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Elly Herwana, Elly
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Journal : Universa Medicina

 1 
Comparative analysis of transport media for isolating Shigella Lesmana, Murad; Salim, Oktavianus Ch.; Herwana, Elly; Bukitwetan, Paul; Surjawidjaja, Julius E
Universa Medicina Vol 27, No 2 (2008)
Publisher : Faculty of Medicine, Trisakti University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2008.v27.51-56

Abstract

Transport media for Shigella include buffered glycerol saline (BGS), and Cary-Blair (CB). However being a liquid medium BGS may leak or spill during transport and thus may cause contamination. The other concern is the 30% concentration of glycerol in the BGS which may be inhibitory to some susceptible Shigella species. This study was conducted to determine the best and safe transport media for Shigella. Rectal swab samples were obtained from 289 dysenteric patients and transported to the laboratory in Cary-Blair (CB) transport medium, standard buffered glycerol saline (BGS), BGS with the addition of 0.5% agar (BGS-A), and BGS with the addition of 0.5% agar and reduced glycerol to 15% (BGS-M). Recovery rates between CB, BGS, BGS-A and BGS-M and their combinations were compared. The overall prevalence of Shigella recovered from any of the four tubes was 24.9% (72/289). CB and BGS-M recovered Shigella in 54 out of 289 patients (18.7%), CB and BGS-A in 50 (17.3%), and CB and BGS in 49 (17.0%), while CB, BGS, BGS-A, and BGS-M alone gave positive Shigella in 30 (10,4%), 29 (10.0%), 34 (11.8%) and 46 (15.9%), respectively. This study suggests that a minor modification to the BGS raised the recovery rate of Shigella.
Resistensi dari bakteri enterik: aspek global terhadap antimikroba Yenny, Yenny; Herwana, Elly
Universa Medicina Vol 26, No 1 (2007)
Publisher : Faculty of Medicine, Trisakti University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2007.v26.46-56

Abstract

Resistensi antimikroba dari bakteri merupakan suatu masalah kesehatan masyarakat yang sifatnya global. Masalah ini menjadi bertambah penting dalam hal pengobatan infeksi enterik. Di negara-negara berkembang resistensi terhadap obat-obat lapis pertama (first-line drugs) telah dijumpai di antara luman-kuman patogen enterik, yang disebabkan oleh penggunaan antimikroba yang semena-mena. Pada beberapa kasus, derajat resistensi memaksa digunakannya obat-obat lapis kedua dan ketiga, yang harganya lebih mahal. Situasi ini juga mengancam timbulnya resistensi terhadap golongan obat-obat antimikroba golongan ini yang pada akhirnya menyebabkan beban ekonomi yang besar dan resistensi multipel. Di banyak negara berkembang, data mengenai prevalensi resistensi antimikroba sedikit sekali ditemukan. Kurangnya fasilitas laboratorium merupakan kendala besar dalam mengembangkan surveilans yang efektif. Untuk mempertahankan jangka efektivitas suatu antimikroba, khususnya di negara berkembang, perlu dilakukan perbaikan sistem surveilans untuk memantau timbulnya resistensi antimikroba, perbaikan akses laboratorium, peraturan penggunaan antimikroba yang lebih baik, dan pendidikan masyarakat.
Prevalence of extended spectrum beta-lactamase in Klebsiella pneumoniae Herwana, Elly; Yenny, Yenny; Pudjiadi, Laurentia; Surjawidjaja, Juius E; Lesmana, Murad
Universa Medicina Vol 27, No 3 (2008)
Publisher : Faculty of Medicine, Trisakti University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2008.v27.98-105

Abstract

Increased irrational use of antibiotics promotes bacterial resistance to these drugs. Among the resistance mechanisms developed by bacteria is the production of â-lactamase which can destroy the â-lactam ring and cause resistance to the other â-lactam antibiotics, such as amoxycillin. Extended spectrum â-lactamase (ESBL), an enzyme found in bacterial plasmids, is capable of hydrolyzing third-generation cephalosporins, namely cefotaxime, ceftazidime, ceftriaxone, and the monobactams. ESBL is predominantly found in Klebsiellas spp., Escherichia coli and other bacteria of the Enterobacteriaceae family. This study was conducted to determine the prevalence of Klebsiella resistant to cephalosporins and the prevalence of those producing ESBL. A total of 65 clinical isolates of Klebsiella were tested by the disk diffusion method according to Kirby-Bauer to determine their antibiotic susceptiblity and by the double-disk synergy method to detect the presence of ESBL. The results show that 18.5% of Klebsiella isolates tested were resistant to ceftazidime and cefixime, 13.9% to ceftriaxone, and 23.1% to aztreonam. Testing for ESBL revealed that the prevalence of ESBL producers in clinical Klebsiella isolates ranged from 10.8% to 12.3%. The presence of ESBL, plus the potential for plasmid-mediated quinolone and carbapenem resistance, undoubtedly will create significant therapeutic problems in the future.
Multimicronutrient supplementation in older persons decreased zinc deficiency but not serum TNF- Herwana, Elly; Yenny, Yenny
Universa Medicina Vol 30, No 2 (2011)
Publisher : Faculty of Medicine, Trisakti University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2011.v30.102-110

Abstract

The increase in the population of older persons needs to be accompanied by increased quality of healthcare in older persons, particularly a decrease in the incidence of infections. Impaired immune responses are common in older adults, and immune senescence likely contributes to the increased incidence of infectious diseases in the older persons. The aging process decreases the immune response and many studies have been conducted to explain the role of supplementation with various micronutrients, such as vitamin C, vitamin E, â-carotene and zinc, on the immune response. The aim of the present study was to assess the influence of 6 months of multi-micronutrient (MMN) supplementation on zinc and tumor necrosis factor (TNF-á) levels in older persons. A randomized controlled trial was conducted on 78 older persons, who were divided into two groups. The treatment group received MMN supplementation containing 40 mg elemental zinc, 120 mg ascorbic acid, 6 mg â-carotene, 15 mg á-tocopherol  and 400 ìg folic acid and the control group 400 mg calcium carbonate. The study did not demonstrate that 6 months of MMN supplementation resulted in significant differences between both groups, with respect to total protein, albumin, globulin, and TNF-á levels. In contrast, MMN supplementation significantly decreased the proportion of older persons with zinc deficiency in the treatment group, in comparison with the control group. The present data suggest that in older persons with relatively good immune and protein status, improvement of the immune status by MMN supplementation may be difficult and at best limited.
The role of polyphenols in causing cardiovascular disease Yenny, Yenny; Herwana, Elly
Universa Medicina Vol 27, No 1 (2008)
Publisher : Faculty of Medicine, Trisakti University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2008.v27.29-38

Abstract

Research on flavonoids has increased since the discovery of the French Paradox, the low cardiovascular mortality rate observed in Mediterranean population in association with red wine consumption and a high saturated fat intake. Plant polyphenol (flavonoid) occurs naturally in fruits, vegetables, and beverages such as tea and wine. Epidemiologic studies suggest that higher polyphenol intake from fruits and vegetables is associated with decreased risk for cardiovascular disease. The mechanisms explaining this observation remain unclear. The vascular endothelium is a critical regulator of vascular homeostasis, and endothelial dysfunction contributes to the pathogenesis and clinical expression of coronary artery disease. Platelet aggregation is a central mechanism in the pathogenesis of acute coronary syndromes, including myocardial infarction and unstable angina. There are numerous reports suggesting that plant polyphenols improve endothelial function and inhibit platelet aggregation in humans.
Low density lipoprotein cholesterol decreases vascular cell adhesion molecule-1 in postmenopausal women Pusparini, Pusparini; Wiradharma, Danny; Herwana, Elly
Universa Medicina Vol 30, No 3 (2011)
Publisher : Faculty of Medicine, Trisakti University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2011.v30.146-154

Abstract

In premenopausal women cardiovascular disease is rarely encountered, but after menopause the prevalence of cardiovascular disease increases drastically. There are several risk factors for cardiovascular disease, known as traditional risk factors, among others body fat concentration, age, duration of menopause, body mass index (BMI), and estradiol concentration. Cardiovascular disease is considered as an inflammatory disorder, in which adhesion molecules play an important role. Vascular cell adhesion molecule-1 (VCAM-1) is one of the adhesion molecules with an important role in the atherosclerotic process. The aim of this study was to determine the relationship of risk factors affecting the expression of VCAM-1 in postmenopausal women. This study was a cross-sectional study involving 182 postmenopausal women in the age range of 47- 60 years, who were residents of Mampang Prapatan subdistrict, South Jakarta. Venous blood samples were obtained for laboratory investigations, viz. fasting blood glucose, total cholesterol, high density lipoprotein (HDL) cholesterol, low density lipoprotein (LDL) cholesterol, triglycerides, creatinine, serum glutamic oxaloacetic transamirase (SGOT), serum glutamic pyruvic transmirasi (SGPT), bilirubin, total protein, albumin, estradiol and vascular cell adhesion molecule-1 (VCAM-1).A multiple regression analysis was performed on traditional risk factors and their relationship with VCAM-1 concentration. The results showed there were five traditional risk factors influencing VCAM-1 concentration, viz. duration of menopause, BMI, estradiol concentration, HDL cholesterol, and LDL cholesterol. Among these five factors, LDL cholesterol had the greatest influence on VCAM-1 expression (beta coefficient = -0.253 and p=0.001). In conclusion, LDL cholesterol concentration decreased VCAM-1 expression in postmenopausal women.
HIGH DIETARY DAIDZEIN INTAKE LOWERS CHOLESTEROL LEVELS AMONG POST-MENOPAUSAL WOMEN Herwana, Elly; Pusparini, Pusparini; Graciela, Audria
Universa Medicina Vol 39, No 1 (2020)
Publisher : Faculty of Medicine, Trisakti University

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (571.588 KB) | DOI: 10.18051/UnivMed.2020.v39.47-54

Abstract

BackgroundMenopause is associated with changes in metabolic profile. Although hormone replacement therapy (HRT) has been shown to have beneficial effects on lipid metabolism, its adverse effects have indicated a need for alternative estrogen-based treatments. Several investigations have evaluated the effects of isoflavones on serum lipid levels in postmenopausal women, but the results were ambiguous. The objective of this study was to determine the relationship of dietary daidzein, genistein, and glycitein levels with lipid profile in postmenopausal women.MethodsA cross-sectional study was conducted involving 186 post-menopausal women. A food recall questionnaire was used to measure dietary genistein, daidzein, and glycitein levels. Serum total cholesterol (TC), low density lipoprotein (LDL) cholesterol, high density lipoprotein (HDL) cholesterol, and triacylglycerol (TAG) were measured using the enzymatic colorimetric method. Simple and multivariate linear regression were used to analyze the data.ResultsGenistein intake was significantly associated with TC (b=145.48, p=0.023) and HDL cholesterol levels (b=48.80, p=0.032). Daidzein intake was significantly associated with TC (b=-204.60, p=0.003), LDL cholesterol (b=-160.81, p=0.014) and HDL cholesterol levels (b=-67.118, p=0.032). Glycitein was not significantly associated with TC (b=232.78;p=0.133), HDL (b=43.59;p=0.428), and LDL (b=235.84;p=0.116). Dietary daidzein had a more lowering effect on TC (Beta=-2.80) and HDL cholesterol (Beta=-2.67) than had genistein on TC (Beta=2.66) and HDL cholesterol (Beta=2.03).ConclusionsHigh dietary daidzein level has a significant lowering effect on TC, LDL cholesterol and HDL cholesterol in post-menopausal women. Our study supports the advice given to the public to increase soy isoflavone intake in post-menopausal women.
Mandatory universal use of cloth mask for prevention of coronavirus disease 2019 transmission Yenny, Yenny; Herwana, Elly; Wratsangka, Raditya
Universa Medicina Vol. 40 No. 1 (2021)
Publisher : Faculty of Medicine, Universitas Trisakti

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2021.v40.57-68

Abstract

Since the outbreak in Wuhan City, China, in late December 2019, the Coronavirus Disease 2019 (COVID-19) has spread to nearly the whole world, so that it was declared a pandemic by the Word Health Organization. The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causative organism of COVID-19, is extremely infectious and can adhere to droplet nuclei of < 5 mm diameter and become airborne (aerosol). Since COVID-19 was declared a pandemic, there has been controversy on the use of cloth masks by the public, because of the still inconclusive evidence of the efficacy of cloth masks in protecting against COVID-19 transmission. Universal masking as a healthcare intervention in the community is currently made mandatory by local governments of most countries, since they follow the recent recommendation by the World Health Organization. The issuing of the WHO recommendation on the public use of masks was based on a study demonstrating that COVID-19 transmission does not occur only through droplets but also through aerosols. In addition, there was a study showing that COVID-19 transmission does not only occur from patients with clinical symptoms but also through asymptomatic and pre-symptomatic subjects, so that universal masking is of benefit in providing protection when used by healthy people and as source control to prevent cross-transmission to other people. This review article aims to discuss the mechanism of COVID-19 transmission, the evidence related to the efficacy of cloth masks, and the guidelines related to the selection and use of masks by the general population.
Co-Authors Adrianus Kosasih Alvina Alvina Danny Wiradharma, Danny Graciela, Audria Joice Viladelvia Kalumpiu, Joice Viladelvia Juius E Surjawidjaja, Juius E Julius E Surjawidjaja, Julius E Khansha, Azzahra Putri Kurniasari Kurniasari Kurniasari Kurniasari Kurniasari Kurniasari, Kurniasari Laurentia Pudjiadi, Laurentia Murad Lesmana Oktavianus Ch. Salim, Oktavianus Ch. Paul Bukitwetan, Paul Pusparini Pusparini Putra, Muhammad Iqbal Arigi Raditya Wratsangka, Raditya Sembiring, Rinawati Soesanto, Sheila Yenny YENNY YENNY