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INDONESIA
MEDIA MEDIKA INDONESIANA
Published by Universitas Diponegoro
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Articles 134 Documents
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Serum Serotonin Levels among Homosexual and Heterosexual Men Santoso Santoso; Lusiana Batubara
MEDIA MEDIKA INDONESIANA 2013:MMI VOLUME 47 ISSUE 1 YEAR 2013
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ABSTRACT Background: Variations in sexual preferences and orientations have both proximate and ultimate causes. Serotonin (5-HT) system is a key in the regulation of reward-related behaviors, from eating, drinking to sexual activity. Recent study demonstrated that a serotonin level is involved in sexual preference in rodent as animal models. This study focuses on the profile of serotonin levels from blood among homosexual compared to heterosexual men.Methods: Eight adult (34.5±7.69) homosexual men were purposively collected from homosexual communities in Surabaya, as well thirteen adult (27.61±5.14) heterosexual men from Semarang. Complete psychological examinations were done, then serum serotonin levels were measured using ELISA. Furthermore age and Zung-self-rating depression scale were cross matched, then serum serotonin levels were tested using Mann-Whitney U Test to determine the difference of serotonin levels among two groups.Results: Our data demonstrated that 25% of homosexual men suffered from depression. There was no difference on serum serotonin levels among homosexual men compared to heterosexual men (p=0.41).Conclusion: There is no significant difference on serum serotonin levels among homosexual and to heterosexual men.Keywords: Sexual preferences, homosexual, heterosexual, serotonin, depressionABSTRAKKadar serum serotonin pada laki-laki homoseksual dan heteroseksualLatar belakang: Variasi dalam preferensi dan orientasi seksual memiliki beberapa faktor penyebab. Serotonin (5-HT) merupakan kunci dalam pengaturan perilaku mulai dari makan, minum sampai aktivitas seksual. Penelitian terdahulu menyebutkan bahwa kadar serotonin memiliki peran dalam penentuan preferensi seksual pada tikus. Penelitian ini bertujuan untuk menganalisis kadar serotonin darah pada laki-laki homoseksual dan heteroseksual.Metode: Delapan laki-laki homoseksual dewasa secara purposif (34,5±7,69 tahun) diambil dari komunitas homoseksual di Surabaya dan 13 laki-laki heteroseksual dari Semarang (27,61±5,14 tahun), kemudian dilakukan skrining tanda depresi dengan menggunakan  Zung-self-rating depression scale. Kadar serotonin serum diperiksa dengan menggunakan metode ELISA. Data yang diperoleh kemudian dianalisis dengan menggunakan uji Mann-Whitney U untuk melihat perbedaan kadar serotonin serum pada kedua kelompok.Hasil: 25% laki-laki homoseksual mengalami depresi, dan tidak ada perbedaan kadar serotonin pada serum laki-laki homoseksual maupun heteroseksual (p=0.41).Simpulan: Tidak terdapat perbedaan antara kadar serotonin serum laki-laki homoseksual dengan heteroseksual.
Suplementasi Vitamin E dan Profil Lipid Penderita Dislipidemia: Studi pada Pegawai Rumah Sakit Profesor Dokter Margono Soekarjo Purwokerto Diah Krisnansari; Martha Irene Kartasurya; M. Zen Rahfiludin
MEDIA MEDIKA INDONESIANA 2011:MMI Volume 45 Issue 1 Year 2011
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ABSTRACT Vitamin E supplementation and lipid profile in patients with dislipidemia Background: The prevalence of dislipidemia in Indonesia increase lately. Vitamin E has important role in cholesterol metabolism and protecting low density lipoprotein cholesterol against oxidation. This study was to investigate the effect of vitamin E supplementation on lipid profile.Method: The study was a randomised controlled clinical trial. Subjects were the employees of Professor Doctor Margono Soekarjo hospital aged 30-50 years who suffered from dislipidemic. The supplementation groups received 400 IU vitamin E and the control group received placebo once a day for 30 days. Lipid profile was examined using vitros system chemistry analyser 250 dan 350. Nutritional intake were gathered using food recall method and processed with nutrisurvey. Analyses were conducted using T-test, Mann Whitney, Wilcoxon and Chi square tests.  Result: There were no differences in total (p=0.910), LDL (p=0.457) and HDL cholesterol levels (p=0.809) as well as trigliseride level (p=0.687) between the two groups before suplementation. There were differences in total (p=0.004) and LDL (p=0.002), there were no differences in HDL cholesterol level (p=0.332) and trigliseride level (p=0.940) between the two groups after supplementation. There were differences on the changes in total cholesterol (p=0.001) and LDL cholesterol (p=0.000) and no differences on the changes in HDL cholesterol level (p=0.197) as well as trigliserida level (p=0.438). There was no difference in nutritional intake between the two groups. Conclusion: That supplementation of vitamin E 400 IU once daily for 30 days improve lipid profile. Keywords: Dislipidemia, vitamin E, total cholesterol, LDL cholesterol, HDL cholesterol, trigliseride   ABSTRAK Latar belakang: Angka kejadian dislipidemia di Indonesia semakin meningkat. Vitamin E merupakan antioksidan penting dalam metabolisme kolesterol, melindungi kolesterol LDL terhadap oksidasi dan meningkatkan kolesterol HDL. Penelitian ini bertujuan mengetahui pengaruh suplementasi vitamin E terhadap profil lipid penderita dislipidemia. Metode: Desain studi adalah acak buta ganda terkontrol dengan subyek 42 orang karyawan RS Profesor Dokter Margono Soekarjo penderita dislipidemia yang berusia 30-50 tahun, dibagi menjadi dua kelompok yaitu 22 orang memperoleh vitamin E 400 IU dan 20 orang memperoleh placebo sekali sehari selama 30 hari. Karakteristik subyek diperoleh melalui wawancara, berat badan dan tinggi badan diperoleh melalui pengukuran. Profil lipid diukur sebelum dan sesudah suplementasi dengan vitros system chemistry analyser 250 dan 350. Asupan gizi diperoleh melalui food recall dan dianalisis dengan program nutrisurvey. Data dianalisis dengan uji T, Mann Whitney, Wilcoxon dan Chi square. Hasil: Tidak ada perbedaan kolesterol total (p=0,910), kolesterol LDL (p=0,457), kolesterol HDL (p=0,809) dan trigliserida (p=0,687) antara kedua kelompok sebelum suplementasi. Ada perbedaan kolesterol total (p=0,004) dan kolesterol LDL (p=0,002), tidak ada perbedaan kolesterol HDL (p=0,332) dan trigliserida (p=0,940) antara kedua kelompok sesudah suplementasi. Ada perbedaan perubahan kolesterol total (p=0,001) dan kolesterol LDL (p=0,000), tidak ada perbedaan perubahan kolesterol HDL (p=0,197) dan trigliserida (p=0,438) antara kedua kelompok. Tidak ada perbedaan asupan gizi antara kedua kelompok. Simpulan: Suplementasi vitamin E 400 IU sekali sehari 30 hari dapat memperbaiki kolesterol total dan kolesterol LDL penderita.  
Vaginal Acidity and Whiff Test for Screening Bacterial Vaginosis in Pregnant Women Tri Nur Tri Nur Kristina
MEDIA MEDIKA INDONESIANA 2008:MMI Volume 43 Issue 2 Year 2008
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Keasaman vagina dan tes whiff untuk penapisan bacterial vaginosis pada ibu hamil.Background: It has been acknowledged that bacterial vaginosis (BV) in pregnant women is associated with miscarriage and premature delivery. Microscopic examination of vaginal secretion should be used in the diagnosis of BV. Nevertheless, usually microscope does not exist in antenatal care facility in the community based setting. Therefore, screening tool of BV among pregnant women attending antenatal care that is simple, cheap, and fast is needed.Methods: Diagnostic study was conducted among pregnant women attending antenatal care in the Community Health Centre. Vaginal acidity combines with whiff test were used as a screening tool, and compared blindly with Gram stain of vaginal smear as a gold standard to diagnose BV.Results: This study showed that the sensitivity and specificity of the vaginal acidity combine with whiff test to diagnose BV were 93.1% and 69% respectively. It means that false negative and false positive were 6.9% and 31% respectively. In the screening method, high sensitivity or less false negative is needed. Therefore, only few people who really have the disease (the false negative) can’t be reached by the gold standard of diagnostic test.Conclusions: It could be concluded that the combination of vaginal acidity and whiff test is a useful tool for screening BV in pregnant women especially in the community-based health facility.Keywords: Bacterial Vaginosis, sensitivity, specificity ABSTRAKLatar belakang: Vaginosis Bakterial (VB) pada ibu hamil diketahui secara luas sebagai faktor risiko terjadinya abortus dan kelahiran prematur. Diagnosis VB harus ditegakkan dengan pemeriksaan sekret vagina menggunakan pemeriksaan mikroskopik, yang pada umumnya tidak tersedia di tempat pemeriksaan kehamilan primer. Oleh karena itu dibutuhkan alat pemeriksaan (penapisan) VB pada ibu hamil yang mudah, murah dan cepat.Metode: Penelitian ini merupakan studi diagnostik pada ibu hamil yang memeriksakan kehamilannya di Puskesmas. Keasaman vagina dikombinasikan dengan tes whiff digunakan sebagai alat penapisan dan dibandingkan secara membuta dengan pengecatan Gram pada sekret vagina yang digunakan sebagai standar baku emas untuk mendiagnosis VB.Hasil: Hasil penelitian menunjukkan keasaman vagina dikombinasikan tes whiff memiliki sensitifitas 93,1% dan spesifisitas 69%. Hal ini berarti kemungkinan adanya negatif palsu hanya 6,9% sedangkan kemungkinan positif palsu 31%. Dalam metode penapisan dibutuhkan alat diagnostik yang memiliki sensitifitas tinggi atau hanya sedikit yang negatif palsu, sehingga hanya sedikit pula yang akan luput dari pemeriksaan Gram.Kesimpulan: Kombinasi keasaman vagina dengan tes whiff dapat dipergunakan untuk penapisan VB pada ibu hamil terutama di fasilitas kesehatan primer.Kata Kunci: Vaginosis Bakterial, sensitivitas, spesifisitas
Proteksi Probiotik pada Mukosa Ileum Mencit yang Terpajan Lipopolisakarida Escherichia Coli Alpha Fardah Athiyyah; Ariani Setiawati; Andy Darma; Anang Endaryanto; I Ketut Sudiana; Reza Ranuh; Subijanto MS
MEDIA MEDIKA INDONESIANA 2012:MMI VOLUME 46 ISSUE 2 YEAR 2012
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Probiotic’s protection in ileal mucosa of mice after lipopolysaccaride Escherichia coliBackground: Gastrointestinal infection is one of the major causes of morbidity in children. Diarrhea is the common manifestation. Diarrheal prevention needs a balance mucosal immune system. Probiotic used in prevention of gastrointestinal infection needs to be considered. The aim of the study is to prove probiotic protection in ileal mucosa after lipopolysaccaride (LPS) Escherichia coli O55:B5 inoculation anatomically and immunologically.Method: Experimental study with male Balb/c, age 10-12 weeks, body weight 30-40g and randomized into treatment group and placebo group. Treatment group received mix probiotic for 14 days and on day 15 were inoculated by LPS Escherichia coli O55:B5, and day 16-21 were given mix probiotic again. Placebo group received LPS Escherichia coli O55:B5 on day 15. Mice necropsy were conducted at day 22. Immunohistochemistry examination used to look for amount expression cell for IL-2, IFN-γ, TNF-α, IL-4, IL-5,IL-6, IL-10 dan TGF-β in ileal mucosa. Scanning electron microscope was used to see ileal mucosal structure. Statistic analysis used in this study was multivariate analysis.Results: Sixteen Balb/c mices were randomized into 2 groups, each group consist 8 mices. There was significant difference on amount of cells expression IL-5 (p=0.022), IL-6 (p=0.05), and also on amount of cells expression TGF-β (p=0.036). On probiotic- LPS group, there was no Th1 domination but on the other hand, Treg became dominant. Th1 and Th2 response were still balance. Structural damages occurred in LPS group and did not occur in probiotic-LPS group.Conclusion: Probiotic protection in ileal Balb/c mice mucosa after LPS Escherichia coli O55:B5 inoculation is through anatomy and immunology changes.Keywords: Probiotic, LPS, Escherichia coli, protection, immunologyABSTRAKLatar belakang: Infeksi gastrointestinal dengan manifestasi tersering diare merupakan salah satu infeksi yang sering terjadi pada anak. Pencegahan diare memerlukan keseimbangan sistem imun mukosa yang baik. Penggunaan probiotik untuk pencegahan terhadap infeksi gastrointestinal perlu dipikirkan. Penelitian ini bertujuan untuk membuktikan proteksi probiotik pada ileum mencit yang terpajan lipopolisakarida (LPS) Escherichia coli O55:B5 secara anatomis dan imunologis.Metode: Uji eksperimental dengan menggunakan mencit Balb/c jantan berusia 10-12 minggu, berat badan 30-40g dan dirandomisasi menjadi kelompok perlakuan dan kelompok kontrol. Kelompok perlakuan mendapatkan mix probiotik selama 14 hari, hari ke-15 mendapatkan LPS Escherichia coli O55:B5 dan hari ke-16-21 kembali mendapatkan mix probiotik. Kelompok kontrol mendapatkan LPS Escherichia coli O55:B5 saja pada hari ke-15. Seluruh mencit dinekropsi pada hari ke-22. Pemeriksaan imunohistokimia untuk melihat ekspresi sel penghasil sitokin IL-2, IFN-, TNF-α, IL-4, IL-5, IL-6, IL-10 dan TGF-ß di jaringan ileum. Scanning microscope electron (SEM) untuk melihat struktur mukosa ileum. Analisis statistik yang digunakan adalah analisis multivariat.Hasil: Enam belas ekor mencit Balb/c terbagi menjadi dua kelompok, masing-masing 8 mencit. Pada kelompok probiotik-LPS didapatkan perbedaan bermakna dibandingkan dengan kelompok LPS pada jumlah penghasil sitokin IL-5 (p=0,022), IL-6 (p=0,050) dan jumlah sel penghasil sitokin TGF-β (p=0,036). Pada kelompok probiotik-LPS, dominasi respon Th1 tidak terlihat lagi dan menimbulkan dominasi Treg pada kelompok ini. Posisi Th1 dan Th2 masih dapat dipertahankan secara seimbang. Kerusakan struktur yang terjadi pada kelompok LPS tidak didapatkan pada kelompok Probiotik-LPS.Simpulan: Proteksi probiotik pada mukosa ileum yang terpajan LPS Escherichia coli terjadi secara anatomi dan imunologi.
Pengaruh Larutan Ekstrak Siwak (Salvadora persica) Terhadap Streptococcus mutans: Studi In Vitro dan In Vivo Oedijani Santoso; Aini Pramoda Wardani; Nila Kusumasari
MEDIA MEDIKA INDONESIANA 2012:MMI VOLUME 46 ISSUE 3 YEAR 2012
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The influence of Siwak (Salvadora persica) extract solution on Streptococcus mutans, in vitro and in vivo studyBackground: Streptococcus mutans is the primary cause of dental caries. Siwak (Salvadora persica) may improve oral health with antibacterial effects and prevent decreasing of salivary pH. The aim of this research was to know the influence of siwak extract solution on the growth of S.mutans (in vitro) and salivary pH (in vivo).Method: I. Laboratory experimental with the post test only control group design using S.mutans as samples. The intervention groups were given siwak extract solution at various concentrations 3.1%, 6.2%, 12.5%, 25%, 50%, and 100%. The data was obtained by visually observing the growth of S.mutans colonies. Statistical test used the Kruskal-Wallis test followed by Mann-Whitney test. II. Clinical trial with the post test only control group design. 74 samples divided randomly into two groups they were control and test group. The test group rinse the mouth with 25% the siwak extract solution. Salivary pH was measured using Hanna digital pH meter with 0,1 sensitivity. The data analyzed by Shapiro-Wilk test continued by Mann-Whitney test.Result: I. Test group with concentrations of 50% and 100% were no visible growth of S.mutans, however another group still appeared the growth of S.mutans. Kruskal-Wallis test revealed a significant difference (p=0.003), Mann-Whitney test which also showed a significant difference (p=0.025). II. There was significant different on salivary pH at the test group compared to the control group (p<0.05).Conclusion: I. Siwak extract solution can inhibit the growth of S.mutans, concentration of 50% is the lowest concentration that effective to inhibit the growth of S. mutans. II. Giving the solution of siwak extract 25% can increase salivary pH significantly.Keywords: Siwak extract solution, S. mutans, salivary pH ABSTRAKLatar belakang: Streptococcus mutans merupakan penyebab utama karies. Siwak (Salvadora persica) mampu meningkatkan kesehatan mulut dengan efek antibakterial dan mencegah penurunan pH saliva. Tujuan penelitian untuk mengetahui pengaruh larutan ekstrak siwak terhadap pertumbuhan S.mutans (in vitro) dan pH saliva (in vivo).Metode: I. Eksperimental laboratorik rancangan the post test only control group design, S.mutans sebagai sampel. Perlakuan diberikan larutan ekstrak siwak konsentrasi 100%, 50%, 25%, 12,5%, 6,2%, dan 3,1%, penilaian pertumbuhan koloni S.mutans secara visual. Analisis data dengan uji Kruskal-Wallis dilanjutkan dengan uji Mann-Whitney. II. Uji klinis rancangan the post test only control group design. Sampel 74 orang, secara random dibagi dua kelompok kontrol dan perlakuan diberikan larutan ekstrak siwak 25% untuk kumur. pH saliva diukur dengan pH meter digital Hanna dengan sensitivitas 0,1. Analisis data dengan uji Shapiro- Wilk dilanjutkan dengan uji Mann-Whitney.Hasil: I. Kelompok perlakuan konsentrasi 50% dan 100% tidak tampak adanya pertumbuhan S. mutans, namun kelompok yang lain masih tampak adanya pertumbuhan S. mutans. Uji Kruskal-Wallis didapatkan perbedaan signifikan (p=0,003), uji Mann-Whitney juga didapatkan perbedaan signifikan (p=0,025). II. Terdapat perbedaan bermakna pada pH saliva antara kelompok perlakuan dibanding kontrol (p<0,05).Simpulan: I. Larutan ekstrak siwak dapat menghambat pertumbuhan S. mutans, konsentrasi 50% adalah konsentrasi terendah yang efektif menghambat pertumbuhan S. mutans. II. Kumur larutan ekstrak siwak 25% dapat meningkatkan pH saliva secara bermakna. 
Respons Histopatologik Karsinoma Serviks Uteri Setelah Pemberian Kemoradiasi T Mirza Iskandar; Maria Mexitalia; Sarjadi Sarjadi; Edi Dharmana; Noor Pramono
MEDIA MEDIKA INDONESIANA 2011:MMI Volume 45 Issue 3 Year 2011
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ABSTRACTFactors associated with histopathologic responses of cervical cancer after chemoradiation therapyIntroduction: Cervical carcinoma is the second most common women cancer in the world. A combined of surgical, radiation and chemotherapy is the main cervical carcinoma treatment. The histopathological response is one performance to assess the result of the treatment. The purpose of the study is to analyze the factors of cervical cancer which contributes to the histopathological response after chemoradiation treatment.Methods: The design of the study was a case control, done at Dr. Kariadi Hospital Semarang in 2008. Patients with biopsy-proven cervical carcinoma were entered into the study. The variables of risk factors included the stage of the cancer by FIGO staging, the type and differentiation of the tumour, the anemia and the history of the transfusion and the immunotherapy by BCG vaccine. The histopathological response was assessed after the chemoradiation treatment. Chi-square was used to analyze the risk factors and logistic regression was used for the multivariate analysis.Results: Between April-August 2008, 77 patients finished the chemoradiation treatment. The type of the cancer was squamous cell carcinoma (71.4%) and the stage was III B (81.8%). The staging, type and differentiation of the tumor, and the history of transfusion did not contributes to the histopathological response. After adjustment of other factors, the contribution of anemia to poor histopathological response were 6.25 times (95% CI 1.12-34.90; p=0.037) higher than good histopahological response.Conclusion: Anemia is the risk factor of poor histopathological response of cervical carcinoma after chemoradiation therapy.Keywords: Cervical carcinoma, chemoradiation, histopahological responseABSTRAKPendahuluan: Karsinoma serviks uteri (KSU) merupakan kanker kedua terbanyak pada wanita di seluruh dunia. Sampai saat ini terapi pilihan utama KSU adalah operasi, radiasi dan kemoterapi. Salah satu penilaian keberhasilan terapi adalah dengan respon histopatologik. Tujuan penelitian ini adalah menilai faktor-faktor yang berperan terhadap respons histopatologik setelah terapi kemoradiasi.Metode: Desain penelitian adalah kasus kontrol. Penelitian dilakukan di RSUP Dr. Kariadi Semarang. Kriteria inklusi adalah KSU yang telah menyelesaikan kemoradiasi. Faktor-faktor yang dinilai berperan terhadap respons histopatologi adalah tipe histologis dan diferensiasi tumor, stadium tumor berdasarkan FIGO, anemia dan riwayat transfusi serta pemberian imunoterapi dengan BCG. Analisis statistik menggunakan kai-kuadrat dan regresi logistik.Hasil: Selama periode April-Agustus 2008 terdapat 77 penderita yang menyelesaikan kemoradiasi. Sebagian besar penderita berada pada stadium IIIB (71,4%) dan mempunyai tipe histologi karsinoma sel skuamosa (81,8%). Stadium tumor, tipe histologi dan diferensiasi tumor, riwayat transfusi serta imunoterapi BCG tidak berperan pada respons histopatologik. Setelah memperhitungkan faktor perancu, risiko anemia terhadap respons histopatologi yang jelek adalah 6,25 kali (95% CI 1,12-34,90; p=0,037).Simpulan: Anemia merupakan faktor risiko terjadinya respon histopatologik yang jelek pada penderita karsinoma serviks uterisetelah mendapatkan terapi kemoradiasi.
Kejadian Pasung di Jawa Tengah Alifiati Fitrikasari
MEDIA MEDIKA INDONESIANA 2010:MMI VOLUME 44 ISSUE 3 YEAR 2010
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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. 
Karakteristik Penderita Sindroma Terowongan Karpal (STK) di Poliklinik Instalasi Rehabilitasi Medik RS Dr. Kariadi Semarang 2006 Lusan Maria T Tamba; Handojo Pudjowidyanto
MEDIA MEDIKA INDONESIANA 2008:MMI Volume 43 Issue 1 Year 2008
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ABSTRACTThe characteristics of carpal tunnel syndrome of patients in the medical rehabilitation (PMR) outpatient clinic Dr. Kariadi Hospital Semarang 2006Background: Carpal tunnel syndrome (CTS) is a common clinical disorder in daily practice, especially in the PMR outpatient clinic Dr. Kariadi Hospital Semarang. However it seems there is no pattern of patient characteristic and medical rehabilitation programs applied for the CTS patients. The objective of this study was to explore patient characteristics and the medical rehabilitation programs.Methods: The study was an observational descriptive study. Data were collected from medical records of new patients diagnosed with CTS in PMR Department Dr. Kariadi Hospital Semarang in 2006.Results: There were 34 patients (4% of 838 new patients) diagnosed with CTS, 32 (94,1%) were female and 2 (5,9%) were male, 18 (53%) with unilateral CTS and 16 (47%) with bilateral CTS. Most of them were 41-50 (38,2%) and 51-60 years old (35,3%) and dominantly were house wife (61,8%). The most frequent clinical manifestations were numbness (97%), with positive Tinel’s sign (88,2%). Electrodiagnostic examination was done in 17 subjects (50%). The most frequent medical rehabilitation program isultrasound therapy (76,5%), six times a week.Conclusion: CTS patients are predominantly women with positive Tinel sign, and therapy given is mostly ultrasound and ortotic prosthetic with splint.Key Words: carpal tunnel syndrome, clinical manifestation, medical rehabilitation programABSTRAKLatar belakang: Sindroma Terowongan Karpal (STK) merupakan gangguan yang sering ditemukan dalam praktek sehari-hari, khususnya di Poliklinik Instalasi Rehabilitasi Medik (IRM) RS Dr. Kariadi Semarang. Namun hingga saat ini belum diketahui karakteristik penderita dan program rehabilitasi yang diberikan. Penelitian ini bertujuan untuk mengetahui pola penderita STK dan program rehabilitasi medik yang diberikan.Metode: Penelitian bersifat observasional deskriptif. Data diperoleh dari rekam medis pasien dengan diagnosis STK yang berobat pertama kali ke Poliklinik IRM RS Dr. Kariadi Semarang tahun 2006, meliputi karakteristik penderita dan program rehabilitasi medik.Hasil: Selama 1 tahun (2006) didapatkan 34 penderita STK baru, yaitu 4% dari seluruh pasien baru (838 orang). Sebanyak 32 orang (94,1%) adalah perempuan dan 2 orang (5,9%) laki-laki, 18 (53%) unilateral dan 16 (47%) bilateral. Kelompok usia terbanyak adalah 41-50 tahun (38,2%) dan 51-60 tahun (35,3%). Pekerjaan terbanyak adalah ibu rumah tangga (61,8%). Keluhan/gejala terbanyak adalah parestesi (97%) dengan Tanda Tinel positif didapatkan pada 88,2% penderita. Pemeriksaan elektrodiagnostikdilakukan pada 17 orang (50%). Program rehabilitasi terbanyak diberikan adalah terapi ultrasound pada 26 orang (76,5%) dengan frekuensi setiap hari selama satu minggu.Simpulan: Penderita STK predominan perempuan dengan Tanda Tinel positif dan terapi yang diberikan adalah ultrasound dan splint ortotik prostetik.
Uji Diagnostik Pemeriksaan Tulang Osteolitik Berbasis Intensitas Citra Digital Susilo Susilo; Maesadji Tjokro Nagoro; Kusminarto Kusminarto; Wahyu Setia Budi
MEDIA MEDIKA INDONESIANA 2012:MMI VOLUME 46 ISSUE 1 YEAR 2012
Publisher : MEDIA MEDIKA INDONESIANA

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Diagnostic test of osteolytic bone examination based on digital image intensityBackground: The visual examination of bone radiographs using digital computed radiography (CR) is an examination for the diagnosis of bone-metastatic cancer. The subjectivity of interpretation of bone radiographs may lead to doctor’s doubt in making decision to treatment patients with bone-metastatic cancer. Software Matlab-based computer application program makes a standard method to organize the results of bone radiographs. The objective of this study is to develop a software based on Matlab to analyze the diagnostic values, and to determine the optimal of cut off point to diagnose of osteolytic bone.Method: The researches data are collected from Department of Radiology of three hospitals i.e. Dr. Kariadi Hospital Semarang, Dr. Sardjito Hospital and Bethesda Hospital Yogyakarta. This research was carried out during four month from April to August 2009. Radiographs of osteolytic bone interpreted by radiologist were compared with PA examination result of the osteolytic bone which were viewed as the gold standard. The steps in this study i.e. patients are classified as a normal or osteolytic bone patients based on the cut off point that had been determined, calculate the value of the diagnostic test using 2x2 tables, determined the area under the curve (AUC) by the procedure of receiver operating characteristic (ROC), and determined the optimal of cut off point.Result: The results of study show that the diagnostic test for osteolytic bone by using Matlab-based software has sensitivity of 0.88, specificity of 0.891, positive expected value of 0.897, negative expected value of 0.950 and the cut off point at 0.93, while, the value of area under the curve (AUC) is 94% (95% CI: 89.7%-98.3%), and the accuracy is 0.881 for the case of osteolytic bone.Conclusion: Matlab-based software being used for diagnosing osteolytic bone has relatively high sensitivity and specificity.Keywords: Digital image, bone metastases, osteolytic, optimum cut off point ABSTRAKLatar belakang: Pemeriksaan radiograf tulang secara visual menggunakan sistem radiografi digital CR (computed radiography) merupakan pemeriksaan untuk diagnosis kanker metastasis tulang. Subyektivitas interpretasi radiograf tulang dapat menyebabkan keraguan dokter dalam mengambil keputusan untuk pengobatan pasien dengan kanker tulang metastatik. Software berbasis program aplikasi computer Matlab membuat suatu metode standard untuk mengorganisasikan hasil radiograf tulang. Tujuan penelitianadalah mengembangkan software berbasis Matlab untuk menganalisis nilai-nilai diagnostik, cut off point optimal dan akurasi pemeriksaan pada diagnosis tulang osteolitik.Metode: Data penelitian diambil di bagian radiologi dari tiga rumah sakit, yaitu RSUP Dr. Kariadi Semarang, RSUP Dr. Sardjito dan Rumah Sakit Bethesda Yogyakarta. Penelitian dilakukan selama empat bulan dari April sampai Agustus 2009. Radiograf tulang  osteolitik yang diinterpretasikan oleh radiolog ini dibandingkan dengan hasil pemeriksaan PA tulang osteolitik yang dianggap sebagai gold standard. Langkah yang dilakukan dalam penelitian ini adalah pasien diklasifikasikan sebagai pasien tulang normal dan pasien osteolitik berdasar cut off point yang telah ditetapkan, menghitung nilai uji diagnostik menggunakan tabel 2x2, menghitung luasan di bawah kurva (AUC) dengan cara receiver operating characteristic (ROC), serta menetapkan cut off point optimal.Hasil: Hasil penelitian menunjukkan bahwa uji diagnostik tulang osteolitik menggunakan software berbasis Matlab memiliki sensitivitas 0,875, spesifisitas 0,891, nilai dugapositif 0,897, nilai duga negatif 0,950 dan cut off point 0,93. Nilai luasan di bawah kurva (AUC) ROC adalah sebesar 94%
Estimating The Annual Cost of Smoking-Related Diseases in Indonesia Bambang Sutrisna; Lujna Surtidewi; Anwar Jusuf; Ahmad Hudoyo; Dede Kusmana; Budhi Setianto; Endang Purwaningsih
MEDIA MEDIKA INDONESIANA 2009:MMI VOLUME 43 ISSUE 5 YEAR 2009
Publisher : MEDIA MEDIKA INDONESIANA

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Background: Smoking plays a role in the development of chronic diseases and causes substantial negative economic consequences. This study was carried out to estimate the annual cost of smoking-related cardio-cerebrovascular and pulmonary  diseases in the population by taking into account the direct costs associated with such co-morbid conditions in Indonesia.Methods: Meta-analysis using the Mix-Programme Software of the data of patients from university medical centers who were active smokers for more than a year and more than 20-pack years or passive smokers for more than a year and diagnosed with Coronary Heart Disease, Myocardial Infarction, Stroke, COPD, Chronic bronchitis, or Lung Cancer had been conducted. Annual direct cost was taken into account using the Decision Analysis Tree Age Pro (=DATA) software; cost data related to health care expenditure were derived from secondary data sources in Jakarta. In addition, Population Attributable Risk (PAR) for each comorbid conditions was calculated based on published epidemiological data from local and international journals.Results: One-hundred and eighty-seven patients (96% male) satisfying the inclusion criteria, were analyzed, of whom confirmed diagnosis of Stroke was amongst 29% of the patients, CHD 16%, Myocardial Infarction 16%, Lung Cancer 15%, COPD 17%, and Chronic Bronchitis 7%. Mean direct annual cost was highest for Lung Cancer (Rp 51.6 million) followed by Myocardial infarction (Rp 38.5 million) and CHD (Rp 37.8 million); PAR for various co-morbid conditions (based on variations in relative risk and smoking prevalence estimates) were: Stroke ~16%-26%, CHD ~17%-27%, MCI ~ 22%-33%, Lung Cancer ~ 17%-26%, COPD ~ 13%-21%, Chronic Bronchitis ~ 42%-59%.Conclusions: Annual cost of smoking-related diseases in Indonesia has been estimated. The highest cost is for Lung Cancer. The highest PAR is for Chronic Bronchitis.Keywords: Smoking-related diseases, Annual cost, Indonesia. ABSTRAKEstimasi pembiayaan per tahun penyakit terkait merokok di IndonesiaLatar belakang: Merokok berkaitan dengan kejadian berbagai penyakit kronis dengan konsekuensi ekonomi berupa biaya yang sangat banyak. Penelitian ini bertujuan untuk mengestimasi biaya dampak merokok pada berbagai kondisi ko-morbid terkait penyakit jantung, otak dan paru di masyarakat Indonesia.Metode: Meta-analisis dengan Mix-Programme software pada data sekunder penderita penyakit jantung iskemik, infark miokard, stroke, COPD, bronkitis kronis atau kanker paru dari Rumah Sakit Pendidikan Jakarta dengan kriteria : perokok aktif lebih 1 tahun dan merokok lebih 20 pak/tahun atau perokok pasif lebih 1 tahun. Cost-analysis dengan Tree Age Pro (=DATA) software dilakukan untuk membandingkan pengeluaran/biaya pengobatan per tahun menurut berbagai ko-morbid. Population Attributable Risk (PAR) untuk kondisi ko-morbid merujuk perhitungan yang ada pada jurnal epidemiologi lokal maupun internasional.Hasil: Seratus delapan puluh tujuh=187 pasien (96% laki-laki) memenuhi kriteria inklusi; diantaranya 29% pasien menderita stroke, 16% penyakit jantung iskemik, 16% infark miokard, 15% kanker paru, 17% COPD, dan bronkitis kronis 7%. Rerata pengeluaran biaya per tahun tertinggi adalah kanker paru (Rp 51,6 juta), diikuti penyakit jantung iskemik (Rp 37,8 juta); dan infark miokard (Rp 38,5 juta). PAR untuk masing-masing kondisi komorbid sebagai berikut: stroke 16-26%, penyakit jantung iskemik 17-27%, infark miokard 22-33%, kanker paru 17- 26%, COPD 13-21%, dan bronkitis kronis 42-59%.Simpulan: Pengeluaran biaya per tahun tertinggi untuk penyakit terkait dampak merokok adalah kanker paru-paru dan bila PAR terbesar pada bronkitis kronis.

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