Thiazolidinedione and cardiovascular risk in type 2 diabetes mellitus

By Yenny

Cardiovascular disorders are the most common complications encountered in patients with type 2 diabetes mellitus (DM). The relationship is likely to be multifactorial and may also involve a specific, though ill-defined, diabetic cardiomyopathy. Patients with heart failure accompanied by DM have a reduced cardiac output compared with patients without DM. Thiazolidinediones (TZDs) are agonists of peroxisome proliferator-activated receptor gamma (PPARã) and have beneficial effects in the control of blood glucose and cardiovascular parameters, but the ability of these drugs to induce retention of plasma has to be taken into consideration in prescribing them for patients with DM at high risk of cardiovascular disease. The molecular mechanism of fluid retention by TZDs has not been fully elucidated. Available evidence indicate a possible role of epithelial sodium channels (ENaC) in causing the side effects of TZDs. This paper will discuss the mechanism of ENaC in inducing fluid retention and the management to be applied for anticipating these side effects.

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A P I T H E R A P Y (Venom of Apis cerana mellifera)

Rosdiana Natzir
Department of Biochemistry,Faculty of Medicine,Hasanuddin University

Bee venom consists of some pharmacologically or enzimatically active components, and its complete biochemical and pharmacological analyzed. The main anti-inflamatory pharmacological components are peptides: mellitin; apamin; peptide 401; adolapin and protease inhibitors. Honeybee venom has a variety of immunological effects leading to its wide use for degenerative disorders, as well as arthritis and related diseases. Now, most recently Indonesia and others have used bee venom to treat various chronic inflammatory diseases,but there are no scientific guidelines for using this substance. So,this review paper is an attempt to explain the efficacy and safety of honeybee venom in apitherapy.(J Med Nus. 2004; 25:103-107)

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The role of polyphenols in causing cardiovascular disease

By Yenny and Elly Herwana

Research on flavonoids has increased since the discovery of the French Paradox, the low cardiovascular mortality rate observed in Mediterranean population in association with red wine consumption and a high saturated fat intake. Plant polyphenol (flavonoid) occurs naturally in fruits, vegetables, and beverages such as tea and wine. Epidemiologic studies suggest that higher polyphenol intake from fruits and vegetables is associated with decreased risk for cardiovascular disease. The mechanisms explaining this observation remain unclear. The vascular endothelium is a critical regulator of vascular homeostasis, and endothelial dysfunction contributes to the pathogenesis and clinical expression of coronary artery disease. Platelet aggregation is a central mechanism in the pathogenesis of acute coronary syndromes, including myocardial infarction and unstable angina. There are numerous reports suggesting that plant polyphenols improve endothelial function and inhibit platelet aggregation in humans. Keywords: Polyphenol, flavonoid, cardiovascular

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PERIOPERATIVE MANAGEMENT OF HEAD INJURY

Muh Ramli Ahmad
Department of Anesthesilogy Faculty of Medicine Hasanuddin University Makassar

SUMMARY
The incidences of head injury in the United State reached 500.000 cases yearly. Ten percents or them died before reach the hospital. Management of head injury has to be started on the spot of the accident (prehospital) in order to avoid secondary brain damage. The secondary brain damage might be caused either by systemic disorder or intracranial. The systemic disorders are hypoxemia, hypercapnia, hypotension, anemia, hypovolemia, hyponatremia, hyperthermia, sepsis, and coagulopathies. Intracranial factors are epidural/ subdural hematoma, cerebral contusion, intracerebral infection, and post-trauma epilepsy. Preoperative evaluations are included: Anamnesis the history of accident and the mechanism of injury, which can help to determine the prognosis. The vital signs have to be examine, hypotension could be caused by injury in others place. Hypertension especially accompanied by bradycardia showed elevated of intracranial pressure by mass lesion that needs surgical procedure. The principal management of head injury are optimize of cerebral perfusion, avoid secondary ischemia and administration of drugs/ techniques which can caused elevation of intracranial pressure. Premedication in head injury usually is unnecessary. However, if general anesthesia is the alternative for ideal induction require maneuver to avoid hypotension, elevation of both blood pressure or intracranial pressure. Penthotal is an ideal induction agent if there no contraindications where it can reduce the cerebral blood flow (CBF) and intracranial pressure (ICP); while if there any contraindication propofol is the choice. The maintenance of anesthesia used drugs, which less affected to the CBF, CBV, CMRO2 and auto regulation, usually using the combination of barbiturate, narcotic, N2O, volatile anesthetic with, low MAC and muscle relaxant.(J Med Nus. 2004; 25:50-54)

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ACTIVE TIMES AND BITING HABITS OF COMMON MOSQUITOES

Isra Wahid,1 Abdullah Tahir,2 Ilhamuddin,3 Ira Fitriani,3 Sudarman,3 Ambo Tuo Nurdin.3
1Dept. Parasitology Hasanuddin University School of Medicine, 2 Dept. Public Health and Preventive
Medicine Hasanuddin University School of Medicine; 3 Students of Hasanuddin University School of Medicine

SUMMARY
In the filariasis and malaria endemic area, Mamuju, South Sulawesi, the only vector recognized for limphatyc filariasis (elephantiasis) is the mosquito Mansonia uniformis. However, in the recent survey (2001-2002), other mosquitoes that can potencially spread the filarial helminth were found such as Anopheles, Culex, Aedes, and Ochlerotatus. On October 2003, we conducted a survey on the mentioned genera and other mosquitoes as well, to see how their active times and biting habits can be a pontencial mean to spread mosquito borne diseases, especially filariasis, in the region. (J Med Nus. 2004; 25:7-12)

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