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Majalah Kedokteran Bandung
Articles by issue : Vol 48, No 3 (2016)
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Articles
Imunitas Bawaan pada Kusta: Hubungan Ekspresi Kaspase-1 dengan Interleukin-18 pada Lesi Kulit Pasien Kusta

Suwarsa, Oki, Gunawan, Hendra, Achdiat, Pati Aji

Majalah Kedokteran Bandung Vol 48, No 3 (2016)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Respons imun terhadap Mycobacterium leprae (M. leprae) terdiri atas respons imun bawaan dan didapat. Salah satu enzim yang berperan pada imunitas bawaan adalah kaspase-1 dengan fungsi memecah sitokin proinflamasi prointerleukin (IL)-18 menjadi IL-18 aktif. IL-18 bersama IL-12 secara sinergis akan merangsang produksi interferon (IFN-γ) sehingga timbul respons imun seluler yang bersifat protektif. Tujuan penelitian ini adalah menganalisis korelasi positif ekspresi kaspase-1 dengan IL-18 pada lesi kulit pasien kusta. Penelitian dilaksanakan selama bulan Oktober–Desember 2014 di Poliklinik Morbus Hansen Departemen Ilmu Kesehatan Kulit dan Kelamin serta Laboratorium Imunohistokimia Departemen Patologi Anatomi Fakultas Kedokteran Universitas Padjadjaran/Rumah Sakit Dr. Hasan Sadikin Bandung. Penelitian ini merupakan penelitian klinis analitik observasional dengan rancangan potong lintang. Subjek penelitian berjumlah 19 pasien kusta yang didapatkan melalui consecutive sampling. Terhadap subjek penelitian dilakukan anamnesis, pemeriksaan fisis, pemeriksaan bakteriologis, dan biopsi plong. Pada jaringan hasil biopsi lesi kulit dilakukan pemeriksaan imunohistokimia ekspresi kaspase-1 dan IL-18 yang dinilai dengan histoscore, kemudian dilakukan analisis korelasi menggunakan uji Rank-Spearman. Pada hasil penelitian ini didapatkan nilai ekspresi histoscore kaspase-1 pada lesi kulit pasien kusta berturut-turut tipe tuberkuloid (TT)=12,00; borderline tuberculoid (BT)=8,33; mid-borderline (BB)=8,00; borderline lepromatous (BL)=4,00; dan lepromatous (LL)=10,67. Nilai histoscore ekspresi IL-18 pada lesi kulit pasien kusta berturut-turut pada tipe TT=9,33; BT=6,50; BB=4,60; BL=4,00; dan LL=9,33. Berdasarkan hasil analisis statistik uji Rank-Spearman pada derajat kepercayaan 95% didapatkan korelasi positif yang bermakna antara ekspresi histoscore kaspase-1 dan IL-18 (rs=0,618; p=0,005). Simpulan penelitian ini adalah terdapat korelasi positif antara ekspresi kaspase-1 dan IL-18 pada lesi kulit pasien kusta. Semakin tinggi ekspresi kaspase-1 pada lesi kulit pasien kusta maka semakin tinggi ekspresi IL-18. [MKB. 2016;48(3):181–6]Kata kunci: Imunitas bawaan, interleukin-18, kaspase-1, kustaInnate Immunity in Leprosy: Correlation between Caspase-1 and Interleukin-18 Expression in Leprosy Patient’s Skin Lesion Immune response against M. leprae contains innate and adaptive immunity. Caspase-1 is one of the enzymes which have a role in innate immunity to activate pro-IL-18 into its active form. IL-18 and IL-12 sinergically enhance the production of IFN-γ which triggers the protective cellular immunity. The aim of this study was to analyze the positive correlation between the expression of caspase-1 and IL-18 in leprosy patients’ skin lesions. The study was conducted from October tol December 2014 at the Dermatology and Venereology, and Immunohistochemistry Laboratory, Pathology Anatomy Department, Universitas Padjadjaran/Dr. Hasan Sadikin General Hospital Bandung. This was a clinical observational analytical study with cross-sectional design. Subjects were 19 leprosy patients recruited through consecutive sampling. History taking, physical examination, bacteriological examination, and punch biopsy were performed on all subjects. Caspase-1 and IL-18 expressions were examined and measured with histoscore. Correlation analysis was performed using Rank-Spearman test. The histoscore for the expression of caspase-1 in leprosy patients’ skin lesions was as follows: TT type=12.00; BT=8.33; BB=8,00; BL=10.00; and LL=10.67. The histoscore for the IL-18 expression in leprosy patients’ skin lesions were TT type=9.33; BT=4.60; BL=4.00; and LL=9.33. Rank-Spearman analysis with desired confidence level of 95% showed a statistically significant positive correlation between the histoscore of caspase-1 expression and IL-18 expression.(rs=0.618, p=0.005). In conclusion, this study demonstrates a positive corelation between caspase-1 expression and IL-18 expression in leprosy skin lesions. An increase of caspase-1 expression indicates an increase of IL-18 expression. [MKB. 2016;48(3):181–6]Key words: Caspase-1, interleukin-18, innate immunity, leprosy

Prevalensi Sarkopenia pada Lansia di Komunitas (Community Dwelling) berdasarkan Dua Nilai Cut-off Parameter Diagnosis

Vitriana, Vitriana, Defi, Irma Ruslina, Irawan, Gaga Nugraha, Setiabudiawan, Budi

Majalah Kedokteran Bandung Vol 48, No 3 (2016)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Sarkopenia, sindrom penurunan massa dan fungsi otot terkait usia dapat mengurangi kualitas hidup dan peningkatan mortalitas pada lanjut usia (lansia). Banyak metode penapisan dan definisi operasional menyebabkan angka prevalensi sarkopenia bervariasi di dunia. Penelitian ini bertujuan mengetahui prevalensi sarkopenia pada lansia yang tinggal di komunitas berdasarkan massa otot yang diukur dengan bioimpedance analysis, kekuatan genggam tangan menggunakan hand dynamometer, serta performa fisik melalui uji jalan 6 menit dengan mempergunakan dua nilai cut-off, nilai rekomendasi Asian Working Group for Sarcopenia (AWGS) dan nilai populasi lansia Taiwan karena belum didapatkan nilai cut-off populasi lansia Indonesia. Penelitian deskriptif potong lintang pada 229 partisipan (71 orang laki-laki dan 158 orang perempuan) dengan menggunakan teknik consecutive sampling dilakukan pada bulan Agustus sampai Desember 2014 pada populasi lansia di Kota Bandung dan Jatinangor. Hasil penelitian menunjukkan angka prevalensi sarkopenia berdasarkan nilai cut-off rekomendasi AWGS adalah 9,1% (7,4% untuk laki-laki dan 1,7% untuk perempuan), sedangkan prevalensi sarkopenia berdasarkan nilai cut-off populasi Taiwan sebesar 40,6% (20,1% untuk laki-laki dan 20,5% untuk perempuan). Perbedaan prevalensi yang cukup besar mendorong diperlukan penetapan nilai cut-off parameter diagnosis sarkopenia spesifik pada populasi lansia Indonesia yang tinggal di komunitas untuk dapat menentukan prevalensi sarkopenia lebih akurat. [MKB. 2016;48(3):164–70]Kata kunci: Cut-off, lansia, komunitas, prevalensi, sarkopenia Sarcopenia Prevalence In Community-Dwelling Elderly based on Two Cut-off Points Diagnosis ParametersSarcopenia, aging muscle mass loss, and function syndromes can lead to decreased quality of life and increased elderly mortality. The availability of various screening methods and operational definitions in different studies has produced different findings of sarcopenia prevalence. The purpose of this study was to discover the prevalence of sarcopenia in Indonesian community-dwelling elderly based on muscle mass measured by bioimpedance analysis, handgrip strength using hand dynamometer, and physical performance based on six minutes walking test  with two different cut-off point parameters of sarcopenia, i.e. the cut-off point recommended by Asian Working Group for Sarcopenia (AWGS) and the cut-off point based on the reference used in  Taiwan elderly population reference due to the lack of references for Indonesian elderly population. A cross-sectional study was conducted to 229 participants (71 men and 158 women) from the community-dwelling elderly population between August and December 2014 in Bandung and Jatinangor. The results of the study showed that the sarcopenia prevalence in this study based on AWGS was 9.1% (7.4% in men and 1.7% in women) while the prevalence based on the Taiwan reference revealed a prevalence of 40.6% (20.1% in men and 20.5% in women). This highly different prevalences shows the importance of defining a specific cut-off point for elderly population in community-dwelling Indonesia to get a more accurate sarcopenia prevalence. [MKB. 2016;48(3):164–70Key words: Community dwelling, cut-off, elderly, prevalence, sarcopenia

Kualitas Spermatozoa Mencit Balb /C Jantan Setelah Pemberian Ekstrak Buah Kepel (Stelechocarpus Burahol)

Fatmawati, Dina, Isradji, Israhnanto, Yusuf, Iwang, Suparmi, Suparmi

Majalah Kedokteran Bandung Vol 48, No 3 (2016)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Buah kepel (Stelechocarpus burahol) terbukti memiliki kandungan fitoestrogen yang diduga memiliki pengaruh terhadap kualitas sperma, namun sejauh ini kajian ilmiah mengenai efek buah kepel terhadap kualitas sperma belum banyak dilakukan. Penelitian ini bertujuan mengetahui efek ekstrak buah kepel terhadap motilitas, konsentrasi, viabilitas, dan morfologi spermatozoa mencit jantan (Mus musculus). Penelitian ini merupakan penelitian eksperimental dengan rancangan post test only control group design. Ekstraksi buah kepel menggunakan metode sokletasi dengan pelarut etanol 96%. Sebanyak 24 ekor mencit yang dibagi ke dalam 4 kelompok, yaitu kelompok kontrol yang diberi akuades, kelompok I, II, dan III yang disonde ekstrak buah kepel (EBK) dengan dosis 0,65; 1,3; dan 2,6 mg/ekor maisng-masing selama 14 hari. Motilitas, konsentrasi, viabilitas, dan morfologi spermatozoa dianalisis dengan mengambil sampel sperma dari kauda epididimis pada hari ke-15. Berdasarkan hasil uji ANOVA menunjukkan bahwa viabilitas, morfologi, dan konsentrasi spermatozoa rata-rata antara kelompok kontrol dan perlakuan (I, II, III) tidak berbeda signifikan (p>0,05). Persentase motilitas spermatozoa mengalami penurunan secara signifikan pada kelompok III (2,6 mg/ekor) dibanding dengan kontrol, kelompok I, dan kelompok II (p<0,05). Simpulan yang dapat ditarik dari penelitian ini adalah ekstrak buah kepel dengan dosis 2,6 mg/ekor/hari dapat menurunkan kualitas spermatozoa sehingga berpotensi sebagai senyawa antifertilitas pada pria. [MKB. 2016;48(3):155–59]Kata kunci: Kepel (Stelechocarpus buharol), konsentrasi spermatozoa, kualitas spermatozoa, Sperm Quality of Male Balb/C Mice after Kepel (Stelechocarpus burahol) Fruit Extract AdministrationKepel (Stelechocarpus burahol) fruits contains phytoestrogen that have been shown to have a potential phytoestrogen that may affect sperm quality. However, few studies on this effect have been conducted. The aim of this study was to evaluate the effect Stelechocarpus burahol administration on sperm quality in mice. This experimental study used post-test only with control-group design. The sox-chlelation method was performed to obtain the ethanol extract from kepel fruit. Twenty four mice were randomly divided into 4 groups of kepel fruit extract dose: 0 mg/mice (control or group I), 0.65 mg/mice (group II), 1.3 mg/mice (group III), and 2.6 mg/mice (group IV).  One milliliter of kepel fruit extract was administered orally every day for 14 days. On day 15 the sperm were collected and analyzed for motility, concentration, viability, and morphology. There was no effect of kepel fruit extract found among the treated groups (group I, II, III, IV) on the percentage of sperm concentration, morphology, and viability (p>0.05). However, the percentage of motility in group IV (kepel fruit extract at a dose of 2.6 mg/mice) was decreased significantly compared to control and other treatment groups (p<0.05). In conclusion, 2.6 mg/mice Kepel extract  decreases sperm quality; hence, it is a potential candidate for antifertility in men. [MKB. 2016;48(3):155–9]Key words: Kepel (Stelechocarpus burahol), sperm concentration, sperm quality

Korelasi antara Modification of Diet in Renal Disease (MDRD) dan Cystatin C Serum pada Usia 40–70 Tahun

Jus, Jason, Irwanto, Ronald, Pusparini, Pusparini

Majalah Kedokteran Bandung Vol 48, No 3 (2016)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Pelaporan estimasi laju filtrasi glomerulus (eLFG) pada setiap hasil pemeriksaan kreatinin dianjurkan, walaupun saat ini tidak semua laboratorium mencantumkan pada hasil pemeriksaan. Modification of Diet in Renal Disease (MDRD) merupakan formula yang digunakan untuk mengestimasi laju filtrasi glomerulus menggunakan kreatinin serum. Cystatin C serum merupakan pemeriksaan yang relatif baru dan petanda yang baik untuk menilai fungsi ginjal. Penelitian ini bertujuan mengetahui korelasi antara MDRD dan cystatin C serum. Penelitian ini menggunakan data sekunder dari 260 subjek penelitian usia 40–70 tahun yang memeriksakan kreatinin serum dan cystatin C serum selama periode Januari 2013–September 2014 di laboratorium klinik swasta di Jakarta Barat dengan desain potong lintang. Hasil penelitian menunjukkan bahwa usia rata-rata subjek 55,7+7,8 tahun. Kadar cystatin C serum rata-rata 0,99 + 0,6 mg/L, MDRD 80,24±28,1 mL/min/1,73m2. Terdapat korelasi negatif antara MDRD dan cystatin C serum dengan r=-0,767, p=0,001 (uji Pearson). Disimpulkan bahwa semakin tinggi nilai MDRD, nilai cystatin C serum semakin rendah. MDRD dapat digunakan sebagai alternatif uji fungsi ginjal bila pemeriksaan cystatin C serum tidak tersedia. [MKB. 2016;48(3):129–34]Kata kunci: Cystatin C, eLFG, kreatinin, MDRD Correlation between Modification of Diet in Renal Disease (MDRD) and Serum Cystatin C in 40–70 Years Old Reporting of the estimated glomerular filtration rate (GFR) in every creatinine test is suggested, despite the fact that every laboratory reports it in their result. Modification of Diet in Renal Disease (MDRD) is a formula that is used to estimate the GFR using serum creatinine. Serum cystatin C is a relatively new test and superior for assessing kidney functions. The purpose of this study was to show the correlation between MDRD and serum cystatin C. A cross-sectional study was conducted using secondary data from 260 subjects, aged 40–70 years old to assess serum creatinine and serum cystatin C at a private laboratory in West Jakarta, during the period of January 2013–September 2014. The result of the study showed that the mean age of subjects was 55.7+7.8 years old, the mean serum cystatin C level was 0.99 + 0.6 mg/L, and the mean MDRD was 80.24±28.1 mL/min/1.73 m2. Pearson correlation analysis showed a negative correlation between MDRD and serum cystatin C with r = -0.767 and p =0.001. In conclusion, higher MDRD presents lower cystatin C serum; hence,  MDRD can be used as an alternative renal function test when serum cystatin C is not available. [MKB. 2016;48(3):129–34] 

Pengaruh Transplantasi Allograf Pancreatic Stem Cell terhadap Kadar Insulin dan C-Peptide Tikus Putih Penderita Diabetes Melitus Tipe I

Setiawan, Boedi, Plumeriastuti, Hani

Majalah Kedokteran Bandung Vol 48, No 3 (2016)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Penyakit diabetes melitus merupakan salah satu penyakit degeneratif yang hingga kini masih belum tuntas terapinya dan masih menjadi ancaman serius bagi dunia kesehatan di Indonesia dan dunia. Tujuan penelitian ini adalah mengetahui kadar insulin dan C-peptide tikus putih penderita diabetes melitus tipe I yang diberikan transplantasi allograf pancreatic stem cell dengan laparotomi intrapankreatik. Penelitian ini dilakukan selama 6 bulan (Juli–Desember 2014) di lab. Stem Cell, Institute of Tropical Diseases, Universitas Airlangga, Surabaya. Dua belas tikus putih jantan Rattus novergicus galur Wistar dibagi secara acak menjadi dua kelompok . Kelompok pertama (P0) disuntik aloksan 150 mg/kg bobot badan tanpa terapi stem cell . Kelompok kedua disuntik aloksan dengan dosis 150 mg/kg bobot badan dan diterapi dengan 1x106/kg bobot badan stem cell pankreas secara laparotomi intrapankreatik (P1). Akhir penelitian adalah pada hari ke-31 percobaan. Hasil penelitian menunjukkan bahwa kadar glukosa darah pada akhir penelitian berbeda sangat nyata (p <0,01) antara kelompok perlakuan yang menerima terapi stem cell (P1) dengan P0 kontrol positif, meskipun nilai kadar glukosa darah rata-rata tidak senormal seperti pada hari ke-1. Tingkat C-peptide dan insulin P0 dan P1 berbeda sangat nyata (p<0,01). Dapat disimpulkan bahwa terapi stem cell secara laparotomi intrapankreatik dapat menurunkan kadar glukosa darah, serta meningkatkan kadar C-peptide dan insulin. [MKB. 2016;48(3):135–39]Kata kunci: Diabetes melitus, insulin, stem cell Insulin and C-peptide Levels in Diabetes Mellitus Type I White Rats  treated with  Pancreatic Stem Cell Allograft TransplantationDiabetes mellitus is one of the degenerative diseases in which the therapy still remains unresolved and is still a serious threat to the global health, including to the health of Indonesian people. The aim of this study was to describe the level of insulin and C-peptide in diabetes mellitus type I white rats treated with  pancreatic stem cell allograft through intrapancreatic laparotomy. This study was conducted at the Institute of Tropical Diseases, Universitas Airlangga, Surabaya in a 6 month period (July–December 2014). Twelve male white rats Rattus novergicus Wistar strain, were randomly divided into two groups. The first group (P0) was injected by alloxan, 150 mg/kg body weight, without stem cell therapy. Another group was injected by alloxan, 150 mg/kg body weight, and was treated with 1x106/kg body weight pancreatic stem cell throughintrapancreatic laparotomy (P1). The experiment was finalized on the 31th day of the experiment. The results showed that the blood glucose levels at the end of experiment were highly significantly different p<0.01 between the treatment group that received stem cell therapy (P1) and P0 positive control, although the average value of blood glucose levels was not as normal as on the first day. C-peptide and insulin levels of P0 and P1 group differed significantly (p<0.01). It can be concluded that stem cell therapy through intrapancreatic laparotomy can reduce blood glucose levels and increase the levels of C-peptide and insulin. [MKB. 2016;48(3):135–39]Key words: Diabetes mellitus, insulin, stem cell

Indeks Massa Tubuh Awal Kehamilan Ibu sebagai Indikator yang Paling Berperan terhadap Kenaikan Berat Badan Ibu Selama Hamil

Zuhairini, Yenni, Kasmanto, Hendro, Nugraha, Gaga Irawan

Majalah Kedokteran Bandung Vol 48, No 3 (2016)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Berat bayi lahir rendah dipengaruhi oleh kenaikan berat badan ibu selama hamil. Penelitian ini bertujuan mencari indikator status gizi ibu trimester pertama yang paling berperan terhadap kenaikan berat badan ibu selama hamil. Kohort ini dilakukan selama tahun 2014 yang merupakan bagian dari Tanjungsari Cohort Study di Jawa barat. Variabel status gizi ibu trimester pertama (indeks massa tubuh (IMT), massa lemak (ML), massa lemak bebas (MLB), lingkar lengan atas (LLA)) dihubungkan dengan kenaikan berat badan (BB) ibu selama hamil dari trimester pertama sampai ketiga dengan analisis bivariat Pearson dilanjutkan dengan regresi linier multivariat. Perbedaan kenaikan berat badan ibu selama hamil pada tiap kelompok dengan uji ANOVA satu arah. Perubahan asupan energi dan protein diuji dengan uji T independen pada semua kelompok. Diperoleh 37 subjek yang telah mencapai trimester ketiga menunjukkan korelasi antara IMT, ML, MLB, LLA dengan kenaikan BB ibu selama hamil. Terdapat hubungan negatif IMT dengan KBB (p=0,002 dan r2=0,234). Kenaikan berat badan ibu selama hamil pada IMT kurang, normal, overweight, obes 1 dan obes 2 masing-masing 7,38; 8,54; 6,73; 4,38 dan 3,30 kg. Perubahan asupan energi dan protein pada subjek dengan IMT tinggi dan rendah masing-masing p=0,09 dan p=0,96. Simpulan, indeks massa tubuh ibu trimester pertama merupakan indikator yang paling berperan terhadap kenaikan berat badan ibu selama hamil, IMT berbanding terbalik dengan kenaikan berat badan ibu selama hamil kecuali pada IMT kurang. [MKB. 2016;48(3):171–5]Kata kunci: Ibu hamil, indeks massa tubuh, kenaikan berat badan Body Mass Index in Early Pregnancy as the Most Contributing Indicator for Weight Gain during Pregnancy Low birth weight is influenced by maternal weight gain during pregnancy. This study aimed to reveal the most contributing pre-pregnancy maternal nutritional status indicators pre-  that are responsible for maternal weight gain during pregnancy. This study  was carried out during the year of 2014  and was performed as a part of Tanjungsari Cohort Study in West Java. The pre-pregnancy maternal nutritional status variables (body mass index (BMI), fat mass (FM), fat free mass (FFM), and mid upper arm circumference (MUAC)) were associated with the gestational weight gain (GWG) of pregnant  women from  the  first  to the  third  trimester  using  Pearson  bivariate analysis followed by multivariate linear regression. The difference of GWG in each group was analyzed using one-way ANOVA test, while changes in energy and protein intake were tested using independent T test in all groups. From 37  subjects  who  had  reached  the  third  trimester, it was shown that there was a correlation of BMI, ML, MLB, and LLA to GWG. Themultivariate analysis showed a negative correlation between BMI and GWG (p=0.002 and r2=0.234). Maternal weight gain during pregnancy in underweight, normal weight, overweight, obese 1, and obese 2 women were 7.38, 8.54, 6.73, 4.38, and 3.30 kg, respectively, while changes in energy and protein intake in subjects with high and low BMI were p=0.09 and p=0.96, respectively. In conclusion, the pre-pregancy maternal body mass index is the most contributing indicator for maternal weight gain during pregnancy, BMI is inversely related to maternal weight gain during pregnancy, except in the underweight group. [MKB. 2016;48(3):171–5]Key words: Body mass index, gestational weight gain, pregnant women

Pemberian Ekstrak Bayam Merah (Amarantus Tricolor linn) Memperbaiki Ekspresi BDNF dan GLUR1 pada Area Hipokampus Tikus Muda yang Terpapar Anestesi Inhalasi Halothane dan Sevoflurane

Argarini, Raden, Wigati, Kristanti Wanito, Herawati, Lilik, Riawan, Wibi, Rehatta, Nancy M.

Majalah Kedokteran Bandung Vol 48, No 3 (2016)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Otak dalam tahap perkembangan memiliki tingkat kerentanan lebih tinggi terhadap zat anestesi dibanding dengan otak orang dewasa. Penelitian ini bertujuan mengamati pengaruh pemberian ekstrak bayam merah terhadap penanda biologis fungsi kognitif dan neuroplastisitas, yaitu Brain Derived Neurotrophic Factor (BDNF) dan AMPA Glutamate Receptor subunit 1 (Glur1) pada area hipokampus tikus yang terpapar anestesi inhalasi halothane dan sevoflurane. Rancangan penelitian adalah randomized posttest only control group. Penelitian ini dilakukan di Departemen Biokimia Fakultas Kedokteran Universitas Airlangga dan prosedur anestesi dilakukan di Rumah Sakit Hewan Fakultas Kedokteran Hewan Universitas Airlangga pada bulan Mei 2014–Oktober 2014. Subjek penelitian adalah 23 ekor tikus putih jantan (Rattus norvegicus) galur Wistar, umur 1–1,5 bulan, bobot kurang lebih 60–100 gram dengan kondisi sehat fisik. Subjek dibagi menjadi 5 kelompok, yaitu K (kontrol); K1 (halothane 1 MAC); K2 (bayam merah 800 mg/kgBB+Halothane 1 MAC); K3 (sevoflurane 1MAC) dan K4 (bayam merah 800 mg/kgBB+ Sevoflurane 1 MAC). Hasil penelitian menunjukkan adanya penurunan ekspresi BDNF pada pemberian halothane dan sevoflurane serta peningkatan kembali ke normal pada kelompok yang sebelumnya telah diberikan bayam merah sebelum terpapar gas anastesi (p=0,000). Ekspresi GLUR1 meningkat pada pemberian halothane dan sevoflurane dan penurunan kembali ke normal pada kelompok yang sebelumnya telah diberikan bayam merah sebelum terpapar gas anestesi (p=0,000). Simpulan penelitian ini adalah pemberian ekstrak bayam merah memiliki potensi untuk mencegah neurotoksisitas pada fungsi kognitif tikus yang terpapar gas anastesi. [MKB. 2016;48(3):148–54]Kata kunci: AMPA Glutamate Receptor subunit 1 (GLUR1), Brain Derived Neurotrophic Factor (BDNF), ekstrak bayam merah, halothane, sevofluraneRed Spinach Extract Administration (Amarantus Tricolor linn) in Young Rats Exposed to Inhalation Anesthetic Halothane and Sevoflurane Improves BDNF and GLUR1 Expressions in Hippocampus AreaIn the development stage, brain has a higher level of vulnerability than the adult brain to anesthetic agents. The aim of this study was to investigate the effects of red amaranth extract to brain derived neurotrophic factor (BDNF) and AMPA glutamate receptor subunit 1 (Glur1) expressions as biomarkers of cognitive and neuroplasticity in rat hippocampus areas exposed to inhaled anesthetics halothane and sevoflurane. The design of this study was a randomized posttest only control group. This study was conducted at the Department of Biochemistry Faculty of Medicine, Universitas Airlangga, and the anesthetic procedures were performed at the Veterinary Hospital, Faculty of Veterinary Medicine Universitas Airlangga during the period of May–October 2014. The subjects of this study were 23 white male rats (Rattus norvegicus) wistar strain, aged 1–1.5 months, weighted approximately 60–100 grams in a healthy physical condition. The subjects were divided into 5 groups, K (control); K1 (1 MAC halothane); K2 (red amaranth 800 mg/kgBW + 1 MAC halothane); K3 (1 MAC sevoflurane); and K4 (red amaranth 800mg/kgBW+1 MAC sevoflurane). The results of this study showed a decrease in the expression of BDNF when halothane and sevoflurane were administered. Red amaranth treatment prior to anesthetic gases exposure preserved and increased BDNF expression (p=0.000) while GLUR1 expression increased in the group that received halothane and sevoflurane administration and decreased back to normal in the group that received red amaranth treatment prior to exposure to anesthetic gases (p=0.000). In conclusion, red amaranth extract has the potential effect to prevent cognitive neurotoxicity on the cognitive function in rats exposed to anesthetic gases. [MKB. 2016;48(3):148–54]Key words: AMPA Glutamate Receptor subunit 1 (GLUR1), Brain Derived Neurotrophic Factor(BDNF), halothane, sevoflurane, red amaranth extract 

Comparison of Knowledge, Attitude, Motivation-to-Breastfeed Exclusively between Allied Health Students and Students of Other Fields at Universitas Padjadjaran

Astuti, Sri, Judistiani, Tina Dewi, Rahmiati, Lina, Susanti, Ari Indra

Majalah Kedokteran Bandung Vol 48, No 3 (2016)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Comparison of Knowledge, Attitude, and Motivation-to-Breastfeed Exclusively between Allied Health Students and Students of Other Fields at Universitas PadjadjaranUniversity students are among future intellectuals who will play an important role in community education and empowerment, especially on the topic of exclusive breastfeeding, in which the coverage is low in Indonesia. This study aimed to compare students’ knowledge, attitude, and motivation-to-breastfeed exclusively between allied health studies (AHS), i.e medicine and midwifery,  and other fields studies (OFS), i.e. psychology, communication, literacy, and farming. Further information will be gained from exploring the correlation of knowledge-attitude, as well as attitude - motivation in both groups. A study was conducted among Indonesian female students in their final year of bachelor degree in October to November 2013. The subjects recruited were 196/340 female AHS and 300/633 female OFS. The remaining students were absent at data collection time. Validity and reliability of the questionnaires were satisfactory. Ethical clearance was obtained from the Committee on Health Research Ethics, Faculty of Medicine, Universitas Padjadjaran. The mean scores must be higher than the cut off points to pass. Student’s T test result showed a highly significant difference (AHS vs OFS group: 83.1 vs 71.1 for  knowledge, 91.3 vs 86.4 for attitude, and 88.3 vs 83.6 for  motivation-to-breastfeed exclusively,  p<0.001). It is revealed also that the correlation index between knowledge-attitude as well as attitude -  motivation-to- breastfeed exclusively were higher in AHS group, but some AHS students scored lower than the OFS students. Discussion on this topic is presented in this article. Corrective interventions are needed for students who scored low.  This study shows a satisfactory students’ scores of knowledge, attitude, motivation-to-breastfeed exclusively. The AHS group has a better performance and correlation index between  knowledge and attitude, attitude and  motivation-to-breastfeed exclusively. [MKB. 2016;48(3):176–80]Key words: Allied health students, attitude, knowledge, motivation-to-breastfeed exclusively, students of other fields Hubungan antara Pengetahuan dan Perilaku, serta Motivasi Menyusui pada Mahasiswi Fakultas Medis dan Non-medis di Universitas PadjadjaranMahasiswi universitas yang keberadaanya di antara para intelektual masa depan mempunyai peran penting dalam pendidikan dan pemberdayaan masyarakat, khususnya mengenai air susu ibu (ASI) eksklusif yang mempunyai cakupan rendah di Indonesia. Penelitian ini bertujuan membandingkan pengetahuan, sikap, dan motivasi untuk menyusui secara eksklusif antara beberapa studi kesehatan (AHS), yaitu kedokteran dan kebidanan, serta studi bidang lain (OFS), yaitu psikologi, komunikasi, sastra, dan pertanian. Informasi lebih lanjut akan mengeksplorasi hubungan pengetahuan, sikap, serta sikap-motivasi pada kedua kelompok. Penelitian ini dilakukan dari Oktober–November 2013. Sampel terdiri atas 196/340 perempuan AHS dan 300/633 OFS perempuan di Universitas Padjadjaran. Sampel yang tidak diambil adalah mahasiswi yang tidak hadir pada saat pengumpulan data. Validitas dan reliabilitas kuesioner yang memuaskan. Izin etik diperoleh dari Komite Etik Penelitian Kesehatan Fakultas Kedokteran Universitas Padjadjaran. Hasil nilai yang lebih tinggi mempunyai poin untuk lulus. Hasil uji-t mahasiswi menunjukkan perbedaan yang sangat signifikan (AHS vs kelompok OFS adalah 83,1 vs 71,1 untuk pengetahuan, 91,3 vs 86,4 sikap, dan 88,3 vs 83,6 motivasi untuk menyusui secara eksklusif, p<0,001). Indeks korelasi antara pengetahuan dan sikap serta sikap dengan motivasi untuk menyusui secara eksklusif lebih tinggi pada kelompok AHS, namun beberapa mahasiswi AHS mempunyai nilai lebih rendah daripada mahasiswi OFS. Hal tersebut dibahas dalam artikel, intervensi korektif yang diperlukan antara mahasiswi yang mendapat nilai rendah. Penelitian ini menunjukkan hasil yang memuaskan pada nilai mahasiswi tentang pengetahuan, sikap, dan motivasi untuk menyusui secara eksklusif. Kelompok AHS menunjukkan kinerja dan indeks korelasi yang lebih baik antara pengetahuan dan sikap, sikap dengan motivasi untuk menyusui secara eksklusif. [MKB. 2016;48(3):176–80]Kata kunci: Mahasiswi kesehatan, motivasi untuk menyusui secara eksklusif, mahasiswi non-kesehatan, sikap dan pengetahuan

Ekspresi CD3 dan CD26 pada Limfosit T sebagai Biomarker Potensial Penyakit Systemic Lupus Erythematosus

Suselo, Yuliana Heri, Balgis, Balgis, Indarto, Dono

Majalah Kedokteran Bandung Vol 48, No 3 (2016)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Systemic lupus erythematosus (SLE) merupakan penyakit autoimun yang sering dijumpai pada wanita. Penyakit ini ditandai oleh hiperautoreaktivitas limfosit T dan B. Di dalam sistem imun, CD3 dibantu CD26 sebagai molekul kostimulator berkaitan erat dengan aktivasi dan migrasi limfosit T. Pada penyakit SLE, ekspresi CD3 dan CD26 serta aktivitas enzim CD26 belum diketahui. Tujuan penelitian ini adalah mengetahui ekspresi CD3 dan CD26 dalam darah serta kultur limfosit T pasien SLE. Rancangan penelitian ini bersifat eksperimen laboratorium dengan pendekatan studi retrospektif. Penelitian dilakukan di Laboratorium Biomedik, Fakultas Kedokteran Universitas Sebelas Maret Surakarta selama lima bulan (Mei–September 2012). Diagnosis SLE ditentukan menurut kriteria dari American College of Rheumatology (ACR). Darah vena diambil dari tiga pasien SLE dan dua orang sehat. Satu µg/mL phytohaemmaglutinin (PHA) digunakan untuk stimulasi kultur limfosit T. Ekspresi CD3 dan CD26 ditentukan dengan flows sytometry. Substrat H-Gly-Pro pNA digunakan untuk menguji aktivitas enzim CD26. Data yang terkumpul dianalisis dengan uji t. Ekspresi CD3 dan CD26 menurun dalam darah dan kultur limfosit T pada pasien SLE dibanding dengan kontrol, sedangkan aktivitas enzim CD26 pada kultur limfosit T pasien SLE lebih tinggi daripada kontrol (0.042 vs 0.030 U/mL), tetapi perbedaan tersebut tidak bermakna secara statistik (p>0.05). Simpulan, terdapat penurunan ekspresi CD3 dan CD26 baik disirkulasi darah maupun di kultur limfosit T subtipe CD4+. CD3 dan CD26 berpotensi sebagai biomarker penting untuk SLE. Namun, riset lanjutan masih perlu dilakukan untuk menjelaskan peran keduanya dalam patogenesis penyakit SLE. [MKB. 2016;48(3):140–7]Kata kunci: CD3, CD26, systemic lupus erythematosus (SLE)CD3 and CD26 Expression on T Lymphocytes as a Potential Biomarker of Systemic Lupus ErithematosusSystemic lupus erythematosus (SLE) is an autoimmune disease that is frequently found in women and characterized by hyperautoreactivity of T and B cells. In the immune system, expressions of CD 3 and CD26 (as co-stimulatory molecule) are related to T cells activation and migration. Co-expression of CD3 and CD26 in SLE patients has not been determined. The aim of this study was to investigate the co-expression of CD3 and CD26 in blood and T cell culture of SLE patients. This was an analytical descriptive study with a retrospective approach. This study was performed at the Biomedical laboratory, Faculty of Medicine, Sebelas Maret University, for five months (May–September 2012). SLE diagnosis was determined by using the criteria from the American College of Rheumatology (ACR). Vein blood was collected from three female patients with SLE and two healthy female controls. T cells isolated from the blood were cultured and stimulated with 1 µg/mL phytohaemmaglutinin (PHA). Flow cytometry was used to determine the coexpression of CD3 and CD26. CD26 enzyme activities in T cell culture were spectrophotometrically measured using H-Gly-Pro pNA substrate. Collected data were then analyzed using Student’s t test. Decreased coexpression of CD3 and CD26 was lower in blood samples and T cell cultures of SLE female patients than in control. Meanwhile, CD26 enzyme activities in SLE T cell cultures were higher than control (0.042 vs 0.030 U/mL) but no statistical difference was found (p>0.05). In conclusion, there is a decreased coexpression of CD3 and CD26 in blood circulation and T cell cultures subtype CD4+. CD3 and CD26 in SLE patients could be a prospective biomarker. Further research is required to unravel the roles of CD3 and CD26 in SLE pathogenesis. [MKB. 2016;48(3):140–7]Key words: CD3, CD26, systemic lupus erythematosus (SLE) 

Perbandingan Kadar Interleukin-17 Serum Pasien Akne Vulgaris Tipe Papulopustular dengan Komedonal

Maulinda, Shinta, Hindritiani, Reti, Ruchiatan, Kartika, Suwarsa, Oki

Majalah Kedokteran Bandung Vol 48, No 3 (2016)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Patogenesis akne vulgaris (AV) bersifat multifaktorial dan faktor yang berperan penting adalah inflamasi yang terutama diinduksi oleh reaksi imunologis terhadap Propionibacterium acnes (P. acnes). Bakteri ini dapat ditemukan baik pada lesi inflamasi berupa papula dan pustula, maupun noninflamasi seperti komedo, dengan jumlah P. acnes lebih tinggi pada lesi inflamasi. Secara klinis komedo merupakan lesi noninflamasi, namun secara mikroskopis sudah terjadi inflamasi. P. acnes dapat menginduksi pelepasan sitokin proinflamasi antara lain IL-17. Tujuan penelitian ini adalah membandingkan kadar IL-17 serum antara pasien AV tipe papulopustular dan komedonal. Penelitian ini merupakan penelitian analitik observasional secara potong lintang dengan peserta penelitian masing-masing 12 pasien AV tipe papulopustular dan komedonal derajat dua atau lebih di Poliklinik Dermatologi Kosmetik Departemen Ilmu Kesehatan Kulit dan Kelamin Rumah Sakit Dr. Hasan Sadikin Bandung selama periode Oktober–November 2014. Pada kedua kelompok dilakukan pengambilan darah tepi untuk pengukuran kadar IL-17 serum dengan metode ELISA. Hasil penelitian menunjukkan kadar IL-17 serum rata-rata (SD) pada pasien AV tipe papulopustular adalah 0,65 (1,12) pg/mL, sedangkan pada tipe komedonal adalah 0,46 (0,42) pg/mL, perbedaan tersebut secara statistik tidak bermakna (p=1,000). Simpulan, kadar IL-17 serum pasien AV tipe papulopustular tidak berbeda dibanding dengan AV tipe komedonal menunjukkan bahwa kemungkinan pada lesi komedo sudah terjadi inflamasi. [MKB. 2016;48(3):160–3]Kata kunci: Akne vulgaris, IL-17 serum, tipe komedonal, tipe papulopustular Comparison of Interleukin-17 Serum Level between Papulopustular and Comedonal Types of Acne VulgarisThe pathogenesis of acne vulgaris (AV) is multifactorial and inflammation, which is primarily cause by induction of immunological response to Propionibacterium acnes (P. acnes), is suggested as the main important factor in AV development. These bacteria can be found in the form of papules and pustules in inflammatory lesions and as comedones in noninflammatory lesions, with a higher presentation seen in the inflammatory lesions. Clinically, comedo is a noninflammatory lesion; however, inflammation can be observed microscopically. P. acnes can release proinflammatory cytokines, including IL-17. The aim of this study was to compare the IL-17 serum level between papulopustular type and comedonal type of AV. This study was a cross sectional-analytic observational, conducted at the Cosmetic Dermatology Clinic, Dermatology and Venereology, Dr. Hasan Sadikin General Hospital Bandung during October–November 2014. The participants were AV patients with at least second degree papulopustular (n12) and comedonal types (n12). Blood samples from all subjects were collected and the IL-17 serum levels were measured using ELISA methods. This study showed that the mean (single deviation) IL-17 serum levels in papulopustular and comedonal type of AV were 0.65 (1.12) pg/mL and 0.46 (0.42) pg/mL, respectively, and the difference was not statistically significant (p:1.000). The IL-17 serum level in the papulopustular type is not different from that of the comedonal type of AV in this study, which indicates that the inflammatory events probably had occurred  in comedonal lesions. [MKB. 2016;48(3):160–3]Key words: Acne vulgaris, comedonal type, IL-17 serum level, papulopustular type