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"The prevalence of coronary heart disease in the adult population with diabetes mellitus (DM) is far greater (55%) than in the general public (2-4%). There is an acknowledged correlation between type I hidden ischemia and the incidence of myocardiac infarct. There needs to be a way to determine the presence or absence of ischemia. An alternative examination method is the Dobutamine Stress Echocardiography (DSE).This study was conducted at the Metabolic-Endocrine and the Cardiology Out-Patient Clinics of the Department of Internal Medicine ofCipto Mangunkusumo Central Public General Hospital, Jakarta, from February to August 2001.The aim of the study is to detect undetected myocardiac ischemia using the electrocardiography among patients with type 2 diabetes mellitus and podiatric abnormality and testing the correlation between certain factors (sex, age, body mass index, lipid profile, fasting blood glucose, post prandial blood glucose, HbAlc, peripheral vascular disease, smoking, retinopathy, and neuropathy) with myocardiac ischemia.Methodology: The study was designed as a comparative study of the incidence of myocardiac ischemia between type 2 diabetes mellitus patients with and without podiatric abnormalities. The sample consisted of 28 patients. Samples underwent the dobutamine stress echocardiographyResults: dobutamine stress echocardiography examination using Apogee on 14 patients with type 2 diabetes mellitus with podiatric abnormality demonstrated a positive ischemic response in 4 people (28.6%). No positive findings were found in type 2 diabetes mellitus patients without podiatric abnormality.Conclusion: 1. DSE could detect myocardiac ischemia in 28.6% of type 2 diabetes mellitus undetected with electrocardiography. 2. Other factors that influenced a positive dobutamine stress echocardiography were autonomic neuropathy, diabetic retinopathy, the duration of diabetes mellitus, fasting blood glucose, and podiatric abnormality."

"Hypoglycemia is a reduction in blood glucose level below 60 mg'/o Epidemiologic data report a 0.02/1000 patent/year mortality rate due to hypoglycemia in patients using insulin in the United Kingdom. Reports from Indonesia are still quite rare. Parto Almojo (1993) reported the incidence rate of hypoglycemia in diabetic patients hospitalized at Sardjilo Hospital, Yogyakarta. Conditions are quite different than in Western nations, perhaps due to a smaller population of patients with type I diabetes mellitus in Indonesia"

"Tujuan Kekerapan hiponatremia pada usia lanjut cukup tinggi disebabkan adanya peningkatan kadar ADH, dan ANP yang merupakan bagian dari 8 perubahan fisiologi. Komplikasi yang ditimbulkan cukup spesifik yaitu meningkatnya risiko patah tulang, penurunan kesadaran hingga kejang-kejang. Penyebab tersering hiponatremia pada usia lanjut adalah asupan air yang tinggi. Mendapatkan asupan air optimal yaitu volume asupan air tertinggi yang tidak menimbulkan hiponatremia dan hipovolemia. Metode Dilakukan penelitian pada 31 orang usia lanjut sehat setelah melalui pemilihan dari 107 usia lanjut secara simple random sampling dan kriteria eksklusi. Kemudian dibagi secara Randomisasi Blok dalam 5 kelompok asupan air (1000-2500 mL). Hasil Dapat dibuktikan bahwa 1000 mL merupakan asupan air optimal pada usia lanjut sehat. Diperlihatkan juga bahwa kadar ADH plasma memiliki gambaran hubungan dengan volume asupan air yang tidak menimbulkan hiponatremia dan kadar NT-proBNP tidak berkorelasi dengan kadar natrium urin sewaktu. (Med J Indones 2009; 18: 18-25) Kesimpulan Asupan air optimal pada usia lanjut adalah 1000 mL/24 jam.

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Aim The prevalence of hyponatremia in the elderly is quite high due to the rising of ADH and ANP concentrations which are part of eight physiologic changes. The complications are quite specific, among others, increased risk of bone fracture, declining of conciousness, and convulsion. The frequent cause of hyponatremia is high water intake. To achieve the optimal water intake designated as the highest water intake that did not cause hyponatremia and hypovolemia. Methods A study was conducted on 31 healthy elderly subjects, selected from 107 persons using simple random sampling and exclusion criteria. By block randomisation were classified into five water-intake groups (1000-2500 mL). Results In this study, it could be proved that 1000 mL was the optimal. It was also unraveled that the ADH levels had a role in determining the water intake volume that did not cause hyponatremia and NT-proBNP concentrations did not correlate with spot urine sodium. Conclusion The optimal water intake for the elderly is 1000 mL per day. Keywords: Hyponatremia, healthy elderly, water intake."

"ABSTRACTBACKGROUND:proliferative diabetic retinopathy (DR) is an advanced form of DR that eventually could lead to blindness. Levels of vitreous advanced glycation end products (AGEs) and D-dimer may reflect the pathological changes in the retina, but only few studies have assessed their correlation with blood hemoglobin A1C (HbA1c) levels. This study aimed to find the association between blood HbA1c levels with vitreous AGEs and D-dimer levels in patients with proliferative DR. METHODS:an analytical cross-sectional study was performed in subjects with proliferative DR who underwent vitrectomy. Subjects were divided into 2 subgroups, i.e. uncontrolled (HbA1c >7%) and controlled (HbA1c <7%) groups. Vitreous AGEs and D-dimer levels were assessed; the levels were compared between uncontrolled and controlled hyperglycemic patients. Statistic correlation tests were also performed for evaluating blood HbA1c, vitreous AGEs, and D-dimer levels.RESULTS:a total of 47 patients were enrolled in this study and 32 (68.1%) of them were women. Median vitreous AGEs level was 11.0 (3.0 - 48.0) µg/mL; whereas median vitreous D-dimers level was 5,446.0 (44.0 - 37,394.0 ) ng/mL. The median vitreous AGEs levels was significantly higher in patients with uncontrolled vs. controlled hyperglycemia (14.0 vs. 4.0 mg/mL; p<0.001). There was a significant positive correlation with moderate strength between blood HbA1c level and vitreous AGEs level (r=0.524; r2=0.130; p=0.0001). Blood HbA1c level could be used to predict vitreous AGEs level by using the following calculation: vitreous AGEs = -1.442+ (1.740xblood HbA1c). Vitreous D-dimer levels were not significantly different between uncontrolled and controlled hyperglycemia (median 4607.5 vs. 5701.6 ng/mL; p = 0.458). There was a positive significant correlation between blood HbA1c and vitreous D-dimer levels (r = 0.342; p = 0.019); however the correlation was weak. Vitreous AGEs level had a positive significant correlation with vitreous D-dimer levels (r = 0.292; p = 0.046) and the correlation strength was also weak.CONCLUSION:median vitreous AGEs levels were significantly higher in proliferative DR patients with uncontrolled than those with controlled hyperglycemia. Blood HbA1c level can be used to assess vitreous AGEs level in patients with proliferative DR by using the following calculation: vitreous AGEs = -1.442+(1.740 x HbA1c). However, the blood HbA1c level can not be used to predict vitreous D-dimer level in patients with proliferative DR."