Majalah Kedokteran Bandung
ISSN : -     EISSN : -
Articles 648 Documents
Motivasi Kader Meningkatkan Keberhasilan Kegiatan Posyandu

Djuhaeni, Henni, Gondodiputro, Sharon, Suparman, Rossi

Majalah Kedokteran Bandung Vol 42, No 4 (2010)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Original Source | Check in Google Scholar |

Abstract

Salah satu komponen sistem kesehatan di Indonesia adalah pemberdayaan masyarakat, khususnya posyandu yang keberhasilan kegiatannya bergantung pada peran serta kader dan masyarakat. Peran serta kader dan masyarakat sangat dipengaruhi oleh faktor motivasi yang mereka miliki. Penelitian ini bertujuan untuk menganalisis pengaruh serta faktor motivasi yang paling berpengaruh terhadap peran serta kader dan masyarakat dalam kegiatan posyandu di Kabupaten Kuningan selama tahun 2009. Metode penelitian cross sectional explanatory survey dengan menggunakan kuesioner. Total sampel sebanyak 300 responden, terdiri dari masing-masing 100 orang untuk kader aktif dan tidak aktif yang diambil secara multistage sampling serta 100 orang masyarakat sebagai kontrol diambil secara purposive sampling. Motivasi internal dan eksternal sebagai variabel independen dan partisipasi kader/masyarakat sebagai variabel dependen, kemudian dianalisis menggunakan teknik structural equation modeling (SEM). Hasil penelitian memperlihatkan bahwa faktor motivasi berpengaruh terhadap peran serta kader dan masyarakat dalam posyandu. Meskipun demikian terdapat berbagai variasi pengaruh, pada kader aktif motivasi eksternal lebih berpengaruh (p=0,97) dibandingkan dengan motivasi internal (p=-0,41). Pada kader tidak aktif terjadi hal sebaliknya, sedangkan pada masyarakat, kedua faktor motivasi menunjukkan pengaruh yang tidak bermakna. Simpulan, pengaruh dan perbedaan pengaruh motivasi terhadap peran serta kader dan masyarakat menentukan keberhasilan kegiatan posyandu. [MKB. 2010;42(4):140–8].Cadres Motivation as the Drive for the Success of PosyanduOne of the most important component of the health system in Indonesia is community empowerment, especially posyandu, which depends on their cadres and the community. It was hypothetically assumed that motivation will increase the participation for both cadres and community in the posyandu. The study aims were to analyze the effect of motivation and also determine which motivation factors that had the most influence towards participation in Kuningan district during 2009. The method adapted cross sectional explanatory survey using questionnaire. A total of 300 respondents were carried out, consisting 100 respondents each taken from active and inactive cadres (multistage sampling) and other 100 taken from the community (purposive sampling). Independent variables (internal and external motivation) and dependent variables (community participation) were mentioned and analyzed using structural equation modeling (SEM) technique. The results showed that motivation were actually had influence towards participations for both cadres and community in posyandu. However, the effect varies between groups. On active cadres, external motivation had more influence (p=0.97) compared to internal motivation (p=-0.41). The exact opposite happened in inactive cadres (internal more than external) and community. It can be concluded that cadres motivation is important as the drive for the success of posyandu. [MKB. 2010;42(4):140–8]. DOI: http://dx.doi.org/10.15395/mkb.v42n4.26

Kadar Asam Urat Serum sebagai Biomarker Preeklamsi

Sumanti, Neli ( Laboratorium Patologi Klinik Rumah Sakit Paru Dr. M. Goenawan Partowidigdo, Cisarua Bogor ) , Noormartany, - ( Departemen Patologi Klinik Fakultas Kedokteran Universitas Padjadjaran-Rumah Sakit Dr. Hasan Sadikin Bandung ) , Alamsyah, Muhammad ( Departemen Patologi Klinik Fakultas Kedokteran Universitas Padjadjaran-Rumah Sakit Dr. Hasan Sadikin Bandung ) , Rostini, Tiene

Majalah Kedokteran Bandung Vol 45, No 2 (2013)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Original Source | Check in Google Scholar |

Abstract

Preeklamsi masih merupakan masalah kesehatan yang menjadi salah satu penyebab kematian ibu selain akibat perdarahan dan infeksi. Etiologi dan patogenesis preeklamsi belum diketahui pasti. Peningkatan kadar asam urat serum timbul bersamaan dengan peningkatan tekanan darah dan terjadi sebelum timbul proteinuria sehingga dapat dipakai sebagai salah satu biomarker. Tujuan penelitian ini menganalisis perbandingan kadar asam urat serum pada kehamilan in partu normal dengan in partu preeklamsi. Penelitian potong lintang dilakukan di Rumah Sakit Dr. Hasan Sadikin Bandung pada bulan Maret–Mei 2011. Subjek penelitian 45 wanita hamil in partu normal sebagai kelompok kontrol dan 44 wanita in partu dengan preeklamsi sesuai dengan kriteria inklusi dan eksklusi. Kadar asam urat serum pada wanita hamil normal adalah 3,43±0,14 mg/dL. Pada penelitian ini nilai titik potong kadar asam urat serum 4,8 mg/dL dengan nilai sensitivitas 93% dan spesifisitas 80%. Simpulan,kadar asam urat pada in partu preeklamsi lebih tinggi dibandingkan dengan kehamilan normal. Peningkatan kadar asam urat dapat dipertimbangkan sebagai salah satu biomarker preeklamsi, sebaiknya kadar asam urat serum digunakan sebagai pemeriksaan serial pada ibu hamil saat pelayanan antenatal. [MKB. 2013;45(2):98–104]Kata kunci: Biomarker, kadar asam urat, preeklamsiSerum Levels of Uric Acid as a Biomarker in PreeclampsiaPreeclampsia remains a health problem that becomes one of the causes of maternal deaths besides bleeding and infection. The etiology and pathogenesis of preeclampsia are unclear. Increased serum uric acid levels is seen simultaneously with the increase of blood pressure and occurred before the onset of proteinuria. Therefore, the uric acid can be used as a biomarker. The aim of this study was to analyze the serum uric acid levels between normal and preeclampsia pregnancies. The study was conducted in Dr.Hasan Sadikin Hospital Bandung between March and May 2011, using cross sectional study design. Subjects were 45 inpartu normal pregnant women as control and 44 in partu pregnant women with preeclampsia accordance with inclusion and exclusion criteria. Levels of uric acid in normal pregnancy are 3,43 ±0.14 mg/dL. In this study uric acid levels resulting in cut-off levels of 4,8 mg/dL with a sensitivity value of 93%, and specificity 80%. Conclusions: uric acid levels in at term preeclampsia are higher compared with normal pregnancies. Increased levels of uric acid can be considered as one of biomarkers of preeclampsia, hence the serum uric acid levels used as serial examinations in pregnant women during antenatal care. [MKB. 2013;45(2):98–104]Key words: Biomarker, preeclampsia, uric acid level DOI: http://dx.doi.org/10.15395/mkb.v45n2.89

Functional Independence Measure Penderita Cedera Servikal

Arifin, Muhammad Zafrullah ( Department of Neurosurgery, Universitas Padjadjaran, Hasan Sadikin Hospital, Bandung, Indonesia ) , Henky, Jefri ( Department of Neurosurgery, Universitas Padjadjaran, Hasan Sadikin Hospital, Bandung, Indonesia )

Majalah Kedokteran Bandung Vol 45, No 3 (2013)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Original Source | Check in Google Scholar |

Abstract

Cedera servikal merupakan salah satu cedera tulang belakang terbanyak pada penderita trauma. Di Amerika Serikat tahun 2008 dari 100.000 kasus cedera tulang belakang, 2/3 merupakan kasus cedera servikal. Penilaian awal dilakukan berdasarkan American Spinal Cord Injury Association (ASIA) Impairment Score, sedangkan hasil setelah penatalaksanaannya sering diabaikan untuk evaluasi keberhasilan ahli di rumah sakit. Tujuan penelitian untuk mengetahui nilai functional independence measure (FIM) penderita cedera servikal dengan manajemen konservatif dan korelasinya dengan usia, jenis kelamin, jenis trauma, onset trauma, abnormalitas tulang servikal, lesi cervical spine, dan ASIA Impairment Score. Dilakukan studi kohor prospektif pada semua pasien cedera servikal yang memenuhi kriteria inklusi di Departemen Bedah Saraf Rumah Sakit (RS) Dr. Hasan Sadikin Bandung. Subjek dikelompokkan berdasarkan usia, jenis kelamin, trauma tunggal/multipel, akut/kronik, abnormalitas tulang servikal, lesi komplet/inkomplet, ASIA Impairment Score, dan komplikasi awal cedera. Pada penderita dilakukan penilaian FIM di Poliklinik Bedah Saraf. Data dianalisis menggunakan uji-t dan uji chi-kuadrat dengan p<0,05. Terdapat 17 penderita cedera servikal yang dirawat di Departemen Bedah Saraf RS Dr. Hasan Sadikin Bandung periode April 2009–April 2010. Observasi kohor prospektif nilai FIM rata-rata penderita cedera servikal adalah 4+1,63. Analisis chi-kuadrat menyatakan bahwa tidak terdapat hubungan usia (p=0,064), jenis kelamin (p=0,144), jenis trauma penyerta (p=0,959), onset cedera (p=0,220), abnormalitas tulang servikal (p=0,869) dengan besarnya nilai FIM pasien cedera servikal. Terdapat hubungan jenis lesi cervical spine (p=0,037), ASIA Impairment Score (p<0,001) dengan besarnya nilai FIM penderita cedera servikal. Simpulan, jenis lesi cervical spine dan ASIA Impairment Score memiliki hubungan bermakna dengan besarnya nilai FIM penderita 3 bulan pascacedera servikal. [MKB. 2013;45(3):180–6]Functional Independence Measure in Patients with Cervical Spine InjuryCervical spine injury is one of the most common spinal cord injuries in trauma patients. From 100,000 spinal cord injury cases reported in the United States of America (2008), 2/3 involved cervical spine injury. American Spinal Cord Injury Association (ASIA) Impairment Score is used as an initial assessment but further prognostic outcome of these patients is often not paid enough attention. The objective of this study was to find the value of functional independence measure (FIM) cervical spine injury patients with conservative management and correlation with age, sex, type of trauma, onset of trauma, cervical bone abnormalities, type of spinal lesion and ASIA Impairment Score. A prospective cohort study was performed to all patients with cervical spine injury which fullfil the inclusion criteria treated in Neurosurgery Department of Dr. Hasan Sadikin Hospital Bandung. The subjects were classified based on age, sex, single/multiple trauma, acute/chronic, cervical bone abnormalities, complete/incomplete lesion, ASIA impairment score and initial complication. The patients were performed to FIM examination in Outpatient clinic of Neurosurgery. T-test and chi-square test with p<0.05 were done to analyze the data. There were 17 cervical spine injury patients treated in Neurosurgery Department of Dr. Hasan Sadikin Hospital Bandung during April 2009–April 2010. The average FIM value of cervical spine injury in those patients was 4+1.63 by cohort prospective study. There were no correlation between FIM value with age (p=0.064), sex (p=0.144), type of trauma (p=0.959), onset of trauma (p=0.220) and cervical bone abnormalities (p=0.869). We found a significant correlation between FIM value with type of cervical spine lesion (p=0.037) and ASIA Impairment Score (p<0.001) in cervical spine patients. In conclusion, type of cervical spine lesion and ASIA impairment score have significant correlation with FIM value of patients in 3 months after cervical injury.[MKB. 2013;45(3):180–6] DOI: http://dx.doi.org/10.15395/mkb.v45n3.15

Perbandingan Pemberian Susu Kedelai Bubuk dan Susu Kedelai Rumah Tangga terhadap Glukosa Darah Puasa pada Tikus Diabetes Melitus Hasil Induksi Aloksan Monohidrat

Khrisna, Ramon ( Departemen Kependidikan Rumah Sakit Mata Cicendo ) , Sudjatno, H. R. Muchtan ( Departemen Farmakologi dan Terapi Fakultas Kedokteran Universitas Padjadjaran- Rumah Sakit Dr. Hasan Sadikin, Bandung ) , Firmansah, Abdullah ( Departemen Ilmu Gizi Medik Fakultas Kedokteran Universitas Padjadjaran- Rumah Sakit Dr. Hasan Sadikin, Bandung )

Majalah Kedokteran Bandung Vol 43, No 2 (2011)
Publisher : Fakultas Kedokteran, Universitas Padjadjaran

Show Abstract | Original Source | Check in Google Scholar |

Abstract

Berbagai penelitian menemukan bahwa kedelai dan produk olahannya memiliki banyak manfaat terhadap berbagai kelainan metabolisme, salah satunya terhadap diabetes melitus (DM). Tujuan penelitian ini adalah untuk mengetahui dan membandingkan penurunan kadar glukosa darah puasa sesudah pemberian susu kedelai bubuk dan susu kedelai rumah tangga pada tikus DM hasil induksi aloksan. Penelitian ini dilakukan di Departemen Farmakologi Klinik RS Dr. Hasan Sadikin Bandung periode Oktober−Desember 2008 dengan metode eksperimental di laboratorium, menggunakan 30 ekor tikus yang dibagi secara acak dalam lima kelompok, salah satunya kelompok kontrol positif. Kadar glukosa darah puasa (GDP) masing-masing kelompok diperiksa setelah 14 hari perlakuan. Hasil penurunan kadar GDP rata-rata tertinggi adalah pada kelompok tikus yang mendapatkan susu kedelai rumah tangga 2 kali/hari, yaitu sebesar 297,67 mg/dL, diikuti kelompok yang mendapatkan susu kedelai bubuk 2 kali/hari (270,17 mg/dL), kelompok yang mendapatkan susu kedelai bubuk 3 kali/hari (232,67 mg/dL), dan kelompok yang mendapatkan susu kedelai rumah tangga sebanyak 3 kali/hari (178 mg/dL), sedangkan hasil penurunan kadar GDP rata-rata kontrol positif adalah 16,17 mg/dL. Hasil penurunan kadar GDP rata-rata kelompok perlakuan berbeda signifikan terhadap kelompok kontrol positif (p=0,003), namun tidak terdapat perbedaan penurunan kadar GDP yang signifikan antara masing-masing kelompok perlakuan (p=0,425). Simpulan, kedua jenis susu kedelai, baik susu kedelai bubuk maupun susu kedelai rumah tangga dapat menurunkan kadar GDP pada tikus DM hasil induksi aloksan, namun tidak terdapat perbedaan antara pemberian susu kedelai bubuk dan susu kedelai rumah tangga. Frekuensi pemberian kedua jenis susu kedelai tidak memberikan perbedaan penurunan glukosa darah. [MKB. 2011;43(2):98–104].Kata kunci: Glukosa darah, susu kedelai bubuk, susu kedelai rumah tangga, tikus diabetes melitusThe Comparison of Powdered Soymilk and Domestic Soymilk Administration on Fasting Blood Glucose Level on Induced DiabeticMelitus Rats Aloxan MonohydrateSeveral researches had proven that soybean and its processed goods have many benefits for several metabolism disorders, one of which is diabetes mellitus (DM). The objective of this research was to determine and compare the decrease in fasting blood glucose level after administration of powdered soymilk to domestic soymilk which was injected into diabetic rats caused by aloxan injection. This research study was conducted in Farmacology Clinic Department Dr. Hasan Sadikin Hospital Bandung on October−December 2008, with as a randomized, positivecontrolled clinical trial. Thirty mice were randomly divided into 5 groups, one of which was a control group. Fasting blood glucose (FBG) level from each group were measured after 14 days of soymilk administration. The group which was administered domestic soymilk twice daily had the highest mean decrease of FBG level (297.67 mg/dL), followed by the group powdered soymilk twice daily (270.17 mg/dL), the group with powdered soymilk three times daily (232.67 mg/dL), and the group with domestic soymilk three times daily (178 mg/dL), meanwhile the positive-controlled group had mean decrease of FBG level as 16,67 mg/dL. The result was significant compared to positive-controlled group (p=0.003). However, the difference between each group was not significant (p=0.425). It is concluded that two types of soymilk, powdered and domestic, decrease the FBG level in diabetic rats, however, the difference between the two types are insignificant. The frequency of administration of the two types of soymilk also do not give difference in decreasing the blood glucose level. [MKB. 2011;43(2):98–104].Key words: Blood glucose level, diabetic mellitus rat, domestic soymilk, powdered soymilk

Hubungan Imunoekspresi E-cadherin dan C-erbB2 dengan Derajat Keganasan Histopatologik Karsinoma Kistik Adenoid Kelenjar Liur

Mariam, Marry Siti ( Jurusan Biologi Mulut Fakultas Kedokteran Gigi Universitas Padjadjaran ) , Nasserie, Wazilah ( Jurusan Biologi Mulut Fakultas Kedokteran Gigi Universitas Padjadjaran )

Majalah Kedokteran Bandung Vol 44, No 2 (2012)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Original Source | Check in Google Scholar |

Abstract

Karsinoma kistik adenoid (KKA) merupakan keganasan kelenjar liur terbanyak, prognosisnya sukar diprediksi dengan tingkat kekambuhan yang tinggi. Berdasarkan beberapa penelitian, prognosis KKA kelenjar liur yang berhubungan dengan tingkat ketahanan hidup sangat terkait dengan derajat keganasan histopatologik berdasarkan tipe pola pertumbuhannya. Penelitian ini dilaksanakan di Departemen Patologi Anatomi Fakultas Kedokteran Universitas Padjadjaran Bandung tahun 2009. Tujuan penelitian untuk mengetahui perubahan imunoekspresi protein adhesi E-cadherin (molekul adhesi antar sel epitel) dan proto-onkogen C-erbB2 (keluarga C-erbB/reseptor faktor pertumbuhan epidermal) pada KKA kelenjar liur dikorelasikan dengan derajat keganasan histopatologik. Desain penelitian studi potong lintang tanpa acak secara retrospektif pada 51 blok parafin penderita karsinoma kistik adenoid kelenjar liur. Sampel didiagnosis ulang, serta ditentukan derajat keganasan histopatologiknya (menurut modifikasi Szantos dan Batsakis) dilanjutkan dengan pemeriksaan imunohistokimia terhadap E-cadherin dan C-erbB2. Hasil menunjukkan korelasi sangat bermakna (p<0,01) perubahan imunoekspresi E-cadherin yang negatif (82%) dengan derajat keganasan histopatologik 1, 2, dan 3 (4%, 33%, dan 46%). Perubahan imunoekspresi C-erbB2 tidak berkorelasi dengan meningkatnya derajat keganasan (p=0,11). Terjadi perubahan peningkatan imunoekspresi dari derajat 1 (5%) ke derajat 2 (11%), namun kembali menurun pada derajat 3 (8%). Simpulan, imunoekspresi E-cadherin dapat digunakan sebagai petanda tumor untuk memprediksi prognosis keganasan KKA kelenjar liur. Perubahan imunoekspresi C-erbB2 pada KKA kelenjar liur menunjukkan perilaku biologinya dan peran utama C-erbB2 pada KKA kelenjar liur terutama pada fase inisiasi dan promosi karsinogenesis. [MKB.2012;44(2):70–6].Correlation of E-cadherin and C-erbB2 Immunoexpression with the Degree of Histopathological Malignancy on Salivary Gland Adenoid Cystic CarcinomaAdenoid cystic carcinoma (ACC) is the most common salivary gland malignancies, with high rate of local recurrence and unpredictable prognosis. Based on previous research, prognosis of ACC in salivary gland which is correlated with survival rates, is related with histopathological malignancy degree based on its growth pattern type. This study was conducted in Pathology Anatomy Department of Medical Faculty, Padjadjaran University Bandung in 2009. The aim of this study was to analyze the alteration of immunoexpression of E-cadherin (adhesion molecule of epithelial cells) and C-erbB2 proto-oncogen (the family of C-erbB/epidermal growth factor receptor) in salivary gland. Adenoid cystic carcinoma correlated with cross-sectional non-random study on 51 paraffin blocks, from patients with salivary gland ACC retrospectively. The repeated histopatologic examination was to diagnose ACC and to get data of the histopathological malignancy degree (according to Szantos and Batsakis modification), and it was continued with immunohistochemistry examination of E-cadherin and C-erbB2. The alteration of negative immunoexpression of E-cadherin (82%) had correlation significantly (p<0.001) with the histological malignancy degrees 1, 2, and 3 (4%, 33% and 46%). The C-erbB2 immunoexpression change had no correlation with the increasing histopatologic malignancy degree (p=0.11). The alteration of C-erbB2 immunoexpression, increased from first (5%) to second degree (11%) but decreased on the third degree (8%). In conclusions, the immunoexpression of E-cadherin can be used as tumor marker to predict malignancy prognosis of salivary gland ACC. The expression changes of C-erbB2 in ACC indicate its biological behavior and the main role of C-erbB2 on salivary gland ACC is in the initiation and promotion phase of carcinogenesis. [MKB. 2012;44(2):70–6]. DOI:  http://dx.doi.org/10.15395/mkb.v44n2.126

Kematian Akibat Pneumonia Berat pada Anak Balita

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

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

Show Abstract | Original Source | Check in Google Scholar |

Abstract

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

Prothrombin Time, Activated Partial Thromboplastin Time, Fibrinogen, dan D-dimer Sebagai Prediktor Decompensated Disseminated Intravascular Coagulation Sisseminated pada Sepsis

Fenny, Fenny ( Bagian Patololgi Klinik Fakultas Kedokteran Universitas Padjadjaran-Rumah Sakit Hasan Sadikin, ) , Dalimoenthe, Nadjwa Zamalek ( Bagian Patololgi Klinik Fakultas Kedokteran Universitas Padjadjaran-Rumah Sakit Hasan Sadikin, ) , Noormartany, Noormartany ( Bagian Patololgi Klinik Fakultas Kedokteran Universitas Padjadjaran-Rumah Sakit Hasan Sadikin, ) , Pranggono, Emmy ( Bagian Ilmu Penyakit Dalam Fakultas Kedokteran Universitas Padjadjaran-Rumah Sakit Hasan Sadikin, Bandung ) , Dewi, Nina Susana ( Bagian Patololgi Klinik Fakultas Kedokteran Universitas Padjadjaran-Rumah Sakit Hasan Sadikin, )

Majalah Kedokteran Bandung Vol 43, No 1 (2011)
Publisher : Fakultas Kedokteran, Universitas Padjadjaran

Show Abstract | Original Source | Check in Google Scholar |

Abstract

AbstrakSepsis adalah respons sistemik terhadap infeksi dan terutama terjadi pada pneumonia. Sepsis dapat menyebabkan komplikasi disseminated intravascular coagulation (DIC) yang dibedakan menjadi compensated dan decompensated DIC. Tujuan penelitian ini adalah untuk menentukan apakah nilai prothrombin time (PT), activated partial thromboplastin time (aPTT), kadar fibrinogen, dan D-dimer dapat digunakan sebagai prediktor decompensated DIC pada penderita sepsis. Penelitian dilakukan di Laboratorium Patologi Klinik Rumah Sakit Hasan Sadikin Bandung mulai September 2008 sampai Juni 2010. Subjek penelitian adalah penderita sepsis yang disebabkan pneumonia. Nilai PT, aPTT, kadar fibrinogen, dan D-dimer semua subjek sepsis dicatat kemudian dilakukan pengamatan sampai subjek dinyatakan mengalami decompensated atau non-decompensated DIC; selanjutnya dilakukan analisis nilai PT, aPTT, kadar fibrinogen, dan D-dimer pada kelompok decompensated dan non-decompensated DIC. Penelitian menggunakan rancangan cohort. Subjek berjumlah 39 orang (58%) penderita sepsis dengan luaran decompensated DIC dan 28 orang (42%) penderita sepsis dengan luaran non-decompensated DIC. Dari parameter hemostasis yang diperiksa, didapatkan bahwa nilai PT, aPTT, dan fibrinogen merupakan prediktor decompensated DIC pada penderita sepsis dengan risiko relatif (RR) masing-masing 240,500; 7,157; dan 6,421. Simpulan, prothrombin time, aPTT, dan fibrinogen merupakan pemeriksaan untuk mengetahui aktivasi koagulasi. Parameter hemostasis yang merupakan prediktor decompensated DIC pada penderita sepsis adalah nilai PT dan aPTT yang memendek serta kadar fibrinogen yang meningkat. [MKB. 2011;43(1):49–54].Kata kunci: Activated partial thromboplastin time, D-dimer, disseminated intravascular coagulation, fibrinogen, prothrombin time, sepsisProthrombin Time, Activated Partial Thromboplastin Time, Fibrinogen,and D-dimer as a Predictor of Decompensated Disseminated Intravascular Coagulation in SepsisAbstractSepsis is a systemic response to infection especially in pneumonia case. Sepsis can cause complications such as disseminated intravascular coagulation (DIC) which can be divided into compensated and decompensated DIC. The purpose of this study was to assess whether the value of prothrombin time (PT), activated partial thromboplastin time (aPTT), fibrinogen, and D-dimer levels can be used as predictors of decompensated DIC in sepsis patients. This study was conducted at the Laboratory of Clinical Pathology Rumah Sakit Hasan Sadikin Bandung since September 2008 to June 2010. Subjects were patients with sepsis caused by pneumonia. PT and aPTT values, fibrinogen, and D-dimer levels was recorded from all sepsis patients then patients were observed until diagnosed decompensated or non-decompensated DIC, then the value of PT, aPTT, fibrinogen and D-dimer levels in the group of decompensated DIC and non-decompensated DIC were analysed. This study used cohort design. Subjects were 39 sepsis patients (58%) with outcome decompensated DIC and 28 sepsis patients (42%) with outcome non-decompensated DIC. From the hemostasis parameter test out, it was found that PT, aPTT, and fibrinogen were the predictor of decompensated DIC in patients with sepsis with relative risk 240.500, 7.157, and 6.421; respectively. Conclusions, prothrombin time, aPTT, fibrinogen are the test to know coagulation activation. Hemostasis parameter to predict decompensated DIC in sepsis patients are the shorten PT, aPTT, and the increased fibrinogen. [MKB. 2011;43(1):49–54].Key words: Activated partial thromboplastin time, D-dimer, disseminated intravascular coagulation, fibrinogen,prothrombin time, sepsi

Peran Lem Fibrin Otologus pada Penempelan Tandur Konjungtiva Bulbi Mata Kelinci terhadap Ekspresi Gen Fibronektin dan Integrin

Enus, Sutarya ( Departemen Ilmu Kesehatan Mata, Fakultas Kedokteran Universitas Padjadjaran-Rumah Sakit Mata Cicendo ) , Natadisastra, Gantira ( Departemen Ilmu Kesehatan Mata, Fakultas Kedokteran Universitas Padjadjaran-Rumah Sakit Mata Cicendo ) , Shahib, M. Nurhalim ( Departemen Bio Kimia Fakultas Kedokteran Universitas Padjadjaran-Rumah Sakit Dr. Hasan Sadikin Bandung ) , Sulaeman, Rachmat ( Departemen Ilmu Penyakit Dalam Fakultas Kedokteran Universitas Padjadjaran-Rumah Sakit Dr. Hasan Sadikin Bandung )

Majalah Kedokteran Bandung Vol 43, No 4 (2011)
Publisher : Fakultas Kedokteran, Universitas Padjadjaran

Show Abstract | Original Source | Check in Google Scholar |

Abstract

AbstrakPenempelan jaringan dan penyembuhan luka pada cangkok konjungtiva lebih cepat pada teknik lem fibrin otologus (LFO) dibandingkan dengan teknik jahitan. Kedua proses tersebut memerlukan interaksi fibronektin (FN) dan integrin α5 yang mengaktivasi alur persinyalan intraselular. Tujuan penelitian untuk menentukan kekuatan ekspresi gen FN serta integrin α5 pada kelompok teknik LFO dan jahitan. Uji eksperimental hewan pada kelinci New Zealand White yang terbagi kelompok teknik LFO dan jahitan masing-masing 8 kelinci bertempat di Laboratorium Sentral (Biologi Molekuler) FK Unpad Bandung, periode Mei–Oktober 2008. Sampel jaringan untuk pemeriksaan reverse transcriptase polymerase chain reaction (RT-PCR) diambil dari eksterpasi satu hari sesudah jaringan cangkok konjungtiva bulbi. Analisis data untuk uji hipotesis dengan Mann Whitney for small sample. Ekspresi gen messenger ribonucleic acid (mRNA) FN secara bermakna lebih kuat pada teknik LFO dibandingkan dengan teknik jahitan (1,9 vs 1,0; p=0,014). Tidak terdapat perbedaan bermakna ekspresi gen (mRNA) integrin α5 antara teknik LFO dan teknik jahitan (1,2 vs 1,0; p=0,235). Sebagai simpulan ekspresi gen FN lebih kuat pada teknik LFO dibandingkan dengan jahitan, sedangkan ekspresi gen integrin α5 pada teknik LFO lebih kuat dibandingkan dengan teknik jahitan namun secara statistik tidak bermakna satu hari pascabedah. [MKB. 2011;43(4):183–8].Kata kunci: Fibronektin, integrin α5, lem fibrin otologus, RT-PCRThe Role of Autologous Fibrin Glue on Attachment Rabbit Conjungtival Graft Based on Fibronectin and Integrin Gene ExpressionThe tissue attachment and wound healing in conjunctional transplantation was more rapid with autologous fibrin glue (AFG) than suture techniques. Both tissue attachment and wound healing process need interaction between fibronectin (FN) dan integrin α5 activating the intra cellular signal transduction pathway. The aim of this study was to evaluate the gene expression, i.e. FN and integrin in conjunctival transplantation, comparing between AFG and suturing techniques. Animal experimental study was done in New Zealand White rabbits, which divided into AFG and suturing technique at Laboratorium Sentral (Biologi Molekuler) FK Unpad Bandung during May–October 2008, each 8 rabbits, respectively. The tissue sample for reverse transcriptase polymerase chain reaction (RT-PCR) examination was taken from the tissue excision one day after conjunctival bulbi transplantation. Data analysis was tested using Mann Whitney for small sample. The FN gene expression power of messenger ribonucleic acid (mRNA) in the AFG technique was stronger than that in suturing technique (1.9 vs 1.0, p=0.014). There was no significant difference in integrin α5 gene expression of mRNA between AFG and suturing techniques (1.2 vs 1.0, p=0.235). In conclusions, FN gene expression in AFG technique is stronger than suturing technique. There is no difference in integrin α5 gene expression between two techniques, however there is a tendency of increased integrin α5 gene expression one day after surgery. [MKB. 2011;43(4):183–8].Key words: Autologous fibrin glue, fibronectin, integrin α5, RT-PCR

Uji Validitas Neutrophil Gelatinase Associated Lipocalin sebagai Penanda Diagnosis Gangguan Ginjal Akut pada Sepsis

Hidayat, - ( Laboratorium Patologi Klinik Rumah Sakit Dr. H. Abdul Moeloek Lampung ) , Parwati, Ida ( Laboratorium Patologi Klinik Rumah Sakit Dr. H. Abdul Moeloek Lampung ) , Gondodiputro, Rubin Surachno ( Departemen Ilmu Penyakit Dalam Fakultas Kedokteran Universitas Padjadjaran-Rumah Sakit Dr. Hasan Sadikin Bandung ) , Rita, Coriejati ( Laboratorium Patologi Klinik Rumah Sakit Dr. H. Abdul Moeloek Lampung )

Majalah Kedokteran Bandung Vol 44, No 2 (2012)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Original Source | Check in Google Scholar |

Abstract

Gangguan ginjal akut (GgGA) merupakan penurunan fungsi ginjal secara mendadak yang ditandai dengan peningkatan kreatinin serum ≥0,3 mg/dL atau meningkat >1,5 kali dari kadar sebelumnya atau penurunan urine output (UO) <0,5 mL per jam selama >6 jam. Sepsis merupakan penyebab tersering GgGA dengan angka kejadian berkisar 20–50% dan angka kematian mendekati 70%. Kadar neutrophil gelatinase associated lipocalin (NGAL) urine penderita GgGA dapat meningkat secara cepat dan lebih awal dibandingkan dengan kadar kreatinin serum sehingga NGAL dapat dijadikan penanda diagnosis GgGA. Penelitian bertujuan mengetahui validitas NGAL urine sebagai penanda diagnosis GgGA pada penderita sepsis. Sebanyak 50 sampel urine diambil dari penderita sepsis di Unit Gawat Darurat (UGD), Intensive Care Unit (ICU), dan Medical Intermediate Care (MIC) di Rumah Sakit Dr. Hasan Sadikin Bandung selama Februari sampai Mei 2010 dan dilakukan pemeriksaan kadar NGAL urine dengan metode enzyme linked immunosorbent assay (ELISA). Data yang diperoleh dianalisis dengan uji nonparametrik Mann-Whitney, kurva receiver operating characteristic (ROC), dan uji validitas. Hasil penelitian didapatkan kadar NGAL urine penderita sepsis dengan GgGA lebih tinggi secara bermakna dibandingkan dengan penderita sepsis tanpa GgGA (3.380 ng/mL berbanding 116 ng/mL; p<0,001). Pada cut-off point 107 ng/mL, NGAL urine memiliki sensitivitas 100%, spesifisitas 36%, positive predictive value (PPV) 60,9%, negative predictive value (NPV) 100%, dan akurasi 68%. Simpulan, kadar NGAL urine memiliki validitas yang baik dan dapat dijadikan sebagai penanda diagnosis terjadinya GgGA pada penderita sepsis. [MKB. 2012;44(2):121–6]. Validity Test of Neutrophil Gelatinase Associated Lipocalin as Diagnostic Marker forAcute Kidney Injury on SepsisAcute kidney injury (AKI) is an abrupt decrease of renal function which marked by increase of serum creatinine ≥0.3 mg/dL or ≥1.5 times of previous level or decrease urine output <0.5 mL/hour in >6 hours. Sepsis is the most common cause of AKI with incidence rate is about 20–50% and mortality nearly 70%. Urine neutrophil gelatinaseassociated lipocalin (NGAL) level in AKI patients can increase quickly and earlier compared with serum creatinine and could be as a marker for AKI. The purpose of this study was to assess the validity of urine NGAL as diagnostic marker of AKI on sepsis patients. Subjects were 50 urine samples of sepsis patients from Emergency Department (ED), Intensive Care Unit (ICU) and Medical Intermediate Care (MIC) in Dr. Hasan Sadikin Hospital Bandung between February and May 2010 and were examined with enzyme linked immunosorbent assay (ELISA) method. Data analysis was performed by non parametric Mann-Whitney test, receiver operating characteristic (ROC) analysis and validity test.The results found that urine NGAL of AKI patients were significantly higher compared with non AKI patients (3,380 ng/mL vs 116 ng/mL, p<0.001). A cut-off point >107 ng/mL for urine NGAL had a sensitivity of 100%, specificity of 36%, positive predictive value (PPV) of 60.9%, negative predictive value (NPV) of 100% and accuracy of 68%. In conclusions, urinary NGAL level has good validity and could be used as a screening test for AKI on sepsis patients. [MKB. 2012;44(2):121–6]. DOI: http://dx.doi.org/10.15395/mkb.v44n2.131

Ekspresi Reseptor-Estrogen pada Adenoma Pleomorfik Parotis

Yazid, Achmad Syawqie

Majalah Kedokteran Bandung Vol 42, No 4 (2010)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Original Source | Check in Google Scholar |

Abstract

Adenoma pleomorfik parotis (APP) merupakan tumor jinak yang umum terjadi pada kelenjar liur parotis, memiliki perilaku biologi beragam, yaitu sering rekurens setelah dioperasi, dapat berubah menjadi ganas, juga kadang bermetastasis ke kelenjar getah bening atau ke organ lain. Selayaknya untuk tumor APP ini dilakukan pencarian bentuk terapi alternatif lain selain terapi bedah yang diduga penyebab tingginya rekurensi tumor. Terapi alternatif lain dapat berupa hormonal yang memerlukan data dasar ekspresi reseptor estrogen oleh sel tumor APP. Untuk mengungkapkan ekspresi reseptor estrogen oleh sel tumor APP, dilakukan penelitian retrospektif eksperimental laboratoris pemeriksaan imunohistokimia teknik LsAB/labelled strepavidine-biotine terhadap ekspresi estrogen receptor (ER) pada 50 sampel tumor APP di Bagian Patologi Anatomi FKUP/RSHS pada tahun 1998–1999. Pengamatan ditujukan pada kelompok penyebaran tingkat imunoekspresi ER oleh sel tumor APP: 0=negatif; +1=fokal (>20%); +2=heterogen (20–50%); dan +3=difus (>50% sel tumor imunoreaktif). Hasil menunjukkan 40/50 sampel tumor APP (80%) imunoreaktif terhadap ER dengan komposisi imunoekspresi: 67,5% heterogen (27/40) dan 32,5% difus (13/40). Pola pulasan homogen teramati pada inti sel tumor. Sepuluh kasus memperlihatkan hasil negatif (negatif 8 kasus dan fokal 2 kasus). Komponen jaringan tumor APP yang positif meliputi sel epitel duktal/tubuloduktal, area miksomatosa, dan hiperselular. Simpulan, tumor APP berperan sebagai target hormon estrogen dan besar kemungkinannya responsif terhadap terapi hormonal. [MKB. 2010;42(4):181–6].Kata kunci: Adenoma pleomorfik, estrogen receptor, tumor parotisEstrogen-Receptor Expression in Parotid Pleomorphic AdenomaParotid pleomorphic adenoma (PPA) is a benign tumor frequently found in parotid salivary gland. This tumor has various biological behaviors including recurrence after surgery, ability to transform into the malignant form, and occasionally, metastasizes to lymph nodes or other organs. For this PPA tumor, it is appropriate to look for alternative therapy forms other than surgery which is assumed to be the cause of the high tumor recurrence. Other alternatives may include hormonal therapy that needs baseline data on estrogen-receptor expression by PPA tumor cells. To collect the baseline data, a laboratory experimental retrospective study on immunohistochemical study using LsAB/labelled strepavidine-biotine technique of estrogen receptor (ER) receptor on 50 PPA tumor samples at the Anatomic Pathology Department of the Faculty of Medicine, Padjadjaran University/Hasan Sadikin General Hospital during 1998–1999 has been conducted. The observation is focused on the grouping of ER immunoexpression level spread by PPA tumor cells: 0=negative; +1=focal (>20%); +2=heterogeneous (20–50%); and +3=diffuse (>50% immunoreactive tumor cells). The results showed that 40/50 PPA tumor samples (80%) were immunoreactive towards ER with an immunoexpression composition of: 67.5% heterogeneous (27/40) and 32.5% diffuse (13/40). A homogenous smear pattern was observed in tumor cell nucleus. Ten cases showed negative results (8 cases negative and 2 cases focal). The positive PPA tumor tissue components included ductal /tubuloductal epithels, mixomatose and hypercellullar areas. In conclusion, PPA tumor plays the role as target of estrogen hormone and there is a high possibility that it is responsive to hormonal therapy. [MKB. 2010;42(4):181–6].Key words: Estrogen receptor, parotid tumors, pleomorphic adenoma DOI: http://dx.doi.org/10.15395/mkb.v42n4.34

Page 4 of 65 | Total Record : 648