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MEDIA MEDIKA INDONESIANA
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Preparat Anti Jamur Dalam Pencegahan Mukositis Oral Akibat Efek Samping Radioterapi pada Pasien Keganasan Kepala Leher Henny Kartikawati
MEDIA MEDIKA INDONESIANA 2011:MMI Volume 45 Issue 3 Year 2011
Publisher : MEDIA MEDIKA INDONESIANA

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ABSTRACTEffect of anti fungal preparations as oral mucositis prevention from radiotherapy side effects in nasopharyngeal carcinoma patientsBackground: Oral mucositis may lessened food intake and delays the radiation schedule in patients with nasopharyngeal carcinoma. Antifungal treatment fluconazole is known to be effective for treating fungal infections of mucous membrane and systemic infections caused by Candida sp. Itraconazole is also effective in treating fungal infections of mucous membrane or systemic infections. This study proves the effectiveness of fluconazole and itraconazole in the prevention of moderate to severe mucositis.Methods: An experimental study design with pre and post test randomized-control trial. Group A1 received fluconazole as prophylactic treatment, group A2 received itraconazole as prophylactic treatment. Group B was as control or non-prophylaxis. The treatment was given from day 11 to day 26 of radiotherapy (for 3 weeks). The outcome of this study was the incidence of moderate to severe mucositis and the findings of Candida Sp. on moderate to severe mucositis using KOH examination.Results: Moderate to severe mucositis was found in 6 cases in the control group (75%), markedly more than the prophylactic fluconazole group with only 2 cases (25%). The incidence of moderate to severe mucositis was also fewer in the itraconazole group, with only 8 cases (36.36%) compared to control group with 15 cases (68.18%). Examination using KOH showed positive fungal infection was greater in the control group compared to fluconazole and itraconazole groups.Conclusion: Fluconazole and itraconazole are useful in preventing the occurrence of moderate to severe mucositis as the side effects of radiotherapy in nasopharyngeal carcinoma patients, with relative risk reduction (RRR) of 40% for fluconazole and 45.8% ofitraconazole.Keywords: Fluconazole, itraconazole, mucositis, radiotherapyABSTRAKLatar belakang: Mukositis oral dapat menurunkan intake makanan dan tertundanya jadwal radiasi pada pasien keganasan kepala leher. Fluconazole adalah obat anti fungal yang efektif untuk mengobati infeksi jamur pada mukosa dan infeksi sistemik yang disebabkan oleh Candida sp. Itraconazole juga efektif untuk menangani infeksi jamur pada mukosa atau sistemik. Penelitian ini membuktikan efektivitas fluconazole dan itraconazole dalam pencegahan mukositis sedang-berat.Metode: Studi eksperimental dengan desain pre and post test randomized control trial. Kelompok A1 mendapat fluconazole, kelompok A2 menerima itraconazole sebagai perlakuan profilaksis. Kelompok B adalah kontrol atau non profilaksis. Perlakuan diberikan hari ke-11 sampai -26 radioterapi (3 minggu). Outcome penelitian ini berupa jumlah kejadian mukositis sedang-berat dan ditemukannya Candida Sp pada mukositis sedang-berat dengan pemeriksaan KOH.Hasil: Mukositis sedang-berat didapat 6 kasus kontrol (75%), jauh lebih banyak dibanding profilaksis fluconazole (2 kasus/25%). Kelompok itraconazole 8 kasus (36,36%) kejadian mukositis sedang-berat, lebih sedikit dibanding kontrol (15 kasus/68,18%). Penilaian KOH positif jamur lebih banyak pada kelompok kontrol dibanding fluconazole dan itraconazole.Simpulan: Fluconazole dan itraconazole bermanfaat untuk mencegah kejadian mukositis sedang-berat akibat efek samping radioterapi pada penderita karsinoma nasofaring, dengan nilai RRR (relative risk reduction) 40% pada fluconazole dan 45,8% pada itraconazole.
Pola Asuh Ibu, Kejadian Diare dan Pertumbuhan Sampai 4 Bulan pada Bayi yang Mengalami Hambatan Pertumbuhan Dalam Rahim Thresia Dewi Kartini Berek; Zinatul Faizah; Endang Purwaningsih
MEDIA MEDIKA INDONESIANA 2008:MMI Volume 43 Issue 3 Year 2008
Publisher : MEDIA MEDIKA INDONESIANA

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ABSTRACTMother caring pattern, diarrhea occurrence and growth in the first four months of infants with intra uterine growth retardationBackground: Infants with Intra Uterine Growth Retardation (IUGR) are very sensitive toward infection especially diarrhea. Diarrhea may disrupt growth, while good quality of mother caring pattern improve growth. This study aimed to see the association between mother caring pattern, diarrhea occurrence and the growth of infants with IUGR.Methods: This prospective cohort study was conducted in 44 IUGR infants with from birth to 4 months old. Data were collected by interviews to the mother, using a structured questionnaire and observation. The variables measured were mother caring pattern, diarrhea occurrences, environmental sanitation, health service utility and growth. Data were analyzed using Pearson and Rank-Spearman correlation tests, as well as multiple linear regressions.Results: Eighty-eight point six percents of the respondents had good quality of caring pattern. The mean diarrhea episode per child was 0.84 (±1.1), with duration of 1.8 days/episode. Cummulative incidence of diarrhea was 84.1% and incidence density of diarrhea was 3.1 person-years. Diarrhea occurrences in subjects who were partially breastfed were higher than the subjects who wereexclusively breastfed. There was a correlation between mother’s feeding practice and growth (WAZ: p<0.004, BMI: p<0.039). There was no correlation between mother’s caring pattern, diarrhea occurrences, environmental sanitation, health service utility and growth. Environmental sanitation, health service utility, diarrhea occurrences, mother’s caring pattern of feeding, nursing andhygiene, were all contributed to 31.7% of WAZ scores.Conclusions: Among the mother caring pattern, only feeding practice was correlated to the growth of infants with IUGR, while diarrhea occurrences was not correlated. It is recommended that mothers of infants with IUGR should be given counseling with regard to infant feeding practice.Keywords: Pola Asuh Ibu, Kejadian Diare dan Pertumbuhan Sampai 4 Bulanpada Bayi yang Mengalami Hambatan Pertumbuhan Dalam RahimABSTRAKLatar Belakang: Bayi dengan hambatan pertumbuhan dalam rahim (IUGR) sangat rentan terhadap infeksi terutama diare yang dapat mengganggu pertumbuhannya. Pola asuh ibu diharapkan dapat memperbaiki dan menunjang pertumbuhan optimal bayi yang lahir dengan IUGR. Penelitian ini bertujuan untuk mengetahui hubungan pola asuh ibu dan kejadian diare dengan pertumbuhan bayi dengan IUGR.Metode: Penelitian kohort prospektif pada 44 bayi IUGR sampai umur 4 bulan. Variabel yang diamati: pola asuh ibu, kejadian diare, sanitasi lingkungan, pemanfaatan pelayanan kesehatan dan pertumbuhan. Analisis data dengan korelasi Pearson, Rank- Spearman dan analisis regresi linier ganda.Hasil: Pola asuh ibu 88,6% baik. Rerata episode diare 0,84(±1,16) dengan lama diare 1,8 hari/episode. Insidensi kumulatif diare 84,1% dan densitas insiden diare 3,1 orang-tahun. Kejadian diare subyek ASI parsial lebih banyak dibandingkan subyek ASI eksklusif. Ada hubungan antara praktik ibu memberi makan bayi dengan pertumbuhan bayi (BB/U p<0,004 dan BMI p<0,039). Tidak ada hubungan pola asuh ibu, kejadian diare, sanitasi lingkungan dan pemanfaatan pelayanan kesehatan dengan pertumbuhan bayi. Secara bersama-sama sanitasi lingkungan, pemanfaatan pelayanan kesehatan, kejadian diare, praktik ibu memberi makan,merawat, menjaga kebersihan diri dan bayi berpengaruh terhadap pertumbuhan bayi dengan kontribusi terbesar dari skor-Z BB/U(31,7%).Simpulan: Pada pola asuh ibu hanya praktik ibu memberi makan bayi berhubungan dengan pertumbuhan bayi yang lahir IUGRsampai umur 4 bulan.
Keadaan Sosio-Ekonomi dan Status Pb Darah Anak pada Pemajanan Pb Lingkungan Henna Rya Sunoko
MEDIA MEDIKA INDONESIANA 2009:MMI VOLUME 43 ISSUE 4 YEAR 2009
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The socio-economic factor and children blood lead level in environmental lead exposureBackground: Low level lead exposures usually are coming from various environmental sources including air, food and water. This has important implications with respect to its regulation. The socio-economic factors can also affect blood lead level in children. This study was aimed to examine the influence of housing condition, earning and education of children’ primary caregivers on children blood lead levels.Methods: The study involved 54 children aged 5-10-years, coming from Gebang Sari, Sekaran and Moro Demak. Cross-sectional design was adopted in this research. The collected data were analyzed using non parametric Wilcoxon signed rank test to determine the mean differences of lead among the locations. OR prevalence and frequencies as well as cross tabulation of blood lead level and housing condition, earning and education data were also analyzed.Results: There were significance differences amongst Gebang Sari, Sekaran and Moro Demak children blood lead levels (p<0.05). Gebang Sari ambient lead air was the highest compared to those of other two locations. Compared to Sekaran and Moro Demak, Gebang Sari was dominated by higher children’ primary caregivers earning and education levels. OR prevalence of >10 ppb lead cut-off for earning level was 2.332 (1.49, 3.65). OR prevalence of >10 ppb lead cut-off for education level was 2.092 (1.295, 3.382).Conclusions: Children blood lead levels were not only influenced by ambient air lead but also by housing condition, earning and education of their primary caregivers.Keywords: Children blood lead level, housing condition, earning, educationABSTRAKLatar belakang: Toksisitas akibat pemajanan Pb lingkungan pada dosis rendah dapat berasal dari berbagai sumber seperti udara, air dan makanan. Hal ini mempunyai implikasi penting terhadap regulasi. Faktor sosio-ekonomi juga berpengaruh terhadap kadar Pb darah anak. Penelitian ini ditujukan untuk mempelajari pengaruh kondisi rumah, tingkat pendapatan dan pendidikan dari orang tua atau wali anak terhadap kadar Pb darah anak.Metoda: Penelitian mengikutsertakan 54 anak, umur 5-10 tahun, berasal dari Gebang Sari, Sekaran dan Moro Demak. Penelitian didesain secara cross-sectional. Data dianalisis secara non-parametrik dengan Wilcoxon signed rank test untuk mengetahui rerata kadar Pb darah anak antar lokasi. OR prevalensi, frekuensi dan tabulasi silang antara kadar Pb darah dengan kondisi rumah, pendapatan dan pendidikan juga dianalisis.Hasil: Terdapat beda yang bermakna antara kadar Pb darah subjek di Gebang Sari dan Sekaran dengan Kadar Pb darah subjek di Moro Demak (p<0,05). Kadar Pb udara ambien Gebang Sari tertinggi dibanding kadar Pb udara di dua lokasi lainnya. Tingkat pendapatan dan pendidikan orang tua atau wali subjek penelitian Gebang Sari lebih tinggi dibanding Sekaran dan Moro Demak. OR prevalensi pada cut-off Pb >10 ppb untuk tingkat pendapatan adalah 2,332 (1,49, 3,65). OR prevalensi pada cut-off Pb >10 ppb untuk tingkat pendidikan adalah 2,092 (1,295, 3,382).Simpulan: Kadar Pb darah anak tidak hanya dipengaruhi oleh kadar Pb udara ambien tetapi juga dipengaruhi oleh kondisi rumah, tingkat pendapatan dan pendidikan orang tua atau wali.
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
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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.
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.
Phytoestrogen Genistein and Black Cohosh and Marker of BMD in Menopausal Women Rizani Amran; Adenan Abadi; Theodorus Theodorus; Elvi Widiastuti
MEDIA MEDIKA INDONESIANA 2012:MMI VOLUME 46 ISSUE 2 YEAR 2012
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Background: In Indonesia, phytoestrogens can be found in the market as supplement to resolve climacteric complaint and osteoporosis. This phytoestrogens has not been proven scientifically to have benefit in overcoming the climacteric complaints and osteoporosis in menopausal women. Therefore, it is important to have clinical test searching data for knowing the increase of bone mineral density (BMD).Methods: The design was comparison clinical test in the form of “add on” with double blind in Hospital of Mohammad Hoesin Palembang started in August 2010 until February 2011 putting subjects into fitoestrogen and placebo groups randomly. T-score of spine and femur were measured using done densitometry before and after 6 months supplementation.Results: In the beginning of study, it was found that the average of spine T-score in the group of phytoestrogens was -1.455±0.264 after 6 months it increased to -1.295±0.223 with change 0.160±0.153 (p=0.001).Whereas in placebo group the average of spine T-score at the beginning of the study was -1.295±0.223 becoming -1.560±0.414 with decrease of -0.100±0.273 (p=0.118). Femur T-score level, of phytoestrogens group at the beginning of the study was -1.415±0.215, after 6 months it became -1.270±0.141 with change of 0.145±0.170 (p=0.001). In placebo group, the average of femur T-score was -1.475±0.202 becoming -1.595±0.421 with of decrease -0.120±0.33 (p=0.124). The status of spine and femur T-score BMD both in, phytoestrogens and placebo group was osteopenia at the beginning of the study. After 6 months, spine T-score in phytoestrogens group did not change, and in placebo group, 2 subject showed osteoporosis with spine T-score and femur T-score -2.7 and -2.75(±0.212).Conclusions: The administration of phytoestrogens is able to maintain bone mineral density and prevent the occurrence of osteoporosis.Keywords: Phytoestrogens, BMD, T-score, menopauseABSTRAK Fitoestrogen genistein dan black cohosh dan penanda BMD pada perempuan menopauseLatar belakang: Di Indonesia, fitoestrogen beredar di pasaran sebagai suplemen untuk mengatasi keluhan klimakterik dan osteoporosis. Fitoestrogen ini belum terbukti secara ilmiah bermanfaat untuk mengatasi keluhan klimakterik maupun osteoporosis pada perempuan menopause. Oleh karena itu uji klinik ini dilakukan untuk mencari data guna mengetahui meningkatnya gambaran BMD.Metode: Desain adalah uji klinik berpembanding dalam bentuk add on, secara tersamar ganda di RS Dr. Mohammad Hoesin Palembang bulan Agustus 2010 sampai dengan Februari 2011 pada subyek yang dibagi dalam kelompok fitoestrogen dan placebo secara acak. Variabel yang diukur adalah skor T tulang vertebra dan femur menggunakan bone densitometer sebelum dan setelah 6 bulan mendapat suplemen.Hasil: Pada awal penelitian rerata T-skor tulang belakang kelompok fitoestrogen -1,455±0,264 setelah 6 bulan menjadi -1,295±0,223 dengan perubahan 0,160 ± 0,153 (p=0,001). Sedangkan kelompok plasebo rerata T-skor tulang belakang pada awal penelitian -1,295±0,223 menjadi -1,560±0,414 dengan penurunan -0,100±0,273 (p=0,118). Pada kadar T-skor femur, di awal penelitian kelompok fitoestrogen -1,415±0,215 setelah 6 bulan menjadi -1,270±0,141 dengan besaran perubahan 0,145±0,170 (p=0,001). Pada kelompok plasebo rerata T-skor femur pada awal penelitian -1,475±0,202 menjadi -1,595±0,421 dengan perubahan -0,120±0,33 (p=0,124). Status BMD T-skor tulang belakang dan femur di awal penelitian, kelompok fitoestrogen dan kelompok plasebo adalah osteopeni. Setelah 6 bulan kemudian, pada kelompok fitoestrogen tidak terdapat perubahan status BMD sedangkan pada kelompok plasebo terdapat 2 orang yang densitas mineral tulangnya mengalami perubahan menjadi osteoporosis dengan rerata T-skor tulang belakang -2,70 dan T-skor femur -2,750 ± 0,212.Simpulan: Pemberian fitoestrogen dapat mempertahankan densitas mineral tulang dan mencegah terjadinya osteoporosis.
Pengaruh Pemberian Ekstrak Phyllanthus niruri Linn Terhadap Infiltrasi Limfosit dan Ekspresi Perforin pada Kanker Kolon Tikus Sprague-Dawley Endang Sawitri; Ign. Riwanto; Tjahjono Tjahjono; Edi Dharmana
MEDIA MEDIKA INDONESIANA 2013:MMI VOLUME 47 ISSUE 1 YEAR 2013
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ABSTRACTThe effect of Phyllanthus niruri Linn extract on lymphocytes infiltration and perforin expression in colon cancer of Sprague-Dawley RatBackground: Colon cancer treatment currently involves immunotherapy that aims to improve the quality of life and survival of patients. Phyllanthus niruri Linn (P. niruri L) may act as an immunomodulator, but its potency in antitumor immune responses has not been revealed. The study was conducted to evaluate the differences between the immunological status of rats suffering colon cancer which were not given to those given the extract of P. niruri L.Methods: The study was randomized posttest-only control group design. Samples were 30 Sprague-Dawley male rats, bodyweight 170-220 gr which induced by 1.2 DMH 30 mg/kgBW subcutaneously. On the weeks 9, 11 and 13, four induced rats each week were sacrified to detect the development of colon cancer. On the weeks of 13th all of 4 rats were developed colon cancer, so the induction were stopped. The rest of 18 induced rats were randomly into two groups: without P.  niruri L or positive control (K+)=9 rats and  given P. niruri L extract 13.5 mg/kg orally or  X  group=9  rats.  After 19th week all of rats were then terminated and tumor lesion of colon were processed hystophatologically. The tissues of colon cancer were stained by H&E for evaluate the lymphocytes infiltration and immunohistochemistry monoclonal antibody anti-perforin for perforin expression. Non pairs t-test was used with considered significant if p<0.05.Results: The mean of lymphocytes infiltration of the group X was 401.89±70.19, it was higher compared to K+ 191.89±50.68 (p=0.000). The mean percentage of perforin expression of group X was 39.00±1.80%, it was higher compared to K+ 23.00± 3.00% (p=0.000). Conclusion: The extract of P. niruri L increases immunologic status through mechanism of lymphocytes infiltration and perforin expression elevation of colon cancer in animal mode.Keywords : Phyllanthus niruri Linn, colon cancer, lymphocytes infiltration, perforinABSTRAKLatar belakang: Penanganan kanker kolon saat ini melibatkan imunoterapi yang bertujuan untuk meningkatkan kualitas hidup dan survival penderitanya. Phyllanthus niruri Linn bekerja sebagai imunomodulator, tetapi potensinya dalam respons imun antitumor belum banyak diungkap. Penelitian bertujuan untuk mengevaluasi perbedaan status imunologis antara tikus coba yang menderita kanker kolon yang tidak diberi dengan yang diberi ekstrak P. niruri L.Metode: Penelitian ini merupakan randomized posttest-only control group design. Sampel berupa 30 ekor tikus Sprague-Dawley jantan, yang diinduksi 1,2 DMH 30 mg/kgBB subkutan sekali setiap minggu. Pada minggu ke-9, 11 dan 13 masing-masing empat ekor tikus dimatikan untuk melihat perkembangan tumor. Minggu ke-13 pada kolon empat tikus telah tumbuh kanker kolon, sehingga induksi dihentikan dan sisa 18 tikus dirandom alokasi menjadi 2 kelompok. Kelompok kontrol positif (K+) tanpa pemberian P. niruri L (9 tikus) dan kelompok diberi P. niruri L. 13,5 mg/kg per hari melalui sonde (9 tikus). Minggu ke-19 semua tikus diterminasi, lesi tumor pada kolon diproses menjadi sediaan histopatologik, kemudian dipulas dengan H&E untuk memeriksa infiltrasi limfosit dan pulasan imunohistokimia menggunakan antibodi monoklonal anti-perforin untuk melihat ekspresi perforin. Analisis data menggunakan uji t tidak berpasangan dengan derajat signifikansi p<0,05.Hasil: Rerata jumlah infiltrasi limfosit kelompok X adalah 401,89±70,19 lebih tinggi dibanding kelompok K+ yaitu191,89±50,68 (p=0,000). Persentase rerata ekspresi perforin kelompok X sebesar 39,00±1,80%, lebih tinggi dibandingkan dengan K+ yakni 23,00±3,00% (p=0,000).Simpulan: Ekstrak P. niruri L meningkatkan status imunologi melalui mekanisme peningkatan infiltrasi limfosit dan ekspresi perforin untuk melawan kanker kolon pada tikus coba
Kadar Merkuri pada Rambut Masyarakat di Sekitar Penambangan Emas Tanpa Ijin Andri DH; Anies Anies; Suharyo H
MEDIA MEDIKA INDONESIANA 2011:MMI Volume 45 Issue 3 Year 2011
Publisher : MEDIA MEDIKA INDONESIANA

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Abstract

ABSTRACTHair mercury concentration in community living sourrounding the illegal gold miningBackground: Higher mercury concentration in the hair surrounding of illegal gold mining communities occurred due to mercury exposed continuously in a long time. The purpose of this research was to identify the risk factors affecting the mercury concentration of the community hair living in the illegal gold mining activity.Methods: The study was a case control study. Subject were people living around the Mandor’s river consisting of 68 families (34 cases and 34 controls). Data collection was done through structured interviews, observation, depth interviews, and examination of the rate of mercury in the laboratory for hair samples. Data were analyzed by chi-square test and logistic regression.Results: There were significant relationship between length of stay when (p=0.003), house distance (p=0.002), employment(p=0.004), a water source (p=0.004), habit of bathing in river (p=0.015) and consumption of local fish (p=0.007) with mercury level in the hair. Variable local vegetable consumption and nutritional status do not have a significant influence on the rate of mercury in hair with (p=0.330) and (p=0.500). The risk for mercury level in the hair above the thresholds were the length of stay ≥15 years (OR=7.07; 95% CI=2.12-23.57) and consumption of local fish >3 times/weeks (OR=6.14; 95% CI=1.86-20.30), with a probability of 89.3%.Conclusion: Risk factors for the occurrence of mercury in the hair above the threshold is the length of stay ≥15 years andconsumption of local fish >3 times/weeks. Therefore it recommended to relocate house away from the river and decrease the consumption of Mandor’s river fish.Keywords: Illegal gold mining, length of stay, fish consumption, mercury concentrationABSTRAKLatar belakang: Aktivitas penambangan emas tanpa ijin (PETI) yang menggunakan merkuri untuk proses amalgamasi akanberakibat meningkatnya kadar merkuri pada perairan. Meningkatnya kadar merkuri pada rambut masyarakat di sekitar aktivitas PETI terjadi karena paparan merkuri yang berlangsung terus menerus dalam waktu yang lama. Penelitian ini bertujuan untuk memperoleh informasi tentang faktor risiko yang berpengaruh terhadap kadar merkuri pada rambut masyarakat yang tinggal di sekitar aktivitas PETI.Metoda: Penelitian ini merupakan penelitian observasional dengan rancangan case control. Sampel penelitian adalah masyarakat yang tinggal di sekitar aliran sungai Mandor dengan sampel 68 kepala keluarga (34 kasus dan 34 kontrol) di wilayah kecamatan Mandor. Pengumpulan data dilakukan dengan wawancara terstruktur, observasi, wawancara mendalam, dan pemeriksaan kadar merkuri di laboratorium untuk sampel rambut. Data dianalisis dengan uji chi-square dan regresi logistik.Hasil: Terdapat hubungan yang signifikan antara lama tinggal (p=0,003), jarak tempat tinggal (p=0,002), jenis pekerjaan(p=0,004), sumber air bersih (p=0,004), kebiasaan mandi (p=0,015) dan konsumsi ikan hasil setempat (p=0,007) dengan kadar merkuri pada rambut. Variabel konsumsi sayuran setempat dan status gizi tidak memiliki hubungan yang signifikan dengan kadar merkuri pada rambut masing-masing dengan (p=0,330) dan (p=0,500). Variabel yang berisiko terjadinya kadar merkuri pada rambut melebihi ambang batas adalah lama tinggal ≥15 tahun (OR=7,07; 95%CI=2,12–23,57) dan konsumsi ikan hasil setempat >3 kali per minggu (OR=6,14; 95% CI=1,86-20,30), dengan nilai probabilitas sebesar 89,3%.Simpulan: Berdasar hasil tersebut disimpulkan bahwa yangmerupakan faktor risiko terjadinya kadar merkuri pada rambut melebihi ambang batas adalah lama tinggal ≥15 tahun dan mengkonsumsi ikan hasil setempat >3 kali per minggu. Oleh karena ini disarankan untuk mengurangi konsumsi ikan yang berasal dari sungai Mandor dan merelokasi rumah jauh dari sungai Mandor
Metformin Dosis Rendah Jangka Pendek dan Risiko Timbulnya Aterosklerosis pada Prediabetes Non Obes Djoko Hardiman
MEDIA MEDIKA INDONESIANA 2008:MMI Volume 43 Issue 2 Year 2008
Publisher : MEDIA MEDIKA INDONESIANA

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Abstract

ABSTRACTLow-dose short-term metformin and the risk of atherosclerosis in non obese prediabetic.Background: The establishment of macrovascular (cardiovascular) event is initiated in the period of prediabetic. Metformin plays role in the carbohydrate and lipid metabolism as well as vascular protection. The mechanism of the cardiovascular event risk increase in the prediabetic individual has not been clearly established. The study was to determine if insulin resistance control by low-dose short-term metformin administration in the non-obese prediabetic individual might decrease the atherosclerosis risk.Method: The present study was a prospective, experimental study with pretest-posttest control group design. It was conducted on the first degree relative of type-2 DM patient who met the criteria of non-obese prediabetic individual. Subjects were randomly classified into treatment group (designed for metformin administration), and the control group (designed for placebo administration). The prediction of atherosclerosis risk was based on the hsCRP, PAI-1, VCAM-1 and fibrinogen levels.Results: The margin between pre and post metformin administration term were 1.89 vs 0.06 mg/L (p=0.001), 1.42 vs 0.84 IU/mL (p=0.015), 180.85 vs 03.81 mg/L (p=0.061) and 80.15 vs 31.42 mg/dL (p=0.001) for hsCRP, PAI-1, VCAM-1 and Fibrinogen in the treatment and control group, respectively.Conclusion: Low-dose short-term metformin administration might decrease the atherosclerosis risk factor in the non-obese prediabetic individuals.Keywords: Metformin, non-obese prediabetic, hsCRP, PAI-1, Fibrinogen, VCAM-1ABSTRAKLatar belakang: Awal terjadinya penyakit makrovaskuler (kardiovaskuler) terjadi pada periode prediabetes. Metformin mempunyai efek terhadap metabolisme karbohidrat, lipid dan proteksi terhadap vaskuler. Mekanisme timbulnya peningkatan resiko penyakit kardiovaskuler terjadi pada individu dengan prediabetes. Penelitian ini bertujuan untuk membuktikan bahwa pengendalian resistensi insulin pada individu prediabetes non obes dengan metformin dosis rendah jangka pendek, dapat menurunkan resiko timbulnyaaterosklerosis.Metode: Penelitian ini adalah suatu penelitian eksperimental yang bersifat prospektif dengan pretest-posttest control group design. Sampel dalam penelitian ini adalah turunan dari penderita DM tipe 2 yang tergolong ke dalam kriteria prediabetes. Subjek penelitian dikelompokkan atas dua kelompok, yaitu kelompok perlakuan yang mendapatkan kapsul yang berisi metformin, dan kelompok kontrol yang mendapatkan kapsul yang berisi kontrol. Pemilihan kelompok yang mendapat kontrol atau metformin  dilakukan secara acak. Penentuan risiko aterosklerosis dengan menggunakan kadar hs-CRP, PAI-1, VCAM-1 dan fibrinogen.Hasil: Hasil penelitian ini menunjukkan rerata selisih kadar hs-CRP, PAI-1, VCAM-1 dan fibrinogen pre dan post pemberian metformin antara kelompok perlakuan dan kontrol adalah kadar hs-CRP 1,89 dan -0,06 mg/L (p=0,001), PAI-1 1,42 dan -0,84 IU/mL (p=0,015), VCAM-180,85 dan -3,81 ng/mL (p=0,061) dan fibrinogen 80,15 dan -31,42 mg/dL (p=0,001).Simpulan: Pemberian metformin dosis rendah jangka pendek menurunkan risiko terjadinya aterosklerosis pada prediabetes non obes.
Are GSTM1 Null and GSTT1 Null Risk Factor of Autism Spectrum Disorder? A Preliminary Study Donna Hermawati; Sue-Mian Then; Tri Indah Winarni; Rahman Jamal; Sultana MH Faradz
MEDIA MEDIKA INDONESIANA 2012:MMI VOLUME 46 ISSUE 2 YEAR 2012
Publisher : MEDIA MEDIKA INDONESIANA

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Abstract

Background: Low plasma total glutathione (tGSH) levels, elevated levels of oxidized glutathione (GSSG) and low ratios of tGSH to GSSG in autism were reported. Glutathione S-transferases (GST) are antioxidant enzymes that play important role in cellular detoxification and the excretion of environmental pollutants including heavy metals. Glutathione S-transferase mu (GSTM1) and Glutathione S-transferase theta (GSTT1) are known to be highly polymorphic. Homozygous deletions of these genes result in lack ofenzyme activity and impaired the ability to excrete metals including mercury. Combined effects of mercury (Hg) accumulation coupled with decreased levels of antioxidants (low glutathione and antioxidant enzymes) contribute to the phenotypic presentation of autism spectrum disorder (ASD). Association of GSTM1 null genotype with autism has been reported. Therefore the preliminary study was performed to investigate the role of GSTM1 null and GSTT1 null as risk factor of ASD associated with phenotype expression.Method: Fifty one ASD patients were recruited from special need & autism school and 45 controls from Semarang & Solo. Blood veins samples were collected and genomic DNA was extracted by salting-out method in CEBIOR Semarang. Genotyping for GSTM1 and GSTT1 gene was done in UMBI Malaysia. Multiplex PCR was performed and PCR products were separated on 1.2 % agarose gel, stained with ethidium bromide and visualized on UV transiluminator. GSTM1 & GSTT1 gene product is about 625 bp and 459 bp. Absence of GSTM1 and GSTT1 gene band was interpreted as GSTM1 null & GSTT1 null.Results: The frequency of GSTM1 null and GSTT1 null in ASD higher compared with control group but the difference is not statistically significant (p=0.357, OR=0.504; 95% CI 0.117-2.168 and p=0.364, OR=0.674; 95% CI 0.287-1.580). There is also no statistically different in the distribution of GSTM1 null and GSTT1 null between mild to moderately autistic and severely autistic (p=0.983, OR=0.980; 95% CI 0.158-6.095 and p=0.439, OR=1.633; 95% CI 0.471-5.656).Conclusion: GSTM1 null and GSTT1 null are not risk factor of ASD. Further investigations are needed with a bigger sample size, analyzing multiple GST genes and GST activity determination to find out the gene susceptibility of ASD and factors that contribute to the phenotype expression of ASD.Keywords: GSTM1 null, GSTT1 null, risk factor, autism spectrum disorder ABSTRAKApakah GSTM1 Null dan GSTT1 Null merupakan faktor risiko autism spectrum disorder? Studi pendahuluanLatar belakang: Pada autism ditemukan bahwa glutathion total plasma (tGSH) rendah, oxidized glutathione (GSSG) meningkat dan rasio tGSH terhadap GSSG rendah. Glutathione s-transferase (GST) merupakan enzim antioksidan yang berperan penting dalam proses detoksifikasi seluler dan ekskresi polutan lingkungan termasuk diantaranya logam berat. Polimorfisme gen GST mu (GSTM1) dan GST theta (GSTT1) cukup tinggi. Delesi homozigot gen GSTM1 dan GSTT1 yang menyebabkan berkurang sampai tidak adanya aktivitas enzim GST serta menurunnya level antioksidan berkontribusi terhadap risiko ASD. Oleh karena itu dilakukan penelitian pendahuluan untuk mengetahui hubungan antara gen GSTM1 null dan GSTT1 null sebagai faktor risiko ASD dengan ekspresi fenotip.Metode: Lima puluh satu pasien ASD dari SLB dan sekolah autis serta 45 kontrol dari Semarang dan Solo diambil darah vena, kemudian diekstraksi dengan metode salting-out diCEBIOR Semarang. Pemeriksaan genotip gen GSTM1 & GSTT1 dilakukan di UMBI Malaysia. Metode yang digunakan adalah PCR multipleks, setelah itu produk PCR dipisahkanpada 1,2% gel agarosa kemudian dicat dengan ethidium bromida dan hasilnya dilihat menggunakan transiluminator UV. Besar produk untuk GSTM1 & GSTT1 adalah 625 bp &459 bp. Tidak adanya band untuk gen GSTM1 & GSTT1 diinterpretasikan sebagai GSTM1 null & GSTT1 null.Hasil: Frekuensi gen GSTM1 null dan GSTT1 null pada ASD lebih tinggi dibandingkan kontrol tetapi tidak ditemukan perbedaan yang signifikan (p=0,357, OR=0,504; 95% CI0,117-2,168 and p=0,364, OR=0,674; 95% CI 0,287-1,580). Distribusi gen GSTM1 null dan GSTT1 null pada autis ringan sedang dan autis berat juga tidak ditemukan perbedaan yang signifikan secara statistik (p=0,983, OR=0,980; 95% CI 0,158-6,095 and p=0,439, OR=1,633; 95% CI 0,471-5,656).Simpulan: GSTM1 null dan GSTT1 null bukan merupakan faktor risiko ASD. Penelitian lebih lanjut sangat diperlukan dengan jumlah sampel yang lebih besar, analisis gen GSTmultipel dan pemeriksaan aktivitas GST untuk mendapatkan gen faktor risiko ASD dan faktor-faktor yang mempengaruhi ekspresi fenotip ASD.

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