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sTfR Sebagai Faktor Risiko Bangkitan Kejang Demam Abdul Khanis; Tjipta Bahtera; Noor Wijayahadi
MEDIA MEDIKA INDONESIANA 2010:MMI VOLUME 44 ISSUE 3 YEAR 2010
Publisher : MEDIA MEDIKA INDONESIANA

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sTfR parameter as a risk factor of febrile seizuresBackground: Febrile seizures is the most often neurologic disorder in children and 2%-5% children under 5 years old have experienced febrile seizures. Prognosis of febrile seizures is good, however the seizure brings serious worries to the parents. Iron deficiency as a risk factor of febrile seizures is still controversial.Objective: To analyze iron deficiency with serum transferrin receptor (sTfR) parameter as a risk factor of febrile seizures in children.Method: Study design was case control with subjects 72 children aged 3 months – 5 years in Dr. Kariadi hospital on August 2009 – January 2010, 36 children with febrile seizures as case group and 36 children with febrile with no seizure as control group. Clinical data and blood sampling were recorded from study subjects for sTfR level measurement. Risk factors were analyzed with odds ratio (95% confidence interval) and multivariate logistic regression.Results: Mean sTfR level was 6.2 μg/mL (2.6-6.8) in case group and 2.0 μg/mL (1.8-2.3) in control group. Multivariate analysis showed iron deficiency with sTfR parameter was significantly as a risk factor for febrile seizures (p<0.001; OR=25.1; 95%CI 5.1-122.6). sTfR level could be used as febrile seizures indicator with sTfR level cut-off point was 2.55 μg/ml. Conclusion: sTfR parameter can be used is a risk factor for febrile seizures. ABSTRAKLatar belakang: Kejang demam merupakan kelainan saraf tersering pada anak dan 2%-5% anak di bawah umur 5 tahun pernah mengalami kejang demam. Prognosis kejang demam baik, namun cukup mengkhawatirkan bagi orang tuanya. Defisiensi besi sebagai faktor risiko bangkitan kejang demam masih kontroversial. Tujuan penelitian ini menganalisis defisiensi besi dengan parameter serum transferrin receptor (sTfR) sebagai faktor risiko bangkitan kejang demam pada anak.Metode: Penelitian kasus kontrol ini dengan subyek penelitian 72 anak berumur 3 bulan sampai 5 tahun di RSUP Dr. Kariadi pada Agustus 2009 – Januari 2010, 36 anak kelompok kasus dengan bangkitan kejang demam dan 36 anak kelompok kontrol dengan demam tanpa kejang. Subyek penelitian dicatat data klinis dan pengambilan darah untuk diperiksa kadar sTfR. Faktor risiko dianalisis dengan rasio odds (95% interval kepercayaan) dan multivariat regresi logistik.Hasil: Rerata kadar sTfR pada kelompok kasus 6,2 μg/mL (2,6-6,8) dan kelompok kontrol 2,0 μg/mL (1,8-2,3). Analisis multivariat menunjukkan defisiensi besi dengan parameter sTfR secara bermakna merupakan faktor risiko bangkitan kejang demam (p<0,001; OR=25,1; 95%CI 5,1-122,6). Kadar sTfR dapat dipergunakan sebagai indikator bangkitan kejang demam dengan cut-off point kadar sTfR adalah 2,55 μg/mL.Simpulan: Parameter sTfR merupakan faktor risiko bangkitan kejang demam.

Kejadian Pasung di Jawa Tengah Alifiati Fitrikasari
MEDIA MEDIKA INDONESIANA 2010:MMI VOLUME 44 ISSUE 3 YEAR 2010
Publisher : MEDIA MEDIKA INDONESIANA

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Shackelled/stocked psychiatric cases in Central JavaBackground: Stocks deprivation to person with mental disorder is against human rights, but is stll commonly practiced in developing countries including Indonesia. There is not yet a study on this issue in Central Java. The study aimed to describe the characteristic of stocks deprivation subjects, socio cultural condition of the community.Method: A qualitative ethnographic study with a cross sectional design was carried in Kabupaten Pati, Pekalongan, Jepara, Rembang, Salatiga and Blora. In depth interview was done by a psychiatrist using unstructured questenaire. Result of the interview are presented in a descriptive and narrative explaination.Results: Twenty seven stocks deprivation cases were found, consisted of 21 males and 6 females and most of them were diagnosed as schizophrenics, but some families to consider the subject because of ill spirit. Reasons prevent the deprivation of the subjects berserk, lost or become public scorn around, especially young children. All of them were from economically deprived families. Duration of deprivation was between 8 months to 28 years. Ways of deprivation was mostly chained or tied and put away from main house. As the initiator of most stocks are families on the grounds as family and community efforts in maintaining social order (for not disturbing the environment) within the limitation of economics and education.Conclusion: Stocks deprivation is mainly an ignorancy economic and cultural issues with ignorancy on mental health management being worsened by poverty as the main factor. Solution and prevention on this issue should be a mental health promotion at primary health care service level.ABSTRAKLatar belakang: Pemasungan terhadap orang yang mengidap gangguan kejiwaan merupakan tindakan yang bertentangan dengan HAM, tetapi masih umum ditemukan di negara berkembang, termasuk di Indonesia. Belum ada penelitian mengenai masalah ini di Jawa Tengah. Studi bertujuan untuk mengetahui karakteristik subyek pasung dan memahami budaya pasung yang hidup dalam masyarakat dan untuk menemukan solusi terhadap praktek pemasungan.Metode: Dilaksanakan studi kualitatif etnografi dengan pendekatan belah lintang, di kabupaten Pati, Pekalongan, Jepara, Rembang, Salatiga dan Blora. Data diperoleh dengan interview mendalam dan di analisis secara diskriptif naratif.Hasil: Didapatkan 27 kasus pasung, terdiri dari 21 pria dan 6 wanita, dan hampir semua terdiagnosis sebagai skizofrenia, tetapi sebagian keluarga menganggap sakit subyek karena kesambet makhluk halus. Alasan pemasungan mencegah subyek mengamuk, hilang, menjadi cemooh masyarakat sekitar terutama anak-anak kecil. Seluruh subyek penelitian berasal dari masyarakat miskin. Masa pemasungan berkisar antara 8 bulan sampai 28 tahun. Metode pasung terbanyak dengan diikat tali maupun rantai dan ditempatkan di ruang yang terpisah dengan rumah utama. Sebagai inisiator pasung terbanyak adalah keluarga dengan alasan sebagai upaya masyarakat dan keluarga dalam menjaga tertib sosial (tidak mengganggu lingkungan) dalam keterbatasan ekonomi (kemiskinan) dan pendidikan.Simpulan: Pasung merupakan masalah ketidaktahuan, dan ekonomi budaya masyarakat di mana faktor yang paling berpengaruh adalah ketidaktahuan masyarakat tentang penanganan gangguan jiwa yang diperberat oleh faktor ekonomi yang kurang. Pemecahan atau pencegahannya memerlukan pendekatan program promosi kesehatan jiwa di tingkat pelayanan kesehatan primer.

Intensitas Latihan Interval dan Aktivitas Antioksidan Endogen Muchsin Doewes; Kiyatno Kiyatno
MEDIA MEDIKA INDONESIANA 2010:MMI VOLUME 44 ISSUE 3 YEAR 2010
Publisher : MEDIA MEDIKA INDONESIANA

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Interval training intensity and endogen antioxidant activityBackground: Physical training increases free radical generation which is balanced by endogenous antioxidant generation e.g. SOD (superoxide dismutase) and GPx (glutathione peroxidase). This later is influenced by intensity, duration, muscle type and age. The aims of this study is to compare the three kinds of interval training intensity in enhancing SOD and GPx activity.Method: An experimental quantitative study with the posttest only control group design was used in this study. Thirty six students of JPOK-FKIP Sebelas Maret University were randomly selected to become the experimental subjects and divided into four groups (1) intensive repetition runing 10x50 m, (2) extensive repetition runing 3x400 m, (3) continuous aerobic training past running 30 minutes, and (4) controlled group. The interval training were treated 3x per week for 8 weeks. At the 8th week SOD and GPx activity were determined by using enzymatic method with Cobas Mira instrument. The t-test with SPSS 13.0 for window program was use for analyzing all collected data with 95% CI.Result: There were significance difference the SOD and GPx activity between extensive repetition group with controlled group (p<0.05).Conclusion: The extensive repetition intensity is the significance for enhancing the enzymatic activity of SOD and GPx to compare with control group, and have the higher level than intensive repetition and continuous aerobic training.ABSTRAKLatar belakang: Latihan fisik meningkatkan pembentukan radikal bebas yang diimbangi peningkatan pembentukan antioksidan endogen seperti SOD (superoxide dismutase) dan GPx (glutathione peroxidase). Pembentukan antioksidan SOD dan GPx dipengaruhi oleh intensitas latihan, durasi, jenis otot yang dilatih dan umur. Tujuan penelitian ini untuk membandingkan tiga kelompok intensitas latihan interval yang meningkatkan aktivitas enzim SOD dan GPx.Metode: Jenis penelitian kuantitatif–eksperimental menggunakan rancangan penelitian the posttest only control group design. Subyek penelitian diambil secara acak sederhana (n=36), dibagi menjadi 4 kelompok (1). K1: intensive repetition lari 10x50 m, (2). K2: extensive repetition lari 3x400 m, (3). K3: continuous aerobic training lari cepat 30 menit; (4). K4: kelompok kontrol. Latihan interval dilakukan 3 kali/minggu dilakukan berkesinambungan selama 8 minggu berturut-turut. Pada minggu ke delapan diambil 5 mL darah untuk diperiksa aktivitas SOD dan GPx menggunakan metode enzimatik dengan alat Cobas Mira. Analisis data dengan uji t menggunakan program komputer SPSS 13.0 for Window dengan tingkat kepercayaan 95%.Hasil: Terjadi perbedaan bermakna kadar SOD dan GPx pada extensive repetition dengan kelompok kontrol (p<0,05).Simpulan: Aktivitas enzim SOD dan GPx paling tinggi pada latihan interval extensive repetition dibanding intensive repetition dan continuous aerobic training, dan berbeda bermakna dengan kelompok kontrol.

Peran Nefroprotektif Pentoxifylline Terhadap Ekspresi TGF-β1, Kolagen Tipe-4, MMP-9, Glomerulosklerosis serta Albuminuria pada Mencit Galur Swiss Setelah Diinduksi Doksorubisin Bambang Purwanto
MEDIA MEDIKA INDONESIANA 2010:MMI VOLUME 44 ISSUE 3 YEAR 2010
Publisher : MEDIA MEDIKA INDONESIANA

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Nephroprotective effect of pentoxifylline through improvement in the expression of TGF-β1, type-IV collagen, MMP-9, glomerulosclerosis and albuminuria in swiss strain mice after inducing by doxorubicinBackground: Nephrotoxic effects of doxorubicin (DXR) as a cancer drug is still a problem. Pentoxifylline (PTX) has the nephrotoxic effects. The combination of DXR and PTX might reduce the nephrotoxic effects of DXR. The aim of study was to prove the nephroprotective effect of PTX on DXR nephrotoxicity through the improvement of TGF-β1, type-4 collagen, MMP-9, as well as the levels of glomerulosclerosis and albuminuria.Method: Fourty-four males Swiss strain mice, divided into three groups as control group (C) injected with NaCl 0.9%; DXR induced nephrotoxicity (D); and effect of PTX on D (P/D) by intraperitoneally, respectivelly, each group consisted of 8 mice. Injections done once a week for three consecutive weeks. At the 4th and 8th weeks post-treatment, all eight mice of each group were sacrificed. Examination of TGF-β1, type-4 collagen, and MMP-9 expression was done by immunohistochemistry with monoclonal antibody. Glomerulosclerosis examination was done by a histopathologist, using VvG staining. While albuminuria examination was done by Elisa. The statistic was investigated using one-way ANOVA.Result: In the fourth week proteins expression was increased from C to D and subsequently decreased in P/D for TGF-β1, collagen type-IV, glomerulosclerosis and albuminuria. Otherwise MMP-9 expression was increased from C to D and in P/D. While in the eighth week proteins expression was increased from C to D and subsequently decreased in P/D for TGF-β1, collagen type-IV, glomerulosclerosis, and albuminuria. Otherwise MMP-9 expression was decreased from C to D and subsequently increased in P/D.Conclusion: The combination of PTX and DXR can reduce the nephrotoxic effects of DXR. PTX was proved to be nephroprotector inducing by DXR.ABSTRAKLatar belakang: Efek nefrotoksik doxorubicin (DXR) sebagai obat kanker masih menjadi masalah. Pentoxifylline (PTX) memiliki efek nefroprotektif. Kombinasi DXR dan PTX diharapkan untuk mengurangi efek nefrotoksik DXR. Tujuan penelitian ini adalah menjelaskan perbedaan ekspresi TGF-β1, kolagen tipe-IV, MMP-9, serta tingkat glomerulosklerosis dan albuminuria dalam keadaan normal, nefrotoksik dan nefroprotektif.Metode: Mencit strain Swiss jantan 48 ekor, secara acak dibagi tiga kelompok dengan setiap kelompok 16 ekor. Masing-masing kelompok diberikan intraperitoneal sekali seminggu selama tiga minggu berturut-turut 0,2 ml NaCl 0,9% pada kelompok kontrol (C); 0,038 mg DXR/20 g berat badan untuk kelompok nefrotoksik (D); serta dosis kombinasi 0,038 mg DXR/20 g berat badan dan 1,6 mg PTX/20 g berat badan untuk kelompok terapi (P/D). Pada minggu ke-4 dan 8 setelah pengobatan, 8 mencit masing-masing kelompok dikorbankan untuk pengumpulan sampel. Ekspresi TGF-β1, kolagen tipe-IV dan MMP-9 dinilai dengan immunohistokimia. Glomerulosklerosis dinilai secara histopatologis, menggunakan pewarnaan VvG. Sementara albuminuria dinilai dengan teknik Elisa. Statistik dianalisis menggunakan one-way ANOVA. Hasil: Pada minggu keempat terlihat ekspresi meningkat dari C ke D dan kemudian menurun pada P/D untuk TGF-β1, kolagen type-IV, glomerulosklerosis dan albuminuria. Sebaliknya ekspresi MMP-9 meningkat dari C ke D dan pada P/D. Pada minggu ke delapan terlihat ekspresi meningkat dari C ke D dan kemudian menurun pada P/D untuk TGF-β1, kolagen type-IV, glomerulosklerosis, dan albuminuria. Sebaliknya ekspresi MMP-9 menurun dari C ke D dan selanjutnya meningkat pada P/D.Simpulan: Penggunaan kombinasi PTX dan DXR dapat mengurangi efek nefrotoksik dari DXR.

Masalah Mental Remaja di Kota Semarang Fitri Hartanto; Hendriani Selina
MEDIA MEDIKA INDONESIANA 2010:MMI VOLUME 44 ISSUE 3 YEAR 2010
Publisher : MEDIA MEDIKA INDONESIANA

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Adolescent mental problems in the city of Semarang Background: The gap between the child's physical, social and psychological in adolescence can cause mental problems in the form of emotional disturbance, behavior, resistant and depression. No data on the distribution of mental problems among adolescents in Semarang.Methods: Descriptive study with cross sectional approach conducted on 578 Junior High School Students who are spread in 5 Junior High School in Semarang. SDQ (the strength and difficulties questionnaire) measure tool were used in assessing their mental status, which is presented in a descriptive narrative.Results: In the domain of prosocial are 8.0% abnormal and 14.5% borderline, hyperactive domain are 4.9% abnormal and 5.9% borderline, emotional domain are 18.5% abnormal and 9.1% borderline, the domain of behavior are 13.9% abnormal and 15.7% borderline, and the domain of peer group are 3.8% abnormal and 20.6% borderline.Conclusion: The result of the assessment of mental problems adolescents in Semarang got emotional problems 18.5%, behavior 13.9%, the total difficulties 9.1%, 8.1% prosocial, hyperactivity 4.9%, and peer group 3.8%.ABSTRAKLatar belakang: Kesenjangan yang terjadi antara perkembangan fisik, sosial dan psikologik pada masa remaja dapat menyebabkan masalah mental berupa gangguan emosi, perilaku, serta depresi. Belum ada data tentang distribusi masalah mental pada remaja di Kota Semarang.Metode: Penelitian deskriptif dengan pendekatan belah lintang dilakukan terhadap 578 pelajar SLTP yang tersebar pada 5 SLTP di wilayah Semarang. Alat ukur SDQ (the strength and difficulties questionnaire) dipakai dalam menilai status mental mereka yang disajikan dalam narasi deskriptif. Hasil: Pada ranah prososial didapatkan 8,0% abnormal dan 14,5% borderline, ranah hiperaktif 4,9% abnormal dan 5,9% borderline, ranah emosi 18,5% abnormal dan 9,1% borderline, ranah perilaku 13,9% abnormal dan 15,7% borderline, dan ranah peer group 3,8% abnormal dan 20,6% borderline. Simpulan: Hasil penilaian masalah mental remaja di Kota Semarang didapatkan masalah emosi 18,5%, perilaku 13,9%, total difficulties 9,1%, prososial 8,1%, hiperaktif 4,9%, dan peer group 3,8%.

Skor Diskriminan Manifestasi Klinis dan Laboratorik sebagai Prediktor Syok pada Demam Berdarah Dengue Mohamad Supriatna; MMDEAH Hapsari; Maria Mexitalia; Yusrina Istanti
MEDIA MEDIKA INDONESIANA 2010:MMI VOLUME 44 ISSUE 3 YEAR 2010
Publisher : MEDIA MEDIKA INDONESIANA

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Discriminant score of clinical and laboratory manifestations as a predictor of shock in dengue hemorrhagic fever Background: Case fatality rate of dengue shock syndrome (DSS) is still high. In Dr. Kariadi Hospital Semarang (RSDK) was 5.7 to 10.8% during 2000 to 2004. This is due to clinical course of dengue hemorrhagic fever (DHF) are unpredictable whether patients will develop to shock or not. We aimed to formulate discriminant score of clinical and laboratory manifestations that can be used as a predictor of shock in DHF.Methods: An observational analytic study was done. Consecutive sample were taken from DHF patients aged 3–14 years who were treated at RSDK in February 2001–March 2003. Diagnosis was established based on WHO 1997 criteria and serologic indirect-ELISA. Septic children were excluded. Clinical and laboratory manifestations were examined at admission or when diagnosed as DHF. Chi-square, Mann-Whitney, and discriminant analysis were done to formulate discriminant score.Results: There were 152 DHF patients enrolled, consist of 61 non-DSS and 91 DSS. Discriminant score formulation was obtained as: D=–1.103 + (0.013 x bleeding type) + (1.229 x vomiting) + (0.478 x abdominal pain) + (0.922 x hepatomegaly) – (0.039 x haemoglobin) + (0.014 x haematocryt) – (0.404 x albumin) – (0.046 x total protein) + (0.043 x pleural effusion index). Discriminant score mean for DSS is +0.739 and non-DSS –1.103 with cut-off point of –0.182. If the score <–0.182 patients become non-SSD and ≥–0.182 DSS. Conclusion: Discriminant score of clinical and laboratory manifestations can be used as a predictor of shock in DHF with prediction accuracy of 80.3%.ABSTRAKLatar belakang: Angka kematian sindrom syok dengue (SSD) masih tinggi. Di RSUP Dr. Kariadi (RSDK) Semarang 5,7–10,8% pada tahun 2000–2004. Hal ini disebabkan perjalanan klinis demam berdarah dengue (DBD) sulit diprediksi apakah penderita akan mengalami syok atau tidak. Tujuan penelitian adalah merumuskan skor diskriminan manifestasi klinis dan laboratoris yang dapat dijadikan sebagai prediktor syok pada DBD. Metoda: Dilakukan penelitian observasional analitik dengan sampel secara consecutive dari penderita DBD umur 3–14 tahun yang dirawat di RSDK pada Februari 2001–Maret 2003. Diagnosis ditegakkan berdasar kriteria WHO 1997 dan serologis indirect-ELISA. Anak dengan sepsis dieksklusi dari penelitian. Manifestasi klinis dan laboratoris diperiksa saat masuk rumah sakit atau saat diagnosis ditegakkan. Uji Chi-square, Mann-Whitney, dan analisis diskriminan dilakukan untuk merumuskan skor diskriminan.Hasil: Didapatkan 152 penderita DBD yang terdiri dari 61 non-SSD dan 91 SSD. Rumus skor diskriminan yang didapat sebagai berikut: D=–1,103 + (0,013 x jenis perdarahan) + (1,229 x muntah) + (0,478 x nyeri perut) + (0,922 x hepatomegali) – (0,039 x hemoglobin) + (0,014 x hematokrit) – (0,404 x albumin) – (0,046 x protein total) + (0,043 x indeks efusi pleura).Rerata skor diskriminan SSD +0,739 dan non-SSD –1,103 dengan cut off point –0,182. Bila skor <–0,182 penderita akan menjadi non-SSD dan ≥–0,182 akan menjadi SSD. Simpulan: Skor diskriminan manifestasi klinis dan laboratoris dapat dijadikan sebagai prediktor syok pada DBD dengan 80,3% ketepatan prediksi.

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Kota semarang,

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