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Search results for , issue " Vol 37, No 01 (2005)" : 14 Documents clear
Diagnostic test of huffy coat smear with Gram staining at sepsis neonatorum. Christina Kastanti Nugrahani,, Christina Kastanti Nugrahani,
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 37, No 01 (2005)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

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Abstract

Background: Neonatal sepsis is known as a leading cause of neonatal morbidity and mortality. It is hard to diagnose clinically sepsis due to its nonspecific manifestations. Blood culture has been the gold standard for neonatal sepsis. Unfortunately, it takes time to get the result, it is costly, and it is not easily performed. Buffy coat smear with Gram stain in attempt to diagnose neonatal sepsis is less costly and easily performed.Objective: To know the diagnostic value of buffy coat smear with Gram staining to diagnose neonatal sepsis.Methods: This cross sectional study was carried out at the Maternal-Perinatal Installation of Dr. Sardjito Hospital, Yogyakarta, between October 131, 2003 to March 3111, 2004. The inclusion criteria was clini-cally sepsis neonates (0-28 days old). Neonates with blood disorder, congenital anomaly, or had got antibiotic previously were excluded from this study. The buffy coat smear with Gram staining was examined and than was blindly validated with blood culture.Result: There were 127 neonates enrolled in this study. Buffy coat smear with Gram stain to diagnose neonatal sepsis produced sensitivity 77% (95% Cl, 65-88), specificity 85% (95% Cl, 77-93), positive predictive value (PPV) 78% (95% Cl, 67-90), negative predictive value (NPV) 84% (95% Cl, 76-92), positive likelihood ratio 5,24 (95% Cl, 2,98-9,24), and negative likelihood ratio 0,3 (95% Cl, 0,16- 0,45).Conclusion: Buffy coat smear with Gram stain was sufficiently accurate as diagnostic test for neonatal sepsis. The diagnostic value of buffy coat is expected to be useful for clinicians to predict neonatal sepsis earlier and guide them in making decision for clinical management.Keywords: neonatal sepsis - diagnostic test - buffy coat - gram positive staining 
Retkulocyte production index in various anemia Setyawati, Setyawati
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 37, No 01 (2005)
Publisher : Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (183.743 KB)

Abstract

Background: Reticulocyte production index (IPR) is used to determine the classification of functional anemia. More specific laboratory parameters are used in managing patient. There were some inappropriate of IPR correlation with the diagnosis of anemia in clinical practice.Objectives: The study was designed to know normal hematocrit in Sardjito General Hospital, to determine IPR in various anemia and to compare with standard IPR and final diagnosis in anemia. Methods: Observational study was done in patients with anemia who whole blood examination in uderwent Clinical Pathology Laboratory on January 2001 until May 2002. Reticulocyte and hematocrit examination were performed before treatment. Patients were followed until. The diagnosis of anemia was established based on the clinical manifestations and laboratory results. Normal mean calculated hematocrit was based on age and sex. IPR was calculated based on standard hematocrit (45%) and mean normal hema-tocrit.Results: The normal mean hematocrit in male, female, children and infant were 43%, 39%, 40% and 48%, respectively. There was significant difference between the 2 formulas. The concordance of IPR determination in hipoproliferative anemia and maturation defects were 100%, in hemolytic/hemorrhagic anemia and maturation defect was 23,5%. The IPR of hypoproliferative anemia and maturation defect anemia differed significantly with haemolytic/ hemorrhagic anemia. IPR determination using factual hematpcrit show a better correlation with classification of functional than using standard hematocrit of 45%.Conclusion: IPR determination based on normal calculated hematocrit mean gave more benefit in increasing the correlation with classification of functional anemia. IPR value showed inappropriate result in hemolytic/hemorhagic anemia probably due to comorbidities.Key words: IPR - functional clasification anemial - anemia - normal calculated hematocrit
Antioxidant activity of mengkudu fruit juice (Morinda citrifolia) and the role as an inhibitor of advanced glycation and products (AGES) by glycosilation reaction Eko Suhartono, Eko Suhartono
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 37, No 01 (2005)
Publisher : Universitas Gadjah Mada

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Abstract

Background: Mengkudu is a traditional plant with active compound that has antioxidant activity. Diabetes mellitus complication has causative link with AGEs formation that involves free radical. Objective: To know antioxidant activity of mengkudu and the role to inhibit AGEs formation. Methods: This experiment used pre and post test control group design. Antioxidant activity was deter-minedby reacting the mengkudu juice with 2,4 dinitrophenylhydrazin (DNPH) and analyzed with spectro-photometer a.=390 nm. AGEs absorbancy was measured every 48 hours until 20 days with spectropho-tometer ?=340 nm. Dicarbonyl level was determined with DNPH method that was developed by Uchida and modified by Sadikin.Result: Antioxidant activity of 0.25 g/ml mengkudu juice (Morinda citrifolia) was 125.46±27.79%.Beside that, mengkudu juice can inhibit advanced glycation end products (AGEs) formation.Conclusion: Mengkudu juice can decrease AGEs formation and has antioxidant activity. Key words: antioxidant - mengkudu juice - AGEs - glycosilation 
The efficacy of artemether and primaquin versus chloroquine-primaquine on uncomplicated malaria: A study on children in Kokap, Samigaluh area, and Oirimulyo Puskesmas, Kulon Progo Margareta Yuliani, Margareta Yuliani
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 37, No 01 (2005)
Publisher : Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (147.988 KB)

Abstract

Background: Malaria is one of infectious diseases influencing mortality of newborns, infants, and delivering mothers, Chloroquine is a standard anti-malaria or fist-line antimalarial drug for treatment and chemoprophylaxis of susceptible uncomplicated malaria in Indonesia. Increased resistance toward standard medications turns out to be one of difficulties in malaria prevention, especially in endemic areas. To solve the problem, a new antimalaria drugs i.e. artemether is now under extensive studies. Objective: To know the efficacy of artemether-primaquine therapy compared to chloroquine-primaquine therapy in children with uncomplicated malaria.Methods: Sixty-three children were enrolled in this study through active case detection (ACD) and passive case detection (PCD) from April to July 2004 in Kokap, Samigaluh and Girimulyo Puskesmas, Kulon Progo; they fulfilled inclusion criteria of uncomplicated malaria, were willing to participate in 28-day study by signing informed consent form. Subjects were randomly divided into two groups of treatment. Clinical and parasitological observation were done on DO, D1, D2, D3, D7, D14, D21, D28. WHO (2003) therapeutic response criteria was used to evaluate the therapeutic efficacy. The result of academic clinical and parasitological response (ACPR) was compared to treatment failure (early treatment failure/ ETF and late treatment failure/LTF). Statistical analysis was done using Pearson X2.Results: Final results revealed that artemether-primaquine group showed ACPR and failed therapy of 30/ 32 (93.8%) and 2/32 (6.3%) respectively, while chloroquine-primaquine group 22/31 (71%) and 9/31 (92%) respectively. These results were statistically significant (p<0.05). The average rate of fever clearance time (FCT) and parasite clearance time (PCT) in artemether-primaquine group were 24.63 t 8.65 hours and 32.61 t 13.1 hours, respectively, while in chloroquine-primaquine group were 42 ± 8.65 hours and 32.61 t 18.9 hours, respectively. Nausea and abdominal pain as side effects of both therapy occurred in 18.8% and diarrhea in 6.3% of subjects, they recovered with no treatment. In chloroquine-primaquine group nausea or vomiting were found in 22.6% of subjects; in addition abdominal pain, headache, blurred vision and itching in 12.9%, 32.3%, 6.5%, and 3.2% respectively.Conclusion: Artemether-primaquine showed better therapeutic efficacy (92,8%) compared to chloro- quine-primaquine (71%) on children with uncomplicated malaria. Key words: artemether-primaquine - chloroquine-primaquine - uncomplicated malaria - therapeutic response side effects 
Incompleted gestational age as a risk factor for developmental disorder at 6 up to 36 months of age. Pramudito, Pramudito
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 37, No 01 (2005)
Publisher : Universitas Gadjah Mada

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Abstract

Background: In developed countries, survival rate of preterm baby with gestational period more than 26 weeks has increased. Most studies on developmental outcomes were conducted on preterm baby with gestational period of less than 32 weeks. On the other hand, in developing countries the mortality rate of preterm baby with gestational period of less than 32 weeks is still high.Objective: To assess whether the incompleted gestational age is a risk factor for developmental disorder at 6 up to 36 months of age.Methods: Sixty four subjects born between 2001 April 1 to 2004 January 31 in Dr. Sardjito Hospital were enrolled, consisted of 31 children with incompleted gestational age (exposed group) and 33 children with completed gestational age (unexposed group). The developmental milestone was assessed using the DenverDeve/opmenta/ Screening Test/DDST (Denver //). Age line adjusment is used for exposed grou when the subject was born 4 weeks before completed gestational age and less than 3 years old.Results: There was no statistically significant diferrence on the prevalence of developmental, disorder at 6 to 36 months of age between exposed group and unexposed group in every area i.e. for gross motor: RR (95% Cl): 0,87 (0,24-3,19); language RR (95% Cl ): 1,48 (0,30-7,23 ) and personal social RR (95% Cl): 1,10 (0,10-17,83) or developmental conclusion: RR (95% Cl): 0,75 (0,23-2,48Conclusion: On the basis of developmental screening using DDST (Denver 11) incompleted gestational age (32-36) weeks was not a risk factor for developmental disorder at 6 to 36 months of age. Key words: incompleted gestational age - development disorder - Denver Developmental Screening Test/ DDST (Denver ll).
Laboratory blood group examination of proteolysis degradation human blood Beta Ahlam Gizela, Beta Ahlam Gizela
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 37, No 01 (2005)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

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Abstract

Background: Blood group examination has many purposes and one of them is identification. In several forensic cases there is incompatibility of blood group in corpse and in other evidences usually used blood group examination is serum agglutination method. From the previous study, it was found that there was increasing osmotic fragility of red cell. For that reason, we need to know how the result of blood group tests in degradation human blood.Objective: The purpose of this study is to know blood groups of proteolysis degradation human blood.Method: This study was an experimental study. The subjects was people that have blood group A, B, AB, and 0. Blood samples were examined serially for blood grouping, when the samples were just taken, after stored in room temperature, with addition of protease enzyme (tripsin) in 20 seconds, 1 hour, 2 hours, 3 hours, and 24 hours, and without protease enzyme after 7 days. The data was analysed using chi-square statistics.Result: This study showed there was significant proportionally different(p<0.05) in blood group chang-ing of non-0 blood group to be 0 blood group after stored the blood in 3 hours with protease enzyme addition (5(16.68%)). In 24 hours, it was showed that all of non-0 blood group changed to 0 blood group (100%). Blood group examination of the blood without protease enzyme addition stored for 7 days showed that all of them were observed as 0 blood group.Conclusion: There is blood group changing by agglutination method from non-O blood group to 0 blood group in proteolysis degradation blood. Key words: blood group - proteolysis degradation - group changing
Accelerated phase of chronic mylogenous leukemia in paediatric with metabolic acidosis and poor nutritional status. A case report Riadi Wirawan, Riadi Wirawan
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 37, No 01 (2005)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

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Abstract

We reported a case of a twelve year old girl diagnosed as chronic myelogenous leukemia (CML), metabolic acidosis and poor nutrional status. The chief complaints were bulging abdomen, without abdominal pain, nausea and vomiting, accompanied by episodic pain in the lower extremities and buttocks without swelling or redness. Physical examination revealed hepatosplenomegaly, multiple lympadenopathy, body weight for age 54% of P50 and body weight for height 60% of P50; under P65. The laboratory findings were normochromic normocytic anemia, leucocytosis with shift to the left, myelocyte and neutrophil domination, thrombocytosis, hypercellular bone marrow with hyperactive granulopoiesis and megakaryocyte, erythropoiesis and NAP score decreased and the result of blood gas analysis was partially compensated metabolic acidosis with hypoxemia.Key words: Chronic myelogenous leukemia - metabolic acidosis - poor nutritional status - infection - hydroxyurea, cytosar 
Diagnostic test of huffy coat smear with Gram staining at sepsis neonatorum. Christina Kastanti Nugrahani,, Christina Kastanti Nugrahani,
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 37, No 01 (2005)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (154.805 KB)

Abstract

Background: Neonatal sepsis is known as a leading cause of neonatal morbidity and mortality. It is hard to diagnose clinically sepsis due to its nonspecific manifestations. Blood culture has been the gold standard for neonatal sepsis. Unfortunately, it takes time to get the result, it is costly, and it is not easily performed. Buffy coat smear with Gram stain in attempt to diagnose neonatal sepsis is less costly and easily performed.Objective: To know the diagnostic value of buffy coat smear with Gram staining to diagnose neonatal sepsis.Methods: This cross sectional study was carried out at the Maternal-Perinatal Installation of Dr. Sardjito Hospital, Yogyakarta, between October 131, 2003 to March 3111, 2004. The inclusion criteria was clini-cally sepsis neonates (0-28 days old). Neonates with blood disorder, congenital anomaly, or had got antibiotic previously were excluded from this study. The buffy coat smear with Gram staining was examined and than was blindly validated with blood culture.Result: There were 127 neonates enrolled in this study. Buffy coat smear with Gram stain to diagnose neonatal sepsis produced sensitivity 77% (95% Cl, 65-88), specificity 85% (95% Cl, 77-93), positive predictive value (PPV) 78% (95% Cl, 67-90), negative predictive value (NPV) 84% (95% Cl, 76-92), positive likelihood ratio 5,24 (95% Cl, 2,98-9,24), and negative likelihood ratio 0,3 (95% Cl, 0,16- 0,45).Conclusion: Buffy coat smear with Gram stain was sufficiently accurate as diagnostic test for neonatal sepsis. The diagnostic value of buffy coat is expected to be useful for clinicians to predict neonatal sepsis earlier and guide them in making decision for clinical management.Keywords: neonatal sepsis - diagnostic test - buffy coat - gram positive staining 
Retkulocyte production index in various anemia Setyawati, Setyawati
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 37, No 01 (2005)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (183.743 KB)

Abstract

Background: Reticulocyte production index (IPR) is used to determine the classification of functional anemia. More specific laboratory parameters are used in managing patient. There were some inappropriate of IPR correlation with the diagnosis of anemia in clinical practice.Objectives: The study was designed to know normal hematocrit in Sardjito General Hospital, to determine IPR in various anemia and to compare with standard IPR and final diagnosis in anemia. Methods: Observational study was done in patients with anemia who whole blood examination in uderwent Clinical Pathology Laboratory on January 2001 until May 2002. Reticulocyte and hematocrit examination were performed before treatment. Patients were followed until. The diagnosis of anemia was established based on the clinical manifestations and laboratory results. Normal mean calculated hematocrit was based on age and sex. IPR was calculated based on standard hematocrit (45%) and mean normal hema-tocrit.Results: The normal mean hematocrit in male, female, children and infant were 43%, 39%, 40% and 48%, respectively. There was significant difference between the 2 formulas. The concordance of IPR determination in hipoproliferative anemia and maturation defects were 100%, in hemolytic/hemorrhagic anemia and maturation defect was 23,5%. The IPR of hypoproliferative anemia and maturation defect anemia differed significantly with haemolytic/ hemorrhagic anemia. IPR determination using factual hematpcrit show a better correlation with classification of functional than using standard hematocrit of 45%.Conclusion: IPR determination based on normal calculated hematocrit mean gave more benefit in increasing the correlation with classification of functional anemia. IPR value showed inappropriate result in hemolytic/hemorhagic anemia probably due to comorbidities.Key words: IPR - functional clasification anemial - anemia - normal calculated hematocrit
The efficacy of artemether and primaquin versus chloroquine-primaquine on uncomplicated malaria: A study on children in Kokap, Samigaluh area, and Oirimulyo Puskesmas, Kulon Progo Margareta Yuliani, Margareta Yuliani
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 37, No 01 (2005)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (147.988 KB)

Abstract

Background: Malaria is one of infectious diseases influencing mortality of newborns, infants, and delivering mothers, Chloroquine is a standard anti-malaria or fist-line antimalarial drug for treatment and chemoprophylaxis of susceptible uncomplicated malaria in Indonesia. Increased resistance toward standard medications turns out to be one of difficulties in malaria prevention, especially in endemic areas. To solve the problem, a new antimalaria drugs i.e. artemether is now under extensive studies. Objective: To know the efficacy of artemether-primaquine therapy compared to chloroquine-primaquine therapy in children with uncomplicated malaria.Methods: Sixty-three children were enrolled in this study through active case detection (ACD) and passive case detection (PCD) from April to July 2004 in Kokap, Samigaluh and Girimulyo Puskesmas, Kulon Progo; they fulfilled inclusion criteria of uncomplicated malaria, were willing to participate in 28-day study by signing informed consent form. Subjects were randomly divided into two groups of treatment. Clinical and parasitological observation were done on DO, D1, D2, D3, D7, D14, D21, D28. WHO (2003) therapeutic response criteria was used to evaluate the therapeutic efficacy. The result of academic clinical and parasitological response (ACPR) was compared to treatment failure (early treatment failure/ ETF and late treatment failure/LTF). Statistical analysis was done using Pearson X2.Results: Final results revealed that artemether-primaquine group showed ACPR and failed therapy of 30/ 32 (93.8%) and 2/32 (6.3%) respectively, while chloroquine-primaquine group 22/31 (71%) and 9/31 (92%) respectively. These results were statistically significant (p<0.05). The average rate of fever clearance time (FCT) and parasite clearance time (PCT) in artemether-primaquine group were 24.63 t 8.65 hours and 32.61 t 13.1 hours, respectively, while in chloroquine-primaquine group were 42 ± 8.65 hours and 32.61 t 18.9 hours, respectively. Nausea and abdominal pain as side effects of both therapy occurred in 18.8% and diarrhea in 6.3% of subjects, they recovered with no treatment. In chloroquine-primaquine group nausea or vomiting were found in 22.6% of subjects; in addition abdominal pain, headache, blurred vision and itching in 12.9%, 32.3%, 6.5%, and 3.2% respectively.Conclusion: Artemether-primaquine showed better therapeutic efficacy (92,8%) compared to chloro- quine-primaquine (71%) on children with uncomplicated malaria. Key words: artemether-primaquine - chloroquine-primaquine - uncomplicated malaria - therapeutic response side effects 

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