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Pneumonitis Radiasi pada Penderita Karsinoma Payudara yang Mendapat Terapi Kemoradiasi di RSUP Dr. Kariadi Fatchoerochman Fatchoerochman; Nasirun Zulqarnain; Eko Kuntjoro
MEDIA MEDIKA INDONESIANA 2010:MMI VOLUME 44 ISSUE 1 YEAR 2010
Publisher : MEDIA MEDIKA INDONESIANA

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Radiation pneumonitis in breast cancer patients who recieved chemoradiation therapy at Dr. Kariadi hospitalBackground: The diagnosis of radiation pneumonitis relied on clinical symptoms and chest x-ray. Radiation pneumonitis will arise 6 to 12 week after external radiation therapy was completed, combination with chemotherapy will increase risk factor of radiation pneumonitis. The aim of this research is to find incidence of radiation pneumonitis among the breast cancer patient with chemoradiation therapy. Method: This study was an analitic descriptive, with subjects were patients with stage II-III breast carcinoma that have finished chemoradiation therapy at Dr. Kariadi hospital from January 1st 2007 to March 31st 2009. They were contacted by telephone or came for control. Radiation was given with dosage of 50 Gy and booster 10 Gy on chest wall. Incidence data of radiation pneumonitis was analyzed. Result: The mean age was 48.7 years. The incidence of radiation pneumonitis was 13 from 32 subjects (40.6%), with 69% was mild degree. As much as 31.3% used CAF regiment, 55.6% CAF-xeloda regiment, 20.0% CEF regiment, and xeloda + CEF-xeloda was 100%. There was no significant difference of radiation pneumonitis proportion based on age (p=0.09) and stadium (p=0.15). Most of the patients examined by chest x-ray with pulmonary symptoms, while no pulmonary symptom disapproved to be taken the chest x-ray. This caused the selection bias, thus the incidence of radiation pneumonitis tend to be high.Conclusion: There were high tendency (40.6%) of radiation pneumonitis incidence at stage II-III breast cancer patient who get chemoradiation therapy at Dr. Kariadi General Hospital, but the most degree of radiation pneumonitis is mild.ABSTRAKLatar belakang: Diagnosis pneumonitis radiasi didasarkan pada gejala klinis dan pemeriksaan x foto toraks. Pneumonitis radiasi akan timbul 6-12 minggu setelah terapi radiasi lengkap dan pemberian kemoterapi akan meningkatkan faktor risiko pneumonitis radiasi. Penelitian ini bertujuan mencari insidens pneumonitis radiasi pada penderita karsinoma payudara.Metode: Penelitian ini adalah deskriptif analitik dengan subjek penderita karsinoma payudara stadium II-III yang telah menyelesaikan terapi kemoradiasi di RSUP Dr. Kariadi pada periode 1 Januari 2007 sampai dengan 31 Maret 2009 yang bisa dihubungi lewat telepon atau datang kontrol. Radioterapi diberikan dengan dosis 50 Gy dan booster 10 Gy pada dinding dada. Data insidens pneumonitis dianalisis secara deskriptif analitik.Hasil: Rerata umur subjek 48,7 tahun. Insidens pneumonitis radiasi sebanyak 40,6%. Sebagian besar (69%) gambaran pnemonitis termasuk dalam kategori ringan. Sebanyak 31,3% menggunakan regimen CAF, 55,6% menggunakan CAF-xeloda, 20,0% menggunakan CEF. Xeloda dan CEF-xeloda masing-masing ditemukan 1 dari 1 subjek (100%). Tidak ada perbedaan bermakna proporsi kejadian pneumonitis radiasi berdasarkan kelompok umur (p=0,09) dan kelompok stadium (p=0,15). Sebagian besar pasien yang bersedia datang untuk dilakukan pemeriksaan x foto toraks PA adalah yang merasa ada kelainan pada paru-parunya, sedangkan yang merasa tidak ada kelainan pada paru-parunya tidak bersedia untuk diperiksa. Hal ini yang menyebabkan adanya selection bias pada subjek penelitian ini sehingga insiden pneumonitis radiasi cenderung tinggi.Simpulan: Insiden pneumonitis radiasi pada penderita karsinoma payudara stadium II-III yang mendapat terapi kemoradiasi di RSUD Dr. Kariadi cenderung tinggi yakni 40,6%, dengan derajat pneumonitis radiasi mild yang terbanyak.

Hipotiroidisme pada Wanita Usia Subur (WUS) di Daerah Pertanian: Penelitian di Kecamatan Kersana Kabupaten Brebes Suhartono Suhartono; Sri Djokomoeljanto; Suharyo Hadisaputro; Hertanto Wahyu Subagio; Apoina Kartini
MEDIA MEDIKA INDONESIANA 2010:MMI VOLUME 44 ISSUE 1 YEAR 2010
Publisher : MEDIA MEDIKA INDONESIANA

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Background: Hypothyroidism can cause infertility, spontaneous abortion, fetal growth-development disorders, placental abruption and prematurity. Exposure to pesticides, both of organochlorines and organophosphate, can cause hypothyroidism. The aim of the study was to examine the prevalence of hypothyroidism in WCA in agricultural areas.Methods: A cross-sectional study was conducted in two hundred and eight women of WCA who were randomly selected from four villages and TSH levels were examined. The TSH cut-off point for the diagnosis of hypothyroidism was 4.5 μIU/mL. In a sub-sample, fT4 levels, UEI and thiocyanate in urine, were also examined. Result: The mean level of TSH was 3.66 (±5.330) μIU/mL, the lowest value was 0.05, and the highest was 60 µIU/mL; the median was 2.38 μIU/mL; the mean FT 4 (n=89) was 16.207±3.0438 pmol/L; UEI median value (n=41) was 288.0 mcg/L; while the mean of urinary thiocyanate levels (n=41) was 1.468±1.25 mcg/mL. There were 47 WCA (22,6%) with hypothyroidism, 46 of which (97.9%) are sub-clinical hypothyroidism.Conclusion: The prevalence of hypothyroidism in WCA was 22.6% and almost all women had sub-clinical hypothyroidism. Pesticide exposure is suspected as a risk factor for hypothyroidism in this population.ABSTRAKLatar belakang: Hipotiroidisme merupakan keadaan, di mana kelenjar tiroid tidak dapat memproduksi hormon cukup untuk memenuhi kebutuhan tubuh. Pada WUS, hipotiroidisme dapat menyebabkan infertilitas, abortus spontan, gangguan tumbuh-kembang janin, placental abruption dan bayi lahir sebelum waktunya. Pajanan pestisida, baik dari golongan organoklorin maupun organofosfat, dapat menyebabkan hipotiroidisme. Penelitian ini bertujuan mengkaji berapa besar prevalensi hipotiroidisme pada WUS yang bertempat tinggal di daerah pertanian.Metode: Penelitian ini menggunakan desain cross-sectional. 208 WUS dipilih secara acak dari empat desa dan dilakukan pemeriksaan kadar TSH. Diagnosis hipotiroidisme ditegakkan berdasarkan kadar TSH 4,5 µIU/mL. Pada sebagian WUS (sub-sampel) dilakukan pemeriksaan kadar fT4, UEI dan kandungan tiosianat dalam urin. Hasil: Rerata kadar TSH adalah 3,66 (±5,330) µIU/mL, nilai terendah 0,05, nilai tertinggi 60 µIU/mL sedangkan median TSH 2,38 µIU/mL; rerata fT 4 (n=89) adalah 16,207±3,0438 pmol/L; nilai median UEI (n=41) adalah 288,0 µg/L; rerata kadar tiosianat urin (n=41) adalah 1,25±1,468 µg/mL. Didapatkan 47 WUS (22,6%) dengan hipotiroidisme, 46 di antaranya (97,9%) adalah hipotiroidisme sub-klinik.Simpulan: Prevalensi hipotiroidisme pada WUS sebesar 22,6%, hampir semuanya hipotiroidisme sub-klinik. Pajanan pestisida patut dicurigai sebagai faktor risiko pada WUS di daerah pertanian yang diteliti ini.

Kadar IFN-γ (fungsi TH-1 CD4+) dan IL-4 (Fungsi TH-2 CD4+) pada Penderita Artritis Lepra Suyanto Hadi; Triyuliati Triyuliati
MEDIA MEDIKA INDONESIANA 2010:MMI VOLUME 44 ISSUE 1 YEAR 2010
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The correlation between IFN-γ (TH-1 CD4+ function) and IL-4 level (TH-2 CD4+ function) in leprosy arthritisBackground: It was hypothesized by some expertise that there is a negative correlation between TH-1 CD4+ function (IFN- level) and TH-2 CD4+ function (IL-4 level) in rheumatoid arthritis and lupus pathogenesis (Leader). The correlation between IFN-γ level and IL-4 level in the leprosy arthritis has never been reported. The objective of the study is to evaluate the correlate between IFN- and IL-4 level in leprosy arthritis. Method: The correlation between IFN- level (pg/ml) and IL-4 level (pg/ml) were analysed after stimulated with several M. leprae Ag. (10 kDa, 35 kDa, and MLSA 2 ug/ml) on the peripheral blood lymphocyte culture of leprosy arthritis patients (n=22) (RPMI 1640 sigma). The study was carried out at Hayati Laboratory Gajah Mada University. The Spearman correlation test was used in analysis.Result: There were no significant correlations between IFN- and IL-4 level given 3 different numbers of M. leprae with r1=-0.32, r2=0.262, and r3=0.324 with p1=0.888, p2=0.238, and p3=0.747 respectively of Spearman test on arthritis leprosy group. Conclusion: There is no correlation between IFN- and IL-4 level in leprosy arthritis patients.ABSTRAKLatar belakang: Dihipotesiskan oleh para ahli adanya korelasi negatif antara fungsi limfosit TH1CD4+ (kadar IFN- pg/ml) dan limfosit TH-2 CD4+ (kadar IL-4 pg/ml) pada artritis reumatoid dan lupus eritematosus sistemik (Leader). Korelasi kadar IFN-γ (pg/ml) dan kadar IL-4 (pg/ml) pada artritis lepra belum pernah dilaporkan. Penelitian ini bertujuan untuk mengevaluasi korelasi antara kadar IFN- dan IL-4 pada penderita artritis lepra.Metode: Metode penelitian yang dipergunakan adalah belah lintang. Dilakukan analisis hubungan kadar IFN- (pg/ml) dan IL-4 (pg/ml) pada kultur limfosit darah perifer (RPMI 1640 sigma) penderita artritis lepra pasca stimulasi beberapa Ag M. leprae (10 kDa, 35 kDa, dan MLSA 2 ug/ml). Kultur limfosit darah dilakukan di Laboratorium Hayati FK UGM Yogyakarta. Dilakukan uji korelasi dengan Spearman. Hasil: Tidak terdapat korelasi antara kadar IFN- (pg/ml) dengan kadar IL-4 (pg/ml) setelah distimulasi dengan dosis berbeda, dengan nilai r1=-0,32, r2=0,262, dan r3=0,324 berturut-turut disertai nilai p1=0,888, p2=0,238, dan p3=0,747 dengan uji korelasi Spearman. Simpulan: Tidak terdapat korelasi antara kadar IFN-γ dengan IL-4 pada kultur limfosit darah perifer penderita artritis lepra

Efek Pemberian Ekstrak Eurycoma Longifolia dan Pimpinella Alpina pada Spermatogenesis Tikus Spraque Dawly Achmad Zulfa Juniarto
MEDIA MEDIKA INDONESIANA 2010:MMI VOLUME 44 ISSUE 1 YEAR 2010
Publisher : MEDIA MEDIKA INDONESIANA

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The effect of eurycoma longifolia and pimpinella alpina on spermatogenesis in male Spraque Dawly Background: Alternative medicine used to overcome infertility among others is using traditional herbs. Crops which often used are pasak bumi (Eurycoma longifolia) and purwaceng (Pimpinella alpina). Several studies reported that pasak bumi and purwaceng could improve testosterone, luteinizing hormone and follicle stimulating hormone level in animal. The aim of the study was to analyze whether the extract of Eurycoma longifolia and Pimpinella alpina had effect on motility and spermatogenesis in white male Spraque Dawly mouse.Material and Method: Thirty white male mice, aged 40 days, with mean body weight of 200 grams were divided into 10 groups randomly. Each mouse was placed into individual cage and was given 25 mg Pimpinella alpina, 25 mg Eurycoma longifolia Jack and plain water in control group. Food was given ad libitum. All the treatment was given every morning for 53 days successively then the testis and epididymis were taken for analysis. Result: Administration of Eurycoma longifolia and Pimpinella alpina increased the number and motility of sperms as well as the spermatogenesis. However, there was no difference between the effect of Eurycoma longifolia and Pimpinella alpine.Conclusion: Extract of Eurycoma longifolia and Pimpinella alpina can improve spermatogenesis.ABSTRAKLatar belakang: Pengobatan alternatif untuk mengatasi infertilitas antara lain adalah dengan menggunakan pasak bumi (Eurycoma longifolia Jack) dan purwaceng (Pimpinella alpina). Pada beberapa penelitian keduanya terbukti meningkatkan kadar hormon testosteron, luteinizing hormone dan follicle stimulating hormone. Tujuan dari penelitian ini adalah untuk mempelajari apakah pemberian ekstrak pasak bumi dan purwaceng berpengaruh terhadap peningkatan derajat spermatogenesis serta jumlah dan motilitas sperma pada tikus putih jantan Spraque Dawly.Metode: Tiga puluh ekor tikus putih jantan, umur 40 hari dengan berat badan rata-rata 200 gram dibagi menjadi 10 kelompok secara acak. Tiap-tiap kelompok terdiri dari 3 ekor tikus. Setiap tikus ditempatkan dalam kandang individual. Makanan yang diberikan secara ad libitum. Masing-masing kelompok diberi perlakuan ekstrak akar pasak bumi sebanyak 25 mg, purwaceng sebanyak 25 mg dan akuades sebagai kontrol. Semua perlakuan tersebut diberikan tiap pagi selama 53 hari berturut-turut, kemudian diperiksa testis untuk derajat spermatogenesisnya dan epididimisnya. Untuk pemeriksaan jumlah dan motilitasnyaHasil: Pemberian ekstrak pasak bumi maupun purwaceng meningkatkan jumlah, motilitas spermatozoa serta derajat spermato-genesis tikus bila dibandingkan dengan kontrol (p<0,01). Efek pemberian pasak bumi tidak berbeda dengan pemberian purwaceng (p>0,01).Simpulan: Ekstrak Eurycoma longifolia dan Pimpinella alpine meningkatkan derajat spermatogenesis.

Berbagai Konsentrasi Ekstrak Daun Serai Wangi dan Daun Mimba Terhadap Kematian Larva Aedes aegypti Margo Utomo; Umi Budiarti
MEDIA MEDIKA INDONESIANA 2010:MMI VOLUME 44 ISSUE 1 YEAR 2010
Publisher : MEDIA MEDIKA INDONESIANA

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Several concentration of serai wangi leaf extract (Cymbopongan nardus L) and mimba (Azadiracta indica a juss L) and the death of Aedes aegypti larvaeBackground: Infection diseases spread through Aedes aegypti is still high in Indonesia. Herbal larvacide was essentially developed to kill Aedes aegypti larva. Serai wangit leaf extract contains aldehid, geroniol and citronelol. Mimba leaf extract contains azadirachitin. The aim of the study is to analyze the influenced several concentration of extract to kill the larvae.Method: A randomized post test only control group design was done, on 900 tails, 25 per tube of Aedes aegypti B2P2VRP Salatiga isolated, which was taken by random sampling. Extract of serai wangi and mimba leaf with any concentration, were taken from Balai Penelitian Tanaman Obat (BPTO) Tawangmangu. Result: One hundred percent larvae died in serai wangi extract at 60% level concentration with LC50 in 25.82% concentration and LC90 in 39.52% while for mimba extract 100% larvae died in 80% concentration with LC50 in 37.20% concentration and LC90 in 55.27%. There was significant difference in the death of Aedes aegypti larvae in various concentrations. Conclusion: Serai fragrant extract has better killing effect than mimba extract.ABSTRAKLatar belakang: Penyakit yang ditularkan lewat Aedes aegypti masih cukup tinggi di Indonesia. Larvasida alami sangat penting dikembangkan untuk membunuh larva Aedes aegypti. Ekstrak daun serai wangi mengandung aldehid, geroniol dan sitronelol. Ekstrak daun mimba mengandung azadirachitin. Tujuan penelitian ini adalah untuk mengetahui pengaruh berbagai konsentrasi ekstrak serai wangi (Cymbopongan nardus L) dan mimba (Azadiracta indica A juss L) terhadap kematian larva Aedes aegypti. Metode: Desain penelitian adalah randomized post test only control group menggunakan 900 ekor larva isolat laboratorium B2P2VRP Salatiga, dibagi tiap tabung 25 ekor, dengan acak sederhana, dengan kontrol dan 3 kali ulangan. Ekstrak daun serai wangi dan daun mimba dari Balai Penelitian Tanaman Obat Tawangmangu.Hasil: Kematian larva 100% terjadi pada konsentrasi ekstrak serai wangi 60%, LC50 pada konsentrasi 25,82% dan LC90 pada konsentrasi 39,52%. Kematian larva 100% terjadi pada konsentrasi ekstrak daun mimba 80%, LC50 pada konsentrasi 37,20% dan LC90 pada konsentrasi 55,27%.Simpulan: Ekstrak daun serai wangi lebih baik daya bunuhnya daripada ekstrak daun mimba.

Pain Stimulated by Electric Foot Shock to Liver and Spleen Microscopic Immunological Response Features (BALB/c Mice Experimental Study) Dwi Pudjonarko; M Naharuddin Jenie; Udadi Sadhana
MEDIA MEDIKA INDONESIANA 2010:MMI VOLUME 44 ISSUE 1 YEAR 2010
Publisher : MEDIA MEDIKA INDONESIANA

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Background: Pain affects immune system by decreasing type I-immune response that might be seen on microscopic features of liver and spleen. The objective of the study is to prove the effect of pain to immune response that confirmed by liver microabscess formation, hepatocytes destruction and spleen multinucleated giant cells of Balb/c mice suffered from pain.Method: This study adapts Laboratory Experimental and Post-Test Only Control Group Design. The samples were 12 female BALB/c mice (average weight 21.88 (SD=1.75) grams and divided into two groups. The control group (C) received no other additional treatment. The Pain (P) group received pain stimulated by Electric Foot Shock (EFS) 1-3 mA at day 12th to 21st. All groups were intravenously injected with 104 live L. monocytogenes at day 21st and sacrificed at day 26th by chloroform anaesthesia. Then, liver microabscess formation, hepatocytes destruction and spleen multinucleated giant cells were counted. Data were analyzed by independent t-test (significant if p<0.05).Result: There were significant differences in the liver microabscess formation, hepatocytes destruction and spleen multinucleated giant cells (p<0.05) between the groups. The number of liver microabscess formation and hepatocytes destruction in the P group were higher than C group. The number of spleen multinucleated giant cells in the P group were lower than C group. Conclusion: Pain has an immunosuppressive effect not only on high liver microabscess formation and hepatocytes destruction, but also low spleen multinucleated giant cells.ABSTRAKPengaruh nyeri yang distimulasi electric foot shock terhadap gambaran mikroskopis respon imunologis di hepar dan lien. (Studi eksperimental pada mencit Balb/c).Latar belakang: Nyeri dapat mempengaruhi imunitas tubuh dengan menurunkan produksi sitokin tipe 1 yang kemungkinan akan mempengaruhi gambaran mikroskopis respon imunologis baik di hepar maupun lien. Penelitian ini bertujuan untuk membuktikan penurunan imunitas seluler yang dilihat dari mikroabses dan kerusakan hepatosit pada hepar serta sel datia lien mencit BALB/c yang mendapatkan stimulasi nyeri dengan electric foot shock (EFS).Metode: Penelitian ini merupakan penelitian eksperimental laboratorik, dengan pendekatan the post test–only control group design yang menggunakan 12 ekor mencit betina strain BALB/c, umur 6-8 minggu dan rerata barat badan 21,88 (SD=1,75) gram. Sampel dibagi dalam 2 kelompok dan mendapatkan makanan standar. Pada kelompok Kontrol (K), mencit tidak mendapatkan perlakuan, sedangkan kelompok Nyeri (N), mencit mendapat sensasi nyeri menggunakan EFS mulai hari ke-12 sampai 21. Pada hari ke-21, semua mencit disuntik 104 listeria monocytogenes hidup iv. Dilakukan terminasi mencit pada hari ke-26 untuk dilakukan penghitungan mikroabses dan kerusakan hepatosit pada hepar serta sel datia lien. Dilakukan uji beda antar kelompok perlakuan dengan independent t-test. Perbedaan dinyatakan bermakna bila didapatkan nilai p<0,05.Hasil: Terdapat perbedaan yang bermakna pada jumlah mikroabses dan kerusakan hepatosit pada hepar serta sel datia lien pada mencit yang distimulasi nyeri dengan EFS dibandingkan kontrol (p<0,05). Stimulasi nyeri dengan EFS menyebabkan mikroabses dan kerusakan hepatosit pada hepar lebih tinggi terhadap kontrol, sedangkan sel datia pada lien jumlahnya lebih rendah bila dibandingkan kontrol

Hipertensi pada Obesitas Masa Anak Mexitalia Mexitalia; M Herumuryawan; M Sakundarno; Hertanto Wahyu Subagio; Agustinus Soemantri
MEDIA MEDIKA INDONESIANA 2010:MMI VOLUME 44 ISSUE 1 YEAR 2010
Publisher : MEDIA MEDIKA INDONESIANA

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Background: The prevalence of obesity in children increased rapidly in recent years. One of the comorbidity of obesity is the premature onset of cardiovascular risk factors such as hypertension. The objective of the study is to describe the relationship between obesity and the elevated of blood pressure in children.Method: The population for this cross-sectional study was students in one of the junior high school in Semarang with the mean age of 13.5 years. The anthropometric and blood pressure data were taken in 2006. BMI was measured with bioelectrical impedance analysis (BIA) Omron Karada Scan and classified based on International Obesity Task Force according to CDC 2000 graphs. The blood pressure was measured by using Omron Digital type SEM-1 and classified based on national high blood pressure education program (NHBPEP). Anova, Spearman correlation and chi-square test were performed to analyze the data.Result: Of 1.129 students (50.7% boys and 49.3% girls), 185 (16.4%) were overweight and 160 (14.2%) were obese. Hypertension was detected in 304 students (26.9%). There were significant correlation between systolic blood pressure with BMI (r=0.466) and diastolic blood pressure with BMI (r=0.337). The risk to hypertension in overweight was 2.8 times greater (OR=2.79; 95% CI 1.97-3.96 p<0.001) and in obesity was 6.6 times greater (OR=6.61; 95% CI 4.59-9.52 p0.001) than normoweight children. Chinese race has 1.4 times greater risk to have hypertension than native Indonesian children.Conclusion: Overweight and obeis children have greater risk for hypertension than normal children. AbstrakLatar belakang: Prevalensi obesitas pada anak meningkat pesat dalam beberapa tahun terakhir. Salah satu komorbiditas obesitas yang terjadi sejak dini adalah penyakit kardiovaskuler seperti hipertensi. Tujuan dari penelitian ini adalah mengetahui hubungan antara obesitas dengan peningkatan tekanan darah pada anak.Metode: Desain penelitian adalah belah lintang dengan populasi adalah siswa sebuah SLTP di kota Semarang dengan rerata umur 13,5 tahun. Pengambilan data antropometri dan tekanan darah dilakukan tahun 2006. Indeks massa tubuh (IMT) diukur Bioelectrical Impedance Analysis (BIA) Omron Karada Scan dan status gizi ditetapkan berdasarkan kriteria International Obesity Task Force dengan memakai grafik CDC 2000. Tekanan darah diukur dengan Omron Digital type SEM-1 dan ditetapkan berdasarkan klasifikasi National High Blood Pressure Education Program (NHBPEP), dinyatakan hipertensi bila tekanan darah >persentil ke-90. Data dianalisis dengan Anova, Spearman correlation dan chi-square. Hasil: Dari 1.129 siswa (50,7% laki-laki dan 49,3% perempuan), 185 (16.4% adalah gizi lebih dan 160 (14,2%) obesitas. Didapatkan 304 siswa (26,9%) dengan hipertensi. Terdapat korelasi signifikan antar IMT dengan tekanan darah sistolik (r=0,466) dan tekanan darah diastolik (r=0,337). Risiko untuk terjadi hipertensi meningkat 2,8 kali (OR=2,79; 95% CI 1,97-3,96 p<0,001) pada anak dengan gizi lebih dan 6,6 kali (OR=6,61; 95% CI 4,59-9,52 p0,001) pada anak dengan obesitas. Ras Tionghoa mempunyai risiko 1,4 kali lebih tinggi untuk terjadi hipertensi dibandingkan pribumi.

Derajat Sindroma Distres Respirasi pada Foto Thorax dan Derajat Asfiksia pada Neonatus Prematur Farah Hendara Ningrum; Hermina Sukmaningtyas; Mardiana Wahyuni
MEDIA MEDIKA INDONESIANA 2010:MMI VOLUME 44 ISSUE 1 YEAR 2010
Publisher : MEDIA MEDIKA INDONESIANA

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The degrees of respiratory distress syndrome from thorax X-ray and degrees of asphyxia in preterm neonatesBackground: Respiration Distress Syndrome (RDS) is a complication of prematurity lung disorder and common causes of premature neonatal morbidity. Clinically RDS provides signs of asphyxia that can be assessed with APGAR score. Chest X-ray can also diagnose and determine the degree of RDS radiologically. This study aims to find the relationship degree of RDS clinically with radiologically.Methods: Analytic observational study with cross-sectional design. The subjects were premature neonates with asphyxia in Kariadi General Hospital Semarang who had APGAR score and RDS on the standard Chest x-ray examination and selected using consecutive sampling method. The relationship between the RDS clinical degree based on APGAR score with radiological degrees tested with the Chi square test (X2) and Kendall tau-b. There were four grading for RDS. Chest x-ray images were interpretated by 2 expert radiologists independently and then Kappa value was evaluated.Results: There were 23 RDS cases consisted 12 severe, 8 moderate and 3 mild asphyxia cases. Radiologically showed grade I (9), grade II (5), grade III (5) and grade IV (4) neonates. Kappa value=1 (p<0.001). Chi square test (X2) showed clinical asphyxia degree was not significantly different with the degree of RDS on chest x-ray. Kendall tau-b correlation test showed a significant and moderate degree correlation (r=0.5; p=0.01).Conclusions: The degree of asphyxia in premature infants are in line with radiological images.ABSTRAKLatar belakang: Sindroma distres respirasi (SDR) yang bermanifestasi dalam bentuk asfiksia merupakan kelainan paru komplikasi prematuritas penyebab tersering morbiditas neonatus prematur. X-foto thorax membantu diagnosis SDR sekaligus menentukan derajat SDR. Penelitian ini bertujuan menilai hubungan derajat klinis SDR dengan derajat radiologi.Metode: Studi observasional analitik dengan rancangan cross-sectional. Subjek penelitian adalah neonatus prematur dengan asfiksia di RSUP Dr. Kariadi Semarang yang mempunyai skor APGAR serta mendapatkan pemeriksaan X-foto thoraks standar. Pemilihan subjek menggunakan metode consecutive sampling. Terdapat empat derajat SDR secara radiologis Hubungan antara derajat klinis SDR berdasarkan skor APGAR dengan derajat radiologis diuji dengan Chi square(X2) dan derajat korelasi dengan uji Kendall tau-b. Hasil X-foto thorax diinterpretasi terpisah oleh 2 ahli radiologi dan diuji Kappa. Hasil: Dijumpai 23 asfiksia neonatus prematur dengan SDR terdiri dari 12 kasus asfiksia berat, 8 kasus asfiksia sedang dan 3 kasus asfiksia ringan. Secara radiologis ditemukan SDR derajat I sebanyak 9, 5 derajat II, 5 derajat III dan derajat IV pada 4 neonatus. Nilai Kappa=1 (p<0,001). Derajat asfiksia secara klinis tidak berbeda bermakna dengan derajat radiologi SDR (Chi square(X2) p=0,007). Uji korelasi Kendall tau-b menunjukkan korelasi bermakna tingkat sedang (r=0,5; p=0,01) antara derajat asfiksia secara klinis dengan derajat radiologi SDR. Simpulan: Derajat asfiksia pada bayi prematur sejalan dengan derajat radiologik foto thorax pada SDR.

Suplementasi Seng dan Probiotik pada Diare Akut Cair Anak Fenty Karuniawati; Budi Santosa; Endang Purwaningsih; Bambang Hariyana
MEDIA MEDIKA INDONESIANA 2010:MMI VOLUME 44 ISSUE 1 YEAR 2010
Publisher : MEDIA MEDIKA INDONESIANA

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Backgrounds: Clinical trials have demonstrated that zinc supplement during diarrhea episodes reduces the duration and severity of illness. Studies have shown that probiotic may be useful in treating acute diarrhea. Study that evaluated diet enriched with zinc and probiotic showed significant reduction on the duration of diarrhea. Whether this combination is better than either supplementation of zinc or probiotic alone is unknown. The objective of the study was to compare the duration of diarrhea among children with acute watery diarrhea given zinc, probiotic and combined zinc - probiotic supplementation.Methods: Consecutive sampling from 6-24 months old hospitalized children with acute watery diarrhea in Kariadi hospital was done. There were 77 subjects randomized into 4 study groups. Three groups were supplemented daily with zinc, probiotic, or zinc and probiotic and one group as control. Each group had received standard therapy including rehydration and dietetic. Data were analyzed with Chi-square test, t test and one way ANOVA.Results: There were no differences in age, breastfeeding history, nutritional and social economic status, day before admission, and level of zinc serum among groups. Supplemented group showed significant reduction on the duration of diarrhea compared with control (p=0.02). There was no significant difference on the duration of diarrhea between zinc-probiotic and zinc or probiotic groups (p=0.15). Zinc-probiotic supplemented group had the lowest duration of diarrhea among groups.Conclusions: Zinc and probiotic are able to reduce the duration of acute watery diarrhea.ABSTRAKLatar belakang: Berbagai uji klinis menunjukkan suplementasi seng menurunkan durasi dan beratnya diare. Suplementasi probiotik juga menunjukkan manfaat pada terapi diare akut. Penelitian tentang diet yang difortifikasi seng dan probiotik menunjukkan penurunan durasi diare secara bermakna. Belum diketahui apakah suplementasi seng dan probiotik secara kombinasi lebih baik dari pada suplementasi seng dan probiotik secara terpisah. Penelitian ini bertujuan membandingkan durasi diare pada anak yang dirawat dengan diare akut cair yang diberikan suplementasi seng, probiotik, kombinasi seng dan probiotik serta kontrol.Metoda: Subjek diambil secara konsekutif dari anak usia 6-24 bulan yang dirawat dengan diare akut cair di RSUP Dr. Kariadi Semarang. Didapatkan 77 subjek dan diacak menjadi 4 kelompok. Tiga kelompok diberi perlakuan berupa suplementasi seng saja, suplementasi probiotik saja atau kombinasi seng dan probiotik serta satu kelompok sebagai kontrol. Setiap kelompok mendapat terapi standar berupa rehidrasi dan dietetik. Data dianalisis dengan menggunakan uji Chi-square, t test dan one way ANOVA.Hasil: Tidak terdapat perbedaan bermakna pada umur, riwayat pemberian ASI, status gizi dan sosial ekonomi, lama sakit sebelum dirawat, dan kadar seng serum diantara keempat kelompok. Kelompok suplementasi mempunyai penurunan durasi diare yang bermakna dibandingkan kontrol (68,6 vs 83,8 jam, p=0,02). Tidak didapatkan perbedaan bermakna antara kelompok kombinasi seng dan probiotik dibandingkan kelompok seng atau probiotik saja (p=0,15). Kelompok seng dan probiotik mempunyai durasi diare paling pendek dibandingkan kelompok lain.

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Kota semarang,

Jawa tengah

INDONESIA