BACKGROUND: Many studies have shown low Vitamin-D level as a risk factor for autoimmune diseases, especially multiple sclerosis and thyroid disease. Graves’ disease (GD) is an autoimmune disease caused by autoantibodies that stimulate thyroid-stimulating hormone (TSH) receptors by increasing thyroid hormone synthesis and secretion. Several studies report that many patients with autoimmune thyroid disease including GD have low Vitamin-D status. AIM: The objective of the study was to evaluate the effect of Vitamin-D supplement on GD patients on improvement in thyroid hormone levels. METHODS: Open random clinical trial was conducted in GD patients to determine changes in thyroid hormone to achieving normal levels between those receiving methimazole plus Vitamin-D supplementation compared with those who only received methimazole. Patients were checked for TSH receptor antibody, thyroid profile and Vitamin-D level before treatment and rechecked for thyroid profile and Vitamin-D level 3 months after treatment. t-test used to compare the drug efficacy (p < 0.05) in two groups. RESULTS: From 25 children with GD accompanied by Vitamin-D deficiency with an average value of Vitamin-D was 16 ng/mL. GD children who receive methimazole with Vitamin-D supplement had elevated TSH levels in the 3rd month of therapy that was significantly different compared to GD children who received methimazole only (p = 0.00), and the increase of TSH was also followed by an increase in Vitamin-D levels. CONCLUSION: All children with GD had Vitamin D deficiency, and the addition of Vitamin-D supplement to GD therapy would improve TSH faster than children who did not receive Vitamin-D supplement.

Mortality and morbidity due to stroke rank the highest in Indonesia (15.4%), and most types of stroke are ischemic (87%). Inflammation has a role in the pathophysiology of both ischemic stroke and also inhibits acute symptomatic epileptic seizures (3-6%) in the first 7 days after stroke. Statins have been used for the treatment of dyslipidemia in stroke patients. Some studies showed that statins reduced the inflammatory response after a stroke and prevented the recovery of epileptic seizures. This study aimed to determine the differences in lymphocytes, hs-CRP, Electroencephalogram (EEG) with and without Simvastatin in acute ischemic stroke. This research was an experimental study with a double-blind, randomized control trial design consisting of two groups, a group given Simvastatin 20 mg/day, and a group given a placebo for seven days. The difference in lymphocytes, hs-CRP, EEG, and epileptic seizures between the two groups were then analyzed. The sample was 26 people, consisting of 17 (65.4%) males and 9 (34.6%) females with an average age of 59±5.8 years. Chi-Square and Fisher's test showed a significant difference in hs-CRP (p=0.005) and epileptic seizures (p=0.015), but no significant difference in lymphocytes (p=0.336) and EEG (p=0.42) between groups given Simvastatin 20 mg/day and those given placebo. There was a significant difference in hs-CRP and epileptic seizures, but no significant difference in lymphocyte count and EEG between the two groups with and without Simvastatin administration.

Chronic Kidney Disease (CKD) will cause anemia which can lead to death. CKD patients undergoing hemodialysis therapy can also experience anemia. Therefore, it is necessary to check the erythrocyte index consisting of Mean Corpuscular Volume (MCV), Mean Corpuscular Hemoglobin (MCH), and Mean Corpuscular Hemoglobin Concentration (MCHC) to determine the type of anemia so that appropriate therapy can be given. Objectives: To determined the description of the erythrocyte index in CKD patients undergoing hemodialysis at H. Adam Malik General Hospital Medan. Methods: This research used the descriptive observational method with a cross-sectional design. The study population was all CKD patients who underwent hemodialysis at the Adam Malik General Hospital Medan period July 2018 until June  2019 according to inclusion and exclusion criteria (total sampling) using medical record data. Results: From 149 study samples, 92 people (61.7%) were male, 57 people were female (38.3%), more in the age range of 55-64 years, hemoglobin (Hb) on average in low grades (98.9% men, 94.7% women), and erythrocyte index (MCV, MCH, MCHC) averages in the normal range. Conclusion: The description of patients with chronic kidney disease undergoing hemodialysis at H. Adam Malik General Hospital in July 2018 - June 2019, in general, is normochromic normocytic anemia.Keywords:  CKD, erythrocyte index, Hb, hemodialysis

The hyperactivity of platelet had been seen in patients with metabolic syndrome which can be caused by several factors, such as:insulin resistance, obesity, dyslipidemia and hypertension. The hyperactivity of platelet leads to its aggregation that can be increased therisk of cardiovascular disease. This study is aimed to know the platelet aggregation and mean platelet volume in patients with metabolicsyndrome and obesity by determination 30 patients were choosen for this cross sectional study, those whom attended to the laboratoryand policlinic at H. Adam Malik Medan Hospital, between May 2013 until August 2013. The diagnosis used of metabolic syndromecriteria established by the International Diabetic Federation 2005. From the 30 patients with 15 metabolic syndrome and 15 obesity,four patients were excluded because of their tryglyceride were more than 200 mg/dL. There is no significant differences between theplatelet aggregation with the agonist adenosin difosfat (ADP) in patient with metabolic syndrome and obesity. And there is no significantdifferences of the mean platelet volume values between the metabolic syndrome (9.6±0.93) and the obesity group (9.73±0.74), with pvalue 0.846. Based on this study there is no significant differences between the platelet aggregation and the Mean Platelet Volume values(MPV) in the metabolic syndrome and the obese group