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Majalah Kedokteran Bandung
Published by Universitas Padjadjaran
ISSN : 0126074X     EISSN : 23386223     DOI : 10.15395/mkb
Core Subject : Health,
Medicine & Pharmacology
Majalah Kedokteran Bandung (MKB)/Bandung Medical Journal publishes peer-reviewed original articles and case reports in basic medical research, clinical research, and applied medical science. This journal is published quarterly (March, June, September, and December) by Faculty of Medicine Universitas Padjadjaran. Articles are original research that needs to be disseminated and written in English. All submitted manuscripts will go through the double-blind peer review and editorial review before being granted with acceptance for publication.
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Validitas Metode Polymerase Chain Reaction GeneXpert MTB/RIF pada Bahan Pemeriksaan Sputum untuk Mendiagnosis Multidrug Resistant Tuberculosis Sirait, Nurlina; Parwati, Ida; Dewi, Nina Susana; Suraya, Nida
Majalah Kedokteran Bandung Vol 45, No 4 (2013)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Pengendalian tuberkulosis saat ini terkendala oleh metode diagnostik konvensional yang lambat terutama untuk mendeteksi multidrug resistant tuberculosis (MDR-TB). Deteksi dini MDR-TB sangat penting untuk mencegah penyebaran MDR-TB dan mengurangi angka kematian. Penelitian ini bertujuan menganalisis validitas pemeriksaan polymerase chain reaction genexpert MTB/RIF suatu pemeriksaan molekuler automatis yang cepat untuk mendeteksi MDR-TB. Penelitian dilakukan di Poliklinik Directly Observed Treatment Short- Course (DOTS) Rumah Sakit Dr. Hasan Sadikin Bandung. Subjek penelitian adalah penderita tersangka MDRTB. Sampel penelitian berupa dahak yang dilakukan pemeriksaan mikroskopis, uji kepekaan metode proporsi media Lowenstein Jensen dan polymerase chain reaction genexpert MTB/RIF. Selama periode Agustus 2012 sampai Januari 2013 didapatkan 88 subjek penelitian, kelompok usia terbanyak 25–34 tahun. Hasil pemeriksaan kultur didapatkan 54 sampel tumbuh, 34 sampel tidak tumbuh, dan 3 sampel merupakan Mycobacteria lain dari tuberkulosis. Sebesar 97,5% sampel yang resisten rifampisin juga resisten terhadap isoniazid. Pemeriksaan GeneXpert MTB/RIF menunjukkan sensitivitas 92,3% dan spesifisitas 75% dengan akurasi 88,2%. Simpulan, pemeriksaan GeneXpert MTB/RIF memiliki validitas tinggi untuk mendiagnosis MDR-TB terhadap baku emas uji kepekaan M. tuberculosis metode proporsi pada media Lowenstein Jensen. Pemeriksaan ini disarankan sebagai alat skrining MDR-TB. [MKB. 2013;45(4):234–9]Kata kunci: GeneXpert MTB/RIF, MDR-TB, uji kepekaan metode proporsiValidity of Polymerase Chain Reaction GeneXpert MTB/RIF Method on Sputum Sample Examination to Diagnose Multidrug Resistant TuberculosisControl of tuberculosis is hampered by slow conventional diagnostic methods especially for the detection of multidrug resistant tuberculosis (MDR-TB). Early detection of MDR-TB is essential to interrupt MDR-TB transmission and reduce the death rate. The aim of this study was to assess the validity of polymerase chain reaction genexpert MTB/RIF examination, which is a rapid automated molecular examination for the detection of MDR-TB. The study was conducted at the Directly Observed Treatment Short-Course (DOTS) clinic at Dr. Hasan Sadikin General Hospital Bandung. Subjects were patients with suspected MDR-TB. The research sample was sputum which was subjected to microscopic examination, susceptibility test proportion methods in Lowenstein Jensen media and polymerase chain reaction genexpert MTB/RIF examination. During August 2012 until January 2013, 88 subjects were obtained, with most of them were 25–34 years old. There were 54 samples obtained that grew in culture and 34 samples did not grow while 3 samples were other Mycobacteria of tuberculosis. It was also found that 97.5% of rifampin-resistant samples were also resistant to isoniazid. Examination of GeneXpert MTB/RIF showed a sensitivity of 92.3%, specificity of 75% with an accuracy of 88.2%. In conclusion, GeneXpert MTB/RIF examination has high validity for diagnosing MDR-TB against M. tuberculosis gold standard resistance test using the proportion method in Lowenstein Jensen media. The examination is recommended for MDR-TB screening. [MKB. 2013;45(4):234–9]Key words: GeneXpert MTB/RIF,MDR-TB, susceptibility test proportion methods DOI: http://dx.doi.org/10.15395/mkb.v45n4.170
Kadar Laktat Darah sebagai Faktor Risiko Mortalitas pada Sepsis Neonatorum Leifina, Nadya; Yuniati, Tetty; Kartasasmita, Cissy B.
Majalah Kedokteran Bandung Vol 45, No 4 (2013)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Tolak ukur dini, bedside, dan parameter dapat tersedia di semua fasilitas kesehatan masih diperlukan untuk memantau perubahan metabolisme dan memperkirakan mortalitas pada sepsis neonatorum. Penelitian ini bertujuan mengetahui laktat darah sebagai faktor risiko mortalitas pada sepsis neonatorum. Penelitian berupa kohort prospektif dan dilakukan di RS Dr. Hasan Sadikin Bandung periode September–November 2010 dengan subjek adalah sepsis neonatorum. Pemeriksaan laktat darah menggunakan alat accutrend® lactate Plus yang dilakukan pada awal diagnosis, 12 jam, 24 jam, dan 48 jam pertama perawatan; kemudian dilakukan follow-up sampai penderita meninggal, pulang, atau hidup sampai usia 28 hari pascadiagnosis sepsis neonatorum. Data karakteristik subjek, gejala-gejala klinis, dan hasil pemeriksaan laboratorium dianalisis dengan univariat. Hasil analisis p<0,25 dianalisis dengan regresi logistik. Nilai yang bermakna bersama dengan kadar laktat darah 12 jam dianalisis dengan cox proportional hazard model. Setelah dilakukan observasi terdapat 28 neonatus mengalami kematian dari 69 neonatus yang didiagnosis sepsis neonatorum. Berat badan lahir <2.500 gram (p=0,008), usia kehamilan <37 minggu (p=0,006), retraksi (p=0,010), dan waktu pengisian kapiler ≥3 detik (p=0,042) berhubungan dengan mortalitas. Hiperlaktatemia pada 12 jam meningkatkan risiko mortalitas tiga kali pada sepsis neonatorum (HR 3,062; IK 95%: 1,078–8,700). Kesimpulan penelitian ini adalah hiperlaktatemia 12 jam merupakan faktor risiko mortalitas pada sepsis neonatorum. [MKB. 2013;45(4):199–205]Kata kunci: Faktor risiko, laktat, mortalitas, neonatal, sepsis Blood Lactate Level as Mortality Risk Factor in Neonatal SepsisEarly, bedside, and readily available parameters to observe metabolic changes and predicted mortality in neonatal sepsis is still needed in every health facility. The aim of this study was to explore blood lactate as apossible mortality risk factor in neonatal sepsis. A prospective cohort study was held during the period of September–November 2010 involving newborns diagnosed as suffering from neonatal sepsis in Dr. Hasan Sadikin General Hospital Bandung. Blood lactate was measured with accutrend® lactate Plus at admission and in 2, 24 and 48 hours of hospitalization. We performed univariate analysis on subject characteristics, clinical symptoms, and laboratory examination data. Results with p<0.25 were re-analyzed using logistic regression. Significant results along with the 12 hour blood lactate level were analyzed using cox proportional hazard model. Based on the observation, of the 69 newborns included in this study, 28 died. Statistic analysis showed significant correlation between mortality and birth weight <2,500 gram (p=0.008), gestational age <37 weeks (p=0.006), retraction (p=0.010), and capillary refill time ≥3 seconds (p=0.042). Hyperlactatemia in 12 hours increased the risk for mortality in neonatal sepsis (HR 3.062, CI 95%:1.078–8.700). It is concluded that hyperlactatemia in 12 hours is the risk factor for mortality in neonatal sepsis. [MKB. 2013;45(4):199–205]Key words: Blood lactate, mortality, neonatal, risk factor, sepsis DOI: http://dx.doi.org/10.15395/mkb.v45n4.165
Hubungan Imunoekspresi CD34 dengan Gradasi dan Stadium (Duke) pada Adenokarsinoma Kolorektal Yulianti, Herry; Hernowo, Bethy S.
Majalah Kedokteran Bandung Vol 45, No 4 (2013)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Karsinoma kolorektal umum terjadi di Eropa Barat Laut dan Amerika Utara, tetapi rendah di Afrika, Asia, dan Amerika Selatan. Di Indonesia, karsinoma kolorektal merupakan masalah kesehatan masyarakat dan merupakan tiga penyakit kanker terbanyak. Angiogenesis adalah pertumbuhan dan proliferasi pembuluh darah baru dari pembuluh darah yang sudah ada. Secara imuno histokimia, mikrovaskular dapat diidentifikasi dengan menggunakanmonoklonal cluster of differentiation (CD34) antibodi. Pada beberapa penelitian, microvascular density (MVD) berhubungan dengan gradasi histologi, stadium, metastasis, dan prognosis tumor. Tujuan penelitian ini untuk mengetahui hubungan ekspresi CD34 dengan gradasi dan stadium (klasifikasi Duke) pada karsinoma kolorektal. Metode penelitian adalah cross sectional terhadap 40 kasus adenokarsinoma kolorektal yang berasal dari Departemen Patologi Anatomi Rumah Sakit Dr. Hasan Sadikin Bandung-Fakultas Kedokteran Universitas Padjadjaran tahun 2004–2005. Potongan blok parafin dari jaringan kolorektal karsinoma diwarnai dengan hematoksilin eosin untuk evaluasi histologi dan imunohistokimia menggunakan monoclonal CD34 antibody. Penghitungan MVD yang imunoreaktif dilakukan di bawah mikroskop cahaya dengan pembesaran 400x, dihitung rata-rata pada 5 tempat daerah neovaskularisasi yang paling padat. Hasil penelitian menunjukkan hubungan yang signifikan MVD dengan stadium (p<0,01) dan tidak ada hubungan yang signifikan antara MVD dan gradasi (p<0,05). Simpulan, hubungan MVD dengan kedalaman invasi dan metastasis ke kelenjar limfe yang dinilai dengan klasifikasi Duke dan CD34 dapat digunakan untuk memprediksi prognosis, memperkirakan kemungkinan metastasis melalui pembuluh darah, dan memprediksi respons terhadap terapi antiangiogenik. [MKB. 2013;45(4):240–4]Kata kunci: Adenokarsinoma kolorektal, CD34, gradasi, klasifikasi DukeCorrelation between CD34 Immunoexpression and Colorectal Adenocarcinoma Grade and Stage (Duke) Carcinoma colorectal is commonly found in Nortwest Europe and North America, but not frequently found in Africa, Asia and South America. Colorectal cancer (CRC) is a public health problem in Indonesia and currently ranks among the three most common cancers. Angiogenesis is the growth and proliferation of new blood vessels from existing vasculature. Microvessels were identified immunohistochemically using monoclonal cluster of differentiation (CD34) antibody. Several studies have noted that microvascular density (MVD) correlates with stage of disease, histological grade, metastasis, and prognosis in cancers. The aim of this study was to explore the relation between CD34 immunoexpresion and grade and stage (Duke classification) in colorectal adenocarcinoma. This is a cross sectional study with 40 colorectal carcinoma cases from Department of Pathology Anatomy, Dr. Hasan Sadikin General Hospital/Faculty of Medicine, Universitas Padjadjaran Bandung during 2004−2005. A section from paraffin embedded tissue of colorectal carcinoma was stained with hematoxylin eosin for histological and immunohistochemical evaluations using monoclonal CD34 antibody. Microvascular density was counted in five tumor areas with most intensive neovascularization using 400x field light microscopy. A significant correlation was found between the MVD and stage (p<0.01) while no significant relationship found between MVD and different grade (p<0.05). In conclusion, correlations are found between MVD with tumor invation depth and lymph node metastases determined by the Duke’ staging system and CD34 can be used to predict prognosis, possibility of hematogenous metastases and responses to antiangiogenic therapy. [MKB. 2013;45(4):240–4]Key words: Adenocarcinoma colorectal, CD34, Duke clasification, grade DOI: http://dx.doi.org/10.15395/mkb.v45n4.171
Efikasi Fortifikasi Cookies Ubi Jalar untuk Perbaikan Status Anemia Siswi Sekolah Briawan, Dodik; Sulaeman, Aris; Syamsir, Elvira; Herawati, Dian
Majalah Kedokteran Bandung Vol 45, No 4 (2013)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Selain suplementasi tablet besi, fortifikasi pangan lokal diperlukan sebagai alternatif program untuk perbaikan status besi. Tujuan penelitian ialah menguji efikasi fortififikasi cookies ubi jalar untuk peningkatan hemoglobin (Hb) pada siswi sekolah. Studi dilakukan dengan desain pre-post intervention study, yang melibatkan 74 siswi SMK Pelita Kabupaten Bogor. Studi dilaksanakan pada bulan Mei–Juli 2012. Cookies ubi jalar difortifikasi dengan 10,5 mg vitamin A, 42 μg vitamin B12, 1,25 g vitamin C, 2 mg asam folat, dan besi fumarat 150 mg per 100 g Cookies sebanyak 40 g diberikan seminggu tiga kali selama dua bulan. Hasil penelitian menunjukkan kadar Hb rata-rata sebelum intervensi 13,4±1,4 g/dL. Setelah intervensi, terdapat perubahan kadar Hb 0,4±1,6 g/dL dan sebanyak 65,2% subjek mengalami kenaikan Hb. Kenaikan Hb ini tidak memengaruhi prevalensi anemia yang sedikit meningkat dari 10,8% menjadi 18,8% dan secara statistik tidak nyata (p>0,05). Simpulan, intervensi fortifikasi cookies ubi jalar selama dua bulan tidak menurunkan prevalensi anemia pada anak sekolah. Disarankan studi berikutnya untuk menambah waktu intervensi dan menggunakan indikator status besi lainnya. [MKB. 2013;45(4):206–12]Kata kunci: Anemia, cookies, fortifikasi, siswi, ubi jalarEfficacy of Fortified Sweet Potato Cookies for Improving Anemia Status in Female StudentsLocal food fortification for improving iron status is one of the alternative programs in addition to iron tablet supplementation. The objective of this study was to analyze the efficacy of fortified sweet potato cookies for improving hemoglobin (Hb) concentrations in female students. The pre-post intervention study was applied to 74 female students of SMK Pelita in Bogor District. The study was conducted from May to July 2012. The sweet potato cookies used were fortified with 10.5 mg vitamin A, 42 μg vitamin B12, 1.25 g vitamin C, 2 mg folic acid, and 150 mg iron fumarate per 100 g cookies. Subjects received 40 g cookies three times a week for two months. The average Hb concentration before intervention was 13.4±1.4 g/dL. After intervention, there was an increase in hemoglobin concentration (mean 0.4±1.6 g/dL). About 65.2% subjects experienced increase in their Hb concentration. However, after the intervention the anemia prevalence slightly increased from 10.8% to 18.8% although this increase is not statistically significant (p>0.05). In conclusion, fortified sweet potato cookies intervention for two months does not reduce anemia prevalence in female students. Further studies are required by extending intervention times and applying other indicators of iron status. [MKB. 2013;45(4):206–12]Key words: Anemia, cookies, fortification, schoolgirls, sweet potato DOI: http://dx.doi.org/10.15395/mkb.v45n4.166
Ekspresi Protein B-RAF Mutan pada Karsinoma Tiroid Papilifer yang Bermetastasis ke Kelenjar Getah Bening Regional Achmad, Dimyati; Sebastian, Jeremy; Hernowo, Bethy S.; Rizki, Kiki A.
Majalah Kedokteran Bandung Vol 45, No 4 (2013)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

AbstrakKarsinoma tiroid papilifer (KTP) dapat tumbuh progresif dan sekitar 33−61% kasus secara klinis telah metastasis ke kelenjar getah bening (KGB) regional pada saat diagnosis ditegakkan. Mutasi gen B-RAF dihubungkan dengan sifat biologis progresivitas KTP. Mutasi gen B-RAF akan mengkode protein B-RAF mutan yang bertindak sebagai regulator sentral pada jalur mytogen activated-pathway kinase (MAPK) dalam proses proliferasi dan dediferensiasi. Mutasi gen B-RAF dapat diidentifikasi pada tingkat deoxyribosenucleic acid (DNA), ribonucleic acid (RNA), dan protein. Masih terdapat kontroversi antara hubungan mutasi B-RAF dan metastasis KGB regional. Tujuan penelitian ini untuk mengetahui hubungan protein B-RAF mutan dengan metastasis ke KGB regional pada KTP. Penelitian ini merupakan penelitian observasional rancangan kuantitatif, studi kasus kontrol berpasangan. Penelitian dilakukan di Subbagian Bedah Onkologi, Kepala dan Leher, Departemen Ilmu Bedah dan Patologi Anatomi Fakultas Kedokteran Universitas Padjadjaran/ Rumah Sakit Dr. Hasan Sadikin Bandung. Sampel penelitian terdiri atas 38 kasus KTP dengan metastasis dan 38 kasus kontrol tanpa metastasis ke KGB regional yang dirawat di Rumah Sakit Dr. Hasan Sadikin Bandung pada periode Januari 2003−Desember 2010 dan dipilih berdasarkan proses matching. Masing-masing kelompok diperiksa B-RAF mutan dengan metode imunohistokimia. Hubungan antara tiap variabel bebas dan variabel tergantung diuji menggunakan analisis bivariat Uji McNemar.Hasil penelitian menunjukkan protein B-RAF mutan memiliki hubungan bermakna (p=0,023) dengan metastasis ke KGB regional pada KTP. Terdapat protein B-RAF mutan pada KTP mempunyai risiko untuk metastasis ke KGB regional sebesar 5,92 kali dibandingkan dengan tanpa mutasi B-RAF. Penelitian ini juga menunjukkan prevalensi B-RAF mutan sebesar 65,8% (32 kelompok kasus dan 18 kelompok kontrol). Simpulan, protein B-RAF mutan memiliki hubungan dengan metastasis ke KGB regional pada KTP. [MKB. 2013;45(4):245–50]Kata kunci: Imunohistokimia, karsinoma tiroid papilifer, metastasis ke KGB regional, mutasi B-RAFMutant B-RAF Protein Expression in Regional Lymph Node Metastasized Papillary Thyroid CarcinomaPapillary thyroid carcinoma (PTC) can become progressive and in about 33−61% of cases it has metastasized to regional lymph nodes at diagnosis. Mutation of B-RAF gene correlated with the biological characteristic of lymph node progressivity. Mutation of B-RAF will encode mutant B-RAF protein which acts as the central regulator on mytogen activated-pathway kinase (MAPK) pathway in terms of proliferation and dedifferentiation processes. B-RAF gene mutation can be identified at deoxyribosenucleic acid (DNA), ribonucleic acid (RNA) and protein levels. There are still controversies in corelation between B-RAF mutation and regional lymph node metastasis. The purpose of this study was to discover the correlation between mutant B-RAF protein and regional lymph node metastasis on PTC. This is a quantitative observational paired case-control study. The study was conducted at the Surgical Oncology, Head and Neck Division Departement of Surgery and Pathology Anatomy Departement, Faculty of Medicine, Universitas Padjadjaran/Dr. Hasan Sadikin General Hospital Bandung in April 2011–January 2012. The sample consisted of 38 PTC cases with metastasis and 38 control cases without regional lymph node metastasis treated in Dr. Hasan Sadikin Hospital between January 2003–December 2010 which have been selected based on the matching process. Each group was examined using the immunohistochemistry method. Correlation between each dependent and non-dependent variables were tested using McNemar bivariate analysis. The results showed that mutant B-RAF protein have a significant correlation (p=0.023) with lymph node metastasis in PTC. The risk of metastasis in B-RAF mutant group was 5.92 times higher than without mutation. This study also showed that from 76 PTC cases studied, the prevalence of mutant B-RAF was about 65.8% (32 in cases and 18 in control group). In conclusion, there is a correlation between mutant B-RAF protein and regional lymph node metastasis in papillary thyroid carcinoma. [MKB. 2013;45(4):245–50]Key words: B-RAF mutation, immunohystochemistry, papillary thyroid carcinoma, regional lymph node metastasis DOI: http://dx.doi.org/10.15395/mkb.v45n4.200
Perbandingan Efek Musik Klasik Mozart dan Musik Tradisional Gamelan Jawa terhadap Pengurangan Nyeri Persalinan Kala I Fase Aktif pada Nulipara Oktavia, Nike Sari; Gandamiharja, Supriadi; Akbar, Ieva B.
Majalah Kedokteran Bandung Vol 45, No 4 (2013)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Rasa nyeri persalinan yang kadang luar biasa pada sebagian wanita muncul akibat refleks fisik dan respons psikis ibu. Musik terbukti dapat meningkatkan konsentrasi, mengurangi kecemasan, dan mengalihkan perhatian rasa nyeri yang dialami pasien. Tujuan penelitian ini untuk mengetahui apakah musik klasik Mozart dan tradisional gamelan jawa dapat mengurangi nyeri persalinan, dan apakah musik klasik Mozart lebih baik daripada tradisional gamelan jawa terhadap pengurangan nyeri persalinan kala I fase aktif pada nulipara. Penelitian ini menggunakan metode eksperimen semu dengan total 30 orang nulipara yang berada dalam kala I fase aktif persalinan. Penelitian dilakukan di RSIA Arvita Bunda Kabupaten Sleman Yogyakarta selama Desember 2010–Maret 2011. Subjek penelitian berada dalam 3 kelompok: Mozart (n=10), gamelan jawa (n=10), dan kontrol (n=10). Penilaian nyeri dilakukan dua kali pada masing-masing kelompok dengan numerical rating scale (NRS), yaitu saat ibu berada di awal fase aktif dan di akhir kala I persalinan. Uji analisis statistik menggunakan Wilcoxon Signed Ranks (Z) dan Uji Mann Whitney. Hasil yang didapatkan antara lain, pada kelompok Mozart terdapat nilai median 7,5 (7–10) menjadi 6 (5–9), pada kelompok gamelan jawa median 7 (5–9) menjadi 7,5 (5–10), sementara pada kontrol median 7 (4–9) menjadi 9,5 (6–10). Terdapat perbedaan nyeri antara kelompok Mozart dan kontrol (p=0,001), terdapat perbedaan nyeri antara kelompok gamelan jawa dan kontrol (p=0,022), dan perbandingan antara musik klasik Mozart dan musik tradisional gamelan jawa (p=0,124). Kesimpulan penelitian ini, musik klasik Mozart dan tradisional gamelan jawa mengurangi nyeri persalinan kala I fase aktif pada nulipara, serta tidak ada perbedaan antara keduanya. [MKB. 2013;45(4):218–25]Kata kunci: Musik klasik Mozart, musik tradisional gamelan jawa, nyeri persalinanComparison of Classical Music Mozart Efect and Javanese Gamelan Music Efect to Relief Labor Pain in Stage I Active Phase for NulliparaLabor pain that may sometimes extreme in some pregnant women arises because of the physical reflection and psychological response of the mother. Music is proven to increase concentration, create comfort, and distract the feeling of pain in patients. The aim of this study was to explore wether Mozart classical music and Javanese gamelan music can decrease the level of pain in the process of labor and whether Mozart is better than gamelan in reducing pain in nulipara during stage 1 active phase of labor. This study was conducted by using quasy experiment method with a total of 30 nullipara patients in stage 1 active phase in RSIA Arvita Bunda, Sleman Yogyakarta during the period of December 2010 to March 2011. The subjects were divided into three groups: Mozart (n=10), Javanese gamelan (n=10), and control (n=10). Pain assesment were conducted twice for each group using the numerical rating scale (NRS), which was performed during the beginning of stage I active phase of labor and the end of stage 1 active phase of labor. The data were analyzed using Wilcoxon Signed Ranks (Z) and Mann Whitney statistical tests. The results of this study showed a change in the median value from 7.5 with a range of 7–10 to median 6 (5–9) in Mozar group, from the median value of 7 (5–9) to 7.5 (5–10) in gamelan group and from median 7 (4–9) to 9.5 (6–10) in control group. There was a significant difference between Mozart and control groups (p=0.001), and between Javanese gamelan group and control group (p=0.022), and the comparison between Mozart classical music and Javanese gamelan music (p=0.124). It is concluded that Mozart classical music and Javanese gamelan relief pain in stage 1 active phase of nullipara and no differences are found between the two. [MKB. 2013;45(4):218–25]Key words: Javanese gamelan music, labor pain, Mozart classical music DOI: http://dx.doi.org/10.15395/mkb.v45n4.174
Ekstrak Etanol Propolis Menurunkan Kadar IL-17 Serum pada Mencit Balb/C Model Asma Kronik Hadinoto, Sri Hartati; Sarsono, Sarsono; Aisyah, Siti; Prasetyo, Diding H.
Majalah Kedokteran Bandung Vol 45, No 4 (2013)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Interleukin-17 (IL-17) menginduksi perekrutan neutrofil ke dalam saluran napas dan berperan dalam patogenesis asma serta penentuan keparahan penyakit. Tujuan penelitian ini adalah menganalisis efek ekstrak etanol propolis (EEP) isolat Gunung Lawu terhadap kadar IL-17 serum pada mencit Balb/C model asma kronik. Penelitian ini merupakan penelitian eksperimental laboratoris dengan sampel 28 ekor mencit Balb/C jantan yang dibagi menjadi empat kelompok: kontrol, asma, asma+EEP, dan asma+antihistamin. Penelitian dilakukan di Laboratorium Histologi dan Biomedik, Fakultas Kedokteran, Universitas Sebelas Maret, Surakarta, selama periode April-September 2012. Model asma kronik dibuat dengan menginduksi mencit Balb/C jantan menggunakan injeksi intraperitoneal (i.p.) ovalbumin (OVA, 100 μg/mencit) dan aluminium hidroksida (10%, 50 mg/mencit) dalam phosphate-buffered saline (PBS). Hewan coba disensitisasi selama 6 minggu dengan inhalasi 2% (b/v) OVA aerosol dalam NaCl 0,9% selama 30 menit/hari setiap 3 hari/minggu, untuk kelompok asma, asma+EEP, dan asma+antihistamin. Mencit kontrol tidak diinokulasi selama penelitian. Deteksi kadar IL-17 serum menggunakan enzyme-linked immunosorbent assay (ELISA). Uji kadar IL-17 serum menggunakan analysis of variance (ANOVA) dan untuk menentukan perbedaan kemaknaan digunakan p<0,05. Kadar IL-17 serum kelompok kontrol menunjukkan 17,15±8,25 pg/mL dan antihistamin 38,98±7,57 pg/mL. Ekstrak etanol propolis secara bermakna menurunkan kadar IL-17 serum (75,62±17,64 pg/mL vs 45,59±10,69 pg/mL, p<0,001) dibandingkan dengan kelompok asma. Simpulan, EEP isolat Gunung Lawu menurunkan kadar IL-17 pada hewan coba model asma kronik. [MKB. 2013;45(4):213–7]Kata kunci: Asma, interleukin-17 (IL-17), propolisEthanolic Extract of Propolis Decreases Serum IL-17 Levels in Balb/C Model of Chronic AsthmaInterleukin-17 (IL-17) induces the neutrophil recruitment into the respiratory tract while playing a role in the pathogenesis of asthma and determining the severity of disease. The aim of this study was to analyze the effect of ethanol extract of propolis (EEP) Lawu mountain isolates on IL-17 serum levels in Balb/C mice model with chronic asthma. This study was an experimental research laboratory with 28 male Balb/C mice divided into control, asthma, asthma+EEP and asthma+antihistamine groups. The study was conducted at the Histology and Biomedical Laboratory, Faculty of Medicine, Sebelas Maret University, Surakarta, during April to September 2012. A model of chronic asthma was induced in male Balb/C mice using an intraperitoneally (i.p.) injection ovalbumin (OVA, 100 μg/mice) and aluminum hydroxide (10%, 50 mg/mice) in phosphate-buffered saline (PBS). Experimental animals were sensitized for 6 weeks with inhaled 2% (w/v) OVA aerosol in 0.9% NaCl for 30 minutes/day, 3 days in a week, for asthma, asthma with EEP, and asthma with antihistamine mice model groups. Control mice were not inoculated during the study. Detection of IL-17 serum level was conducted by using enzyme-linked immunosorbent assay (ELISA). One way analysis of variance (ANOVA) for IL-17 serum level and p<0.05 were used to determine significant differences. Serum levels of IL-17 showed 17.15±8.25 pg/mL in control group and 38.98±7.57 pg/mL in antihistamine, respectively. Ethanol extract of propolis showed significant decreased in IL-17 levels (75.62±17.64 pg/mL vs 45.59±10.69 pg/mL, p<0.001) compared to asthma group. In conclusion, EEP Lawu mountain isolates can decrease IL-17 level in chronic asthma animal models. [MKB. 2013;45(4):213–7]Key words: Asthma, interleukin-17 (IL-17), propolis DOI: http://dx.doi.org/10.15395/mkb.v45n4.167
Perbedaan Kadar Platelet Activating Factor Plasma antara Penderita Demam Berdarah Dengue dan Demam Dengue Setiabudi, Djatnika; Setiabudiawan, Budi; Parwati, Ida; Garna, Herry
Majalah Kedokteran Bandung Vol 45, No 4 (2013)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Manifestasi klinis infeksi virus dengue dapat berupa demam dengue atau keadaan yang lebih berat yaitu demam berdarah dengue. Patogenesis yang menerangkan hal tersebut belum jelas. Teori yang sering dikemukakan yaitu pada penyakit dengue berat terjadi peningkatan kadar mediator proinflamasi. Tujuan penelitian ini untuk melihat perbedaan kadar platelet activating factor plasma penderita demam berdarah dengue dengan demam dengue. Penelitian observasional dengan rancangan potong lintang dilakukan pada Januari–Februari 2013. Subjek penelitian adalah penderita dengue usia 1–14 tahun yang dirawat di Rumah Sakit Dr. Hasan Sadikin Bandung, RSUD Kota Bandung (Ujungberung), dan RSUD Kota Cimahi (Cibabat). Diagnosis dengue dikonfirmasi dengan pemeriksaan antigen nonstruktural-1 dan atau pemeriksaan serologis imunoglobulin M dan G. Sampel darah fase demam, kritis dan pemulihan diambil untuk pemeriksaan kadar platelet activating factor plasma menggunakan metode enzymelinked immunosorbent assay. Selama kurun waktu penelitian didapat 26 penderita dengue, terdiri atas 14 kasus demam dengue dan 12 demam berdarah dengue. Kadar platelet activating factor plasma pada fase kritis penderita demam berdarah dengue [541,45 (239,30–2.449,00)] pg/mL lebih tinggi secara bermakna dibandingkan dengan penderita demam dengue [289,55 (149,50–961,50)] pg/mL; p=0,007. Simpulan, kadar platelet activating factor plasma pada fase kritis penderita demam berdarah dengue lebih tinggi daripada penderita demam dengue. [MKB. 2013;45(4):251–6]Kata kunci: Demam berdarah dengue, demam dengue, platelet activating factor The Difference of Platelet Activating Factor Plasma Level between Dengue Hemorrhagic Fever and Dengue Fever patientsDengue virus infection can manifest as dengue fever and, more severely, as dengue hemorrhagic fever. Their pathogenesis until now is not fully understood. One of the most favorable theories stated the presence of increasing titer of pro-inflammatory mediator in severe dengue. The aim of this study was to determine the difference of plasma platelet activating factor titer between dengue hemorrhagic fever and dengue fever patients. This observational study with cross sectional design was conducted during January–February 2013. Subjects were dengue patients, 1 to 14 years old, hospitalized at Dr. Hasan Sadikin General Hospital, Bandung District Hospital (Ujungberung), and Cimahi District Hospital (Cibabat). Dengue cases were confirmed based on nonstructural-1 antigen and/or immunoglobulin M and G rapid test. Blood samples from febrile, critical and recovery phase were drawn for the examination of platelet activating factor titer using the enzyme-linked immunosorbent assay method. There were 26 dengue cases (14 as dengue fever and 12 as dengue hemorrhagic fever). Plasma platelet activating factor titer at the critical phase was significantly higher in dengue hemorrhagic fever patients [541.45 (239.30–2,449.00)] pg/mL compared to dengue fever patients [289.55 (149.50–961.50)] pg/mL; p=0.007. In conclusion, plasma platelet activating factor titer at the critical phase is higher in dengue hemorrhagic fever patients than in dengue fever patients. [MKB. 2013;45(4):251–6]Key words: Dengue hemorrhagic fever, dengue fever, platelet activating factor DOI: http://dx.doi.org/10.15395/mkb.v45n4.172
PERAN EKSTRAK ETANOL TOPIKAL DAUN MENGKUDU (MORINDA CITRIFOLIA L.) PADA PENYEMBUHAN LUKA DITINJAU DARI IMUNOEKSPRESI CD34 DAN KOLAGEN PADA TIKUS GALUR WISTAR Rahmayani S., Indah Puti; Maskoen, Ani Melani; Hernowo, Bethy S.
Majalah Kedokteran Bandung Vol 45, No 4 (2013)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Luka akan menimbulkan masalah jika penanganannya kurang baik sehingga menyebabkan luka kronik. Mengkudu (Morinda citrifolia L.) merupakan tanaman khas daerah tropis termasuk Indonesia, yang buah, daun, dan akarnya sering digunakan dalam pengobatan tradisional, di antaranya untuk menyembuhkan luka. Penelitian dengan rancangan eksperimental sederhana ini bertujuan untuk mengetahui efek penggunaan ekstrak etanol daun mengkudu terhadap penyembuhan luka pada pemberian topikal, dengan melihat gambaran histopatologis yang terdiri atas sel fibroblas, infiltrasi sel inflamasi, imunoekspresi cluster of differentiation 34 (CD34), dan deposisi kolagen. Penelitian dilakukan di laboratorium Farmakologi dan Patologi Anatomi RS Dr. Hasan Sadikin Bandung pada November 2010?September 2011. Penelitian ini dilakukan pada 36 tikus dengan membuat eksisi pada punggung tikus. Kemudian tikus-tikus tersebut dibagi menjadi 2 kelompok yaitu kelompok kontrol dan perlakuan ekstrak etanol daun mengkudu topikal pada luka. Jaringan luka tiap kelompok diamati secara mikroskopis pada hari ke-3, 7, dan 14. Hasil penelitian menunjukkan penyembuhan luka kelompok perlakuan cenderung lebih baik, dilihat pada data hari ke-3, 7, dan 14 pada semua parameter. Uji statistik Mann-Whitney pada tingkat kepercayaan 95% (p<0,05) untuk jumlah fibroblas, infiltrasi sel inflamasi, imunoekspresi CD34, dan kolagen berturut-turut p=0,319; p=0,290; p=0,251; dan p=0,245. Simpulan, ekstrak etanol topikal daun mengkudu cenderung bermanfaat pada penyembuhan luka, walaupun secara statistik tidak bermakna. [MKB. 2013;45(4):226?33]Kata kunci: CD34, daun mengkudu, kolagen, penyembuhan lukaRole of Noni (Morinda citrifolia L.) Leaf Ethanolic Extract TopicalApplication on Wound Healing Examined from CD34 Immunoexpression and Collagen on Wistar RatsProblems in wound healing occurred if proper care is not given and the wound develops into a chronic wound. Noni (Morinda citrifolia L.) is one of the most common plants in tropical areas, including Indonesia, which fruit, leaves dan root are used in traditional treatment, for example wound healing. This experimental research with post test-only control group design identified the effect of topical application of noni leaves ethanol extract on wound healing by examining the histopathological appearance of fibroblas count, inflammatory cell infiltration, cluster of differentiation 34 (CD34) immunoexpression, and collagen deposition. The research was performed between November 2010 until September 2011 at the Pharmacology and Pathology Anatomy laboratories of Dr. Hasan Sadikin General Hospital Bandung. Excisions were made on each back of the rat of the 36 rats that were divided into control and test groups where the test group received topical application of noni leaves ethanol extract. The wound was examined on day 3, 7, and 14 using a light microscope. The result showed a tendency of better wound healing in the test group for all parameters based on the data on day 3, 7, and 14. Mann-Whitney Test with 95% confidence interval (p<0.05) showed that the p value for fibroblast count, inflammation cell infiltration, CD34 immunoexpression and collagen subsequently were p=0.319, p=0.290, p=0.251, and p=0.245, respectively. In conclusion, topical application of noni leaves ethanol extract has a benefit on wound healing although the results are not statistically significant. [MKB. 2013;45(4):226?33]Key words: CD34, collagen, noni leaves, wound healing DOI: http://dx.doi.org/10.15395/mkb.v45n4.169

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