Papers by Robikhul Ikhsan
Review of Primary Care Practice and Education (Kajian Praktik dan Pendidikan Layanan Primer)
Background: The condition of prediabetes is still reversible whereas diabetes is irreversible. Pr... more Background: The condition of prediabetes is still reversible whereas diabetes is irreversible. Prediabetes prevalence continues to increase rapidly worldwide. It is estimated that >470 million people will have prediabetes by 2030. The prevalence and risk factors for the cause of prediabetes in the Daerah Istimewa Yogyakarta (DIY) are not known because there was not enough research and data. Yogyakarta has a high risk of prediabetes because Yogyakarta has the highest level of sugar consumption in Indonesia (16.9%). Objective: This research aimed to analyze the risk factors for prediabetes and identify the most dominant risk factors for prediabetes in primary health care centers at DIY. Methods: This observational, analytical research used a cross-sectional study approach. The population of this research was the population in DIY. The subjects of the research were a group of individuals aged >25 years in Sleman and Bantul who met the inclusion and exclusion criteria. A sample si...
Journal of Pharmaceutical and Biomedical Analysis, 2011
A simple, precise, accurate, and stability-indicating liquid chromatographic method was validated... more A simple, precise, accurate, and stability-indicating liquid chromatographic method was validated for the determination of amiodarone hydrochloride impurities (amiodarone impurity D and impurity E) as well as for the determination of amiodarone hydrochloride in tablet formulations. Liquid chromatography with a UV detector at a wavelength of 240 nm using a C18 column was employed in this study. Isocratic elution was employed using a mixture of buffer solution pH 5.0, methanol, and acetonitrile (30:30:40, v/v/v). This method was validated for the determination of amiodarone hydrochloride in accordance with USP requirements for assay determination, which include accuracy, precision, selectivity, linearity and range. The current method demonstrates good linearity over the range of 0.005-0.015 mg mL-1 of amiodarone hydrochloride. The % recovery of the method is 99.7%. The precision of this method refl ected by relative standard deviation of sample replicates is 0.80%. Validation of the same method for the determination of amiodarone impurity D and impurity E was also performed according to USP requirements for quantitative determination of impurities which include accuracy, precision, linearity and range, selectivity, and Limit of quantitation (LOQ). Low LOQ of amiodarone impurities using this method enables the detection and quantitation of these impurities at low concentration.
SAGE Open Medical Case Reports
Adrenal insufficiency in systemic lupus erythematosus is rarely detected, especially in male pati... more Adrenal insufficiency in systemic lupus erythematosus is rarely detected, especially in male patients. Nevertheless, such coexistence can occur, and screening for systemic lupus erythematosus should be considered in primary adrenal insufficiency with symptoms of systemic multiorgan involvement. We report a 22-year-old Asian man, initially diagnosed with bicytopenia, developed severe unintentional weight loss, skin and mucosal hyperpigmentation, along with persistent fatigue. Laboratory examination showed positive antinuclear antibody—indirect immunofluorescence, elevated anti-double-stranded DNA, extremely low morning serum cortisol, and mildly elevated thyroid stimulating hormone with normal free T4. He was diagnosed with systemic lupus erythematosus, manifesting as chronic primary adrenal insufficiency, subclinical hypothyroidism, and bicytopenia. He was treated with mycophenolic acid of 180 mg b.i.d, methylprednisolone of 4 mg q.d, and vitamin D3 1000 IU q.d. Methylprednisolone w...
F1000Research
Background: Graves' disease is a prevalent autoimmune disorder that causes hyperthyroidism. D... more Background: Graves' disease is a prevalent autoimmune disorder that causes hyperthyroidism. Despite being widely recognized, the risk factors for its associated condition, ophthalmopathy, are not well understood. High Mobility Group Box 1 (HMGB1), a damage-associated molecular pattern biomarker, has been linked to autoimmune diseases and may play a role in Graves' ophthalmopathy. The aim of this study is to assess the correlation between the levels of circulating HMGB1 and the occurrence of Graves' ophthalmopathy (GO). Methods: This cross-sectional study evaluated 44 recently diagnosed Graves' disease patients at Sardjito Hospital. The presence of Graves' ophthalmopathy (GO) was determined using criteria set by Bartley and Gormans. The levels of HMGB1 were measured in the blood of both groups (22 GO patients and 22 controls without GO) using ELISA. Statistical analysis, including binomial logistic regression and Mann-Whitney test, was conducted to analyze the dat...
Case Reports in Endocrinology
SARS-CoV-2 infection induces the dysfunction of many organs including the thyroid gland through t... more SARS-CoV-2 infection induces the dysfunction of many organs including the thyroid gland through the role of ACE2 receptors as well as the consequences of the cytokine storm. Thyroid diseases such as subacute thyroidism, Graves’ disease, thyrotoxicosis, and Hashimoto’s thyroiditis have been documented in patients with SARS-CoV-2 infection. However, there are limited reports about the consequences of SARS-CoV-2 infection-related thyroid complications. We describe a case of man who was admitted to the emergency department due to repeated lower limb weakness since diagnosed with COVID-19. He had refractory hypokalemia and was treated with potassium replacement therapy for 2 months. However, the complaints continued. The patient has no history of thyroid disease, yet the laboratory result showed hyperthyroidism. Accordingly, he received oral thiamazole. As the laboratory parameters of the thyroid hormones improved, potassium levels returned to normal and the limb weakness stopped. This u...
PLOS ONE
Interindividual variation is important in the response to metformin as the first-line therapy for... more Interindividual variation is important in the response to metformin as the first-line therapy for type-2 diabetes mellitus (T2DM). Considering that OCT1 and MATE1 transporters determine the metformin pharmacokinetics, this study aimed to investigate the influence of SLC22A1 and SLC47A1 variants on the steady-state pharmacokinetics of metformin and the glycemic response. This research used the prospective-cohort study design for 81 patients with T2DM who received 500 mg metformin twice a day from six primary healthcare centers. SLC22A1 rs628031 A>G (Met408Val) and Met420del genetic variants in OCT1 as well as SLC47A1 rs2289669 G>A genetic variant in MATE1 were examined through the PCR-RFLP method. The bioanalysis of plasma metformin was performed in the validated reversed-phase HPLC-UV detector. The metformin steady-state concentration was measured for the trough concentration (Cssmin) and peak concentration (Cssmax). The pharmacodynamic parameters of metformin use were the fas...
Review of Primary Care Practice and Education (Kajian Praktik dan Pendidikan Layanan Primer), 2020
Background: Numerous studies have shown the increasing of prediabetes incidence from the time be... more Background: Numerous studies have shown the increasing of prediabetes incidence from the time being. Some of the prediabetes screening methods that can be performed at primary health care were American Diabetes Association (ADA) scoring for prediabetes. However, there was no data that describes the validity and applicability of the ADA scoring on prediabetes patients in Indonesia. Objective: To discribe prediabetes screening and to find out the applicability of the ADA scoring method in Yogyakarta primary health care. Method: The diagnostic test by scoring system of the ADA questionnaire was compared with OGTT (oral glucose tolerance test) as the gold standard. The subjects were patients of primary health care in Yogyakarta who fulfill the inclusion and exclusion criteria. Result: The subjects were 279 respondents with 227 female (81.4%) and 52 male patients (18.6%). The mean age of the study subjects was 50.4 years (SD 12.81). The sensitivity and specificity of the scoring method...
Background. Alteration of the endocrine system in the elderly people may be caused by changes in ... more Background. Alteration of the endocrine system in the elderly people may be caused by changes in secreted hormone levels or decreased sensitivity of target organs. These changes also apply to thyroid function, which can cause disability, cognitive impairment, cardiovascular risk, and decreased muscle mass and strength in the elderly. Physiologically, there are several changes in the concentration of thyroid hormone Concentrations due to aging process, such as reduced TSH (Thyroid Stimulating Hormone), total T3 (Triiodothyronine) and free T levels, and increased rT3 (Reverse triiodothyronine), which is an inactive T (Thyroxine) metabolite in the serum. Even so,the free T4 and the total T44 remain unchanged, except for the sick. As a result, proper diagnosis and management are expected to minimize the deprivation experienced by the subjects due to a decrease in functional mobility. Aims. The aim of the study was to assess the correlation between the levels of thyroid hormones and func...
Background. Uraemic pruritus is the complaint most often found in patients with terminal renal fa... more Background. Uraemic pruritus is the complaint most often found in patients with terminal renal failure (15-49 %) and hemodialysis patients (50-90%). Mikroinflamasi role as ferritin be one cause. Phototherapy NBUVB theoretically can lower serum ferritin, thereby reducing the intensity of pruritus in patients . Objective. The main objective to determine the effect of phototherapy NBUVB to decrease serum ferritin levels of uremic pruritus patients undergoing regular hemodialysis. The next goal NBUVB know the influence of phototherapy to decrease the intensity of itch (VAS). Methods. Quasi experimental with pre-post comparison design, comparing the reduction in serum ferritin levels before and after phototherapy NBUVB, here p < 0.05 is said to be significant. Results. A total of 29 subjects who underwent the study protocol, 18 were male, the average age was 55.7 years, the largest cause of kidney disease is hypertension (48.3%), average 4.2 years old undergoing hemodialysis. There wa...
Background: Since the antithyroid drugs was introduced, propylthiouracil (PTU) and methimazole (M... more Background: Since the antithyroid drugs was introduced, propylthiouracil (PTU) and methimazole (MMI) are widely used in treating hyperthyroidism. However less study were conducted to compare which of these antithyroid drug is better in reducing the FT� level. Objectives: The aim of this study is to compare which of these two oral antithyroid drugs (MMI or PTU) is better in reducing the FT� level after 30 days therapy. Method: This was a retrospective descriptive study using the data from medical records with code ICD 10. E05: Hyperthyroidism. The survey was conducted in Instalasi Rekam Medis, RSUP Dr. Sardjito, Yogyakarta. The data analysis was done in January 2014 using IBM SPSS 20. Result: The mean difference of FT� level after 30 days for both MMI and PTU is insignificant (p=0.15). However, MMI shows a greater decrease in reducing FT� level in the second month of therapy and a greater stability in maintaining FT� level when reaching the normal range. Meanwhile PTU shows...
Background. One of the characteristics of the Diabetes diet is giving food with a high complex ca... more Background. One of the characteristics of the Diabetes diet is giving food with a high complex carbohydrates, particularly fiber. The benefit of resistant starch fiber includes maintaining blood glucose and increasing insulin sensitivity. Aims. This study aimed to find the effect of providing food made from resistant starch fiber (Dioscorea esculenta, Maranta arundinaceae L, Cucurbita moschata, Manihot utilissma) on the improvement of blood glucose control in diabetes patients based on glycated albumin test. Methods. The Quasi-experimental study was used in diabetes type-2 patients who visited endocrinology polyclinic at Dr Sardjito Hospital, during 1 November 2015-31 January 2016. Food made from the resistant starch fiber was served as a daily snack for one month. Blood glycated albumin was examined before and after food providence. SPSS was used for statistical analyses. Results. We recruited 17 subjects in the control group and 17 subjects in the treatment group. In the control...
Background. Liver cirrhosis is a pathological condition that describes the end stage of hepatic f... more Background. Liver cirrhosis is a pathological condition that describes the end stage of hepatic fibrotic which progressively ongoing that signed by distortion from hepar architecture and the formation of the regenerative modulus. Liver cirrhosis causes impairment in most of the liver function including the hormonal balance and metabolism of steroids. In the male patients, liver cirrhosis causes hypogonadism and feminization. Sexual dysfunction in cirrhotic patients is still underestimated and underdiagnosed. The most common sexual dysfunction in male cirrhotic patients is impotence or erectile dysfunction. Erectile dysfunction (ED) is define as a persistence inability to reach and/ or maintain enough erection to satisfy the sexual activity. International Index of Erectile Function 5/IIEF-5 could mark erectile dysfunction. Despite the prevalence of erectile dysfunction is high in patients with liver cirrhosis, only a few studies revealing the relationship between severity of liver ci...
Background: Thyroid storm is a rare manifestation of thyrotoxicosis that is commonly attacking fe... more Background: Thyroid storm is a rare manifestation of thyrotoxicosis that is commonly attacking females of thirty to sixty years old. It is classically presented as fever, tachycardia, tremors, nausea, vomiting, diarrhoea, dehydration, delirium and coma. If left untreated, thyroid storm often can cause fatal. The mechanisms of thyroid storm is still unclear although it is related to the elevated level of free thyroid hormones and depressed TSH. Objectives: The objective of this study is to find the correlation of the level of thyroid hormones with the Burch and Wartofsky's Score in patients who diagnosed of thyroid storm in RSUP Dr. Sardjito. Method: The data is traced from patient�s medical records who diagnosed with thyroid storm (ICD 10 : E.05.11) dated from January 2008 to December 2012. We describe the patients� profile of clinical symptoms and signs by using Burch and Wartofsky's scoring system. And then, the level of thyroid hormones which are TSH and FT4 are recor...
Purpose: The aim of this study was to determine the correlation between knowledge of healthy beh... more Purpose: The aim of this study was to determine the correlation between knowledge of healthy behavior and obesity on the occurrence of type 2 diabetes mellitus. Methods: This research was an observational-analyticalquantitative study with case-control design. The study subjects were selected by purposive sampling totalling 212 outpatients and inpatients in the RSUD Aji Batara Agung Desa Sakti in which 106 patients were suffering type 2 diabetes and 106 control patients that were not suffering diabetes mellitus. All subjects were between 25-64 years old. Results: Knowledge of healthy behavior was not statistically significant in the occurrence of type 2 diabetes mellitus while in the univariable data analysis, central obesity was statistically significant. This finding was closely related to the behavior of low physical inactivity but central obesity increased with age and the prevalence was greater in women. Multivariable analysis showed that central obesity, physical inactivity ...
Background : Insulin sensitizer drugs such as metformin has suggested giving in metabolic syndrom... more Background : Insulin sensitizer drugs such as metformin has suggested giving in metabolic syndrome patient and NAFLD, which both pathogeneses were insulin resistance. Angiotensin II receptor blocker (ARB), anti-hypertension drugs, has the similar properties to improve regulation of Proliferator-Activated Receptor Gama (PPARɤ). This aim of the study is to prove the improvement of insulin resistance which examined by HOMA-IR method on metabolic syndrome patient with NAFLD after receiving metformin and valsartan medication. Method : This study was conducted to the patient in Endocrinology Clinic Sardjito General Hospital aged 35-36 years who meet diagnostic criteria for metabolic syndrome based on the IDF in 2006 and NAFLD. Convenience sampling method is done for 11 months (May 2012 – March 2013) and was expected sample size 35. HOMA-IR examination made before and after administration of metformin and valsartan for 12 weeks. Cut off value for HOMA –IR on pathological metabolic syndrome...
Metformin sebagai obat antidiabetik oral terpilih pada terapi diabetes melitus tipe 2 (DMT2) menu... more Metformin sebagai obat antidiabetik oral terpilih pada terapi diabetes melitus tipe 2 (DMT2) menunjukkan ketidaktercapaian target glikemik pada 35 – 40% pasien. Penelitian ini bertujuan menganalisis faktor pasien yang berpengaruh terhadap respon glikemik penggunaan metformin tunggal pada pasien DMT2. Penelitian kohort prospektif dilakukan pada 5 Puskesmas periode Januari-Oktober 2015 dengan melibatkan pasien DMT2 dewasa tanpa riwayat disfungsi tiroid dan gagal hati kronik. Parameter respon glikemik menggunakan glukosa darah puasa (GDP) dan g lycated a lbumin (GA). Sebanyak 35 pasien dengan rata-rata usia, indeks masa tubuh (IMT), serta eLFG masing-masing yaitu 50,48±6,67 tahun, 25,99±4,79 kg/m 2 , dan 96,49±18,17 mL/mnt terlibat dalam penelitian. Penelitian menunjukkan selain indeks glikemik awal, faktor demografi pasien tidak berkorelasi baik dengan nilai GDP, GA maupun perubahan nilai keduanya setelah penggunaan rutin monoterapi metformin. Sementara itu, lama terapi metformin sebe...
Key Engineering Materials, 2020
Using a CO2 laser photoacoustic spectroscopy with intracavity setup and multicomponent method we ... more Using a CO2 laser photoacoustic spectroscopy with intracavity setup and multicomponent method we have done measurement on the ammonia, ehtylene and acetone gas concentrations in the breath of liver disease patients and in the healthy volunteers. The results of multicomponent analysis show that the average concentration of ammonia gas obtained from the breath of liver disease patients and healthy volunteers are (3.27 ± 0.75) and (1.34 ± 0.24) ppm, respectively. The highest and the lowest ammonia gas concentration of liver disease patients are 4.77 and 1.99 ppm. While, the highest and the lowest ammonia gas concentration of healthy volunteers are 1.89 and 1.08 ppm. For the ethylene and acetone concentrations, we found no significant difference between the average concentrations in the liver disease patients and in the healthy volunteers.
Indonesian Journal of Clinical Pharmacy, 2017
Pengendalian glikemik yang baik pada diabetes melitus tipe 2 (DMT2) terbukti dapat mencegah penya... more Pengendalian glikemik yang baik pada diabetes melitus tipe 2 (DMT2) terbukti dapat mencegah penyakit komplikasi akibat DMT2. Puskesmas sebagai sarana pelayanan kesehatan primer merupakan garda terdepan yang diharapkan dapat memberikan pelayanan pengelolaan DMT2 dengan baik untuk mencegah penyakit komplikasi seperti penyakit gagal ginjal kronik (GGK). Kejadian GGK yang seringkali tanpa gejala spesifik serta keterbatasan pemeriksaan diagnostik di puskesmas menyebabkan keterlambatan diagnosis GGK maupun pengelolaan terapi yang sub-optimal. Penelitian ini bertujuan menganalisis kontrol glikemik dan kejadian GGK pada pasien DMT2 di puskesmas serta faktor pasien yang memengaruhi kontrol glikemik dan kejadian GGK. Penelitian potong-lintang pada 6 puskesmas di Yogyakarta tahun 2015 ini melibatkan pasien DMT2 dewasa tanpa riwayat gagal hati kronik. Parameter kontrol glikemik menggunakan Glukosa-Darah-Puasa (GDP), Glycated-Albumin (GA), atau hemoglobin terglikasi (HbA1C), sedangkan nilai eLFG digunakan sebagai dasar klasifikasi GGK. Sebanyak 101 pasien dengan rata-rata usia 50,75±6,73 tahun terlibat dalam penelitian. Kontrol glikemik kategori baik ditemukan hanya pada 13,86% pasien, sedangkan 12,87% pasien mengalami GGK. Tidak ada faktor pasien yang memengaruhi kontrol glikemik. Sementara itu, usia dan durasi DMT2 berkorelasi dengan kejadian GGK (p<0,01). Berdasarkan penelitian ini, kontrol glikemik yang buruk dapat meningkatkan kemungkinan kejadian GGK sebesar 63,64%. Oleh karena itu, diperlukan strategi pengelolaan DMT2 maupun pencegahan GGK yang lebih baik termasuk penyediaan fasilitas pemeriksaan yang memadai untuk meminimalkan kejadian clinical inertia di puskesmas.
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Papers by Robikhul Ikhsan