Andy Darma
Departemen Ilmu Kesehatan Anak RSU Dr. Soetomo Universitas Airlangga, Jl. Mayjen Prof. Dr. Moestopo 6-8, Surabaya

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Proteksi Probiotik pada Mukosa Ileum Mencit yang Terpajan Lipopolisakarida Escherichia Coli Athiyyah, Alpha Fardah; Setiawati, Ariani; Darma, Andy; Endaryanto, Anang; Sudiana, I Ketut; Ranuh, Reza; MS, Subijanto
MEDIA MEDIKA INDONESIANA 2012:MMI VOLUME 46 ISSUE 2 YEAR 2012
Publisher : MEDIA MEDIKA INDONESIANA

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Abstract

Probiotic’s protection in ileal mucosa of mice after lipopolysaccaride Escherichia coliBackground: Gastrointestinal infection is one of the major causes of morbidity in children. Diarrhea is the common manifestation. Diarrheal prevention needs a balance mucosal immune system. Probiotic used in prevention of gastrointestinal infection needs to be considered. The aim of the study is to prove probiotic protection in ileal mucosa after lipopolysaccaride (LPS) Escherichia coli O55:B5 inoculation anatomically and immunologically.Method: Experimental study with male Balb/c, age 10-12 weeks, body weight 30-40g and randomized into treatment group and placebo group. Treatment group received mix probiotic for 14 days and on day 15 were inoculated by LPS Escherichia coli O55:B5, and day 16-21 were given mix probiotic again. Placebo group received LPS Escherichia coli O55:B5 on day 15. Mice necropsy were conducted at day 22. Immunohistochemistry examination used to look for amount expression cell for IL-2, IFN-γ, TNF-α, IL-4, IL-5,IL-6, IL-10 dan TGF-β in ileal mucosa. Scanning electron microscope was used to see ileal mucosal structure. Statistic analysis used in this study was multivariate analysis.Results: Sixteen Balb/c mices were randomized into 2 groups, each group consist 8 mices. There was significant difference on amount of cells expression IL-5 (p=0.022), IL-6 (p=0.05), and also on amount of cells expression TGF-β (p=0.036). On probiotic- LPS group, there was no Th1 domination but on the other hand, Treg became dominant. Th1 and Th2 response were still balance. Structural damages occurred in LPS group and did not occur in probiotic-LPS group.Conclusion: Probiotic protection in ileal Balb/c mice mucosa after LPS Escherichia coli O55:B5 inoculation is through anatomy and immunology changes.Keywords: Probiotic, LPS, Escherichia coli, protection, immunologyABSTRAKLatar belakang: Infeksi gastrointestinal dengan manifestasi tersering diare merupakan salah satu infeksi yang sering terjadi pada anak. Pencegahan diare memerlukan keseimbangan sistem imun mukosa yang baik. Penggunaan probiotik untuk pencegahan terhadap infeksi gastrointestinal perlu dipikirkan. Penelitian ini bertujuan untuk membuktikan proteksi probiotik pada ileum mencit yang terpajan lipopolisakarida (LPS) Escherichia coli O55:B5 secara anatomis dan imunologis.Metode: Uji eksperimental dengan menggunakan mencit Balb/c jantan berusia 10-12 minggu, berat badan 30-40g dan dirandomisasi menjadi kelompok perlakuan dan kelompok kontrol. Kelompok perlakuan mendapatkan mix probiotik selama 14 hari, hari ke-15 mendapatkan LPS Escherichia coli O55:B5 dan hari ke-16-21 kembali mendapatkan mix probiotik. Kelompok kontrol mendapatkan LPS Escherichia coli O55:B5 saja pada hari ke-15. Seluruh mencit dinekropsi pada hari ke-22. Pemeriksaan imunohistokimia untuk melihat ekspresi sel penghasil sitokin IL-2, IFN-, TNF-α, IL-4, IL-5, IL-6, IL-10 dan TGF-ß di jaringan ileum. Scanning microscope electron (SEM) untuk melihat struktur mukosa ileum. Analisis statistik yang digunakan adalah analisis multivariat.Hasil: Enam belas ekor mencit Balb/c terbagi menjadi dua kelompok, masing-masing 8 mencit. Pada kelompok probiotik-LPS didapatkan perbedaan bermakna dibandingkan dengan kelompok LPS pada jumlah penghasil sitokin IL-5 (p=0,022), IL-6 (p=0,050) dan jumlah sel penghasil sitokin TGF-β (p=0,036). Pada kelompok probiotik-LPS, dominasi respon Th1 tidak terlihat lagi dan menimbulkan dominasi Treg pada kelompok ini. Posisi Th1 dan Th2 masih dapat dipertahankan secara seimbang. Kerusakan struktur yang terjadi pada kelompok LPS tidak didapatkan pada kelompok Probiotik-LPS.Simpulan: Proteksi probiotik pada mukosa ileum yang terpajan LPS Escherichia coli terjadi secara anatomi dan imunologi.
THE ROLE OF ENDOSCOPIC PROCEDURE IN DIAGNOSING GASTROINTESTINAL DISORDER IN CHILDREN Athiyyah, Alpha Fardah; Darma, Andy; Ranuh, Reza; Subijanto, Subijanto
Jurnal Ners Vol 7, No 2 (2012): Vol 7 No. 2 Oktober 2012
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jn.v7i2.4015

Abstract

Introduction: Gastrointestinal endoscopy in children requires more than the technical expertise needed to pass an endoscope through a smaller digestive tract lumen. Children require more careful attention to patient preparation and sedation compared with adults. The incidence of various disease varies through childhood and differs from the adult. Aim of this study is to elucidate profile esophagoduodenoscopic dan colonoscopic procedures in diagnosing gastrointestinal tract disorder in children in Soetomo Hospital, including role of nursing team role these procedures. Method: This study is a descriptive study which is done in Gastroenterlology Division Soetomo Hospital in October 2009–March 2012 for patients undergoing esophagoduodenoskopy and colonoscopy. Age, sex, indication, preparation, sedation, results, complication data were collected. Data from pathological examination were also collected. Data analysis were done descriptively such as mean, median and percentage, and presented in tables. Result: There were 114 patients undergo esophagoduodenoscopy procedure and 7 patients undergo colonoscopy procedures. The most indication for esophagoduodenoscopy was recurrent abdominal pain (71.1%) and for colonoscopy was chronic diarrhea (42.8%). Nill by mouth for 6 hours is preparation for esophagoduodenoscopy and for colonoscopy needs bowel preparation a day before. Bowel preparation is using Biphosphate Sodium Phosphate oral and enema. Most of all sedation was done by anasthesiologist. Nursing team role were start from preparation, relaxing patient, and monitoring during and after procedure. Chronic gastroduodenitis was found on 110 (96.4%) cases, 15 cases of it accompanied nodularity. Seventy cases (64.9%) from 114 cases of biopsy result were Helicobacter pylore positive, and 21 cases of it has Barrets esophagus. Colonoscopy procedure results 5 (71.4%) cases were colitis, and 3 of them are amoebic colitis. Discussion: Diagnosis of sructural and histological abnormalities could be establish with endoscopic procedure. This is an important role in diagnosing gastrointestinal disorder in children and nursing team have important role in it.
Assessment of the Rapid Immunochromatographic Test as a Diagnostic Tool for Norovirus Related Diarrhea in Children Ranuh, Reza Gunadi; Athiyyah, Alpha Fardah; PA, Deanty Ayu; Darma, Andy; Rahardjo, Dadik; Shirakawa, Toshiro; Sudarmo, Subijanto Marto
Folia Medica Indonesiana Vol 55, No 1 (2019): March
Publisher : Faculty of Medicine, Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/fmi.v55i1.12557

Abstract

In developing countries, Norovirus is the second-leading cause of acute diarrhea, after rotavirus. The approved gold standard method for diagnosis of norovirus infection is RT-PCR. The rapid immunochromatographic test is a novel and expedient method for diagnosing norovirus that is relatively affordable. However, the use of the rapid immunochromatographic test remains controversial because of its accuracy. This study aimed to explore whether the rapid immunochromatographic test could be used for diagnosing norovirus-related diarrhea in children. Rapid immunochromatographic test (QuickNaviTM-Norovirus2) and RT-PCR on stool samples was used to diagnose norovirus. Stool samples were obtained from pediatric patients aged between 1 and 60 months who had diarrhea and were admitted to the pediatric ward at Dr. Soetomo General Hospital Surabaya, between April 2013 and March 2014. Ninety-four subjects provided stool samples that were tested using QuickNaviTM-Noro2 and RT-PCR. Using the test, 64 samples tested positive for norovirus and 30 tested negatives. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of the rapid immunochromatographic test were consecutively 90.3%, 42.9%, 43.8%, 90%, and 58.5%. RT-PCR was used to test all samples to assess the accuracy, which showed that one from 31 samples contained the GI strain (1.1%), while 30 samples (32%) contained the GII strain. This study definitively establishes that the rapid immunochromatography test is not sufficiently accurate for use as a screening or diagnostic tool in norovirus-related diarrhea cases in children.