cover
Filter by Year
Majalah Kedokteran Bandung
Articles by issue : Vol 44, No 1 (2012)
10
Articles
Toksisitas Akut per Oral Ekstrak Etanol Daun Dewa (Gynura pseudochina (Lour.) DC) terhadap Kondisi Lambung Tikus Jantan dan Betina Galur Wistar

Astri, Yesi ( Fakultas Kedokteran Universitas Muhammadiyah Palembang, jalan KH Bhalqi 13 Ulu Plaju Palembang Indonesia 30263 ) , Sitorus, Truly ( Departemen Farmakologi Fakultas Kedokteran Universitas Padjadjaran Bandung ) , Sigit, Joseph I. ( Sekolah Farmasi Institut Teknologi Bandung ) , Sujatno, Muchtan

Majalah Kedokteran Bandung Vol 44, No 1 (2012)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Original Source | Check in Google Scholar | Full PDF (1804.13 KB)

Abstract

Toksisitas oral akut merupakan efek samping yang terjadi dalam waktu singkat melalui pemberian tunggal peroral ataupun dengan dosis berulang dalam waktu 24 jam dan dapat terjadi pada setiap organ tubuh. Traktus gastrointestinal sangat potensial terhadap paparan agen toksik yang tampak sebagai gambaran erosi dan tukak. Penelitian ini merupakan penelitian eksperimental uji toksisitas akut per oral dan dilakukan di laboratorium Farmakologi Klinik RS Dr. Hasan Sadikin Bandung pada bulan Juli–September 2009. Penelitian ini bertujuan untuk mengetahui toksisitas akut ekstrak etanol daun dewa terhadap lambung dengan menghitung indeks tukak ekstrak etanol daun dewa (Gynura pseudochina (Lour.) DC) pada tikus galur Wistar. Untuk mengatasi dampak negatif, tindakan penelitian ini dilakukan dengan pendekatan 3R (reduction, refinement, dan replacement). Indeks tukak dinilai dengan menentukan jumlah dan diameter tukak melalui pembedahan hewan coba pada hari ke-15 dan dilakukan pemeriksaan secara mikroskopis dengan penilaian histopatologi. Data dianalisis dengan uji Kolmogorov-Smirnov yang dilanjutkan dengan one sample t-test pada Statistical Package for the Social Sciences (SPSS) for windows versi 13.0 pada derajat kepercayaan 95%. Indeks tukak antar kelompok tikus jantan dan betina menunjukkan perbedaan yang bermakna antara kelompok kontrol dan kelompok ekstrak etanol dosis >1,625 g/kgBB (p<0,05). Simpulan, pemberian ekstrak etanol daun dewa pada tikus galur Wistar menyebabkan tukak lambung pada dosis >1,625 g/kgBB. [MKB. 2012;44(1):38–43].Kata kunci: Gynura pseudochina (Lour.) DC, indeks tukak, toksisitas oral akutAcute Oral Toxicity of Ethanol Extract of Dewa Leaf (Gynura pseudochina (Lour.) DC) to Male and Female Wistar Rats’ Gaster MucosaAcute oral toxicity is the adverse effects occurring within a short time of oral administration of a single dose of a substance or multiple doses given within 24 hours through body’s organs. Gastrointestinal tract potentially influenced by toxic materials exposure, shown as gastric erosion and ulcer. This is an acute oral toxicity experimental research, held in Pharmacology laboratorium of Dr. Hasan Sadikin Hospital on July–September 2009. This research aims to determine ethanol extract of Dewa leaf acute toxicity to gaster by measuring ulcer index of ethanol extract of Dewa leaf (Gynura pseudochina (Lour.) DC) in Wistar rats. This research approached with 3R (reduction, refinement and replacement) to overcome negative impact. Ulcer index determined by ulcer’s quantity and diameter due to rats necropsy at 15th day, and histopathology examined. The results are statistically analyzed using Kolmogorov-Smirnov test and then continued with one sample T-test on Statistical Package for the Social Sciences (SPSS) for windows version 13.0, at 95% confidence interval level. Ulcer index significantly different between control group and ethanol extract of Dewa leaf group dose >1.625 g/kgBB (p<0.05). In conclusion, ethanol extract of Dewa leaf on Wistar rats cause gastric ulcer at dose >1.625 g/kgBB. [MKB. 2012;44(1):38–43]Key words: Acute oral toxicity, Gynura pseudochina (Lour.) DC, ulcer index DOI: http://dx.doi.org/10.15395/mkb.v44n1.71 

Perbedaan Kadar Adiponektin, Asimetrik Dimetilarginin Plasma, dan Respons Vasodilatasi Arteri Brakialis antara Dewasa Muda dengan Riwayat Bayi Berat Lahir Rendah dan Normal

Purnomowati, Augustine ( Departemen Ilmu Penyakit Dalam Fakultas Kedokteran Universitas Padjadjaran-Rumah Sakit Dr. Hasan Sadikin ) , K.S. Kariadi, Sri Hartini ( Departemen Ilmu Penyakit Dalam Fakultas Kedokteran Universitas Padjadjaran-Rumah Sakit Dr. Hasan Sadikin ) , Achmad, Tri Hanggono ( Departemen Biokimia Fakultas Kedokteran Universitas Padjadjaran Rumah Sakit Dr. Hasan Sadikin Bandung ) , C. Mose, Johanes ( Departemen Obstetri dan Ginekologi ) , Setianto, Budhi ( Departemen Kardiologi dan Kedokteran Vaskular Fakultas Kedokteran Universitas Padjadjaran Rumah Sakit Dr. Hasan Sadikin Bandung )

Majalah Kedokteran Bandung Vol 44, No 1 (2012)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Original Source | Check in Google Scholar | Full PDF (929.954 KB)

Abstract

Adiponektin mempunyai efek antiaterogenik, antiinflamasi, sensitizer insulin, dan berperan penting dalam mengatur pertumbuhan janin. Hipoadiponektinemia dapat menyebabkan disfungsi endotel. Risiko penyakit kardiovaskular meningkat pada subjek dengan riwayat bayi berat lahir rendah (BBLR). Penelitian ini bertujuan menganalisis perbedaan kadar adiponektin, asimetrik dimetilarginin (ADMA) plasma dan respons vasodilatasi arteri brakialis melalui tes flow mediated brachial artery (FMBA) antara dewasa muda dengan riwayat BBLR dan bayi berat lahir normal (BBLN), serta korelasi kadar adiponektin dengan fungsi endotel pada BBLR. Penelitian kohor retrospektif dilakukan periode November 2009–Januari 2010 berasal dari Growth Study Cohort Tanjungsari Kabupaten Sumedang. Sebanyak 134 subjek dipilih secara simple random, terdiri atas 67 BBLR dan 67 BBLN yang karakteristik umumnya sama. Analisis multivariat melalui Hotelling’s trace menunjukkan FMBA, kadar ADMA, dan adiponektin berbeda bermakna (p<0,001) antara BBLR dan BBLN. Analisis simultaneous confidence interval menunjukkan kadar adiponektin plasma dan FMBA bermakna lebih rendah (p=0,015 dan p<0,001) pada BBLR dibandingkan dengan BBLN. Korelasi tidak bermakna antara kadar adiponektin dan ADMA (r=-0,16; p=0,176) dan FMBA (r=0,13; p=0,281) BBLR. Kecil peran adiponektin pada disfungsi endotel, mungkin variabel lain berperan, seperti tumor necrosis factor α. Simpulan, terdapat perbedaan kadar adiponektin plasma dan FMBA antara dewasa muda dengan riwayat BBLR dan BBLN, tetapi kecil peran adiponektin pada disfungsi endotel dewasa muda dengan riwayat BBLR. [MKB. 2012;44(1):1–6].Kata kunci: Adiponektin, asimetrik dimetilarginin, BBLR, tes flow mediated brachial arteryDifferences of Plasma Adiponectine, Asymmetric Dimethylarginine and Brachial Artery Vasodilatation Response in Young Adult with Low and Normal Birth Weight HistoryBeside an anti-atherosclerotic, anti-inflammation effect, and a sensitizer insulin, adiponectin also play an important role in fetal growth. Hypoadiponectinemia may lead to endothelial dysfunction. Low birth weight (LBW) has increase risk of cardiovascular disease. The aim of this study was to analyze the differences of plasma adiponectin, asymmetric dimethylarginine (ADMA) level and vasodilatation response of brachial artery by doing flow mediated brachial artery (FMBA) test between young adults with LBW and normal birth weight (NBW), and the role ofadiponectin level in endothelial function of the LBW. This was a retrospective cohort study during November 2009– January 2010, 134 subjects were randomly selected from the Growth Study Cohort of Tanjungsari Sumedang. They consisted of 67 LBW and 67 NBW young adults, with similar basic characteristics. A multivariate analysis via Hotelling’s trace showed that there was a significant difference (p<0.001) for FMBA, ADMA, and adiponectin level, but simultaneous confidence interval measurements indicated that the rate of FMBA and the level of plasma adiponectin were significantly lower (p<0.001, p=0.015, respectively) in LBW compared to NBW. The correlation between adiponectin and ADMA level (r=-0.16, p=0.176), and FMBA (r=0.13, p=0.281) in LBW were not significant, suggesting a small role of plasma adiponectin in endothelial dysfunction of young adults with LBW, other variables could play a role such as tumor necrosis factor α. In conclusions, the level of plasma adiponectin and FMBA are different between LBW and NBW, but the role of adiponectin may be small in endothelial dysfunction in young adults with LBW. [MKB. 2012;44(1):1–6].Key words: Adiponectin, asymmetric dimethylarginine, flow mediated brachial artery, LBW test DOI: http://dx.doi.org/10.15395/mkb.v44n1.72

Metode Cepat Identifikasi Flavonoid dari Daun Ocimum sanctum L. (Selasih)

Dhianawaty, Diah ( Departemen Biokimia Fakultas Kedokteran Universitas Padjadjaran Bandung, jalan Raya Bandung Sumedang km 21 ) , Panigoro, Ramdan ( Departemen Biokimia Fakultas Kedokteran Universitas Padjadjaran Bandung, jalan Raya Bandung Sumedang km 21 ) , Surialaga, Samsudin ( Departemen Biokimia Fakultas Kedokteran Universitas Padjadjaran Bandung, jalan Raya Bandung Sumedang km 21 ) , Purushothman, Pricilla ( Departemen Biokimia Fakultas Kedokteran Universitas Padjadjaran Bandung, jalan Raya Bandung Sumedang km 21 )

Majalah Kedokteran Bandung Vol 44, No 1 (2012)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Original Source | Check in Google Scholar | Full PDF (1897.245 KB)

Abstract

Manfaat suatu tumbuhan sebagai obat herbal diperoleh dari kandungan kimianya, misalnya flavonoid. Flavonoid bermanfaat untuk kesehatan tubuh manusia. Oleh karena itu, kandungan flavonoid dapat dijadikan sebagai acuan manfaat suatu tanaman dan dibutuhkan metode identifikasi flavonoid yang cepat. Tujuan penelitian untuk memperoleh metode cepat kandungan flavonoid dalam Ocimum sanctum. Telah dilakukan penelitian ekstraksi, isolasi, dan identifikasi flavonoid daun Ocimum sanctum di laboratorium Kimia Medik Fakultas Kedokteran Universitas Padjadjaran pada tahun 2005. Flavonoid diekstraksi sinambung dengan etanol 95%, diisolasi dengan kromatografi kertas/lapis tipis selulose dan asam asetat 2%, kemudian dilanjutkan dengan pengembang: n-butanol–asam asetat–air, kloroform–asam asetat–air, forestall, asam asetat 5%, 15%, 35%, dan 50%. Flavonoid diidentifikasi dengan pereaksi geser dan sinar ultraviolet. Hasil isolasi dengan asam asetat 2% dan 35% berturut-turut memberikan dua bercak flavonoid, sebagai flavon, FOAc-1 mempunyai Rf=0,69 dan FOAc-2 mempunyai Rf=0,57. Pengembang lainnya memberikan satu bercak flavonoid. Simpulan, isolasi dengan asam asetat 2% dan 35% berturut-turut serta identifikasi dengan pereaksi geser dan sinar ultraviolet merupakan metode yang cepat untuk identifikasi kandungan flavonoid dalam Ocimum sanctum. [MKB. 2012;44(1):32–7]. Kata kunci: Flavonoid, identifikasi flavonoid, Ocimum sanctumRapid Identification Method of Flavonoid from Ocimum sanctum L. (Selasih) Leaves A plant’s effectiveness as a herbal drug comes from its chemical content such as flavonoids. Flavonoids are useful for human body health. Therefore flavonoids content can be used as a marker from the usefulness of a plant, and rapid identification method of flavonoid is needed. The objective of the research was to get a rapid method of flavonoid content identification from Ocimum sanctum. The extraction, isolation and identification of flavonoids from Ocimum sanctum leaves has been done at Medical Chemistry laboratory Faculty of Medicine Universitas Padjadjaran in 2005. Flavonoids were extracted continually by 95% ethanol, were isolated with paper chromatography/cellulose TLC and 2% acetic acid, then continued with elucidation reagents: n-butanol–acetic acid–water, chloroform–acetic acid–water, forestall, 5%, 15%, 35% and 50% acetic acids. Flavonoids were identified with diagnostic reagents and ultraviolet light. Isolation with 2% and 35% acetic acids respectively gave two spots of flavonoids as flavon, FOAc-1 had Rf=0.69 and FOAc-2 had Rf=0.57. The other elucidation reagents gave one spot of flavonoid. In conclusion, isolation with 2% and 35% acetic acids respectively and identification with diagnostic reagent and ultraviolet light is a rapid method for identification of flavonoids content in Ocimum sanctum. [MKB. 2012;44(1):32–7].Key words: Flavonoid, identification of flavonoid, Ocimum sanctum DOI: http://dx.doi.org/10.15395/mkb.v44n1.73

Perbandingan Efektivitas Natrium Laktat dengan Manitol untuk Menurunkan Tekanan Intrakranial Penderita Cedera Kepala Berat

Arifin, Muhammad Zafrullah ( Department of Neurosurgery, Universitas Padjadjaran, Hasan Sadikin Hospital, Bandung, Indonesia ) , Risdianto, Ajid

Majalah Kedokteran Bandung Vol 44, No 1 (2012)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Original Source | Check in Google Scholar | Full PDF (1291.866 KB)

Abstract

Peningkatan tekanan intrakranial masih menjadi penyebab utama kematian pada penderita cedera kepala. Penggunaan obat baru sebagai terapi osmosis diharapkan mampu menurunkan tekanan intrakranial. Penelitian prospektif, samar ganda, acak dilakukan terhadap 20 penderita cedera kepala berat di Unit Gawat Darurat (UGD) Rumah Sakit Dr. Hasan Sadikin Bandung selama bulan Februari–Juli 2009. Penderita dikelompokkan dalam 2 kelompok yang mendapat terapi manitol atau natrium laktat. Dilakukan pengukuran tekanan intrakranial, kadar laktat, kadar natrium, serta kalium sebelum dan sesudah terapi osmosis dengan uji Shapiro-Wilk untuk analisis distribusi dan uji t berpasangan atau uji Wilcoxon untuk perbandingan rata-rata mempergunakan program statistical products and solution services (SPSS). Kelompok natrium laktat mengalami penurunan tekanan intrakranial (p<0,001) serta kenaikan kadar laktat (p=0,035). Kelompok manitol mengalami penurunan tekanan intrakranial (p=0,005) dan perubahan kadar laktat (p=0,135). Kadar natrium dan kalium pada kedua kelompok tidak terdapat perubahan yang bermakna. Penurunan tekanan intrakranial kelompok manitol dan natrium laktat tidak berbeda bermakna (p=0,417). Kadar laktat antara kelompok natrium laktat dan manitol berbeda bermakna (p=0,016), yaitu kenaikan kadar laktat yang lebih tinggi pada kelompok natrium laktat. Simpulan, pemberian natrium laktat dan manitol sama efektifnya menurunkan tekanan intrakranial pada penderita cedera kepala berat. Pemberian natrium laktat meningkatkan kadar laktat secara bermakna dibandingkan dengan pemberian manitol. Tidak terdapat perbedaan bermakna kadar natrium dan kalium pada kedua kelompok penelitian. [MKB. 2012;44(1):26–31].Comparisson between Natrium Lactate and Mannitol Effectivity in Decreasing Intracranial Pressure in Severe Head Injury PatientsIncreasing of intracranial pressure still a main cause of death in head injury patient. A new osmotic therapy probably an alternative to decrease intracranial pressure. A prospective randomized double blind study was done in 20 severe head injury in Dr. Hasan Sadikin Hospital Bandung emergency unit during February–July 2009. Subjects were divided in 2 groups, the first group was treated by natrium lactate and the second group was mannitol. We measured intracranial pressure, lactate concentration, potassium and natrium concentration before and after treatment. The statistical analysis were performed by using Shapiro-Wilk test for distribution analysis and paired t-test or Wilcoxon test for mean comparison using statistical products and solution services (SPSS) program. Intracranial pressure decreased in natrium lactate group (p<0.001) with increased of lactate concentration (p=0.035). In mannitol group we get a decreased in intracranial pressure (p=0.005), and in lactate concentration (p=0.135). No significant changed of potassium and natrium concentration in each group. No significant intracranial decrease for natrium lactate versus mannitol was apreciated (p=0.417), but a significant different in lactate concentration (p=0.016). We noticed lactate concentration in natrium lactate had a higher increase. In conclusions, we noticed a significant intracranial pressure decreased by manitol as same as natrium lactate treatment. Natrium lactate administration was increasing lactate concentration significantly than mannitol done. No significant difference in natrium and potassium was noticed in both groups. [MKB. 2012;44(1):26–31].  DOI: http://dx.doi.org/10.15395/mkb.v44n1.74 

Aktivitas Enzim Superoksida Dismutase, Katalase, dan Glutation Peroksidase Wanita Penderita Sindrom Metabolik

Winarsi, Hery ( Fakultas Biologi Universitas Soedirman, jalan Suparno 63 Karangwangkal Purwokerto 53122 ) , M. Wijayanti, Siwi P. ( Jurusan Kesehatan Masyarakat Fakultas Kedokteran dan Ilmu-ilmu Kesehatan Universitas Soedirman ) , Purwanto, Agus ( RSUD Margono Soekarjo Purwokerto )

Majalah Kedokteran Bandung Vol 44, No 1 (2012)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Original Source | Check in Google Scholar | Full PDF (890.492 KB)

Abstract

Rendahnya status antioksidan endogenus memicu perkembangan kondisi sindrom metabolik (SM). Penelitian ini bertujuan untuk mengeksplorasi aktivitas enzim antioksidan superoksida dismutase (SOD), katalase, dan glutation peroksidase (GSH-PX) dalam plasma wanita penderita sindrom metabolik. Penelitian dilakukan periode Maret–November 2010, dengan responden penelitian adalah 30 wanita yang memiliki kriteria sebagai berikut: kadar guladarah >normal, body mass index >25 kg/m2, hipertrigliseridemia, high-density lipoprotein (HDL) rendah, usia >40 tahun, dan tinggal di Purwokerto. Seleksi responden dimulai melalui survey di poliklinik internis Rumah Sakit Umum Margono Soekarjo Purwokerto. Kepada calon responden dijelaskan tentang tujuan penelitian, kondisi SM, dan perkembangannya. Calon responden yang bersedia bergabung diminta menandatangani informed consent, diukur berat badan, tinggi badan, dan tekanan darahnya. Diambil sampel darahnya 2 mL, intravena, ditentukan kadar glukosa darah, trigliserida, dan HDL. Bagian plasma, diuji aktivitas enzim SOD, katalase, dan GSH-PX. Data dipresentasikan sebagai rata-rata + standard error. Status antioksidan wanita penderita sindrom metabolik rendah, ditunjukkan oleh aktivitas SOD 379,3 Unit/mg protein, katalase 6,42 UI/mg protein, dan GSH-PX 804,9 nmol/g protein, serta kadar malondialdehid (MDA) sebesar 2.943,4 pmol/mL. Karena itu responden perlu asupan kaya antioksidan. Simpulan, status antioksidan peroksidase sama rendah yang ditunjukkan oleh rendahnya aktivitas enzim SOD, katalase, dan glutation peroksidase. [MKB. 2012;44(1):7–12].Kata kunci: Glutation peroksidase, katalase, sindrom metabolik, superoksida dismutase The Activity of Superoxide Dismutase, Catalase and Glutathione Peroxidase Enzymes in Metabolic Syndrome WomenThe low endogenous antioxidant status induced development of metabolic syndrome (MetS) condition. The aim of this research was to explore superoxide dismutase (SOD), catalase (Cat), and glutathione peroxidase (GSH-PX) plasma activity on metabolic syndrome women plasma. Respondents were thirty women with blood glucose level >normal, body mass index >25 kg/m2, hypertrigliceridemic, low level cholesterol-high-density lipoprotein (HDL), the age >40 years and live in Purwokerto. Respondents’ selection was started by a survey at internist polyclinic of Margono Soekarjo General Hospital Purwokerto. They were motivated and given an explanation about aim of the research, their diseases and development risk who were willing to be respondents were asked to sign the informed consent. Then, their body weight, height and blood pressure were measured. Their blood sample of 2 mL were taken intravenously and tested for blood glucose, triglyceride and HDL levels. Plasma was tested for the activities of SOD, Cat and GSH-PX enzymes. Presented data was mean + standard error. The antioxidant status of MetS women were low, showed on the activities of SOD, catalase, and glutathione peroxidase enzyme were 379.3 Unit/mg protein, 6.42 UI/mL, 804.9 nmol/g protein respectively, and malondialdehyde (MDA) level was 2,943.4 pmol/mL. Therefore, they need food enrich antioxidant. In conclusions, peroxidase antioxidant status was similar shown by low SOD, catalase and glutathione peroxidase enzyme activity, [MKB. 2012;44(1):7–12].Key words: Catalase, glutathione peroxidase, metabolic syndrome, superoxide dismutase DOI: http://dx.doi.org/10.15395/mkb.v44n1.75

Peluang Kematian Penderita Human Immunodeficiency Virus-Acquired Immune Deficiency Syndrome berdasarkan Gabungan Derajat Anemia, Indeks Massa Tubuh, dan Jumlah Cluster Differentiation 4

Sumantri, Rachmat ( Departemen Ilmu Penyakit Dalam Fakultas Kedokteran Universitas Padjadjaran-Rumah Sakit Dr. Hasan Sadikin Bandung, jalan Pasteur 38 Bandung ) , Supandiman, Iman ( Departemen Ilmu Penyakit Dalam Fakultas Kedokteran Universitas Padjadjaran-Rumah Sakit Dr. Hasan Sadikin Bandung ) , Indjradinata, Ponpon ( Departemen Ilmu Kesehatan Anak Fakultas Kedokteran Universitas Padjadjaran-Rumah Sakit Dr. Hasan Sadikin Bandung ) , van der Ven, Andre ( Radboud University Netherlands ) , van Crevel, Reinout ( Radboud University Netherlands )

Majalah Kedokteran Bandung Vol 44, No 1 (2012)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Original Source | Check in Google Scholar | Full PDF (1330.245 KB)

Abstract

Prevalensi anemia pada infeksi human immunodeficiency virus (HIV) cukup tinggi, berkisar antara 1,3% sampai 95% bergantung pada stadium penyakitnya. Anemia, cluster differentiation 4 (CD4), dan viral load (VL) merupakan faktor risiko independen untuk kematian. Indeks massa tubuh (IMT) merupakan faktor risiko yang penting untuk anemia dan progresivitas penyakit. Dilakukan penelitian kohor untuk mengevaluasi respons pengobatan selama follow-up 6 bulan dengan endpoint kematian, serta menghitung peluang kematian penderita acquired immunodeficiency syndrome (HIV-AIDS) berdasarkan gabungan derajat anemia, IMT, dan jumlah CD4. Subjek penelitian adalah penderita HIV-AIDS di klinik Teratai Rumah Sakit Dr. Hasan Sadikin (RSHS) Bandung, periode Januari−Juni 2008, studi kohor dilakukan pada periode Juli−Desember 2008. Tercatat 534 penderita HIVAIDS yang masuk dalam data di klinik Teratai RSHS, sampai akhir penelitian terdapat 458 penderita yang masih aktif berobat, 38 penderita drop-out, 8 penderita pindah ke tempat lain, dan 28 penderita meninggal. Prevalensi anemia kelompok yang sama pada penelitian sebelumnya yaitu 41,6%. Dalam follow-up selama 6 bulan terdapat 26 kematian pada kelompok anemia dan hanya 2 kematian pada kelompok nonanemia. Gabungan antara derajat anemia sedang-berat, dengan CD4 ≤50/mm3, dan IMT <18,5 menunjukkan peluang kematian terbesar, dalam penelitian ini sebesar 80%. Simpulan, faktor risiko yang penting untuk kematian pada penderita HIV-AIDS yaitu jumlah CD4, derajat anemia, dan IMT. [MKB. 2012;44(1):50–6].Kata kunci: Anemia, CD4, indeks massa tubuhOpportunity of Death in Human Immunodeficiency Virus-Acquired Immunodeficiency Syndrome Patients by Combining Degree of Anemia, Body Mass Index, and Cluster Differentiation 4 CountThe prevalence of anemia in human immunodeficiency syndrome (HIV) infection was quite high, ranging from 1.3 to 95% depending on the stadium of HIV infection. Anemia, cluster differentiation 4 (CD4), and viral load were known as the independent risk factors for death. Body mass index (BMI) is an important risk factor for anemia and progression of the HIV infection. A cohort study had been conducted to evaluate the response of therapy, and deaths as the end point, and to calculate the opportunity of death  by combining the degree of anemia, BMI, and CD4 in HIV-AIDS patients. The subjects were patients in Teratai Clinic Dr. Hasan Sadikin General Hospital-Bandung from  January to June 2008. During 6 months of follow-up from  July−December 2008, there were 534 patients in the database of Teratai Clinic, with only 458 continuing the therapy, thirty eight  patients were dropped-out, eight patients moved to other hospital and 28 patients died. The prevalence of anemia from previous study of those 534 patients was 41.6%. After 6 months of follow-up, there were 26 deaths among anemic patients and 2 deaths in non-anemic patients. The combination of moderate-severe anemia, CD4 ≤50/mm3 and BMI <18.5 showing the highest opportunity of death in this study was 80%. In conclusion, the important risk factors of deaths in HIV-AIDS patients were CD4, grade of anemia, and BMI. [MKB. 2012;44(1):50–6].Key words: Anemia, body mass index, CD4DOI: http://dx.doi.org/10.15395/mkb.v44n1.212

Kadar D-Dimer Plasma sebagai Prediktor Kematian Penderita Pneumonia Usia 2–59 Bulan

Saraswati, Retno ( Rumah Sakit MH. Thamrin Cileungsi, jalan Narogong Km 16 Limusnunggal Cileungsi Bogor 16820, telepon ) , Lukmanul Hakim, Dzulfikar D. ( Departemen Ilmu Kesehatan Anak Fakultas Kedokteran Universitas Padjadjaran-Rumah Sakit Hasan Sadikin Bandung ) , Garna, Herry ( Departemen Ilmu Kesehatan Anak Fakultas Kedokteran Universitas Padjadjaran-Rumah Sakit Hasan Sadikin Bandung )

Majalah Kedokteran Bandung Vol 44, No 1 (2012)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Original Source | Check in Google Scholar | Full PDF (1305.772 KB)

Abstract

Pada pneumonia berat, terjadi koagulasi intravaskular dan intraalveolar yang merupakan respons proses inflamasi lokal dan sistemik infeksi paru. Konsekuensi klinis dari perubahan koagulasi ini yaitu peningkatan kadar D-dimer plasma sebagai petanda aktivitas koagulasi dan fibrinolisis serta meluasnya disfungsi organ bahkan kematian. Tujuan penelitian ini untuk mengetahui validitas kadar D-dimer plasma yang tinggi sebagai prediktor kematian penderita pneumonia usia 2 sampai 59 bulan. Penelitian ini merupakan penelitian observasional analitik dengan rancangan prospektif yang dilaksanakan di Rumah Sakit Dr. Hasan Sadikin Bandung. Subjek penelitian anak usia 2 sampai 59 bulan yang didiagnosis sebagai pneumonia dan berobat ke Instalasi Gawat Darurat Anak selama bulan Oktober–November 2009. Pemeriksaan D-dimer plasma dilakukan saat penderita datang dan kemudian dilakukan observasi sampai penderita meninggal atau dipulangkan dari rumah sakit. Empat puluh lima anak ikut serta dalam penelitian ini, 15 (33%) di antaranya meninggal selama observasi. Kadar D-dimer plasma menunjukkan hubungan yang bermakna (p=0,04) terhadap kematian penderita pneumonia dengan median dan rentang sebesar 0,60 mg/L (0,1–5,10 mg/L). Cut-off point D-dimer plasma >0,4 mg/L sebagai prediktor kematian penderita pneumonia memberikan sensitivitas 73,3% (IK 95%; 44,9–92,0) dan spesifisitas 70,0% (IK 95%; 50,6–85,2%) dengan akurasi 71,1%. Simpulan, kadar D-dimer plasma yang tinggi dapat memprediksi kematian penderita pneumonia usia 2 sampai 59 bulan. [MKB. 2012;44(1):57–62].Kata kunci: Kadar D-dimer plasma, koagulasi, pneumonia, prediktor kematianPlasma D-Dimer Level as Predictor of Mortality in 2–59-Month-Old Pneumonia PatientsIntravascular and intraalveolar coagulation can be found in severe pneumonia as a response to local and systemic inflammation process in severe pneumonia. Clinical consequences of this coagulation changes is an increase of plasma D-dimer levels as a marker of coagulation and fibrinolyis activation, the number of organ dysfunction even death. The aim of this study was to understand the validity of high plasma D-dimer levels as a predictor of mortality in 2 to 59-month-old pneumonia patients. This was a prospective observational analytic study which washeld in Dr. Hasan Sadikin Hospital Bandung. The subjects of this study were 2 to 59 months old children who were diagnosed as pneumonia and visited Pediatric Emergency Departement during October–November 2009. Plasma D-dimer assay was performed at admission and observed until the patient died or discharged from the hospital. Forty-five children were included in this study, 15 (33%) died during observation. Plasma D-dimer level showed significant correlations (p=0.04) with the mortality in 2 to 59-month-old pneumonia patients with median and range of 0.60 mg/L (0.1–5.10 mg/L). Plasma D-dimer cut-off point of >0.4 mg/L gave 73.3% sensitivity (CI 95%, 44.9–92.0%), and 70.0% specificity (CI 95%, 50.6–85.2%) with 71.1% accuracy for predicting mortality in 2 to 59-month-old pneumonia patients. In conclusions, there were significant correlations between elevated plasma Ddimer levels and mortality in 2 to 59-month-old patients with pneumonia. [MKB. 2012;44(1):57–62].Key words: Coagulation, plasma D-dimer levels, pneumonia, predictor of mortality DOI: http://dx.doi.org/10.15395/mkb.v44n1.213

Korelasi antara Imunoekspresi p53 dan Respons Kemoterapi Neoadjuvan Regimen Fluororasil, Adriamisin, dan Siklofosfamid pada Karsinoma Duktus Payudara Invasif

Muhartono, - ( Bagian Patologi Anatomi Fakultas Kedokteran Universitas Lampung, jalan Soemantri Brojonegoro 1 Bandar Lampung ) , Hanriko, Rizki ( Bagian Patologi Anatomi Fakultas Kedokteran Universitas Lampung, jalan Soemantri Brojonegoro 1 Bandar Lampung )

Majalah Kedokteran Bandung Vol 44, No 1 (2012)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Original Source | Check in Google Scholar | Full PDF (915.71 KB)

Abstract

Karsinoma duktus payudara invasif (KDPI) stadium IIIB perlu penanganan multimodalitas. Kemoterapi neoadjuvan (KN) diberikan untuk menurunkan ukuran dan stadium tumor agar dapat dilakukan operasi. Regimen KN yang biasanya digunakan yaitu fluororasil, adriamisin, dan siklofosfamid (FAS). Kemoterapi FAS bekerja dengan cara merusak deoxyribonucleic acid dan menginduksi apoptosis sel kanker. Terjadinya kelainan protein atau gen yang berhubungan dengan apoptosis (p53) diduga mempengaruhi respons kemoterapi tersebut. Tujuan penelitian ini untuk mengetahui korelasi imunoekspresi p53 dengan respons kemoterapi neoadjuvan FAS. Penelitian ini merupakan penelitian analitik potong lintang terhadap 40 kasus KDPI yang diberikan KN FAS di Rumah Sakit Dr. Hasan Sadikin Bandung periode Maret 2008–Februari 2009. Respons KN FAS dinilai berdasarkan ukuran massa tumor setelah pemberian FAS. Blok parafin penderita dibuat pulasan hematoksilin-eosin dan imunohistokimia dengan menggunakan mouse monoclonal antibody p53 protein (Novocastra), kemudian ditentukan tingkat imunoekspresi p53. Uji statistik dengan Somers’d dan Gamma untuk menguji korelasi antar variabel. Nilai p<0,05 secara statistik dianggap bermakna. Pada 40 kasus KDPI, 20 berespons dan 20 kasus tidak berespons terhadap KN FAS; 13 kasus terekspresi p53>75%, 14 kasus p53=10–75%, 7 kasus p53<10%, dan 6 kasus tidak terekspresi p53. Terdapat korelasi bermakna antara imunoekspresi p53 dan respons kemoterapi FAS (p=0,000). Simpulan, semakin tinggi ekspresi p53, semakin tidak berespons terhadap KN FAS. Imunoekspresi p53 dapat memprediksi respons KN FAS pada KDPI stadium IIIB. [MKB. 2012;44(1):13–8].Kata kunci: Karsinoma duktus payudara invasif, imunoekspresi, p53 Correlation between p53 Immunoexpression and Fluorouracyl, Adriamycin and Cyclophosphamide Regimen Neoadjuvant Chemotherapy Responses in Invasive Ductal Breast CarcinomaInvasive ductal breast carcinoma (IDBC) stage IIIB need multimodality treatment. Neoadjuvant chemotherapy (NC) is given to reduce the size and stage of tumor so that surgery can be performed. Neoadjuvant chemotherapy regimens generally used was fluorouracil, adriamycin and cyclophosphamide (FAC). FAC chemotherapy works by damaging deoxyribonucleic acid and induce apoptosis of cancer cells. Abnormalities of proteins or genes associated with apoptosis (p53) is believed to affect the chemotherapy response. This study was purpose to determine correlation between immunoexpression of p53 and response of neoadjuvant FAC chemotherapy in invasive ductal breast carcinoma. The study was a cross sectional analytic study of 40 IDBC cases given FAC NC at Dr. Hasan Sadikin Hospital Bandung between March 2008–February 2009. Response of FAC NC judged on the size of tumor mass following administration of FAC. Haematoxylin-eosin and immunohistochemistry stain using a mouse monoclonal antibody to p53 protein (Novocastra) was made from paraffin blocks of patients, then determined the immunoexpression levels of p53. Somers’d and Gamma statistical were used to test the correlation between variables. The p-value <0.05 was considered statistically significant. In 40 IDCB cases, 20 cases were responded and 20 cases did not respond to FAC NC; 13 cases expressed p53>75%, 14 cases p53 10–75%, 7 cases p53<10%, and 6 cases were not expresed p53; There was a significant correlation between immunoexpression of p53 and the response of FAC chemotherapy (p=0.000). In conclusions, the higher expression of p53, the lower response to NC FAC. Immunoexpression of p53 can predict the response of FAC NC on IDBC stage IIIB. [MKB.2012;44(1):13–8].Key words: Immunoexpression, invasive ductal breast carcinoma, p53 DOI: http://dx.doi.org/10.15395/mkb.v44n1.209

Penurunan Nyeri Persalinan Primigravida Kala I Fase Aktif Pascapenghirupan Aromaterapi Lavender

Tarsikah, -, Susanto, Herman ( Departemen Obstetri Ginekologi, Fakultas Kedokteran Universitas Padjadjaran Rumah Sakit Dr. Hasan Sadikin Bandung ) , Sastramihardja, Herri S. ( Departemen Farmakologi Fakultas Kedokteran Universitas Padjadjaran Rumah Sakit Dr. Hasan Sadikin Bandung )

Majalah Kedokteran Bandung Vol 44, No 1 (2012)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Original Source | Check in Google Scholar | Full PDF (1291.028 KB)

Abstract

Nyeri persalinan merupakan bagian pada proses normal yang tidak jarang menyebabkan stres fisiologis dan psikologis terhadap ibu yang berdampak pada ibu maupun janin. Sebagian besar persalinan (90%) disertai nyeri, bahkan sampai nyeri berat. Penanganan nonfarmakologi merupakan salah satu alternatif untuk mengurangi nyeri persalinan. Penelitian ini bertujuan untuk menganalisis efek analgesik penghirupan aromaterapi lavender pada nyeri persalinan primigravida kala I fase aktif. Rancangan yang digunakan adalah studi praeksperimental, satu kelompok diobservasi sebelum dan sesudah perlakuan terhadap 30 ibu bersalin di Rumah Bersalin (RB) Kasih Ibu Jatirogo kabupaten Tuban provinsi Jawa Timur sebagai sampel yang dipilih secara konsekutif. Pengukuran variabel menggunakan skala nyeri numerik. Dilakukan analisis univariabel kuantitatif untuk mengetahui nyeri sebelum dan sesudah perlakuan. Analisis kuantitatif bivariabel Wilcoxon signed ranks test digunakan untuk mengetahui pengurangan nyeri dengan tingkat kemaknaan p<0,05. Penelitian ini dilakukan periode 14 September–31 Oktober 2009. Hasil analisis univariabel menyatakan bahwa skor nyeri rata-rata sebelum perlakuan 7,3 (SD 1,1) dansesudah perlakuan 5,9 (SD 1,4). Hasil uji Wilcoxon signed ranks test menunjukkan pengurangan nyeri yang bermakna pascapenghirupan aromaterapi lavender (Z=-4,338; p=0,000). Simpulan, terdapat pengurangan nyeri persalinan pascapenghirupan aromaterapi lavender. [MKB. 2012;44(1):19–25].Kata kunci: Nyeri persalinan, penghirupan aromaterapi lavender Labor Pain Reduction in Primigravida Active Phase after Inhalation of Lavender AromatherapyLabor pain is part of a normal process, which often causes physiological and psychological stress to mother. These stress have impact to both mother and fetus. Largely (90%) labor comes with pain and in some cases severe pain. Non-pharmacological approach is one of alternatives to reduce labor pain. This research aims to analyse the analgesic effect of lavender aromatherapy inhalation on labor pain in primigravida in the active phase. The study was pra-experimental by observing one group before and after treatment. The group involved 30 parturients in RB Kasih Ibu Jatirogo district of Tuban, East Java. The sampling method was based on consecutive admission. The variables were measured by using numerical rating scales (NRS). Univariable quantitative analysis was applied to describe the pain before and after treatment. Wilcoxon signed ranks test bivariable quantitative analysis was used to investigate pain relief with significance level of p<0.05. The univariable analysis result revealed that mean pain score before treatment was 7.3 (SD 1.1) and after treatment 5.9 (SD 1.4). Wilcoxon signed ranks test result showed significant pain relief after lavender aromatherapy inhalation (Z=-4.338, p=0.000). The research shows that there is a reduction of labor pain after lavender aromatherapy inhalation. [MKB. 2012;44(1):19–25].Key words: Inhalation lavender aromatherapy, labor pain DOI:  http://dx.doi.org/10.15395/mkb.v44n1.210

Jenis dan Jumlah Mikroorganisme Aerob pada Persalinan Spontan Kurang dan Cukup Bulan tanpa Ketuban Pecah Dini

Krisnadi, Sofie Rifayani ( Departemen Obstetri dan Ginekologi Fakultas Kedokteran Universitas Padjadjaran-Rumah Sakit Dr. Hasan Sadikin Bandung ) , Effendi, Jusuf Sulaeman ( Departemen Obstetri dan Ginekologi Fakultas Kedokteran Universitas Padjadjaran-Rumah Sakit Dr. Hasan Sadikin Bandung )

Majalah Kedokteran Bandung Vol 44, No 1 (2012)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Original Source | Check in Google Scholar | Full PDF (1254.589 KB)

Abstract

Persalinan kurang bulan merupakan penyebab utama mortalitas dan morbiditas perinatal. Angka kejadian persalinan kurang bulan yang disebabkan infeksi sebesar 40–50%. Tujuan penelitian ini untuk membuktikan bahwa persalinan spontan kurang bulan tanpa ketuban pecah dini didahului oleh korioamnionitis serta mengetahui perbandingan jenis dan jumlah mikroorganisme aerob penyebab korioamnionitis pada persalinan spontan kurang dan cukup bulan tanpa ketuban pecah dini. Penelitian ini merupakan studi komparatif dengan rancangan studi silang (cross sectional). Penelitian ini dilakukan di Rumah Sakit Dr. Hasan Sadikin Bandung dan rumah sakit jejaringnya periode Juli–Agustus 2009 dengan subjek penelitian sebanyak 53 penderita. Analisis data dengan uji statistik digunakan uji chi-kuadrat dan untuk membandingkan perbedaan dua usia persalinan rata-rata digunakan uji beda (uji t). Kemaknaan ditentukan berdasarkan nilai p<0,05. Tidak terdapat perbedaan karateristik penderita pada kedua kelompok subjek penelitian. Terdapat hubungan bermakna kedua kelompok dengan korioamnionitis (p=0,004), terdapat perbedaan bermakna jenis mikroorganisme aerob antara kedua kelompok (p=0,025), dan terdapat perbedaan bermakna jumlah mikroorganisme aerob antara kedua kelompok (p=0,003). Simpulan, persalinan spontan kurang bulan tanpa ketuban pecah dini disebabkan korioamnionitis dan jumlah mikroorganisme mempengaruhi kejadian persalinan spontan kurang bulan tanpa ketuban pecah dini. [MKB. 2012;44(1):44–9].Kata kunci: Korioamnionitis, mikroorganisme aerob, persalinan spontan kurang bulan tanpa ketuban pecah diniSpecies and Number of Aerob Microorganism in Preterm and Term Spontaneous Delivery with Intact MembranePreterm birth is the main cause of perinatal mortality and morbidity. Prevalence of preterm delivery which is caused by infection is 40–50%. The aim of this study was to determine that spontaneous preterm delivery without premature rupture of the membrane is initiated by chorioamnionitis and to find out the comparison of aerob microorganism species and number from spontaneous preterm and term delivery without premature rupture of the membrane. This was a comparative cross sectional study. This study was conducted in Dr. Hasan Sadikin Hospital Bandung and satelite hospital, from July to August 2009, the subjects were 53 patients. This study analyzed with chi-square and t-test to differentiate average of gestational age with p<0.05. There’s no significant difference of characteristic between two research subject groups, significant difference between two research subject groups with chorioamnionitis (p=0.004), significant difference of aerob microorganism species between two research subject groups (p=0.025) and significant difference number of aerob microorganism between two research subjects (p=0.003). In conclusions, chorioamnionitis can initiate a spontaneous preterm delivery without premature rupture of the membrane and the number of microorganism indicated the virulence of microorganism that caused chorioamnionitis which is initiated spontaneous preterm delivery without premature rupture. [MKB. 2012;44(1):44–9].Key words: Aerob microorganism, chorioamnionitis, spontaneous preterm delivery without premature rupture of the membrane DOI: http://dx.doi.org/10.15395/mkb.v44n1.211