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Low CD4+ T cell counts are not risk factor for Malassezia species infection in HIV/AIDS patients Agnes Sri Siswati, Epi Panjaitan, Satiti Retno Pudjiati,
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 46, No 04 (2014)
Publisher : Universitas Gadjah Mada

Human immunodefiiency virus (HIV) infection and aquired immunodeficiency syndrome (AIDS)cause a progressive depletion of CD4+ T cell populations accompanied by progressive impairmentof cellular immunity and increasing susceptibility to opportunistic infections. Seborrheic dermatitisis one of the most common skin opportunistic infections on HIV/AIDS patients. Malasseziaspecies is bilieved as the causative of seborrheic dermatitis. The aim of the study was to evaluatelow CD4+ T cell counts as risk factor for Malassezia sp. infection in HIV/AIDS patients. This wasan observational study with cross-sectional design conducted on HIV/AIDS patients who attendedin Department of Dermatology and Venereology, Faculty of Medicine Universitas Gadjah Mada/Dr Sardjito General Hospital, Yogyakarta and met the inclusion and exclusion criteria. Culture ofMalassezia sp. was conducted in Department of Microbiology and classified as high (>100 CFU/tape) and low (<100 CFU/tape) density colonies. CD4+ T cell counts were measured in Departmentof Clinical Pathology and classified as high (>200 cells/mm3) and low (<200 cells/mm3) CD4+ Tcell counts. A total of 83 subjects with HIV/AIDS comprising 54 (65.1%) males and 29 (34.9%)females aged 20 - >60 years were involved in the study. The number of Malassezia sp. colonyon subjects with high and low CD4+ T cell counts were 31.55 Â± 26.21 and 25.2 Â± 33.89 CFU/tape, respectively. No significantly relationship between between CD4+ T cell count and Malasseziasp. colony number was observed in the study (p=0.607; 95%CI=0.04-5.19; RP=0.452). Inconclusion, low CD4+ T cell counts is not risk factor for Malassezia sp. infection in HIV/AIDSpatients.

Pure Neural Leprosy Verdy, Verdy; Budiyanto, Arief; Siswati, Agnes Sri
Berkala Ilmu Kesehatan Kulit dan Kelamin Vol 27, No 1 (2015): BIKKK APRIL 2015
Publisher : Faculty Of Medicine Airlangga University

Background: Pure neural leprosy (PNL) is an infection by Mycobacterium leprae with clinical manifestation as nerve thickening, sensory nerve impairment, with or without motoric nerve involvement, and without skin lesion. Pure neural leprosy causes progressive degeneration of nerve function. Diagnosis establishement of PNL is difficult. Purpose: To discuss about PNL especifically in aspects of the diagnosis and therapy. Reviews: Gold standard in diagnosis of PNL is histopathological examination from nerve biopsy but this procedure is still difficult for various reasons. Some investigations can be done for PNL such as cytological fine needle aspiration, Mitsuda test, serology test for antibody anti-PGL1, electroneuromyography (ENMG), and polymerase chain reaction (PCR). Pure neural leprosy classification is based on findings of abnormality in neurological, immunological, and histopathological. Pure neural leprosy therapy is based on the classification of paucibacillary or multibacillary. Conclusions: The clinical and epidemiological findings plus with the electroneuromyography alteration were finally accepted as sufficient criteria to diagnose PNL. Pure neural leprosy therapy follows WHO regiment in accordance with the paucibacillary or multibacillary classification.Key words: pure neural leprosy, Mycobacterium leprae, nerve biopsy, anti-PGL-1, electroneuromyography.

Successful Treatment of Actinomycetoma with Combination of Cotrimoxazole and Tetracycline Verdy, Verdy; Dewi, Vina Ajeng Puspa; Budiyanto, Arief; Siswati, Agnes Sri
Berkala Ilmu Kesehatan Kulit dan Kelamin Vol 27, No 1 (2015): BIKKK APRIL 2015
Publisher : Faculty Of Medicine Airlangga University

Background: Actinomycetoma is an infection of chronic granulomatous disease on the skin, subcutaneous tissue, fascia, and bone, occured after trauma because of bacteria innoculation. Clinical features seem painless nodules, abscess, fistula, and sinusÂ with granulated discharge.Gold standard treatment for actinomycetoma is cotrimoxazole. Combination therapy with other antibiotic is needed to prevent resistance and improve therapeutic efficacy. Purpose: To discuss successful treatment of actinomycetoma with combination of cotrimoxazole and tetracycline Case: A 19-years-old woman had complained ofÂ chronic post-traumatic wounds since two years ago. Dermatological examination showed multiple painless nodules, sinus, and discharge on right dorsum pedis. Histopathological examination demonstrated sinus in dermis, suppurative granulomas, and SplendoreHoeppli phenomenon in dermis layer. Case Management: Combination therapy consist of cotrimoxazole 2x960 mg, that was given for 6 months and tetracycline 4x500 mg, that was given in the first 1 month.Â No side effects and drug allergy during and/or post treatment was found. After clinical evaluation for 6 months, successful of treatmentÂ was obtained and no recurrence was found. Conclusion: The combination therapy of cotrimoxazole for 6 months and tetracycline for 1 month was proven to be effective and no recurrence was found.Key words: actinomycetoma, cotrimoxazole, tetracycline.

Uji Potensi Antibakteri Sodium Ascorbyl Phosphate terhadap Propionibacterium acnes In Vitro Sulistiyowati, Yuli; Siswati, Agnes Sri
Mutiara Medika: Jurnal Kedokteran dan Kesehatan Vol 11, No 1 (2011)
Publisher : Universitas Muhammadiyah Yogyakarta

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18196/mmjkk.v11i1.930

Akne vulgaris adalah gangguan pada unit pilosebaseus yang sering terjadi pada dewasa muda. Propionibacterium acnes adalah bakteri anaerob yang merupakan flora folikel dan berperan penting dalam patogenesis akne. Sodium Ascorbyl Phosphate (SAP) merupakan bentuk phosphate ester ascorbic acid yang mudah diserap oleh kulit, sehingga sering digunakan dalam produk kosmetik baik sebagai senyawa tunggal maupun campuran. Apabila senyawa ini terbukti mempunyai pengaruh terhadap jumlah koloni P. acnes, maka SAP dapat digunakan sebagai salah satu obat alternatif antiakne. Tujuan penelitian adalah untuk mengetahui kadar minimal SAP yang dapat menghambat pertumbuhan P. acnes invitro. Penelitian dilakukan secara eksperimental lab dengan bahan uji SAP yang dibuat dalam konsentrasi 0,5%, 1%, 1,5%, 2%, 2,5 %, 3%, 3,5%, 4%, 4,5 % kadar hambat minimal SAP terhadap P. acnes dengan metode dilusi cair. Penelitian ini dilakukan pengulangan sebanyak 3 kali. P. acnes cair di dapatkan dari Laboratorium Mikrobiologi FK UGM. Hasil penelitian menunjukkan bahwa kadar hambat minimal SAP terhadap Propionibacterium acnes adalah 2,5 % b/v. Dari penelitian ini dapat disimpulkan bahwa SAP memiliki potensi antibakteri terhadap Propionibacterium acnes.

Efek Antimikotik Minyak Mimba (Azadirachta indica) terhadap Dermatofita Estri, Siti Aminah Tri Susilo; Habib, Inayati; Suswardana, Suswardana; Siswati, Agnes Sri
Mutiara Medika: Jurnal Kedokteran dan Kesehatan Vol 6, No 2 (2006)
Publisher : Universitas Muhammadiyah Yogyakarta

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18196/mmjkk.v6i2.1889

Recently, natural substances have been much developed for antimycotic medicine, such as neem tree that can be found in Indonesia. Oilfrom the neem seed has been proved to have antimycotic effect on non-dermatophytic fungi. The aim of this research was to determine antimycotic effects of neem oil on T. mentagrophytes, E. floccusum and M. gypseum by means of dilution method.This research utilized a simple experimental method. One ml of water and 1 ml of casein yeast glucose were placed into 10 tubes. One ml of pure neem oil was introduced into tube I and the liquids were mixed. Afterwards, 1 ml of solution from tube I was added into tube II. One ml of the solution from tube II was then added into tube III, and so forth up to tube X. Subsequently, 1 ml of dermatophytic suspension (106 cell/ml) was introduced into each tube. The growth of dermatophyte colony was examined on day 5 to 7, after being incubated at room temperature.Results of this research showed that on day 5, T. mentagrophytes began to appear in tube IV (neem oil concentration of 3,12%), while E. floccusum and M. gypseum appeared in tube III (6,25%). On day 7, all colonies began to appear in tube II; therefore, the minimal inhibitory concentration was 12,5%). Neem oil started to have antimycotic effect on T. mentagrophytes, E. floccusum and M. gypseum at a concentration of 6,25%.Akhir-akhir ini banyak dikembangkan bahan alami sebagai antimikotik, antara lain pohon mimba yang banyak terdapat di Indonesia Minyak dari bij i mimba terbukti mempunyai efek antimikotik terhadap berbagai jamur non dermatofita. Tujuan penelitian ini adalah untuk mengetahui efek antimikotik minyak mimba terhadap T. mentagrophytes, E. floccusum dan M. gypseum dengan metode dilusi.Penelitian menggunakan metode eksperimental sederhana. Pada 10 tabung dimasukkan 1 ml aqua dan lml casein yeast glucose. Pada tabung I ditambahkan 1 ml minyak mimba murni dan dicampur. Pada tabung ke II ditambahkan 1 ml larutan dari tabung I, begitu seterusnya sampai tabung ke X. Selanjutnya pada masing-masing tabung ditambahkan 1 ml suspensi dermatofita 106 sel/ml. Pertumbuhan koloni dermatofita dinilai pada hari ke 5-7 setelah diinkubasi pada suhu kamar.Hasil penelitian menunjukkan bahwa pertumbuhan koloni T. mentagrophytes pada hari ke-5 mulai tampak pada tabung ke-4 (konsentrasi 3,12%), koloni E. floccusum dan M. gypseum pada tabung ke-3 (konsentrasi 6,25%). Pada hari ke-7 semua koloni mulai tampak pada tabung ke-3, sehingga kadar hambat minimal pada konsentrasi 12,5%. Efek antimikotik minyak mimba terhadap T mentagrophytes, E. floccusum dan M. gypseum mulai tampak pada konsentrasi 6,25%.

Uji Potensi Antibakteri Sodium Ascorbyl Phosphate terhadap Propionibacterium acnes In Vitro Sulistiyowati, Yuli; Siswati, Agnes Sri
Mutiara Medika: Jurnal Kedokteran dan Kesehatan Vol 11, No 1 (2011)
Publisher : Universitas Muhammadiyah Yogyakarta

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18196/mmjkk.v11i1.930

Akne vulgaris adalah gangguan pada unit pilosebaseus yang sering terjadi pada dewasa muda. Propionibacterium acnes adalah bakteri anaerob yang merupakan flora folikel dan berperan penting dalam patogenesis akne. Sodium Ascorbyl Phosphate (SAP) merupakan bentuk phosphate ester ascorbic acid yang mudah diserap oleh kulit, sehingga sering digunakan dalam produk kosmetik baik sebagai senyawa tunggal maupun campuran. Apabila senyawa ini terbukti mempunyai pengaruh terhadap jumlah koloni P. acnes, maka SAP dapat digunakan sebagai salah satu obat alternatif antiakne. Tujuan penelitian adalah untuk mengetahui kadar minimal SAP yang dapat menghambat pertumbuhan P. acnes invitro. Penelitian dilakukan secara eksperimental lab dengan bahan uji SAP yang dibuat dalam konsentrasi 0,5%, 1%, 1,5%, 2%, 2,5 %, 3%, 3,5%, 4%, 4,5 % kadar hambat minimal SAP terhadap P. acnes dengan metode dilusi cair. Penelitian ini dilakukan pengulangan sebanyak 3 kali. P. acnes cair di dapatkan dari Laboratorium Mikrobiologi FK UGM. Hasil penelitian menunjukkan bahwa kadar hambat minimal SAP terhadap Propionibacterium acnes adalah 2,5 % b/v. Dari penelitian ini dapat disimpulkan bahwa SAP memiliki potensi antibakteri terhadap Propionibacterium acnes.

Low CD4+ T cell counts are not risk factor for Malassezia species infection in HIV/AIDS patients Epi Panjaitan; Satiti Retno Pudjiati; Agnes Sri Siswati
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 46, No 04 (2014)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Human immunodefiiency virus (HIV) infection and aquired immunodeficiency syndrome (AIDS)cause a progressive depletion of CD4+ T cell populations accompanied by progressive impairmentof cellular immunity and increasing susceptibility to opportunistic infections. Seborrheic dermatitisis one of the most common skin opportunistic infections on HIV/AIDS patients. Malasseziaspecies is bilieved as the causative of seborrheic dermatitis. The aim of the study was to evaluatelow CD4+ T cell counts as risk factor for Malassezia sp. infection in HIV/AIDS patients. This wasan observational study with cross-sectional design conducted on HIV/AIDS patients who attendedin Department of Dermatology and Venereology, Faculty of Medicine Universitas Gadjah Mada/Dr Sardjito General Hospital, Yogyakarta and met the inclusion and exclusion criteria. Culture ofMalassezia sp. was conducted in Department of Microbiology and classified as high (>100 CFU/tape) and low (<100 CFU/tape) density colonies. CD4+ T cell counts were measured in Departmentof Clinical Pathology and classified as high (>200 cells/mm3) and low (<200 cells/mm3) CD4+ Tcell counts. A total of 83 subjects with HIV/AIDS comprising 54 (65.1%) males and 29 (34.9%)females aged 20 - >60 years were involved in the study. The number of Malassezia sp. colonyon subjects with high and low CD4+ T cell counts were 31.55 ± 26.21 and 25.2 ± 33.89 CFU/tape, respectively. No significantly relationship between between CD4+ T cell count and Malasseziasp. colony number was observed in the study (p=0.607; 95%CI=0.04-5.19; RP=0.452). Inconclusion, low CD4+ T cell counts is not risk factor for Malassezia sp. infection in HIV/AIDSpatients.

The efficacy of intense pulsed light and heat energy therapy compared to benzoyl peroxide gel 2.5% in the treatment of mild and moderate acne vulgaris Triasari Oktavriana; Agnes Sri Siswati; Kristiana Etnawati
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 47, No 4 (2015)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

The use of technology-based light therapies such as intense pulsed light and heat energy(IPL) provides an alternative therapy for patients with acne. However, clinical evidenceis required to evaluate the efficacy and safety of the IPL. This study aimed to evaluate theefficacy of IPL compared to benzoyl peroxide (BP) as standard therapies in patients withacne vulgaris. The study was conducted with randomized controlled trial parallel designinvolving patients with mild and moderate acne vulgaris. Acne severity was determined bythe method of Combined Acne Severity Classification (CASC). Statistical analysis usingrepeated measurement analysis of variance was conducted to assess the reduction inlesions and number of P. acnes in each group followed by independent t-test to compareof both groups. A p value <0.05 was considered significant. Sixty-two patients withmild and moderate acne vulgaris were enrolled in this study and treated with IPL (32patients) and with BP gel 2.5% (30 patients). Two patients from the IPL were droppedout. All subjects showed improvement in acne lesions. Reduction of the number ofnon-inflammatory lesions at IPL therapy group was not significantly different than theBP gel 2.5% at week 2 (p=0.705) and 4 (p=0.186). Reduction in the numberof inflammatory lesions in the IPL treatment group was not significantly different than BPgel 2.5% at week 2 (p=0.604) but significantly higher at week 4 (p=0.003). Thereduction of P. acnes colonization in the IPL group was significantly higher than BP gel2.5% group at week 2 (p=0.000) and 4 (p=0.000). In conclusion, the efficacy of IPLin the reduction of the number of inflammatory lesions and the P. acnes colonization isbetter than BP on patients with acne vulgaris.

The role of Malassezia sp, sebum level and Trans Epidermal Water Loss (TEWL) toward the dandruff severity between hijab and non hijab wearing subjects Kristiana Etnawati; Agnes Sri Siswati; Satiti Retno Pudjiati; Devi Artami Susetiati; Dwi Retno Adiwinarni; Affendi Purbananto
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 50, No 3 (2018)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Dandruff is a common symptom in adolescence, which possibly due to increasing ofMalassezia sp. colonization, sebum level as well as skin hydration. Wearing hijab ispredicted to increase the humidity and sebum level lead to increase the number ofMalassezia sp. and dandruff severity. A case-control study was conducted on 19 femalewith dandruff who wear hijab and 19 female with dandruff who do not wear hijab, agebetween 18 and 27 years old. The dandruff severity was defined clinically using ascoring system (0-100), only subjects with minimum score of 28 will be included in thisstudy. The sebum and trans epidermal water loss (TEWL) levels were measured withSebumeter and Tewameter from Courage Khazaka. The Malassezia sp. was examinedusing microscopic examination of the squama and culture in the Saboraud medium.There were no significant differences found between hijab and non-hijab groups fordandruff severity. No difference found between two groups for sebum level, Malasseziasp. number microscopically, and Malassezia sp. colonization. Only TEWL level in hijabgroup that was found to be higher than non-hijab group. Wearing hijab does not increasethe dandruff severity, sebum level and colonization number of Malassezia sp. Wearinghijab is found to increase the TEWL level.

Efek Antimikotik Minyak Mimba (Azadirachta indica) terhadap Dermatofita Siti Aminah Tri Susilo Estri; Inayati Habib; Suswardana Suswardana; Agnes Sri Siswati
Mutiara Medika: Jurnal Kedokteran dan Kesehatan Vol 6, No 2 (2006)
Publisher : Universitas Muhammadiyah Yogyakarta

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18196/mmjkk.v6i2.1889

Recently, natural substances have been much developed for antimycotic medicine, such as neem tree that can be found in Indonesia. Oilfrom the neem seed has been proved to have antimycotic effect on non-dermatophytic fungi. The aim of this research was to determine antimycotic effects of neem oil on T. mentagrophytes, E. floccusum and M. gypseum by means of dilution method.This research utilized a simple experimental method. One ml of water and 1 ml of casein yeast glucose were placed into 10 tubes. One ml of pure neem oil was introduced into tube I and the liquids were mixed. Afterwards, 1 ml of solution from tube I was added into tube II. One ml of the solution from tube II was then added into tube III, and so forth up to tube X. Subsequently, 1 ml of dermatophytic suspension (106 cell/ml) was introduced into each tube. The growth of dermatophyte colony was examined on day 5 to 7, after being incubated at room temperature.Results of this research showed that on day 5, T. mentagrophytes began to appear in tube IV (neem oil concentration of 3,12%), while E. floccusum and M. gypseum appeared in tube III (6,25%). On day 7, all colonies began to appear in tube II; therefore, the minimal inhibitory concentration was 12,5%). Neem oil started to have antimycotic effect on T. mentagrophytes, E. floccusum and M. gypseum at a concentration of 6,25%.Akhir-akhir ini banyak dikembangkan bahan alami sebagai antimikotik, antara lain pohon mimba yang banyak terdapat di Indonesia Minyak dari bij i mimba terbukti mempunyai efek antimikotik terhadap berbagai jamur non dermatofita. Tujuan penelitian ini adalah untuk mengetahui efek antimikotik minyak mimba terhadap T. mentagrophytes, E. floccusum dan M. gypseum dengan metode dilusi.Penelitian menggunakan metode eksperimental sederhana. Pada 10 tabung dimasukkan 1 ml aqua dan lml casein yeast glucose. Pada tabung I ditambahkan 1 ml minyak mimba murni dan dicampur. Pada tabung ke II ditambahkan 1 ml larutan dari tabung I, begitu seterusnya sampai tabung ke X. Selanjutnya pada masing-masing tabung ditambahkan 1 ml suspensi dermatofita 106 sel/ml. Pertumbuhan koloni dermatofita dinilai pada hari ke 5-7 setelah diinkubasi pada suhu kamar.Hasil penelitian menunjukkan bahwa pertumbuhan koloni T. mentagrophytes pada hari ke-5 mulai tampak pada tabung ke-4 (konsentrasi 3,12%), koloni E. floccusum dan M. gypseum pada tabung ke-3 (konsentrasi 6,25%). Pada hari ke-7 semua koloni mulai tampak pada tabung ke-3, sehingga kadar hambat minimal pada konsentrasi 12,5%. Efek antimikotik minyak mimba terhadap T mentagrophytes, E. floccusum dan M. gypseum mulai tampak pada konsentrasi 6,25%.

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