Majalah Kedokteran Bandung
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Efek Probiotik terhadap Mortalitas, Derajat Inflamasi Intestinal, dan Kadar IgA pada Mencit Model Sepsis

Indrayanto, Yoseph ( Laboratorium Biologi Fakultas Kedokteran, Universitas Sebelas Maret Surakarta ) , Prasetyo, Diding Heri ( Divisi Imunologi, Laboratorium Biokimia Fakultas Kedokteran, Universitas Sebelas Maret Surakarta )

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

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Abstract

Sepsis mengubah mikrobiologi saluran pencernaan, menyebabkan hilangnya flora komensal dan pertumbuhan bakteri patogen yang berlebih. Pemberian probiotik penderita sepsis dapat mengembalikan keseimbangan mikrobiota dan memiliki efek positif pada fungsi imunitas tubuh serta struktur dan fungsi gastrointestinal. Penelitian ini bertujuan untuk menentukan efek pemberian probiotik terhadap mortalitas, inflamasi intestinal, dan kadar imunoglobulin A (IgA) serum pada mencit model sepsis. Penelitian ini merupakan penelitian eksperimental laboratoris, dengan sampel 36 ekor mencit Balb/C jantan dibagi menjadi kelompok: kontrol, sepsis, dan sepsis+probiotik. Penelitian dilakukan di laboratorium Histologi dan Biomedik Fakultas Kedokteran Universitas Sebelas Maret Surakarta,periode Januari–April 2012. Mencit Balb/C jantan diinjeksi cecal inoculum (200 mg/kgBB) secara intraperitoneal (i.p), untuk kelompok sepsis maupun sepsis dengan probiotik. Kelompok mencit kontrol tidak diinokulasi selama penelitian. Inflamasi intestinal ditentukan dengan pengecatan hematoksilin eosin (HE) pada hari ke-8. Mortalitas dinilai sampai hari ke-8. Kadar IgA serum ditentukan menggunakan enzyme-linked immunosorbent assay. Twotailed Fisher Exact Test untuk uji mortalitas, Kruskal-Wallis untuk uji inflamasi intestinal, sedangkan analysis of variance untuk uji kadar IgA serum. Persentase kematian kelompok probiotik tidak berbeda bermakna (10% vs 40%, p=0,065) dibandingkan dengan kelompok sepsis. Probiotik bermakna menurunkan derajat inflamasi intestinal dibandingkan dengan kelompok sepsis (p<0,001). Kadar IgA serum kelompok mencit kontrol 35,82±4,55 ng/mL. Probiotik secara bermakna meningkatkan kadar IgA serum (65,07±34,97 ng/mL vs 6,20±5,80 ng/mL, p<0,001) dibandingkan dengan kelompok mencit sepsis. Simpulan, pemberian probiotik menurunkan derajat inflamasiintestinal dan mortalitas, serta meningkatkan kadar IgA serum pada mencit model sepsis. [MKB. 2013;45(1):10–5]Kata kunci: IgA, inflamasi, probiotik, sepsis Probiotic Effects of Mortality, Degree of Intestinal Inflammation, and IgA Levels in Sepsis Mice ModelSepsis results in changes to the microbiology of the gastrointestinal tract, leading to a loss of commensal flora and an overgrowth of potentially pathogenic bacteria. Administering probiotics to sepsis patients may restore balance to the microbiota and have positive effects on immune function and gastrointestinal structure and function. This study was aimed to evaluate the effect of probiotic on mortality, intestinal inflammation and immunoglobulin A (IgA) serum level in mice model of sepsis. This study was an experimental research laboratory, with 36 male Balb/C mice were divided into: control, sepsis, and sepsis+probiotic groups. The study was conducted at Histology and Biomedical Laboratory, School of Medicine, Sebelas Maret University, Surakarta, in January to April 2012. Sepsis was induced in the male Balb/C mice using an intraperitoneally (i.p) injection of cecal inoculum (200 mg/ kgBW), for sepsis mice model and sepsis with probiotic. Control mice were not inoculation during the study. Detection of intestinal inflammation with hematoxylin and eosin (HE) staining on 8th day. Mortality perceived until 8th day. IgA serum level measurement with enzyme-linked immunosorbent assay. Two-tailed Fisher exact test for the analysis of mortality, Kruskal-Wallis test for the intestinal inflammation, one way analysis of variance for IgA serum level. Probiotic showed no significantly mortality (10% vs 40%, p=0.065) compared to sepsis group. Probiotic showed significantly decreased intestinal inflammation compared to sepsis group (p<0.001). Control mice showed levels of IgA 35.82±4.55 ng/mL. Probiotic showed significantly increased IgA levels (65.07±34.97 ng/mL vs 6.20±5.80 ng/mL, p<0.001) compared to sepsis group. In conclusions, probiotic decrease intestinal inflammation and mortality, on the other hand increase IgA level in mice model of sepsis. [MKB. 2013;45(1):10–5]Key words: IgA, inflammation, probiotic, sepsis DOI: http://dx.doi.org/10.15395/mkb.v45n1.95

Polimorfisme C1167T Gen Reseptor Tipe II Transforming Growth Factor-â, Kadar Soluble Endoglin, dan Vascular Cell Adhesion Molecule-1 pada Preeklamsia

Anwar, Anita D. ( Bagian Obstetri dan Ginekologi Fakultas Kedokteran Universitas Padjadjaran Rumah Sakit Hasan Sadikin, Bandung ) , Achmad, Tri Hanggono ( Bagian Biokimia Fakultas Kedokteran Universitas Padjadjaran Rumah Sakit Hasan Sadikin, Bandung ) , Sukandar, Hadyana ( Bagian Epidemiologi Fakultas Kedokteran Universitas Padjadjaran Rumah Sakit Hasan Sadikin, Bandung ) , Krisnadi, Sofie R. ( Bagian Obstetri dan Ginekologi Fakultas Kedokteran Universitas Padjadjaran Rumah Sakit Hasan Sadikin, Bandung ) , Wirakusumah, Firman F. ( Bagian Obstetri dan Ginekologi Fakultas Kedokteran Universitas Padjadjaran Rumah Sakit Hasan Sadikin, Bandung )

Majalah Kedokteran Bandung Vol 42, No 3 (2010)
Publisher : Fakultas Kedokteran, Universitas Padjadjaran

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Abstract

Transforming growth factor-â (TGF-â) diduga berperan pada preeklamsia. Reseptor TGF-â tipe II (TâR-II) dihasilkan dari transkripsi gen TGF-â receptor type II (TGFBR2). Polimorfisme gen TGFBR2 pada basa C1167T dapat menyebabkan hipoksia yang menginduksi iskemia serta meningkatkan produksi solubel endoglin (sEng) dan vascular cell adhesion molecule-1 (VCAM-1). Tujuan penelitian ini untuk mengetahui korelasi polimorfisme gen TGFBR2 pada basa C1167T dengan kadar sEng dan VCAM-1 ibu preeklamsia. Subjek adalah ibu preeklamsia usia kehamilan 28–42 minggu dan kehamilan normal sebagai kontrol, masing-masing 120 orang. Penelitian dilakukan di Rumah Sakit Hasan Sadikin, Bandung, September 2008–Mei 2009. Sampel berupa darah vena, pemeriksaan polimorfisme dilakukan dengan DNA Wizard® genomic DNA purification, kadar sEng dan VCAM-1 dengan imunoesai. Hasil penelitian menunjukkan polimorfisme CT pada kelompok preeklamsia 92 (76,7%) dan kontrol 70 (58,3%) {p<0,001; OR (95%CI): 2,35 (1,30–4,26)}. Kadar sEng (ng/mL) 12,46 berbanding 10,29 pada kelompok kontrol {p<0,001; OR (95%CI): 3,71 (2,11–6,57)}. Kadar VCAM-1 berbeda bermakna, yaitu 1.218,43 berbanding 705,59 {(p<0,001; OR (95%CI): 7,56 (4,11–14,0)}. Disimpulkan terdapat perbedaan proporsi dan korelasi polimorfisme C1167T gen TGFBR2, kadar sEng, dan VCAM-1 antara preeklamsia dan kehamilan normal. [MKB. 2010;42(3):115-22].Kata kunci: Polimorfisme gen TGFBR2, preeklamsia, sEng, VCAM-1C1167T Type II Transforming Growth Factor-â Receptor Gene Polymorphism, Soluble Endoglin and Vascular Cell Adhesion Molecule-1Levels in PreeclampsiaTransforming growth factor-â (TGF-â) plays a role in preeclampsia. TGF-â receptor type II (TâR-II) is produced from the transcription of the type II TGF-â receptor gene (TGFBR2). Polymorphism of TGFBR2 gene on the base C1167T could cause hipoxia that induces ischaemia and product soluble endoglin (sEng) and vascular cell adhesion molecule-1 (VCAM-1). The aim was to find out the association of C1167T type II TGF-â receptor gene polymorphism with sEng and VCAM-1 levels in preeclampsia. The study was done at Hasan Sadikin Hospital, Bandung, September 2008–May 2009. Indicates that C1167T polymorphism events were found in the preeclampsia that were 92(76.7%) of 120 cases and 70 (58.3%) control of 120 normal pregnancies with the difference in the appearance polymorphism which means p<0.001 OR (95%CI):2,35 (1.30–4.26). There was a difference between sEng (ng/μL) 12.46 for preeclampsia and 10.29 for the control group p<0.001 OR (95%CI): 3.71 (2.11–6.57). There was also a difference between VCAM-1 (ng/μL) 1,218.43 for the preeclampsia and 705.59 for the control group {p<0.001 OR (95%CI): 7.56 (4.11–14.0)}. There was a result that in preeclamptic patient having polymorphism sEng level was 14.19 ng/mL and VCAM-1 level is 961,85 ng/mL. It is concluded that there are difference proportion and association of C1167T type II TGF-â receptor gene polymorphism with sEng and VCAM-1 levels between preeclampsia and normal pregnancy patients. [MKB. 2010;42(3):115-22].Key words: Preeclampsia, sEng, TGFBR2 gene polymorphism, VCAM-1

Perubahan Gambaran Histopatologi Paru pada Paparan Debu Batubara Memakai Alat Model 2010

Kania, Nia ( Bagian Patologi Anatomi, Rumah Sakit Umum Daerah Ulin, Fakultas Kedokteran Universitas Lambung Mangkurat, Banjarmasin ) , Setiawan, Bambang ( Bagian Kimia Kedokteran, Fakultas Kedokteran Universitas Lambung Mangkurat, Banjarbaru ) , Nurdiana, Nurdiana ( Bagian Farmakologi, Fakultas Kedokteran Universitas Brawijaya, Malang ) , Widodo, M. Aris ( Bagian Farmakologi, Fakultas Kedokteran Universitas Brawijaya, Malang ) , Kusuma, HMS Chandra ( Bagian Ilmu Kesehatan Anak, Rumah Sakit Umum Daerah Syaiful Anwar, Fakultas Kedokteran Universitas Brawijaya, Malang )

Majalah Kedokteran Bandung Vol 43, No 3 (2011)
Publisher : Fakultas Kedokteran, Universitas Padjadjaran

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Abstract

Tambang batubara di permukaan tanah mendorong pembuatan alat paparan debu batubara skala laboratorium. Optimasi alat paparan debu batubara model 2010 dilakukan untuk menentukan lokasi akumulasi debu batubara serta perubahan histopatologi paru. Penelitian eksperimental dilakukan pada kontrol (K), paparan debu batubara 14 hari (BB1), dan debu batubara 28 hari (BB2). Karakterisasi debu batubara dilakukan dengan scanning electron microscope (SEM) dan X-ray fluorescence (XRF) di Laboratorium Fisika Universitas Negeri Malang. Pemeriksaan histopatologis paru dilakukan di Laboratorium Patologi Anatomi RSUD Ulin Banjarmasin. Penelitian dilakukan periode Agustus−November 2010. Scanning electron microscope paru menunjukkan diameter partikel <10 mm dan akumulasi partikel di alveolus. Parenkim paru berupa struktur alveolus tipis (K), penebalan alveolus dan edema epitel edematous (BB1), peningkatan edematous dan penyempitan rongga alveolus (BB2). Epitel bronkus dilapisi epitel silindris, epitel goblet, sel radang yang minimal (K), perpanjangan epitel silindris, hiperplasia epitel goblet dan mukus (BB1). Sel epitel menjadi menipis, lebih banyak mukus dan morfologi epitel menjadi tidak jelas (BB2). Epitel bronkoalveolus dilapisi epitel silindris, minimal sel goblet dan sel radang (K). Hiperplasia epitel goblet yang mendominasi disertai mukus (BB1). Epitel silindris dengan proliferasi sel goblet, mukus, taburan sel radang, dan fibrosis (BB2). Simpulan, alat paparan model 2010 memicu akumulasi debu batubara di alveolus serta perubahan histopatologi berupa inflamasi, hiperplasia sel goblet, dan fibrosis. [MKB. 2011;43(3):127–33]. Kata kunci: Alveolus, debu batubara, histopatologi, paruLung Histopatology Changed in Coal Dust Exposure with Model 2010EquipmentCoal mining on surface ground stimulate to create coal dust exposure equipment on laboratory scale. Optimation of model 2010 coal dust exposure equipment focus on coal dust accumulation and histopathologic of lung. This experimental study was done in control (K), coal dust exposure for 14 days (BB1), and coal dust exposure for 28 days (BB2). Coal dust characterization was done by scanning electron microscope (SEM) and X-ray fluorescence in Physics Laboratory Malang State of University. Histopathologic analysis was done in Pathologic Laboratory Ulin General Hospital. Research was done August−November 2010. Lung SEM showed particle diameter 10 mm and particle accumulated in alveolus. Lung parenchym showed thin alveolus structure (K), thickenning of alveolus and edematous epithelial (BB1), increased edematous and narrower alveolus space (BB2). Epithelial in bronchus layering by cylindrical and goblet epithelial, inflammation cell (K), elongation of cylindrical epithelial, hyperplasia goblet epithelial and mucous (BB1). Epithelial became thick, more mucous, and epithelial morphology became unclear (BB2). Bronchoalveolus epithelial layering by cylindrical epithelial, minimal goblet cell and inflammation cell (K). Goblet cell hyperplasia and mucous (BB1). Cylindrical epithelial with goblet cell proliferation, mucous inflammation cell, and fibrosis (BB2). In conclusions, coal dust exposure with model 2010 equipment trigger coal dust accumulation in avelous and histopathologic changes of inflamation, goblet cell hyperplasia, and fibrotic. [MKB. 2011;43(3):127–33].Key words: Alveolus, coal dust, histopathologic, lung

Karakteristik Dengue Berat yang Dirawat di Pediatric Intensive Care Unit

Lukmanul Hakim, Dzulfikar D. ( Departemen Ilmu Kesehatan Anak Fakultas Kedokteran Universitas Padjajaran Rumah Sakit Dr. Hasan Sadikin Bandung ) , Garna, Herry ( Departemen Ilmu Kesehatan Anak Fakultas Kedokteran Universitas Padjajaran Rumah Sakit Dr. Hasan Sadikin Bandung ) , Winiar, Wiwin ( Departemen Ilmu Kesehatan Anak Fakultas Kedokteran Universitas Padjajaran/Rumah Sakit Dr. Hasan Sadikin Bandung )

Majalah Kedokteran Bandung Vol 44, No 3 (2012)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Virus dengue dapat menyebabkan infeksi pada semua kelompok usia dengan manifestasi klinis beragam mulai dari asimtomatik, ringan, sampai berat yang biasanya merupakan kasus fatal. Dengue berat ditandai dengan kebocoran plasma, hemokonsentrasi, dan gangguan hemostasis. Penelitian ini bertujuan untuk mengetahui karakteristik penderita dengue berat yang dirawat di ruang Pediatric Intensive Care Unit (PICU) RS Dr. Hasan Sadikin Bandung sejak Januari 2009 sampai Desember 2010. Penelitian dilakukan secara retrospektif deskriptif berdasarkan data dari rekam medis penderita. Sebanyak 21 penderita dengue berat dirawat selama 2 tahun, 15/21 penderita perempuan dan 6/21 laki-laki, serta 5/21 anak meninggal dunia selama dirawat dengan sebab kematian tersering sindrom syok dengue (SSD) dan kogagulopati intravaskular diseminata (KID). Sebagian besar penderita berusia 1−5 tahun dengan status gizi baik. Hepatomegali ditemukan pada semua penderita dengan hematokrit rata-rata 38%. Pada penelitian ini, manifestasi klinis dengue berat berupa SSD (15/21), KID (11/21), ensefalopati (6/21), efusi pleura (5/21), miokarditis (3/21), serta acute respiratory distress syndrome (3/21). Simpulan, dengue berat lebih banyak didapatkan pada anak perempuan, usia 1–5 tahun, serta status gizi baik. Manifestasi klinis dengue berat yang dominan berupa syok, koagulasi intravaskular diseminata, dan ensefalopati. [MKB. 2012;44(3):147–51].Kata kunci: Dengue berat, karakteristik, pediatric intensive care unitCharacteristic of Severe Dengue Hospitalized in Pediatric Intensive Care UnitDengue viral infections affect all age groups and produce a spectrum of clinical illness that ranges from asymptomatic to severe and occasionally fatal disease. Severe dengue characterized by plasma leakage, hemoconcentration, and hemostatic disorder. The aim of this study was to know the characteristic of severe dengue patients admitted to Pediatric Intensive Care Unit (PICU) Dr. Hasan Sadikin Hospital Bandung during January 2009 to December 2010. This was a retrospective descriptive study based on the data collected from the medical records. Twenty-one severe dengue cases in two years were admitted 15/21 girls and 6/21 boys, and 5/21 of them died during hospitalization because of dengue shock syndrome (DSS) and disseminated intravascular coagulation (DIC). Most of them were 1−5 years old with good nutritional status. Hepatomegaly was found in all cases with mean hematocrit was 38%. In this research, the most manifestation of severe dengue were DSS (15/21), DIC (11/21), encephalopathy (6/21), pleural effusion (5/21), myocarditis (3/21), and acute respiratory distress syndrome (3/21). In conclusions, severe dengue are more common in girls, 1–5 years old, and well-nourished children. The most common clinical manifestation of severe dengue are shock, disseminated intravascular coagulation, and encephalopathy. [MKB. 2012;44(3):147–51]. DOI: http://dx.doi.org/10.15395/mkb.v44n3.85

Peningkatan Ketebalan Miokardium Mencit (Mus musculus L.) Akibat Paparan Medan Listrik Tegangan Tinggi

Busman, Hendri ( Jurusan Biologi Fakultas Matematika dan Ilmu Pengetahuan Universitas Lampung ) , Muhartono, Muhartono ( Bagian Patologi Anatomi Fakultas Kedokteran Universitas Lampung, jalan Soemantri Brojonegoro 1 Bandar Lampung )

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

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Pembangunan saluran transmisi listrik tegangan tinggi diduga dapat merugikan manusia atau makhluk hidup lain. Tujuan penelitian untuk mengetahui pengaruh paparan medan listrik tegangan tinggi pada ketebalan miokardium ventrikel kiri mencit jantan (Mus musculus L.). Penelitian dilaksanakan di Laboratorium Zoologi Fakultas Matematika dan Ilmu Pengetahuan Alam Universitas Lampung serta Laboratorium Patologi Balai Penyidikan dan Pengujian Veteriner Regional III Bandar Lampung, pada bulan Juni−November 2011.Penelitian menggunakan rancangan acak lengkap dengan 4 perlakuan, ulangan 6 kali, dan dibagi dalam empat kelompok. Kelompok kontrol (K) tidak diberi perlakuan, kelompok 1 (P1) diberi paparan 5 kV/m, kelompok 2 (P2) diberi paparan 6 kV/m, dan kelompok 3 (P3) diberi paparan 7 kV/m, masing-masing 8 jam/hari selama 37 hari. Data dianalisis menggunakan analysis of variance. Hasil penelitian didapatkan ketebalan miokardium ventrikel kiri mencit jantan pada K sebesar 1.329,83±173,29 μm; P1 sebesar 1.507,50±109,24 μm; P2 sebesar 1.536,70±103.42 μm; dan P3 sebesar 1.574.23±123,36 μm. Terdapat peningkatan ketebalan miokardium rata-rata dengan bertambahnya daya paparan medan listrik (p=0,019). Simpulan, terdapat hubungan antara paparan medan listrik tegangan tinggi dan perubahan ukuran ketebalan miokardium ventrikel kiri mencit jantan, semakin tinggi paparan medan listrik semakin tebal miokardium ventrikel kiri mencit jantan. [MKB. 2013;45(3):155–60] Increased Thickness Myocardium Mice (Mus musculus L.) Caused by Exposure to High Voltage Electric FieldDevelopment of high voltage power transmission line could be expected to harm humans or other living creatures. Research objective was to determine the effect of exposure tohigh-voltage electric field to the thickness of the left ventricular myocardium male mice (Mus musculus L.). The experiment was conducted at the Laboratory of Zoology Faculty of Mathematics and Natural Sciencesat the University of Lampung and Central Pathology Laboratory Regional Veterinary Investigation III Bandar Lampung, in June−November 2011. Research using completely randomized design with 4 treatments, replicated 6 times and divided into four groups.The control group (K) was not given treatment, group 1 (P1) given exposure to 5 kV/m, group 2 (P2) given exposure to 6 kV/m and group 3 (P3) given exposure to 7 kV/m for 8 hours/day, to 37 days. Data were analyzed using analysis of variance. The results obtained thickness of the left ventricular myocardium of male mice at K1,329.83±173.29 μm; P1 at 1,507.50±109.24 μm; P2 at 1,536.70±103.42 μm, and P3 at 1,574.23±123.36 μm. There was an increase in the average thickness of the myocardium with increasing exposure to power an electric field with a statistical test obtained (p=0.019). In conclusion, there is a significant relationship between exposure to high-voltage electric field to change the size of the thickness of the left ventricular myocardium male mice, the higher the electric field exposure thicker left ventricular myocardium male mice. [MKB. 2013;45(3):155–60] DOI: http://dx.doi.org/10.15395/mkb.v45n3.145

Karakteristik Gangguan Dengar Sensorineural Kongenital pada Anak yang Dideteksi dengan Brainstem Evoked Response Audiometry

Dewi, Yussy Afriani ( Departemen Ilmu Kesehatan Telinga, Hidung, Tenggorok, Bedah Kepala dan Leher Fakultas Kedokteran Universitas Padjadjaran-Rumah Sakit Dr. Hasan Sadikin, Bandung ) , Agustian, Ratna Anggraeni ( Departemen Ilmu Kesehatan Telinga, Hidung, Tenggorok, Bedah Kepala dan Leher Fakultas Kedokteran Universitas Padjadjaran-Rumah Sakit Dr. Hasan Sadikin, Bandung )

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

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Gangguan dengar merupakan salah satu kelainan yang sering timbul sejak lahir (kongenital), sehingga deteksi dan rehabilitasi dini yang tepat dapat meningkatkan perkembangan bicara dan berbahasa. Penelitian ini dilakukan untuk mengetahui berbagai aspek gangguan dengar kongenital dari segi klinik maupun sosiologik. Subjek penelitian adalah anak yang dilakukan brainstem evoked response audiometry (BERA) di Rumah Sakit Dr. Hasan Sadikin dengan gangguan dengar sensorineural bilateral kongenital selama periode April 2002–April 2005. Penelitian dilakukan secara deskriptif retrospektif. Sebanyak 286 anak termasuk dalam penelitian terdiri atas 149 (52,1%) laki-laki dan 137 (47,9%) perempuan. Sebanyak 58,7% terdeteksi pada usia >1–3 tahun. Usia anak saat dicurigai menderita gangguan dengar mulai dari usia 5 bulan sampai 14 tahun. Tenggang waktu antara usia pada saat mulai dicurigai adanya gangguan dengar dan dilakukan BERA adalah 82 (28,7%) <6 bulan, 72 (25,2%) antara >6 bulan sampai <1 tahun, dan 70 (24,4%) antara >1 sampai< 2 tahun. Penderita lebih banyak berasal dari daerah perkotaan, yaitu 149 (52,1%) anak dan sebagian besar dirujuk oleh spesialis THT sebanyak 129 (45,1%). Derajat gangguan dengar terbanyak adalah berat 181 (63,3%) dan sangat berat 96 (33,6%), sebagian besar bersifat simetris (71%). Faktor risiko terbanyak tidak teridentifikasi (51,1%), prematur/BBLR (13,6%), asfiksia (13,3%), hiperbilirubinemia (8,7%), dan rubela (7,3%). Simpulan, usia curiga pada saat anak dideteksi mengalami gangguan dengar masih tinggi. Agar deteksi dapat lebih dini, perlu peningkatan pengetahuan tenaga kesehatan dan masyarakat serta upaya pencegahan terhadap faktor risiko. [MKB. 2011;43(2):77–82].Kata kunci: Anak, brainstem evoked response audiometry (BERA), gangguan dengar sensorineural bilateral kongenital Characteristic of Congenital Bilateral Sensorineural Hearing Loss inChildren Diagnosed by Brain Evoked Response AudiometryHearing loss is one of the most common congenital anomalies, therefore early detection and rehabilitation might enhance speech ability. The purpose of this study was to explore the clinical and sociological characteristics of congenital bilateral sensorineural hearing loss. Subjects were children who suffered from congenital bilateral sensorineural hearing loss diagnosed by brainstem evoked response audiometry (BERA) in Dr. Hasan Sadikin Hospital from period of April 2002–April 2005. Data obtained retrospectively from patient’s record and presented descriptively. There were 286 children included in the study consisted of 149 (52.1%) males and 137 (47.9%) females. More (58.8%) children were detected by BERA at age of >1–3 years. Children’s age that first suspected to have hearing disorder was between 5 months and 14 years old. The delay between suspected and diagnosis was 82 (28.7%) <6 months, 72 (25.2%) between >6 months–<1 year, 70 (24.4%) between >1–<2 years. There were 52.1% (149) subjects came from urban area and 45.1% (129) of them were referred by otolaryngology-head and neck surgery specialists. The degrees of hearing loss were severe 181 (63,3%) and profound 96 (33.6%). Most cases (71%) were symmetrical. The cause of hearing loss in 51.1% of children couldn’t be determined, 13.6% were premature/low birth weight, 13.6% asphyxia, 8.7% hyperbilirubinemia, and 7.3% rubella. Conclusions, age of children when suspected to have hearing disorder is still high. Early detection needs knowledge from health provider officer, society, and prevention of the risk factors. [MKB. 2011;43(2):77–82].Key words: Brainstem evoked response audiometry (BERA), child, congenital bilateral sensorineural hearing loss

Perbedaan Kadar Adiponektin, Asimetrik Dimetilarginin Plasma, dan Respons Vasodilatasi Arteri Brakialis antara Dewasa Muda dengan Riwayat Bayi Berat Lahir Rendah dan Normal

Purnomowati, Augustine ( Departemen Ilmu Penyakit Dalam Fakultas Kedokteran Universitas Padjadjaran-Rumah Sakit Dr. Hasan Sadikin ) , K.S. Kariadi, Sri Hartini ( Departemen Ilmu Penyakit Dalam Fakultas Kedokteran Universitas Padjadjaran-Rumah Sakit Dr. Hasan Sadikin ) , Achmad, Tri Hanggono ( Departemen Biokimia Fakultas Kedokteran Universitas Padjadjaran Rumah Sakit Dr. Hasan Sadikin Bandung ) , C. Mose, Johanes ( Departemen Obstetri dan Ginekologi ) , Setianto, Budhi ( Departemen Kardiologi dan Kedokteran Vaskular Fakultas Kedokteran Universitas Padjadjaran Rumah Sakit Dr. Hasan Sadikin Bandung )

Majalah Kedokteran Bandung Vol 44, No 1 (2012)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Adiponektin mempunyai efek antiaterogenik, antiinflamasi, sensitizer insulin, dan berperan penting dalam mengatur pertumbuhan janin. Hipoadiponektinemia dapat menyebabkan disfungsi endotel. Risiko penyakit kardiovaskular meningkat pada subjek dengan riwayat bayi berat lahir rendah (BBLR). Penelitian ini bertujuan menganalisis perbedaan kadar adiponektin, asimetrik dimetilarginin (ADMA) plasma dan respons vasodilatasi arteri brakialis melalui tes flow mediated brachial artery (FMBA) antara dewasa muda dengan riwayat BBLR dan bayi berat lahir normal (BBLN), serta korelasi kadar adiponektin dengan fungsi endotel pada BBLR. Penelitian kohor retrospektif dilakukan periode November 2009–Januari 2010 berasal dari Growth Study Cohort Tanjungsari Kabupaten Sumedang. Sebanyak 134 subjek dipilih secara simple random, terdiri atas 67 BBLR dan 67 BBLN yang karakteristik umumnya sama. Analisis multivariat melalui Hotelling’s trace menunjukkan FMBA, kadar ADMA, dan adiponektin berbeda bermakna (p<0,001) antara BBLR dan BBLN. Analisis simultaneous confidence interval menunjukkan kadar adiponektin plasma dan FMBA bermakna lebih rendah (p=0,015 dan p<0,001) pada BBLR dibandingkan dengan BBLN. Korelasi tidak bermakna antara kadar adiponektin dan ADMA (r=-0,16; p=0,176) dan FMBA (r=0,13; p=0,281) BBLR. Kecil peran adiponektin pada disfungsi endotel, mungkin variabel lain berperan, seperti tumor necrosis factor α. Simpulan, terdapat perbedaan kadar adiponektin plasma dan FMBA antara dewasa muda dengan riwayat BBLR dan BBLN, tetapi kecil peran adiponektin pada disfungsi endotel dewasa muda dengan riwayat BBLR. [MKB. 2012;44(1):1–6].Kata kunci: Adiponektin, asimetrik dimetilarginin, BBLR, tes flow mediated brachial arteryDifferences of Plasma Adiponectine, Asymmetric Dimethylarginine and Brachial Artery Vasodilatation Response in Young Adult with Low and Normal Birth Weight HistoryBeside an anti-atherosclerotic, anti-inflammation effect, and a sensitizer insulin, adiponectin also play an important role in fetal growth. Hypoadiponectinemia may lead to endothelial dysfunction. Low birth weight (LBW) has increase risk of cardiovascular disease. The aim of this study was to analyze the differences of plasma adiponectin, asymmetric dimethylarginine (ADMA) level and vasodilatation response of brachial artery by doing flow mediated brachial artery (FMBA) test between young adults with LBW and normal birth weight (NBW), and the role ofadiponectin level in endothelial function of the LBW. This was a retrospective cohort study during November 2009– January 2010, 134 subjects were randomly selected from the Growth Study Cohort of Tanjungsari Sumedang. They consisted of 67 LBW and 67 NBW young adults, with similar basic characteristics. A multivariate analysis via Hotelling’s trace showed that there was a significant difference (p<0.001) for FMBA, ADMA, and adiponectin level, but simultaneous confidence interval measurements indicated that the rate of FMBA and the level of plasma adiponectin were significantly lower (p<0.001, p=0.015, respectively) in LBW compared to NBW. The correlation between adiponectin and ADMA level (r=-0.16, p=0.176), and FMBA (r=0.13, p=0.281) in LBW were not significant, suggesting a small role of plasma adiponectin in endothelial dysfunction of young adults with LBW, other variables could play a role such as tumor necrosis factor α. In conclusions, the level of plasma adiponectin and FMBA are different between LBW and NBW, but the role of adiponectin may be small in endothelial dysfunction in young adults with LBW. [MKB. 2012;44(1):1–6].Key words: Adiponectin, asymmetric dimethylarginine, flow mediated brachial artery, LBW test DOI: http://dx.doi.org/10.15395/mkb.v44n1.72

Status Periodontal dan Kehilangan Tulang Alveolar pada Restorasi Proksimal yang Overhang

Garna, Devy Firena ( Bagian Periodonsia Fakultas Kedokteran Gigi Universitas Padjadjaran Bandung ) , Amaliya, Amaliya ( Bagian Periodonsia Fakultas Kedokteran Gigi Universitas Padjadjaran Bandung )

Majalah Kedokteran Bandung Vol 44, No 3 (2012)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Jaringan periodontal yang sehat bergantung pada penempatan restorasi yang tepat terutama di bagian proksimal, sedangkan penempatan yang berlebih (overhang) dapat berperan sebagai faktor terjadinya gingivitis dan kehilangan tulang alveolar. Tujuan penelitian untuk mengetahui relasi prevalensi status periodontal dan kehilangan tulang alveolar pada restorasi proksimal. Studi deskriptif potong lintang pada penderita yang berkunjung di Poli Gigi Puskesmas Tarogong kabupaten Garut periode bulan Maret–November 2010 dinilai status periodontal yang meliputi indeks perdarahan gusi menurut The National Institute of Dental Research, kedalaman poket menggunakan probe Williams dengan skala 0–10 mm, indeks plak Silness-Löe dan kehilangan tulang alveolar dengan analisis teknik Schei. Sampel yang didapat sebanyak 21 dari 35 restorasi proksimal overhang mengalami perdarahan gusi pada saat probing. Indeks plak Silness-Löe 8 dari 14 subjek penelitian termasuk dalam kategori buruk dan 6 dari 14 kategori sedang. Restorasi proksimal overhang dengan kedalaman poket di atas 3 mm sebanyak 24 dari 35 restorasi dengan kehilangan tulang alveolar rata-rata sebanyak 8%. Relative risk perdarahan gusi pada restorasi proksimal yang overhang 1,05 sedangkan kedalaman poket adalah 1,60. Simpulan, pada restorasi proksimal overhang didapatkan nilai indeks plak sedang hingga buruk, kedalaman poket lebih dari 3 mm, dan kehilangan tulang alveolar [MKB. 2012;44(3):133–7].Periodontal Status and Alveolar Bone Loss on Overhanging Proximal RestorationsA healthy periodontal tissue dependent on placing a proper restoration especially proximal restoration whereas to place an overhang restoration could be a risk factor for gingivitis and alveolar bone loss. The aim of the study was to find out relation prevalence periodontal status and alveolar bone loss on proximal restorations. A descriptive cross-sectional study was conducted on patients who visited Tarogong Dental Unit Public Health Centre, Garut Regency between March and November 2010 and their periodontal status including The National Institute of Dental Research. Gingiva bleeding index, probing pocket depth using Williams probe with scale 0–10 mm, Silness-Löe plaque index and Schei technic alveolar bone loss analysis were recorded. Twenty-one out of thirtyfive of overhanging proximal restorations had bleeding on probing. Based on plaque index (Silness-Löe) 8 out of 14 respondents were categorized as a poor and 6 out of 14 had moderate category of plaque index. Overhanging proximal restorations, which had pocket depth more than 3 mm, were 24 out of 35 restorations with 8% mean alveolar bone loss. Relative risk of gingival bleeding on overhanging proximal restoration was 1.05 meanwhile the relative risk of pocket depth was 1.60. In conclusions, on overhanging proximal restorations show that there are poor plaque index, bleeding gingival, probing pocket depth more than 3 mm and alveolar bone loss. [MKB. 2012;44(3):133–7]. DOI: http://dx.doi.org/10.15395/mkb.v44n3.134

Risk Factors to Growth Retardation in Major Thalassemia

Uda, Riva ( Department of Child Health, Faculty of Medicine, Universitas Padjadjaran-Hasan Sadikin Hospital ) , Idjradinata, Ponpon S. ( Department of Child Health, Faculty of Medicine, Universitas Padjadjaran-Hasan Sadikin Hospital ) , Djais, Julistio TB ( Department of Child Health, Faculty of Medicine, Universitas Padjadjaran-Hasan Sadikin Hospital )

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

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Abstract

The increasing in the life span of patients with major thalassemia should be followed by increased quality of life. There are factors which can affect growth retardation in these patients. The aim of this study was to find out the risk factors for growth retardation in patients with major thalassemia. An analytical study with cross-sectional design was conducted at Pediatric Thalassemia Clinics of Dr.Hasan Sadikin Hospital, Bandung, in June to July 2006. The subjects of this study were patients with major thalassemia. Inclusion criteria’s were age under 14 years old, had no chronic diseases like tuberculosis, cerebral palsy with complete medical records. Risk factors were the timing of diagnosis, initial and dose of deferoxamine, volume of transfused blood, mean pretransfusion hemoglobin level, family income, and age. Antropometric measurement indices were used to assess the growth which expressed in Z score. Growth evaluated based on height/age (H/A) and growth retardation if H/A <-2 SD. Risk factors for growth retardation were analyzed separately using chi-square test and odds ratio (OR) with 95% confidence interval (CI). Then they were analyzed simultaneously with logistic regression method. Subjects consisted of 152 patients with major thalassemia. Seventy three thalassemia patients were stunted. Analysis showed that age (OR: 5.42, 95% CI:2.32–12.65, p <0.001), dosage of deferoxamine (OR: 4.0, 95% CI: 1.29–12.41, p: 0.016), and family income (OR: 2.32, 95% CI: 1.06–5.06, p: 0.036) were risks factors for growth retardation. Conclusion, risk factors for growth retardation in major thalassemia are age, dosage of deferoxamine, and family income. [MKB. 2011;43(1):21–5].Key words: Major thalassemia, risk factors, stuntedFaktor Risiko terhadap Gangguan Tumbuh pada Thalassemia MayorBertambahnya harapan hidup penderita thalassemia, seyogianya diikuti dengan kualitas hidup seperti anak normal. Terdapat berbagai faktor risiko yang mempengaruhi terjadinya gangguan tumbuh pada penderita thalassemia mayor. Tujuan penelitian ini untuk mengetahui berbagai faktor risiko terjadinya gangguan tumbuh pada penderitathalassemia mayor. Penelitian ini merupakan penelitian analitik dengan rancangan cross sectional di Poliklinik Anak thalassemia Dr. Hasan Sadikin, Bandung, pada bulan Juni–Juli 2006. Subjek penelitian ini adalah penderita thalassemia mayor. Kriteria inklusi adalah penderita berusia <14 tahun, tidak mempunyai penyakit kronik seperti tuberkulosis, palsi serebral, dan rekam medis yang lengkap. Faktor risiko adalah usia saat penegakan diagnosis, usia mulai menggunakan desferoksamin, dosis desferoksamin, volume darah yang telah diterima, kadar hemoglobin rata-rata sebelum transfusi, penghasilan keluarga, dan usia penderita. Dengan antropometri akan ditentukan pertumbuhan berdasarkan skor-Z. Pertumbuhan dinilai dari indeks tinggi badan/usia dan penderita yang mengalami gangguan tumbuh bila tinggi badan/usia <-2 SD. Faktor risiko gangguan tumbuh dianalisis menggunakan uji ki kuadrat dan rasio odds (RO) dengan interval kepercayaaan (IK) 95%, selanjutnya dilakukan analisis dengan metode regresi logistik. Subjek terdiri atas 152 penderita thalassemia mayor. Terdapat 73 penderita yang mengalami gangguan tumbuh. Hasil analisis menunjukkan usia penderita (RO 5,42; IK 95%: 2,32–12,65, p <0, 001), dosis desferoksamin (RO 4,0; IK95%:1,29–12,41, p: 0,016), dan penghasilan keluarga (RO 2,32; IK 95%:1,06–5,06, p: 0,036). merupakan faktor risiko terjadinya gangguan tumbuh. Simpulan, faktor risiko terjadinya gangguan tumbuh pada thalassemia mayor adalah usia, dosis desferoksamin, dan penghasilan keluarga. [MKB. 2011;43(1):21–5].Kata kunci: Faktor risiko, gangguan tumbuh, thalassemia mayor

Efek Ekstrak Air Buah Pepaya (Carica papaya L.) Muda terhadap Gambaran Histologi Kelenjar Mamma Mencit Laktasi

Kharisma, Yuktiana ( Bagian Farmakologi Fakultas Kedokteran Universitas Islam Bandung, jalan Hariang Banga 2 Tamansari Bandung ) , Ariyoga, Armaya ( Bagian Farmakologi Fakultas Kedokteran Universitas Islam Bandung ) , Sastramihardja, Herri S. ( Program Pascasarjana Program Studi Ilmu Kedokteran Dasar Universitas Padjadjaran Bandung )

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

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Abstract

Air susu ibu (ASI) merupakan makanan terbaik bagi bayi. Menurut Survei Kesehatan Rumah Tangga tahun 2005,ASI eksklusif di perkotaan 4−12% dan pedesaan 4–5%. Penelitian ini bertujuan untuk mengetahui efek ekstrak air buah pepaya muda (Carica papaya L.) terhadap gambaran histologi kelenjar mamma laktasi. Penelitian dilakukan di laboratorium Farmakologi Klinik Unpad dan laboratorium Unit Penelitian Kesehatan RS Dr. Hasan Sadikin pada bulan Juli−September 2009. Penelitian merupakan penelitian eksperimental laboratorium terhadap 21 ekor induk mencit laktasi galur Swiss Webster, diacak menjadi 3 kelompok (n=7) dengan jumlah anak 10 ekor/induk. Kelompok I merupakan kontrol negatif. Kelompok II diberikan luteotropin 6 mg/30 g BB/hari per oral (p.o.) dan kelompok III diberikan sediaan uji 20 mg/30 g BB/hari (p.o.). Peningkatan produksi air susu diketahui melalui peningkatan jumlah dan diameter rata-rata alveoli kelenjar mamma laktasi. Perlakuan diberikan pada hari ke-4 hingga ke-16 masa menyusui. Hasil dianalisis dengan uji analysis of variance (ANOVA), dilanjutkan dengan uji Tukey. Hasil penelitian terhadap jumlah alveoli kelompok I: 310,57±30,16; kelompok II: 464,42±25,83 dan kelompok III: 465,14±72,41. Diameter alveoli kelenjar mamma laktasi kelompok I, II, dan III berturut-turut sebesar 296,50±21,27 μ; 394,57±53,97 μ; dan 384,29±40,40 μ. Simpulan bahwa ekstrak air buah pepaya muda memberikan efek lebih baik dibandingkan dengan kontrol negatif dan sebanding dengan luteotropin dalam meningkatkan jumlah dan diameter alveoli rata-rata kelenjar mamma laktasi. [MKB.2011;43(4):160–5].Kata kunci: Carica papaya L., histologi kelenjar mamma, produksi air susuEffect of Unripe Papaya (Carica papaya L.) Aqueous Extract on Histological Feature of Mice Lactating Mammary GlandsBreast milk is the best food for infants. Household Health Survey in 2005 showed exclusive breastfeeding were 4–12% in urban and 4–5% in rural areas. Objective of the study was to examine the effect of unripe papaya aqueous extract (Carica papaya L.) on lactating mammary glands histological appearance. The experiment was held on July–September 2009 at Padjadjaran University Clinical Pharmacology Laboratory and Health Research Unit of Dr. Hasan Sadikin Hospital in July–September 2009. A laboratorium experimental study conducted to 21 lactating Swiss Webster mice with 10 babies each. They were divided randomly into 3 groups (n=7). Group I was negative control. Group II: luteotropin 6 mg/30 g BW/day (per oral) and group III: unripe papaya aqueous extract 20 mg/30 g BW/day (per oral). Increased milk production was measured by average lactating mammary glands alveolar amounts and diameter count. Experiment started at 4th–16th lactation day. The result was analyzed using analysis of variance (ANOVA) followed by Tukey test. The average of alveolar amounts of group I, II and III, were 310.57±30.16, 464.42±25.83, and 465.14±72.41, respectively. The average lactating mamary glands alveolar diameter of group I: 296.50±21.27 μ, group II: 394.57±53.97 μ and group III: 384.29±40.40 μ. Research showed that unripe papaya aqueous extract has better than negative control and equivalent effect with luteotropin on lactating mammary glands histological appearance. [MKB. 2011;43(4):160–5].Key words: Carica papaya L., histological mammary glands, milk production

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