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"ABSTRAKBackground: diabetes mellitus is a silent-killer. Its prevalence and impact on health expenses increase from year to year. This study aims to investigate the characteristics and the risk factors that affect diabetes mellitus in Indonesia.Methods: this is a cross sectional study. Data were obtained from the Basic Health Research (RISKESDAS) in 2013. The samples were individuals aged ≥15 years, whose fasting blood glucose and 2 hours blood glucose after the imposition have been measured. 38.052 individuals were selected for this study. The variables of age, sex, marital status, level of education, employment status, living area, regional status, hypertension, obesity, smoking habit, and dyslipidemia are analyzed as risk factors for diabetes mellitus. Bivariate analysis was using chi-square test with significance level of p<0.05 and confidence interval (CI) of 95%, and multivariate analysis using multiple logistic regression test.Results: our study showed that 13% have diabetes mellitus in 2013. Factors affecting diabetes mellitus were age>55 years (OR=5.10; 95%CI 4.42 to 5.89; p<0.001), female (OR=1.37; 95%CI 1.26 to 1.49; p<0.001), rural (OR=1.16; 95%CI 1.08 to 1.26; p<0.001), married (OR=1.31; 95%CI 1.07 to 1.58; p<0.05), unemployed (OR=1.14; 96%CI 1.05 to 1.23; p<0.05), obesity (OR=1.46; 95%CI 1.35 to 1.58; p<0.001), hypertension (OR=1.68; 95%CI 1.55 to 1.81; p<0.001) and dyslipidemia (OR=1.53; 95%CI 1.39- 1.68; P<0.001).Conclusion: as many as 13% of individuals have diabetes mellitus in 2013. Age, gender, living area, employment status, obesity, hypertension, and dyslipidemia are the contributing factors to diabetes mellitus."

"House dust mites (HDM) are an important inhalant allergen in allergic asthma. However, molecular diagnostic study of specific IgE to HDM allergens has not been done in Indonesia. in addition, the association of quantitative specific IgE measurement with asthma severity has not been investigated. This study aimed to investigate difference of serum quantitative specific IgE levels induced by Dermatophagoides (D)."

"Background: thyroid dysfunction is more likely to occur in diabetes mellitus patients than general population. Until now, no study has been done to find prevalence of hypothyroidism and hyperthyroidism in Indonesian diabetics. This study aimed to find the proportion and characteristics of thyroid dysfunction in Indonesian type 2 diabetes mellitus patients. Methods: a cross-sectional study was conducted in Endocrine and Diabetes Polyclinic, Department of Internal Medicine, Cipto Mangunkusumo Hospital from July to September 2015. This study include type 2 diabetes mellitus patients, age ≥ 18 year-old, willing to undergo thyroid laboratory testing. In this study, hypothyroidism defined as TSH more than 4.0 mIU/L, while hyperthyroidism is defined as TSH less than 0.4 mIU/L with eCLIA. Results: from 364 subjects who were recruited from Endocrine and Diabetes Polyclinic, Cipto Mangunkusumo Hospital, 303 subjects underwent this study until analysis. Two hundred and three (273) subjects (90.1%) were euthyroid, 7 subjects (2.31%) were hyperthyroid, and 23 subjects (7.59%) were hypothyroid. Majority of the patients had subclinical hypothyroidism (56.5% based on Zulewski and Billewicz Score and 65.2% based on fT4 laboratory result), while 42.9% and 71.4% subjects had clinical hyperthyroidism based on clinical appearance and fT4 laboratory result respectively. Conclusion: proportion of hypothyroidism was 7.59% and hyperthyroidism was 2.31%, while the proportion of total thyroid dysfunction was 9.9% among diabetics. It is suggested that screening for thyroid dyscfunction can be done in high risk condition as a part of comprehensive management in type 2 diabetes mellitus patients."

"ABSTRAKBackground: a freshwater fish Ophiocephalus striatus or known locally to Indonesian as haruan,can potentially increases IGF-1 and albumin levels in elderly patients with hypoalbuminemia due to the contents of amino acids, fatty acids, vitamins, and minerals. This study was conducted to investigate the effect of Ophiocephalus striatus extract on the level of IGF-1 and albumin in elderly patients with hypoalbuminemia due to the contents of amino acids, fatty acids, vitamins, and minerals. This study was conducted to investigate the effect of Ophiocephalus striatus extract on the level of IGF-1 and albumin in elderly patients with hypoalbuminemia.Methods: the study is a double-blind randomized controlled trial involving malnourished elderly inpatients (≥60 years old) recovering from acute condition before hospital discharge, with Mini Nutritional Assessment score ≤23.5 and albumin level <3.5 g/dL. A total of 109 subjects were randomly divided into two groups: one group received 10 g Ophiocephalus striatus extract per day for 14 days and another group received placebo. Albumin and IGF-1 levels were obtained before and after intervention.Results: ninety subjects completed the study (extract group=45 subjects; placebo group =45 subjects) for 14 days. The median of age were 69 (64;75) years and the male to female ratio were 2 : 3. The changes of IGF-1 and albumin levels from before to after intervention between extract group compared to placebo group were 14.7 (0.30;31.5) ng/mL vs 1.0 (-6;13.15) ng/mL (p=0.002) and 0.5 (0.15;0.70) g/dL vs 0.10 (0.0;0.50) g/dL (p=0.003), respectively. There were significant differences in the improvement of IGF-1 and albumin levels between extract and placebo group.Conclusion: supplementation of Ophiocephalus striatus extract was associated with a significant increase in IGF-1 and albumin levels in elderly patients with hypoalbuminemia."

"ABSTRAKBackground: diagnostic of pulmonary TB in HIV patients is a problem due to non specific clinical features, or radiological appearance. HIV patients with CD4≤200 cells/mL infected with M. tuberculosis have less capacity in containing M. tuberculosis, developing granulomas, casseous necrosis, or cavities. This condition is caused by weakend inflammatory which later reduced sputum production and may cause false negative result. This study aimed to assess differences in the positivity level of acid fast bacilli (AFB) and cultures of M. tuberculosis from non-bronchoscopic sputum (spontaneous and induced sputum) compared to bronchoscopic sputum (bronchoalveolar lavage) in HIV positive patients suspected pulmonary tuberculosis with CD4<200 cells/μL.Methods: this cross sectional study was conducted in adult HIV patients treated in Hasan Sadikin Hospital with CD4≤200 cells/μL suspected with pulmonary tuberculosis by using paired comparative analytic test. All patients expelled sputum spontaneously or with sputum induction on the first day. On the next day, bronchoalveolar lavage (BAL) was performed. The two samples obtained from two methods were examined by AFB examination with staining Ziehl Neelsen (ZN) and cultured of M. tuberculosis on solid media Ogawa on all patients. Positivity, sensitivity and increased sensitivity of AFB and culture of M. tuberculosis in the non bronchoscopic and bronchoscopic groups were compared.Results: there were differences in the positivity level of AFB with ZN staining between non-bronchoscopic and bronchoscopic groups which were 7/40 (17.5%) vs 20/40 (50.0%) (p<0.001). The differences between the cultures of non-bronchoscopic and bronchoscopic groups were 16/40 (40.0%) vs 23/40 (57.5%) (p=0.039). Bronchoscopic sputum increased the positivity level of the ZN AFB examination by 32.5% (from 17.5% to 50.0%) as well as on culture examination by 17.5% (from 40.0% to 57.5%).Conclusion: Bronchoalveolar lavage can improve the positivity level of smears and cultures in patients suspected of pulmonary TB in HIV patients with CD4<200 cells/μL."

"ABSTRAKNational Health Insurance (NIH/JKN) has been enacted since January 2014. Various outcomes of geriatric patient care, such as improved functional status and quality of live have not been evaluated. Prolonged hospitalization and re-hospitalization are potentially affecting the affeciency care of this vulnerable group. This study aimed to identify the differences of functional status improvement, quality of life improvement, length of stay, and hospitalization of geatric patients admitted to CMH between prior to and after NHI implementation is favor."