Online ISSN: 2515-8260

Author : Aman, Andi Makbul

The Comparison of AIRI values in Obese and Non Obese Acute Coronary Syndrome patients

Resy Rosalina; Husaini Umar; Pendrik Tandean; Hasyim Kasim; Andi Makbul Aman; Haerani Rasyid; Arifin Seweng

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 8, Pages 190-197

Introduction : Insulin resistance (IR) has an important role in pancreatic -cell dysfunction and incidence of type-2 Diabetes Mellitus (DM-2), and such resistance is also able to indicate the pathophysiological component of other endocrine metabolic disorders such as hypertension, obesity, dyslipidemia, and cardiovascular disease (CVD). Obesity is a major risk factor for endothelial dysfunction which develops as a result of abnormal regulation of vasoactive substances including nitric oxide, where endothelial dysfunction is the starting point in the pathogenesis of IR. This study’s objective is to compare Admission Insulin Resistance Index (AIRI) values in Obese and Non-Obese Acute Coronary Syndrome patients.
Methods: This was a cross sectional study with consecutive sampling method consisting of 60 subjects who were treated with Acute Coronary Syndrome at Dr. Wahidin Sudirohusodo Hospital Makassar, Indonesia from July-September 2020. Anthropometric examinations include measuring body weight and height to determine body mass index (BMI).
AIRI was measured insulin admission (IU / ml) x plasma glucose admission (mg / dl) / 405. Statistical analyses used were Chi Square test and Spearman’s Correlation test ( significance p <0,01 ).
Results: Average age of the subjects was 54.9 + 13.6 years old, with 76,7 % male. Based on the results of clinical, laboratory and ECG examination, the subjects had hypertension (48.3%), obesity (35%), decreased HDL (38.3%), increased triglycerides (28.3%), increased LDL (70%), increased RBG (76.7%), experienced IR (20%), diagnosed of STEMI (35%), NSTEMI (53.3%), and UAP (11.7%). There was a significant relationship between obesity and AIRI (p <0,001). Where in obese, it was found that the percentage of AIRI's tertile 3 (70%) was the highest compared to AIRI's tertile 2 (20%) and AIRI's tertile 1 (15%). Meanwhile, those who were not obese were found to have the highest level of 1 AIRI (85%) compared to 2 AIRI (80%) and 3 AIRI (30%).

Systematic Review And Meta-Analysis: Risk Factors Of Acute Kidney Injury In Major Abdominal Surgery

Emminarty .; Hasyim Kasim; Haerani Rasyid; Syakib Bakri; Andi Makbul Aman; Husaini Umar; Muh. Ilyas; Arifin Seweng; Gita vita soraya

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 8, Pages 944-952

Background and objective: Acute kidney injury (AKI) is a common complication in patients undergoing major abdominal surgery. Various recent studies reported an incidence of AKI after surgery ranging from 6.7 to 32%. Risk factors for AKI in this setting may be procedure-related factors, post-operative complications and several patient-related include age, gender, comorbid disease Diabetes Melitus (DM), Hypertension (HT), Cardiovascular disease (CVD), and physical status. This study aimed to explore the risk factors of AKI in major abdominal surgery
Methods: We conducted a systematic literature search from PubMed and Cochrane Library. We included articles describing AKI in the setting of major abdominal surgery, published from 2015 until now, and cohort study design. This review was registered with PROSPERO (CRD42020216405)
Results: From 478 articles, 4 articles met our inclusion criteria describing AKI outcomes in varied population 683-3751. Prevalence of AKI 8,8 %. Age patient risk AKI in major abdominal surgery with Mean difference was 3.04 (95% CI = 1.83-4.25; P <0.00001). Meta-analysis of the four studies showed that Male had a pooled Odds ratio (OR) of 1.79 (95% CI = 1.04-3.08; P = 0.04) , DM OR 1.64 (95% CI 1.36-2.03; P <0.00001), HT pooled OR 1.90 (95% CI = 1.30-2.78; P = 0.0009), CVD has an OR of 1.58 (95% CI = 0.91-2.75; P = 0.10), physical status ASA≥ 3 (The American Society of Anesthesiologists) score has pooled OR 1.70 (95% CI = 1.16-2.49; P = 0.007)
Conclusion: Risk factors of AKI in major abdominal surgery setting are higher significantly in male, and patient with comorbid disease DM and HT had a significantly high risk of AKI, as well as physical status score ASA > 3.

The Dynamics of C-reactive Protein Associated with Nutritional Status Changes in Kidney Failure Patients at Initiation and After 3 Months of Dialysis

Trina Primalia Irawanti; Haerani Rasyid; Syakib Bakri; Hasyim Kasim; Andi Makbul Aman; Fabiola Maureen Shinta Adam; Nur Ahmad Tabri; Arifin Seweng

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 8, Pages 152-159

Among kidney failure patients, especially those on dialysis, malnutrition is associated with poor outcomes. Malnutrition is a multifactorial process, including inflammation, which can be measured by C-reactive protein (CRP). The objective is to evaluate the dynamics of CRP associated with nutritional status changes in kidney failure patients at initiation and after 3 months of dialysis. A prospective cohort study using a consecutive sampling method consisting of 40 kidney failure patients who received initial dialysis at Dr. Wahidin Sudirohusodo Hospital, Makassar, Indonesia from January-March 2020. Nutritional status was evaluated with Subjective Global Assessment (SGA), and CRP was measured at the initial dialysis and after 3 months. All subjects received nutritional education at the beginning. Nutritional status was defined as well-nourished (WN, SGA A) and malnourished (MN, SGA B and C), then classified into 4 groups denoting nutritional changes: Group 1 (WN to WN), Group 2 (MN to WN), Group 3 (WN to MN), and Group 4 (MN to MN). ANOVA, paired t-test, and chi-square test (significance p<0.05) were used for statistical analyses. Subject’s mean age was 50.5±14.8 years old; 52.5% were male. Diabetes and obstructive nephropathy were the most frequent underlying diseases, both had a prevalence of 35%. At initiation, the prevalence of malnutrition was 77.5%; after 3 months, it was 70%. The highest proportion of Group 4 were female (62.5%) and those with diabetes (45.9%). Among all subjects, mean CRP decreased (9.4±32.3 mg/dL) after 3 months. While mean CRP based on nutritional changes, Group 2 had the highest reduction (18.8±26.8 mg/dL), and Group 3, CRP increased (17.5±17.0 mg/dL). C-reactive protein is negatively associated with nutritional status changes in kidney failure patients after 3 months of dialysis. Malnutrition was higher in female subjects and those with diabetes.

The Effect Of Highly Active Antiretroviral Therapyon Lipid Profileof Hiv Patients

Vera Bahar; Andi Makbul Aman; Sudirman Katu; Syakib Bakri; Haerani Rasyid; Husaini Umar; Risna Halim; Arifin Seweng

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 8, Pages 953-960

Background:The widespread use of highly active retroviral therapy (HAART) has indicated a dramatic reduction in impairment due to immunodeficiency. Several studies have shown that an adverse event of HAART on dyslipidemia and insulin resistance. This study aimed to assess changes in lipid profiles after HAART.
Methods:A prospective cohort study with a consecutive sampling method consists of 59 HIV-infected patientsreceiving HAART at Dr. Wahidin Sudirohusodo Hospital, Makassar, Indonesia, from March-September 2020. Lipid profiles were measured at the initial time and after three months of HAART. The drug regimen was divided into two groups: Regimen 
group 1 (tenofovir, lamivudine, efavirenz), and another regimen group (consist of 4 regimen group combination: zidovudine, lamivudine, efavirenz; tenofovir, emtricitabine, lopinavir/ritonavir; tenofovir, lamivudine, nevirapine, and tenofovir, lamivudine, rilpivirine). ANOVA paired t-test and chi-square test were used for statistical analysis(it is significant if p is<0.05).
Results:The mean age of the subjects was 32.1 ± 6.6 years old. About 76.3% of subjects were male. Regimen 1 was used by 88.1% of the subjects and another regimen only 11.9% of the subjects. There were 27 subjects (45.8%) were underweight. The proportion of subjects with lipid abnormalities after 3 months of HAART significantly higher in LDL-c and TG level (P= 0.002 and 0.021). Regimen group1 showed increased levels of total cholesterol (TC), LDL-c, and TG (P = 0.037, 0.041, and 0.001) after HAART.
Conclusion:Highly active retroviral therapy is associated with lipid profile changes in HIV patients after 3 months of therapy.

Correlation of CD4 Count andNeutrophil-Lymphocyte Ratio in Human Immunodeficiency Virus-Acquired Immunodeficiency Syndrome (HIV-AIDS)Patients

Kartika Handayani; Sudirman Katu; Syakib Bakri; Risna Halim; Andi Makbul Aman; Haerani Rasyid; Hasyim Kasim; Arifin Seweng

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 8, Pages 985-993

Background: Human Immunodeficiency Virus (HIV) is an RNA virus that causes a decrease in the immune system and destroys specific white blood cells called T-helper lymphocytes or Cluster of Differentiation 4 (CD4); CD4 is a parameter in HIV-AIDS patients while NLR is a simple parameters that were used to assess inflammatory status.
Purpose: This study aims to determine the relationship between CD4 and NLR levels in HIV-AIDS patients.
Methods: This is an observational study with a cross-sectional design conducted in September 2019-September 2020. The study populations were all HIV patients that hospitalized and outpatient at Dr. Wahidin Sudirohusodo Hospital and his network hospital. Data were analyzed descriptively to found out the association between CD4 and NLR levels in HIV-AIDS patients using the Spearman trial.  Results: A total of 150 subjects, consist of 62 (41.3%) subjects at age 30-39 years, 122 (81.3%) male subjects, 108 (72%) subjects who had PEM nutritional status, and 102 subjects (68%) subject with CD4 count <50. Based on the Spearman test, there is negative correlation of CD4 and NLR in HIV-AIDS patient.
Conclusion: There are significant negative correlation between CD4 and NLR in HIV-AIDS patients at Dr. Wahidin Sudirohusodo Makassar, which higher NLR correlates with the lower value of CD4..

Relationship Between Estimated Glomerular Filtration Rate With Plasma Lipid Levels In Non-Dialysis Diabetic Kidney Disease Patients

Cely Palebangan; Haerani Rasyid; Andi Makbul Aman; Syakib Bakri; Husaini Umar; Andi Fachruddin Benyamin; Hasyim Kasim; Arifin Seweng

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 8, Pages 935-943

Aims: To assess the relationship between estimated glomerular filtration rate (eGFR) and plasma lipid levels in non-dialysis diabetic kidney disease (ND-DKD) subjects.
Materials and methods : In this cross-sectional study, outpatients from June to September 2020 who had been diagnosed with ND-DKD at Wahidin Sudirohusodo Hospital and Universitas Hasanuddin Hospital were enrolled. Creatinine was examined to determine eGFR based on the chronic kidney disease epidemiology collaboration (CKD-EPI) formulation, lipid profile, and metabolic characteristics. For statistical analysis, Pearson correlation test and Chi-Square test were performed, significant if the p < 0.05.
Results : Of the 103 study participants analyzed with a mean age of 54,7 ± 9,1 years, it was found that the mean showed dyslipidemia, with plasma lipid levels in mg/dl were 254.1; 45.9; 156.2; 191.8 for total cholesterol (TC), high-density lipoprotein cholesterol (HDLc), low-density lipoprotein cholesterol (LDLc), triglyceride (TG), respectively, and the mean eGFR value was 61.6 min ml/1.73m2. From the analysis of the relationship between eGFR and plasma lipid levels, it was found that only the HDLc level was significantly associated with eGFR, and this relationship was only influenced by female gender.
Conclusions : There was a significant positive correlation between eGFR and HDLc level in ND-DKD subject where the lower the eGFR, the lower HDLc level.