Physical Activity Maintain Immune Response Through TLR-2/TLR-4 Gene Expression in Type-2 Diabetes Mellitus Patient at Medan City.

Background: The Increasing in type-2 diabetes mellitus (T2DM) needs to solve comprehensively and holistically. Patients with T2DM should have self-coping due to lifestyle modification. Abdominal fat accumulation can release pro-inflammatory cytokine that leads TLR-2 and TLR-4 to the response. These two kinds of toll-like receptors exist on the monocyte surface membrane which is an innate immunity cell. Objective: The aims of this study were to get the profile of physical activity, metabolic state, and mononuclear cell response to the expression of the TLR2 and TLR4 genes in T2DM patients. Methods: It was a descriptive-analytic study with a cross-sectional study design. Thirty-two eligible patients with inclusion criteria participated as subjects. All subjects answered questions by IPAQ, and checked metabolic state with body composition analysis. The TLR2 and TLR4 gene expression was determined with quantitative Real- Time PCR. Results: This study result found that most T2DM patients were in a highly active category in which most of their activity was walking (light intensity). The average abdominal circumferences were 91.81 ± 15.4 cm, body fat percentage was 29.5 ± 8.8%, and fasting blood sugar was 187.07 ± 67.03 mg/dl. Mononuclear cells number were normal. The expression of the TLR2 gene was lower by 0.71 fold and TLR4 gene expression was lower by 0.9 fold compared with non-DM (p<0.05). By chi-square test, there was a positive correlation between TLR2 gene expression with fasting blood glucose (p=0.011, and a positive correlation between the abdominal circumference and TLR4 gene expression (p=0.011). Conclusion: Type-2 Diabetes mellitus patients in primary health care keep walking as their physical activity to maintain blood glucose. Patients need to do moderate to vigorous exercise regularly to reduce body fat percentage especially abdominal fat to reduce Toll-like receptor gene expression, so insulin resistance and blood glucose level might decline to normal.

Differences Interval Training and Continuous Training on Endorphin Level and Anxiety Degrees in SECABA Rindam III Siliwangi Student Soldiers with Moderate Anxiety.

Background: Endorphin is a biological change in molecular physiology that is commonly connected with anxiety. An increase in the level of anxiety is caused by both an increase and a decrease in the number of endorphins that are present in the brain; however, up until this point, it has never been reported that there is a relationship between the level of anxiety and the influence of interval training. Objective: The purpose of this study was to analyze the effect of training interval on endorphin level and anxiety degrees of secaba student soldiers with moderate degrees of anxiety. Methods: The subject of the study was a student soldier of Secaba Rindam III Siliwangi with moderate anxiety. The subject of the study gets information about the objectives and procedures of the study. Subjects who are willing to participate in the study sign informed consent. The next step was that group 1 was given an interval training treatment 3 times a week for 12 weeks and group 2 was given continuous training treatment. Results: The results showed that there was a difference where interval training is better than continuous training against increasing endorphin levels (30.9111.733 vs. 39.6519.956; p=0.043). The degree of anxiety decreased significantly after being given interval training treatment (64.64±3.671 vs. 29.50±4.165; p=0.0001). Similarly, there was a significant difference (p=0.027; p<0.05) where the treatment in the interval training group was better than that of the continuous training group against a decrease in the degree of anxiety. Conclusion: Interval training can increase endorphin levels in Secaba Rindam III Siliwangi Student Soldiers with Moderate Anxiety and Interval Training can lower the Degree of Anxiety in Secaba Rindam III Siliwangi Student Soldiers with Moderate Anxiety.

Effect of Massage Therapy with Lime (Citrus Aurantifolia) Essential Oil on the Recovery of Delayed Onset of Muscle Soreness in Athletes.

Background: Physical exercise is a systematic exercise to increase muscle strength achieve goals such as improving the athlete's physical and preventing injury. Athletes must do is massage therapy to prevent muscle fatigue and pain due to physical exercise or during competition. The increase of lactic acid levels affects the maximum working ability of muscle fibers, decreases physical performance, and is fatigue in which the onset of pain. Lime essential oil as a topical oil contains high ester substances that have pharmacological effects such as natural analgesic effects to relieve pain. Objective: The purpose of this study was to determine the effect of massage therapy with lime essential oil as a topical oil on the recovery of delayed-onset muscle soreness (DOMS) in athletes. Methods: The participants are boxing athletes, 30 men, 20-22 years old, and non-smokers. Participants were divided into three groups. The exercise group (E) was doing exercises and was not given massage therapy; the exercise massage (EM) group, namely, doing exercises and being massaged with ordinary lotion as a topical oil; and the EM lime (EMC) group did exercises and was given a massage with lime essential oil as the topical oil. Results: The results showed that there was a significant difference in the average levels of lactic acid (p = 0.000) and the athlete's pain intensity (p = 0.000) in the three groups, namely, the exercise group (E), the exercise and massage group (EM), and the exercise and massage with lime essential oil (EMC). Conclusion: This study finds that lime essential oil used as topical massage therapy oil is better for accelerating the DOMS.

Stroke among Type 2 Diabetes Mellitus Patients at Haji Adam Malik General Hospital, Medan, Indonesia.

BACKGROUND: Increasing Blood Sugar Level (BSL) in Diabetes Meletus can be various microvascular and macrovascular changes, in the end, will cause complications. The complications can occur in some organs, such as the heart, blood vessels, eyes, kidney, and nerves. Stroke is one of the complications from diabetes that is increasing in every year. AIM: The study aims to analyse the relationship between diabetes and the prevalence of stroke at Haji Adam Malik General Hospital Medan. METHODS: This study is an analytical study with a cross-sectional approach. The population was all Integrated Inpatient ward at Haji Adam Malik General Hospital Medan. The subjects were 180 people chosen by consecutive sampling technique. RESULTS: The results showed that diabetes has a relationship with the prevalence of stroke (p < 0.05; CI = 95%). The risk of diabetes is 1.34 times higher than those without diabetes at Haji Adam Malik General Hospital Medan. CONCLUSION: Based on the results, the diabetic patient has a higher risk of incidence of stroke. Excellent control for diabetic patients will prevent them from stroke and any complication.

Red Dragon Fruit (Hylocereus Polyrhizus) Extract Decreases Lactic Acid Level and Creatine Kinase Activity in Rats Receiving Heavy Physical Exercise.

BACKGROUND: Heavy physical exercise causes relative hypoxia. In hypoxic condition, the cell's energy comes from anaerobic metabolism that produces lactic acid. An increment of oxygen need leads to ischemia-reperfusion, triggers free radical formation and damages muscles. Creatine kinase (CK) is a marker of muscle tissue damage. Red dragon fruit (RDF) has potential as antioxidant to reduce free radical formation. AIM: This study aims to determine RDF extract potential to reduce the lactic acid level and CK activity after heavy physical exercise. METHODS: A total of 32 male rats (Rattus Norvegicus) were randomly divided into 4 groups: group NORDF, treated heavy physical exercise and distilled water; group RDF100, treated heavy physical exercise and at 100 mg/kg BW RDF extract; group RDF200, treated heavy physical exercise and at 200 mg/kg BW RDF extract and group RDF300, treated heavy physical exercise and at 300 mg/kg BW RDF extract. The rats swam for 20 minutes, 3 times a week for 3 weeks. RESULTS: RDF300 group showed lower lactic acid level and CK activity as compared to that of NORDF (p = 0.00) and RDF100 (p = 0.00) groups, but RDF300 are not significantly different for lactic acid (p = 0.45) and for CK (p = 0.68). CONCLUSION: Red dragon fruit extract has potential in lowering lactic acid level and CK activity in male rats receiving heavy physical exercise.

Validity and Reliability of an Instrument for Assessing Self-Care Behaviours in Diabetes Mellitus Type 2 Patients in Binjai City, Indonesia.

BACKGROUND: Self-care behaviour becomes very important for diabetic patients; good self-care behaviour will prevent complications and improving the quality of life. AIM: The aim of this study was to provide a preliminary assessment of the validity and reliability of a new measure of self-care behaviour of Diabetes Mellitus Type 2. METHODS: The research was a cross-sectional study. The study population was T2DM patients from Primary Health Centers (PHC) in Binjai City, Indonesia. Sample determination using a single simple formula for the hypothesis of one population with calculation is 115 patients; sampling was done by convenience sampling with inclusion and exclusion criteria. Research questionnaire Self-care behaviour of T2DM patients was forming by knowledge, attitudes, communication, family support, financing, motivation, and self-efficacy. Each of the predictors forms self-care behaviour and finally, the instrument consists of 28 questions. The data analysis techniques were Confirmatory Factor Analysis (CFA) tests with Structural Equation Models (SEM) with AMOS aids. RESULTS: Based on the results of the confirmatory analysis proved that the instrument is valid and reliable, the measure the self-care behaviour of T2DM. CONCLUSION: The new instrument for assessing self-care behaviour of T2DM patients is valid and reliable, besides being able to assess self-care behaviour, they can also know the components that make up self-care.

The effect of red-fleshed pitaya ( Hylocereus polyrhizus) on heat shock protein 70 and cortisol expression in strenuous exercise induced rats.

Background: Oxidative stress from exercise can contribute to damaging cells, increasing heat shock protein 70 (HSP70) and suppressing the immune system in the body. This research aimed to determine the antioxidant potential of red-fleshed pitaya extract on HSP70 and cortisol expression in rats which were subjected to strenuous exercise. Methods: The subjects of this research were 32 Sprague Dawley male rats, aged 3 months, with an average weight of 200 g. Red-fleshed pitaya extract was obtained from methanol extraction process; a maceration technique was performed and the extract was concentrated using an air-drying method. Rats were randomly divided into four groups. Group 1 were subjected to strenuous exercise and treated with distilled water only; while Groups 2, 3 and 4 were subjected to strenuous exercise and treated with 100 mg/kg body weight, 200 mg/kg body weight and 300 mg/kg body weight of red-fleshed pitaya extract, respectively. Strenuous exercises in rats was performed by intense swimming of 20 min/day, 3 days a week for 3 weeks. HSP70 expression and cortisol were measured with Enzyme-Linked Immune Sorbent Assay (ELISA) method. Results: There was a significant reduction of HSP70 (p=0.000) and cortisol expression (p=0.000) between the groups. Also, there was a significant difference in the average decreasing of HSP70 expression between group 4 and either groups 1 or 2 (p=0.000). However, a significant difference between groups 4 and 3 was not observed (p=0.813). Lastly, a significant difference was found in the average decrease of cortisol expression between groups 4 and 1 (p=0.000), 2 (p=0.000), and 3 (p=0.000) respectively. Conclusion: Red-fleshed pitaya is potential to be utilized as antioxidant to decrease the HSP70 and cortisol expression.