cover
Filter by Year
Majalah Kedokteran Bandung
Articles by issue : Vol 50, No 2 (2018)
10
Articles
Peran Induksi TNF-α Serial Doses dalam Peningkatan VEGF dan PDGF Mesenchymal Stem Cells

Putra, Agung, Hutagalung, Ananta, Hasanal, Ihdina Hanifa, Trisnadi, Setyo, Djannah, Durrotul, Cahyono, Erwin Budi, Intan, Yulice Soraya Nur

Majalah Kedokteran Bandung Vol 50, No 2 (2018)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Original Source | Check in Google Scholar | Full PDF (1316.352 KB)

Abstract

Mesenchymal stem cell (MSC) mempunyai kemampuan immunoregulasi dan regenerasi melalui supresi pelepasan mediator proinflamasidan peningkatan molekul proliferasi terutama vascular endothelial growth factor (VEGF) dan platelet-derived growth factor (PDGF). Mesenchymal stem cell yang diaktivasi TNF-α dengan dosis tertentu mampu meningkatkan sekresi VEGF dan PDGF, namun dosis optimal TNF-α yang mampu memaksimalkan ekspresi molekul tersebut belum diketahui secara pasti. Variasi dosis TNF-α digunakan pada penelitian ini dengan tujuan mengetahui dosis optimal, rendah, dan tinggi TNF-α dalam memaksimalkan ekspresi VEGF dan PDGF. Penelitian ini mengunakan post-test only control group design dengan 5 kelompok penelitian, terdiri atas satu kelompok kontrol (K) dan 4 kelompok perlakuan (P) (TNF-α= 5, 10, 40, 80 ng/mL) yang diinduksikan pada MSC dengan inkubasi 24 jam, kemudian kadar PDGF dan VEGF diukur dengan metode ELISA. Penelitian ini dilakukan antara bulan September–November 2017 di Laboratorium Stem Cell and Cancer Research (SCCR), Fakultas Kedokteran, Universitas Islam Sultan Agung, Semarang. Hasil penelitian menunjukkan peningkatan kadar PDGF dan VEGF secara signifikan (p<0,05) dimulai dari dosis TNF-α 5 ng/mL, optimal padadosis 10 ng/mL dan mulai terjadi penurunan pada dosis 40 ng/mL. Induksi TNF-α pada MSC mampu memaksimalkan kadar VEGF dan PDGF pada dosis 10 ng/mL.Kata kunci: MSC, PDGF, TNF-α, VEGF Effect of TNF-α Serial Doses Inducition on Increasing VEGF dan PDGF in Mesenchymal Stem Cells Mesenchymal Stem Cells (MSCs) have immunoregulation and regeneration capabilities through suppression of proinflammatory mediator release and increase of proliferative molecules, particularly the vascular endothelial growth factor (VEGF) and platelet-derived growth factor (PDGF) TNF-α activated MSC in a certain dose has the ability to increase VEGF and PDGF levels; however, the exact optimum dose of TNF-α to optimize the levels of VEGF and PDGF is unclear. In this study, TNF-α dose variations were used to determine the optimum, low, and high doses of TNF-α in optimizing VEGF and PDGF expression. This was a post-test only control group study with five study groups consisting of one control (K) and four treatment groups(P). The treatment groups were treated with 5, 10, 40 and 80 ng/mL of TNF-α for 24 hours. PDGF and VEGF levels were measured using ELISA. This study was conducted between September–November 2017 at the Stem Cell and Cancer Research Laboratory (SCCR), Faculty of Medicine, Sultan Agung Islamic University, Semarang. The results show significant increased in PDGF and VEGF levels (p<0.05) starting from TNF-α 5 ng/mL as the initiation dose to 10 ng/mL as the optimum dose and reduction was seen starting from 40 ng/mL dose. TNF-induced MSCs have the ability to increase the VEGF and PDGF levels with an optimum dose of 10 ng/mL.Key words: MSC, PDGF, TNF-α, VEGF

Gambaran Faktor Risiko Prolaps Organ Panggul Pasca Persalinan Vaginal di Daerah Istimewa Yogyakarta

Pangastuti, Nuring, Sari, Dwi Cahyani Ratna, Santoso, Budi Iman, Agustiningsih, Denny, Emilia, Ova

Majalah Kedokteran Bandung Vol 50, No 2 (2018)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Original Source | Check in Google Scholar | Full PDF (677.733 KB)

Abstract

Prolaps organ panggul merupakan salah satu bentuk disfungsi dasar panggul pada perempuan. Disfungsi dasar panggul adalah keadaan terganggunya fungsi dasar panggul merupakan salah satu kondisi kesehatan yang banyak dikeluhkan perempuan. Lebih dari 46% perempuan dengan riwayat persalinan vaginal mengalami disfungsi dasar panggul,dan peningkatan jumlah paritas berkorelasi dengan peningkatan kejadian prolaps organ panggul. Tujuan penelitian ini adalah untuk mengetahui gambaran karakteristik faktor risiko prolaps organ panggul pasca persalinan vaginal di wilayah Daerah Istimewa Yogyakarta. Penelitian dilakukan pada Januari–Maret 2018. Hasil penelitian didapatkan 51 subjek penelitian dengan persalinan vaginal yang dapat dilakukan pemeriksaan POPQ pada 3 bulan pascapersalinan. Prolaps organ panggul didapatkan pada sebagian besar pasien pascasalin, yaitu sejumlah 46 orang, prolaps uteri 33 orang, sistokel 44 orang, serta rektokel pada 46) orang. Hanya 5 orang yang tidak memiliki gambaran prolaps organ panggul pada 3 bulan pascapersalinan.Dari penelitian ini dapat disimpulkan bahwa faktor risiko prolaps organ panggul pascapersalinan vaginal di Daerah Istimewa Yogyakarta terdiri atas faktor intrinsik (usia ibu, panjang genital hiatus maupun perineal body), dan ekstrinsik (paritas, indeks massa tubuh overweight dan obes, kenaikan berat badan selama hamil >15 kg, serta dilakukan episiotomi dan terjadi robekan perineum). Upaya pencegahan terutama edukasi, perbaikan gaya hidup, pengendalian indeks massa tubuh, pengaturan diet, olahraga penguatan otot dasar panggul, pembatasan jumlah kehamilan dan persalinan, serta pertolongan persalinan sesuai Asuhan persalinan normal. Kata kunci: Disfungsi dasar panggul, faktor risiko, persalinan vaginal, prolaps organ panggul Risk Factors for Pelvic Organ Prolapse in Women with History of Vaginal Delivery in YogyakartaPelvic organ prolapse is one form of pelvic floor dysfunctions in women that impairs the pelvic floor function and also one of the most frequently conditions complained by women. More than 46% women with history of vaginal delivery have experienced pelvic floor dysfunction where higher number of parity correllates to increased pelvic organ prolapse incident. The aim of this study was to understand the  characteristic risk factors of pelvic organ prolapse incident post vaginal delivery in Special Region of Yogyakarta. The study ws performed during the period of January to March 2018 on 51 subjects with history of vaginal delivery evaluated using POPQ in 3 months postpartum. Pelvic floor dysfunction was present in most postpartum patients, i,e, 46 people while 33 experienced uterine prolapse, 44 experienced cystocele, and 46 experienced rectocele. Only 5 subjects had no pelvic floor dysfunction in any form. Risk factors for pelvic organ prolapse in post vaginal delivery in the Special Region of Yogyakarta consist of intrinsic factors (maternal age, genital length of hiatus, and perineal body), and extrinsic factors (parity, overweight status and obese status based on body mass index, weight gain during pregnancy exceeding 15 kg,  episiotomy and the occurrence of perineal rupture). Prevention actions include  education followed by lifestyle improvement, control of body mass index, dietary regulation, exercise, restrictions on the number of pregnancies and childbirth, and safe delivery according to normal birth care standard.Key words: Pelvic floor dysfunction, pelvic organ prolapse, risk factors, vaginal delivery

Peran Terapi Adjuvan Vitamin D3 Terhadap Kadar T Regulator dan Gejala Klinis Penderita Rinitis Alergi Yang Mendapat Imunoterapi Subkutaneus Initial Build Up Dose

Sudiro, Melati, Madiadipoera, Teti, Setiabudiawan, Budi, Boesoirie, Thaufiq S.

Majalah Kedokteran Bandung Vol 50, No 2 (2018)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Original Source | Check in Google Scholar | Full PDF (61.23 KB)

Abstract

Imunoterapi spesifik (ITS) merupakan pilihan terapi pada rinitis alergi yang tidak memberikan respons perbaikan klinis dengan medikamentosa. Peran zat adjuvan diduga dapat meningkatkan efektivitas dan efikasi ITS. Penelitian ini bertujuan menganalisis peran adjuvan vitamin D3 pada ITS terhadap percepatan timbulnya respons imun toleran. Penelitian analitik komparatif numerik dua kelompok tidak berpasangan dengan rancangan uji klinis acak terkontrol ganda ini dilakukan di Klinik Rinologi-Alergi THT-KL RSUP dr. Hasan Sadikin Bandung sejak Mei 2016–April 2017. Sampel terdiri atas 18 pasien menerima ITS+kalsitriol dan 18 pasien menerima ITS+plasebo yang memenuhi kriteria penelitian diambil secara consecutive sampling. Dilakukan pemeriksaan jumlah sel Tregulator dengan flowcitometry pada baseline, minggu ke-8 dan 15 dan skor gejala hidung.  Analisis dengan Uji Mann-Whitney, uji Friedman, uji T berpasangan dan analisis Post hoc. Perbandingan kenaikan rerata median jumlah sel Treg kelompok intervensi dengan kontrol pada minggu ke 8 menunjukkan nilai p=0,04, rerata MFI Treg pada kelompok intervensi dengan kontrol nilai p=0,002. Analisis post hoc terhadap MFI Treg menunjukkan peningkatan pada kelompok intervensi dengan p=0,001 pada minggu ke-8. Disimpulkan perubahan di tingkat imunologi mulai terjadi pada minggu ke-8, tetapi perbaikan gejala klinis terlihat setara.Kata kunci: Imunoterapi spesifik, rinitis alergi, sel t-toleran perifer, sel T-regulator, vitamin D3 Role of Adjuvant Therapy with Vitamin D3 on T-Regulator in Allergic Rhinitis Patient with Subcutaneus Immunotherapy Allergen-specific immunotherapy (AIT) is a potentially disease-modifying therapy that is useful for the treatment of allergic rhinitis, especially in those who do not response to pharmacotherapy. Currently, the role of adjuvant is expected to increase the clinical efficacy in AIT.  The aim of this study was to analyze the role of vitamin D3 adjuvant in AIT to induce immune tolerance. This was an unpaired comparative analytic research with a randomized controlled trial dstudy conducted at the Rhinology-Allergy Clinic ORL-HNS of Dr. Hasan Sadikin General Hospital Bandung from May 2016 to April 2017. Eighteen subjects with AIT+ calcitriol treatment and 18 subjects with AIT+placebo treatment who met the study criteria were selected through consecutive sampling. All subjects were evaluated for Treg cells using flow citometry at baseline, week 8, and week 15. Nasal symptom score was also evaluated.  Statistical analysis performed in this study included Mann-Whitney test, Friedman test, T-Paired test,and Post hoc analysis. There was a significant different of Treg cells average results between the intervention group and control at week 8 with a p-value of 0.04. The mean delta value on MFI Treg reflected significant differences within intervention group (p=0.002). Post hoc analysis results presented a significant increase in MFI Treg in the intervention group at week 8 (p=0,001). Therefore, immunological changes start in week eight but the improvement of clinical symptoms looks similar. Key words: Allergic rhinitis, peripheral t-cell tolerance, regulatory t(treg) cell allergen specific immunotherapy, vitamin D3

Perbedaan Status Gizi Penderita Tuberkulosis Paru antara Sebelum Pengobatan dan Saat Pengobatan Fase Lanjutan di Johar Baru, Jakarta Pusat

Ernawati, Kholis, Ramdhagama, Nazza R., Ayu, Lydia A. P., Wilianto, Muhamad, Dwianti, Vini T. H., Alawiyah, Syafhira A.

Majalah Kedokteran Bandung Vol 50, No 2 (2018)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Original Source | Check in Google Scholar | Full PDF (600.943 KB)

Abstract

Penyakit tuberkulosis (TB) Paru merupakan penyakit menular yang disebabkan oleh kuman Mycobacterium tuberculosis. Faktor yang memengaruhi kemungkinan terkena penyakit TB paru salah satunya adalah status gizi yang buruk. Status gizi yang buruk akan meningkatkan risiko penyakit tuberkulosis paru. Sebaliknya, TB paru berkontribusi menyebabkan status gizi yang buruk karena proses perjalanan penyakit yang mempengaruhi daya tahan tubuh. Tujuan penelitian adalah menganalisis perbedaan status gizi penderita TB paru sebelum pengobatan dengan saat pengobatan fase lanjutan di Johar Baru, Jakarta Pusat. Penelitian dilakukan pada bulan Januari–Maret 2017. Populasi penelitian adalah  penderita TB paru dewasa (umur ≥17 tahun) yang sedang dalam masa pengobatan fase lanjutan (≥ pengobatan 4 bulan) yang berada di wilayah kerja Puskesmas Johar Baru sebanyak 51 orang. Dari populasi yang ada diambil sampel sebanyak 30 orang responden penderita TB Paru dengan teknik pengambilan sampel secara sampling kuota. Hasil penelitian menunjukkan bahwa status gizi responden sebelum pengobatan sebagian besar memiliki status gizi yang normal. Status gizi responden ketika pengobatan TB Paru ada peningkatan status gizi yang normal dan status gizi yang lebih serta penurunan status gizi yang kurang. Hasil uji bivariat menunjukkan tidak ada perbedaan nyata status gizi penderita TB Paru antara sebelum pengobatan dengan saat pengobatan fase lanjutan (p=0,763). Simpulan, perbandingan status gizi penderita TB sebelum pengobatan dan saat pengobatan fase lanjutan adalah terdapat penurunan status gizi kurang dan peningkatan status gizi normal. Hasil uji bivarat menunjukkan tidak ada beda nyata status gizi antara sebelum pengobatan dan saat pengobatan fase lanjutan.  Kata kunci: Fase pengobatan penyakit TB, status gizi, TB paru Differences in Nutritional Status of Pulmonary Tuberculosis Patients between Before Medication and during Advanced Treatment Phase in Johar Baru, Central JakartaPulmonary tuberculosis (TB) is a contagious disease caused by Mycobacterium tuberculosis bacteria. Factors that affect the likelihood of developing pulmonary TB disease include poor nutritional status as itnutritional status increases the risk of pulmonary tuberculosis. In contrast, pulmonary TB contributes to poor nutritional status due to the disease-causing processes that affect the immune system. The objective of the study was to analyze the difference in nutritional status between patients with pulmonary tuberculosis before treatment and who were in advanced treatment phase in Johar Baru, Central Jakarta. The study was conducted in January–March 2017 on a population of   51 adult tuberculosis patients (aged ≥17 years old) who were in the advanced treatment phase (≥4 months of treatment) in Johar Baru Public Health Center. Of the existing population, 30 30 respondents with pulmonary TB patients were selected as samples using quota sampling. Results showed that most respondents had normal nutritional status before treatment. During treatment, more respondents experienced Nutritional statusincerased norma nutritional status while a small number experienced decreased normal status. Wilcoxon Signed Ranks Test results showed no significant difference in nutritional status of patients with pulmonary tuberculosis between before treatment and during  advanced treatment phase (p=0,763). It is concluded that some TB patients during advance treatment phase experience increased nutritional status and some experienced decreased nutritional status. No significant difference in nutritional status between before treatment and during advanced phase treatment is found.Key words: Nutritional status, phase of treatment of TB disease, pulmonary TB 

Gambaran Kontainer Potensial dan Kondisi Lingkungannya Sebagai Tempat Perindukan Nyamuk di Universitas Padjadjaran Jatinangor

Faridah, Lia, Hamda, Muhammad Ersyad, Syafei, Neneng Syarifah, Agrianfanny, Yukan Niko

Majalah Kedokteran Bandung Vol 50, No 2 (2018)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Original Source | Check in Google Scholar | Full PDF (614.967 KB)

Abstract

Nyamuk memiliki peran penting sebagai vektor penyakit menular seperti demam berdarah dengue, malaria, filariasis, demam kuning, dan chikungunya sehingga keberadaan nyamuk perlu dikontrol. Pengawasan tempat perindukan nyamuk akan membantu pihak berwenang untuk merancang pengendalian kepadatan nyamuk. Pertumbuhan larva nyamuk dipengaruhi oleh kondisi lingkungan seperti suhu air, kelembapan udara, dan pH air. Kondisi tersebut dapat bervariasi karena perbedaan geografis, variasi musiman, atau bahkan perubahan iklim.Tujuan penelitian ini adalah mengetahui kontainer potensial dan kondisi lingkungannya sebagai tempat perindukan nyamuk di Universitas Padjadjaran Jatinangor. Penelitian deskriptif dilakukan dengan mengamati larva nyamuk dalam wadah air baik di dalam maupun di luar gedung fakultas. Kondisi lingkungan (pH, suhu dan kelembapan) diukur dan dicatat selama pengamatan untuk setiap kontainer. Hasil penelitian menunjukkan bahwa dari 582 kontainer yang diteliti terdapat 72 (12,4%) positif  larva nyamuk. Kontainer yang paling potensial di dalam bangunan adalah ember, sedangkan di luar bangunan adalah bambu Aedes sp. Mendominasi penemuan larva di lapangan. Suhu air rerata yang diperoleh adalah 24,3oC, kelembapan 66,7% dan pH 8,1. Kondisi suhu dan pH sesuai dengan kondisi optimum perkembangan larva pada umumnya. Sementara tingkat kelembapan yang lebih rendah (kelembapan 81,6–89,5%) masih mampu membuat larva nyamuk tumbuh dengan baik di Universitas Padjadjaran Jatinangor.Kata kunci: Kelembapan, larva nyamuk, pH, suhu air, Universitas Padjadjaran Potential Container and Its Environmental Conditions for Mosquito Breeding Site in Universitas Padjadjaran JatinangorPlaying pivotal role as vector of infectious disease such as dengue hemorrhagic fever, malaria, filariasis, yellow fever and chikungunya, mosquito needs to be controlled. Surveillance for mosquito breeding places will help the authorities in devising means in controlling mosquito density. The growth of mosquito larvae is influenced by environmental conditions such as water temperature, humidity, and pH. Those conditions may vary due to geographic differences, seasonal variations, or even climate change. The purpose of this study was to understand the potential container and its environmental conditions for larvae in Universitas Padjadjaran Jatinangor. A descriptive study was conducted by observing the presence of mosquito larvae in water containers both inside and outside of faculty buildings. Environmental conditions (pH, water temperature and humidity) were measured and recorded during observation for each water container.  Results showed that from 582 containers examined, 72 (12.4%) were positive for larvae. The most potential container in the building was bucket, while foroutside of the building, the most potential container was bamboo. Aedes sp. dominated larvae discovered in this study. The average water temperature obtained was 24.30C with 66% humidity, and pH 8.1. These temperature and pH values are the optimum condition for larvae development in general.  However, lower humidity level (humidity 81.6–89.5%) can still enable good growth of mosquito’s eggs in the campus area of Universitas Padjadjaran Jatinangor.Key words: Humidity, mosquito larvae, pH, water temperature, Universitas Padjadjaran 

Perbandingan R-Baux Score dengan BOBI Score sebagai Prediktor Mortalitas Pasien Luka Bakar di RSUP Dr. M. Djamil Padang

Fitri, Azdiana, Saputra, Deddy, Putra, Andani Eka

Majalah Kedokteran Bandung Vol 50, No 2 (2018)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Original Source | Check in Google Scholar | Full PDF (746.155 KB)

Abstract

Sistem skoring pada luka bakar sangat dibutuhkan sebagai nilai objektif untuk prediktif mortalitas. Belum ada sistem skoring objektif terbaik sebagai prediktif mortalitas luka bakar. Penelitian ini bertujuan membandingkan akurasi R- Bauxdan BOBI score dalam memprediksi mortalitas pasien luka bakar di RSUP Dr. M. Djamil, Padang. Penelitian dilakukan Januari 2013 sampai September 2017, menggunakan desain studi retrospektif pada pasien luka bakar yang dirawat di Unit Luka Bakar RSUP Dr. M. Djamil, Padang. Data diolah menggunakan uji diagnostik, uji Kappa, dan uji regresi logistik terhadap variabelnya. Jumlah sampel adalah 394 sampel. Sampel terbanyak laki-laki, rerata usia 28,3 ± 18,3 tahun, penyebab luka bakar terbanyak api, rerata total body surface area (TBSA) 26,1%, trauma inhalasi 51% dan angka mortalitas 26,4%. Uji sensitivitas BOBI score dibanding dengan R-Baux score adalah 96,83%: 92,89% dengan koefisien Kappa sebesar 0,50. Analisis regresi logistik menunjukkan variabel umur, TBSA, dan trauma inhalasi saling berhubungan pada R-Baux score. Uji diagnostik BOBI score lebih baik dibanding dengan R-Bauxscore dan nilai koefisien Kappa menunjukkan kesesuaian hasil dengan BOBI score. BOBI score lebih baik sebagai prediktor mortalitas di RSUP Dr. M. Djamil Padang dibanding dengan R-Bauxscore karena menunjukkan akurasi lebih baik setelah diuji dengan nilai real. Kata kunci: BOBI score, luka bakar, mortalitas, r-baux scoreComparison between R-Baux Score and BOBI Score as a Predictor of Burn Mortality in Dr. M. Djamil Hospital PadangBurns are the type of trauma with high morbidity and mortality. No best  objective scoring system is currently available to predict mortality in burn cases. This study aimed to compare the accuracy of R-Baux and BOBI scores in predicting mortality among burn patients in Dr. M. Djamil Hospital, Padang. This was a retrospective study on burn patients treated in burn unit of this hospital from January 2013 to September 2017. Assessments were performed on diagnostic test, kappa tests, and logistic regression test. Out of 394 samples enrolled men were more prominent, while the mean age of these patients was 28.3±18.3 years old with fire as the most frequent cause. The, mean TBSA and inhalation injury were  26.1% and 51%, respectively, with an overall mortality of 26.4%. The sensitivity test performed to compare  BOBI and R-Baux scores revealed the result of 96.83%: 92.89% with o.50 coefficient’s value of Kappa. Logistic regression test showed that age, TBSA, dan inhalation injury significantly correlated with R-Baux score, Diagnostic test result of BOBI score was better than R-Baux score and the coefficient’s value of Kappa showed a matched result with BOBI score with medium strength. BOBI score shows better accuracy as the mortality predictor of burn cases in Dr. M. Djamil Hospital Padang.Key words: BOBI score, burns, mortality, r-baux score

Old Mice Epididymal Sperm Quality After Short Term Gavage of Cogon Grass Root Ethanol Extract

Lubis, Alkaustariyah, Widyastuti, Rini, Robianto, Sondi, Priscilla, Madeleine, Syamsunarno, Mas Rizky A. A.

Majalah Kedokteran Bandung Vol 50, No 2 (2018)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Original Source | Check in Google Scholar | Full PDF (678.672 KB)

Abstract

Cogon grass (Imperata cylindrica) has been known as traditional herb because of its antioxidant activity. The oxidant level in the body increases linearly with age. Antioxidant works by decreasing the vulnerability of mammalian spermatozoa towards free radical attack. This study aimed to determine whether the active compound of Imperata cyclindrica root extract improved or damaged  sperm function in old mice. This was a complete randomized study performed in the Mouse Animal Laboratory Faculty of Medicine, Universitas Padjadjaran during the period of August to December 2017. This study was carried out by oral administration of three different doses i.e 115, 230, and 345 mg/kg body weight of cogon grass root ethanol extract into 24- weeks-old DDY strain mice for 14 days. Results showed no significant difference in body weight  and testicular index before and after treatment (p<0.05). Interestingly, sperm concentration decreased significantly in 345 mg/kgBW group when compared  to control (2.03x106 and 6.43x106 respectively, p<0.05). On the other hand, sperm motility and sperm with normal morphology increased following dose pattern, although not significantly, when compared to control (p<0.05). Hence, cogon grass root ethanol extract cannot maintain optimum epididymal sperm quality in old mice.  Key words: Aging, Imperata cylindrica, sperm quality Kualitas Sperma Epididimis Mencit Tua setelah Pemberian Ekstrak Akar Alang-Alang secara Oral Jangka PendekAlang-alang (Imperata cylindrica) dikenal sebagai obat tradisional karena efek antioksidan yang dimiliki. Kadar oksidan pada tubuh meningkat seiring pertambahan usia. Antioksidan bekerja dengan cara mengurangi kerentanan spermatozoa terhadap radikal bebas. Penelitian ini bertujuan untuk menentukan apakah komponen aktif ekstrak akar alang-alang dapat memperbaiki atau merusak fungsi sperma pada mencit tua. Penelitian ini dilakukan di Laboratorium Hewan Fakultas Kedokteran Universitas Padjadjaran periode Agustus hingga Desember 2017. Eksperimen dibagi menjadi satu grup kontrol dan tiga grup perlakuan dengan dosis 115, 230 dan 345 mg/kgBB selama 14 hari. Hasil menunjukkan tidak ada perbedaan signifikan pada berat badan dan index testis sebelum dan sesudah perlakuan. Menariknya, jumlah sperma menurun dengan signifikan pada kosentrasi tertinggi 345 mg/kgBB dibanding kontrol, yaitu 2,03x106 dan 6,43x106 (p<0.05). Selain itu, terjadi peningkatan motilitas sperma dan morfologi normal secara gradual hingga dosis tertinggi dibanding dengan kontrol walaupun tidak signifikan. Berdasar atas hasil yang didapat, ekstrak akar alang-alang dapat menjaga kualitas sperma pada mencit tua walaupun tidak optimal.Kata kunci: Imperata cylindrica, kualitas sperma, penuaan 

Pengaruh Faktor Risiko terhadap Waktu Timbulnya Efek Samping Kanamisin pada Tuberkulosis Resistan Obat

Wati, Martha Ratna, Reviono, Reviono, Putranto, Wachid, Sutanto, Yusup Subagio, Harsini, Harsini

Majalah Kedokteran Bandung Vol 50, No 2 (2018)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Original Source | Check in Google Scholar | Full PDF (540.161 KB)

Abstract

Kanamisin adalah obat untuk terapi tuberkulosis resistan obat (TB RO) yang menimbulkan efek samping gangguan pendengaran, gangguan fungsi ginjal, dan gangguan elektrolit terutama hipokalemia. Penelitian bertujuan menilai kesintasan waktu timbulnya efek samping dan pengaruh faktor risiko usia, riwayat terapi streptomisin serta berat badan terhadap efek samping akibat pemberian kanamisin pasien TB RO. Penelitian kohort retrospektif dari data rekam medis pasien TB RO dari Januari 2011 sampai April 2017 di RSUD Dr. Moewardi Surakarta. Analisis pengaruh faktor risiko terhadap efek samping menggunakan uji cox regression. Dari 238 pasien didapatkan gangguan pendengaran 143 pasien, gangguan fungsi ginjal 147 pasien, dan hipokalemia 169 pasien. Usia lebih dari 40 tahun hazard ratio (HR) 2,419 (IK: 95%; 1,716–3,409; p= 0,000) dan jenis kelamin perempuan HR: 1,549 (IK: 95%; 1,089–2,202; p= 0,015) berisiko terjadi gangguan pendengaran. Usia lebih dari 40 tahun HR: 1,892 (IK: 95%; 1,353–2,646; p= 0,000) dan jenis kelamin perempuan HR: 1,667 (IK: 95%; 1,179–2,357; p= 0,004) berisiko terjadi gangguan fungsi ginjal. Riwayat streptomisin sebelumnya dan indeks massa tubuh (IMT) tidak berisiko timbul efek samping akibat pemberian kanamisin. Pengawasan ketat timbulnya efek samping gangguan pendengaran dan gangguan fungsi ginjal pasien usia lebih dari 40 tahun dan perempuan pada pengobatan TB RO.Kata kunci: Efek samping, gangguan fungsi ginjal, gangguan pendengaran, kanamisin, TB resistan obat Effects of Risk Factors on the Onset of Kanamycin’s Adverse Events in Drug Resistant TuberculosisKanamycin is a therapy for drug-resistant tuberculosis (TB) which may cause hearing loss, impaired kidney function, and electrolyte disorders, especially hypokalemia. The objective of this study was to assess patient survival and the effects of risk factors such as age, previous history of streptomycin therapy, and weight on adverse events due to kanamycin administration in patients with drug resistant TB. A retrospective cohort study was conducted in TB patients by using medical records from January 2011 to April 2017 in Dr. Moewardi Hospital Surakarta. Cox regression analysis was used to analyze the relation between risk factors and adverse events. Of 238 patients, 143 patients experienced hearing loss, 147 patients experienced impaired kidney function, and 169 patients had hypokalemia. Age over 40 and female gender had higher risks for hearing loss and impaired kidney function (HR: 2.419 (95% CI: 1.716–3.409; p= 0,000) and HR: 1,892 (95% CI: 1.353–2.646; p=0,000); HR: 1.549 (95%CI: 1.089–2.202; p=0,015), and HR: 1.667 (95% CI: 1.179–2.357; p=0.004)), respectively. History of streptomycin and body mass index (BMI) were not risk factors for  kanamycin’s adverse events. Therefore, closed monitoring on hearing loss and impaired kidney function is necessary for drug resistant TB patients aged over 40, and female patients. Key words: Adverse events, drug resistant tuberculosis, hearing loss, impaired kidney function, kanamycin

Characteristics of Anemia in Children with HIV Infection

Ghozali, Mohammad, Adhi Sunjaya, Al Farizi, Indrati, Agnes Rengga

Majalah Kedokteran Bandung Vol 50, No 2 (2018)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Original Source | Check in Google Scholar | Full PDF (831.509 KB)

Abstract

Anemia is a hematologic complication commonly encountered in HIV patients. Although the severity of anemia is generally mild, anemia has been shown to be a strong risk factor for disease progression, particularly in HIV infected person. With different severity and types of anemia in HIV patients, it is necessary to identify the severity and type of anemia in HIV-infected children, thus helping to determine the prognosis and management of their anemia. The purpose of this study was to describe HIV patient staging infection, co-morbidities, and type of anemia in HIV-infected children based on their therapy. A descriptive quantitative research was conducted in Dr. Hasan Sadikin General Hospital Bandung. Data were collected from patients’ medical records diagnosed with HIV between 2015–2017. The severity of anemia was set according to World Health Organization standards in 2011 and the types of anemia were identified from the erythrocyte index on routine hematologic examination. Forty-seven of 73 children had anemia. Based on the severity of anemia, 26% mild anemia, 60% moderate anemia, and 15% severe anemia were found. Subsequently, hypochromic microcytic (40%), macrocytic (32%), and normocytic normochromic (28%) anemia were identified. Considering the direct and indirect mechanism to yield anemia in HIV-infected patients, this double sword symptom becomes the most common complication burdened the growth and development of HIV-infected children. This study made it even more pronounced. Key words: Anemia, Children, HIV Karakteristik Anemia pada Anak Terinfeksi HIVAnemia adalah komplikasi hematologi paling sering ditemukan pada pasien HIV. Meskipun tingkat anemia pada umumnya ringan, anemia telah terbukti menjadi faktor risiko kuat terhadap perkembangan penyakit. Terdapat perbedaan tipe anemia pada pasien HIV dengan etiologi yang berbeda pula sehingga perlu dilakukan identifikasi mengenai tingkat dan tipe anemia pada pasien HIV anak, yang pada akhirnya dapat membantu menentukan prognosis dan penatalaksanaan anemia pada pasien ini. Suatu penelitian deskriptif kuantitatif ini bertujuan mengetahuitingkat dan tipe anemia dengan mengklasifikasikannya berdasarkan komorbiditas pada pasien HIV/AIDS anak di RSHS tahun 2015–2017 menggunakan data rekam medik pasien pemeriksaan hematologi rutin. Tingkat anemia ditetapkan berdasar atas standar WHO, sementara jenis anemia dilihat dari indeks eritrosit. Sebanyak 73 pasien anak terinfeksi HIV, didapatkan 47 anak mengalami anemia. Tingkat anemia ditemukan anemia ringan (26%), anemia sedang (60%), dan anemia berat (15%). Tipe anemia yang ditemukan adalah normositik normokromik (28%), makrositik (32%), dan mikrositik hipokromik (40%). Tingkat anemia pada pasien HIV anak di RSHS pada umumnya adalah anemia sedang. Tipe anemia terbanyak pada penelitian adalah mikrositik hipokromik. Kata kunci: Anak, anemia, HIV

Studi Gambaran Histopatologi Hepar Tikus Putih Strain Wistar yang Diinduksi Aspirin Pascapemberian Ekstrak Etanol Umbi Iles-iles (Amorphophallus variabilis Bl.) Selama 7 Hari

Makiyah, Arfatul, Khumaisah, Lela Laelatul

Majalah Kedokteran Bandung Vol 50, No 2 (2018)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Original Source | Check in Google Scholar | Full PDF (46.143 KB)

Abstract

Paradigma yang berkembang di masyarakat kita saat ini ramuan tradisional dikarenakan bahan-bahannya berasal dari alam adalah tidak berbahaya dan tidak mempunyai efek samping. Tujuan penelitian adalah mengetahui gambaran histopatologi hepar tikus putih strain Wistar yang diinduksi aspirin pasca pemberian ekstrak umbi iles-iles (Amorphophallus variabilis Bl.). Penelitian ini dilaksanakan di Laboratorium Farmakologi Universitas Padjadjaran pada bulan April–Mei 2018.  Tikus putih strain Wistar sebanyak 20 ekor dibagi menjadi 4 kelompok. Tikus putih strain wistar pada setiap perlakuan diberikan ekstrak iles-iles secara oral selama 7 hari pada tanggal 8–14 April 2018. Parameter gambaran histopatologi hepar tikus putih strain wistar yang diinduksi aspirin pascapemberian ekstrak umbi iles-iles (Amorphophallus variabilis Bl.) dengan dosis yang berbeda (0 mg/kgBB, 220 mg/kgBB, 110 mg/kgBB, 55 mg/kgBB) adalah preparat histopatologi hepar masing-masing dilakukan 5 lapang pandang mikroskopik. Hasil penelitian hasil Uji Kruskall Wallis menunjukkan bahwa kelompok tikus putih strain Wistar yang diberi ekstrak dengan dosis masing-masing 110 dan 220 mg/kgBB lebih banyak (p<0,05) tikus putih strain Wistar yang mengalami penebalan septa interalveolaris dibanding dengan kelompok I (kontrol). Pemberian ekstrak terstandar etanol umbi iles-iles dosis tunggal 110 mg/kgBB dan 220 mg/kgBB pada tikus putih strain Wistar tampak menimbulkan perubahan histopatologi berupa radang, nekrosis, kongesti, dan perlemakan hepar. Kata kunci:  Ekstrak Etanol, histopatologi, umbi Iles-iles (Amorphophallus variabilis Bl.) Liver Histopathological Features in White Wistar Rats Induced with Aspirin After 7 Days Administration of Ethanol Extract from Iles-iles Bulb(Amorphophallus variabilis Bl.) The society currently has a paradigm that traditional medicine is safer because the ingredients come from nature, making them harmless and no side effects should be experienced. The aim of this study was to identify the histopathological features of aspirin-induced Wistar rats after the administration of iles-iles bulb extract (Amorphophallus variabilis Bl.). This study was conducted at the Pharmacology Laboratory of Universitas Padjadjaran in April to May 2018. Twenty Wistar white rat strain were divided into 4 groups treated by 4 different doses of iles-iles extract i.e., 0, 55, 110, and 220 mg/kg BW. Wistar strain white rats on each treatment received iles-iles extract orally for 7 days during the period of 8 to14 of April 2018. The histopathological feature parameters of Wistar rats induced with aspirin after 7 days administrations of iles-iles extract (Amorphophallus variabilis Bl.) were then observed. Results based on analysis using Kruskall Wallis test showed that many rats in the groups treated by 110 and 220 mg/kgBW extract (p<0.05) presented thickened interalveolar septum when compared to group I (control). Provision of standardized ethanol extract of iles-iles tuber using a single dose of 110 mg/kgBW and 220 mg/kgBW in white mice of Wistar strains appears to cause histopathological changes such as inflammation, necrosis, congestion, and changes in hepatic fatty acids.Key words: Ethanol extract, histopathology, iles-iles tubers (Amorphophallus  variabilis Bl.)