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Background: One of the most neglected complications of diabetes mellitus (DM) is gastro-esophageal reflux disease (GERD) which arises from autonomic neuropathy and diabetic gastropathy related to the extent of DM. This study was done to find prevalence of GERD in DM patients with GERD-questionnaire (GERDQ), dietary factor proportion, and their association with other GERD risk factor in rural area. Methods: This cross sectional study was conducted in Puskesmas Pelaihari from August to September 2013. Subjects with DM aged ≥ 18 were selected consecutively from both newly and previously diagnosed patients with exclusion criteria: pregnancy, in proton-pump inhibitor therapy, and had other metabolic disease(s). DM was diagnosed with ADA criteria, while GERD was diagnosed in patients with score of ≥ 8 of Indonesian GERDQ. Results: There were 30 subjects (29.7%) with GERD among 101 patients with DM and dietary factors found in GERD patients were spicy diet (90%), high-fat food (90%), irritative beverages (87%), and irritative diet (23%). Only female gender was associated with GERD vs non-GERD in DM patients (87% vs 68%, p = 0.048). Meanwhile, duration of DM (2 [0-13] vs 2 [0-19], p = 0.976), obesity (37% vs 38%, p = 0.897), age (53.2±10.5 vs 54.7 ± 9.3, p = 0.481), and uncontrolled diabetes (90% vs 94%, p = 0.421) were not associated with the GERD among DM patients. Conclusion: Prevalence of GERD in DM is somewhat high in this study. Female group with DM needs to be screened for GERD as early as possible.

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Background: The increase number of the metabolic syndrome (MetS) among young adults was mostly caused by obesity. MetS increases the risk of coronary heart disease (CHD) which can be estimated by Framingham risk score (FRS). The study was aimed to know the prevalence of MetS and FRS in obese young adults and to associate them with the components of MetS. Methods: A total of 70 male and female students aged 18-25 years with BMI ≥25 kg/m2 in Faculty of Medicine Universitas Indonesia were selected consecutively. The blood samples used to test fasting blood glucose, total cholesterol, high-density lipoprotein, and triglyceride were examined in Department of Clinical Pathology, Cipto Mangunkusumo Hospital after fasting for 14-16 hours. International Diabetes Federation (IDF) definition was used to diagnose MetS. Univariate and bivariate analysis were done. Results: The prevalence of MetS based on IDF definition was 18.6% among obese young adults. The most associated MetS components was hypertriglyceridemia (OR 12.13; 95% CI 2.92-50.46; p=0.001), followed with high blood pressure (OR 9.33; 95% CI 2.26-38.56; p = 0.001), low-HDL (OR 8.33; 95% CI 2.17-32.05; p=0.003), and impaired fasting glucose (p=0.03). Four subjects had FRS ≥1% and 66 subjects had risk <1%. Increased FRS was not associated with MetS (p=0.154). There was no component of MetS associated with increased FRS. Conclusion: Prevalence of MetS in obese young adults was similar with obese children and adolescents. Although no association of MetS and FRS was found, they are significant predictors for CHD which should not be used separately.

Background: Prehypertension and hypertension were related with many complications of nearly every organ, but often neglected by young adults in rural area. This research was done to observe the prevalence of prehypertension and hypertension among young adult in a primary health care of rural area at Cicurug, Sukabumi District, West Java. Methods: This cross-sectional study was done in Cicurug Public Health Center, Sukabumi District, West Java. The subjects were consecutively recruited from the outpatient clinic on Monday until Saturday in September 2012,18-25 years old, not pregnant nor having shock. They were interviewed about their age, gender, physical activity, sitting hours, smoking habit, alcohol consumption, and family history and examined by trained health professionals (weight, height, body mass index [BMI], systolic and diastolic blood pressure). Results: From 111 young adults, 34.2% had prehypertension and 17.1% had hypertension. Within sex groups, the prevalence of prehypertension was higher in females, whereas hypertension was occurred more in males. Neither of family history from mother nor father were associated with prehypertension and hypertension compared with normotension. Total activity was not associated with prehypertension (OR = 2.6; p = 0.052) and hypertension (OR = 1.758; p = 0.498). BMI was associated with hypertension (OR = 3.354; p = 0.041) and not associated with prehypertension (OR = 2.343; p = 0.099). Conclusion: Prevalence of prehypertension and hypertension were relatively high among young adult in primary health care of rural area. Intervention to prevent further complications needs to be done early with lifestyle modification because blood pressure is associated with modifiable risk factors, such as BMI and total activity. (Med J Indones. 2013;22:39-45) Keywords: Hypertension, prehypertension, rural area, young adult

Background: Highly active antiretroviral therapy (HAART) can reduce morbidity and mortality of HIV-infected patients. However, it depends upon adherence to medication. The objective of this study was to examine the adherence to HAART and to evaluate individual patient characteristics i.e. self-efficacy, depression level, and social support and to finally determine HAART adherence in selected regions in Indonesia. Methods: This cross-sectional study was conducted in Jakarta, Malang, Bandung, Makasar and Banda Aceh. The subject of the study was HIV-infected patients who were older than 13 years old and had taken HAART for at least a month. They were recruited consecutively then asked how many pills they had missed during the previous month. Poor adherence can be stated if the percentage of adherence rate is below 95%. HIV treatment adherence self-efficacy scale (HIVASES), Beck Depression Inventory (BDI-II) and Interpersonal Support Evaluation List (ISEL) was adapted to assess self-efficacy, depression level and social support, respectively. Results: We found that 96% (n=53) of the subjects adhered to HAART. There were no associations between adherence with self-efficacy, depression level, and social support. The main cause of non-adherence in this study was 'simply forget’. Conclusion: Adherence to HAART was found to be high and not associated with self-efficacy, depression level and social support in some central regions in Indonesia. (Med J Indones 2011; 20:50-5) Keywords: adherence, depression, HAART, HIV, self-efficacy, social support