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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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Manifestasi Klinis Refluks Laringofaring: Studi pada Anak Usia 0–24 Bulan dengan Laringomalasia Sudiro, Melati; Saputri, R. Ayu Hardianti; Madiadipoera, Teti; Boesoirie, M. Thaufiq S.; Setiabudiawan, Budi
Majalah Kedokteran Bandung Vol 49, No 2 (2017)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (293.038 KB) | DOI: 10.15395/mkb.v49n2.1057

Abstract

Laringomalasia merupakan kelainan kongenital anomali laring yang banyak ditemukan pada bayi baru lahir dan penyebab tersering stridor serta obstruksi saluran napas. Pemeriksaan laringoskopi serat lentur memperlihatkan terlipat atau terhisapnya struktur supraglotik ke dalam laring selama inspirasi. Obstruksi saluran napas pada laringomalasia akan menyebabkan tekanan negatif intratorakal, menyebabkan asam lambung naik ke jaringan laringofaring dan diduga menimbulkan refluks laringofaring (RLF). Telah dilakukan penelitian dengan pendekatan potong lintang yang bertujuan mengidentifikasi dan menilai hubungan antara laringomalasia dan gambaran refluks laringofaring pada usia 0–24 bulan yang datang ke poliklinik THT-KL RSHS Bandung periode Januari 2012–Maret 2015 berdasar atas data rekam medis dan hasil pemeriksaan laringoskopi serat lentur.  Seratus tujuh pasien laringomalasia dengan keluhan stridor mengikuti penelitian ini, 69 laki-laki (64,5%) dan 38 perempuan (35,5%) dengan usia rata-rata 4,19 bulan. Laringomalasia tipe 1 merupakan tipe terbanyak (57,9%). Gambaran RLF yang berhubungan dengan tingkat berat laringomalasia adalah edema plika ventrikularis dengan OR 3,71 (IK 95%=1,07–12,91; p=0,039) dan edema aritenoid dengan OR 4,74 (IK 95%=1,19–18,89; p=0,027). Edema ventrikular dan aritenoid merupakan gambaran RLF yang berhubungan dengan tingkat berat laringomalasia pada pada anak usia 0–24 bulan. [MKB. 2017;49(2):115–21]Kata kunci: Edema aritenoid, edema plika ventrikularis, laringomalasia, refluks laringofaring Laryngopharyngeal Reflux Manifestation: a Case Study of Laryngomalacia in Children Aged 0–24 MonthsLaryngomalacia is the most common laryngeal anomaly of the newborn and the main cause of stridor and airway obstruction in infants. From a flexible laryngoscopy examination, this anomaly is observed as curled or collapsed supraglottic structures into larynx during inspiration. Airway obstruction in laryngomalacia creates a negative intra-thoracal pressure that causes acid reflux to laryngopharynx tissue and is suspected to cause laryngopharyngeal reflux (LPR). A cross-sectional study was conducted with the objectives of identifying and assessing the relationship between laryngomalacia and LPR in patients aged 0–24 months who visited the Ear, Nose, Throat, Head, and Neck Clinic of Dr. Hasan Sadikin General Hospital Bandung in the period of January 2012–March 2015, which was based on medical records and results of flexible laryngoscopy. A hundred and seven patients diagnosed with laryngomalacia  who experienced stridor symptoms in this study consisted of 69 males (64.5%) and 38  females (35.5%) with mean age of 4.19 months. Type-1 laryngomalacia represents the most cases (57.9%). Indication of LPR sign correlated with type of laryngomalacia is ventricular edema OR 3.71 (CI 95%=1.07–12.91; p=0.039) and arytenoid edema OR 4,74 (CI 95%=1.19-18.89; p=0.027). Ventricular and arytenoid edemas are signs of LPR that correlate with laryngomalacia level in patients  aged 0–24 months. [MKB. 2017;49(2):115–21]Key words: Arytenoid edema, laringomalacia, laringopharyngeal reflux, ventricular edema 
UJI AKTIVITAS ANTIBAKTERI EKSTRAK KASAR UMBI SARANG SEMUT (MYRMECODIA PENDENS) DIBANDING DENGAN KLORHEKSIDIN TERHADAP STREPTOCOCCUS SANGUINIS Attamimi, Fathimah Azzahra; Ruslami, Rovina; Maskoen, Ani Melani
Majalah Kedokteran Bandung Vol 49, No 2 (2017)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (266.593 KB) | DOI: 10.15395/mkb.v49n2.1053

Abstract

Streptococcus sanguinis merupakan bakteri pionir penyebab plak gigi. Penggunaan obat kumur klorheksidin merupakan tindakan untuk mengontrol pembentukan plak gigi, namun karena efek sampingnya, klorheksidin tidak dapat digunakan untuk jangka panjang. Umbi sarang semut (Myrmecodia pendens) merupakan tanaman obat yang memiliki banyak aktivitas biologis untuk kesehatan. Penelitian ini bertujuan menguji aktivitas antibakteri ekstrak kasar umbi sarang semut terhadap bakteri S. sanguinis dibandingkan dengan klorheksidin dan pengaruh pemberian konsentrasinya terhadap kematian sel bakteri. Metode penelitian menggunakan uji  Kirby-Bauer untuk menentukan diameter hambat pertumbuhan bakteri, dilanjutkan dengan uji MIC untuk mengetahui nilai MIC dari sampel dan pengaruhnya terhadap kematian sel bakteri. Penelitian dilakukan pada bulan Agustus-Oktober 2015 di Laboratorium Kimia Organik Universitas Padjadjaran Hasil uji Kirby-Bauer ekstrak kasar umbi sarang semut menunjukkan aktivitas antibakteri. Zona hambat yang dihasilkan oleh ekstrak kasar tidak berbeda signifikan dengan klorheksidin (12 mm vs 15 mm, p>0,05). Nilai MIC ekstrak kasar berada diantara 9,77 ppm dan 19,53 ppm, nilai ini lebih kecil dibanding dengan klorheksidin, yaitu sebesar 1,935 ppm. Selain itu, terdapat korelasi positif dan kuat antara konsentrasi ekstrak kasar dan kematian sel bakteri S. sanguinis (r=0,867). Dapat disimpulkan ekstrak kasar umbi sarang semut memiliki efek antibakteri lebih kecil dibanding dengan klorheksidin. Peningkatan konsentrasi eksrak kasar umbi sarang semut memiliki korelasi positif dan kuat terhadap peningkatan kematian sel bakteri S. sanguinis. [MKB. 2017;49(2):94?101] Kata kunci: Antibakteri, ekstrak kasar, klorheksidin, S. sanguinis, umbi sarang semut  Antibacterial Activity Test of Ant Nest Tuber (Myrmecodia Pendens) Crude Extract against  Streptococcus Sanguinis Compared to Chlorhexidine Streptococcus sanguinis is a pioneer bacterium that causes dental plaque formation. The use of chlorhexidine mouthwash is one of the treatments to control dental plaque. However, due to its side effects, chlorhexidine cannot be used in a long period. Ant nest tuber (Myrmecodia pendens) is one of the medicinal plants with variousbiological activities that are beneficial to human health. The purpose of this study was to examine the antibacterial activity of ant nest tuber crude extract against bacteria S. sanguinis compared to chlorhexidine and measure the effect of increased concentration on bacterial cell death. This study was conducted using Kirby-Bauer method to measure the diameter of bacterial growth inhibition in August?October 2015 at the Organic Chemistry Laboratory of Universitas Padjadjaran. The MIC was then measured to determine the MIC values of the sample and the effect on bacterial cell death. Kirby-Bauer test showed that the inhibition zone produced by crude extract was not significantly different from the one produced by chlorhexidine (12 mm vs 15 mm, p>0.05) when both were used to inhibith the growth of S. sanguinis. The MIC value of crude extract was between 9.77 ppm and 19.53 ppm, smaller than the MIC value of the chlorhexidine of 1.93 ppm. In addition, there was a positive and strong correlation (r=0.867) between the concentration of crude extract and S. sanguinis cell death.  Hence,  crude extract from ant nest tuber has a lower antibacterial effect than chlorhexidine in inhibiting the growth of S. sanguinis. Additionally, there is a strong correlation between the increased concentration of crude extract and increased S. sanguinis cell death. [MKB. 2017;49(2):94?101] Key words: Antibacterial, ant nest tuber, chlorhexidine, crude extract, S. sanguinis 
CINICO-EPIDEMIOLOGICAL PROFILE OF VITILIGO PATIENTS IN DR. HASAN SADIKIN GENERAL HOSPITAL BANDUNG Dwiyana, Reiva Farah; Marindani, Vani; Agustina, Rohana; Setiawan, Setiawan; Idjradinata, Ponpon S.; Sutedja, Endang
Majalah Kedokteran Bandung Vol 49, No 2 (2017)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (452.63 KB) | DOI: 10.15395/mkb.v49n2.1056

Abstract

Vitiligo is the most common hypopigmentation disorder; however, until now there iss no comprehensive epidemiological-clinical study of vitiligo in Indonesia. A descriptive study  using a questionnaire among vitiligo patients in Dr. Hasan Sadikin General Hospital Bandung was conducted to determine the clinical findings, socio-demographic factors, coexisting autoimmune disorders, and severity of disease. All vitiligo patients were recruited during the period of February 2012 to April 2014 from the Dermatology Outpatient Clinic of Dr. Hasan Sadikin General Hospital Bandung, as well as from the Endocrinology and Rheumatology Clinic Department of Internal Medicine; Endocrinology and Allergy and Immunology Clinics Department of Child Health; and Department  of Nuclear Medicine the same hospital. We collected data on socio-demographic profiles, clinical profile, and severity of vitiligo based on Vitiligo European Task Force (VETF). Out of 242 patients, female patients made up the majority of the patients (66.12%). In addition, most patients  wereunder 20 years (33.47%) and experienced onset of vitiligo highest in the first decade of life (29.34%). About 19.42% had positive family history of vitiligo and only 6.2% had history of autoimmune diseases. The majority of patients (77.27%) had vulgaris type of vitiligo with  head-neck (35.36%) asthe most frequent initial site of onset. Based on VETF,  the skin affected was mostly below 10% of body surface area (82.23%), i.e. staging score of between 0?5 (57.44%), and spreading score of between >0?(+5) or 68.18%. It is concluded that vitiligo most commonly occurs in females with the highest onset of under 10-years old and strong relationship with genetic predisposition.T he affected area was relatively small, despite the high spreading score. [MKB. 2017;49(2):132?8]   Key words: Clinical profile, epidemiology, vitiligo  Profil Kliniko-Epidemiologi pada Pasien Vitiligo di RSUP Dr. Hasan Sadikin Bandung   Vitiligo merupakan kelainan hipopigmentasi tersering, tetapi hingga kini belum ada penelitian epidemiologi-klinik yang komprehensif di Indonesia. Penelitian deskriptif menggunakan kuesioner dilakukan pada pasien vitiligo di Rumah Sakit Dr. Hasan Sadikin Bandung untuk mengetahui gambaran klinis, faktor sosio-demografik, kelainan autoimun yang menyertai, dan keparahan penyakit. Seluruh pasien vitiligo dari periode Februari 2012 hingga April 2014 yang berkunjung ke poliklinik Kulit dan Kelamin Rumah Sakit Dr. Hasan Sadikin Bandung, serta poliklinik: Endokrinologi dan Rematologi, Ilmu Penyakit Dalam; Endokrinologi dan Alergi-imunologi, Ilmu Kesehatan Anak; serta Kedokteran Nuklir, diikutsertakan dalam penelitian. Data yang dihimpun mencakup keadaan sosiodemografi, klinik, dan keparahan vitiligo berdasar atas Vitiligo European Task Force (VETF). Dari 242 pasien, perempuan merupakan jenis kelamin terbanyak (66,12%), usia di bawah 20 tahun (33,47%), dan awitan vitiligo terjadi pada dekade pertama kehidupan (29,34%). Sekitar 19,42% memiliki riwayat vitiligo pada keluarga dan hanya 6,2% yang memiliki penyakit autoimun. Umumnya tipe vitiligo vulgaris (77,27%) dengan predileksi pertama pada kepala-leher (35,36%). Area kulit yang terkena berdasarkan VETF ialah di bawah 10% dari body surface area (82,23%), staging score 0?5 (57,44%), dan spreading score antara >0?(+5) atau 68,18%. Simpulan penelitian ini ialah vitiligo banyak mengenai perempuan, awitan tersering pada usia di bawah 10 tahun dengan predisposisi genetik yang tinggi, serta daerah yang terkena vitiligo relatif kecil meskipun spreading score-nya tinggi. [MKB. 2017;49(2):132?8]   Kata kunci: Epidemiologi, gambaran klinik, vitiligo
KONSEP KUALITAS PELAYANAN KESEHATAN BERDASAR ATAS EKSPEKTASI PESERTA JAMINAN KESEHATAN NASIONAL Hadiyati, Ida; Sekarwana, Nanan; Sunjaya, Deni Kurniadi; Setiawati, Elsa Pudji
Majalah Kedokteran Bandung Vol 49, No 2 (2017)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (19.202 KB) | DOI: 10.15395/mkb.v49n2.1054

Abstract

Masyarakat memiliki hak untuk mendapatkan pelayanan kesehatan yang bermutu dan terjangkau. Sejak awal tahun 2014, pemerintah berupaya meningkatkan akses pelayanan kesehatan melalui program Jaminan Kesehatan Nasional. Pelayanan kesehatan tersebut tentunya harus tetap berkualitas. Peneliti bertujuan merumuskan konsep kualitas pelayanan kesehatan berdasar atas ekspektasi pasien. Desain penelitian ini adalah kualitatif dengan paradigma konstruktivisme. Partisipan terdiri atas 17 pasien rawat jalan peserta Jaminan Kesehatan Nasional dan 7 petugas kesehatan Rumah Sakit Umum Daerah Al-Ihsan dan Soreang Kabupaten Bandung, Pengumpulan data dilakukan dengan cara wawancara mendalam selama bulan Agustus?November 2016. Pelayanan kesehatan yang berkualitas terdiri atas 11 dimensi. Dimensi sarana prasarana mengutamakan kecukupan kapasitas fasilitas. Dimensi karyawan mengutamakan kesesuaian jumlah kapasitas tenaga kerja. Dimensi pelayanan medis mengutamakan komunikasi. Dimensi pelayanan administrasi mengutamakan sistem antrian yang tertib. Dimensi keamanan pelayanan mengutamakan minimalisasi risiko bahaya. Dimensi kepercayaan menunjukkan loyalitas. Dimensi akses mengutamakan kemudahan menjangkau rumah sakit. Dimensi kesetaraan merupakan perlakuan yang sama antara pasien peserta JKN dan non-JKN. Dimensi transparansi informasi merupakan penyajian informasi yang jelas. Dimensi iur biaya mengungkapkan tidak ada penambahan biaya dalam tindakan medis maupun pengobatan. Dimensi kualitas antar bagian merupakan pelayanan yang sama di setiap titik bagian pelayanan. Pelayanan kesehatan yang berkualitas berdasar atas harapan pasien meliputi dimensi sarana prasarana, karyawan, pelayanan medis, pelayanan administrasi, keamanan pelayanan, kepercayaan terhadap rumah sakit, akses, kesetaraan, transparansi informasi, iur bayar, dan kualitas antarbagian. [MKB. 2017;49(2):102?9] Kata kunci: Ekspektasi pasien, Jaminan Kesehatan Nasional, kualitas pelayanan kesehatan  Health Service Quality Concept based on Expectation of the National Health Insurance Participants Community has the right to receive affordable and qualified health care. Since the early 2014, the government has attempted to increase health care access through the implementation of the National Health Insurance (Jaminan Kesehatan Nasional, JKN) scheme that still requires quality health care. The aim of this study was to formulate the concept of health care quality based on patients? expection. This was a qualitative study using constructivism paradigm on 17 JKN-member outpatients and 7 health care workers of Al-Ihsan General Public Hospital and Soreang Public District Hospital, Bandung District. Data were collected through in-depth interviews during the period of August?November 2016. Quality health care consists of 11 dimensions: facility and infrastructure dimension that prioritizes on adequacy of facility capacity; employee dimension that prioritizes on the number and capacity of human resource; medical service dimension that prioritizes on communication; administrative service dimension that prioritizes on orderly queuing system; service safety dimension that prioritizes on minimizing hazard risk; trust dimension that shows loyalty; access dimension that prioritizes on easy access to hospital; equality dimension that emphasizes same treatment for JKN and non-JKN patients; information transparency that prioritizes on clear information provision; cost sharing dimension that underlines no additioanl fee for medical actions and treatments; and inter-department quality dimension that includes same services in each service point. It is revealed that quality health care based on patients? expectation includes facility and infrastrucutre, employee, medical service, administrative service, service security, trust towards hospital, access, equality, information transparency, cost-sharing, and inter-department quality. [MKB. 2017;49(2):102?9] Key words: Health Service Quality, National Health Insurance, Patient Expectation 
Hubungan Rinitis Alergi dengan Kejadian Otitis Media Supuratif Kronik Diana, Fatma; Haryuna, T. Siti Hajar
Majalah Kedokteran Bandung Vol 49, No 2 (2017)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (599.534 KB) | DOI: 10.15395/mkb.v49n2.369

Abstract

Otitis media supuratif kronik (OMSK) merupakan infeksi telinga tengah yang berat, tidak hanya terjadi di negara berkembang, tetapi juga di negara maju. Prevalensi OMSK di dunia melibatkan 65–330 juta penduduk. Terdapat beberapa teori yang mengungkapkan peran rinitis alergi dalam terjadinya OMSK, teori yang paling banyak digunakan adalah disfungsi tuba eustachius. Penelitian ini merupakan penelitian analitik dengan pendekatan kasus-kontrol tanpa berpasangan. Pengambilan sampel dengan metode consecutive sampling sebanyak 80 responden yang terdiri atas 40 responden OMSK dan 40 responden non-OMSK yang datang ke Poliklinik THT RSUP H. Adam Malik Medan pada bulan Agustus–Oktober 2014. Seluruh responden dilakukan anamnesis, pemeriksaan telinga dan hidung, serta mengisi kuesioner Score for Allergic Rhinitis (SFAR). Hasil penelitian menunjukkan bahwa pada kelompok OMSK, 28 orang (70%) menderita rinitis alergi dan 12 orang (30%) tidak menderita rinitis alergi. Pada kelompok non-OMSK 6 orang (15%) menderita rinitis alergi dan 34 orang (85%) tidak menderita rinitis alergi. Terdapat hubungan yang signifikan antara rinitis alergi dan kejadian OMSK (p<0,001). Pasien rinitis alergi memiliki risiko 13 kali lebih besar untuk menderita OMSK dibanding dengan pasien tanpa rinitis alergi (OR=13,222; 95% IK=4,400–39,732). Probabilitas pasien rinitis alergi untuk menderita OMSK sebesar 92,9%. Simpulan, terdapat hubungan antara rinitis alergi dan kejadian OMSK. [MKB. 2017;49(2):79–85]   Kata kunci: Otitis media supuratif kronik, rinitis alergi, score for allergic rhinitis Relationship between Allergic Rhinitis and Incidence of Chronic Suppurative Otitis Media   Chronic suppurative otitis media (CSOM) is a severe infection of the middle ear that is seen not only in developing countries but also in industrialized countries. The prevalence of CSOM in the world involves 65–330 million people. There are some theories regarding the role of allergic rhinitis in CSOM patients with eustachian tube dysfunction theory as the most widely used theory. This was a non-matched case control analytical study on 80 respondents, 40 CSOM respondents and 40 non-CSOM respondents, who were sampled using consecutive sampling method at the Ear-Nose-Throat (ENT) clinic of H. Adam Malik General Hospital in August–October 2014. Anamnesis as well as ear and nose examinations were performed and all respondents fill out the Score For Allergic Rhinitis (SFAR) questionnaire. The results showed that in  CSOM group, 28 people (70%) suffered from allergic rhinitis and 12 people (30%) did not suffer from allergic rhinitis. In non-CSOM group, the numbers were 6 people (15%) and 34 (85%), respectively. There was a significant relationship between allergic rhinitis and the incidence of CSOM (p<0.001). Allergic rhinitis patients have a 13 times greater risk to suffer CSOM than patients without allergic rhinitis (OR=13.222, 95% CI=4.400–39.732). The probability of patients with allergic rhinitis to suffer CSOM is 92.9%. In conclusion, there is a relationship between allergic rhinitis and the incidence of CSOM. [MKB. 2017;49(2):79–85]   Key words: Allergic rhinitis, chronic suppurative otitis media, score for allergic rhintis 
Isolasi Bacillus thuringiensis Lokal dari Tanah Kota Bandung Berdasarkan Ketinggian Sudigdoadi, Sunarjati; Sukandar, Hadyana; Faridah, Lia
Majalah Kedokteran Bandung Vol 49, No 2 (2017)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15395/mkb.v49n2.1055

Abstract

Demam dengue (DD) merupakan penyakit endemis di negara berkembang termasuk Indonesia. Kasus DD di Kota Bandung mencapai angka tertinggi di antara kota lain di Jawa Barat, yaitu sebesar 1.180 kasus. Belum ditemukan obat yang tepat dalam menangani infeksi ini. Walaupun sudah ditemukan vaksin, namun penggunaan vaksin ini masih terbatas pada usia dan kalangan tertentu. Dengan demikian, pengendalian vektor baik secara kimiawi maupun biologis, masih menjadi prioritas. Salah satu agen biologis untuk mengendalikan populasi larva nyamuk adalah Bacillus thuringiensis (Bt). Penelitian dilakukan selama bulan Januari–Desember 2015. Penelitian ini merupakan suatu eksperimen dengan rancangan faktorial yang bertujuan mendapatkan isolat Bt dari tanah di berbagai ketinggian di Kota Bandung. Sampel tanah diambil dari ketinggian 600 m, 800 m, serta 1000 m dan setiap ketinggian diambil 3 lokasi dengan metode acak. Bt diisolasi dengan medium selektif. Isolat bakteri yang diperoleh kemudian diidentifikasi dengan pewarnaan gram, pengamatan endospora subterminal, uji fermentasi glukosa, sitrat, indol, dan manitol. Kelimpahan Bt di tiap ketinggian dihitung menggunakan Bt index. Hasil identifikasi mendeteksi terdapat 3 isolat yang menunjukkan kemiripan dengan Bt, yaitu isolat STBD.2.02, CBRM.3.01, dan KOPO.3.02. Nilai Bt index menunjukkan kelimpahan Bt di ketinggian 800 m lebih tinggi dibanding dengan ketinggian yang lain. [MKB. 2017;49(2):110–4]   Kata kunci: Bacillus thuringiensis lokal, Bandung, ketinggian, tanah     Local Bacillus thuringiensis Isolation from Bandung Soil by Altitude Dengue fever (DF) is an endemic disease in developing countries including Indonesia. Bandung has the highest number of Dengue Fever in West Java Province with 1,180 cases. There  is currently  no drugs or vaccines that can prevent dengue fever and dengue hemorrhagic fever, making vector control, both chemically and biologically, the primary prevention approach. One biological agent that has been used to control the larval population is Bacillus thuringiensis (Bt). This study is an experimental study with factorial design aimed to obtain Bt isolates from soil of various altitude around Bandung city area period January to December 2015. Soil samples were acquired from 600 m, 800 m and 1,000 m above sea level. Sampling was conducted randomly from 3 points at every altitude. Bt were isolated with a selective medium. The acquired bacteria samples were then identified using gram stain, subterminal endospore observation, as well as glucose fermentation, citrate, indole, and manitol tests. Bt abundance for each altitude was calculated using Bt index. Three isolates with similarity with Bt were identified, i.e. STBD 2.02, CBRM 3.01 and KOPO 3.02 isolates. Bt index value indicates that the abundance of Bt at 800 m altitude is the highest compared to others. [MKB. 2017;49(2):110–4]   Key words: Altitude, Bandung, local Bacillus thuringiensis, soil
Faktor yang Memengaruhi Perilaku Penggunaan Air Bersih pada Masyarakat Kumuh Perkotaan berdasar atas Integrated Behavior Model Raksanagara, Ardini S.; Santanu, Ayu Mutiara; Sari, Sri Yusnita Irda; Sunjaya, Deni K.; Arya, Insi Farisya Deasy; Agustian, Dwi
Majalah Kedokteran Bandung Vol 49, No 2 (2017)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15395/mkb.v49n2.1059

Abstract

Kebutuhan air bersih semakin meningkat terutama di wilayah perkotaan. Kelurahan Tamansari merupakan wilayah kumuh yang berlokasi di tengah Kota Bandung, 60% penduduk menggunakan air bersih perpipaan sisanya menggunakan sumber air tanah, namun tidak semua sumber air dilindungi secara benar sehingga berpotensi terkontaminasi. Penelitian ini bertujuan menganalisis faktor yang memengaruhi perilaku penggunaan air bersih pada masyarakat kumuh perkotaan dengan mengaplikasikan teori Integrated Behavior Model. Penelitian potong lintang dilakukan pada 188 rumah tangga di 10 RW pada bantaran sungai Cikapundung di Kelurahan Tamansari. Survei dilakukan menggunakan kuesioner dan ceklist observasi pada sumber air perpipaan (PDAM), sumur terlindungi (ST), dan sumur tidak terlindungi (STT). Hasil penelitian menunjukkan sikap, norma yang dipersepsikan dan faktor personal memengaruhi niat untuk menggunakan air bersih pada ketiga jenis sumber air yang digunakan. Pada pengguna PDAM tidak ada faktor yang signifikan memengaruhi perilaku. Pada pengguna ST perilaku dipengaruhi oleh faktor kepentingan menggunakan air bersih. Pada pengguna STT faktor niat, hambatan lingkungan dan kebiasaan memengaruhi perilaku menggunakan air bersih. Faktor-faktor yang memengaruhi perilaku khususnya di wilayah kumuh perkotaan berbeda-beda berdasar atas sumber air bersih yang digunakan sehingga upaya promosi kesehatan untuk melakukan perubahan perilaku harus dikembangkan sesuai dengan jenis sumber air yang digunakan. [MKB. 2017;49(2):122–31]Kata kunci: Air bersih, integrated behavior model , kumuh perkotaan, perilaku  Integrated Behavior Model: Factors Influencing Clean Water Use among  Urban Slum DwellersThe increasing need for clean water, especially in urban area, is becoming more prominent. Tamansari Urban Village is a slum area located in the center of Bandung City. Sixty percents of its dwellers use pipe water as the clean water source while the rest uses ground water. However, not all water sources are protected correctly that there is a potential for contamination. This study aimed to analyze factors influencing clean water use behavior among urban slum dwellers by applying the Integrated Behavior Model. A cross-sectional study was performed on 188 households in 10 RW (neighborhood unit) on Cikapundung River Bank in Taman Sari Urban Village. Questionnaires and observation checklists were used for piping water source (Local Water Company, PDAM), protected wells, and unprotected wells. The results of this study showed that the attitude, perceived norms, and personal factors influenced the intention to use clean water for the three clean water sources. Among PDAM users, no significant factor was seen to influence behavior. Among protected well users, the behavior was influenced by the interest factor in using clean water. Among unprotected well users, attitude, environmental barriers, and habit influenced the behavior of using clean water. Factors influencing behaviors, especially in urban slum areas, are different based on the source of clean water used; hence, the implementation health promotion through behavioural change should be adapted to the type of water source used. [MKB. 2017;49(2):122–31]Key words: Behavior, clean water, integrated behavior model, urban slum 
Pengaruh Puguntano terhadap HOMA-IR Pada Pasien Diabetes Melitus yang Baru Didiagnosis Siahaan, Billy Stinggo; Lindarto, Dharma
Majalah Kedokteran Bandung Vol 49, No 2 (2017)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (254.352 KB) | DOI: 10.15395/mkb.v49n2.1051

Abstract

Resistensi insulin sangat penting pada diabetes melitus sebagai prediktor yang kuat terhadap perkembangan diabetes melitus dan target terapi saat hiperglikemia sudah terjadi. HOMA-IR merupakan suatu metode yang telah tervalidasi dalam menilai resistensi insulin pada pasien diabetes melitus. Puguntano suatu tanaman budidaya yang terdapat di Sumatra Utara diketahui memiliki efek antidiabetes. Sampel diambil dari tahun 2015-2016 di Rumah Sakit Haji Adam Malik Medan. Studi ini mencoba menilai pengaruh puguntano sebagai tanaman budidaya di Sumatera Utara terhadap resistensi insulin pada pasien Diabetes Melitus tipe 2. Untuk mengetahui pengaruh pemberian serbuk puguntano terhadap HOMA-IR pada pasien DM tipe 2 yang baru didiagnosis. Dilakukan uji klinis terbuka dengan desain paralel selama 12 minggu pada 24 pasien (12 pasien dan 12 kontrol) Diabetes Mellitus tipe 2 yang baru terdiagnosa  yang dibagi dalam 2 grup masing-masing diberikan puguntano dan metformin selama 12 minggu. HOMA-IR dan HbA1c diperiksa pada awal dan akhir pengobatan (minggu ke 12). Didapatkan penurunan HOMA-IR rata-rata pada grup puguntano 1,71 (±2,29) (p=0,034). Tidak didapatkan perbedaan penurunan HOMA-IR rata-rata antara kedua grup puguntano vs metformin 1.71 (±2,29) vs 0,80 (±1,47) (p=0,402). Didapatkan penurunan nilai HOMA-IR dengan pemberian puguntano pada penderita Diabetes Mellitus tipe 2 yang baru didiagnosis. Simpulan, efek puguntano dalam mengontrol gula darah terutama dalam perannya memperbaiki sensitifitas insulin tidak jauh berbeda dengan metformin yang telah menjadi obat standar dalam pengobatan lini pertama diabetes melitus tipe 2. [MKB. 2017;49(2):67–72] Kata kunci: Diabetes melitus, HOMA-IR, puguntano  Effect of Puguntano on HOMA-IR in Newly Diagnosed Type 2 Diabetes Mellitus Insulin resistance is important not only as a powerful predictor of future development of type 2 diabetes mellitus but also as a therapeutic target once hyperglycemia is present. HOMA-IR is a method for assessing insulin resistance that has been validated worldwide. Puguntano is one of the traditional plants found in North Sumatera that has been recognized for its anti-diabetic effect. Samples were taken from 2015–2016 at H. Adam Malik General Hospital Medan. This study tried to assess the effect of puguntano as a traditional plant in North Sumatera on insulin resistance in type 2 diabetes melitus patients and aimed to determine the effect of puguntano treatment on HOMA-IR in newly diagnosed type 2 diabetes mellitus patients. This was a randomized open clinical trial on 24 newly diagnosed type 2 diabetes mellitus patients (12 patients and 12 controls) divided into 2 groups who were assigned to receive  puguntano or Metformin for 12 weeks. HOMA-IR and Hba1c were determined at baseline and at the end of 12 weeks. In puguntano group, the mean decrease of HOMA-IR was 1.71 (± 2.29) (p=0.034). There was no difference in terms of the mean decrease of HOMA-IR between the puguntano and Metformin group, which was 1.71 (±2.29) vs 0.80 (±1.47) (p=0.402). There was a decrease mean of HOMA-IR level with puguntano treatment in newly diagnosed type 2 diabetes mellitus patients which was statistically significant. In conclusions, the effect of puguntano in controlling blood sugar especially in its role of improving insulin sensitivity is not much different from metformin which has become a standard drug in the first-line treatment of type 2 diabetes mellitus. [MKB. 2017;49(2):67–72] Key words: Diabetes mellitus, HOMA-IR, puguntano
Pengetahuan dan Sikap Mahasiswa Fakultas Kedokteran dan Fakultas Psikologi terhadap Lansia Teressa, Maria; Rukmini, Elisabeth
Majalah Kedokteran Bandung Vol 49, No 2 (2017)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (156.411 KB) | DOI: 10.15395/mkb.v49n2.967

Abstract

Populasi lanjut usia (lansia) di negara maju maupun negara berkembang akan meningkat dan menimbulkan masalah kesehatan. Banyaknya masalah kesehatan yang terjadi selama proses penuaan memerlukan sikap dan perhatian khusus terhadap lansia. Calon profesional yang terkait dengan bidang kesehatan perlu dipersiapkan untuk menyikapi dan memberi perhatian kepada lansia. Tujuan penelitian ini adalah untuk mendapatkan perbandingan pengetahuan dan sikap mahasiswa terhadap lansia antara mahasiswa Fakultas Kedokteran (FK) dan mahasiswa Fakultas Psikologi (FP) Unika Atma Jaya dari tanggal 1 Juli 2016 sampai 31 Desember 2016. Penelitian ini melibatkan 86 mahasiswa FK dan FP tingkat pertama, kedua, dan ketiga Unika Atma Jaya. Pengetahuan dan sikap mahasiswa terhadap lansia pada mahasiswa kedokteran dan psikologi diukur dengan alat ukur Pengetahuan dan Sikap Mahasiswa terhadap Lansia dan dibanding dengan menggunakan uji-t tidak berpasangan. Mahasiswa FK dan FP Unika Atma Jaya memiliki pengetahuan dan sikap yang tinggi terhadap lansia. Skor mahasiswa psikologi rata-rata lebih tinggi (33,47) dibanding dengan mahasiswa kedokteran (33,35), meskipun perbedaan ini tidak signifikan. Simpulan, tidak terdapat perbedaan pengetahuan dan sikap mahasiswa terhadap lansia antara mahasiswa kedokteran dan mahasiswa psikologi. [MKB. 2017;49(2):73–8] Kata kunci: Lansia, mahasiswa, pengetahuan, perbandingan, sikap  Medical and Psychology Students’ Knowledge and Attitude toward Elderly The proportion of older people is increasing worldwide, and so are the health problems. Health concerns related to aging create a growing need for health workers to provide care to elder people. Therefore, health care workers must be prepared to address and care for elderly. The aim of this study was to compare medical and psychology students’ knowledge and attitude towards elderly in Atma Jaya Catholic University of Indonesia. This study was conducted from 1 July 2016 to 31 December 2016. A total of 86 of the first, second, and third year students completed a questionnaire referred to as Students’ Knowledge and Attitude toward Elderly Questionnaire (SKAEQ). The medical and psychology students’ knowledge and attitude was  compared using independent t-test. The results showed that medical and psychology students had high knowledge and attitude towards elderly. Although the mean score of the psychology students (33.47) was higher than the medical students’ (33.35), the difference was not significantly different. In conclusion, there is no difference in the knowledge and attitude towards elderly between medical and psychology students. [MKB. 2017;49(2):73–8] Key words: Attitude, comparison, elderly, knowledge, student 
Profil Keamanan setelah Pemberian Dosis Primer Vaksin Pentabio® pada Bayi di Indonesia Sundoro, Julitasari; Rusmil, Kusnandi; Sitaresmi, Mei Neni; Arhana, Arhana; Djelantik, I.G.G.; Hadinegoro, Sri Rezeki; Satari, Hindra Irawan; Syafriyal, Syafriyal; Bachtiar, Novilia Sjafri; Sari, Rini Mulia
Majalah Kedokteran Bandung Vol 49, No 2 (2017)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15395/mkb.v49n2.1052

Abstract

Vaksin Hib mulai digunakan pada Pogram Imunisasi Nasional sejak tahun 2013 secara bertahap dan di seluruh Indonesia mulai tahun 2014 dalam bentuk vaksin kombinasi DTP/HB/Hib (Pentabio®), yang memberikan  kekebalan terhadap difteria, pertusis, tetanus, hepatitis B, dan Haemophilus influenzae tipe b. Studi ini menilai reaksi sitemik, reaksi lokal, dan reaksi yang serius pascaimunisasi dengan Pentabio®. Sebanyak 4.000 bayi penerima vaksin Pentabio®bergabung dalam studi ini. Reaksi yang timbul dicatat pada kartu harian oleh petugas yang sudah dilatih. Vaksin Pentabio®yang diamati pada PMS ini menggunakan vaksin rutin dari Program Imunisasi Nasional dalam waktu pengamatan 28 hari di empat propinsi, yaitu Nusa Tenggara Barat, Bali, Yogyakarta, dan Jawa Barat pada periode Mei–Desember 2014. Sebanyak 3.978 data dapat dianalisis karena 22 di antaranya tidak memberikan informasi yang valid. Reaksi sistemik yang paling banyak timbul adalah demam 0,85% pada 30 menit pertama, dan meningkat menjadi 14,03% pada satu hari pascaimunisasi, kemudian sembuh pada hari berikutnya. Reaksi lokal yang paling sering timbul adalah nyeri pada tempat suntikan pada 67,6% subjek pada 30 menit setelah imunisasi, dan meningkat menjadi 87,23% pada 1 hari pascaimunisasi namun sembuh pada hari berikutnya. Mayoritas nyeri yang timbul adalah kategori ringan. Tidak ditemukan kejadian ikutan pascaimunisasi serius selama pengamatan. Simpulan, reaksi lokal dan sistemik pascaimunisasi dengan Pentabio® dapat ditoleransi pada bayi. [MKB. 2017;49(2):86–93]   Kata kunci: Bayi, Pentabio®, post marketing surveillance, reaksi lokal, reaksi sistemik   Safety Profile Following Pentabio® Primary Dose Vaccination in Indonesian Infants   Since 2013 Indonesian Expanded Program on Immunization (EPI) has  graduallyincluded Hib vaccine into routine EPI schedule in four provinces and has established the vaccine inclusion in the the nationwide program through integration of Hib vaccine into existing DTP/HB vaccine in the form of pentavalent vaccine (DTP/HB/Hib). Pentabio® vaccine is given to provide protection against diphtheria, tetanus, pertussis, hepatitis B, and Hib infection in infants and children under 5 years old.  The objective of this study was to assess the systemic reactions, local reactions, and any serious adverse event after Pentabio® immunization. About 4,000 infants were involved in this study. Systemic and local reactions were recorded on diary cards by trained health care provider. Pentabio® vaccines in this PMS were obtained from the National Immunization Program within 28 days of observation in four provinces, West Nusa Tenggara, Bali, Yogyakarta, and West Java in May–December 2014. In total, 3,978 infants were analyzed, while the other 22 forms were not included due to incomplete information. The most common systemic reaction was fever, found in 0.85% of the subjects at 30 minutes after injection, and increased to 14.03% at day 1 (one) after immunization, which disappeared the day after. The most common local reaction was pain, which was found in 67.6% subjects at 30 minutes after injection, and increased to 87.23% at day 1 (one) after immunization to disappear the day after. The intensity of the pain was mostly mild. No serious adverse event following immunization found during observation. [MKB. 2017;49(2):86–93]   Key words: Infants, local reactions, Pentabio®, post marketing surveillance, systemic reactions 

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