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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

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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 The Effect of TNF-α Serial Doses Induced MSC on Increasing VEGF dan PDGF Mesenchymal Stem Cells (MSCs) have immunoregulation and regeneration capability by supressing the release of proinflammatory mediator and increasing proliferative molecules, particulary vascular endothelial growth factor (VEGF) and platelet-derived growth factor (PDGF) TNF-α activated MSC with certain dose have ability to increase VEGF and PDGF level, however the exact optimum dose of TNF-α to optimize the level of VEGF and PDGF is unclear. In this study, we used TNF-α dose variation to determine the optimum, low and high dose of TNF-α in optimizing VEGF and PDGF expression. This study used to post-test only control group design.There were five study groups, consist of one control (K) and four treatment groups(P) were treated with TNF-α5, 10, 40 and 80 ng/mL for 24 hours, all groupswere measured PDGF and VEGF levels using ELISA. This research 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 significantly increased of PDGF and VEGF levels (p<0.05) from TNF-α 5 ng/mL as initiation dose, 10 ng/mL as optimum dose and the decrease dose start at 40 ng/mL. TNF-induced MSCs have ability to increase VEGF and PDGF level with optimum dose at 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

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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 The Description of Risk Factors for Pelvic Organ Prolapse in Women with History of Vaginal Delivery in YogyakartaPelvic organ prolapse is one form of pelvic floor dysfunction in women. Pelvic floor dysfunction is an impairment of pelvic floor function, also one of the most frequently complained by women. More than 46% women with history of vaginal delivery has experienced pelvic floor dysfunction, where increase in number of parity is correlated to increase in pelvic organ prolapse incident. The aim of this research was to understand the description of risk factors’ characteristics of pelvic organ prolapse incident post vaginal delivery in Daerah Istimewa Yogyakarta district. The research had been done from January to March 2018. The result obtained 51 subjects with history of vaginal delivery which can be evaluated by POPQ in 3 months postpartum. Pelvic floor dysfunction was present in most postpartum patients, with 46 people. If all the diagnoses were described, each consists of uterine prolapse in 33  people, cystocele in 44 people, and rectocele in 46 subjects. Only 5 people had no pelvic floor dysfunction in any form. Risk factors for pelvic organ prolapse in post vaginal delivery in Daerah Istimewa Yogyakarta consists of intrinsic (maternal age, genital length of hiatus and perineal body), and extrinsic factors (parity, overweight and obese body mass index, weight gain during pregnancy exceeding 15 kg, as well as the episiotomy and the occurrence of perineal rupture). Prevention action are especially education, then followed by lifestyle improvement, control of body mass index, dietary regulation, exercise, restrictions on the number of pregnancies and childbirth, and safe delivery help assistance according to asuhan persalinan normal (normal birth care). 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

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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  The 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 adjuvan is expected to increase clinical efficacy in AIT.  The aim of this study was to analyze the role of adjuvan vitamin D3 in AIT to induction immune tolerance.  The study was an unpaired comparative analytic research with a randomized controlled trial design, conducted at Rhinology-Allergy Clinic ORL-HNS dr. Hasan Sadikin Hospital Bandung from May 2016–April 2017. Eighteen subjects given AIT+ calcitriol and 18 subjects recieve AIT+placebo meet Research’s criteria, were taken by consecutive sampling. All subjects evaluated for Treg cells by flow citometry at baseline, week 8, week 15 and nasal symptoms score. Statistical analysis in this study was Mann-Whitney test, Friedman test, T-Paired test and Post hoc analysis. There was a significant different of Treg cells average results in intervention group and control at week 8 with p-value = 0.04. The mean delta value shows of MFI Treg shows significant differences within intervention group (p=0.002). Post hoc analysis results show there were significant increasing MFI Treg in the intervention group at week 8 (p=0,001). As a conclusion, immunology 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

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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 with Advanced Phase Treatment in Johar Baru, Central JakartaTuberculosis (TB) lung disease is a contagious disease caused by Mycobacterium tuberculosis bacteria. Factors that affect the likelihood of developing pulmonary TB disease one of them is poor nutritional status. Poor nutrition 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 of nutritional status between patients with pulmonary tuberculosis before treatment with advanced treatment phase in Johar Baru, Central Jakarta. The study was conducted in January–March 2017. The study population were adult tuberculosis (age ≥ 17 years old) who were in the phase of advanced treatment phase (≥ 4 months treatment) located in Johar Baru Public Health Center area of 51 people. Of the existing population were taken a sample of 30 respondents with pulmonary TB patients with sampling technique by quota sampling. The results showed that the nutritional status of respondents before treatment most had normal nutritional status. Nutrition status of respondents when treatment of pulmonary tuberculosis is that there is an increase of normal nutritional status and more nutritional status and decreasing nutrient status is less. Wilcoxon Signed Ranks Testresults showed no significant difference in nutritional status of patients with pulmonary tuberculosis between before treatment with advanced treatment phase (p = 0,763). Conclusion, the comparison of the nutritional status of TB patients before treatment and during the advanced phase of treatment is that there is a decrease in nutritional status and an increase in normal nutritional status. The results of the bivarat test showed that there was no significant difference in nutritional status between before treatment and during advanced phase treatment.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

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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 need to be controlled. Surveillance for mosquito breeding places will help the authorities for 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 know the potential container and its environmental conditions for larvae in Universitas Padjadjaran Jatinangor. A descriptive research conducted and observed the presence of mosquito larvae in water containers both inside and outside of faculty buildings. Environmental conditions (pH, water temperature and humidity) are measured and recorded during observation for each water container.  The result showed that from 582 containers examined, there were 72 (12.4%) positive larvae. The most potential container in the building is bucket, while the outside of the building is bamboo. Aedes sp. dominated the discovery of larvae in the field. The average water temperature obtained was 24.3 oC, humidity 66.7% and pH 8.1. Condition of temperature and pH in accordance with the optimum condition of larvae development in general. Meanwhile lower humidity level (humidity 81.6–89.5%) was still able to make eggs grow well in 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

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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 R-Baux Score with BOBI Score as a Predictor of Burn Mortality in Dr. M. Djamil Hospital PadangBurns are a type of trauma with high morbidity and mortality.There is nothing yet the best  objective scoring system to predict mortality in burns. This study aims to compare the accuracy of R-Baux and BOBI score in predicting mortality of burn patients in Dr. M. Djamil Hospital, Padang. This research was a retrospective study design to all burn patients treated in burn unit  from January 2013 to September 2017. This research processed and analyzed by assessing diagnostic tests, kappa tests, and logistic regression test.  Out of 394 samples enrolled. Most of men, mean age was 28.3±18.3 years old, cause of burns was fire, mean TBSA was 26.1%, inhalation injury was 51% and overall mortality was 26.4%. The sensitivity tests for BOBI and R-Baux score was 96.83%: 92.89% with coeffisien’s value of Kappa 0.50. Logistic regression test shows that age, TBSA dan inhalation injury were significantly correlated with R-Baux score.The diagnostic tets of BOBI score is better than R-Baux score and coefficien’s value of Kappa shows the match result with BOBI score with medium strength. BOBI score shows better accuracy as a mortality predictor in Dr. M. Djamil Hospital, Padang, than R-Baux score after being compared with real value.Key words: BOBI score, burns, mortality, r-baux score

The Quality of Epididymal Sperm of Old Mice 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

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Abstract

Cogon grass (Imperata cylindrica) has been known as traditional herb because its antioxidant activity. The oxidant level in the body is increased linearly with ages. Antioxidant work by decreasing vulnerability of mammalian spermatozoa to free radical attack. This study was aimed to determine whether the active compound of Imperata cyclindrica root extract improve or damage the sperm function in old mice. This study used complete randomized design and was performed in the Mouse Animal Laboratory Faculty of Medicine, UniversitasPadjadjaran on 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 cogongrass root ethanol extract into 24- weeks-old DDY strain mice for 14 days. The result showed no significant difference in body weight  and testicular index before and after treatment (p<0.05). Interestingly, sperm concentration decreased significantly in group 345 mg/kgBW compared withcontrol (2.03x106 and 6.43x106 respectively, p<0.05). In the other side, sperm motility and sperm with normal morphology increased followed-dose pattern although not significant compared with control (p<0.05). Our result indicated that cogon grass root ethanol extract can notmaintain optimally epididymal sperm quality in old mice. Key words: Aging, Imperata cylindrica, sperm qualityKualitas 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

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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  The Effect of Risk Factor on The Onset of Kanamycin’s Adverse Events in Drug Resistant TuberculosisKanamycin is therapy for drug-resistant tuberculosis (TB) which can cause hearing loss, impaired kidney function, and electrolyte disorders especially hypokalemia. The objective of this study was to assess the 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 the adverse events. Of the 238 patients, 143 patients with hearing loss, 147 patients with impaired kidney function, and 169 patients with hypokalemia. Age over 40 and female gender had higher risk 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 the risk factors of kanamycin’s adverse events. Therefore closed monitoring on hearing loss and impaired kidney function is necessary for drug resistantTB patients aged over 40 and female patient. Key words: Adverse events, drug resistant tuberculosis, hearing loss, impaired kidney function, kanamycin

The Characteristic of Anemia Observed 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

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Abstract

Anemia is a hematologic complication that 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 who had been 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 seen from the erythrocyte index on routine hematologic examination. Forty-seven children of 73 were having 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

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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.)     Histopathology Overview of Hepar in White Wistar Rats Induced with Aspirin After 7 Days Administration of Ethanol Extracts of Iles-iles Bulb (Amorphophallus variabilis Bl.)The paradigm that develops in our society today is traditional ingredients because the ingredients are from nature is harmless and has no side effects. The aim of this study was to find out the histopathologic features of wistar-induced aspirin-induced Wistar rats after administration of iles-iles bulb extract (Amorphophallus variabilis Bl.). This research was conducted at Pharmacology Laboratory of Padjadjaran University in April-May 2018. Twenty Wistar white rat strain were divided into 4 groups consisted of 4 doses of iles-iles extract administration i.e., 0, 55, 110, and 220 mg/kg BW. Wistar strain white rats on each treatment were administered iles-iles extract orally for 7 days on days 8-14 of April 2018. Histopathologic image parameters of Wistar rats induced with aspirin after 7 days administrations of iles-iles extract (Amorphophallus variabilis Bl.) were observed. The results showed that the results of Kruskall Wallis test showed that the group of white rat strains Wistar extracted with dose respectively 110 and 220 mg / kgBW more (p <0.05) white rat strain Wistar thickened sepal interalveolaris compared to group I (control). Provision of standardized ethanol extract of iles-iles tuber 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 hepatic fatty acids. Key words: Ethanol extract, histopathology, iles-iles tubers (Amorphophallus  variabilis Bl.),