Dwi Prasetyo
Department of Pediatrics, Medical Faculty of Universitas Padjadjaran, Hasan Sadikin Hospital, Bandung
Articles
30
Documents
Perbedaan Manifestasi Klinis dan Laboratorium Kolestasis Intrahepatal dengan Ekstrahepatal pada Bayi

Majalah Kedokteran Bandung Vol 48, No 1 (2016)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Ikterus fisiologis sering didapatkan pada bayi dan kebanyakan gejalanya ringan. Gejala ikterik biasanya akan menghilang dalam 2 minggu setelah lahir. Pada ikterus yang terkonjugasi terjadi defek produksi intrahepatal, transpor transmembran dari empedu, yaitu kolestasis intrahepatal (IH) atau obstruksi kolestasis ekstrahepatal (EH) yang mengakibatkan hambatan empedu. Penelitian ini dilakukan untuk melihat perbedaan manifestasi klinis dan laboratorium kolestasis IH dengan EH pada bayi. Studi potong lintang dilakukan pada 72 bayi dengan kolestasis yang datang ke Rumah Sakit Dr. Hasan Sadikin Bandung, periode Januari 2014–Desember 2015. Analisis data dilakukan dengan uji Pearson Chi-kuadrat dan Mann-Whitney. Subjek terdiri atas 43 (60%) laki-laki dan 29 (40%) perempuan, kolestasis IH sebanyak 61 orang (85%), dan EH sebanyak 11 (15%). Pada penelitian ini didapatkan perbedaan bermakna manifestasi klinis asites antara kolestasis IH dan EH (p=0,047), sedangkan venektasi, hepatomegali, dan splenomegali tidak didapatkan perbedaan bermakna. Pada pemeriksaan warna feses tidak didapatkan perbedaan bermakna (p=0,936), demikian juga hasil laboratorium bilirubin total, bilirubin direk, glutamat oksaloasetat transaminase, glutamat piruvat transaminase, alkali fosfatase, dan gama glutamil transferase serum tidak berbeda bermakna. Simpulan, didapatkan perbedaan manifestasi klinis asites, sedangkan manifestasi klinis yang lain dan hasil laboratorium tidak didapatkan perbedaan antara kolestasis IH dan EH. [MKB. 2016;48(1)45–50]Kata kunci: Kolestasis ekstrahepatal, kolestasis intrahepatal, laboratorium, manifestasi klinisDifferences of Clinical Manifestation and Laboratory Findings in Intra-Hepatic and Extra-Hepatic Cholestasis in InfantsAbstractPhysiological jaundice found in infants and most symptoms are often mild. Jaundice symptoms usually disappear within 2 weeks after birth. In conjugated jaundice defects in intra-hepatic production, transmembran transport from bile, i.e. cholestasis intra hepatic (IH), or extra-hepatic (EH) obstruction/cholestasis occur, resulting in bile barriers. This study was conducted to look at the differences in the clinical and laboratory manifestations of IH and EH cholestasis in infants. A cross-sectional study was performed on 72 infants with cholestasis who came to Dr. Hasan Sadikin General Hospital Bandung, during the period of January 2014–December 2015. Data analysis was performed with Pearson Chi-square test and Mann-Whitney. Subjects consisted of 43 (60%) infant boys and 29 (40%) infant girls, IH cholestasis were 61 (85%) and EH cholestasis were 11 (15.3%). Significant differences in the clinical manifestations of acites with IH and EH cholestasis were found (p=0.047), whereas insignificant differences in venectation, hepatomegaly and splenomegaly were observed. On examination of stool color, no significant difference was found (p=0.936). The same was true for laboratory results of total bilirubin, direct bilirubin, serum glutamic oxaloacetic transaminase, glutamic pyruvic transaminase, alkaline phosphatase and gamma glutamyl transferase. In conclusion, we found differences in clinical manifestation of acites, while for other clinical manifestations and laboratory results no differences were found between IH and EH cholestasis. [MKB. 2016;48(1)45–50]Key words: Clinical manifestation, extra-hepatic cholestasis, intra-hepatic colestasis, laboratory

Surveillance of Rotavirus Diarrhea in Dr. Hasan Sadikin General Hospital Bandung

Majalah Kedokteran Bandung Vol 42, No 4 (2010)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

The diarrhea morbidity in Indonesia has increased, however, all the reports had not been done carefully, so that accurate surveillance are essential for improving quality of morbidity data. To determine the prevalence and clinical manifestations of rotavirus diarrhea and to characterize the circulating rotavirus strains, children below 5 years old who were admitted to Hasan Sadikin Hospital, Bandung because of diarrhea, from January 2006 through March 2007 were enrolled in a surveillance study and had stool specimens tested for the presence of rotavirus using enzyme immunoassay (EIA). The strains of rotavirus were determined using reverse transcriptase-polymerase chain reaction (RT-PCR). Rotavirus were detected in 47.8% analyzed samples (87/184), G and P-genotype of rotavirus were G[1] (37.5%) and P[6] (53.5%). Most subjects were males (56%), 6–11 months of age (35%). Most common clinical manifestations besides diarrhea were dehydration (72.7%) and vomiting (50%). Subjects with positive rotavirus more common had dehydration (72% vs 28%) and vomiting (61% vs 39%). In conclusion, vomiting and dehydration are the prominent clinical manifestations of diarrhea with positive rotavirus infection. G1 and P6 are the most common genotype of rotavirus. [MKB. 2010;42(4):155–60].Key words: Clinical manifestations, diarrhea, genotype, prevalence, rotavirus Surveilans Diare Rotavirus di Rumah Sakit Dr. Hasan Sadikin BandungMorbiditas diare di Indonesia meningkat, tetapi semua laporan belum dilakukan secara cermat, sehingga surveilans yang akurat penting untuk memperbaiki kualitas data. Penelitian ini dilakukan untuk menentukan prevalensi dan manifestasi klinis diare rotavirus serta karakteristik strain rotavirus, anak usia di bawah 5 tahun yang dirawat karena diare di RS Hasan Sadikin, Bandung, dari Januari 2006 sampai Maret 2007, diikutsertakan dalam suatu penelitian surveilans dan spesimen fesesnya diperiksa untuk mendeteksi adanya rotavirus dengan menggunakan enzyme immunoassay (EIA). Strain rotavirus diperiksa dengan reverse transcriptase-polymerase chain reaction (RT-PCR). Rotavirus terdeteksi pada 47,8% sampel analisis (87/184), genotipe-G dan P adalah G[1] (37,5%) dan P[6] (53,5%) dari strain. Kebanyakan subjek adalah laki-laki (56%) usia 6–11 bulan (35%). Manifestasi klinis terbanyak adalah dehidrasi (72,7%) dan muntah (50%). Subjek dengan rotavirus positif lebih sering mengalami dehidrasi (72% vs 28%) dan muntah (61% vs 39%). Simpulan, muntah dan dehidrasi adalah manifestasi klinis terbanyak pada diare dengan infeksi rotavirus. Genotipe G1 dan P6 merupakan genotipe rotavirus yang paling sering ditemukan. [MKB.2010;42(4):155–60].Kata kunci: Diare, genotipe, manifestasi klinis, prevalensi, rotavirus DOI: http://dx.doi.org/10.15395/mkb.v42n4.29