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Profil Ekspresi Koreseptor Human Immunodeficiency Virus CCR5 dan CXCR4 pada penderita Infeksi Human Immunodeficiency Virus yang menggunakan Narkoba Suntik

Indrati, Agnes Rengga, Parwati, Ida, Garna, Herry, Alisjahbana, Bachti

Majalah Kedokteran Bandung Vol 50, No 3 (2018)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Infeksi human immunodeficiency virus masih merupakan masalah kesehatan global, termasuk di Indonesia dan pemakai narkoba suntik merupakan populasi yang besar di antara orang dengan  infeksi HIV/AIDS (ODHA) yang berperan penting dalam  transmisi infeksi HIV. Opioid banyak digunakan penasun dan memengaruhi ekspresi CCR5 serta CXCR4 yang merupakan  koreseptor yang digunakan oleh HIV untuk menginfeksi sel limfosit T CD4. Penelitian ini bertujuan menganalisisperbedaan  ekspresi koreseptor HIV CCR5 dan CXCR4 antara ODHA penasun dan ODHA bukan pemakai narkoba. Penelitian observasional analitik dengan  rancangan cross sectional ini dilaksanakan pada September 2011−Mei 2013. Subjek penelitian adalah ODHA penasun yang diikutsertakan secara consecutive sampling  di RSUP Dr. Hasan Sadikin Bandung  serta di komunitas di Jawa Barat. Pemeriksaan ekspresi koreseptor CCR5, CXCR4 dan jumlah sel limfosit T CD4 dilakukan dengan metode flowsitometri. Ditemukan 80 orang subjek penelitian dengan 17 orang pengguna narkoba suntik aktif, 16 orang dalam terapi metadon, 15 orang mantan penasun, dan 32 orang bukan pemakai narkoba. Persentase CXCR4 di permukaan sel limfosit T CD4 lebih tinggi bermakna pada ODHA bukan pemakai narkoba dibanding dengan ODHA penasun (86,13; 78,23; p 0,001). Tidak terdapat perbedaan bermakna  ekspresi CCR5 dan MFI CXCR4 di permukaan sel limfosit T CD4 antara ODHA penasun dan ODHA bukan pemakai narkoba (p>0,05).  Dari penelitian ini disimpulkan bahwaekspresi CXCR4  lebih tinggi pada ODHA penasun dibanding dengan ODHA bukan pemakai narkoba pada sel limfosit T CD4. Ekspresi koreseptor CXCR4 yang lebih tinggi dibanding dengan CCR5 baik pada kelompok ODHA penasun dan bukan pemakai narkoba.  Human Immunodeficiency Virus-Coreceptors CCR5 and CXCR4 Expression Profile in Injecting Drug Users Living with HIV  Human immunodeficiency virus (HIV) is considered as global health problem, includingin Indonesia. A large proportion of people living with HIV/AIDS (PLHAs) are Injecting Drug Users (IDUs) who play an important role in HIV transmission. Opioid that is used by many IDUs influence the expression of CCR5 and CXCR4, which are the co-receptors used by HIV to infect CD4 T lymphocyte cells. This study aimed to compare the expression of HV CCR5 and CXCR4 co-receptors between IDU PLHAs and non-drug user PLHAs. This was a crossectional analytical observation performed in the period of September 2011−May 2013 on IDU PLHAs who were sampled consecutively in Dr. Hasan Sadikin General Hospital Bandung and community in West Java. Flowcytometry was used for analyzing CCR5 and CXCR4 co-receptors as well as the CD4 T lymphocyte count. Eighty subjects were included in the study, consisting of 17 active injecting drug users, 16 IDUs on methadone therapy, 15 former IDUs, and 32 non-drug user PLHAs. The percentage of CXCR4 on CD4 T lymphocyte surface was significantly higher in non-drug user PLHAs when compared to IDU PLHAs (86,13; 78,23; p 0,001). No significant difference was found in the expression of CCR5 and MFI CXCR4 on CD4 T lymphocyte surface between IDU PLHAs and non-drug user PLHAs (p>0,05).  It is concluded that the expression of CXCR4 on CD4 T lymphocyte surface is higher in IDU PLHAs compared to non-drug user PLHAs. The expression of CXCR4 co-receptors is higher than the expression of CCR5 both in IDU PLHAs and non-drug user PLHAs.    

Effect of Moderate Intensity Exercise on Body Weight and Blood Estrogen Level Ovariectomized Mice

Prasetya, Rizka Eka, Umijati, Sri, Rejeki, Purwo Sri

Majalah Kedokteran Bandung Vol 50, No 3 (2018)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Estrogen is a hormone which is related to lipid oxidation, lypogenesis inhibition, and lipolysis rate. The purpose of this study was to determine the effect of moderate intensity exercise on body weight and blood estrogen level in ovarectomized mice (ovx). The study was held in the Laboratory of Biochemistry, Faculty of Medicine Universitas Airlangga during the period of April to May 2017 on old nineteen 3-4 months old female mice, , 20-30 grams of weight, which were divided into two groups: OVX (n=9, ovx without exercise) and OVX+E (n=10, ovx and moderate intensity exercise). Moderate intensity exercise in this study included swimming, three times a week at 3 pm for four weeks using a 6% of body weight load. Experiment data were analyzed by paired t-test and independent t-test using SPSS. The average body weights of the OVX  group were 26.44 ± 1.94 grams and 29.89 ± 2.62 gram at pretest and posttest, respectively., while for the OVX+E group, the weights were 26.50 ± 2.59 grams and 26.40 ± 2.07 grams. There were asignificant intergroup body weight differences (∆OVX= 3.44 ± 2.55 gram and ∆OVX+E= -1.00 ± 1.37 gram) with p=0.004. Blood estrogen level in OVX+E (12.04 ±10.13 ng/ml) was higher than in control (OVX= 11.24 ± 8.33 ng/ml); however, the difference was not significant (p=0.855). Moderate intensity exercise reduces body weight, without any significant increase in blood estrogen level. Hence, the body weight loss is not caused by estrogen, which may be due to the short period of exercise in this study that the estrogen has not had the time to increase.Pengaruh Olahraga Intensitas Sedang terhadap Berat Badan dan Kadar Estrogen Darah pada Mencit Ovariektomi Estrogen merupakan hormon yang berperan pada oksidasi lipid, kecepatan lipolisis, dan hambatan lipogenesis. Penelitian bertujuan mengetahui pengaruh olahraga intensitas sedang terhadap berat badan dan kadar estrogen darah pada mencit ovariektomi (ovx). Penelitian dilaksanakan di Laboratorium Biokimia Fakultas Kedokteran Universitas Airlangga, April–Mei 2017. Sejumlah 19 mencit betina berusia 3–4 bulan, berat 20–30 gram, dibagi menjadi dua kelompok: OVX (n=9, ovx tanpa perlakuan) dan OVX+E (n=10, ovx dengan olahraga intensitas sedang). Olahraga intensitas sedang dilakukan dengan renang, tiga kali seminggu pukul 15.00 WIB selama empat minggu dengan beban 6% dari berat badan. Data dianalisis dengan paired t-test dan independent t-test SPSS. Berat badan OVX pra-tes 26,44±1,94 gram dan pascates 29,89±2,62 gram. Berat badan OVX+E pra-tes 26,50±2,59 gram dan pascates 26,40±2,07. Terdapat perbedaan bermakna berat badan antarkelompok (∆OVX= 3,44±2,55 gram and ∆OVX+E= -1,00±1,37 gram), p=0,004. Kadar estrogen darah OVX+E (12,04±10,13 ng/mL) lebih tinggi daripada konrol (OVX= 11,24±8,33 ng/mL), tetapi tidak berbeda bermakna (p=0,855). Olahraga intensitas sedang menurunkan berat badan, tetapi tidak bermakna meningkatkan kadar estrogen darah. Penurunan berat badan tidak disebabkan oleh estrogen. Peningkatan estrogen belum terjadi mungin disebabkan oleh waktu yang kurang lama.  

Peran Dokter Umum pada Program Promosi Kesehatan di Layanan Primer

Yuliyanti, Suryani, Sugeng, Purwito, Ratnawati, Ratnawati

Majalah Kedokteran Bandung Vol 50, No 3 (2018)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Fasilitas Kesehatan Tingkat Pertama (FKTP) sebagai ujung tombak pelayanan kesehatan perlu mengarus utamakan kegiatan Promosi kesehatan (Promkes). Dokter memiliki posisi strategis dalam kegiatan Promkes di FKTP melalui pemberian Komunikasi, informasi, dan edukasi (KIE) saat melakukan tatalaksana pasien maupun dalam manajemen kegiatannya. Penelitian ini bertujuan menggambarkan peran dokter dalam kegiatan Promkes di FKTP. Penelitian deskriptif dilaksanakan pada bulan Juni sampai Agustus 2017 dengan jumlah responden 48 dokter di FKTP yang bekerjasama dengan Badan Penyelenggara Jaminan Sosial Kesehatan (BPJSK) meliputi Puskesmas, Klinik Pratama, maupun praktik dokter perorangan. Data diambil melalui pengisian kuesioner, wawancara dan observasi, selanjutnya dianalisis secara deskriptif. Gambaran keterlibatan dokter dalam pelaksanaan promkes adalah sebanyak 98% telah melaksanakan promkes di FKTP, 82% melakukan promkes kepada semua pasien, 90% melaksanakan perencanaan promkes, dan konsisten dalam pelaksanaannya, 72% melakukan monitoring dan evaluasi, hanya 16% yang melakukan pengkajian data dalam perencanaan, dan jumlah yang berperan dalam strategi bina suasana, kemitraan dan advokasi masing masing adalah 4, 12, dan 28. Jenis kegiatan promkes yang dilakukan adalah pemberian KIE kepada pasien, keluarga, dan masyarakat. Dokter berperan dalam pemberian KIE bagi individu, keluarga dan masyarakat, tetapi perannya dalam perencanaan berbasis data dan strategi promkes masih perlu ditingkatkan untuk peningkatan pelayanan promkes di FKTP. Role of Physicians in Primary Health Care Health Promotion Program  in SemarangPrimary Health Care (PHC) is the first line  health care provider that has a duty, among others, to do  health promotion (HP). Physicians play a strategic role in health promotion by providing information, education and communication (IEC) to the patients during their practice and Health Promotion (HP) sessions. This study aimed to assess the knowledge, attitude, and role of physicians in HP program in PHC. A descriptive study was conducted between June and August 2017 among Health Social Insurance Agency (Badan Penyelenggara Jaminan Sosial Kesehatan, BPJSK) care provider partners (physicians) working for Public Health Center (Pusat Kesehatan Masyarakat, Puskesmas) and private primary clinics. Data were collected through questionnaire distribution, in-depth interview, and observation and were analyzed descriptively. Of all physicians involved in this study, 98% were involved in HP, 82% provided HP to their patient, 90% were involved in HP planning and its implementation, 72% were involved in monitoring and evaluation.  Only 16% were involved in the analysis of the data for planning and 4%, 12%, and 28% were involved in environment optimization, advocacy, and partnership, respectively. The HP approach implemented by the physicians was IEC to their patients, families, and community. The role of physicians in HP is particularly giving IEC to their patients, families, and community but this role should be improved by adding  HP evidence-based planning and strategy development to improve HP services in PHC.

Potensi Fraksinasi Sarang Semut Papua (Myrmecodia pendans) pada Penurunan Tnf-α dan Perbaikan Secara Histopatologi Kartilago Osteoartritis Lutut Kelinci

Hidajat, Nucki Nursjamsi, Mulyadi, Dicky, Tandjung, Fachry A., Sulaeman, Asep

Majalah Kedokteran Bandung Vol 50, No 3 (2018)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Reaksi seluler kondrosit osteoartritis pada lutut ditandai dengan peningkatan sitokin tumor necrosis factor-α (TNF-α).TNF-α mengaktifkan fibroblas dan makrofag sinovial untuk menyekresi enzim degradasi dan menekan sintesis proteoglikan rawan sendi sehingga memberikan gambaran histopatologik kartilago yang mengalami perubahan. Osteoartritis sekunder terjadi akibat trauma sendi yang menyebabkan nyeri. Terapi obat seperti non-steroidal anti-inflammatory drugs (NSAIDs) yang digunakan menyebabkan efek samping merugikan jika digunakan dalam jangka panjang. Fraksinasi sarang semut papua (Myrmecodia pendans) diketahui memiliki kandungan salah satunya flavonoid yang berfungsi sebagai anti-inflamasi, antioksidan dan pelindung sel. Berdasar hal tersebut maka ingin diketahui potensi fraksinasi sarang semut papua pada osteoartritis kartilago lutut kelinci dalam menghambat enzim proinflamasi, yaitu TNF-α dan memberikan perbaikan secara histopatologik dibanding dengan kontrol. Penelitian menggunakan uji eksperimental hewan dengan desain experimental comparative menggunakan 8 kelinci ras New Zealand yang dibagi menjadi 2 kelompok, yaitu kelompok kontrol dan kelompok yang diberikan fraksinasi sarang semut papua dengan dosis 2,5 mg/kgBB intra-artikular. Kemudian dilakukan pengukuran kadar TNF-α dan skoring secara histopatologik. Penelitian dilakukan di Fakultas Kedokteran, Universitas Padjadjaran periode Februari-Maret 2017. Pada Uji-t tidak berpasangan untuk TNF-α didapatkan nilai p=0,011; Uji Mann Whitney untuk skoring histopatologik dengan nilai p=0,034 pada kelompok yang diberian fraksinasi sarang semut papua. Terdapat penurunan TNF-α dan perbaikan secara histopatologik pada kartilago osteoartritis lutut kelinci yang diberikan fraksinasi sarang semut papua.Potential of Fractionated Papuan Ant Nest (Myrmecodia Pendans) to Decrease TNF-α and Improve Osteoarthritis Cartilage Histopathological Features in Rabbits Knee Condrocyte cellular reaction in knee with osteoarthritis is characterized by increased tumor necrosis factor-α (TNF-α) cytokine level. TNF-α activates fibroblasts and synovial macrophages to secrete degradation enzymes and supress cartilage proteoglycan synthesis, leading to histopathological changes in cartilages. Secondary osteoarthritis is triggered by a joint trauma that leads to pain. Long term drug therapy, such as non-steroidal anti-inflammatory drugs (NSAIDs), will lead to adverse effects. Fractionated Papuan ant nest (Myrmecodia Pendans) is known as containing flavonoid that plays a role as anti-inflamatory agent, antioxidang, and cell protector. This study aimed to identify the potential of fractionated Papuan ant nest to inhibit pro-inflamatory enzyme, i.e. TNF-α, and improve the histopathological features in rabbit knee cartilage with osteoarthritis. This was a comparative animal experiment on 8 New Zeland rabbits that were divided into 2 groups: control group and treatment group conducted at the Faculty of Medicine, Universitas Padjadjaran, in February-March 2017. The treatment group received 2.5 mm/kgBW fractionated Papuan ant nest as treatment. Measurement was then performed on TNF-α level and histopathological scoring. Statitical analysis was performed using unpaired t-test for TNF-α and Mann Whitney test for histopathological scoring. The results showed that the p-values for TNF-α and histopathological scoring were 0.011 and 0.034, respectively, in the group receiving fractionated Papuan ant nest. Reduction of TNF-α level and histopathological improvement are found in rabbit knee cartilage with arthritis when fractionated Papuan ant nest is given.  

Model Program Demam Berdarah Dengue. Peran Serta Masyarakat, serta Sanitasi Dasar di Kota Bandung

Respati, Titik, Faridah, Lia, Raksanagara, Ardini, Djuhaeni, Henni, Sofyan, Asep

Majalah Kedokteran Bandung Vol 50, No 3 (2018)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Munculnya kembali demam berdarah sebagai masalah kesehatan masyarakat yang utama menunjukkan sulitnya mempertahankan kelangsungan program pencegahan dan pemberantasan penyakit ini. Pengetahuan yang memadai mengenai demam berdarah dengue (DBD) dan metode untuk mencegahnya harus dapat dimengerti oleh masyarakat sebelum mereka mau berpartisipasi aktif. Penelitian ini bertujuan menggambarkan faktor-faktor yang memengaruhi DBD berdasar atas peran serta masyarakat, sanitasi dasar, dan program pencegahan dan pemberantasan demam berdarah dengue  Penelitian ini adalah survei pada 2.035 rumah tangga di 12 kecamatan dan 16 kelurahan di Kota Bandung pada bulan Mei – Juni 2015 yang dilakukan dengan metode stratified random sampling. Kuesioner digunakan untuk mengetahui karakteristik, pengetahuan mengenai DBD, pengalaman, persepsi risiko dan sikap dalam kejadian DBD, program DBD yang tersedia, serta fasilitas sanitasi dasar. Analisis data menggunakan partial least square (PLS). Hasil menunjukkan bahwa DBD dipengaruhi oleh keberadaan tempat perindukan nyamuk, fasilitas sanitasi dasar terutama sistem pembuangan air limbah (SPAL), Program DBD serta peran serta masyarakat terutama mengenai pengetahuan. Upaya paling efektif untuk mengurangi tempat perindukan ini adalah dengan menyediakan sarana sanitasi dasar yang dapat diakses oleh seluruh masyarakat serta upaya pemberantasan sarang nyamuk PSN yang sebaiknya dilakukan secara serentak.  Dengue Hemorrhagic Fever Program Model, Community Participation, and Basic Sanitation in Bandung CityThe reemergence of dengue fever as a major public health problem presents difficulties in the sustainability of prevention and eradication programs for this disease. Community must have adequate knowledge on dengue hemorrhagic fever (DHF) and methods to prevent it before they have the willingness to participate actively. This study aimed to describe factors that influence DHF program  ased on community participation, basic sanitation, and prevention and eradication. This was a survey on 2,035 households in 12 sub-districts and 16 villages in Bandung City in May - June 2015. Sampling was perfomed using stratified random sampling method. The questionnaire was used to determine the characteristics, knowledge on DHF, experience, risk perception, and attitudes towards the incidence of DHF; available DHF programs; and basic sanitation facilities. Data analysis was performed using Partial Least Square (PLS). The results showed that DHF was affected by the presence of mosquito breeding sites, basic sanitation facilities, especially sewage disposal systems (SPAL), DHF programs, and community participation especially knowledge. The most effective effort to reduce the breeding place is by providing basic sanitation facilities accessible to the entire community along with simultaneous efforts to eradicate mosquito breeding places.   

Density Gradient Centrifugation Pra-freezing Mengoptimalkan Persentase Morfologi Normal Spermatozoa Pasca-thawing

Suyono, Seso Sulijaya, Hinting, Aucky, Lunardhi, Hamdani, Itishom, Reny

Majalah Kedokteran Bandung Vol 50, No 3 (2018)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Kriopreservasi akan mengganggu struktur dan fungsi spermatozoa. Preparasi semen mampu menghasilkan spermatozoa dengan kualitas baik. Penelitian ini bertujuan menganalisis pengaruh preparasi semen dengan density gradient centrifugation (DGC) pra-freezing terhadap kualitas spermatozoa pasca-thawing. Penelitian dilakukan di boratorium Biologi Kedokteran, Fakultas Kedokteran Universitas Airlangga periode November 2017–Januari 2018. Penelitian eksperimental laboratoris dilakukan menggunakan cairan ejakulat volunter pria infertil. Semua sampel dibagi menjadi dua bagian, kelompok kontrol serta kelompok perlakuan berupa preparasi mini DGC. Setelah penambahan krioprotektan, selanjutnya dilakukan freezing. Pemeriksaan kualitas spermatozoa, meliputi motilitas, viabilitas serta persentase morfologi normal menggunakan metode WHO 2010, baik pra-freezing maupun pasca-thawing. Persentase perubahan kualitas spermatozoa pasca-thawing kedua kelompok dibandingkan menggunakan uji t dan bermakna jika nilai p<0,05. Total 20 sampel cairan ejakulat digunakan dalam penelitian ini. Persentase penurunan motilitas progresif, motilitas total, serta viabilitas pasca-thawing antara kedua kelompok tidak berbeda bermakna dengan nilai p masing-masing 0,422; 0,873 serta 0,432. Namun, penurunan persentase morfologi normal pasca-thawing pada kelompok kontrol jauh lebih besar daripada kelompok perlakuan dengan nilai p<0,001. Penelitian ini menyimpulkan bahwa preparasi semen berupa mini DGC pra-freezing mampu menghasilkan spermatozoa pasca-thawing dengan persentase morfologi normal yang lebih baik daripada protokol direct freezing.Pre-freezing Density Gradient Centrifugation Optimizes the Percentage of Post-thawed Sperms with Normal Morphology Cryopreservation impairs sperm structure and functions. Sperm preparation is a selection technique to obtain a population of high quality sperms. This study aimed to analyze the effect of pre-freezing Density Gradient Centrifugation (DGC) sperm preparation on the quality of post-thawed sperms. An experimental laboratory study was conducted using the ejaculates collected from volunteers visiting to our department. Samples were split into two fractions: control group and treatment group. In the treated group, mini-DGC sperm preparations were developed. After some cryoprotectants were added, samples were then cryopreserved using rapid freezing protocol. The evaluation of sperm quality that included evaluation on motility, viability and percentage of sperm morphology was performed by referring to 2010 WHO standardization on semen analysis. Evaluation was performed under pre-freezing and post-thawed condition. The percentage of sperm parameter changes between the two groups were compared using t-test with p-value <0.05 considered statistically significant. A total of 20 samples were included in this study. Post-thawed progressive motility, total motility, and viability considerably declined between two groups with p-values of 0.422, 0.873, and 0.432 respectively. In post-thawed observation, the percentage of sperms with normal morphology was significantly lower in the control group when compared to the treatment group  (p<0.001). In conclusion, the pre-freezing mini-DGC can optimize the post-thawed percentage of sperms with normal morphology compared to direct freezing protocol

Akurasi Indeks Antropometri Obesitas dalam Mempediksi Kontrol Glicemic Pasien Diabetes Mellitus Tipe 2 di Puskesmas Kota Pekanbaru

Arfianti, Arfianti, Deyana, Frilly, Rosdiana, Dani, Ardini, Nadiah Yamanza, Armi, Wahyuli, Kesumah, Dewi Iramayana Sandra

Majalah Kedokteran Bandung Vol 50, No 3 (2018)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Diabetes melitus (DM) tipe 2 adalah penyakit metabolik yang ditandai dengan peningkatan kadar gula darah. Kontrol gula darah merupakan salah satu tujuan utama tata laksana pasien DM. Obesitas merupakan faktor risiko utama dari DM tipe 2. Tujuan penelitian ini adalah mengetahui hubungan indeks antropometri dengan kontrol gula darah pada pasien DM tipe 2 yang dirawat jalan di puskesmas Kota Pekanbaru. Desain penelitian yang digunakan adalah observasional analitik dengan pendekatan cross-sectional. Sampel pada penelitian ini meliputi 103 pasien DM tipe 2 yang diperoleh dari Puskesmas Sidomulyo dan Simpang Tiga Kota Pekanbaru pada bulan Mei–Juni 2018.Subjek penelitian paling banyak perempuan (58,3%) dan berusia ≥45 tahun (96,1%). Tingkat pendidikanterbanyak adalah SMA (42,7%) dan 54,4% tidak bekerja. Riwayat diabetes ditemukan pada 68,9% subjek dan 85,4% subjek tidak memiliki riwayat merokok. Sebanyak 98,1% pasien diabetes mendapat obat hipoglikemik oral dan 84,5% pasien diabetes memiliki kadar gula darah tidak terkontrol. Penelitian ini menunjukkan bahwa obesitas berdasar atas IMT dan WC tidak berhubungan dengan kontrol gula darah. Sebaliknya, obesitas berdasarkan WHR (p=0,014) dan WHtR (p=0,015) memiliki hubungan dengan kontrol gula darah pada pasien DM. Namun WHR dan WHtR secara tunggal memiliki akurasi yang sangat lemah dalam memprediksi kontrol gula darah pada penderita DM tipe 2.Accuracy of anthropometric Indexes of Obesity to Predict Glycemic Control among Type 2 Diabetic Patients in Primary Health Care in PekanbaruType 2 diabetes mellitus (DM) is a metabolic disease characterized by elevated blood sugar levels. Glycemic control is the main goal of DM patient management. Obesity is a major risk factor for DM. This study aimed to investigate the association between anthropometric indexes and glycemic control in DM patients visiting primary health care facilities in Pekanbaru. This was a cross-sectional analytical observational study on 103 type 2 DM patients from Sidomulyo and Simpang Tiga public health centers in Pekanbaru during the period of May-June 2018. More female subjects participated in this study (58.3%) with overall average age of ≥45 years (96.1%). The highest level of education of the subjects was senior high school (42.7%) and most subjects were unemployed (54.4%). The family history of DM was found in 68.9% subjects and majority had no smoking history (86.4%). As many as 98.1% DM patients were taking oral hypoglicemic drugs. Most of the DM patients had uncontrolled glycemic status (84.5%). This study showed that BMI-based and WC-based obesity was not associated with glycemic control in DM patients. On the other hand, the association between obesity based on WHR (P = 0.02; OR = 5.26) and WHtR (P = 0.008; OR = 6.82) and glycemic control in DM patients was statistically significant. However, WHR dan WHtR alone has no discrimination power to predict glycemic control among type 2 diabetic patients.

Pilihan dan Persepsi Risiko terhadap Jenis Sumber Air Minum pada Masyarakat Kumuh Perkotaan di Bantaran Sungai Cikapundung Kota Bandung

Sari, Sri Yusnita Irda, Raksanagara, Ardini

Majalah Kedokteran Bandung Vol 50, No 3 (2018)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Sistem penyaluran air di wilayah kumuh perkotaan sangat terbatas dan tidak dapat diandalkan baik kuantitas dan kualitas terutama di negara-negara berkembang. Pilihan terhadap jenis sumber air dan tipe pengolahan akan berdampak pada status kesehatan masyarakat. Penelitian ini bermaksud menggali hubungan faktor demografi dan persepsi risiko terhadap pilihan sumber air minum pada masyarakat kumuh perkotaan. Studi potong lintang dilaksanakan pada bulan September–Oktober 2015 pada masyarakat kumuh perkotaan di 20 RW yang berada di bantaran sungai Cikapundung Kota Bandung. Sampel dipilih dengan metode acak sistematis. Data dikumpulkan melalui kuesioner dan kualitas sampel air minum diperiksa dengan Suncoli test kit untuk mendeteksi dan menghitung jumlah bakteri Coliform. Jenis air minum yang dikonsumsi masyarakat kumuh perkotaan adalah merebus air minum yang bersumber air sumur dan air perpipaan atau membeli air minum dalam kemasan. Faktor yang berhubungan dengan pilihan jenis air minum yang dikonsumsi adalah faktor status ekonomi, ketersediaan jenis sumber air bersih yang dimiliki, dan faktor pendidikan kepala keluarga (p<0,001). Persepsi terhadap risiko keamanan sumber air bersih berhubungan dengan pilihan jenis sumber air minum yang dikonsumsi (p<0,001). Upaya promosi kesehatan mengenai cara pengolahan air minum perlu ditingkatkan dan perbaikan penyediaan air perpipaan harus diupayakan. Choice and Risk Perception on Drinking Water source among Urban Slum Dwellers Living on Cikapundung River Basin in Bandung CityWater supply system in urban slum area is often unreliable in terms of water quality and quantity, particularly in developing countries. Choices on the type of water source and water treatment may be associated with public health outcomes. This study aimed to investigate correlation between demographic factors and risk perception on the choice of water source type in urban slum area. A cross-sectional study was conducted during September–October 2015 in 20 neigborhood (Rukun Warga, RW) living on Cikapundung river basin in Bandung City. Households were sampled using systematic random sampling method. Data were collected through a questionnaire and water quality was assessed using Suncoli test kit to examine total Coliform level in drinking water. Drinking water consumed by the urban slum dweller included boiled water from ground well and piped water as well as commercial drinking water. Factors influencing the choice of drinking water were economic status, availability of clean water source, and education level of head of household (p<0.001). Perception towards health risks carried by clean water correlates with the choice of drinking water to be consumed (p<0.001). Health promotion efforts on how to process drinking water need to be improved and piped water provision should be improved.

Pengaruh Pemberian Vitamin D3 terhadap Kadar Reactive Oxygen Species (ROS) pada Sel PHM1-41 yang Mengalami Hipoksia

Aziz, Muhammad Alamsyah, Krisnadi, Sofie Rifayani, Setiabudiawan, Budi, Handono, Budi

Majalah Kedokteran Bandung Vol 50, No 3 (2018)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Kelahiran preterm (kurang bulan) merupakan salah satu penyebab kematian bayi yang hingga kini menjadi permasalahan di seluruh dunia. Salah satu mekanisme patofisiologis yang menyebabkan kelahiran kurang bulan adalah aktivitas sumbu hipotalamus-pituitari-adrenal (HPA) pada ibu dan janin. Stres maternal biologis berupa hipoksia merupakan salah satu penyebab terjadi mekanisme kelahiran kurang bulan melalui jalur aktivasi sumbu HPA ibu dan sebagai respons terhadap reactive oxygen species (ROS).  Vitamin D3 sebagai salah satu sumber ion Ca2+ dibutuhkan untuk mekanisme kontraksi dan relaksasi otot halus miometrium. Selain itu, vitamin D diduga berpengaruh terhadap kerja sumbu HPA. Tujuan penelitian ini adalah mengetahui pengaruh penambahan vitamin D3 pada sel lini PHM1-41 yang menjadi model in vitro dari kontraksi miometrium pada ibu hamil yang mengalami stres hipoksia terhadap kadar ROS intraseluler sel PHM1-41. Penelitian dilakukan di Laboratorium penelitian Aretha Medika Utama, Biomolecular and Biomedical Research Centre dengan kurun waktu penelitian dari bulan Desember 2017 hingga Februari 2018. Sel PHM1-41 yang telah dikultur dengan keadaan hipoksia selama 24 jam diberi penambahan vitamin D3, kemudian diukur kadar ROS intraselulernya. Hasil menunjukkan bahwa kadar ROS menurun signifikan pada kelompok sel yang diberi penambahan vitamin D3 dengan konsentrasi 150 nM dibanding dengan kelompok sel kontrol hipoksia. Hal ini menunjukkan  bahwa penambahan vitamin D3 150 nM memiliki potensi mencegah kelahiran kurang  bulanEffects of Vitamin D3 Treatment on Reactive Oxygen Species (ROS) Level in PHM1-41 Cell Line Experiencing HypoxiaPreterm birth is one of the major global cause of perinatal mortality. One of the pathophysiologic mechanisms leading to preterm birth is the Hypothalamic-Pituitary-Adrenal (HPA) axis activity of mother and fetus.. Maternal biological stress, such as hypoxia condition, is one of the trigger  of preterm birth through the activation of HPA axis as a response to the reactive oxygen species (ROS). Vitamin D3 as a source of Ca2+ ion is needed for myometrium smooth muscle’s contraction and relaxation mechanism. Vitamin D is also thought to strongly influence the HPA axis’s work. The purpose of this study was to determine the effect of  vitamin D3 provisionon PHM1-41 cell line induced by hypoxia as an  of pregnant women’s myometrium contraction through assessment of intracellular ROS level in PHM1-41 cell lines. This study was conducted in Aretha Medika Utama Biomolecular and Biomedical Research Centre from December 2017 to February 2018. PHM1-41 cells were cultured for 24 hours in hypoxia condition,Vitamin D3 was then added and the level of intracellular ROS was measured. Results showed that the ROS level decreased in cell clusters receiving 150nM vitamin D3 when compared to control hypoxia cell cluster. This indicates that the provision of 150nM vitamin D3 potentially prevents preterm  labor incidents.  

Peningkatan Kadar Hemoglobin dengan Pemberian Ekstrak Daun Salam (Syzygium Polyanthum (Wight) Walp) pada Tikus Model Anemia Defisiensi Besi

Adyani, Kartika, Anwar, Anita D., Rohmawaty, Enny

Majalah Kedokteran Bandung Vol 50, No 3 (2018)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Defisiensi zat besi merupakan penyebab utama anemia di negara berkembang. Kadar hemoglobin darah digunakan sebagai penanda anemia defisiensi besi. Indonesia kaya bahan makanan tinggi zat besi namun belum diketahui kemanfaatannya seperti daun salam (Syzygium polyanthum (Wight) Walp). Tujuan penelitian ialah mengetahui peningkatan kadar hemoglobin pada tikus model anemia defisiensi besi sesudah pemberian ekstrak daun salam. Penelitian eksperimental laboratorium dengan rancang acak lengkap dilakukan di Laboratorium Farmakologi dan Terapi Fakultas Kedokteran Unpad periode 4 Mei–19 Juni 2018. Sebanyak 20 ekor tikus Wistar betina berumur 7 minggu diinduksi menggunakan alumunium sulfat 67,5 mg/kg BB secara intramuskuler selama 7 hari, dan dibagi menjadi 5 kelompok perlakuan, yaitu K1 (tanpa perlakuan) K2 (tablet tambah darah 5,4 mg), P1 (ekstrak daun salam 2,2 mg), P2 (ekstrak daun salam 4,4 mg), P3 (ekstrak daun salam 6,6 mg). Kadar hemoglobin diukur menggunakan auto hematology analyzer sysmex. Uji LSD menunjukkan rerata kadar hemoglobin setelah perlakuan pada kelompok perlakuan berbeda signifikan dibanding dengan kelompok kontrol negatif (p<0,05) dan tidak berbeda signifikan dibanding dengan kelompok kontrol positif (p>0,05). Analisis uji median menunjukkan peningkatan kadar hemoglobin berbeda signifikan pada K2, P1, P2, dan P3 (p<0,05). Disimpulkan, ekstrak daun salam meningkatkan kadar hemoglobin pada tikus model anemia defisiensi besi. Increasing Hemoglobin Level Using Bay Leaf (Syzygium Polyanthum (Wight) Walp) Extraction in Rats Models with Iron-Deficiency AnemiaIron deficiency is a major cause of anemia in developing countries. Blood hemoglobin level is used as a marker of iron-deficiency anemia. Iron-rich foods that are not widely known can easily be found in Indonesia, including bay leaf. The aim of this study was to determine the increase in hemoglobin level after the administration of bay leaf extract in rat models with iron-deficiency anemia. This experimental study used completely randomized sampling technique and was performed at Pharmacology and Therapy Laboratory, Faculty of Medicine, Universitas Padjadjaran, from 4 May to 19 June 2018. Twenty 7-week-old female Wistar rats were induced intramuscularly by 67,5 mg/kg BW alumunum sulfate for 7 days and were divided into 5 groups: K1 (without treatment), K2 (5.4 mg of ferrous sulphate), P1 (2.2 mg bayleaf extract), P2 (4.4 mg  bay leaf extract), P3 (6.6 mg bay leaf extract). Hemoglobin levels were measured using Auto Hematology Analyzer Sysmex. Results froom LSD test showed that the average hemoglobin levels after treatment in treatment groups were significantly different from that of the negative control group (p<0.05) and there was no  significant difference when compared to the positive control group (p>0.05). The median analysis test showed that there were significant differences in the increase of hemoglobin levels among K2, P1, P2, and P3 (p<0.05). It is concluded that bay leaf simplicia increases the hemoglobin level in rat model with iron-deficiency anemia.