriksaan gula darah puasa dan insulin puasa untuk mengukur HOMA-IR sebagai luaran primer. Hasilnya terdapat perbedaan bermakna secara statistik perubahan HOMA-IR antara kelompok elektroakupunktur dan medikamentosa dengan kelompok elektroakupunktur sham dan medikamentosa -1,66 2,187 dan -0,29 2,388, p = 0,044 . Terapi kombinasi elektroakupunktur dan medikamentosa efektif untuk menurunkan resistensi insulin pada penderita sindrom metabolik.

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ABSTRACTThe metabolic syndrome is a complex disorder defined by a cluster of interconnected factors that increase the risk of cardiovascular diseases and diabetes mellitus type 2. Insulin resistance and central obesity are considered significant factors as the underlying cause of the metabolic syndrome, since reduction of insulin resistance is an important clinical goal today. Several studies have concluded that acupuncture can improve insulin sensitivity, as it is effective against metabolic disturbances. A single blind randomized controlled trial involved 50 patients randomly allocated into two groups electroacupuncture with medication group n 25 or sham electroacupunture with medication group n 25 . Electroacupuncture therapy was given twice a week for ten times at CV12 Zhongwan, CV4 Guanyuan, ST25 Tianshu, ST36 Zusanli, ST40 Fenglong, SP6 Sanyinjiao, and MA IC3 Endocrine. Fasting blood glucose and fasting insulin serum were assessed to measure HOMA IR as the primary outcome. There was a statistically significant difference in changing of HOMA IR between electroacupuncture with medication group and sham electroacupunture with medication group 1,66 2,187 and 0,29 2,388, p 0.044 . Electroacupuncture with medical treatment effectively decreased insulin resistance of metabolic syndrome patients."

"Sindrom ovarium polikistik (SOPK) adalah salah satu kelainan endokrin yang paling umum terjadi pada wanita usia reproduktif. Patogenenesis SOPK berhubungan langsung dengan resistensi insulin. Beberapa studi menyimpulkan bahwa akupunktur dapat meningkatkan sensitivitas insulin sehingga dapat memperbaiki gejala SOPK. Uji klinis acak tersamar ganda dilakukan pada 44 penderita SOPK yang dibagi secara acak ke dalam dua kelompok, yakni kelompok elektroakupunktur kombinasi medikamentosa (n=22) dan kelompok elektroakupunktur sham kombinasi medikamentosa (n=22). Elektroakupunktur dilakukan 3 kal seminggu, sebanyak 12 kali, selama 4 minggu, pada titik CV3 Zhongji, CV4 Guanyuan, CV6 Qihai, ST25 Tianshu, ST28 Shuidao, ST36 Zusanli, SP6 Sanyinjiao, dan BL57 Chengsan. Pemeriksaan gula darah puasa dan insulin puasa dilakukan untuk mengukur indeks HOMA-IR sebagai luaran primer. Hasil penelitian menunjukkan adanya perbedaan yang bermakna. Median indeks HOMA-IR pada kelompok elektroakupunktur kombinasi medikamentosa sebelum dan sesudah terapi menunjukkan perbedaan bermakna secara statistik (p=0,014). Sedangkan median indeks HOMA-IR pada kelompok elektroakupunktur sham kombinasi medikamentosa sebelum dan sesudah terapi tidak terdapat perbedaan bermakna (p=0,592). Kesimpulan penelitian ini elektroakupunktur kombinasi medikamentosa efektif untuk meningkatkan sensitivitas insulin.

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Polycystic ovary syndrome (SOPK) is one of the most common endocrine disorders in women of reproductive age. The pathogenesis of SOPK is directly related to insulin resistance. Several studies have concluded that acupuncture can increase insulin sensitivity to improve symptoms of PCOS. Double-blind randomized clinical trials were performed on 44 patients with SOPK who were randomly divided into two groups, the electroacupuncture with medication group (n=22) and the electroacupuncture sham with medication group (n=22). Electroacupuncture was given 3 times a week, 12 times, for 4 weeks, at the point of CV3 Zhongji, CV4 Guanyuan, CV6 Qihai, ST25 Tianshu, ST28 Shuidao, ST36 Zusanli, SP6 Sanyinjiao, and BL57 Chengsan. Fasting blood glucose and fasting insulin were performed to measure the HOMA-IR index as the primary outcome. The results showed a significant difference. The median HOMA-IR index in the electroacupuncture with medication group before and after therapy showed statistically significant differences (p = 0.014). While median HOMA-IR index in electroacupuncture sham with medication group before and after therapy there was no significant difference (p = 0.592). The conclusion of this study electroacupuncture combination with medication is effective to improve insulin sensitivity. "

"ABSTRAKSindrom metabolik adalah sekelompok kelainan metabolik yang terdiri dari obesitas, resistensi insulin, dislipidemia dan hipertensi. Setiap komponen dari sindrom metabolik sebagai faktor risiko mayor kardiovaskular. Dislipidemia sebagai faktor risiko utama penyakit kardiovaskular. Penanganan sindrom metabolik memerlukan tatalaksana yang menyeluruh baik farmakologik maupun non farmakologik. Penelitian menunjukkan bahwa akupunktur dapat memperbaiki dislipidemia seperti menurunkan kadar kolesterol total, trigliserida dan LDL serta meningkatkan HDL. Penelitian ini bertujuan untuk mengetahui efektivitas terapi kombinasi elektroakupunktur dan medikamentosa terhadap profil lipid dan lingkar perut penderita sindrom metabolik. Uji klinis acak tersamar tunggal dengan kontrol sham dilakukan pada 50 penderita sindrom metabolik yang dialokasikan secara acak menjadi kelompok terapi kombinasi elektroakupunktur dan medikamentosa kelompok elektroakupunktur atau kelompok terapi kombinasi elektroakupunktur sham dan medikamentosa kelompok kontrol . Kadar kolesterol total, HDL, LDL, trigliserida dan lingkar perut digunakan untuk mengukur keluaran penelitian. Hasil penelitian menunjukkan perbedaan bermakna lingkar perut kelompok elektroakupunktur sebesar -4,00 -5,00 ndash; -2 cm dibandingkan kelompok kontrol 0,00 -2 ndash; 3,00 cm

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ABSTRACTMetabolic syndrome is a group of metabolic abnormalities including obesity, insulin resistance, dyslipidemia and hypertension. Each component of the metabolic syndrome is a major cardiovascular risk factor. Dyslipidemia is a major risk factor for cardiovascular disease. Treatment of metabolic syndromes requires a comprehensive management of both pharmacologic and nonpharmacologic. Study showed that acupuncture can improve dyslipidemia such as lowering total cholesterol, triglycerde, LDL and increasing HDL. This study aims to determine the effectiveness of combination therapy of electroacupuncture and medicatian on lipid profile and waist circumference of metabolic syndrome patients. Single blinded randomized clinical trials with sham control were performed on 50 patients with metabolic syndrome that randomized into a combination group of electroacupuncture and medication electroacupuncture group or a combination group of sham electroacpuncture and medication control group . Total cholesterol levels, HDL, LDL, triglycerides and waist circumference used to measure the study outcomes. The results showed that waist circumference in electroacupuncture group decreased significantly 0f 4,00 5,00 ndash 2 cm compared to the control group of 0,00 2 ndash 3,00 cm, p"

"Sindrom ovarium polikistik (SOPK) merupakan suatu kondisi umum endokrinopati yang ditandai dengan adanya oligoovulasi atau anovulasi, produksi androgen berlebih, dan adanya kista ovarium kecil multipel yang diidentifikasi secara sonografis (kriteria Rotterdam, 2004). SOPK ditemukan pada 10% populasi wanita usia reproduksi dan berhubungan erat dengan disfungsi ovulasi sehingga menurunkan angka fertilitas. Tujuan penelitian ini adalah untuk mengetahui pengaruh terapi kombinasi elektroakupunktur dan medikamentosa terhadap SOPK. Uji klinis acak tersamar ganda dengan kontrol dilakukan terhadap 44 subjek dengan SOPK yang dialokasikan secara acak ke dalam kelompok elektroakupunktur sejati dan medikamentosa (n=22), serta kelompok elektroakupunktur sham dan medikamentosa (n=22). Penilaian menggunakan pencitraan USG transvaginal dan perhitungan panjang siklus menstruasi sebelum dan sesudah perlakuan. Hasil penelitian menunjukkan terdapat perbedaan bermakna rerata volume ovarium antara kedua kelompok sebelum dan sesudah perlakuan (p=0,002); penurunan jumlah folikel antral (p=0,005); angka kejadian menstruasi (p=0,001); dan pemendekan siklus menstruasi (p=0,003). Kesimpulan penelitian ini elektroakupunktur dan medikamentosa memberikan perbaikan terhadap keluhan dan gambaran ovarium pada pasien SOPK.

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Polycystic Ovarian Syndrome (PCOS) is a general endocrinopathy condition that signed with oligoovulation or anovulation cycle, excess androgen production, and an image of multiple small cysts identified by transvaginal ultrasound (Rotterdam criteria, 2004). PCOS found in 10% of reproductive women and highly corresponded with ovulation dysfunction and finally decrease the fertility rate. The goal of this study is to know the effect of electroacupuncture combined with medical treatment in PCOS. A double blind randomized controlled trial is performed in 44 subjects with PCOS and divided into true electroacupuncture combined with medical treatment group (n=22) and sham electroacupuncture combined with medical treatment group (n=22). Ovarian volume and antral follicle are evaluated with transvaginal ultrasound and the length of menstrual cycle is counted before and after the treatment. The results show there are significant mean differences between ovarian volume in two groups before and after treatment (p=0,002); antral follicle count (p=0,005); menstrual incidence during the treatment (p=0,001); and shortened menstrual cycle (p=0,003). The conclusion of this study is electroacupuncture combined with medical treatment could improve PCOS patients’ compaint and ovarian image."

"Latar Belakang. Prevalensi sindrom metabolik (SM) semakin meningkat di daerah ruralIndonesia. Kunci patogenesis SM adalah resistensi insulin yang dapat didiagnosis denganHomeostasis Model Assessment of Insulin Resistance (HOMA-IR) dan IndeksTriglyceride/Glucose (TyG). Hingga saat ini, belum ada nilai titik potong optimal untukindeks tersebut di Indonesia.Metode. Sebanyak 1300 subjek orang dewasa berusia 18-60 tahun dari studi Sugarspin diNangapanda, Flores, Indonesia dibagi menjadi dua grup berdasarkan jenis kelamin.Penentuan nilai titik potong HOMA-IR dan Indeks TyG pada setiap grup dilakukan dengankalkulasi persentil 75 (p75) dan 90 (p90) pada populasi sehat dan dengan metode receiveroperating characteristics (ROC) pada populasi SM dan non-SM. Korelasi antara HOMAIRdan Indeks TyG dinilai dengan korelasi Spearman pada subjek laki-laki dan perempuan.Hasil. Berdasarkan kedua metode, titik potong HOMA-IR dan Indeks TyG berbeda-bedaantara laki-laki dan perempuan. Nilai titik potong HOMA-IR berdasarkan persentil padalaki-laki sehat adalah 0,9 (p75) dan 1,242 (p90); sedangkan pada perempuan adalah 1,208(p75) dan 1,656 (p90). Berdasarkan ROC, titik potong HOMA-IR antara populasi SM dannon-SM pada laki-laki adalah 1,185 dan pada perempuan adalah 1,505. Nilai titik potongIndeks TyG pada laki-laki sehat adalah 8,590 (p75) dan 8,702 (p90); sedangkan padaperempuan adalah 8,448 (p75) dan 8,617 (p90). Berdasarkan ROC, titik potong Indeks TyGadalah 8,905 untuk laki-laki dan 8,695 untuk perempuan. Koefisien korelasi HOMA-IRdan Indeks TyG ialah 0,39 pada laki-laki dan 0,36 pada perempuan.Kesimpulan. Nilai titik potong HOMA-IR untuk resistensi insulin pada laki-laki adalah0,9 (p75), 1,242 (p90), dan 1,185 (ROC); pada perempuan adalah 1,208 (p75), 1,656 (p90),dan 1,505 (ROC). Nilai titik potong Indeks TyG pada laki-laki adalah 8,59 (p75), 8,702(p90), dan 8,905 (ROC); pada perempuan adalah 8,448 (p75), 8,617 (p90), dan 8,695(ROC). Didapatkan hasil korelasi yang lemah antara HOMA-IR dan Indeks TyG.

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Background. Metabolic Syndrome (MS) prevalence is increasing in Indonesia's rural area.

The key pathogenetic mechanism of MS is insulin resistance which can be diagnosed by

Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) and

Triglyceride/Glucose (TyG) Index. There are no predefined cut-offs for these indexes in

Indonesia.

Methods. As many as 1300 adults aged 18-60 years from Sugarspin study in Nangapanda,

Flores, Indonesia were divided into different groups based on sex. We determined the cutoff

points of HOMA-IR and TyG Index in each group by calculation of the 75th (p75) and

90th percentiles (p90) in healthy subjects and by receiver operating characteristics (ROC)

analysis of MS and non-MS subjects. Correlation between HOMA-IR and TyG Index was

performed in both sexes by Spearman's correlation.

Results. Using both methods, HOMA-IR and TyG Index cut-offs were different between

males and females. The HOMA-IR cut-offs for healthy males were 0.9 (p75) and 1.242

(p90); for healthy females were 1.208 (p75) and 1.656 (p90). By ROC, the HOMA-IR cutoff

for males was 1.185 and for females was 1.505. The TyG Index cut-offs for healthy

males were 8.590 (p75) and 8.702 (p90); for healthy females were 8.448 (p75) and 8.617

(p90). The TyG Index ROC cut-offs were 8.905 for males and 8.695 for females. The

correlation coefficients between HOMA-IR and TyG Index were 0.39 for males and 0.36

for females.

Conclusion. The HOMA-IR cut-offs for males were 0.9 (p75), 1.242 (p90), and 1.185

(ROC); for females were 1.208 (p75), 1.656 (p90), and 1.505 (ROC). The TyG Index cutoffs

for males were 8.590 (p75), 8.702 (p90), and 8.905 (ROC); for females were 8.448

(p75), 8.617 (p90), and 8.695 (ROC). The correlation between HOMA-IR and TyG Index

was weak."

"ABSTRAK Latar Belakang. Disfungsi miokardiak subklinis merupakan salah satu konsekuensi berbahaya dari sindrom metabolik, dimana diduga disebabkan oleh resistensi insulin. Kelainan tersebut merupakan kondisi patologis awal, yang berisiko menimbulkan gagal jantung ke depannya. Melalui Two Dimensional-Speckle Tracking Echocardiography 2D-STE dengan parameter Global Longitudinal Strain GLS yang memiliki sensitivitas dan spesifisitas tinggi, disfungsi miokardiak tersebut dapat dideteksi lebih dini. Tujuan Mengetahui hubungan antara resistensi insulin pada sindrom metabolik terhadap disfungsi sistolik VKi subklinis.Metode. Studi ini merupakan studi potong lintang, dengan menggunakan 483 datasekunder dari pegawai RS Jantung Harapan Kita. Dari total data, 119 subjek masuk dalam kriteria inklusi dan eksklusi, yang kemudian dilakukan pemeriksaan GLS.Subjek tersebut terbagi menjadi dua kelompok non resistensi insulin dan resistensi insulin berdasarkan nilai Homeostasis Model Assessment of Insulin Resistance HOMA-IR dengan nilai cut-off 2.0.Hasil. Terdapat perbedaan nilai GLS yang bermakna antara kelompok resistensi insulin dan non resistensi insulin rerata -18.3 SD 3.05 vs -19.7 2.2 , 95 IK -2.39 ndash; -0.37 , p=0.008 . Variabel resistensi insulin memiliki risiko terbesar diikuti variabel trigliserida adjusted OR 2.8, p=0.009 dan 2.4, p=0.03 secara berurutan terhadap disfungsi sistolik VKi subklinis pada sindrom metabolik. Kesimpulan. Resistensi insulin menunjukkan fungsi sistolik VKi yang lebihrendah secara signifikan yang dinyatakan dengan nilai GLS dibandingkan nonresistensi insulin pada sindrom metabolik. Resistensi insulin dan trigliserida adalah petanda independen disfungsi sistolik VKi subklinis diantara komponen sindrom metabolik lain.Kata kunci. resistensi insulin, HOMA-IR, disfungsi sistolik VKi subklinis, GLS,sindrom metabolik, trigliseridaABSTRACT Background. Subclinical myocardial dysfunction is a dangerous consequence ofthe metabolic syndrome, which is thought to be caused by insulin resistance. Thedisorder is an early pathological condition, which poses a risk of heart failure in thefuture. Through Two Dimensional Speckle Tracking Echocardiography 2D STE with the Global Longitudinal Strain GLS parameters that have high sensitivityand specificity, these myocardial dysfunctions can be detected earlier.Objective. To determine the relationship between insulin resistance in metabolicsyndrome to subclinical left ventricle systolic dysfunction.Methods. A cross sectional study, using 483 secondary data from employees of theNational Heart Center of Harapan Kita. 119 subjects were included in the inclusionand exclusion criteria, which were performed 2D STE with GLS parameter. Thesubjects were divided into two groups of non insulin resistance and insulinresistance based on the value of Homeostasis Model Assessment of InsulinResistance HOMA IR with a cut off value of 2.0.Results. There were significant differences in GLS values between the insulinresistance group and non insulin resistance mean 18.3 SD 3.05 vs 19.7 2.2 ,95 CI 2.39 0.37 , p 0.008 . Insulin resistance have the greatest risk followedby triglyceride levels adjusted OR 2.8, p 0.009 and 2.4, p 0.03 respectively tosubclinical left ventricle systolic dysfunction in the metabolic syndrome.Conclusion. Insulin resistance showed a lower left ventricle systolic function asexpressed by GLS score significantly than non insulin resistance in the metabolicsyndrome. Insulin resistance and triglycerides are an independent marker ofsubclinical left ventricle systolic dysfunction among other components of themetabolic syndrome. "

"Irritable bowel syndrome (IBS) merupakan kelainan fungsional saluran cerna berupa rasa nyeri atau tidak nyaman di abdomen yang timbul bersamaan dengan minimal dua dari tiga gejala, yaitu perbaikan keluhan setelah defekasi, perubahan frekuensi defekasi, atau perubahan konsistensi feses. IBS menjadi masalah kesehatan karena tata laksana yang belum optimal sehingga berbagai modalitas terapi dikembangkan, salah satunya akupunktur tanam benang. Penelitian ini bertujuan untuk mengetahui pengaruh terapi kombinasi akupunktur tanam benang dan medikamentosa terhadap gejala dan kualitas hidup penderita IBS. Uji klinis acak tersamar ganda dengan pembanding dilakukan pada 50 penderita IBS yang dialokasikan ke dalam kelompok kombinasi akupunktur tanam benang dan medikamentosa atau kelompok akupunktur sham dan medikamentosa. Skor IBS Symptom Severity Scale (IBS-SSS) dan IBS Quality of Life (IBS-QoL) digunakan untuk mengukur keluaran penelitian. Hasil penelitian menunjukkan perbedaan bermakna rerata skor IBS-SSS sebesar 71,60 lebih rendah (p = 0,000; 95% IK: - 96,36 sampai -30,15) dan skor IBS-QoL sebesar 13,08 lebih rendah (p = 0,000; 95% IK: -16,92 sampai -9,25) pada kelompok terapi kombinasi akupunktur tanam benang dan medikamentosa dibandingkan dengan kelompok akupunktur sham dan medikamentosa. Kesimpulan penelitian adalah terapi kombinasi akupunktur tanam benang dan medikamentosa lebih efektif mengurangi gejala dan meningkatkan kualitas hidup penderita IBS.

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IBS is a functional gastrointestinal disorder characterized by abdominal pain or discomfort associated with improvement with defecation and/or change of frequency or form of stool. Current medical treatments of IBS patients are still unsatisfying, hence other modalities are continuously being improved such as acupoint-catgut embedment.

The aim of this study was to establish the effect of acupoint-catgut embedment combined with medical treatment on symptoms and quality of life of IBS patients. A double blind randomized controlled trial involved 50 IBS patients randomly allocated into catgut embedding therapy with medication group or medication only group. Catgut embedding therapy was given three times at ST 25 Tianshu, ST 36 Zusanli, and ST 37 Shangjuxu every 10 days. IBS-SSS and IBS-QoL were used to measure the primary outcome.

There was a statistically significant difference between groups at one month; with IBS-SSS and IBS-QoL were 71.60 (p = 0,000; 95% CI: -96,36 to -30,15) and 13.08 point (p = 0,000; 95% CI: -16,92 to -9,25) lower in catgut embedding therapy with medication group. The results suggested that acupoint-catgut embedment combined with medical treatment is more effective than medical treatment in alleviating symptoms and enhancing the quality of life of IBS patients."

"Pendahuluan: Resistensi insulin berperan dalam perkembangan prediabetes menjadi diabetes melitus tipe 2 (DMT2). Kondisi ini ditandai dengan adanya hiperglikemia dan hiperinsulinemia. Modifikasi gaya hidup menjadi pilihan utama dalam mencegah progresivitas prediabetes menjadi diabetes. Meskipun pemberian farmakoterapi seperti metformin, thiazolidinedione, dan inhibitor alfa-glukosidase banyak diteliti efektivitasnya dalam mencegah diabetes, namun penggunaannya masih terbatas dan menimbulkan efek samping. Potensi antidiabetes pada tanaman herbal sudah banyak diteliti, salah satunya jati belanda (Guazuma ulmifolia). Kandungan senyawa seperti flavonoid pada ekstrak etanol daun Guazuma ulmifolia diketahui memiliki efek antioksidan dan antihiperglikemia sehingga dapat diteliti sebagai alternatif untuk memperbaiki resistensi insulin pada kondisi prediabetes yang dapat diukur dengan HOMA IR. Metode: Tikus Wistar Jantan dibagi menjadi 5 kelompok yakni normal, kontrol negatif, dan 3 kelompok uji yang diberi diet tinggi lemak fruktosa serta tambahan ekstrak etanol daun Guazuma ulmifolia dengan dosis yang berbeda (25, 50, dan 100 mg/kgBB) selama 3 bulan. Pengukuran glukosa darah puasa dilakukan sebelum dan sesudah induksi, sementara kadar insulin puasa diukur dengan ELISA setelah induksi. Kemudian, kadar glukosa darah puasa dan insulin akan dikalkulasikan sesuai dengan formulasi untuk mendapatkan nilai HOMA IR. Hasil: Pemberian ekstrak etanol daun Guazuma ulmifolia tidak menurunkan kadar insulin puasa dan nilai HOMA-IR secara signifikan (p>0.05) pada kelompok uji dibandingkan kelompok negatif. Kelompok uji yang diberikan dosis 50 mg/kgBB menunjukkan kadar insulin dan nilai HOMA-IR yang lebih rendah, tetapi tidak signifikan secara statistik (p>0.05) dibandingkan kelompok negatif. Kesimpulan: Pemberian ekstrak etanol Guazuma ulmifolia L pada dosis 25, 50, dan 100 mg/kgBB tidak dapat menurunkan kadar insulin puasa dan nilai HOMA IR pada kelompok uji.

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Introduction: Insulin resistance plays a role in the progression of prediabetes to type 2 diabetes mellitus (T2DM). This condition is characterized by the presence of hyperglycemia and hyperinsulinemia. Lifestyle modification is the main option in preventing the progression of prediabetes to diabetes. Although pharmacotherapy such as metformin, thiazolidinedione, and alpha-glucosidase inhibitors have been studied for their effectiveness in preventing diabetes, their use is still limited and causes side effects. The antidiabetic potential of herbal plants has been widely studied, one of which is jati belanda (Guazuma ulmifolia). The content of compounds such as flavonoids in the ethanol extract of Guazuma ulmifolia leaves is known to have antioxidant and antihyperglycemia effects so that it can be studied as an alternative to improve insulin resistance in prediabetes conditions that can be measured by HOMA IR. Methods: Male Wistar rats were divided into 5 groups, namely normal, negative control, and 3 test groups that were given a high-fat fructose diet and additional ethanol extract of Guazuma ulmifolia leaves at different doses (25, 50, and 100 mg/kgBB) for 3 months. Fasting blood glucose measurements were taken before and after induction while fasting insulin levels were measured after induction by ELISA. Then, fasting blood glucose and insulin levels will be calculated according to the formulation to obtain the HOMA IR value. Results : Ethanol extract of Guazuma ulmifolia leaves did not significantly reduce fasting insulin levels and HOMA-IR values (p>0.05) in the test group compared to the negative group. The test group given a dose of 50 mg/kgBB showed lower insulin levels and HOMA-IR values, but not statistically significant (p>0.05) compared to the negative group. Conclusion: Guazuma ulmifolia L ethanol extract at doses of 25, 50, and 100 mg/kgBB could not reduce fasting insulin levels and HOMA IR values in the test group."

"ABSTRAKObesitas adalah akumulasi lemak yang berlebih yang dapat mengganggu kesehatan sebagai akibat ketidakseimbangan asupan dan pengeluaran energi. Obesitas merupakan penyakit kronis yang dapat menjadi faktor risiko penyakit metabolik kronis yang dapat menyebabkan kematian. Lingkar pinggang merupakan cara yang sederhana untuk menilai distribusi lemak tubuh dalam memprediksi morbiditas dan mortalitas yang disebabkan oleh obesitas. Adiponektin merupakan hormon protein yang disekresi oleh sel adiposit yang mempunyai efek anti diabetes, anti inflamasi, anti aterogenik, dan efek kardioprotektif. Untuk mendapatkan hasil optimal diperlukan tatalaksana interdisiplin. Beberapa studi menyimpulkan bahwa elektroakupunktur dapat meningkatkan kadar adiponektin dan menurunkan lingkar pinggang pada pasien obesitas. Pada penelitian ini dilakukan uji klinis tersamar tunggal terhadap 38 pasien obesitas yang secara acak dibagi kedalam 2 kelompok yaitu Elektroakupunktur dan intervensi diet dan kelompok elektroakupunktur sham dan intervensi diet untuk mengetahui pengaruh elektroakupunktur dan intervensi diet terhadap lingkar pinggang dan kadar adiponektin. Hasil penelitian menunjukkan penurunan lingkar pinggang yang bermakna sesudah perlakuan baik pada kelompok perlakuan p=0,000 maupun kelompok kontrol p=0,002 . Terdapat perbedaan bermakna terhadap selisih lingkar pinggang awal dan akhir antara kedua kelompok p=0,002 , namun pada pengukuran adiponektin tidak menunjukkan perubahan bermakna sebelum dan setelah perlakuan baik pada kelompok perlakuan p=0,409 maupun pada kelompok kontrol 0,306. Tidak terdapat perbedaan bermakna antara kedua kelompok p=0,638. Dalam penelitian ini disimpulkan bahwa terapi kombinasi elektroakupunktur dan intervensi diet memiliki pengaruh terhadap lingkar pinggang namun tidak berpengaruh terhadap perubahan kadar adiponektin pada pasien obesitas.

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ABSTRACT<>br>Obesity is the accumulation of excess fat that can interfere with health as a result of theimbalance of energy intake and expenditure. Obesity is a chronic disease that can be arisk factor for chronic metabolic disease that can lead to death. Waist circumference isa simple way to assess the distribution of body fat in predicting morbidity and mortalitycaused by obesity. Adiponectin is a protein hormone secreted by adipocyte cells thathave anti diabetic, anti inflammatory, anti atherogenic, and cardioprotective effects. Toobtain optimal results required interdisciplinary management. Several studies haveconcluded that electroacupuncture can increase adiponectin levels and decrease waistcircumference in obese patients. In this study a single blinded clinical trial of 38 obesepatients was randomly divided into 2 groups electroacupuncture and dietaryinterventions and electroacupuncture sham groups and dietary interventions todetermine the effectiveness of electroacupuncture and dietary intervention of waistcircumference and adiponectin levels. The results showed a significant decrease inwaist circumference after treatment in both treatment groups p 0,000 and controlgroup p 0.002 . There was a significant difference in waist circumference betweenthe two groups p 0.002 , but the measurement of adiponectin showed no significantchange before and after treatment in both treatment groups p 0.409 and in thecontrol group 0.306. There were no significant differences between the two groups p 0.638. In this study it was concluded that combination electroacupuncture anddietary intervention therapy had an effect on waist circumference in obese patients"

"ABSTRAK Gastroesophageal reflux disease (GERD) merupakan suatu kondisi patologis yang disebabkan oleh refluks kandungan lambung ke dalam esofagus. GERD memiliki dampak yang besar terhadap penderitanya baik secara fisik, psikologik, sosial maupun ekonomi. Penurunan kualitas hidup dan produktifitas kerja sering ditemukan pada penderita GERD. Berbagai terapi farmakologis telah dikembangkan, namun belum memberikan hasil yang optimal. Hal tersebut mendorong pengembangan modalitas terapi lain, salah satunya akupunktur tanam benang. Penelitian ini bertujuan untuk mengetahui efektifitas terapi kombinasi akupunktur tanam benang dan medikamentosa terhadap gejala dan kualitas hidup penderita GERD. Uji klinis acak tersamar ganda dengan pembanding dilakukan terhadap 52 penderita GERD yang dialokasikan secara acak ke dalam kelompok kombinasi akupunktur tanam benang dan medikamentosa (kelompok perlakuan) atau kelompok akupunktur sham dan medikamentosa (kelompok kontrol). Akupunktur tanam benang dilakukan pada titik CV12 Zhongwan, ST36 Zusanli dan BL21 Weishu sebanyak 2 kali dengan interval 15 hari. Skor GERDQ, RQS dan SF-36 digunakan untuk mengukur keluaran terapi. Hasil penelitian menunjukkan bahwa penurunan skor GERDQ pada kelompok perlakan lebih besar dari kelompok kontrol (p<0,001) dan peningkatan skor RQS serta peningkatan skor seluruh komponen SF-36 pada kelompok perlakuan lebih besar dibanding kelompok kontrol (p<0,001). Kesimpulan penelitian adalah terapi kombinasi akupunktur tanam benang dan medikamentosa lebih efektif dalam mengurangi gejala dan meningkatkan kualitas hidup penderita GERD dibandingkan dengan terapi medikamentosa saja ABSTRACT Gastroesophageal reflux disease (GERD) is a pathological condition caused by reflux of gastric contents into the esophagus. It has been shown that GERD has significant impact on patients either physically, psychologically, socially or economically. Impaired of quality of life and working productivity are common in GERD patients. Various pharmacological therapies have been developed, but not yet provide optimal results. It encourages the development of other therapeutic modalities, such as acupoint catgut embedment. The aim of this study was to establish the effect of acupoint catgut embedment combine with medical treatment on symptom and quality of life of GERD patients. A double-blind randomized controlled trial involved 52 GERD patients randomly allocated into catgut embedding therapy with medication group (treatment group) or medication only group (control group). Catgut embedding therapy was given 2 times at CV12 Zhongwan, ST36 Zusanli and BL21 Weishu every 15 days. GERDQ, RQS and SF-36 were used to measure the primary outcomes. The result shown, the decreased of GERDQ scores at treatments group significant higher than control groups (p<0,001), the increased of RQS score and all of SF-36 components scores at treatment group significant higher than control group (p<0,001). The result suggested that acupoint-catgut embedment combined with medical treatment is more effective than medical treatment in alleviating symptoms and enhancing the quality of life of GERD patients.;Gastroesophageal reflux disease (GERD) is a pathological condition caused by reflux of gastric contents into the esophagus. It has been shown that GERD has significant impact on patients either physically, psychologically, socially or economically. Impaired of quality of life and working productivity are common in GERD patients. Various pharmacological therapies have been developed, but not yet provide optimal results. It encourages the development of other therapeutic modalities, such as acupoint catgut embedment. The aim of this study was to establish the effect of acupoint catgut embedment combine with medical treatment on symptom and quality of life of GERD patients. A double-blind randomized controlled trial involved 52 GERD patients randomly allocated into catgut embedding therapy with medication group (treatment group) or medication only group (control group). Catgut embedding therapy was given 2 times at CV12 Zhongwan, ST36 Zusanli and BL21 Weishu every 15 days. GERDQ, RQS and SF-36 were used to measure the primary outcomes. The result shown, the decreased of GERDQ scores at treatments group significant higher than control groups (p<0,001), the increased of RQS score and all of SF-36 components scores at treatment group significant higher than control group (p<0,001). The result suggested that acupoint-catgut embedment combined with medical treatment is more effective than medical treatment in alleviating symptoms and enhancing the quality of life of GERD patients.;Gastroesophageal reflux disease (GERD) is a pathological condition caused by reflux of gastric contents into the esophagus. It has been shown that GERD has significant impact on patients either physically, psychologically, socially or economically. Impaired of quality of life and working productivity are common in GERD patients. Various pharmacological therapies have been developed, but not yet provide optimal results. It encourages the development of other therapeutic modalities, such as acupoint catgut embedment. The aim of this study was to establish the effect of acupoint catgut embedment combine with medical treatment on symptom and quality of life of GERD patients. A double-blind randomized controlled trial involved 52 GERD patients randomly allocated into catgut embedding therapy with medication group (treatment group) or medication only group (control group). Catgut embedding therapy was given 2 times at CV12 Zhongwan, ST36 Zusanli and BL21 Weishu every 15 days. GERDQ, RQS and SF-36 were used to measure the primary outcomes. The result shown, the decreased of GERDQ scores at treatments group significant higher than control groups (p<0,001), the increased of RQS score and all of SF-36 components scores at treatment group significant higher than control group (p<0,001). The result suggested that acupoint-catgut embedment combined with medical treatment is more effective than medical treatment in alleviating symptoms and enhancing the quality of life of GERD patients.;Gastroesophageal reflux disease (GERD) is a pathological condition caused by reflux of gastric contents into the esophagus. It has been shown that GERD has significant impact on patients either physically, psychologically, socially or economically. Impaired of quality of life and working productivity are common in GERD patients. Various pharmacological therapies have been developed, but not yet provide optimal results. It encourages the development of other therapeutic modalities, such as acupoint catgut embedment. The aim of this study was to establish the effect of acupoint catgut embedment combine with medical treatment on symptom and quality of life of GERD patients. A double-blind randomized controlled trial involved 52 GERD patients randomly allocated into catgut embedding therapy with medication group (treatment group) or medication only group (control group). Catgut embedding therapy was given 2 times at CV12 Zhongwan, ST36 Zusanli and BL21 Weishu every 15 days. GERDQ, RQS and SF-36 were used to measure the primary outcomes. The result shown, the decreased of GERDQ scores at treatments group significant higher than control groups (p<0,001), the increased of RQS score and all of SF-36 components scores at treatment group significant higher than control group (p<0,001). The result suggested that acupoint-catgut embedment combined with medical treatment is more effective than medical treatment in alleviating symptoms and enhancing the quality of life of GERD patients.;Gastroesophageal reflux disease (GERD) is a pathological condition caused by reflux of gastric contents into the esophagus. It has been shown that GERD has significant impact on patients either physically, psychologically, socially or economically. Impaired of quality of life and working productivity are common in GERD patients. Various pharmacological therapies have been developed, but not yet provide optimal results. It encourages the development of other therapeutic modalities, such as acupoint catgut embedment. The aim of this study was to establish the effect of acupoint catgut embedment combine with medical treatment on symptom and quality of life of GERD patients. A double-blind randomized controlled trial involved 52 GERD patients randomly allocated into catgut embedding therapy with medication group (treatment group) or medication only group (control group). Catgut embedding therapy was given 2 times at CV12 Zhongwan, ST36 Zusanli and BL21 Weishu every 15 days. GERDQ, RQS and SF-36 were used to measure the primary outcomes. The result shown, the decreased of GERDQ scores at treatments group significant higher than control groups (p<0,001), the increased of RQS score and all of SF-36 components scores at treatment group significant higher than control group (p<0,001). The result suggested that acupoint-catgut embedment combined with medical treatment is more effective than medical treatment in alleviating symptoms and enhancing the quality of life of GERD patients."