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MEDIA MEDIKA INDONESIANA
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Articles 134 Documents
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Tingkat Ketahanan Hidup Penderita Kanker Nasofaring pada Berbagai Modalitas Terapi Studi Kasus yang Menjalani Terapi Konvensional dan Pengobatan Komplementer Alternatif Jessica Christanti; Awal Prasetyo
MEDIA MEDIKA INDONESIANA 2012:MMI VOLUME 46 ISSUE 2 YEAR 2012
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Survival rate of patients with nasopharyngeal cancer on various modalitie: Case study of patients on conventional therapy and Indonesian complementary and alternative medicineBackground: There are no data on survival rate of patients with nasopharyngeal cancer (NPC) on complementary alternative medicine in Indonesia. The aim of this study was to analyze the survival rate of patients with nasopharyngeal cancer (NPC) on conventional (modern) and complementary and alternative medicine (CAM) treatments.Methods: A cross-sectional observational study of 33 NPC patients from each conventional (modern) treatment and CAM group was performed. The guided intervews were conducted to describe CAM treatment in NPC patients by using a validated questionnaire based CAM therapies of California Health Interview Survey 2001. Survival analysis was conducted by the Kaplan-Meir method.Results: Most patients (52.3%) used CAM treatments.Multivitamin and herbal medicines were among the commonly used CAM (52.8%). Kaplan-Meier analysis showed no significant results (p=0.444) between groups. The first and second year of survival rate was comparable between groups (66.6% vs. 54.5%; 45.5% vs 33.3%). Furthermore, the median overall survival (OS) was shown (16; 95% CI: 1.58-8.90) in CAM treatment patients and conventional (modern) treatment (12; 95% CI: 8.477-0.00). The prevalenceratio (PR) obtained in this study was 1.2 (95% CI: 0.79-1.69).Conclusion: CAM treatment on NPC patients had no effect on survival rate compared with conventional (modern) treatment.Keywords: NPC, CAM, survival rateABSTRAKLatar belakang: Saat ini, belum ada data tingkat ketahanan hidup penderita kanker nasofaring (KNF) yang menjalani pengobatan komplementer alternatif di Indonesia. Fakta menunjukkan bahwa pengobatan komplementer alternatif di Indonesia merupakan bagian aktivitas sosial budaya. Penelitian ini menganalisis tingkat ketahanan hidup penderita KNF yang memperoleh pengobatan modern konvensional disertai pengobatan komplementer dan alternatif (PKA).Metode: Penelitian cross sectional dilakukan pada 33 penderita KNF di tiap kelompok yang menjalani PKA dan kelompok yang menggunakan pengobatan modern konvensional di wilayah Semarang dan sekitarnya. Wawancara terpimpin untuk terapi PKA dengan menggunakan California Health Interview Survey 2001 yang telah divalidasi. Tingkat ketahanan hidup dianalisis dengan uji Kaplan Meier.Hasil: Sebanyak (52,3%) penderita menjalani PKA, dimana yang tersering adalah dengan multivitamin dan jamu (52,8%). Tingkat ketahanan hidup kelompok PKA di tahun pertama (66,6%) dan tahun ke-2 (45,4%). Tingkat ketahanan hidup tahun pertama dan kedua kelompok obat konvensional 54,5% dan 33,3%. Analisis Kaplan Meier menunjukkan hasil yang tidak bermakna (p=0,444). Analisis median tingkat ketahanan hidup, penderita kelompok PKA didapatkan nilai 16 (CI 95%:1,581-8,900), dan pada kelompok pengobatan modern konvensional didapatkan nilai 12 (CI 95%: 8,477-0,00). Nilai PR didapatkan 1,158 (CI 95%: 0,792-1,692).Simpulan: Penggunaan PKA dan terapi modern konvensional tidak mempengaruhi tingkat ketahanan hidup penderita KNF.
Pengaruh Asap Rokok Terhadap Histopatologi Koklea: Studi pada Tikus Putih (Rattus norvegicus) Bambang Udji Djoko Rianto
MEDIA MEDIKA INDONESIANA 2013:MMI VOLUME 47 ISSUE 1 YEAR 2013
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ABSTRACT The effect of cigarette smoke on histopathology of cochleaBackground: Clinical studies have suggested that cigarette smoking associate with hearing loss. Smoke exposure is a risk factor to endothelial disfunction and developing atherosclerosis. Cochlea is a auditory organ that is sensitive to hipoxia condition. Objective this study was to determine the effect of cigarette smoke exposure to histological cochlear integrity.Methods: This was post test only design experimental study, using twenty male rats (Rattus norvegicus) were divided into 2 groups. The control group (10 rats) was kept in room free from cigarette smoke, while the experimental group (10 rats) was exposed to tobacco smoke, two cigarette per 1 hour exposure, twice a day, every work day, for 6 months from July 2004-February 2005. The cochlea rats were examined in Patologi Anatomi Laboratory Gadjah Mada University for histopathological examination.Results: There was 1 rat died in each group, and 18 rats (9 control group and 9 experimental group) were still alive. Based on histopathological result, there were abnormality in 7 rats (77.7%) of experimental group while all of control group were normal. This difference is significant statistically with Relatif Risk (RR) was 3.5 (95% CI: 0.66-34.53). The histopathological abnormality were of congestion of capilare, vacuolar degeneration, foam cell and necrosis of hair cells.Conclusion: Tobacco smoke causes histopatological abnormality in cochlear integrity. The relatif risk (RR) of histopathological abnormality on experimental group was 3.5.Keywords: Tobacco smoke, cochlea, stria vascularis, hair cells ABSTRAKLatar belakang: Beberapa studi klinik membuktikan bahwa kebiasaan merokok berhubungan dengan penurunan pendengaran. Paparan asap rokok merupakan faktor risiko terhadap disfungsi endotel yang dapat berkembang menjadi aterosklerosis. Koklea merupakan organ pendengaran yang sensitif terhadap keadaan hipoksia. Penelitian ini membuktikan pengaruh paparan asap rokok terhadap integritas histologis koklea.Metode: Rancang penelitian eksperimental yang digunakan adalah post test only design, dengan sampel sebanyak 20 ekor tikus putih jantan (Rattus norvegicus) dibagi menjadi 2 kelompok. Kelompok kontrol (10 ekor) disimpan di dalam ruangan bebas asap rokok. Kelompok eksperimental (10 ekor) diberi pajanan asap rokok 2 batang rokok per pajanan selama 1 jam, 2 kali sehari, setiap hari kerja selama 6 bulan dari bulan Juli 2004-Februari 2005. Koklea tikus diperiksa secara histopatologi di Laboratorium Patologi Anatomi Fakulatas Kedokteran Hewan Universitas Gadjah Mada.Hasil: Dari seluruh sampel didapatkan pada masing-masing kelompok 1 sampel mati, sedangkan 18 ekor tikus yang berhasil hidup sampai akhir masa pajanan (masing-masing kelompok 9 ekor) terdapat kelainan histologi pada 7 (77,7%) ekor tikus kelompok pajanan dengan RR 3,5 (95% CI: 0,66-34,53). Perubahan histopatolgi yang terjadi berupa kongesti pembuluh darah, degenerasi vakuoler, foam cell dan nekrosis sel rambut getar.Simpulan: Asap rokok berpengaruh pada kerusakan integritas histologis koklea. Kerusakan koklea pada kelompok pajanan asap rokok lebih besar dibanding kelompok kontrol dengan risiko relatif/RR sebesar 3,5.
Hiperglikemia dan Aterosklerosis Arteri Karotis Interna pada Penderita Pasca Stroke Iskemik Agus Darmawan; Dodik Tugasworo; Tjokorda Gde Dalem Pemayun
MEDIA MEDIKA INDONESIANA 2011:MMI Volume 45 Issue 1 Year 2011
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ABSTRACTHyperglycemia and atherosclerosis of internal carotid artery in post ischemic stroke patientBackground: Atherosclerosis is the primary cause of death in stroke. Marker of atherosclerosis in carotid artery is intima media thickness (IMT) of artery walls. One of trigger atherosclerosis is hyperglycemia. The objective of the study is to investigate the association between hyperglycemia to atherosclerosis of internal carotid artery in post ischemic stroke patient.Methods: A cross sectional design study, patients post ischemic stroke admitted outpatient clinic of neurology department at Dr. Kariadi General Hospital Semarang, start at May 2010 until July 2010. Analysis of atherosclerosis using carotid duplex ultrasound, analysis of hyperglycemia with fasting blood glucose levels, two-hour postprandial glucose levels and also HbA1c levels using bloodvenous in the laboratory of clinical pathology department at Dr. Kariadi General Hospital. Descriptive statistic and logistic regression test were performed to analyze the data.Result: The mean of fasting blood glucose (FBG) levels were 113.93 (SD 42.2) mg/dL, two-hours postprandial glucose (2hPPG) levels were 182.4 (SD 76.5) mg/dL, HbA1c levels were 6.4 (SD 1.5)%. The mean of intima media thickness of internal carotid artery was 1.2 (SD 1.9) mm. No significance difference  between FBG, 2hPPG and A1c (95% CI, p>0.05) to atherosclerosis of internalcarotid artery in post ischemic stroke patient.Conclusion: There are no significant association between hyperglycemia and atherosclerosis of internal carotid artery in post ischemic stroke patient.Keywords: Hyperglycemia, atherosclerosis, post ischemic stroke ABSTRAKLatar belakang: Aterosklerosis merupakan penyebab kematian utama pada stroke. Petanda aterosklerosis di arteri karotis adalah ketebalan tunika intima media intima media thickness (IMT) di arteri tersebut. Salah satu pemicu aterosklerosis adalah hiperglikemia. Tujuan penelitian ini adalah membuktikan pengaruh hiperglikemia terhadap aterosklerosis arteri karotis interna pada penderita pasca stroke iskemik.Metode: Desain penelitian adalah cross sectional, pada penderita pasca stroke iskemik yang kontrol di Poliklinik Saraf RSUP Dr. Kariadi Semarang mulai Mei 2010 sampai Juli 2010. Analisis aterosklerosis menggunakan USG Karotis Duplex, analisis hiperglikemia dengan menganalisis kadar glukosa darah puasa, kadar glukosa darah 2 jam postprandial dan kadar HbA1c menggunakan darah vena di Laboratorium Patologi Klinik RSUP Dr. Kariadi. Data dianalisis dengan statistik deskriptif dan uji regresi logistik.Hasil: Rerata kadar glukosa darah puasa (GDP) 113,9 (SB 42,2) mg/dL, kadar glukosa darah 2 jam postprandial (GD2PP) 182,4 (SB 76,5) mg/dL dan kadar HbA1c 6,4 (SB 1,5)%. Rerata ketebalan tunika intima media arteri karotis interna 1,2 (SB 1,9) mm. Tidak ada hubungan bermakna antara GDP, GD2PP dan HbA1c (95% CI, p>0,05) terhadap aterosklerosis arteri karotis interna pada penderita pasca stroke iskemik.Simpulan: Tidak ada hubungan hiperglikemia dengan aterosklerosis arteri karotis interna pada penderita pasca stroke iskemik.
Perbedaan Pengaruh Latihan Gerak Terhadap Kekuatan Otot pada Pasien Stroke Non-Hemoragik Hemiparese Kanan Dibandingkan dengan Hemiparese Kiri Irdawati Irdawati
MEDIA MEDIKA INDONESIANA 2008:MMI Volume 43 Issue 2 Year 2008
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The different effect of exercise on the muscle strength of patients with right and left non hemorrhagic hemipareses.Background: The stroke patients experienced difficulty in walking since they have disorder on their muscle strength, balance andmovement coordination, therefore they are difficult to do daily activities. Exercise make stroke patients improvement faster, because they will influence the movement sensation in the brain. The Objective of this study to prove the difference of movement exercise effect toward muscle strength on the right hemiparese of non-haemoragic stroke patients compared to those ones of the lefthemiparese.Method: An experimental research with two group designs; pretest and posttest groups. The research uses two groups of patients. The observed groups consist of 20 patiens for the group of stroke patients of the right hemiparese of non-haemoragic and 20 other patiens for the left hemiparese. They are given movement exercise according to physiotherapy program of Dr. Moewardi Hospital Surakarta. The data analysis was conducted using descriptive statistic and variable comparative hypothesis test which wereprocessed using SPSS version 13.0.Result: On the right and left hemiparese, an average increasing of muscle strength were 18.25 and 21.70 respectively. The result from Mann-Whitney test showed that there was no significant difference on the increasing value of muscle strength among the patient of right hemiparese (p=0.828). The average increasing of muscle strength as much as 57.10% on the right hemiparese and 71.92% on the left hemiparese.Conclusion: There was no significant difference on the increasing value of muscle strength among the patient of right and left hemiparese.Keyword : Movement Exercise, Stroke, Non-Hemoragik.ABSTRAKLatar Belakang: Penderita stroke mengalami kesulitan saat berjalan karena gangguan pada kekuatan otot, keseimbangan dan koordinasi gerak, sehingga kesulitan dalam melakukan aktivitas sehari-hari. Latihan gerak mempercepat penyembuhan pasien stroke, karena akan mempengaruhi sensasi gerak di otak. Tujuan penelitian ini untuk membuktikan perbedaan pengaruh latihan gerak terhadap kekuatan otot pada pasien stroke non-hemoragik hemiparese kanan dibandingkan dengan hemiparese kiri.Metode: Jenis penelitian ini adalah penelitian eksperimental dengan rancangan two group pretest dan posttest. Penelitian ini menggunakan dua kelompok pasien. Kelompok yang yang diteliti adalah pasien stroke non-hemoragik hemiparese kanan 20 pasien dan hemiparese kiri 20 pasien, yang diberi latihan gerak sesuai program fisioterapi Rumah Sakit Dr. Moewardi Surakarta. Analisis data dilakukan dengan statistik deskriptif dan uji hipotesis komparatif variabel dengan program SPSS versi 13.0.Hasil: Pada hemiparese kanan terjadi kenaikan rerata kekuatan otot sebesar 18,25 dan pada hemiparese kiri sebesar 21,70. Hasil uji statistik Mann-Whitney menyimpulkan tidak ada perbedaan yang bermakna pada kenaikan nilai kekuatan otot antara pasien hemiparese kanan dan hemiparese kiri (p=0,828). Rerata kenaikan nilai kekuatan otot 57,10% pada pasien stroke hemiparese kanan dan 71,92% pada pasien stroke hemiparese kiri.Simpulan: Tidak terdapat perbedaan kenaikan nilai kekuatan otot antara pasien stroke hemiparese kanan dibandingkan dengan hemiparese kiri setelah diberikan latihan gerak.
Faktor Risiko Kejang Demam Berulang pada Anak Prastiya Indra Gunawan; Darto Saharso
MEDIA MEDIKA INDONESIANA 2012:MMI VOLUME 46 ISSUE 2 YEAR 2012
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Risk factors of recurrent febrile seizures in childrenBackground: Febrile seizures (FS) are the most common seizure disorder in childhood. Recurrent febrile seizures (RFS) occur in one third of children who experience a first FS. About nine percent had three or more recurrence. Little is known about predictors of recurrence. The aim of this study is to determine the incidence and the risk factors of RFS in children with FS at Dr. Soetomo Hospital Surabaya.Method: This is a cohort prospective study. Data was taken from all children with first FS aged 6 month-old to 5 year-old who were admitted at pediatric ward Dr. Soetomo Hospital from August 2009 to November 2010. They were observed for one year period to ascertain wether FS recurred. Logistic regression statistic was used to analyze those variables including sex, age, body temperature during the fever episode, family history of seizures, diagnosis at the first onset, maternal illness, abnormal delivery and recurrence ofFS.Results: Recurrent FS occured in 65% of the 100 children at one year observation, and 26% of them had further attack. Male to female ratio was 2:1. Thirty-one (77.5%) of subjects were less than 12 months-old. Body temperature ≤38.5OC (OR=5.50, 95%CI, p=0.019) and complex FS (OR 5.03, 95%CI, p=0.025) were related to increase risk of reccurence.Conclusions: The risk of RFS increased with body temperature ≤38.5OC and diagnosed as complex FS at the first FS.Keywords: Children, risk factors, recurrent febrile seizures ABSTRAKLatar belakang: Kejang demam (KD) adalah kasus kejang yang sering dialami anak-anak. KD berulang terjadi pada sepertiga anak yang mengalami KD pertama. Sekitar 9% dari penderita KD mengalami tiga atau lebih kejadian berulang. Hanya sedikit yang diketahui tentang prediktor berulangnya KD. Tujuan penelitian untuk mengetahui angka kejadian KD berulang dan menentukan faktor risiko terjadinya KD berulang pada anak yang mengalami KD di RSUD Dr. Soetomo Surabaya.Metode: Studi kohort prospektif dilakukan pada bulan Agustus 2009 sampai November 2010. Subyek diambil dari anak usia 6 bulan sampai 5 tahun yang menderita KD pertama yang MRS di RSUD Dr. Soetomo. Subyek diamati selama 1 tahun untuk menentukan apakah KD terjadi berulang. Analisis antar variabel jenis kelamin, usia, suhu badan saat terjadi demam, riwayat kejang pada keluarga, diagnosis awal, penyakit ibu, kelahiran yang tidak normal dan kejadian KD berulang, dilakukan dengan regresi logistik.Hasil: KD berulang terjadi 65% pada 100 anak yang diobservasi selama 1 tahun pertama dan 26% mengalami KD lebih dari 2 kali. Rasio laki-laki dibanding perempuan adalah 2:1. Tiga puluh satu (77,5%) anak berusia kurang dari 12 bulan. Faktor risiko suhu badan ≤38,5OC (OR=5,50, 95%CI, p=0,019) dan KD komplikata (OR 5,03, 95%CI, p=0,025) bermakna secara signifikan untuk kejadian berulangnya KD.Simpulan: Risiko KD berulang pada anak meningkat pada suhu badan ≤38,5OC dan diagnosis KD komplikata pada saat KD pertama.
Kadar Autoantibodi dan Manifestasi Klinis pada Pasien Nefritis Lupus Silent dan Nefritis Lupus Overt Kusworini Handono; Atma Gunawan; Rulli Rosandi
MEDIA MEDIKA INDONESIANA 2012:MMI VOLUME 46 ISSUE 3 YEAR 2012
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Autoantibodies level and clinical manifestation differences between patients with silent nephritis lupus and overt nephritis lupusBackground: One of the serious clinical manifestations of SLE is the occurrence of lupus nephritis (LN). The pathogenesis of LN is still unclear. Glomerular inflammation has been associated with high levels of autoantibodies. The purpose of this study was to assess the difference of ANA, anti ds-DNA, anti-Sm antibodies and the clinical manifestations between silent lupus nephritis (SLN) and overt lupus nephritis (OLN).Subject and Methods: Subjects were forty SLE patients (diagnosed according to ARA criteria of 1997). Autoantibodies ANA was assayed with IFA, anti-dsDNA and anti-Sm levels were assayed with ELISA. The diagnosis of LN was established using clinical signs, urinary sediments pattern and kidney biopsy, and then patients classified as a silent lupus nephritis (SLN) or overt lupus nephritis (ONL). Classification of NL histopathologic pattern was established according to WHO criteria. Differences in clinical manifestations, presence of ANA, anti-dsDNA and anti-Sm levels in the SLN and OLN and NL classes were analyzed by Chi squaretest and T test. Statistical significance determined when p<0.05.Results: OLN patients showed a edema, hypertension, anemia and autoantibodies more higher than in SLN patients. The mean level of anti-dsDNA was significantly higher in patients with OLN than in SLN (285.75±41.85 vs 179.01±61.81, p<0.000). Renal biopsy on 20 OLN patients showed: 6 patients with NL grade I/II, 9 patients with NL class III/IV and 5 patients with NL class V. Moreover on 11 SLN patients there were 7 patients with NL class I/II, 3 patients with NL class III/IV and 1 patient with NL class V. The NL classIII/IV NL patients showed anti-dsDNA level higher than the class V NL (p<0.05).Conclusion: OLN patients had clinical manifestations more severe than SLN patients. NL patients with class III/IV showed the presence of anti-dsDNA more frequently and with higher levels than the class V NL. Diagnosing NL based solely on clinical signs and laboratory often is inappropriate.Keywords: SLN, OLN, NL class, autoantibodies ABSTRAKLatar belakang: Salah satu manifestasi serius LES adalah terjadinya nefritis lupus (NL). Patogenesis NL hingga saat ini masih belum jelas. Terjadinya inflamasi di glumerulus telah dikaitkan dengan tingginya kadar autoantibodi. Tujuan penelitian ini mengetahui perbedaan ANA, anti ds-DNA dan anti-Sm pada pasien dengan NL tenang (silent lupus nephritis/SLN) dan NL manifes (overt lupus nephritis/OLN).Metode: Sampel penelitian adalah empat puluh penderita LES (didiagnosis berdasarkan kriteria ARA 1997). ANA diperiksa dengan metoda IFA, anti-dsDNA dan anti-Sm menggunakan metoda ELISA. Diagnosis NL didasarkan adanya tanda klinis, sedimen urin dan biopsi ginjal dan dikelompokkan sebagai silent lupus nephritis (SLN) dan overt lupus nephritis (ONL). Klasifikasi histopatologi NL ditegakkan berdasarkan kriteria WHO. Perbedaan manifestasi klinis, adanya ANA, kadar anti-dsDNA dan anti-Sm pada SLN dan OLN serta kelas NL dianalisis dengan uji Chi square dan T tes. Signifikansi statistik ditentukan bila p<0,05.Hasil: Penderita OLN menunjukkan adanya edema, hipertensi, anemia dan autoantibodi yang lebih tinggi daripada penderita SLN. Rerata kadar anti-dsDNA nyata lebih tinggi pada penderita OLN daripada SLN (285.75±179.01 vs 41,85±61,81; p<0,000). Biopsi ginjal 20 penderita OLN menunjukkan 6 penderita dengan NL kelas I/II, 9 penderita dengan NL kelas III/IV dan 5 penderita dengan NL kelas V. Pada 11 penderita SLN terdapat 7 penderita NL kelas I/II, 3 penderita dengan NL kelas III/IV dan 1 penderita NL kelas V. Penderita dengan NL kelas III/IV menunjukkan kadar anti-dsDNA yang lebih tinggi daripada NL kelas V (p<0,05).Simpulan: Penderita OLN mempunyai manifestasi klinis yang lebih berat daripada penderita SLN. Penderita NL kelas III/IV menunjukkan adanya anti-dsDNA yang lebih sering dan dengan kadar yang lebih tinggi daripada NL kelas V. Diagnosis NL hanya berdasarkan tanda klinis dan laboratoris seringkali menimbulkan kesalahan.
Pengaruh Ekstrak Lengkuas Merah (Alpinia Galanga) Dosis Bertingkat Terhadap Ekspresi Caspase 3 dan Grading Kanker Payudara Mencit C3H Vega Karlowee; Tjahjono Tjahjono; Noor Wijayahadi
MEDIA MEDIKA INDONESIANA 2010:MMI VOLUME 44 ISSUE 2 YEAR 2010
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Effect of oral administered graded doses of alpinia galanga on the caspase 3 expression and histopathological grading of breast cancer in C3H miceBackground: 1’-Acetoxychavicol Acetate (ACA), in Alpinia galanga, known to have pro apoptotic and anticancer effects. The pro apoptotic effect is by elevating caspase 8 and 9 activity. ACA causes the cycle cell stops at G0/G1 phase. The aim of this study is to prove the effect on caspase 3 and histopathological grading of breast cancer.Method: It was an laboratory experimental with post test only control group design. Four groups of C3H mice, aged 2-3 months, had breast cancer inoculation. After the tumor mass were palpabled, K received no extract, P1, P2, P3 received Alpinia galanga extract at dose levels of 225, 450, 750 mg/kgBW/day, for 2 weeks. Immunohistochemistry examination of caspase 3 expression was scored with Allred criteria and cancer grading was scored with modified Scarff-Bloom-Richardson (MSBR) criteria. All data were analyzed by Kruskal-Wallis test, with level of significant α <0.05.Result: At P1, P2, P3 there were 1, 5, 7 mice dead in each group before termination, while in K all were survived. Pro protocol analysis showed no significance difference on caspase 3 expression (p=0.137) and grading score (p=0.399) between groups. Intention to treat analysis showed significance differences on caspase 3 expression between P1 with K (p=0.033) and P3 (p=0.005), and significance difference on grading score between P3 with K (p=0.002) and P1 (p=0.004). Histopathology examination showed damages on liver and kidney, especially in P3, which might be the mice’s cause of death.Conclusion: Caspase 3 expression is the highest at dose level of 225 mg/kgBW/day. Grading score is the lowest at dose level of 750 mg/kgBW/day.ABSTRAKLatar belakang: Senyawa 1’-Acetoxychavicol Acetate (ACA) dalam Alpinia galanga memiliki efek proapoptosis dan antikanker. Efek proapoptosis melalui aktivasi caspase 8 dan 9. ACA menyebabkan terhentinya siklus sel fase G0/G1. Tujuan penelititan ini adalah membuktikan adanya efek terhadap caspase 3 dan grading kanker payudara.Metode: Jenis penelitian eksperimental dengan desain post test only control group. Mencit C3H usia 2–3 bulan dibagi 4 kelompok, diinokulasi kanker payudara. Setelah tumbuh massa tumor, kontrol (K) tidak diberi perlakuan dan P1, P2, P3 diberi ekstrak Alpinia galanga dosis 225, 450, 750 mg/kgBB/hari selama 2 minggu. Penilaian ekspresi caspase 3 berdasarkan kriteria Allred dan grading kanker berdasarkan kriteria modified Scarff-Bloom-Richardson (MSBR). Dilakukan uji beda Kruskal-Wallis dengan tingkat kemaknaan α <0,05. Hasil: Pada P1, P2, P3, didapatkan kematian mencit sebanyak 1, 5, dan 7 ekor, sedangkan K tidak ada. Dalam pro protocol analysis, tidak ada perbedaan bermakna ekspresi caspase 3 (p=0,137) maupun grading kanker (p=0,399) antar kelompok. Pada intention to treat analysis ekspresi caspase 3, ada perbedaan bermakna antara P1 dengan K (p=0,033) dan P3 (p=0,005). Pada grading kanker payudara, ada perbedaan bermakna antara P3 dengan K (p=0,002) dan P1 (p=0,004). Pada histopatologis organ, ditemukan kerusakan hati dan ginjal, terutama pada P3, yang kemungkinan mengakibatkan kematian mencit.Kesimpulan: Skor ekspresi caspase 3 kanker payudara tertinggi didapatkan pada dosis 225 mg/kgBB/hari. Skor grading kanker payudara terendah didapatkan pada dosis 750 mg/kgBB/hari.
Peran Gen Polimorfik δ Asam Amino Levulinat Dehidratase pada Intoksikasi Pb Henna Rya Sunoko
MEDIA MEDIKA INDONESIANA 2008:MMI Volume 43 Issue 1 Year 2008
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ABSTRACTThe role of δ amino levulinic acid dehydratase polymorphism gene in lead intoxication.Background: Three distinct isozymes, designated ALAD 1-1,  1-2, and 2-2 are resulted from the expression of two common alleles, designated ALAD1 and ALAD2. The existence of this polymorphism gene whose product was implicated in the pathogenesis of lead toxicity suggested the potential for a genetically determined differential susceptibility. This study was attempted to investigate the role of ALAD polymorphism gene in lead intoxication showed by children blood lead levels.Methods: The study involved 54 children with 5-10-year-old, coming from Gebang Sari, Sekaran and Moro Demak. Cross-sectional design was adopted in this research. Blood lead level was measured by atomic absorption spectrophotometer. The ALAD polymorphism in exon 4 was determined by polymerase chain reaction (PCR) with restriction fragment length polymorphism, according to the methods described by Schwartz et al. Data were not statistically analyzed due to only two samples were ALAD2.Results: Two samples were ALAD2 (1-2 isozymes) with blood lead levels (BLL) of 24.50 ppb and 91.70 ppb respectivelly. The mean of ALAD2 BLL was about 48.60 ppb higher compared to that of ALAD1BLL.Conclusion: Individuals with ALAD2genotype had blood lead levels higher than those of individuals with the ALAD1 genotype, therefore, ALAD2genotype was much more susceptible to lead .Key Words: ALAD polymorphism gene, ALAD1, ALAD2, blood lead levelABSTRAKLatar belakang: ALAD 1-1, 1-2, dan 2-2, adalah tiga isozym yang berasal dari dua macam alel yaitu ALAD1 dan ALAD2. Keberadaan gen ALAD polimorfik dengan produknya ini, dalam patogenesis toksisitas Pb telah mengimplikasikan bahwa secara genetik sangat potensial untuk menyebabkan terjadinya perbedaan suseptabilitas terhadap Pb. Penelitian ini ditujukan untuk mempelajari peran gen ALAD polimorfik pada intoksikasi Pb yang ditunjukkan oleh tingkat kadar Pb darah.Metode: Penelitian mengikutsertakan 54 anak, umur 5-10 tahun, berasal dari Gebang Sari, Sekaran dan Moro Demak. Penelitian didesain secara cross-sectional. Kadar Pb darah diukur dengan alat atomic absorption spectrophotometer. ALAD polimorfik pada exon 4 dideterminasi dengan polymerase chain reaction (PCR) dengan restriksi “fragmentlength polymorphism” sesuai dengan metoda Schwartz et al. Analisis statistik tidak dilakukan sebab hanya ada dua sampel dengan ALAD2.Hasil: Ditemukan dua sampel anak dengan ALAD2 (1-2 isozymes), kadar Pb darah masing-masing 24,50 ppb dan 91,70 ppb. Rerata kadar Pb darah dengan ALAD2 lebih tinggi sekitar 48,60 ppb dibanding rerata kadar Pb darah dengan ALAD1.Simpulan: Genotipe ALAD2 lebih suseptibel terhadap Pb.
Komposisi Tubuh dan Kesegaran Kardiovaskuler yang Diukur dengan Harvard Step Test dan 20m Shuttle Run Test pada Anak Obesitas Maria Mexitalia; MS Anam; Azusa Uemura; Taro Yamauchi
MEDIA MEDIKA INDONESIANA 2012:MMI VOLUME 46 ISSUE 1 YEAR 2012
Publisher : MEDIA MEDIKA INDONESIANA

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Body composition and cardiovascular fitness measured by Harvard step test and 20m shuttle run test in obese childrenBackground: One of the impacts of obesity are physical and cardiovascular problems. Harvard step test and 20m shuttle run test can be used to measure cardiovascular fitness. Objective of this research is to determine the association between body composition with cardiovascular fitness in obese children measured by Harvard step test (HST) and 20m shuttle run test (SRT).Method: Cross sectional study was conducted to 31 students of Bernardus Elementary School Semarang in August 2010. Body composition (body mass index/BMI and fat percentage) was measured by Tanita BC545. Cardiovascular fitness was measured by HST and 20m SRT. During the step test Polar Vantage? Heart Rate (HR) monitor was attached to the subjects. Data were analyzed with Spearman correlation.Result: The average age was 10.7 (0.68) years. Only 17 children finished level III of Harvard test. The HR recovery never met the normal limit. There was no difference of physical fitness index (PFI) level I, II, and III (p=0.130) but the HR recovery decreased significantly (p=0.020). The mean of VO2max measured by 20m SRT was 20.5 (1.2) ml/kg/min, significantly lower compared with HST 24.2 (2.27) ml/kg/min. There were negative correlation between PFI and BMI (r=-0.381; p=0.034) and VO2max and BMI(r=-0.448; p=0.012).Conclusion: There are negative correlation between body mass index and cardiovascular fitness. However there are difference result of VO2max from Harvard step test comparing with 20m shuttle run test.Keywords: Harvard step test, 20m shuttle run test, physical fitness, obesityABSTRAKLatar belakang: Salah satu dampak obesitas adalah masalah fisik dan kardiovaskuler. Harvard step test (HST) dan 20m shuttle run test (SRT) merupakan tes yang digunakan untuk mengukur tingkat kesegaran kardiovaskuler. Tujuan penelitian adalah mengetahui hubungan komposisi tubuh dengan tingkat kesegaran kardiovaskuler pada anak obesitas menggunakan HST dan 20m SRT.Metode: Penelitian belah lintang dilakukan di SD Bernardus Semarang bulan Agustus 2010. Komposisi tubuh (indeks massa tubuh/ IMT) dan persentase lemak tubuh diukur dengan Tanita BC545. Dilakukan Harvard step test dan denyut jantung selama tes direkam menggunakan Polar Vantage Heart Rate (HR) monitor, serta dilakukan 20m SRT. Data dianalisis dengan uji korelasi Spearman.Hasil: Tiga puluh satu anak obesitas berumur 10,7(0,68) tahun mengikuti penelitian ini. Hanya 17 anak yang bisa menyelesaikan tes Harvard sampai tahap III. Didapatkan rerata HR saat istirahat lebih tinggi dibanding normal. Tidak didapatkan perbedaan physical fitness index (PFI) antara tes I, II, dan III (p=0,130) tetapi didapatkan penurunan HR recovery I, II, dan III yang bermakna (p=0,020). Rerata VO2max SRT 20,5(1,2) ml/kg/menit lebih rendah secara bermakna dibandingkan HST I yaitu 24,2(2,27) ml/kg/menit. Didapatkan hubungan terbalik antara PFI dengan IMT (r=-0,381, p=0,034) dan VO2max dengan IMT (r=-0,448, p=0,012).Simpulan: Didapatkan hubungan terbalik antara indeks massa tubuh dengan kesegaran kardiovaskuler pada anak obesitas, tetapi tidak didapatkan kesesuaian VO2max berdasarkan Harvard step test dan 20m shuttle run test.
Determinan Growth Faltering (Guncangan Pertumbuhan) pada Bayi Umur 2-6 Bulan yang Lahir dengan Berat Badan Normal Dyah Umiyarni Purnamasari; Martha I Kartasurya; Apoina Kartini
MEDIA MEDIKA INDONESIANA 2009:MMI VOLUME 43 ISSUE 5 YEAR 2009
Publisher : MEDIA MEDIKA INDONESIANA

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Growth faltering determinants among 2-6 years old infants born with normal birth weightBackground: Poor growth in infants can be indicated by a decrease in WAZ score, and is started at the age of 3-6 months. Growth faltering can lead to growth failure. Therefore it is important to investigate growth faltering determinants to solve the growth problems.Methods: This case controls study was conducted at Kangkung subdistrict, Kendal district. Cases were the subjects who had growth faltering, and controls were the subjects who had normal growth. Thirty six subjects were included in each group. The determinant variables investigated were non-exclusive breastfeeding, no-colostrum feeding, formula feeding, early complementary food feeding, pacifier used, diarrhea, upper respiratory tract infections and lack of mother’s allocation time for caretaking. Analyses were conducted by bivariate and multivariate logistic regression.Results: Based on the results of bivariate logistic regression analyses, the determinants of growth faltering were: Non-exclusive breastfeeding (OR=3.30; 95%CI:1.15-9.52; PAR=0.61), formula feeding (OR=2.96; 95%CI:1.03-8.53 PAR=0.38), early complementary food feeding at ≤3 months (OR=16; 95%CI: 1.78-143.15) and upper respiratory tract infections (OR=3.35; 95%CI: 1.23-9,10; PAR=0.48). No-colostrum feeding, pacifier used, diarrhea, and lack of mother’s allocation time for caretaking were not the determinants of growth faltering. Multivariate logistic regression analyses showed that non-exclusive breastfeeding (OR=3.43; 95%CI: 1.15-10.17) and upper respiratory tract infections (OR=3.09; 95%CI: 1.09-8.73) were the main determinants of growth faltering.Conclusions: The main determinants of growth faltering among infants aged 2-6 months at Kangkung sub-district were nonexclusive breastfeeding and upper respiratory tract infections. It is recommended to promote exclusive breast-feeding and prevent upper respiratory tract infections among infants.Keywords: Growth faltering, non-exclusive breastfeeding, upper respiratory tract infections, infants, normal birth weight ABSTRAKLatar belakang: Gangguan pada pertumbuhan bayi ditunjukkan dengan penurunan skor Z menurut indeks BB/U, dan pada umumnya dimulai pada umur 2-6 bulan. Gangguan tersebut bila tidak ditangani lebih lanjut akan menjadi growth failure (kegagalan pertumbuhan). Oleh karena itu perlu diketahui faktor determinan growth faltering agar dapat dilakukan pencegahan dan penanggulangan masalah tersebut.Metode penelitian: Penelitian observasional dengan disain penelitian kasus-kontrol, yang dilakukan di Kecamatan Kangkung, Kabupaten Kendal. Subyek adalah bayi yang mengalami growth faltering, dan kontrol adalah bayi yang mengalami pertumbuhan normal. Jumlah subyek masing-masing kelompok kasus dan kontrol adalah 36 subyek. Variabel yang diamati meliputi tidak diberikannya kolostrum, pemberian ASI tidak eksklusif, susu formula, MP-ASI dini, penggunaan kempongan, kejadian diare, ISPA danalokasi waktu asuh ibu. Analisis data dilakukan dengan menggunakan regresi logistik bivariat dan multivariat.Hasil: Berdasarkan analisis regresi logistik bivariat, determinan growth faltering adalah: pemberian ASI tidak eksklusif (OR=3,30; 95%CI: 1,15-9,52; PAR=0,61), susu formula (OR=2,96; 95%CI: 1,03-8,53 PAR=0,38), MP-ASI dini umur ≤3 bulan (OR=16; 95%CI: 1,78-143,15) dan ISPA (OR=3,35; 95%CI: 1,23-9,10; PAR=0,48). Variabel tidak diberikannya kolostrum, penggunaan kempongan, kejadian diare dan alokasi waktu asuh ibu yang kurang bukan merupakan faktor determinan. Analisis regresi multivariat menunjukkan bahwa pemberian ASI tidak eksklusif (OR=3,43; 95%CI: 1,15-10,17) dan kejadian ISPA (OR=3,09; 95%CI:1,09-8,73) merupakan variabel yang paling berpengaruh terhadap kejadian growth faltering.Simpulan: Determinan growth faltering utama pada bayi umur 2-6 bulan di Kecamatan Kangkung adalah Pemberian ASI tidak eksklusif dan kejadian ISPA. Disarankan untuk melakukan penyuluhan tentang pemberian ASI eksklusif dan pencegahan terhadap ISPA pada bayi.

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