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Beberapa Faktor yang Berperan Terhadap Keaktifan Kunjungan Lansia ke Posyandu Studi Kasus di Desa Tamantirto Kecamatan Kasihan Kabupaten Bantul Propinsi DIY Puji Lestari; Soeharyo Hadisaputro; Kris Pranarka
MEDIA MEDIKA INDONESIANA 2011:MMI Volume 45 Issue 2 Year 2011
Publisher : MEDIA MEDIKA INDONESIANA

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ABSTRACTFactors influencing elderly visit to elderly community health care (posyandu lansia): Case study in Tamantirto Village, Kasihan, Bantul, DIYBackground: Elderly community health care (ECHC) is the base of holistic-continuous care for the elderly. The number of elderly at Tamantirto Village is 11.3% of the total residents, which has not been accompanied by a high scope of ECHC visit, where 6 of 9 the ECHCs still have the coverage lower than 50%. Purpose of this study is to prove that age, education, occupation, socio economic status, knowledge, attitude, facilities, access, cadre and health workers services, social role and family role can affect elderly people’s visitations to the ECHC.Methods: Study design: observational analytic, case-control approach. The case: elderly as the ECHC members who actively visited, the control: elderly as ECHC members were who did not actively visit ECHC. The sample’s are 52 cases and 52 controls. The quantitative data were gathered by interviews, while the qualitative data by using focus group disscussion.Results: The factors influencing elderly people’s visitations to the ECHC are age of 71 years old (OR:4.6), not working (OR:8.1), good attitude (OR:3), good facilities (OR:5.4), good service of cadres and health workers (OR:6.5) and a good family role (OR:3.2). The factors that do not affect elderly people’s visitations are educational level, socio economic, knowledge, access, and social role ofthe elderly.Conclusion: Characteristics of elderly activity visit ECHC are age of 71 years old, not working, good attitude, good facilities, good service of cadres and health workers and a good family role.Keywords: Elderly community health care, actively visit, influencing factorsABSTRAKLatar belakang: Posyandu lansia merupakan dasar pelayanan yang holistik dan berkesinambungan pada lansia. Jumlah lansia yang cukup banyak di Desa Tamantirto yaitu sebanyak 11,3% dari jumlah penduduk, belum diiringi dengan cakupan kunjungan yang tinggi, dimana 6 dari 9 posyandu masih mempunyai cakupan di bawah 50%. Tujuan penelitian adalah membuktikan bahwa umur, pendidikan, pekerjaan, kondisi sosial ekonomi, pengetahuan, sikap, fasilitas posyandu, akses terhadap posyandu, pelayanan kader dan petugas kesehatan, peran sosial lansia, serta peran keluarga berpengaruh terhadap kunjungan lansia ke posyandu.Metode: Desain penelitian: analitik observasional, pendekatan kasus kontrol. Kasus adalah lansia anggota posyandu (umur 60 tahun) yang aktif melakukan kunjungan ke posyandu. Kontrol adalah lansia anggota posyandu (umur 60 tahun) yang tidak aktifmelakukan kunjungan ke posyandu. Sampel penelitian 52 kasus dan 52 kontrol. Data kuantitatif diperoleh dengan wawancara, data kualitatif dengan diskusi kelompok terarah.Hasil: Faktor yang berpengaruh terhadap keaktifan kunjungan lansia ke posyandu yaitu umur 71 tahun (OR:4,6), tidak bekerja (OR:8,1), sikap yang baik (OR:3), fasilitas yang baik (OR:5,4), pelayanan kader dan petugas kesehatan yang baik (OR:6,5), peran

Risiko Konsumsi Western Fast Food dan Kebiasaan Tidak Makan Pagi Terhadap Obesitas Remaja Studi di SMAN 1 Cirebon Lilis Banowati; Nugraheni Nugraheni; Niken Puruhita
MEDIA MEDIKA INDONESIANA 2011:MMI Volume 45 Issue 2 Year 2011
Publisher : MEDIA MEDIKA INDONESIANA

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ABSTRACTRisks of western fast food consumption and skipping breakfast to adolescents’obesity: Study at SMAN 1 CirebonBackground: Obesity prevalence in adolescents remains high. Western fast food consumption and skipping breakfast were identified as sub-culture among adolescents.The objective of this study was aimed to determine the risk of western fast food consumption in term of frequency of consumption, energy intake and energy contribution to adolescents’ obesity. It was also aimed to determine therisk of skipping breakfast for adolescents’ obesity.Method: It was an observational study using a case-control approach. Stratified random sampling was used to select participants from population. Seventy six secondary students from SMA Negeri 1 Cirebon were involved, divided into two groups; 38 students as case (BMI>95 persentile) and the rest 38 as controls (BMI 5-85 persentile). Chi-square and multiple logistic regression were employed in data analysis.Results: This study found obese students consumed western fast food more than their counterparts (263 kkal versus 140 kkal) (p=0.001). They were less frequent breakfast having (4.5 times per week) than those who were not obese (5,8 times per week) (p=0.019). Energy intake gained from western fast food consumption ≥244 kkal per day was found as the risk factor for obesity among adolescents (p=0,004) whilst frequency of consumption >9.2 times per month, energy contribution to total calorie intake >7.3% and skipping breakfast were failed to predict adolescents’ obesity (p>0.05). The result of multiple logistic regression test showed that the variable which is the most influential to the incident of obesity is energy intake gained from western fast food consumption (OR=6.26).Conclusion: Western fast food consumption ≥244 kkal per day is a risk factor for obesity.Keywords: Western fast food consumption, skipping breakfast, obesity, adolescentABSTRAKLatar belakang: Prevalensi obesitas remaja cukup tinggi. Hal ini disebabkan oleh konsumsi western fast food dan kebiasaan tidak makan pagi yang sudah merupakan kecenderungan di kalangan remaja. Tujuan penelitian ini untuk mengetahui besar risiko frekuensi konsumsi western fast food, asupan energi konsumsi western fast food, kontribusi energi western fast food dan kebiasaantidak makan pagi terhadap kejadian obesitas remaja SMAN 1 Cirebon.Metode: Jenis penelitian observasional dengan rancangan kasus kontrol. Pengambilan sampel dengan teknik stratified random sampling. Besar sampel 76 orang, terdiri dari 38 orang kasus (IMT >95 persentil) dan 38 orang kontrol (IMT persentil ke-5 -85). Penelitian menggunakan analisis bivariat dengan uji chi square dan analisis multivariat dengan uji regresi logistik ganda.Hasil: Pada remaja obesitas asupan energi konsumsi western fast food (263 kkal) lebih tinggi daripada yang tidak obes (140 kkal) (p=0,001). Sedangkan frekuensi makan pagi lebih rendah (4,5 kali/minggu) daripada yang tidak obes (5,8 kali/minggu) (p=0,019). Hasil analisis menunjukkan asupan energi konsumsi western fast food ≥244 kkal per hari merupakan faktor risiko terjadinyaobesitas (p=0,004). Sedangkan frekuensi konsumsi western fast food >9,2 kali per bulan, kontribusi energi western fast food terhadap total kalori >7,3% dan kebiasaan tidak makan pagi bukan faktor risiko obesitas (p>0,05). Hasil uji regresi logistik ganda menunjukkan bahwa variabel yang paling berpengaruh terhadap obesitas remaja adalah asupan energi konsumsi western fast food(OR=6,26).Simpulan: Konsumsi western fast food ≥244 kkal per hari berisiko untuk terjadinya obesitas.

General Reaction Score and CD56+CD16+CD3- Cells Distributions Among Women with Aircraft Noise Stress Hartono Hartono
MEDIA MEDIKA INDONESIANA 2011:MMI Volume 45 Issue 2 Year 2011
Publisher : MEDIA MEDIKA INDONESIANA

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ABSTRACTBackground: One of the noise impacts is stress. The NK cells (CD56+CD16+CD3-) are also one of the leukocyte subsets, which are responsive to the physiological stress and psychological stress. The aims of the research is to find out the correlation of the general reaction score with CD56+CD16+CD3- cells distributions among women with aircraft noise stress in the area of Adi Sumarmo Airport of Solo, Indonesia.Methods: The research design was an analytical survey with a cross sectional approach, taking location at the Dibal and Gagak Sipat Village, Boyolali District. The respondents who fulfilled the exclusive and inclusive criteria were selected by means of simple random sampling. The number of respondens was 39 and divided into 3 groups; Group 1 was exposed 92.29 dB of noise level (13 respondents); Group 2 was exposed 71.79 dB of noise level (13 respondents); and Group 3 was exposed 52.17 dB of noise level (13 respondents). The data were analyzed by Anova followed by post hoc test using LSD test completed with homogenous subsets and Pearson Correlation test.Results: The Pearson Correlation test was showed that there was significant association between general reaction score with CD56+CD16+CD3- cells distributions (r=0.589; p=0.000).Conclusion: There is correlation of the general reaction score with CD56+CD16+CD3- cells distributions among women with aircraft noise stress in the area of Adi Sumarmo Airport of Solo, Indonesia.Keywords: Aircraft noise, CD56+CD16+CD3-, women, Adi Sumarmo AirportABSTRAKGeneral Reaction Score dan CD56+CD16+CD3- pada wanita yang mengalami stres bising pesawat udaraLatar belakang: Salah satu dampak bising adalah stres. Natural killer cells (CD56+CD16+CD3-) adalah salah satu subset leukosit yang sangat respon terhadap stres fisiologis maupun stres psikologis. Tujuan penelitian adalah untuk mengetahui hubungan antara general reaction score dengan jumlah sel NK (CD56+CD16+CD3-) pada wanita yang memperoleh stres bising pesawat udara disekitar Bandara Adi Sumarmo Solo, Indonesia.Metode: Rancangan penelitian adalah survai analitik dengan pendekatan cross sectional. Lokasi di Desa Dibal dan Gagak Sipat, Kabupaten Boyolali. Responden yang memenuhi kriteria eksklusif dan inklusif diambil sejumlah 39 sebagai sampel dengan cara simple random sampling. Responden selanjutnya dibagi menjadi 3 kelompok; Kelompok 1 responden yang terpapar bising denganintensitas 92,29 dB (13 responden); Kelompok 2 responden yang terpapar bising dengan intensitas 71.79 dB (13 responden); dan Kelompok 3 responden yang terpapar bising dengan intensitas 52.17 dB (13 responden). Data dianalisis dengan uji Anova dilanjutkan dengan post hoc test menggunakan LSD test completed with homogenous subsets dan Pearson Correlation test.Hasil: Pearson Correlation test menunjukkan adanya hubungan yang signifikan antara general reaction score dengan jumlah sel NK (CD56+CD16+CD3-) (r=0.589: p=0.000).Simpulan: Penelitian ini menunjukkan bahwa ada hubungan antara general reaction score dengan jumlah sel NK(CD56+CD16+CD3-) pada wanita yang mengalami stres bising pesawat udara di sekitar Bandara Adi Sumarmo Solo, Indonesia.

Kadar Apolipoprotein B dan Aterosklerosis Arteri Karotis Interna pada Pasien Pasca Stroke Iskemik Haryo Teguh; Retnaningsih Retnaningsih; MI Widiastuti
MEDIA MEDIKA INDONESIANA 2011:MMI Volume 45 Issue 2 Year 2011
Publisher : MEDIA MEDIKA INDONESIANA

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ABSTRACTRelations between apolipoprotein B level with internal carotid artery atherosclerosis in post ischemic stroke patientBackground: Ischemic stroke is caused by brain artery obstruction or brain artery narrowing called atherosclerosis. Its marker is the thickness of tunica intima-media (intima-media thickness/IMT) of the artery. Apolipoprotein B is one of the indicator of atherosclerosis diseases. Most of the previous studies investigate association between apolipoprotein B level and cardiovascular disease, while the association between apolipoprotein B and atherosclerosis in post ischemic stroke patients has not been studied yet.Objective: To investigate association between apolipoprotein B level and internal carotid artery atherosclerosis based on thickness of intima-media in patients post ischemic stroke.Method: This cross-sectional study was done in post ischemic stroke (first attack) subjects in outpatient clinic of Neurology Department Kariadi Hospital Semarang, during December until February 2011. Apolipoprotein B level was measured with Integra method, during 1 month after the onset. The thickness of tunica intima-media of the internal carotid artery was measured by Ultrasonography Duplex.Result: Fourty four patients post ischemic stroke that met the inclusion and exclusion criteria, comprise of 22 male (50%) and 22 female (50%). Atherosclerosis which was defined as tunica intima-media thickness >0.9 mm, was found in 24 subjects (54.6%). Apolipoprotein B level, which designated as high if apoB >105 mg/dl, was found in 25 subjects (56.8%). Multivariate logistics regression test controlling lipid factor as confounding factors resulted in OR 142.1 (p=0.0001).Conclusion: Apolipoprotein B level significantly correlate with atherosclerosis of internal carotid artery represented by thickness of intima-media in patients post ischemic stroke.Keywords: Apolipoprotein B level, internal carotid artery atherosclerosis, ischemic strokeABSTRAKLatar belakang: Stroke iskemik disebabkan obstruksi atau penyempitan pembuluh darah arteri otak yang disebut aterosklerosis. Marker aterosklerosis adalah ketebalan tunika intima-media (intima-media thickness/IMT) di pembuluh darah tersebut. Kadar apolipoprotein B merupakan indikator penyakit yang disebabkan aterosklerosis. Penelitian yang ada kebanyakan menghubungkan pengaruh apoB dengan penyakit kardiovaskuler, pengaruh apoB dengan aterosklerosis pada pasien pasca stroke iskemik belum pernah dilakukan.Tujuan: Membuktikan adanya hubungan antara kadar apolipoprotein B dengan aterosklerosis arteri karotis interna yang dilihat dari ketebalan tunika intima-media pada pasien pasca stroke iskemik.Metode: Penelitian cross sectional, dilaksanakan di Poli Saraf RSUP Dr. Kariadi Semarang, periode Desember 2010-Februari 2011. Subyek penelitian adalah pasien pasca stroke iskemik pertama kali yang diambil secara consecutive sampling. Kadar apolipoprotein B diukur dengan menggunakan metode Integra, pemeriksaan ketebalan tunika intima-media arteri karotis internamenggunakan Ultrasonografi Duplek.Hasil: Empat puluh empat pasien pasca stroke iskemik yang memenuhi kriteria inklusi dan eksklusi, terdiri dari pria 22 (50,0%) dan wanita 22 (50,0%). Dikategorikan aterosklerosis bila ketebalan tunika intima-media >0,9 mm dan terjadi pada 24 subyek (54,6%). Kadar apolipoprotein B tinggi (apoB>105 mg/dl) terdapat sebanyak 25 subyek (56,8%). Hasil analisis uji regresi logistik multivariat yang mengendalikan faktor lipid (kolesterol, LDL, trigliserid) menunjukkan OR 142,1 (p=0,0001).

Ekstrak Keladi Tikus (Typhonium flagelliforme) Fraksi Diklorometanolik dan Ekspresi Caspase-3 dan p21 Cell-Line Kanker Payudara MCF-7 Agung Putra; Tjahjono Tjahjono; Winarto Winarto
MEDIA MEDIKA INDONESIANA 2011:MMI Volume 45 Issue 2 Year 2011
Publisher : MEDIA MEDIKA INDONESIANA

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ABSTRACTThe dichloromethanolic fraction of keladi tikus (Typhonium flagelliforme) extract and the expression of p21 and caspase-3 of MCF-7 breast cancer cell-lineBackground: Breast cancer has a high degree of heterogeneity and problems in therapy, such as insensitive to antiproliferation signal and able to escape from apoptosis program. Typhonium flagelliforme (Lodd), Blume (Araceae) more commonly known as keladi tikus in Indonesia, often used as alternative in treating cancer, including breast cancer. The objective of study is proving the dichloromethanolic fraction of Typhonium flagelliforme tuber extracts influence on the expression of caspase-3 and p21 of MCF-7 cell-line that have deletion in CASP-3 gene.Methods: This study adapts laboratory experimental in-vitro in cells-line MCF-7, with “post test control group only design” and divided into two groups, were incubated in 5h, 10h and 20h. The control group received no other treatment. The treatment group received the dichloromethanolic fraction of Typhonium flagelliforme tuber extracts in IC50. Starting with cytotoxicity assay using MTT to determine the IC50, followed by Immunocytochemical analysis to observe the expression of p21 and caspase-3.Results: Paired sample T test shows a significant differences in treatment groups compared with the controls (p<0.05), namely an increase in the expression of nuclear p21 and caspase-3 on 20h incubation.Conclusion: There were increased in the expression of caspase-3 and nuclear p21, as well as depleted the cytoplasmic of p21 on MCF-7 cell-line that have deletion in CASP-3 in treatment by tuber extract of Typhonium flagelliforme dichloromethanolic fraction.Keywords: p21, caspase-3, MCF-7 cell-line, Typhonium flagelliformeABSTRAKLatar belakang: Kanker payudara mempunyai tingkat heterogenitas tinggi dan problem dalam terapi, diantaranya tidak sensitif terhadap signal antiproliferasi dan mampu menghindar dari program apoptosis. Typhonium flagelliforme (Lodd). Blume (Araceae) yang lebih dikenal sebagai keladi tikus di Indonesia, sering digunakan sebagai alternatif dalam mengobati penyakit kanker,termasuk kanker payudara. Tujuan penelitian ini untuk membuktikan pengaruh Typhonium flagelliforme terhadap ekspresi caspase- 3 dan p21 pada cell-line MCF-7 yang mengalami delesi gen CASP-3.Metode: Penelitian eksperimental laboratorik secara invitro pada cell-line MCF-7, dengan rancangan penelitian post test control group only design, yang dibagi dalam 2 kelompok dan diinkubasi dalam 5 jam, 10 jam dan 20 jam. Kelompok kontrol tidak mendapatkan perlakuan, sedangkan kelompok perlakuan mendapatkan ekstrak umbi Typhonium flagelliforme fraksi diklorometanolik kadar 62,08 μg/mL(IC50). Dimulai dengan uji sitotoksisitas menggunakan MTT untuk menentukan IC50, dilanjutkananalisis imunositokimia untuk melihat ekspresi p21 dan caspase-3.Hasil: Paired sample T test menunjukkan terdapat perbedaan bermakna pada kelompok perlakuan dibandingkan kontrol (p<0,05), dimana terjadi peningkatan ekspresi caspase-3 dan p21 nukleus serta deplesi p21 sitoplasmik pada inkubasi 20 jam.Simpulan: Ekstrak umbi Typhonium flagelliforme fraksi diklorometanolik mampu meningkatkan ekspresi caspase-3 dan p21 nukleus serta deplesi p21 sitoplasmik cell-line MCF-7 yang mengalami delesi gen CASP-3.

Korelasi Kadar TNF-α dan Skor Psoriasis Area and Severity Index (PASI) pada Pasien Psoriasis Asih Budiastuti
MEDIA MEDIKA INDONESIANA 2011:MMI Volume 45 Issue 2 Year 2011
Publisher : MEDIA MEDIKA INDONESIANA

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ABSTRACTCorrelation of serum TNF-α levels and psoriasis area and severity index (PASI) score in psoriatic patientsBackround: Psoriasis is a chronic inflammatory disease characterized by erythematous scaly patches. Psoriasis affects ±2.5% of world population, and 20-30% patients have moderate to severe psoriasis. Psoriatic patients have increased proinflammatory Th1 cytokines expression, including TNF-α, with relative deficiency of Th2 cytokines. Psoriasis area and severity index (PASI) is a subjective method which commonly used to measure disease severity. This study was aimed to determine the correlation betweenserum TNF-α level and PASI score, in order to obtain objective method for measuring disease severity.Method: This was an observational study performed psoriatic patients. Subjects underwent PASI score examination and serum TNF-α assay using ELISA.Result: Subjects were 16 patients (6 females and 10 males), with mean age of 51 years. Serum TNF-α levels ranged from 15,0-202,4 pg/mL. PASI score ranged from 0,3-55,8. The test showed no significant correlation between PASI score and serum TNF-α level. (ρ=-0,265; p=0,322)Conclusion: Serum TNF-α can not be used as clinical parameter of psoriasis severity.Keywords: Psoriasis, TNF-α, PASI scoreABSTRAKLatar belakang: Psoriasis adalah penyakit peradangan kronik dengan gambaran klinis berupa plakat bersisik berwarna merah terang. Penyakit ini mengenai ±2,5% dari populasi dunia, dimana 20-30% menderita psoriasis sedang sampai berat. Pada psoriasis terjadi peningkatan ekspresi sitokin pro inflamasi Th1, di antaranya TNF-α, dan defisiensi relatif sitokin Th2. Skor psoriasis area and severity index (PASI) adalah metode yang paling banyak digunakan untuk mengukur derajat keparahan psoriasis, namun metode ini bersifat subyektif. Penelitian ini bertujuan menentukan apakah terdapat korelasi antara kadar TNF-α serum dan skor PASI, guna mendapatkan parameter obyektif untuk mengukur derajat keparahan psoriasis.Metoda: Penelitian ini merupakan penelitian observasional pada pasien psoriasis. Subyek penelitian menjalani pemeriksaan skor PASI, lalu diperiksa kadar TNF-α serum menggunakan metode ELISA.Hasil: Subyek penelitian terdiri atas 16 penderita (6 wanita dan 10 laki-laki) dengan rerata usia 51 tahun. Rentang kadar TNF-α pada penderita 15,0 pg/mL -202,4 pg/mL. Rentang skor PASI penderita adalah 0,3-55,8. Uji korelasi menunjukkan bahwa tidak terdapat hubungan bermakna (ρ=-0,265; p=0,322) antara skor PASI dan kadar TNF-α, tanpa pengendalian berbagai faktor pengganggu.Simpulan: Kadar TNF-α serum belum dapat dipakai sebagai parameter keparahan psoriasis

Penggunaan Batang Tanaman Betadin (Jatropha mulitifida Linn) untuk Meningkatkan Jumlah Trombosit pada Mus musculus Agus Sundaryono
MEDIA MEDIKA INDONESIANA 2011:MMI Volume 45 Issue 2 Year 2011
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ABSTRACTThe use of plant stem betadin (Jatropha mulitifida Linn) to increase the number of thrombocyt in Mus musculusBackground: Jatropha multifida Linn has been used by the people of Bengkulu as an ornamental plant, some of people use as medicinal for a new wound. That is why known as betadin plants. Jatropha multifida Linn contain flavonoids compound. The aims of this study is to isolate the total flavonoids compound from stems of Jatropha multifida Linn, and then it was used to increase the number of thrombocyt.Methods: Stem Jatropha multifida Linn was isolated by EtOH (96%), the filtrate was evaporated using a rotary evaporator. Fifteen of healthy Mus musculus with 20-50 g, were grouped into 4; group 1 (P0) was treated by aquadest, group 2 (P1) was treated with 0.2 mL of palm oil, group 3 (P2) was treated with a dose of guava extract (0.028 g/kgBW), group 4 (P3) and (P4) were given total flavonoids of Jatropha multifida Linn stems in which each was given with a dose of 0.028g/kgBW and 0,056g/kgBW. After 24 hours of treatment, the thrombocyt changes owere counted under a microscope.Results: The rendement of flavonoids compound in the stem of Jatropha multifida Linn which can be isolated by EtOH is 4%. The flavonoids compound from Jatropha multifida Linn stems at a doses of 0.028 g/kgBW could increased the number of thrombocyt to 543.000/mm3 and at a 0.56 g/kgBW to 813.000/mm3.Conclusion: The flavonoids compoud from Jatropha multifida Linn stems at a doses of 0.028 g/kgBW and doses of 0.56 g/kgBWcould increased the number of thrombocyt at Mus musculus.Keywords: Jatropha multifida Linn, trombocyt, flavonoids, Mus musculusABSTRAKLatar belakang: Jatropha multifida Linn oleh masyarakat Bengkulu digunakan sebagai tanaman hias, sebagian masyarakat ada yang menggunakan sebagai tanaman untuk obat luka baru. Itulah sebabnya maka dikenal dengan tanaman betadin. Batang tanaman Jatropha multifida Linn mengandung senyawa flavonoid. Penelitian ini bertujuan untuk mengisolasi senyawa flavonoid total dari batang tanaman Jatropha multifida Linn, kemudian diujicobakan untuk melihat peningkatan jumlah trombosit pada Mus musculus.Metode: Batang tanaman Jatropha multifida Linn diisolasi dengan maserasi menggunakan EtOH (96%), filtrat diuapkanmenggunakan rotary evaporator. Lima belas Mus musculus sehat dengan berat 20-50 g, dikelompokkan menjadi 4 yaitu kelompok 1 (P0) diberi perlakuan secara oral dengan aquades, kelompok 2 (P1) diberi perlakuan secara oral dengan 0,2 mL minyak manis, kelompok 3 (P2) diberi perlakuan secara oral dengan ekstrak daun jambu biji dengan dosis 0,028 g/kgBB, kelompok 4 (P3) dan kelompok 5 (P4) diberi perlakuan secara oral dengan senyawa flavonoid total batang tanaman Jatropha multifida Linn masingmasingdengan dosis 0,028 g/kgBB dan 0,056 g/kgBB. Setelah 24 jam untuk setiap perlakuan, kenaikan jumlah trombosit dihitung dibawah mikroskop.Hasil: Rendemen flavonoid total dari batang tanaman Jatropha multifida Linn yang dapat diisolasi menggunakan EtOH sebesar 4%. Pemberian senyawa flavonoid total dari batang Jatropha multifida Linn secara oral pada Mus musculus dengan dosis 0,028 g/kgBB mampu meningkatkan jumlah trombosit sebesar 543.000/mm3 dan dosis 0,056 g/kgBB mampu meningkatkan jumlah trombosit sebesar 813.000/mm3.Simpulan: Pemberian senyawa flavonoid total dari batang tanaman Jatropha multifida Linn dengan dosis 0,028 g/kgBB dan 0,056 g/kgBB secara oral mampu meningkatkan jumlah trombosit pada Mus musculus, dan semakin tinggi dosis yang diberikan semakin tinggi kenaikan jumlah trombosit.

Ekstrak Bawang Putih (Allium sativum) dan Ekspresi Insulin serta Derajat Insulitis Pankreas Tikus Sprague-Dawley yang Diinduksi Streptozotocin Meira Dewi; Indra Wijaya; Noor Wijayahadi
MEDIA MEDIKA INDONESIANA 2011:MMI Volume 45 Issue 2 Year 2011
Publisher : MEDIA MEDIKA INDONESIANA

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ABSTRACTAllium sativum, insulin expression and insulitis degree of pancreas Sprague-Dawley rat induced by streptozotocinBackground: The organic-sulphur content in Allium sativum has been scientifically proven to be a potent insulin-mimetic, antioxidant, and anti-inflammation agent by inhibiting the activity of NF-κβ. This research is aimed at finding out the effect of Allium sativum extract towards insulitis level and insulin expression in pancreas of Sprague-Dawley male rats.Method: This research used a randomized post test only controlled group design. There were 28 rats, two were randomly selected for the initial blood glucose test prior to treatment, two were selected on the tenth day after streptozotocin induction to ensure that all rats were in hyperglycaemia condition, and the remains as many as 24 rats were grouped into four groups: three treatmentgroups were administered with Allium sativum in levelled doses of 0.1, 0.25, 0.5 grams/kgBW/day for 14 days, and one group were act as control negative. Kruskall Wallis test continued with Mann Whitney test were used, with significance level of p<0.05.Results: The insulitis level and insulin expression of rats’ pancreas in the three treatment groups showed significant difference compared with the group without treatment showing dose-dependent result. However, it was not able to completely restore the damage pancreas.Conclusion: Allium sativum extract may play important role in restoring damage pancreas.Keywords: Allium sativum, streptozotocin, insulin expression, level of insulitisABSTRAKLatar belakang: Kandungan organosulfur pada Allium sativum secara ilmiah memiliki berbagai potensi sebagai agen insulinomimetic, antioksidan dan antiinflamasi dengan menghambat aktivitas NF-κß. Penelitian ini bertujuan untuk melihat pengaruh pemberian ekstrak Allium sativum terhadap derajat insulitis dan ekspresi insulin pankreas tikus Sprague-Dawley jantan.Metode: Penelitian ini menggunakan desain randomized post test only controlled group. Hewan coba sebanyak 28 ekor tikus, dua ekor tikus diambil acak sebelum perlakuan untuk diperiksa gula darah awal, dua ekor setelah hari ke sepuluh induksi streptozotocin untuk memastikan tikus sudah dalam keadaan hiperglikemia dan sisanya dua puluh empat ekor tikus, dibagi dalam empat kelompok: tiga kelompok perlakuan diberi ekstrak Allium sativum dosis bertingkat 0,1, 0,25, 0,50 g/kgBB/hari selama 14 hari, dan satu kelompok sebagai kontrol negatif. Digunakan uji non parametrik Kruskal Wallis dilanjutkan Mann Whitney dengan taraf kemaknaan p<0,05.Hasil: Derajat insulitis dan ekspresi insulin pankreas tikus pada ketiga kelompok perlakuan menunjukkan perbedaan bermakna dibandingkan dengan kelompok yang tidak mendapat perlakuan dan bersifat dose – dependent, namun belum dapat mengembalikan pulau Langerhan kembali ke keadaan normal.Simpulan: Ekstrak Allium sativum berpeluang memperbaiki pankreas yang rusak.

Clinical Skills Training in the Community: Lesson Learned from Diponegoro and Gadjah Mada University Tri Nur Kristina; Widyandana Widyandana
MEDIA MEDIKA INDONESIANA 2011:MMI Volume 45 Issue 2 Year 2011
Publisher : MEDIA MEDIKA INDONESIANA

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ABSTRACTBackground: Community-based education (CBE) clerkship in Faculty of Medicine Diponegoro University (FMDU) is implemented after finishing clinical rotation in tertiary hospital, whereas in Gadjah Mada University (FMGMU), is a part of clinical rotation. To have insight information of this difference method, the CBE clerkship in FMDU and FMGMU were compared.Methods: Close and open-ended students’ questionnaires were administered in the end of CBE clerkship.Results: Response rate to the questionnaire was 97.8% (n=286). FMDU students reported the most unprepared skills for CBE clerkship was blood smear of malaria, whereas FMGMU’s students reported management of PHC centre. Both students perceived that they are well prepared in communication skills, management of communicable diseases, and several clinical skills, and also reported that they have frequent experience in outpatient department. FMDU’ students perceived that CBE clerkship gave opportunity to work independently, and they felt more prepared to work as a doctor in the community. On the other hand, FMGMU students felt not so confident in patient management, and reported that supervisor did not give enough assistance. They suggested that CBE clerkship should be done at least after clinical rotation in two Departments, i.e.: Internal Medicine or Paediatric andSurgery or Ob-gyn.Conclusions: CBE clinical clerkship required students’ confidence and independency. Preparation should be done properly not only for the students but also supervisor in the community. Tertiary hospital, which has enough skillful supervisors, is important to train basic clinical skills to students before sending them to the community.Keywords: Clerkships, clinical skills, medical students, CBE, communityABSTRAKKepaniteraan klinik di masyarakat: pembelajaran di Universitas Diponegoro dan Gadjah MadaLatar belakang: Kepaniteraan klinik di masyarakat di Fakultas Kedokteran Universitas Diponegoro diimplementasikan setelah mahasiswa kedokteran tingkat akhir menyelesaikan rotasi klinik di rumah sakit pendidikan tersier, sedangkan di Universitas Gadjah Mada kepaniteraan klinik di masyarakat menjadi bagian dari rotasi klinik. Dalam rangka mendapatkan informasi yang mendalam mengenai perbedaan metode tersebut, kepaniteraan klinik di masyarakat pada ke-2 institusi tersebut dievaluasi dan dibandingkan.Metode: Penelitian kuesioner dengan pertanyaan tertutup dan terbuka, diberikan pada mahasiswa di akhir dari kepaniteraan klinik di masyarakat.Hasil: Kuesioner yang dikembalikan sebesar 97,8% (n=286). Mahasiswa FK Undip melaporkan bahwa yang paling kurang dipersiapkan untuk kepaniteraan kinik di masyarakat adalah keterampilan dalam melakukan pemeriksaan darah hapus malaria, sedangkan mahasiswa FK UGM melaporkan bahwa mereka kurang dipersiapkan dalam hal manajemen puskesmas. Mahasiswa dari ke-2 institusi sama-sama merasa bahwa mereka cukup dipersiapkan dalam hal keterampilan komunikasi, manajemen penyakit infeksi, dan beberapa keterampilan klinik. Mereka juga sama-sama melaporkan pengalaman yang cukup sering di poliklinik. Mahasiswa FK Undip merasa bahwa kepaniteraan klinik di masyarakat memberi kesempatan pada mereka untuk bekerja secara independen, dan merasa lebih siap untuk bekerja sebagai dokter di masyarakat. Di lain pihak, mahasiswa FK UGM merasa kurang percaya diri dalam mengelola pasien dan melaporkan bahwa supervisor di puskesmas kurang memberikan supervisi. Mereka menyarankan agar kepaniteraan klinik di masyarakat dilakukan setelah minimal menjalani rotasi klinik di 2 departemen, misalnya:interna/pediatrik dan bedah/kebidanan.

Kekuatan Genggam pada Lansia Wanita Aktif dan Tidak Aktif Berolahraga Gheby Soraya S; Etisa Adi Murbawani
MEDIA MEDIKA INDONESIANA 2011:MMI Volume 45 Issue 2 Year 2011
Publisher : MEDIA MEDIKA INDONESIANA

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Handgrip strength in active and inactive elderly womanBackgrounds: Exercise is one of the factors determining handgrip strength. Lower handgrip strength is an indicator for lower Body Mass Index (BMI). The aim of this study is to compared differences in handgrip strength between active and inactive elderly woman. Methods: This was a cross-sectional study of 26 elderly active woman (spent ≥30 minutes for five times or more a week for exercise) and 26 elderly inactive woman (spent <30 minutes and less than five times a week for exercise). Subject were chosen through purposive sampling. Handgrip strength was measured with handgrip dynamometer. Questionnaire was used for measuring exercise activity. BMI value were obtained from body weight was measurement with digital scale and height measurement with microtoise. Data on energy and protein intake were obtained from food frequency semi quantitative questionnaire (FFSQ). Data analysed were using Kolmogorov-Smirnov, independent t-test, and anacova. Result: Most of active elderly woman (69.2%) had handgrip strength in sufficient category. There were significant differences of handgrip strength between the active and inactive elderly woman (p=0.001) and after being controlled by BMI, energy and protein intake per day (p=0.005). Conclusion: Routine exercise should be recommended to elderly for better handgrip strength.. ABSTRAKLatar belakang: Lansia wanita mempunyai kekuatan genggam yang lebih rendah daripada pria. Kebiasaan olahraga merupakan salah satu faktor yang berpengaruh terhadap kekuatan genggam. Nilai kekuatan genggam merupakan indikator nilai Indeks Massa Tubuh (IMT). Tujuan dari penelitian ini adalah membandingkan kekuatan genggam pada lansia wanita yang aktif dan tidak aktif berolahraga. Metode: Studi cross-sectional pada 26 lansia wanita yang aktif (menghabiskan waktu ≥30 menit dan 5 kali atau lebih dalam seminggu untuk berolahraga) dan 26 lansia wanita yang tidak aktif (menghabiskan waktu <30 menit dan kurang dari 5 kali dalam seminggu untuk berolahraga). Sampel diperoleh dengan cara purposive sampling. Kekuatan genggam diukur menggunakan Handgrip Dynamometer. Kuesioner digunakan untuk mengetahui kebiasaan olahraga. IMT diperoleh dari data berat badan yang diukur dengan timbangan digital dan tinggi badan yang diukur dengan mikrotoa, sedangkan data asupan energi dan protein diperoleh dari Food Frequency Semi Quantitative Questionnaire (FFSQ). Analisis data dengan Kolmogorov-smirnov, Independent t-test dan Anacova. Hasil: Nilai kekuatan genggam sebagian besar lansia wanita yang aktif berolahraga (69,2%) dalam kategori cukup sedangkan sebagian lansia wanita yang tidak aktif berolahraga (53,8%) dalam kategori sangat kurang. Terdapat perbedaan kekuatan genggam sangat bermakna antara lansia wanita yang aktif dan tidak aktif berolahraga (p=0,001) dan setelah dikontrol dengan IMT, asupan energi dan protein (p=0,005).Simpulan: Latihan teratur perlu dilakukan para lansia agar memiliki kekuatan genggam yang baik.

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