Current Internal Medicine Research and Practice Surabaya Journal

Effect of High-Calorie Diet and Moderate-Intensity Physical Exercise on Gastric Histopathological Features of Mice

Ramadhani Rizki Zamzam, Irfiansyah Irwadi, Alphania Rahniayu — Wed, 31 Jan 2024 00:00:00 +0000

Introduction: Habit of consuming excess calories and sedentary lifestyle can cause oxidative stress which is known to be involved in the pathophysiological process of various diseases including diseases of the gastrointestinal mucosa. Increased Reactive Oxygen Species (ROS) due to a high-calorie diet can damage lipids, proteins, and DNA oxidation of the mucosa and lead to inflammation, apoptosis, damage of mucosal and its barrier. Moderate-intensity physical exercise is known to have health benefits, improve quality of life, reduce the risk of death, and prevent the occurrence of diseases related to oxidative stress. The aim of this study was to analyze the effect of high-calorie diet and moderate-intensity physical exercise on gastric histopathological features of mice.
Methods: This research was a true experimental study with posttest only control group design. Female Balb/C strain were randomly assigned into three groups, the control group/K1 (n=12), high-calorie diet group/K2 (n=12), and high-calorie diet and moderate-intensity physical exercise group/K3 (n=9). High-calorie diet in the form of dextrose (D40) was given ad libitum using sonde in a dose of 3-5% of calories or 0.0325 mL/gBW. The moderate-intensity physical exercise was carried out by swimming three times a week for 15 minutes using 6% gBW loading. After 4 weeks of treatment, the mice were sacrificed and their stomach were sampled and prepared for microscopic analysis.
Results: The histopathological examination of the gastric mucosa showed the average number of inflammatory cells was 11.60 for K1, 11.25 for K2, and 14.5222 for K3. The Shapiro-Wilk test revealed that the data on inflammatory cells infiltrations were not normally distributed (p<0.05), so a non-parametric difference test was conducted using the Kruskal-Wallis test. Based on the Kruskal-Wallis test results, it was obtained that p>0.05, which means no significant difference was found between the three study groups.
Conclusion: There was no effect of a high-calorie diet and moderate-intensity physical exercise on the gastric histopathological features of mice (Mus musculus) in this study

Correlation of TED Laterality with Thyroid Status among Thyroid Eye Disease (TED) Patients in a Tertiary Hospital in Indonesia

Zahirah Siti Lutfiyah, Delfitri Lutfi, Hermawan Susanto, Sutjipto — Wed, 31 Jan 2024 00:00:00 +0000

Introduction: Thyroid eye disease (TED), an autoimmune thyroid disorder, is prevalent in Asian countries and exhibits a variety of manifestations. Orbital involvement in TED is usually bilateral but may occur unilaterally in some cases. While it is commonly associated with hyperthyroidism, it also manifests in individuals with hypothyroidism or euthyroidism. The purpose of this study was to investigate the relationship between TED laterality and thyroid status in TED patients treated at the Eye Oncology Clinic of Dr. Soetomo General Academic Hospital in Surabaya, Indonesia.
Methods: The study was retrospective, analytical and observational. Patients diagnosed with TED who were treated at Dr. Soetomo General Academic Hospital between January 2019 and December 2021 were the focus of this study. SPSS analyses of medical records that satisfied the sample criteria were used to compile the data for this study.
Results: There were 88 samples that were dominated by females (57.95%) and aged 41 – 50 (32.96%). Proptosis was the most common clinical manifestation (94.32%), with compressive optic neuropathy was the least common (3,41%). Eyelid retraction occurred in only 22.7% of the patients. TED was categorized into unilateral (44.32%) and bilateral (50%). The majority had hyperthyroidism (70.45%), followed by euthyroidism (25%), and hypothyroidism (4.55%). It was found that there was a significant correlation between thyroid status and TED laterality. Compared to euthyroidism, abnormal thyroid conditions such as hyperthyroidism and hypothyroidism develop bilateral TED more frequently than normal thyroid conditions.
Conclusion: There was a correlation between TED laterality and thyroid status among patient TED.

The Clinical Outcome of COVID-19 Infection on Chronic Diabetic Complications Patients

Wed, 31 Jan 2024 00:00:00 +0000

Introduction: COVID-19 is an infectious disease resulting from the SARS-CoV-2 virus. The virus targets the respiratory system and leads to a significant number of fatalities worldwide. Consequently, it was officially classified as a pandemic in 2020. The Covid varians is now being monitored by the World Health Organization. Diabetes mellitus is one of the disorders that might deteriorate following an infection. Diabetes mellitus and its associated comorbidities continue to pose a significant health challenge in Indonesia, while it is also a focus of concern of the Sustainable Development Goals (SDGs). The study was aimed to assess the risks and outcomes associated with COVID-19 infection and the long-term consequences of diabetes mellitus.
Methods: This was a descriptive study using a retrospective design. Research data were taken from the medical records of patients confirmed positive for COVID-19 infection and also had chronic complications of diabetes mellitus who were treated at Dr Soetomo General Academic Hospital, Surabaya, Indonesia in 2021. There were 156 patients who met the criteria of this research.
Results: There were 156 patients (97 males, 59 females). The average age of the patients was 58, while most of the patients (84%) died and the rest of the patients (16%) survived. Most of the patients with fatality (55.8%) were those with critical severity level and complications of microangiopathy, while the patients who survived (10.3%) were those with moderate severity level and complications of microangiopathy.
Conclusion: COVID-19 patients with diabetes and comorbidities had a higher mortality rate than those who recovered, while most of the patients with fatality were those with significant COVID-19 and diabetic microangiopathy complications.

Association between the Duration of Steroid Therapy with Hyperglycemia in Patients with Systemic Lupus Erythematosus (SLE)

Wed, 31 Jan 2024 00:00:00 +0000

Introduction: Systemic Lupus Erythematosus (SLE) is a systemic autoimmune disease which primary treatment consists of steroid drugs administration. Prolonged steroid administration is often associated with an increase in blood glucose, a condition known as hyperglycemia. Hence, this study aimed to evaluate the association between the duration of steroid therapy with hyperglycemia in patients with SLE treated at a tertiary healthcare center in Surabaya, Indonesia.
Methods: A cross-sectional study was conducted under a purposive sampling frame from January to December of 2022 by utilizing secondary data from electronic medical health records in Dr. Soetomo General Academic Hospital, a tertiary healthcare center in Surabaya, Indonesia. The association between variables were analyzed using Fisher's exact test, chi square test, independent T-test, one-way ANOVA, Mann-Whitney, and Spearman's rank correlation.
Results: Out of 150 included patients, 2.67% experienced hyperglycemia following steroid therapy for SLE. There were no significant associations between clinical variables and hyperglycemia occurence in SLE patients (p>0.05). Patients that received higher doses of steroid did not experience any significant difference in hyperglycemia (p=0.727 for <6 months; p=0.865 for â‰¥6 months). Daily steroid dose was also not significantly associated with the severity of SLE manifestations based on the SLEDAI score (p=0.081). Overall, no significant association was identified between the duration of steroid therapy with hyperglycemia among SLE patients in the hospital (p=0.365).
Conclusion: The study found no significant correlation between clinical variables, hyperglycemia incidence, daily steroids dosage, methylprednisolone dosage, SLE severity, or steroid use duration in patients with Systemic Lupus Erythematosus.

Clinical and Demographic Profiling of Patients with Spondyloarthritis and Its Association with Disease Activity in a Tertiary Hospital in Surabaya, Indonesia

Cahaya Prasta Yudha, Lita Diah Rahmawati, Yulia Nadar Indrasari, Yuliasih — Wed, 31 Jan 2024 00:00:00 +0000

Introduction: The assessment of disease activity is crucial for effectively managing chronic diseases like spondyloarthritis (SpA). Establishing the relationship between disease activity, demographic, and clinical factors is essential for better disease management. This study aimed to delve into the demographic and clinical characteristics of patients at Dr. Soetomo General Academic Hospital, a tertiary hospital in Surabaya, Indonesia, contributing to a comprehensive understanding of SpA occurrences in Surabaya.
Methods: Data were obtained from 38 SpA patients' data classified using ASAS 2009 criteria at Dr. Soetomo General Academic Hospital, excluding individuals with SLE, gout, RA, and septic arthritis. Disease activity was measured using ASDAS-CRP. Association analysis between disease activity, clinical parameters, and demographics was conducted using Mann-Withney U test and Spearman correlation test.
Results: Results indicated a male-to-female ratio of 8:30, with patients having a median age of 48 (95% CI: 41-53) and most of the patients had a senior high school education (42.11%). The patients exhibited a mean BMI of 25.19 ± 3.77, a median disease duration of 8.5 (95% CI: 5-10) years, and a median CRP value of 0.2 (95% CI: 0.1-0.5) mg/dL. The majority displayed moderate disease activity, with a median ASDAS-CRP score of 2 (95% CI: 1.5-2.7). Interestingly, no significant correlation was found between disease activity using ASDAS-CRP and the demographic or clinical parameters studied.
Conclusion: Disease activities were found not to have correlations with the demography and clinical parameters of patients with SpA from Dr. Soetomo General Academic Hospital in Surabaya, Indonesia. This emphasizes the necessity for further research to comprehend the intricate relationship between disease activity and diverse influencing factors.

Lupus Nephritis: A Literature Review

Bestri Fortuna, Awalia, Puspa Wardhani — Wed, 31 Jan 2024 00:00:00 +0000

Systemic lupus erythematosus (SLE) has diverse clinical presentations, including lupus nephritis (LN), if LN manifest the mortality & morbidity will be elevated. The majority of SLE cases found in females, especially during puberty and childbearing age. A comprehensive understanding of the epidemiology, classification, diagnosis, and management of LN is essential for medical practitioners. Initially, the diagnostic process requires clinical examinations to find clinical manifestations. This process then followed by laboratory assessments to diagnose SLE and identify any indication related to kidney damage, commonly proteinuria. Other findings such as haematuria and leukocyturia may also present. Antinuclear antibodies (ANA) test and anti-dsDNA serves as primary diagnostic tool. In addition, kidney biopsy is the gold standard for LN due to its ability to confirm and measure the stadium for treatment guide. The therapy is specifically based on clinical and biopsy findings, categorized by World Health Organization (WHO) into five classes, namely normal, mesangial, focal and segmental proliferative, diffuse proliferative, and membranous. Accurate diagnosis in the initial stage and suitable therapy is crucial to significantly improve the prognosis of LN. In this review, we address some clinical manifestations related to LN and standardised diagnostic assessment tools, with an ultimate goal to improve the outcome of patients with lupus through an individual-specific management.

Efficacy of Bay Leaf (Syzygium polyanthum) in Regulating Lipid Profile in Dyslipidemia Model Rats: A Systematic Review

Wed, 31 Jan 2024 00:00:00 +0000

Introduction: Cardiovascular disease is the leading cause of death in the world, more than any other disease. The leading cause of cardiovascular disease is dyslipidemia. Long-term use of simvastatin can cause other diseases. One of the medicinal plants known to have anti-cholesterol effects is a bay leaf (Syzygium polyanthum). This study aimed to determine how the administration of bay leaf extract regulates lipid profiles.
Methods: This study used a systematic review based on PRISMA guidelines. Sampling in this study was done by collecting studies available in e-databases: PubMed and Google Scholar, with the inclusion criteria being experimental studies about the effect of bay leaf extract administration in regulating lipid profile in rats.
Results: This study consisted of 10 experimental studies on rats. Eight studies showed an improved lipid profile, while two other studies did not show an improving lipid profile after the administration of bay leaf extract.
Conclusion: Most studies revealed that bay leaf extract positively improves lipid profiles by lowering total cholesterol, LDL, and triglycerides, increasing HDL levels, and having antioxidant and anti-inflammatory effects.

The Use of Canagliflozin in Diabetes Mellitus Type 2 on Renal Outcome: A Systematic Review

Vikri Haikal, Soebagijo Adi Soelistijo, Puspa, Jongky Hendro Prajitno — Wed, 31 Jan 2024 00:00:00 +0000

Introduction: One of the leading causes of death in patients with diabetes mellitus is Diabetic Kidney Disease (DKD). Canagliflozin is one of the therapeutic options that can be used to mitigate the progression of DKD. However, the limited existing studies have left the data regarding the effects of canagliflozin on the progression of DKD still unclear. Therefore, a comprehensive study on the efficacy and safety of using canagliflozin in patients with DKD is warranted.
Methods: We performed a systematic search in the PubMed, Cochrane Library, ResearchGate, and Springer for randomized, placebo-controlled trials of the treatment of type 2 diabetes mellitus (T2DM) with canagliflozin that were published. A total of 25 journals were identified, and after excluding irrelevant studies, eighteen studies were ultimately included in this systematic review with total participants of 20,047.
Results: Canagliflozin reduces the rate of estimated glomerular filtration rate (eGFR) decline in patients with diabetes mellitus. The reduction of urinary albumin-to-creatinine ratio (UACR) level was greater in canagliflozin group than in the control group, and the progression of albuminuria was slower in the canagliflozin group than in the control group.
Conclusion: The use of Canagliflozin is considered to be one of the effective therapeutic options for kidney protection in patients with diabetes mellitus who are at risk of chronic kidney disease (CKD).

Hepatocellular Carcinoma with Inferior Vena Cava Thrombus in a Child

Fauziah Pratiwi, Rendi Aji Prihaningtyas, Bagus Setyoboedi, Teddy Ontoseno — Wed, 31 Jan 2024 00:00:00 +0000

Hepatocellular carcinoma (HCC) in children is the second common malignant liver tumor after hepatoblastoma. Chronic hepatitis B virus (HBV) infection causes most hepatocellular cancer worldwide. Metastases to the inferior vena cava (IVC) and right atrium (RA) tumor thrombi are even less common. We reported a case of a 13-year-8-month-old girl with HCC and IVC involvement. Vascular invasion predicts poor overall survival in HCC patients. Patients with HCC involving the IVC had a higher risk of sudden mortality and a poor treatment outcome. It is difficult to treat, and no standard therapy has been established. This case report aimed to describe HCC with IVC involvement. This is a rare disease with a poor prognosis, therefore it is important to detect and manage early.