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Majalah Kedokteran Bandung
Articles by issue : Vol 45, No 1 (2013)
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Articles
Khasiat Proteksi Madu terhadap Kerusakan Hepar Tikus yang Diinduksi Etano

Muhartono, - ( Bagian Patologi Anatomi Fakultas Kedokteran Universitas Lampung, jalan Soemantri Brojonegoro 1 Bandar Lampung ) , D, Larasati N. ( 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 ) , Sutyarso, Sutyarso ( Bagian Patologi Anatomi Fakultas Kedokteran Universitas Lampung, jalan Soemantri Brojonegoro 1 Bandar Lampung )

Majalah Kedokteran Bandung Vol 45, No 1 (2013)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Madu merupakan salah satu produk lebah madu yang sering digunakan sebagai obat sejak zaman dahulu. Madu memiliki aktivitas antioksidan yang tinggi, namun penelitian untuk mengetahui efek protektifnya terhadap kerusakan hepar akibat etanol belum dilakukan di Indonesia. Penelitian ini bertujuan mengetahui efek protektif madu terhadap kerusakan hepar tikus yang diinduksi etanol. Penelitian ini dilaksanakan pada November 2011 di laboratorium Farmakologi dan Patologi Anatomi Fakultas Kedokteran Universitas Lampung. Penelitian eksperimental laboratorik ini menggunakan rancangan acak lengkap terhadap 25 ekor tikus yang dibagi menjadi lima kelompok. Kelompok 1: kontrol; kelompok 2: etanol; kelompok 3, 4, dan 5: madu + etanol. Etanol 0,01 mL/ gBB diberikan per oral kepada kelompok 2, 3, 4, dan 5 selama 14 hari. Kelompok madu + etanol diberi madu per oral dosis 0,0018 mL/gBB, 0,0054 mL/gBB, dan 0,016 mL/gBB 1,5 jam sebelum pemberian etanol. Sampel hepar diambil untuk pemeriksaan histopatologi. Parameter kerusakan hepar berupa degenerasi lemak. Hasilnya menunjukkan etanol menyebabkan degenerasi lemak dibandingkan dengan kelompok kontrol. Kelompok 3, 4, dan 5 menunjukkan penurunan degenerasi lemak secara bermakna (p<0,050; p<0,001; p<0,001). Perbaikan terlihat jelas pada kelompok 5. Simpulan, madu berefek protektif terhadap kerusakan hepar tikus. [MKB. 2013;45(1):16–22]The Protective Effect of Honey on Ethanol-Induced Liver Injury in RatsHoney is one of the honeybee’s’ products which are often used as medicine since a long time ago. Honey has a high antioxidant activity, but studies to investigate its protective effect on ethanol-induced liver injury have not been carried out in Indonesia. The aim of this study was to investigate the protective effect of honey on ethanol-induced rat liver injury. This study done conducted in the Pharmacology and Pathology laboratory in November 2011. This experimental laboratory study used randomized complete design on 25 rats divided into five groups. Group 1: control; group 2: ethanol; group 3, 4 and 5: honey + ethanol. Ethanol 0.01 mL/g body weight was given orally to group 2, 3, 4 and 5 for 14 days. Honey + ethanol groups were given honey at a dose of 0.0018 mL/g body weight, 0.0054 mL/g body weight, and 0.016 mL/g body weight orally at 1.5 hours prior to ethanol administration. Liver samples were taken for histopathological examination. The parameter of liver injury was fatty degeneration. The results showed that ethanol induced fatty degeneration compared to control group. Group 3, 4 and 5 showed significantly decreased fatty degeneration (p<0.050, p <0.001, p <0.001). The improvement was prominent in group 5. In conclusion, honey has a protective effect on rat liver injury. [MKB. 2013;45(1):16–22] DOI: http://dx.doi.org/10.15395/mkb.v45n1.94

Kematian Akibat Pneumonia Berat pada Anak Balita

Wulandari, Diah Asri ( Departemen Ilmu Kesehatan Anak Fakultas Kedokteran Universitas Padjadjaran Rumah Sakit Dr. Hasan Sadikin Bandung ) , Sudarwati, Sri ( Departemen Ilmu Kesehatan Anak Fakultas Kedokteran Universitas Padjadjaran Rumah Sakit Dr. Hasan Sadikin Bandung ) , Suardi, Adi Utomo ( Departemen Ilmu Kesehatan Anak Fakultas Kedokteran Universitas Padjadjaran Rumah Sakit Dr. Hasan Sadikin Bandung ) , Ghrahani D. M., Reni, Kartasasmita, Cissy B.

Majalah Kedokteran Bandung Vol 45, No 1 (2013)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Pneumonia merupakan penyebab utama kesakitan dan kematian pada anak, terutama di negara berkembang. Angka kematian karena pneumonia di negara berkembang 10–15 kali lebih tinggi daripada di negara maju. Penelitian ini bertujuan untuk mengetahui angka kematian dan faktor risiko pada anak balita yang dirawat di rumah sakit karena pneumonia. Penelitian potong lintang ini dilakukan pada anak usia 1–59 bulan yang dirawat di Rumah Sakit Dr. Hasan Sadikin Bandung karena pneumonia periode November 2007─Januari 2009. Tiga ratus delapan belas anak ikut serta dalam penelitian ini. Usia median anak 11‚6 bulan, sebanyak 237 (74‚5%) di antaranya berusia ≤12 bulan. Sembilan puluh tiga (29‚2%) anak didiagnosis pneumonia sangat berat dan 225 (70‚8%) anak pneumonia berat. Dua puluh tiga (7‚2%) penderita meninggal selama perawatan, 20 di antaranya dirawat dengan pneumonia sangat berat (p<0,001; OR 20,274; 95%IK: 5,855–70,197). Kelainan jantung bawaan (p=0,002; OR 5,795; 95%IK: 2,115–15,407) dan leukositosis (≥15.500/mm3; p=0,002; OR 3,879; 95%IK: 1,547–9,727) berhubungan erat dengan kematian. Kuman patogen ditemukan pada 11 dari 23 penderita yang meninggal. Simpulan, kematian karena pneumonia berat masih cukup tinggi. Pneumonia sangat berat, kelainan jantung bawaan, dan leukositosis merupakan faktor risiko yang meningkatkan kematian anak balita dengan pneumonia. [MKB. 2013;45(1):50–5]Mortality Due to Severe Pneumonia in Under-Five Years Old ChildrenPneumonia is one of the leading causes of morbidity and mortality in children, mainly in developing countries with a 10–15 times higher mortality rate than developed countries. The aim of the study was to know the mortality rate and its risk factors among under five years old children who were hospitalized due to severe pneumonia. This cross-sectional study was conducted to 1 to 59 months old children with pneumonia at the Department of Pediatric Dr. Hasan Sadikin Bandung Hospital from November 2007 to January 2009. Three hundred and eighteen children were enrolled in this study. The median age was 11.16 months, and 237 (74.5%) were ≤12 months of age. Very severe pneumonia was diagnosed in 93 (29.2%) and severe pneumonia in 225 (70.8%) children. Twenty three (7.2%) children died during hospitalization, 20 were hospitalized with very severe pneumonia (p<0.001, OR 20.274, 95%CI: 5.855─70.197). Congenital heart disease (p=0.002, OR 5.795, 95%CI: 2.115–15.407) and leucocytosis (≥15,500/mm3, p=0.002, OR 3.879, 95%CI: 1.547–9.727) were significantly associated to the mortality. Pathogenic bacteria were identified in 11 of 23 patients. In conclusions, the mortality of severe pneumonia is still high. Very severe pneumonia, congenital heart disease and leucocytosis are factors that increase mortality among under-five years old children with pneumonia. [MKB. 2013;45(1):50–5] DOI: http://dx.doi.org/10.15395/mkb.v45n1.140

Efek Probiotik terhadap Mortalitas, Derajat Inflamasi Intestinal, dan Kadar IgA pada Mencit Model Sepsis

Indrayanto, Yoseph ( Laboratorium Biologi Fakultas Kedokteran, Universitas Sebelas Maret Surakarta ) , Prasetyo, Diding Heri ( Divisi Imunologi, Laboratorium Biokimia Fakultas Kedokteran, Universitas Sebelas Maret Surakarta )

Majalah Kedokteran Bandung Vol 45, No 1 (2013)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Sepsis mengubah mikrobiologi saluran pencernaan, menyebabkan hilangnya flora komensal dan pertumbuhan bakteri patogen yang berlebih. Pemberian probiotik penderita sepsis dapat mengembalikan keseimbangan mikrobiota dan memiliki efek positif pada fungsi imunitas tubuh serta struktur dan fungsi gastrointestinal. Penelitian ini bertujuan untuk menentukan efek pemberian probiotik terhadap mortalitas, inflamasi intestinal, dan kadar imunoglobulin A (IgA) serum pada mencit model sepsis. Penelitian ini merupakan penelitian eksperimental laboratoris, dengan sampel 36 ekor mencit Balb/C jantan dibagi menjadi kelompok: kontrol, sepsis, dan sepsis+probiotik. Penelitian dilakukan di laboratorium Histologi dan Biomedik Fakultas Kedokteran Universitas Sebelas Maret Surakarta,periode Januari–April 2012. Mencit Balb/C jantan diinjeksi cecal inoculum (200 mg/kgBB) secara intraperitoneal (i.p), untuk kelompok sepsis maupun sepsis dengan probiotik. Kelompok mencit kontrol tidak diinokulasi selama penelitian. Inflamasi intestinal ditentukan dengan pengecatan hematoksilin eosin (HE) pada hari ke-8. Mortalitas dinilai sampai hari ke-8. Kadar IgA serum ditentukan menggunakan enzyme-linked immunosorbent assay. Twotailed Fisher Exact Test untuk uji mortalitas, Kruskal-Wallis untuk uji inflamasi intestinal, sedangkan analysis of variance untuk uji kadar IgA serum. Persentase kematian kelompok probiotik tidak berbeda bermakna (10% vs 40%, p=0,065) dibandingkan dengan kelompok sepsis. Probiotik bermakna menurunkan derajat inflamasi intestinal dibandingkan dengan kelompok sepsis (p<0,001). Kadar IgA serum kelompok mencit kontrol 35,82±4,55 ng/mL. Probiotik secara bermakna meningkatkan kadar IgA serum (65,07±34,97 ng/mL vs 6,20±5,80 ng/mL, p<0,001) dibandingkan dengan kelompok mencit sepsis. Simpulan, pemberian probiotik menurunkan derajat inflamasiintestinal dan mortalitas, serta meningkatkan kadar IgA serum pada mencit model sepsis. [MKB. 2013;45(1):10–5]Kata kunci: IgA, inflamasi, probiotik, sepsis Probiotic Effects of Mortality, Degree of Intestinal Inflammation, and IgA Levels in Sepsis Mice ModelSepsis results in changes to the microbiology of the gastrointestinal tract, leading to a loss of commensal flora and an overgrowth of potentially pathogenic bacteria. Administering probiotics to sepsis patients may restore balance to the microbiota and have positive effects on immune function and gastrointestinal structure and function. This study was aimed to evaluate the effect of probiotic on mortality, intestinal inflammation and immunoglobulin A (IgA) serum level in mice model of sepsis. This study was an experimental research laboratory, with 36 male Balb/C mice were divided into: control, sepsis, and sepsis+probiotic groups. The study was conducted at Histology and Biomedical Laboratory, School of Medicine, Sebelas Maret University, Surakarta, in January to April 2012. Sepsis was induced in the male Balb/C mice using an intraperitoneally (i.p) injection of cecal inoculum (200 mg/ kgBW), for sepsis mice model and sepsis with probiotic. Control mice were not inoculation during the study. Detection of intestinal inflammation with hematoxylin and eosin (HE) staining on 8th day. Mortality perceived until 8th day. IgA serum level measurement with enzyme-linked immunosorbent assay. Two-tailed Fisher exact test for the analysis of mortality, Kruskal-Wallis test for the intestinal inflammation, one way analysis of variance for IgA serum level. Probiotic showed no significantly mortality (10% vs 40%, p=0.065) compared to sepsis group. Probiotic showed significantly decreased intestinal inflammation compared to sepsis group (p<0.001). Control mice showed levels of IgA 35.82±4.55 ng/mL. Probiotic showed significantly increased IgA levels (65.07±34.97 ng/mL vs 6.20±5.80 ng/mL, p<0.001) compared to sepsis group. In conclusions, probiotic decrease intestinal inflammation and mortality, on the other hand increase IgA level in mice model of sepsis. [MKB. 2013;45(1):10–5]Key words: IgA, inflammation, probiotic, sepsis DOI: http://dx.doi.org/10.15395/mkb.v45n1.95

Tingkat Ketepatan Audiometer Skrining Medan Bebas untuk Mendeteksi Gangguan Dengar Anak Sekolah Dasar dengan Otitis Media

Hartanto, Widya W. ( Departemen Ilmu Kesehatan Telinga Hidung Tenggorok Bedah Kepala & Leher Fakultas Kedokteran Universitas Padjadjaran-Rumah Sakit Dr. Hasan Sadikin Bandung ) , Boesoirie, Thaufiq S. ( Departemen Ilmu Kesehatan Telinga Hidung Tenggorok Bedah Kepala & Leher Fakultas Kedokteran Universitas Padjadjaran-Rumah Sakit Dr. Hasan Sadikin Bandung ) , Poerwana, Ratna A. S. ( Departemen Ilmu Kesehatan Telinga Hidung Tenggorok Bedah Kepala & Leher Fakultas Kedokteran Universitas Padjadjaran-Rumah Sakit Dr. Hasan Sadikin Bandung )

Majalah Kedokteran Bandung Vol 45, No 1 (2013)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Skrining pendengaran pada anak sekolah dapat mengetahui lebih dini gangguan dengar akibat otitis media sehingga hasil pengobatannya akan lebih baik. Audiometer skrining medan bebas merupakan alat skrining pendengaran yang sederhana, terjangkau, ringkas, mudah dan singkat, tetapi belum diukur tingkat ketepatannya untuk anak sekolah dasar. Penelitian ini bertujuan untuk menguji tingkat ketepatan audiometer skrining medan bebas untuk mendeteksi gangguan dengar pada anak sekolah dasar yang menderita otitis media. Penelitian uji diagnostik dengan rancangan penelitian potong silang dilakukan di Sekolah Dasar Sejahtera dan Poliklinik Departemen Ilmu Kesehatan Telinga Hidung Tenggorok–Bedah Kepala dan Leher RS Dr. Hasan Sadikin Bandung periode bulan Juni–Agustus 2011. Dari 479 anak sekolah dasar, didapatkan 86 subjek sesuai kriteria inklusi. Terdapat gangguan dengar pada 56 anak yang diperiksa audiometer skrining medan bebas dan 51 anak yang diperiksa audiometri nada murni. Hasil uji diagnostik audiometer skrining medan bebas didapatkan sensitivitas 90,2%; spesifisitas 71,4%; indeks Kappa 0,630. Perbandingan pemeriksaan pendengaran antara audiometri skrining medan bebas dan audiometri nada murni didapatkan p=0,302. Simpulan, tingkat ketepatan audiometer skrining medan bebas sama dengan audiometer nada murni untuk mendeteksi gangguan dengar anak sekolah dasar yang menderita otitis media. [MKB. 2013;45(1):62–8]Accuracy of Portable Screening Audiometer for Detecting Hearing Loss in Elementary School Children with Otitis MediaHearing skrining in school children can detect hearing loss due to otitis media earlier therefor treatment will give better outcome. Portable screening audiometer is a device which are simple, less expensive, brief, easy to use and has shorter examination time but has not been measured its accuracy for hearing screening in elementary school children. The objective of this study was to measure the accuracy of portable screening audiometry for detecting hearing loss in elementary school children with otitis media. A diagnostic test study with cross-sectional method was conducted at Sejahtera Elementary School and at Out-patient Clinic Otorhinolaryngology-Head and Neck Department Dr. Hasan Sadikin Hospital Bandung period June until August 20011. From 479 children, there were 86 children match with inclusion criteria. Hearing loss was found in 56 children examined using portable screening audiometer and in 51 children using pure tone audiometry. Diagnostic test result for portable screening audiometer were 90.2% sensitivity, 71.4% specificity, with Kappa index 0.630 and p value was 0.302 compared to pure tone audiometry. In conclusion, the accuracy of portable screening audiometer is as good as pure tone audiometry in order to detect hearing loss in elementary school children with otitis media. [MKB. 2013;45(1):62–68] DOI: http://dx.doi.org/10.15395/mkb.v45n1.141

Hubungan antara Gejala Gangguan Depresi dan Tension-Type Headache (TTH): Studi Eksploratif

Setiawan, Cecilia J. ( Rumah Sakit Awal Bros, jalan MH. Thamrin No 3 Cikokol Tangerang 15117 ) , Sadeli, Henny Anggraini ( Departemen Ilmu Saraf Fakultas Kedokteran Universitas Padjadjaran ) , A. Sapiie, Tuti Wahmurti ( Departemen Ilmu Saraf Fakultas Kedokteran Universitas Padjadjaran )

Majalah Kedokteran Bandung Vol 45, No 1 (2013)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Prevalensi gangguan depresi semakin meningkat, termasuk yang berkomorbiditas dengan penyakit fisik. Kondisi medik yang telah lama dikaitkan dengan gangguan depresi adalah tension-type headache (TTH). Komorbiditas ini berhubungan dengan perjalanan penyakit TTH kronik. Tujuan penelitian ini untuk mengetahui gejala gangguan depresi yang paling banyak terjadi pada penderita TTH serta menganalisis hubungan antara gejala tersebut dan tipe TTH yang dialaminya. Penelitian ini merupakan studi potong lintang terhadap 32 penderita TTH yang berobat jalan ke Instalasi Rawat Jalan Departemen Ilmu Penyakit Saraf Rumah Sakit Dr. Hasan Sadikin Bandung selama bulan November hingga Desember 2011 yang didiagnosis gangguan depresi. Subjek diperiksa dengan menggunakan instrumen Hamilton Depression Rating Scale (HDRS). Analisis korelasi dilakukan antara skor gejala gangguan depresi yang paling banyak terjadi dengan tipe TTH, dilanjutkan dengan analisis multivariabel untuk mencari rasio prevalens gejala gangguan depresi yang berkorelasi dengan tipe TTH. Angka kejadian gangguan depresi pada TTH didapatkan pada 32/38 penderita, sedangkan gejala gangguan depresi yang paling banyak ditemukan adalah suasana perasaan depresif, kelelahan/berkurangnya minat, dan ansietas psikis. Suasana perasaan depresif dan kelelahan/berkurangnya minat berkorelasi positif dengan tipe TTH (rs=0,411; p=0,019 dan rs=0,379; p=0,032). Dari analisis regresi logistik, hanya suasana perasaan depresif yang meningkatkan risiko TTH kronik, yaitu sebesar 4,74 kali (IK 95% 1,24–18,02). Simpulan, suasana perasaan depresif merupakan gejala yang paling banyak terjadi dan dapat digunakan untuk penapisan dini gangguan depresi pada penderita TTH serta meningkatkan risiko TTHkronik. [MKB. 2013;45(1):28–34]Kata kunci: Gangguan depresi, gejala gangguan depresi, tension-type headacheRelationship between Depressive Disorder Symptoms and the Tension-Type Headache (TTH): An Explorative StudyThe prevalence rate of depressive disorders is increasing, including those having comorbidity with physical illnesses. One of the medical conditions that has been related to depressive disorder is tension-type headache (TTH). This comorbidity is related to the chronic course of TTH. This research aims to know which kind of depressive symptoms are most frequently found in TTH patients and to analyze the correlation between those symptoms and the type of TTH. This was a cross sectional study on 32 TTH patients who visited the outpatient clinic of the Neurology Department of Dr. Hasan Sadikin Hospital Bandung during the period of November to December 2011 and who were diagnosed as having depressive disorder. They were examined using Hamilton Depression Rating Scale (HDRS). We correlated the scores of depressive disorder symptoms with the type of TTH, followed by mutivariable analysis to find the prevalence ratio of depressive disorder symptoms which correlated with the type of TTH. The results showed the prevalence rate of depressive disorder in TTH was 32/38 patients while the most frequent depressive disorder symptoms of the subjects were depressive mood, fatigue and psychological anxiety. Depressive mood and fatigue were positively correlated with the type of TTH (rs=0.411, p=0.019 and rs=0.379, p=0.032). Logistic regression analysis showed that only depressive mood increased the riskof chronic TTH with a prevalence ratio of 4.74 (IK 95% 1.24–18.02). In conclusions, depressive mood, which is the most frequent symptoms of depressive disorder, can be used in the early screening of depressive disorder in TTH patients and this symptom increased the risk of chronic TTH. [MKB. 2013;45(1):28–34]Key words: Depressive disorder, depressive disorder symptoms, tension-type headache DOI: http://dx.doi.org/10.15395/mkb.v45n1.92

Perbaikan Parameter Lipid Darah Mencit Hiperkolesterolemia dengan Suplemen Pangan Bekatul

Hernawati, -, Manalu, Wasmen, Suprayogi, Agik, Astuti, Dewi Apri

Majalah Kedokteran Bandung Vol 45, No 1 (2013)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Serat pangan telah banyak digunakan sebagai pangan fungsional dan direkomendasikan untuk menurunkan kadar lipid darah untuk mencegah hiperkolesterolemia. Bekatul merupakan bahan pangan yang mengandung serat cukup tinggi. Tujuan penelitian untuk mempelajari pengaruh penambahan bekatul pada parameter lipid darah mencit jantan hiperkolesterolemia. Penelitian dilakukan di kandang hewan Jurusan Pendidikan Biologi Universitas Pendidikan Indonesia dan Laboratorium Fisiologi Fakultas Kedokteran Hewan Institut Pertanian Bogor periode Agustus 2011–Maret 2012. Desain penelitian menggunakan rancangan acak lengkap dengan lima kelompok perlakuan, yaitu kontrol negatif mencit normokolesterolemia yang diberi pakan standar tanpa suplementasi bekatul dan kontrol positif mencit hiperkolesterolemia tanpa suplementasi bekatul, selanjutnya kelompok mencit hiperkolesterolemia diberi suplementasi bekatul 16%, 38%, dan 57%. Parameter yang diukur ialah bobot badan, konsentrasi kolesterol total serum, hati, dan feses, kadar trigliserida, high density lipoprotein (HDL-c), low density lipoprotein (LDL-c), dan glukosa darah. Hasil penelitian menunjukkan bahwa suplementasi bekatul dalam diet menurunkan bobot badan, konsentrasi kolesterol serum total dan hati, trigliserida dan LDL-c, serta menaikkan konsentrasi HDL-c dan kolesterol feses, tanpa mengubah konsentrasi glukosa darah. Suplementasi bekatul sebesar 57% menurunkan bobot badan sebesar 10,31%, kadar total kolesterol 17,28%, trigliserida 28,63%, dan LDL-c 79,35%, serta meningkatkan HDL-c sebesar 24,41%. Suplementasi bekatul menurunkan kolesterol hati 57,76% dan meningkatkan pembuangan kolesterol melalui feses sebesar 39,86%. Simpulan, bekatul sebagai suplemen makanan memperbaiki parameter lipida darah mencit jantan hiperkolesterolemia dengan meningkatkan pembuangan kolesterol melalui feses dan menurunkan bobot badan tanpa mengubah kadar glukosa darah [MKB. 2013;45(1):1–9]Kata kunci: Bekatul, hiperkolesterolemia, lipid darah, mencit, serat pangan Improvement of Blood Lipid Parameters of Hypercholesterolemic Mice by Supplementation of Rice BranDietary fiber is widely used as a functional food and recommended to reduce blood lipid level to prevent hypercholesterolemia. An experiment was conducted on the effects of rice bran that has high dietary fiber content on blood lipid parameters of hypercholesterolemic male mice, which was conducted at the Biology Education Department animal cages, Indonesia University of Education and the Veterinary Medicine Faculty Laboratory, Bogor Agricultural Institute from August 2011 to March 2012. The mice were randomly assigned into groups with 5 different treatments: negative control group i.e. normocholesterol mice with a standard diet without rice bran; positive control group i.e. hypercholesterolemic mice with a standard diet without rice bran; and groups with hypercholesterolemic mice with 16%, 38%, and 75% rice bran supplements. The parameters were body weight as well as blood serum, liver and feces cholesterol, triglyceride, high density lipoprotein (HDL-c), low density lipoprotein (LDL-c) and glucose levels. Body weight, blood serum and liver cholesterol as well as triglyceride and LDL concentrations decreased while serum HDL-c and feces cholesterol increased without any significant effect on blood glucose concentration with rice bran supplement. Supplementation of rice bran by 57% (14.30% of nonsoluble dietary fiber content) decreased body weight, total serum cholesterol, triglyceride, and LDL-c of 10.31%, 17.28%, 28.63%, and 79.35%, respectively, and increased HDL-c by 24.41%. Rice bran supplement reduced liver cholesterol levels by 57.76% and increased fecal cholesterol excretion by 39.68%. In conclusion, 57% rice bran supplementation is effective to improve blood lipid parameters of hypercholesterolemic male mice by increasing feces excretion and decreasing body weight with no change in blood glucose level. [MKB. 2013;45(1):1–9]Key words: Blood lipid, dietary fiber, hypercholesterolemia, mice, rice bra DOI: http://dx.doi.org/10.15395/mkb.v45n1.93

Methicillin-Resistant Staphylococcus aureus pada Penderita Dermatitis Atopik dan Sensitivitasnya terhadap Mupirosin Dibandingkan dengan Gentamisin

Istasaputri M., Keni ( Sahid Sahirman Memorial Hospital jl. Sudirman No 86 Jakarta Pusat ) , Sutedja, Endang ( Fakultas Kedokteran Universitas Padjadjaran/Rumah Sakit Dr. Hasan Sadikin Bandung ) , Suwarsa, Oki ( Fakultas Kedokteran Universitas Padjadjaran/Rumah Sakit Dr. Hasan Sadikin Bandung ) , Sudigdoadi, Sunarjati ( Fakultas Kedokteran Universitas Padjadjaran/Rumah Sakit Dr. Hasan Sadikin Bandung )

Majalah Kedokteran Bandung Vol 45, No 1 (2013)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Methicillin-resistant Staphylococcus aureus (MRSA) mulai dijumpai pada penderita dermatitis atopik (DA) derajat sedang hingga berat dan bersifat multiresisten terhadap antibiotik topikal. Gentamisin telah digunakan secara luas, sedangkan mupirosin merupakan pilihan utama eradikasi MRSA. Penelitian ini bertujuan untuk mengetahui kolonisasi MRSA pada penderita DA dan sensitivitasnya terhadap mupirosin dibandingkan dengan gentamisin di Poliklinik Departemen Ilmu Kesehatan Kulit dan Kelamin Rumah Sakit Umum Pusat Dr. Hasan Sadikin Bandung. Survei potong lintang analitik dilakukan selama 19 September–31 Oktober 2011 terhadap 22 penderita DA derajat sedang hingga berat sesuai dengan Scoring Atopic Dermatitis objektif dan 22 individu sehat. Seluruh subjek dilakukan pemeriksaan apusan kulit untuk deteksi MRSA dan uji sensitivitas terhadap mupirosin dan gentamisin. Pada kedua kelompok masing-masing didapatkan 10 laki-laki dan 12 perempuan. Pada kelompok penderita DA didapatkan DA derajat sedang (10/22) dan berat (12/22), dengan lesi akut (14/22) dan kronik (8/22). Pertumbuhan S. aureus didapatkan pada 17/22 penderita DA dengan sensitivitas terhadap mupirosin 14/17 dan gentamisin 11/17 penderita. Pada individu sehat tidak didapatkan pertumbuhan koloni S. aureus. Galur MRSA ditemukan pada 3/17 penderita DA dan dianggap berbeda secara bermakna bila dibandingkan dengan individu sehat (p<0,01), galur ini bersifat sensitif terhadap mupirosin pada 2/3 penderita dan seluruhnya resisten terhadap gentamisin. Simpulan, kolonisasi MRSA perlu dicurigai pada penderita DA derajat sedang hingga berat, sehingga perlu pengobatan tambahan antibiotik topikal mupirosin. [MKB. 2013;45(1):36–44]Kata kunci: Dermatitis atopik, gentamisin, MRSA, mupirosinMethicillin-Resistant Staphylococcus aureus in Atopic Dermatitis Patients and Its Sensitivity to Mupirocin Compared to GentamycinMethicillin-resistant Staphylococcus aureus (MRSA) is found in moderate to severe atopic dermatitis (AD) and is multiresistant against topical antibiotic. Gentamycin is widely used while mupirocin is the first line therapy to eliminate MRSA. This research is intended to observe the colonization of MSRA case in AD patients and its sensitivity to mupirocin compared to gentamycin in Dermato-venereology Clinic Dr. Hasan Sadikin General Hospital Bandung. An analytical cross sectional survey was intended from 19th September–31st October 2011 in 22 moderate to severe AD patients based on objective Scoring Atopic Dermatitis and 22 healthy persons. All subjects went through skin-scraping, MSRA was detected and sensitivity test was done for mupirocin and gentamycin. The subjects consisted of 10 boys and 12 girls in both group. Based on severity, 10/22 of AD subjects were in moderate AD and 12/22 were severe AD, 14/22 of AD subjects presented with acute lesions and 8/22 subjects had chronic lesions. In the group of AD patients, 17/22 growth of S. aureus were found with sensitivity against mupirocin 14/17 and gentamycin 11/17. In healthy individual group, no  S. aureus growth was found. Methicillin-resistant Staphylococcus aureus strain in AD patients was observed on 3/17 patients, and this was declared significantly different compared to healthy individuals (p <0.01). The isolates in 2/3 patients were sensitive to mupirocin and all patients were resistant to gentamycin. In conclusion, the patients of moderate to severe AD are prone to MRSA colonization and therefore requires mupirocin topical antibiotic treatment.  [MKB. 2013;45(1):35–43]Key words: Atopic dermatitis, gentamycin, MRSA, mupirocin DOI: http://dx.doi.org/10.15395/mkb.v45n1.203

Penurunan Tekanan Intraokular Pascabedah Katarak pada Kelompok Sudut Bilik Mata Depan Tertutup dan Terbuka

Hapsari, Rakhma Indria ( Departemen Ilmu Kesehatan Mata, Fakultas Kedokteran Universitas Padjadjaran-Rumah Sakit Mata Cicendo Bandung ) , Prahasta, Andika ( Departemen Ilmu Kesehatan Mata, Fakultas Kedokteran Universitas Padjadjaran-Rumah Sakit Mata Cicendo Bandung ) , Enus, Sutarya ( Departemen Ilmu Kesehatan Mata, Fakultas Kedokteran Universitas Padjadjaran-Rumah Sakit Mata Cicendo Bandung )

Majalah Kedokteran Bandung Vol 45, No 1 (2013)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Penebalan lensa kristalina pada katarak senilis mengakibatkan hambatan pada jalur aliran akuos. Pascabedah katarak terjadi peningkatan kedalaman bilik mata depan (BMD) yang memiliki korelasi positif dengan pelebaran sudut BMD serta penurunan tekanan intraokular (TIO). Tujuan penelitian untuk menganalisis perbedaan penurunan TIO pascabedah katarak pada kelompok sudut BMD tertutup dan terbuka. Penelitian ini menggunakan desain pre-post test, untuk membandingkan penurunan TIO pascabedah katarak fakoemulsifikasi pada 26 mata dari 26 orang penderita, yang dibagi menjadi kelompok sudut BMD tertutup dan terbuka masing-masing berjumlah 13 mata. Tempat penelitian Rumah Sakit Mata Cicendo Bandung periode Maret–Juni 2012. Pengambilan data berdasarkan urutan datang penderita yang direncanakan operasi katarak fakoemulsifikasi. Penilaian sudut bilik mata depan prabedah dilakukan menggunakan lensa gonio Sussman 4-mirror. Tekanan intraokular pascabedah diukur saat pemantauan minggu ketiga pascabedah. Penilaian TIO pra dan pascabedah dilakukan menggunakan alat ukur tonometri aplanasi Goldmann. Analisis statistik dilakukan menggunakan uji t. Hasil menunjukkan perbedaan penurunan TIO secara bermakna lebih besar pada kelompok sudut BMD tertutup (19,6%) dibandingkan dengan kelompok sudut BMD terbuka (11,3%) dengan nilai p=0,022. Simpulan, perbedaan penurunan TIO pascabedah katarak fakoemulsifikasi lebih besar pada kelompok sudut BMD tertutup dibandingkan dengan kelompok sudut BMD terbuka. [MKB. 2013;45(1):56–61]Kata kunci: Gonioskopi, katarak senilis, pascabedah fakoemulsifikasi, sudut bilik mata depan, tekanan intraokularIntraocular Pressure Reduction after Cataract Surgery between Groups with Angle-Closure and Open-Angle Anterior ChamberIncreased crystalline lens thickness in senile cataract causing resistance to aqueous humor outflow. Increased anterior chamber depth had a positive correlation with the widening of the anterior chamber angle and decreased of intraocular pressure (IOP) after cataract extraction. The purpose of this study was to compare IOP reduction after cataract surgery between angle-closure and open-angle group. This pre-post test design study was to compare IOP after phacoemulsification cataract surgery in 26 eyes of 26 patients divided into angle-closure and open-angle groups consisting of 13 eyes each. The study was conducted in Cicendo Eye Hospital Bandung in period of March until June 2012. Patients who planned to have phacoemulsification cataract surgery were recruited consecutively. The anterior chamber angle was measured before surgery using Sussman 4-mirror goniolens. The intraocular pressure were measured before and three weeks after surgery using Goldmann aplanation tonometer. Statistical analysis was done using t test. The results indicated that IOP reduction was statistically significant greater in the angle-closure group (19.6%) compared with open-angle group (11.3%) with p=0.022. In conclusion, IOP reduction after phacoemulsification cataract surgery was greater in the angle-closure group compared with open-angle group. [MKB. 2013;45(1):56–61]Key words: Anterior chamber angle, gonioscopy, intraocular pressure, phacoemulsification surgery, senile cataract DOI: http://dx.doi.org/10.15395/mkb.v45n1.204

Kadar Laktat Darah sebagai Prediktor Kontaminasi Bakteri pada Hernia Inguinalis Lateralis Strangulata

Pratama, Anthony ( Departemen Ilmu Bedah Fakultas Kedokteran Universitas Padjadjaran/Rumah Sakit Dr. Hasan Sadikin Bandung ) , Yarman, Haryono ( Departemen Ilmu Bedah Fakultas Kedokteran Universitas Padjadjaran/Rumah Sakit Dr. Hasan Sadikin Bandung ) , Sulthana, Bambang A. S. ( Departemen Ilmu Bedah Fakultas Kedokteran Universitas Padjadjaran/Rumah Sakit Dr. Hasan Sadikin Bandung )

Majalah Kedokteran Bandung Vol 45, No 1 (2013)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Hernia inguinalis lateralis strangulata merupakan salah satu kasus akut abdomen yang harus segera ditangani. Hernia yang mengalami strangulasi akan mengalami kerusakan integritas sel dan barier mukosa usus sehingga terjadi kontaminasi bakteri. Selain itu, sel usus yang strangulasi akan mengalami metabolisme anaerob yang menyebabkan peningkatan kadar laktat darah. Oleh sebab itu dilakukan penelitian untuk menilai hubungan antara kadar laktat darah dan kontaminasi bakteri pada keadaan strangulasi hernia. Metode penelitian bersifat potong lintang, data prospektif, penderita dengan hernia inguinalis lateralis strangulata yang datang ke Rumah Sakit Dr. Hasan Sadikin Bandung periode Mei 2011–April 2012. Dilakukan pengukuran kadar laktat darah saat penderita datang dan cairan peritoneum yang berasal dari kantung hernia diambil saat operasi. Dilakukan analisis data dengan uji regresi logistik. Subjek penelitian berjumlah 30 orang, terdiri atas 28 lakilaki dan 2 perempuan. Usia rata-rata subjek penelitian 58,5±12,86 tahun. Nilai kadar laktat darah rata-rata 1,76±0,36 mmol/L. Hasil kultur kuman cairan peritoneum terbanyak Escherichia coli. Terdapat hubungan sangat kuat dan sangat bermakna antara kadar laktat darah dan kejadian kontaminasi bakteri, nilai r=0,817 dan p=0,007 (p<0,01). Simpulan, kadar laktat darah dapat dijadikan sebagai alat ukur untuk memperkirakan kontaminasi bakteri pada penderita hernia inguinalis lateralis strangulata. [MKB. 2013;45(1):44–9]Kata kunci: Hernia inguinalis lateralis strangulata, kadar laktat darah, kontaminasi bakteriBlood Lactate Levelas Predictor of Bacterial Contamination in Strangulated Groin HerniaStrangulated groin hernia is one of the acute abdomen and have to be treated immediately. Strangulated hernia will cause damage of cell integrity and barrier of intestinal mucous, which make bacterial contamination occur. Strangulated intestinal cells will have anaerobic metabolism which make the blood lactate level increased. Therefore study was conducted to know the correlation between blood lactate level and bacterial contamination in strangulated groin hernia. The study method was cross-sectional with prospective data, patients with strangulated groin hernia who came to Dr. Hasan Sadikin Hospital Bandung during May 2011–April 2012. Blood lactate level was measured when the patient came to hospital and the peritoneal fluid which came from the hernial sac was taken intraoperatively. The data were analyzed with regression logistic test. There were 30 subjects in this study, 28 males and 2 females. The average age was 58.5±12.86 years old. The average blood lactate level was 1.76±0.36 mmol/L. The most found bacterial culture was Escherichia coli. There was strong and very significance correlation between blood lactate level and bacterial contamination, r=0.817 and p=0.007 (p<0.01). In conclusion, blood lactate level can be a predictor for bacterial contamination occurrence in patient with strangulated groin hernia. [MKB. 2013;45(1):44–9]Key words: Bacterial contamination, blood lactate level, strangulated groin hernia DOI: http://dx.doi.org/10.15395/mkb.v45n1.205

Karakteristik Atom Mineral pada Osteoporosis dengan Arsitektur Porosis dan Nonporosis

Noor, Zairin ( Departemen Bedah Orthopaedi RSU Ulin-Fakultas Kedokteran Universitas Lambung Mangkurat Banjarmasin ) , Sumitro, Sutiman B. ( Departemen Biologi-Fakultas Matematika dan Ilmu Pengetahuan Alam Universitas Brawijaya Malang ) , Hidayat, Mohammad ( Departemen Bedah Orthopaedi RSUD Saiful Anwar-Fakultas Kedokteran Universitas Brawijaya Malang ) , Rahim, Agus Hadian ( Departemen Bedah Orthopaedi Fakultas Kedokteran Universitas Padjadjaran/RS Dr. Hasan Sadikin Bandung )

Majalah Kedokteran Bandung Vol 45, No 1 (2013)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Terdapat hasil yang bervariasi dalam peningkatan bone mineral density (BMD) akibat asupan kalsium mengindikasikan keterlibatan atom mineral lain dalam perkembangan struktur tulang. Kuantitas atom mineral tulang yaitu kadar atom mineral dalam struktur tulang. Penelitian ini bertujuan untuk membandingkan karakteristik atom mineral pada gambaran arsitektur (scanning electron microscope/SEM) porosis dibandingkan dengan nonporosis. Sepuluh penderita osteoporosis dengan gambaran SEM porosis dan tujuh penderita gambaran SEM nonporosis terlibat dalam penelitian ini. Tulang yang diambil ketika operasi fraktur dianalisis mikrostruktur dengan SEM dan karakter atom mineral tulang dengan X-ray fluorescence (XRF). Pemeriksaan SEM dan XRF dilaksanakan di Laboratorium Fisika Universitas Negeri Malang. Penelitian dilakukan mulai Agustus 2010 sampai Januari 2011. Uji t dilakukan untuk menentukan perbedaan kadar mineral tulang. Hasil SEM menunjukkan perbedaan porositas dan integritas trabekular antara SEM porosis dan SEM nonporosis. Analisis XRF didapatkan komposisi atom yang lebih tinggi pada tulang SEM nonporosis yaitu P, S, Fe, Ni, Cr, Pb, dan Si. Sebaliknya, komposisi atom yang lebih tinggi pada tulang SEM porosis adalah Cu, Zn, Ca, dan Mo. Perbedaan komposisi atom tersebut tidak berbeda secara bermakna (p>0,05). Simpulan, perkembangan porositas pada osteoporosis tidak didasari oleh kuantitas atom mineral tulang. [MKB. 2013;45(1):23–7]Kata kunci: Arsitektur, atom mineral, komposit, osteoporosisMineral Atomic Characteristic on Porotic and Non Porotic Architecture  of OsteoporosisThere was variance result in increased bone mineral density (BMD) due to calcium intake which indicates involvement of another mineral atomic in bone structure development. Bone mineral atomic quantity is the level or concentration of mineral atomic in bone structure. Aim of this study was to compare mineral atomic characteristic in architecture (scanning electron microscope/SEM) porotic and non porotic figure. Ten osteoporosis patients with porotic SEM and seven non porotic SEM patients were involved in this study. Bone which was obtained from fracture surgery was analyzed for microstructure by SEM and for bone atomic mineral characteristic by X-ray fluorescence (XRF). Analysis of SEM and XRF were done in Physics Laboratory State University of Malang. This study was done from August 2010 to January 2011. t-test was done to analyse the difference of atomic mineral level. Scanning electron microscope result showed the difference in porosity and trabecular integrity between porotic and non porotic SEM. Analysis of XRF showed atomic composition was higher in porotic SEM such as P, S, Fe, Ni, Cr, Pb and Si. Conversely atomic composition such as Cu, Zn, Ca, and Mo, was higher in non porotic SEM. There was no significant difference between each groups (p>0.05). In conclusion, the development of porocity in osteoporosis is not depend on bone mineral atomic quantity. [MKB. 2013;45(1):23–7]Key words: Architecture, composite, mineral atomic, osteoporosis DOI: http://dx.doi.org/10.15395/mkb.v45n1.96