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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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Sekuens Gen Protein Kapsid Mayor L1 Human Papilomavirus 16 dari Isolat Klinik Asal Bandung Pradita, Anandayu; Sahiratmadja, Edhyana; Suhandono, Sony; Susanto, Herman
Majalah Kedokteran Bandung Vol 46, No 3 (2014)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Kanker serviks disebabkan oleh infeksi kronik human papillomavirus (HPV) dengan genotipe HPV-16 sebagai HPV tersering yang menginfeksi epitel serviks. Protein penyelubung virus yang disebut kapsid mayor (L1) mempunyai peranan penting dalam menginfeksi epitel serviks. Tujuan penelitian untuk mengisolasi dan menganalisis sekuens gen L1 HPV-16. Pengetahuan mengenai sekuens gen L1 dapat memberikan informasi yang berguna, salah satunya yaitu untuk pengembangan vaksin. Pada studi ini, deoxyribonucleic acid (DNA) virus diekstraksi dari sediaan biopsi pasien kanker serviks yang diambil pada bulan Juni sampai Oktober 2010 di Kebidanan dan Kandungan RS Dr. Hasan Sadikin Bandung. Gen diamplifikasi dengan polymerase chain reaction menggunakan primer spesifik. Infeksi HPV-16 pada jaringan kanker dikonfirmasi dengan menggunakan kit komersial untuk tes genotipe HPV. Fragmen L1 kemudian diklon dan diinsersikan ke dalam pJET1.2/L1-16, kemudian dipotong dengan enzim BamHI dan BgIII untuk kemudian divalidasi dan disekuensing. Hasil sekuensing menunjukkan amplikon gen L1 HPV-16 sebesar 1.595 pasang basa. Analisis dari dua amplikon gen L1 HPV-16 menggunakan software BIOEDIT dan Basic Local Alignment Search Tool menunjukkan kesamaan ho mologi 99% dan 97% dengan sekuens L1 HPV-16 asal Thailand yang terregistrasi pada GenBank. Simpulan, telah dilakukan kloning sekuens gen L1 HPV-16 dari dua isolat klinik Bandung. Hasil kloning HPV-16 pada penelitian ini memberikan informasi tentang variasi sekuens yang perlu dipertimbangkan bagi pengembangan vaksin terutama bagi daerah spesifik seperti penduduk asal Indonesia.Kata kunci: Human papillomavirus, kanker serviks, gen L1 HPV-16 Sequence of Human Papilomavirus 16 Major Capsid L1 Gene from Clinical Isolates in BandungCervical cancer is strongly associated with chronic human papillomavirus (HPV) infection. HPV-16 is the most prevalent genotype infecting cervical epithelium. The major coat protein of viral particle (L1) plays a key role in the infection process. Our study aimed to isolate the HPV-16 L1 gene and analyze its sequence. Samples used were samples collected from the Department of Obstetrics and Gynaecology, Dr. Hasan Sadikin General Hospital, Bandung during the period of June to October 2010. In this study, the HPV-16 L1 sequence was analyzed from the viral deoxyribonucleic acid (DNA) extracted from biopsy sample of cervical cancer patient biopsy samples.The HPV-16 L1 amplification was performed using the polymerase chain reaction with specific primer. The HPV infection in the cervical tissue was confirmed by commercial HPV genotyping test. The L1 fragment was cloned into plasmid and the insert of the recombinant clone pJET1.2/L1-16 was digested using BamHI and BgIII. The amplicon result showed HPV-16 L1 gene with a length of 1.595 base pairs. The sequence analysis of two samples using software BIOEDIT dan Basic Local Alignment Search Tool revealed a high level of sequence similarity to L1 HPV-16 from Thailand (99% and 97%) as registered in GenBank. In conclusion, the L1 HPV-16 gene from Bandung isolates revealed variations from published sequence. Knowledge on L1 gene sequence may give additional information to the development of vaccine. Further study on vaccine development is currently ongoing using this HPV-16 clone that may be specific to Indonesian population. Key words: Cervical cancer, human papillomavirus, L1 HPV-16 DOI: 10.15395/mkb.v46n3.317
KORELASI KADAR 8-HYDROXY-2-DEOXYGUANOSINE (8-OHDG) SERUM DENGAN DERAJAT DEFISIT NEUROLOGIS PADA STROK ISKEMIK Liza, -; Parwati, Ida; Birawa, Andi Basuki Prima; Rachmayati, Sylvia
Majalah Kedokteran Bandung Vol 46, No 3 (2014)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Peningkatan stres oksidatif, sekresi radikal bebas pada strok iskemik dapat merusak inti sel neuron di otak. Peningkatan kadar 8-hydroxy-2-deoxyguanosine (8-OHdG) serum pada strok iskemik yang merupakan hasil interaksi radikal bebas dengan gugus C8 basa guanin menandakan kerusakan sel neuron otak yang tercermin pada penilaian defisit neurologis menggunakan skor The National Institutes of Health Stroke Scale (NIHSS). Tujuan penelitian ini untuk mengetahui korelasi kadar 8-OHdG serum dengan derajat defisit neurologis menggunakan skor NIHSS. Bentuk penelitian adalah observasional dengan desain penelitian potong lintang. Penelitian dilakukan di RSUP Dr. Hasan Sadikin Bandung pada bulan Agustus 2013 hingga Januari 2014. Subjek penderita stroke iskemik onset akut berdasarkan CT-scan. Analisis statistik menggunakan Uji Kruskal-Wallis, Uji korelasi rank Spearman?s. Sebanyak 72 subjek penelitian diperoleh median kadar 8-OHdG dalam serum dengan defisit neurologis ringan 3,9 ng/mL (3,3?12,0 ng/mL), sedang 23 ng/mL (8,0?51,0 ng/mL), berat 77,5 ng/mL (54,0-97,0 ng/mL). Korelasi kadar 8-OHdG serum dengan derajat defisit neurologis rs=0,912 (p<0,001). Simpulan, kadar 8-OHdG dalam serum pada stroke iskemik berkorelasi positif sangat kuat, dengan derajat defisit neurologis, hal ini dapat dipertimbangkan untuk digunakan pada keadaan ketidaksesuaian antara gambaran CT-scan dan klinis atau pada fasilitas kesehatan yang tidak mempunyai CT scan.Kata kunci: Defisit neurologis, stroke iskemik, 8-OHdG dalam serum Correlation between Serum 8-Hydroxy-2-Deoxyguanosine (8-OHdG) and Neurological Deficits in Ischemic Stroke Increased oxidative stress and free radicals can cause neuron cell damage. Serum 8-hydroxy-2-deoxyguanosine (8-OHdG) concentration is the result of free radical interactions with cluster C8 guanine bases, which is used to assess the degree of neuron cells damage and the oxidative stress levels. Increased serum 8-OHdG concentration indicating brain cells damage is reflected in neurological deficits based on the The National Institutes of Health Stroke Scale (NIHSS). The aim of this study was to determine the correlation between serum  8-OHdG concentration and the degree of neurological deficit by NIHSS. This was an observational cross-sectional study. Seventy-two patients with acute ischemic stroke who visited Dr. Hasan Sadikin General Hospital Bandung during the period of August 2013 to January 2014 were enrolled. Statistical analysis was performed using Kruskal-Wallis test and rank Spearman?s correlation test. The mild neurological deficit median serum 8-OHdG concentrations was 3.9 ng/mL (3.3?12.0 ng/mL), moderate was 23 ng/mL (8.0?51.0 ng/mL), and severe was 77.5 ng/mL (54.0?97.0 ng/mL). Correlation of serum 8-OHdG concentration with neurological deficits in acute ischemic stroke rs=0.912 (p<0.001). In conclusion, serum 8-OHdG have a strong meaningful positive correlation with neurological deficits. Serum 8-OHdG concentration may be considered to be use in the assessment of discrepancy between CT scan and clinical symptoms and in health facilities with no CT scan facility.Key words: Ischemic stroke, neurological deficits, serum 8-OHdG DOI: 10.15395/mkb.v46n3.313
PREDIKTOR STRES KELUARGA AKIBAT ANGGOTA KELUARGANYA DIRAWAT DI GENERAL INTENSIVE CARE UNIT Farhan, Zahara; Ibrahim, Kusman; Sriati, Aat
Majalah Kedokteran Bandung Vol 46, No 3 (2014)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Terdapat anggota keluarga yang dirawat di ruang perawatan intensif merupakan situasi yang dapat memicu stres pada keluarga. Faktor yang dapat memicu stres pada keluarga meliputi, perubahan lingkungan, aturan ruangan perawatan, perubahan status emosi keluarga, perubahan peran keluarga, perubahan kehidupan sehari-hari, perubahan finansial, serta sikap petugas kesehatan dalam pemberian informasi tentang kondisi kesehatan pasien. Penelitian ini menggunakan rancangan potong lintang. Subjek penelitian sebanyak 60 orang yang mewakili keluarga saat anggota keluarganya sedang dirawat di General Intensive Care Unit (GICU) Rumah Sakit Dr. Hasan Sadikin (RSHS) Bandung periode Maret?Mei 2012. Teknik sampling yang digunakan pada penelitian ini yaitu purposive sampling. Instrumen untuk mengukur prediktor stres disusun berdasarkan kajian teori dan modifikasi instrumen baku family inventory live events, sedangkan instrumen untuk mengukur stres keluarga menggunakan Depression Anxiety Stress Scale 42. Data dianalisis menggunakan uji chi-kuadrat dan analisis regresi logistik. Hasil penelitian menunjukkan faktor perubahan lingkungan, aturan di ruang perawatan, perubahan status emosi, dan perubahan kehidupan sehari-hari memiliki hubungan yang bermakna dengan terjadinya stres (nilai p berturut-turut sebesar 0,01, 0,04, dan 0,03). Simpulan, tidak ada satu pun prediktor yang paling dominan di antara enam prediktor stres keluarga yang dapat memprediksi terjadinya stres. Diharapkan perawat mampu mendeteksi dini masalah psikologis keluarga di ruang intensif dan lebih mengoptimalkan tindakan supportive-educative dalam bentuk pemberian konseling kepada keluarga.Kata kunci: Keluarga, prediktor, stresPredictors of Stress in the Family whose Family Member was Treated in General Intensive Care Unit Hospitalization of family member in intensive care can be a trigger of stress in the family. Several factors which could create a stressful situation in a family are changes of environment, rules in the ward, changes of family emotional status, changes of family member roles, changes of daily activities, changes in financial situation and health care workers' attitude when giving information on patient?s health status. This study was a cross-sectional study. The number of subjects included in this study were 60 representing families whose member was hospitalized in the General Intensive Care Unit (GICU) of Dr. Hasan Sadikin General Hospital (RSHS) Bandung during the period of March to May 2012. The sampling technique used was purposive sampling. The instrument used to measure the stress predictors was developed based on theoretical review and modification of family inventory live events standard instrument. Meanwhile, the instrument used for measuring the family stress was the Depression Anxiety Stress Scale 42. Data were analyzed using chi-square test and logistic regression. The results of this study showed environmental changes, rules in the ward, emotional status changes and daily activity changes significantly corelated with stress (p value 0.01, 0.04 and 0.03, respectively). In conclusion, none of the 6 family predictors dominantly predicts stress. Nurses are expected to do early detection on psychological family problems in intensive care unit and optimize supportive-educative treatment in the form of counseling for family members.Key words: Family, predictors, stress DOI: 10.15395/mkb.v46n3.316
GELOMBANG AUDITORY BRAINSTEM RESPONSE (ABR) PADA ANAK DIBAWAH LIMA TAHUN Wijana, -; Syamsuddin, Alex; Dewi, Yussy Afriani
Majalah Kedokteran Bandung Vol 46, No 3 (2014)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Auditory brainstem response (ABR) adalah pemeriksaan pendengaran yang reliabel, bertujuan untuk menilai singkronisasi saraf pendengaran perifer. Masalah pendengaran pada saat balita akan memberikan efek pada perkembangan, khususnya  bicara dan bahasa. Deteksi dini merupakan hal yang penting sementara referensi nilai ABR untuk Indonesia saat ini masih belum ada. Penelitian ini bertujuan untuk mengetahui nilai ABR pada anak usia di bawah 5 tahun dengan pendengaran normal. Telah dilakukan penelitian deskriptif potong lintang pada 198 balita, terdiri atas 119 laki-laki dan 79 perempuan berusia antara 3 bulan hingga 5 tahun di Poliklinik Dengar dan Bicara Rumah Sakit Dr. Hasan Sadikin Bandung, pada bulan Desember 2008 hingga Juni 2011, pada semua subjek dilakukan pemeriksaan ABR kemudian dihitung rerata setiap gelombang. Balita perempuan memiliki masa laten absolut gelombang I, III dan V,  serta masa laten antara gelombang I?III, III?V dan I?V lebih pendek secara bermakna dibandingkan dengan balita laki-laki. Masa laten rata-rata gelombang V pada balita laki-laki 6,07 msec±0,39 dan perempuan 5,90 msec±0,34. Kelompok usia 0?1 tahun memiliki masa laten absolut yang paling panjang. Tidak terdapat perbedaan masa laten absolut dan antara gelombang di kedua telinga pada laki-laki maupun perempuan pada usia di bawah lima tahun. Simpulan, masa latent absolut rata-rata gelombang V pada anak perempuan di bawah lima tahun adalah 5,90±0,34 msec, sedangkan pada anak laki-laki 6,07±0,39 msec.Kata kunci: Gelombang ABR, masa laten ablosut, masa laten antar gelombangAuditory Brainstem Response (ABR) Waveforms in The First Five YearsAuditory brainstem response (ABR) is a reliable hearing examination. It reflects the integrity of synchronous neurons firing within the periphery auditory pathways.  Hearing impairment on the first five years will cause speech and language delays; therefore, early detection of hearing loss is very important. Nowadays, there is still no ABR value reference in Indonesia. The aim of this study was to establish the ABR values in toddlers with normal hearing.  This was a descriptive cross-sectional study on 198 subjects between the ages of 3 month and 5 years in the period of December 2008 to June 2011 at the Hearing and Speech Clinic, Dr. Hasan Sadikin General Hospital, Bandung. The hearing level were diagnosed by ABR examination in all subjects and the mean of ABR wave was calculated. Girls displayed shorter absolute latency of wave I, III and V, and  interwave latency of I-III, III-V, and I-V compared to boys. The wave V latency in boys was 6.07 msec ±0.39 and 5.90 msec ±0.34 in girls. The 0?1 years old group have the longest absolute and interwave latencies.  There was no significant differences in absolute and interwave latency between both ears in boys and girls. The conclusion of this study is the average wave V latencies in boys and girls are 6.07±0.39 msec and 5.90 ±0.34, respectively.Key words: ABR wave, absolute latency, interwave latency DOI: 10.15395/mkb.v46n3.311
PENGARUH EKSTRAK BAYAM MERAH (AMARANTHUS GANGETICUS) TERHADAP MORFOLOGI STRATUM HIPOKAMPUS MODEL ANAK MENCIT PASCASAPIH INDUK YANG TERPAPAR TIMBAL SELAMA MASA KEHAMILAN Kalanjati, Viskasari; Pratiwi, Made Pury; Syakdiyah, Noer Halimatus; Widiasi, Etha Dini; Anggraeni, Mayang Rizki; Pratiwi, Intan Anggun; Argarini, Raden
Majalah Kedokteran Bandung Vol 46, No 3 (2014)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Kandungan antioksidan ekstrak bayam merah (Amaranthus gangeticus) diduga dapat melawan efek toksik timbal asetat pada sistem saraf pusat. Penelitian ini bertujuan untuk mengamati pengaruh pemberian ekstrak bayam merah terhadap morfologi hipokampus model anak mencit (Mus musculus) pascasapih yang induknya terpapar timbal asetat per oral selama masa kehamilan. Penelitian dilakukan di Laboratorium Hewan Coba Fakultas Kedokteran, Universitas Airlangga (FKUA) pada bulan April?Juni 2013. Dua puluh tujuh ekor anak mencit pascasapih dibagi dalam 3 kelompok: M0 (sodium carboxymethyl cellulose atau CMC Na 0,5%), M1 (CMC Na 0,5%+timbal asetat 1,16 mg/10 g BB/hari) dan M2 (CMC Na 0,5%+timbal asetat 1,16 mg/10 g BB/hari+ekstrak bayam merah 382,2 mg/10 g BB/hari). Sediaan otak diambil untuk dibuat preparat histologi dengan pewarnaan hematoxylin-eosin (HE). Lebar stratum granulare girus dentatus (GD), stratum oriens-piramidale (SOP) CA1, CA2, dan CA3 dianalisis dengan analysis of variance (ANOVA) dan least significant different (p<0,05). SOP CA1 dan CA2 pada kelompok M2 lebih lebar dibandingkan dengan kelompok M1 (p<0,05). SOP CA1 kelompok M2 lebih lebar pula bila dibandingkan dengan M0 (p=0,001). Lebar SG dari GD dan SOP CA3 kelompok M2 menunjukkan nilai yang lebih tinggi (p>0,05). Simpulan, pemberian ekstrak bayam merah dapat mengurangi efek negatif timbal asetat yang merusak struktur hipokampus model anak mencit pascasapih yang induknya terpapar timbal selama kehamilan. Kata kunci: Bayam merah, hipokampus, timbal asetatEffect of Red Spinach (Amaranthus gangeticus) Extract on Hippocampus Morphology of Post-Weaning Mice Infant Model from Lead-Acetate Exposed Pregnant Mice Antioxidants in red spinach (Amaranthus gangeticus) extract are proposed to combat the toxicity of lead acetate in the central nervous system. The effect of red spinach extract to the morphology of post weaning mouse hippocampus model (Mus musculus) in pregnant mice that received oral lead acetate during pregnancy was analyzed. Twenty seven post-weaning mice offsprings were grouped into 3 groups: M0 (sodium carboxymethyl cellulose or CMC Na 0.5%), M1 (CMC Na 0.5%+lead acetate 1.16 mg/10 g of body weight/day) and M2 (CMC Na 0.5%+lead acetate 1.16 mg/10 g of body weight/day+red spinach extract 382.2 mg/10 g of body weight/day). Brains were histologically processed and stained with hematoxylin-eosin (HE). Width of stratum granulare (SG) of the dentate gyrus (GD) and each of stratum oriens-pyramidale (SOP) of CA1, CA2, CA3 from each mouse hippocampus were obtained and analyzed statistically using analysis of variance (ANOVA) and least significant difference (LSD) (p<0.05). The CA1 and CA2 SOPs in M2 were significantly wider compared to those of M1 (p<0.05). Meanwhile, the SOP of CA1 in M2 was significantly wider compared to that of M0 (p=0.001). The SG width of GD and the CA3 SOP in M2 were wider than those of M0 and M1 (p>0.05). In conclusion, red spinach extract might dampen the adverse effects of oral lead acetate in post-weaning mouse hippocampus model from pregnant mice orally exposed to lead acetate during pregnancy. Key words: Hippocampus, lead acetate, red spinach DOI: 10.15395/mkb.v46n3.116
Protektivitas, Reaksi Lokal dan Sistemik setelah Imunisasi dengan Vaksin Td pada Anak Sekolah Dasar di Indonesia Sundoro, Julitasari; Bachtiar, Novilia Sjafri; Syafriyal, -; Sari, Rini Mulia
Majalah Kedokteran Bandung Vol 46, No 3 (2014)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

penelitian ini adalah untuk mengetahui reaksi dan respon imun setelah memperoleh 1 dosis vaksin Td. Penelitian ini merupakan Post Marketing Surveillance, dengan desain kohort pada anak sekolah dasar di Jawa Timur. Reaksi lokal dan sistemik dicatat pada kartu harian hingga 28 hari setelah imunisasi. Darah diambil sebelum dan 28 hari setelah imunisasi. Pengukuran antibodi menggunakan metode uji double antigen ELISA, dengan batas proteksi 0,01 IU/mL baik untuk anti-tetanus maupun anti-difteria. Pengamatan yang berlangsung dari Oktober 2010 hingga April 2011 ini melibatkan sebanyak 2978 anak sekolah dasar, termasuk 159 anak untuk kelompok respon imun. Sebanyak 1,18%-2,45% anak mengalami demam dengan instensitas mayoritas ringan. Reaksi lokal terbanyak adalah nyeri pada 30 menit setelah imunisasi 62,49% naik menjadi 83,38% pada hari ke-1, dan menurun pada hari berikutnya dengan intensitas mayoritas adalah ringan. Tidak ditemukan kejadian pasca imunisasi serius. Sebanyak 98,11% dan 99,37% anak terlindungi terhadap difteria dan tetanus dengan Geometric Mean Titer 1,2280 IU/mL (p=0,000) untuk anti-difteria dan 10,6068 IU/mL (p=0,009) untuk anti-tetanus. Simpulan, dari hasil pengamatan menunjukkan bahwa vaksin ini bersifat imunogenik dan aman setelah pemberian 1 (satu) dosis pada anak sekolah dasar.Kata kunci: Post Marketing Surveillance (PMS), reaksi lokal, reaksi sistemik, vaksin TdProtectivity, Local and Systemic Reactions Following Td Vaccination among Elementary School Students in IndonesiaTd vaccine is given to provide protection to tetanus and diphtheria in children 7 years of age or above. The objectives of this study are to evaluate the reactions and immune response after 1 dose of Td vaccine. This study is a post marketing surveillance with a cohort design among elementary school students in East Java. Systemic and local reactions were recorded in diary cards untill 28 days after immunization. Blood was collected before and 28 days after immunization. Antibody titers were measured using double antigen ELISA with cut off protection rate >0,01 IU/ml. Observation were done between October 2010 to April 2011 which involved 2978 included 159 subjects for immune response group. In this study, fever was occured in 1,18%-2,45% subjects at the first three days with mild in intensity and resolved immediately without any medication. The most often local reaction was pain in 62,49% subjects at 30 minutes after injection, and increased to 83,38% at day 1 after immunization, and decreased the day after, with the intensity mostly were mild. No serious adverse reactions was found. 98,11% and 99,37% subjects were protected to diphtheria and tetanus, with the Geometric Mean Titer 1,2280 IU/mL (p=0,000) for anti-diphtheria and 10,6068 IU/mL (p=0.009) for anti-tetanus. In conclusion, Td vaccine is safe and immunogenic after 1 (one) dose in school age children, and there were no serious adverse event. Keywords: local reactions, post marketing surveillance (PMS), systemic reactions, Td vaccine DOI: 10.15395/mkb.v46n3.315
Hubungan Kadar Albumin Serum dengan Neutrophil Gelatinase-Associated Lipocalin Urine pada Penderita Sindrom Nefrotik Anak Nurisya, Deasy; Nataprawira, Heda Melinda; Sekarwana, Nanan
Majalah Kedokteran Bandung Vol 46, No 3 (2014)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Neutrophil gelatinase-associated lipocalin  (NGAL)  merupakan  penanda biologis  kerusakan ginjal yang kadarnya meningkat sejalan dengan terjadinya kerusakan pada tubulus proksimal. Tujuan  penelitian untuk  menganalisis hubungan  kadar albumin serum dengan NGAL urine pada penderita SN anak dalam serangan.  Subjek adalah  penderita SN dalam serangan berusia 1−14 tahun. Penelitian observasional analitik dengan metode potong lintang dilaksanakan  di Departemen Ilmu Kesehatan Anak Rumah  Sakit Dr. Hasan Sadikin Bandung dan Rumah Sakit Umum Daerah Kota Bandung dari September 2011 sampai Maret 2012. Pemeriksaan kadar albumin serum  dilakukan dengan metode bromcresol green dan  NGAL urine dengan metode enzyme-linked immunosorbent assay (ELISA). Uji statistik dengan Korelasi  Pearson  untuk data dengan distribusi normal.  Subjek terdiri atas 14 laki-laki dan 10 perempuan. Kadar albumin serum rerata dan  NGAL urine rerata  adalah 1,37 (SB 0,33) g/dL dan  2.719,37 (SB 3.781,82) ng/mL.  Hasil analisis menunjukkan hubungan bermakna antara penurunan kadar albumin serum dan  peningkatan kadar NGAL urine (r=-0,519; p=0,009).  Simpulan, semakin rendah kadar albumin serum maka semakin tinggi kadar  NGAL urine. Pada penderita SN anak dengan hipoalbuminemia perlu diwaspadai penurunan fungsi ginjal.    Kata kunci: Albumin, anak,  NGAL urine, sindrom nefrotikCorrelation between Serum Albumin and Urine Neutrophil Gelatinase Associated Lipocalin Levels in Children with Nephrotic SyndromeNeutrophil gelatinase-associated lipocalin (NGAL) is a biological marker found in kidney damage that increases in proximal tubular  damage. The purpose of this study was to analyze the correlation between serum albumin and  urine NGAL (uNGAL) levels in children with NS at initial presentation or relapse. Subjects in this study were 1−14 year-old children with NS. An observational analytical study with cross sectional design was conducted in the Pediatric Department of Dr. Hasan Sadikin General Hospital Bandung and Bandung City Public Hospital from September 2011 to March 2012. The serum albumin level and uNGAL level were measured using bromcresol green method and enzyme-linked immunosorbent assay (ELISA), respectively. Data were analyzed using Pearson correlation test on normal distribution data. Subjects consisted of 14 boys  and 10 girls. Mean serum albumin  and  uNGAL levels were 1.37 (SD 0.33) g/dL  and  2,719.37 (SD 3,781.82) ng/mL, respectively. There was a significant correlation between decreased albumin level and elevated uNGAL level (r=−0.519, p=0.009). In conclusion, the lower the albumin level, the higher the uNGAL level. An awareness should be developed towards the possibility that hypoalbuminemia in children with NS might decrease renal function. Key words:  Albumin, children, nephrotic syndrome, uNGAL DOI: 10.15395/mkb.v46n3.319
Validitas Multiplex Real Time Polymerase Chain Reaction untuk Diagnosis Limfadenitis Tuberkulosis pada Spesimen Blok Parafin Rezeki, Mike; Parwati, Ida; Hernowo, Bethy S.; Tjandrawati, Anna
Majalah Kedokteran Bandung Vol 46, No 3 (2014)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Limfadenitis tuberkulosis merupakan tuberkulosis ekstraparu yang paling sering ditemukan. Saat ini baku emas diagnosis limfadenitis tuberkulosis berdasarkan histopatologi. Pemeriksaan histopatologi tidak memberikan informasi etiologi pasti penyebab limfadenitis, padahal limfadenitis dapat disebabkan Mycobacterium tuberculosis maupun Mycobacterium non-tuberculosis yang sangat berbeda regimen terapinya. Spesimen limfadenitis tuberkulosis dalam blok parafin yang disimpan sangat bermanfaat ketika dibutuhkan pemeriksaan lanjutan.  Pemeriksaan multiplex real time polymerase chain reaction  pada  blok parafin dapat mendeteksi Mycobacterium  tuberculosis atau Mycobacterium  non-tuberculosis. Pemilihan objek penelitian dilakukan berdasarkan randomisasi sederhana. Penelitian uji diagnostik dengan  rancangan potong lintang untuk mengetahui  validitas pemeriksaan multiplex  real time polymerase chain reaction  dalam  mendiagnosis limfadenitis tuberkulosis  sebagai konfirmasi pada blok parafin dilakukan periode Juni 2012˗˗Juni 2013 di Rumah Sakit Dr. Hasan Sadikin Bandung. Objek penelitian terdiri atas 40 blok parafin limfadenitis tuberkulosis dan 22 blok parafin kelompok kontrol. Pemeriksaan multiplex real time poymerase chain reaction menggunakan primer gen sikuens sisipan IS6110 dan gen Mycobacterium protein tuberkulosis MPB64 untuk mendeteksi deoxyribonucleic acid Mycobacterium tuberculosis dan gen 16S rRNA (ribosomal ribonucleic acid) untuk mendeteksi Mycobacterium non-tuberculosis. Hasil uji validitas sensitivitas 75%, spesifisitas 77%, nilai duga positif 86,6%, nilai duga negatif 63%, dan akurasi 75,8%. Pemeriksaan multiplex real time polymerase chain reaction dapat dianjurkan untuk konfirmasi diagnosis limfadenitis tuberkulosis pada blok parafin. Simpulan: multiplex real time polymerase chain reaction  memiliki validitas sedang untuk diagnosis limfadenitis tuberkulosis pada spesimen blok parafin.Kata kunci: Deoxyribonucleic acid, limfadenitis tuberkulosis, multiplex real time polymerase chain reaction, Mycobacterium tuberculosis Validity of Multiplex Real Time Polymerase Chain Reaction for Tuberculous Lymphadenitis Diagnosis on Formalin Fixed Paraffin EmbeddedTuberculous lymphadenitis is one of the most common form of extra pulmonary tuberculous. The diagnosis of tuberculous lymphadenitis based  on  histopathology as a gold standard. Histopathology examination could not inform the etiology of lymphadenitis whether Mycobacterium tuberculosis or Mycobacterium nontuberculosis  of which  the treatment regiment is very different. The archieved specimen like formalin fixed paraffin embedded  of tuberculous lymphadenitis is useful for futher investigation. The multiplex real time polymerase chain reaction  can detect  Mycobacterium tuberculosis or Mycobacterium nontuberculosis  from formalin fixed paraffin embedded. The object of the study use simple random. The study with cross sectional design  to determine validity multiplex real time polymerase chain reaction  on tuberculous lymphadenitis from formalin fixed paraffin embedded, was done June 2012˗˗June 2013 at Dr. Hasan Sadikin Hospital Bandung. Objects  consisted  of  40  formalin fixed paraffin embedded  tuberculous lymphadenitis and  22 control group. The multiplex real time polymerase chain reaction use insertion  sequence IS6110 and Mycobacterium protein tuberculosis MPB64 gen for detect deoxyribonucleic acid Mycobacterium tuberculosis and 16S rRNA (ribosomal ribonucleic acid) gen for Mycobacterium nontuberculosis. The validity test of the Mycobacterium tuberculosis multiplex real time polymerase chain reaction with histopathology as a gold standards gave a sensitivity 75%, specificity 77%, positive predictive value 86.6%, negative predictive value 63%, and accuracy 75.8%. This examination can be used for confirmation of tuberculous lymphadenitis from formalin fixed paraffin embedded. Conclussion: multiplex real time polymerase chain reaction has intermediate validity to diagnose tuberculous lymphadentis on formalin fixed paraffin embedded.Key words: Deoxyribonucleic acid,  multiplex real time polymerase chain reaction, Mycobacterium tuberculosis DOI: 10.15395/mkb.v46n3.314
Pengaruh Pendidikan Penyikatan Gigi dengan Menggunakan Model Rahang Dibandingkan dengan Metode Pendampingan terhadap Tingkat Kebersihan Gigi dan Mulut Siswa-siswi Tunanetra SLB-A Bandung Putri, Megananda Hiranya; Sirait, Tiurmina
Majalah Kedokteran Bandung Vol 46, No 3 (2014)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Mencegah terjadinya karies gigi pada penderita gangguan penglihatan tidak mudah dan lazimnya diperlukan seorang pengasuh (care giver). Metode penelitian ini adalah kuasi eksperimen dengan pre and post test design yang dilaksanakan di Sekolah Luar Biasa Tipe A (SLB-A) Negeri Bandung yang bertujuan untuk mengetahui pengaruh pendidikan penyikatan gigi dengan menggunakan model rahang dibandingkan dengan metode pendampingan terhadap tingkat kebersihan gigi dan mulut siswa-siswi tunanetra di SLB-A Bandung. Subjek penelitian adalah 26 siswa kelompok model rahang yang diberi pembimbingan lisan dan pendidikan penyikatan gigi dengan menggunakan model rahang, melakukan praktik menyikat gigi secara mandiri, serta 26 siswa kelompok pendampingan yang diberi pembimbingan lisan dan dilakukan pendampingan saat menyikat gigi. Kedua kelompok diperiksa kebersihan giginya dengan skor Personal Hygiene Performance (PHP) sebelum dan sesudah pendidikan, dengan 3 kali pengulangan pendidikan. Analisis data dilakukan dengan uji t-dependent yang menunjukkan terdapat perbedaan kebersihan mulut yang signifikan antara sebelum dengan setelah dilakukan pendidikan, berturut-turut pada kelompok model rahang (p=0,00) dan kelompok pendampingan (p=0,00). Analisis data dengan uji t-independent menunjukkan tidak terdapat perbedaan perubahan skor PHP sebelum dan sesudah pendidikan antara kedua kelompok sampel (p>0,05). Simpulan, tidak terdapat perbedaan perubahan skor PHP antara pendidikan penyikatan gigi model rahang dan metode pendampingan. Kata kunci: Metode pendampingan, model rahang, pendidikan penyikatan gigi, skor Personal Hygiene Performance (PHP)Comparison of Toothbrushing Education Effect to Dental and Oral Hygiene Levels between Jaw Model Method and Mentoring Method on in Visually Impaired Students in SLB-A BandungPreventing the occurrence of dental caries in patients with visual impairment is not easy and usually requires support from a caregiver. This study was a quasi experiment with pre- and post-test design which was implemented in SLB-A Bandung, which is a public school for visually impaired students. The purpose of this study was to determine the effect of toothbrushing education by using a model of the jaw compared with the mentoring method to the level of dental and oral hygiene students with visual impairments. The subjects in this study consisted of 26 students who received oral coaching and teeth brushing education using a jaw model with independent tooth brushing and another 26 students who received oral coaching and mentoring during toothbrushing. Both groups were examined for their oral hygiene index using Personal Hygiene Performance (PHP) score before and after the training with 3 repetitions of education. Data analysis was performed using t-dependent test which indicated a significant difference between oral hygiene before and after training in the jaw model group (p=0.00) and advocacy groups (p=0.00), respectively. However, analysis of the data with t-independent test shows no difference in PHP score change before and after education between the two sample groups (p>0.05). Conclusion, there is no difference in PHP score change between toothbrushing education using jaw model method and mentoring method.Key words: Education brushing teeth, jaw model, mentoring method, personal hygiene performance (PHP) score DOI: 10.15395/mkb.v46n3.318
Hubungan Antara Nilai Indeks Pertumbuhan Vertikal Wajah dan Kejadian Otitis Media Kronik pada Subras Deutero Melayu Dewasa Widyastuti, Henny; Aroeman, Nur Akbar; Wijana, -
Majalah Kedokteran Bandung Vol 46, No 3 (2014)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Nilai indeks pertumbuhan vertikal wajah (VERT) menggambarkan  pertumbuhan kraniofasial. Nilai ini berdampak pada pertumbuhan tuba eustakius. Perbedaan morfologi kraniofasial berkorelasi dengan fungsi dan anatomi tuba eustakius serta otot tensor veli palatini yang berperan pada patogenesis otitis media kronik (OMK). Telah dilakukan penelitian yang bertujuan untuk mengetahui pengaruh nilai indeks pertumbuhan vertikal wajah (VERT) dan sefalometri terhadap kejadian OMK yang merupakan penelitian kasus-kontrol dengan subyek yang berobat jalan di poliklinik Telinga Hidung Tenggorok-Bedah Kepala Leher (THT-KL) Rumah Sakit Dr. Hasan Sadikin Bandung selama bulan September‒November 2013. Dilakukan pengukuran sefalometri dua kelompok, yaitu kelompok penderita OMK dan kontrol, perbedaan nilai rata-rata ke duanya dihitung dengan uji t atau uji Mann-Whitney, kemudian dihitung indeks VERT rata-rata, dan hubungan antara kedua variabel dianalisis dengan Rasio Odds. 4 dari 7 subjek kelompok kasus merupakan tipe wajah bulat pendek/brakfasial dengan sudut kedalaman wajah lebih besar  (t = 3,408,  p=0,005) dan sudut bidang mandibula lebih kecil (t= - 4,055; p= 0,002). Subyek dengan indeks VERT > +0,5 (brakhifasial) memiliki risiko 8x untuk menjadi OMK (OR: 8; IK 95%: 0,41–309,1). Simpulan, indeks VERT berhubungan dengan kejadian OMK pada subras Deutero Melayu dewasa. Kata kunci: Indeks vertikal, otitis media kronik, sefalometriAssociation between Vertical Growth Index and Chronic Otitis Media Incident in Adult Deutero MalaysVertical growth index (VERT) describes craniofacial growth. This value affects the eustachian tube growth. Differences in craniofacial morphology correlates with eustachian tube anatomy function and tensor veli palatini muscles that play a role in the pathogenesis of chronic otitis media (COM). This study aimed to determine the effect of vertical growth index (VERT) and cephalometry on COM incident. The design was case-control with subjects from the outpatient clinic of otolaryngology head and neck surgery, Dr. Hasan Sadikin General Hospital during the period of September to November 2013. Subjects were divided into two groups: COM group and control group. Cephalometric measurements were performed and the mean values difference of both groups were calculated using t test or Mann-Whitney test. The mean index VERT was then calculated for each groups and relationship between risk factors and effects were analyzed using Odds Ratio. Four of 7 subjects in the COM group have a short round  face/brachifacial type with  greater facial  depth  angle (t=3.408, p=0.005) with smaller mandibular plane angle are (t = - 4.055, p=0.002). Subjects with VERT index > +0.5 (brachyfacial type) have eight times higher risk to be COM (OR: 8; 95% CI: 0.41 to 309.1). In conclusion, the VERT index has an association with COM incident in adult Deutero Malays. Key words: Cephalometry, chronic otitis media, vertical index DOI: 10.15395/mkb.v46n3.312

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