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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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Potensi Ekstrak Etanol Buah Citrullus lanatus sebagai Agen Imunosupresi melalui Pengamatan Histologi Limpa Mencit BALB/c Makiyah, Sri Nabawiyati Nurul; Wardhani, Ulinna'ma Hayati
Majalah Kedokteran Bandung Vol 49, No 4 (2017)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (5.096 KB) | DOI: 10.15395/mkb.v49n4.1024

Abstract

Citrullus lanatus mengandung flavonoid yang berpotensi sebagai agen imunosupresi. Penelitian ini bertujuan mengkaji perubahan diameter pulpa alba limpa mencit BALB/c yang diinduksi ovalbumin (OVA) setelah pemberian ekstrak etanol buah C. lanatus. Jenis penelitian ini adalah eksperimental dengan post-test only control group design. Sebanyak 30 ekor mencit BALB/c jantan dibagi menjadi enam kelompok, yaitu tiga kelompok kontrol (normal, negatif, dan metilprednisolon) dan tiga kelompok perlakuan ekstrak etanol C. lanatus dosis 175 mg/kgBB, 350 mg/kgBB, dan 700 mg/kgBB per hari. Ekstrak dan Metilprednisolon diberikan selama 28 hari, sedangkan OVA diberikan pada hari ke-15 dan ke-22 secara intraperitoneal dan per oral pada hari ke-23 sampai dengan hari ke-28. Pada hari ke-29, mencit dikorbankan dan organ limpa diambil untuk dibuat sediaan histologi dengan teknik pewarnaan HE. Efek imunosupresi dinilai dari rata-rata diameter pulpa alba limpa. Data dianalisis dengan uji nonparametrik Kruskal-Wallis dilanjutkan uji Mann-Whitney. Diameter pulpa alba limpa mengalami peningkatan setelah diinduksi OVA, pemberian ekstrak etanol C. lanatus dosis 700 mg/kgBB dan metilprednisolon menyebabkan penurunan diameter pulpa alba limpa secara bermakna (p<0,05), tetapi ekstrak etanol C. lanatus dosis 175 dan 350 mg/kgBB tidak menurunkan diameter pulpa alba limpa. Ekstrak etanol C. lanatus dosis 700 mg/kgBB mampu menurunkan diameter pulpa alba pada limpa mencit BALB/c yang diinduksi OVA sehingga berpotensi sebagai agen imunosupresi. Kata kunci: Agen imunosupresi, citrullus lanatus, mencit BALB/c, ovalbumin, pulpa alba limpaCitrullus lanatus Ethanol Extract Potential as Immunosupressive Agent based on Spleen Histology Observation in BALB/c MiceCitrullus lanatus contains flavonoid which is known as an immunosuppresion agent. This study aimed to evaluate BALB/c mice spleen white pulp diameter after Ovalbumin (OVA) induction and administration of C. lanatus ethanol extract. This was a post-test only control group experimental study. Thirty male BALB/c mice were divided into six groups consisting of three control groups (normal, negative, and methylprednisolone) and three C. lanatus ethanol extract treatment groups (175 mg/kg bw, 350mg/kg bw, and 700mg/kg bw dose per day). The ethanol extract and methylprednisolone were administered to the respective groups for 28 consecutive days, while the OVA was given intraperitoneally on day 15 and day 22 and orally from day 23 to day 28. On day 29, the mice were sacrificed and their spleen were processed histologically using the HE staining technique. The immunosupression effect was assessed by measuring the  white pulp spleen diameter. Data were analyzed using nonparametric Kruskal-Wallis test, followed by Mann-Whitney test. After OVA induction, the diameter of white pulp spleen was found to increase. Significant decrease in the spleen white pulp diameter (p<0.05) was seen in the 700 mg/kgbw C. lanatus ethanol extract group and methylprednisolone group. No shortening of the spleen white pulp diameter was seen in 175 mg/kg bw and 350 mg/kgbw C. lanatus ethanol extract groups. Hence, 700 mg/kgbw C. lanatus ethanol extract can decrease the spleen white pulp diameter  in an OVA-induced BALB/c mice and may have a potential to be used as an immunosuppressive agent. Key words: BALB/c mice, citrullus lanatus, immunosuppresion agent, ovalbumin, white pulp of spleen
Hubungan Beberapa Faktor Klinis dan Pengobatan Penyakit Arteri Koroner dengan Pembentukan dan Gradasi Kolateral Arteri Koroner Martha, Januar Wibawa; Purnomowati, Augustine
Majalah Kedokteran Bandung Vol 49, No 4 (2017)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (550.29 KB) | DOI: 10.15395/mkb.v49n4.1199

Abstract

Penyakit arteri koroner (PAK) ditandai lesi aterosklerosis yang menyebabkan penurunan suplai oksigen ke miokardium. Sebagian pasien PAK membentuk pembuluh kolateral yang menambah suplai darah ke miokardium. Pembentukan kolateral didasari proses angiogenesis dan dipengaruhi oleh berbagai faktor. Aspirin telah digunakan sebagai pencegahan angiogenesis. Penelitian ini bertujuan mencari pengaruh faktor klinis dan pengobatan terhadap pembentukan kolateral koroner. Penelitian ini menggunakan metode potong lintang pada pasien PAK yang dilakukan angiografi koroner. Klasifikasi kolateral koroner dinilai menggunakan kriteria Rentrop. Subjek penelitian dibagi menjadi kolateral baik dan kolateral buruk, ditentukan berdasar atas penilaian intervensionis. Faktor yang dianalisis adalah keluhan angina, obat-obatan, lesi stenosis, dan faktor risiko kardiovaskular. Analisis statistik menggunakan korelasi Spearman dan regresi logistik. Sebanyak 382 pasien diikutsertakan dalam penelitian. Seluruh subjek penelitian memiliki stenosis koroner di atas 80% pada salah satu arteri koroner. Analisis kolateral koroner mendapatkan 164 pasien kolateral baik dan 158 orang kolateral buruk. Secara bivariat, faktor-faktor yang berpengaruh pada pembentukan kolateral koroner yang buruk adalah: penggunaan inhibitor ACE (p=0,048), penggunaan aspirin (p=0,047), oklusi pada pembuluh left circumflex (p=0,032), tidak ada keluhan angina (p=0,036), dan diabetes (p=0,047). Regresi logistik tidak menunjukkan kemaknaan dari faktor-faktor diatas terhadap pembentukan kolateral koroner (p=0,088). Penelitian ini menyimpulkan bahwa aspirin, inhibitor ACE, oklusi pembuluh left circumflex, tidak ada keluhan angina dan riwayat diabetes memiliki potensi untuk menghambat pembentukan kolateral koroner. [MKB. 2017;49(4):274–80]Kata kunci: Faktor klinis, kolateral koroner, penyakit arteri koroner Relationship between Several Clinical and Treatment Factors in Cad Patients in Coronary Collateral Development and Gradation Coronary artery disease (CAD) involves atherosclerotic plaques that caused reduction of myocardial oxygen supply. Some CAD patients develop collaterals which augment myocardial blood circulation. Angiogenesis is a precursor for collateral development and influenced by multiple factors. Aspirin has been used as an angiogenesis inhibitor. This study was intended to elucidate clinical and treatment factors that may affect collateral development. This study employed cross-sectional methodology. Subjects were CAD patients who underwent coronary angiography. Grading of coronary collaterals was classified using Rentrop criteria. Subjects were categorized into poor collaterals and good collaterals, determined by an interventionist. Factors  analyzed were anginal symptoms, medications, stenotic lesions, and cardiovascular risk factors. Data were examined using Pearson or Spearman correlation and logistic regression. A total of 382 patients were selected. All subjects had 80% or more stenotic lesions in one or more coronary arteries. There were 164 patients assigned as good collaterals and 158 patients was assigned as poor collaterals. Factors that hampered collateral development were: ACE (p=0.048) and aspirin (p=0.047) use, occlusion of left circumflex artery (p=0.032), no anginal symptoms (p=0.036) and diabetics (p=0,047). None of these factors was statistically significant in logistic regression (p=0.088). The study concluded that aspirin has a potential to diminish coronary collateral development. [MKB. 2017;49(4):274–80]Key words: Clinical factors, coronary artery disease, coronary collaterals
Ligasi dan Transformasi Gen MSP1 Plasmodium falciparum Penyebab Malaria di Kota Jayapura Mawardi, Arsyam; Ramandey, Euniche R.P. F.
Majalah Kedokteran Bandung Vol 49, No 4 (2017)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (484.5 KB) | DOI: 10.15395/mkb.v49n4.1138

Abstract

MSP1 merupakan protein yang antigenik dan paling banyak diekpresikan pada permukaan merozoit ketika menginfeksi eritrosit pasien malaria sehingga banyak dikembangkan untuk desain terapi vaksin. Proses ligasi dan transformasi gen MSP1 merupakan upaya penggandaan gen untuk menghasilkan produk yang sama ketika diekspresikan. Penelitian ini bertujuan mengkloning gen MSP1 P. falciparum  dari pasien malaria tropika di Jayapura menggunakan vektor pJET1.2/blunt dan sel kompeten E. coli DH5 sehingga didapatkan perbanyakan plasmid rekombinan yang mengandung gen MSP1. Darah yang positif mengandung P. falciparum diproses secara molekuler, diawali tahapan isolasi DNA genom, amplifikasi dengan teknik PCR, ligasi ke dalam vektor pJET1.2/blunt dan ditransformasi pada E. coli DH5α dengan metode Heat Shock Transformation, diakhiri dengan konfirmasi PCR untuk memastikan tersisipkannya gen blok 2 MSP1. Hasil penelitian menunjukkan bahwa konfirmasi keberadaan gen MSP1 dalam pJET1.2/blunt dengan PCR berhasil dilakukan. Dari total 10 koloni positif  yang ditumbuhkan dalam kultur cair, kemudian diiisolasi plasmid dan dikonfirmasi dengan PCR diperoleh pita hasil elektroferogram dengan ukuran sekitar 1049 bp yang menunjukan gen MSP1 dalam plasmid. Berdasar atas hasil tersebut, kloning gen MSP1 menggunakan vektor kloning pJET1.2/blunt dan sel kompeten E. coli DH5a telah berhasil dilakukan. Kata kunci: Heat Shock, ligasi, MSP1, P. falciparum, transformasi Malaria-causing MSP-1 Plasmodium falciparum Ligation and Transformation in Jayapura CityMSP1 is the most antigenic and expressed protein on merozoite surface when it infects the erythrocytes of malaria patients which leads to its use for vaccine therapy design development. The ligation and transformation process of the MSP1 gene is a gene duplication attempt for producing  the same product during expression. This study aimed to clone P. falciparum MSP-1 gene from tropical malaria patients in Jayapura using pJET1.2/blunt vectors and E. coli DH5a competent cells, to get the recombinant plasmid propagation of MSP1 gene. Blood that was positive for P. falciparum was molecularly processed, starting with genomic DNA isolation and then followed by PCR amplification, ligation into pJET1.2/blunt vector, and transformation into E. coli DH5α using the heat shock transformation method. The process was ended with PCR confirmation to confirm MSP1 gene insertion. The results showed that the presence of the  MSP1 gene in pJET1.2/blunt was successfully confirmed through PCR. From a total of 10 positive colonies grown in liquid culture,  plasmid was isolated. Electropherogram result presented bands  of about 1049bp, indicating the presence of the MSP1 gene in plasmid. Hence, MSP1 gene cloning using pJET1.2/blunt cloning vector and competent cell E. coli DH5α has been successfully performed. Key words: Heat shock, ligation, MSP-1, P. falciparum, transformation  
UJI DIAGNOSTIK PEMERIKSAAN KADAR TRANSFORMING GROWTH FACTOR BETA 1 CAIRAN PLEURA PADA PLEURITIS TUBERKULOSIS Wahyuningrum, Woro Hapsari; Indrati, Agnes Rengga; Rachmayati, Sylvia; Turbawaty, Dewi Kartika
Majalah Kedokteran Bandung Vol 49, No 4 (2017)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (179.438 KB) | DOI: 10.15395/mkb.v49n4.1152

Abstract

Sulitnya penegakan diagnosis pleuritis tuberkulosis (TB) disebabkan oleh gambaran klinis yang tidak spesifik dan rendahnya sensitivitas pemeriksaan bakteriologik, akibat cairan pleura yang bersifat pausibasiler.Transforming growth factor beta 1 (TGF-?1) mampu menekan respons imun seluler terhadap M. tuberculosis, berperan dalam aktivasi TB laten, kerusakan jaringan, dan fibrosis. Penelitian ini bertujuan mengetahui peranan pemeriksaankadarTGF-?1 cairan pleura dalam penegakan diagnosis pleuritis TB. Penelitian ini adalah uji diagnostik, pengambilan data secara potong lintang. Bahan pemeriksaan berupa cairan pleura yang disimpan dalam ultra low freezer dari pasien rawat inap di RSUP Dr. Hasan Sadikin (RSHS) Bandung dan Rumah Sakit Paru Dr. H.A Rotinsulu Bandung periode Oktober 2014 ? Maret 2015. Total subjek penelitian 68, terdiri dari 17 pleuritis TB confirmed, 22 pleuritis TB probable, dan 29 pleuritis non TB.Kadar TGF-?1 cairan pleura pleuritis TB: 41,4 (10,4 ?19.481) pg/mL. Pemeriksaan kadar TGF-?1 menunjukkan sensitivitas 66,7%, spesifisitas 65,5% pada nilai cut-off  >37 pg/mL. Sensitivitas pemeriksaan kadar  TGF-?1 lebih tinggi bila dibanding dengan pemeriksaan bakteriologik. Hasil negatif pada pemeriksaan bakteriologik dari subjek pleuritis TB probable, 77,3% di antaranya memberikan hasil positif pada pemeriksaan kadar TGF-?1.  Pemeriksaan ini dapat digunakan sebagai tambahan modalitas pemeriksaan laboratorium untuk mendiagnosis pleuritis TB, terutama bila didapatkan hasil negatif pada pemeriksaan bakteriologik, namun kecurigaan pleuritis TB sangat kuat.Kata kunci: Kadar TGF-?1, pemeriksaan bakteriologik, pleuritis TB  Diagnostic Value of Pleural Fluid Transforming Growth Factor Beta 1 Level in Tuberculous PleurisyTuberculous(TB) pleurisy was difficult to be diagnosed as it has nonspecific symptoms and low sensitivity in  bacteriological tests which are caused by paucibacillary of pleural fluid. Transforming Growth Factor Beta 1 (TGF-?1) could suppress  the immune response to M. tuberculosis infection, activating latent TB infection that involves tissue damages and fibrosis. This study aimed to determine the role of pleural fluid TGF-?1 level in diagnosing TB pleurisy. This was a cross-sectional specific descriptive observational study involving a total subjects of 68 that consisted of  17 confirmed TB pleurisy, 22 probable TB pleurisy, and 29 non-TB pleurisy. Pleural fluid collected in October 2014 ? March 2015 from the subjects was stored in an ultra low freezer. The which.level of TGF-?1 in pleural fluid in TB pleurisy was 41,4(10,4 ? 19.481) pg/mL. Pleural  fluid TGF-?1 level showed a sensitivity of 66,7%, specificity of 65,5% and a cut-off value >37pg/mL. The sensitivity level of pleural fluid TGF-?1 was higher than that of the bacteriological test. Pleural fluid TGF-?1 level can be used as an adjunct modality of laboratory test for diagnosing TB pleurisy, especially for patient with high suspiscion of TB pleurisy but yield negative result in the bacteriological test.Key words: Bacteriological tests, TB pleurisy, TGF-?1 levels
PERBANDINGAN VIABILITAS OOSIT PASCAVITRIFIKASI PADA DUA TINGKAT KONSENTRASI SUKROSA YANG BERBEDA Widyastuti, Rini; Khoirinaya, Candrani; Ridlo, M. Rosyid; Syamsunarno, Mas Rizky A. A
Majalah Kedokteran Bandung Vol 49, No 4 (2017)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (6101.625 KB) | DOI: 10.15395/mkb.v49n4.1139

Abstract

Vitrifikasi merupakan suatu teknik kriopreservasi tanpa disertai pembentukan kristal es, baik intraseluler maupun ekstraseluler. Tingkat keberhasilan vitrifikasi sangat dipengaruhi oleh jenis dan konsentrasi krioprotektan yang digunakan. Sukrosa merupakan krioprotektan ekstraseluler yang mempunyai peranan dalam menjaga kestabilan membran sel pada saat proses dehidrasi. Tujuan penelitian ini adalah mengkaji efek penambahan sukrosa dalam dua level konsentrasi yang berbeda pada morfologi dan persentase hidup oosit pascavitrifikasi dengan menggunakan oosit domba yang telah dimatangkan secara in vitro sebagai model. Penelitian dilaksanakan di Laboratorium Riset dan Bioteknologi, Fakultas Peternakan, Universitas Padjadjaran periode September 2016?Desember 2016. Penelitian menggunakan rancangan acak lengkap dengan dua kelompok perlakuan, yaitu penambahan 0,5 M sukrosa atau 0,65 M sukrosa pada media vitrifikasi. Parameter yang diamati adalah persentase oosit hidup dan morfologi oosit yang mati pascavitrifikasi-pencairan kembali. Hasil yang diperoleh menunjukkan bahwa persentase oosit hidup pascavitrifikasi meningkat 20% setelah penambahan sukrosa 0,65M. Fraktur zona pelusida merupakan kerusakan morfologi yang banyak ditemukan pada oosit yang divitrifikasi dengan penambahan 0,5 M sukrosa dalam larutan vitrifikasi. Hasil penelitian ini mengindikasikan bahwa penambahan sukrosa 0,65 M sebagai krioprotektan ekstraseluler meningkatkan peluang hidup oosit setelah proses vitrifikasi. Kata kunci: Krioprotektan, morfologi oosit, sukrosa, vitrifikasiComparison of Oocyte Viability after Vitrification with Two Different Sucrose Concentration LevelVitrification is a cryopreservation technique without the formation of ice crystals, both intracellular and extracellular. The success of vitrification depends on the type and concentration of cryoprotectants.  Sucrose is one of the extracellular cryoprotectants that play a role in maintaining cell membrane during dehydration process. The purpose of this study was to examine the effect of the addition of two different sucrose concentration levels on the morphology and viability of oocyte after vitrification using matured sheep oocytes as a model. This study was conducted at the Research and Biotechnology Laboratory, Faculty of Animal Husbandry, Universitas Padjadjaran during September?December 2016. The oocytes were randomly assigned into groups with two different concentrations of sucrose in vitrification media: i.e. 0.5 M and 0.65 M. The parameters observed were the percentage of live oocytes and the dead oocyte morphology after vitrification-thawing.  The results showed that the percentage of live matured oocytes post-vitrification increased by 20% after the addition of 0.65M sucrose. Fracture of pellucida zone was the major finding in the post-vitrification dead oocytes  in 0.5 M sucrose group. This indicates that vitrification using 0.65M sucrose as extracellular cryoprotectant presents a higher oocyte survival after vitrification-thawing. Key words: Cryoprotectant, oocytes morphology, sucrose, vitrification
PROFILE OF IMMUNIZATION PRACTICE BY GENERAL PRACTITIONERS AND PEDIATRICIANS IN PRIVATE SETTING Soedjatmiko, Soedjatmiko; Gunardi, Hartono; Satari, Hindra Irawan; Singgih, Adrian Himawan; Yolanda, Natharina
Majalah Kedokteran Bandung Vol 49, No 4 (2017)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (66.572 KB) | DOI: 10.15395/mkb.v49n4.1153

Abstract

Basic immunization coverage in Indonesia in 2013 was still low (59.2%) (IBHS, 2013). Physicians? attitude and practice were among the determinant factors of a successful immunization program. This survey aimed to describe general practitioner?s (GP) and pediatrician?s attitude towards immunization and its coverage  in private practices. This cross-sectional study was performed by distributing questionnaires consisting of 5 items on opinion and 10 items on immunization practices to 100 respondents in November 2014. Completed questionnaires were obtained from 29 GPs and 65 pediatricians. Most respondents considered that the Expanded Program in Immunization vaccine should be given. First dose of hepatitis B vaccine was mostly given in the first 12 hours after birth (90% GPs and 74% pediatricians). Oral polio vaccine was mostly given shortly before hospital discharge (65% of GPs and 81% pediatricians) while the DTwP-HB-Hib vaccine were given by 27% of GPs and 21% of pediatricians to >75% patients. Pneumococcal, rotavirus, hepatitis A, typhoid, and influenza vaccines were provided by less than 25% GPs and pediatricians, except for the influenza vaccine which was provided by 31% pediatricians. MMR vaccine was given to >75% patients by 16% of GPs and 29% of pediatricians. This pilot survey of immunization practice in private setting might be the first study in Indonesia that this can be considered as a preliminary report of immunization in private setting. Further studies need to be done, especially regarding problems in immunization in private practices. Key words: Attitude, general practitioners, immunization practice, private setting, pediatriciansGambaran Praktek Imunisasi Dokter Umum dan Dokter Spesialis Anak di Praktek SwastaRiset Kesehatan Dasar 2013 melaporkan bahwa cakupan imunisasi Indonesia masih rendah (59,2%). Sikap dan praktik imunisasi dokter merupakan salah satu faktor penentu keberhasilan. Tujuan penelitian ini mengetahui sikap dokter dan cakupan imunisasi di praktik swasta. Penelitian potong lintang dilakukan dengan menyebarkan kuesioner tentang sikap dan praktik imunisasi kepada responden, yaitu 29 dokter umum (DU) dan 65 dokter spesialis anak (DA) pada bulan November 2014. Mayoritas responden berpendapat bahwa vaksin program pengembangan imunisasi harus diberikan. Vaksin hepatitis B dosis I mayoritas diberikan dalam 12 jam setelah lahir (90% oleh DU dan 74% oleh DA). Vaksin polio oral mayoritas diberikan sebelum pulang perawatan (65% oleh DU dan 81% oleh DA), Vaksin DTwP-HB-Hib diberikan oleh 27% DU dan 21% DA kepada ?75% pasien. Penggunaan vaksin pneumokokus, rotavirus, hepatitis A, tifoid dan influenza pada >75% pasien adalah kurang dari 25%, kecuali vaksin influenza, yaitu 31% digunakan oleh DA. Pemberian vaksin MMR pada >75% pasien dilakukan oleh 16% DU dan 29% DA.  Penelitian imunisasi pada praktik swasta ini mungkin  merupakan laporan yang pertama dipublikasi di Indonesia. Penelitian lebih lanjut diperlukan untuk mengetahui hambatan imunisasi di praktik swasta.Kata kunci: Cakupan imunisasi, dokter,  imunisasi, praktik, spesialis
Perbandingan antara Tramadol 2 mg/kgBB dan Fentanil 2 mg/kgBB Intravena Sebagai Analgetik Intraoperatif pada Operasi Laparotomi Ginekologis; Pengaruhnya terhadap Skor PRST Kurniawan, Arief; Pratiwi, Nur Pudyastuti
Majalah Kedokteran Bandung Vol 49, No 4 (2017)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (378.38 KB) | DOI: 10.15395/mkb.v49n4.1144

Abstract

Perkembangan dan kemajuan teknologi serta ilmu pengetahuan telah mendorong pelaksanaan pelayanan kesehatan yang lebih efektif dan lebih ekonomis dibanding dengan cara yang lazim dikerjakan.  Telah dilakukan penelitian terhadap 32 pasien operasi laparotomi ginekologis yang dibagi menjadi dua kelompok. Kelompok Tramadol (n=16) diberikan tramadol 2 mg/kgBB (pengenceran akuabides sampai 10 mL) lewat jalur infus selama satu menit, sedangkan pada kelompok Fentanil (n=16) diberikan fentanil 2 µg/kgBB dengan cara yang sama. Lima menit kemudian diberikan propofol 2 mg/kgBB, atrakurium 0,5 mg/kgBB, enfluran 2 volume %, N2O:O2=2 L/menit:2 L/menit. Setelah tiga menit dilakukan laringoskopi intubasi. Pasien diventilasi kendali dengan mode ventilator IPPV.  Operasi dilaksanakan bila kedalaman anestesi tercapai berdasar atas skor PRST (P=systolic arterial pressure, R=heart rate, S=sweat, dan T=tears) 2 sampai dengan 4. Analgetik pertolongan 50 µg fentanil diberikan bila skor PRST lebih dari 4. Analgetik postoperatif 30 mg ketorolak dan antimuntah 10 mg metoklopramid diberikan saat jahit kulit. Pencatatan tekanan darah, laju nadi, saturasi O2, dan skor PRST dilakukan sebagai berikut: T0 = penderita tiba di kamar operasi, T1= preintubasi, T2= satu menit setelah intubasi, T3= satu menit setelah insisi, T4 dan seterusnya diukur tiap 15 menit sampai selesai operasi. Pasien diekstubasi setelah pernapasan adekuat. Skala sedasi dan muntah dinilai setiap 15 menit setelah ekstubasi selama dua jam. Dari hasil penelitian didapatkan skor PRST mulai T1 sampai T12 secara statistis tidak berbeda bermakna antara kelompok tramadol dan fentanil (p>0,05). Kedua kelompok mengalami peningkatan skor PRST satu menit setelah intubasi. Skor PRST dipertahankan antara 0 sampai 2. Pada kelompok tramadol dan fentanil masing-masing satu orang mendapatkan analgetik pertolongan fentanil 50 µg karena skor PRST 5. Tidak ditemukan perbedaan skala sedasi dan muntah antara dua kelompok perlakuan. Penelitian ini menunjukkan tramadol 2 mg/kgBB dibanding dengan fentanil 2 µg/kgBB sebagai analgetik intraoperatif pada operasi laparotomi ginekologis memberikan pengaruh  yang sama terhadap skor PRST.Kata kunci: Analgetik intraoperatif, fentanil, laparotomi ginekologis, skor PRST, tramadolComparison of Intravenous Tramadol 2 mg kgBW-1 and Fentanyl 2 mg.kgbw-1 As Intraoperative Analgetic for Gynecologic Laparotomy; Its Effects on PRST Score The development and improvement of technology and sciences influence the effectivity and economic of health care. This study was done on 32 patients who undergoing gynecologic laparotomy. The sample was divided into 2 groups, consisted of 16 patients each group. The tramadol group was given 2 mg.kgbw-1 tramadol (diluted to 10 mL) via infuse line over one minute whereas the fentanyl group was given 2 µg.kgbw-1 fentanyl by the same procedure as tramadol. Inductions was done five minutes later with 2 mg.kgbw-1 propofol, 0.5 mg.kgbw-1 atracurium, and maintenance anesthesia with 2 vol.% enflurane, 50% O2 and 50% N2O at flow rate 4 L/minutes. After three minutes the patient was intubated and ventilated by using control mode. Surgery had performing when depth of anesthesia achieved with PRST (P=systolic arterial pressure, R=heart rate, S=sweat, and T=tears) scored 2 to 4. Rescue analgetic with 50 mcf fentanyl if the PRST score more than 4. Analgetic postoperative 30 mg ketorolac and antiemetic 10 mg metoclopramide were given intravenously during skin closure. Blood pressure, heart rate, oxygen saturation and PRST score were recorded at T0=patient on arrival in theatre, T1=preintubation, T2=one minute after intubation, T3=one minute after incision, T4 and so on were recorded every fifteen minutes until the end of surgery. Extubation was done when patient breath adequately. Sedation scale and incidence of vomiting were evaluated every fifteen minutes for two hours after extubation. The result showed that PRST scores from T1 to T12 were statistically not significant in tramadol group and fentanyl group (p>0.05), but the PRST scores increasing significantly one minute after intubation in both groups. The PRST scores were between 0 to 2. Rescue analgetic was given to one patient in tramadol group and fentanyl group with PRST scored 5. Sedation scale  and incidence of vomiting were statistically not significant  in  both groups. This study concluded that 2 mg.kgbw-1 tramadol and 2 µg.kgBB-1 fentanyl as an intraoperative analgetic during gynecologic laparotomy have the same PRST scores.Key words: Fentanyl, gynecologic, intraoperative analgetic, laparotomy, PRST score, tramadol
Hubungan antara Pola Sidik Bibir dan Jenis Suku Melayu Riau Afandi, Dedi; Mandatasari, Melissa
Majalah Kedokteran Bandung Vol 49, No 4 (2017)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (197.827 KB) | DOI: 10.15395/mkb.v49n4.1147

Abstract

Sidik bibir telah lama digunakan sebagai salah satu metode identifikasi individu.  Penelitian hubungan pola sidik bibir dengan jenis suku belum banyak diteliti, khususnya di Indonesia. Penelitian ini bertujuan mendapatkan hubungan pola sidik bibir antara galur murni suku Melayu Riau dan suku bukan Melayu Riau.Penelitian studi potong lintang dilakukan di Fakultas Kedokteran Universitas Riau antara bulan Juli sampai Agustus tahun 2015.  Sebanyak 160 mahasiswa memenuhi kriteria sampel penelitian dengan metode pengambilan sampel secara acak sederhana.  Kriteria eksklusi adalah mahasiswa Fakultas Kedokteran yang mengalami kelainan anatomi pada bibirnya (labiochisis/ labiopalatochisis), pascatrauma, dan alergi terhadap lipstik. Metode Vahanwal-Nayak-Pagare digunakan untuk mencetak pola sidik bibir. Pola sidik bibir ditetapkan dengan menggunakan klasifikasi Suzuki dan Tsuchihashi pada kedelapan kuadran bibir.  Jenis suku terbanyak adalah suku bukan Melayu Riau 111 (69,4%) dibanding dengan galur murni suku Melayu Riau 49(30,6%). Uji statistik menunjukkan hubungan yang signifikan hanya pada kuadran 3 (p = 0,04).  Dapat disimpulkan bahwa pola sidik bibir dapat digunakan untuk metode alternatif identifikasi personal, akan tetapi tidak dapat digunakan untuk membedakan galur murni suku Melayu Riau dengan bukan Melayu Riau pada populasi penelitian.Kata kunci: Klasifikasi Suzuki dan Tsuchihashi, sidik bibir, suku melayu RiauAssociation between Lip Print Pattern and Riau Malay EthnicsLip print have long been used as one of the personal identification methods. Studies on the lip print pattern associated with ethnicity has not been widely available, especially in Indonesia. This was a  study aimed to identify association between lip printi patterns and pure strains of Riau Malay and non-Malay Riau. A cross-sectional study was conducted at the Faculty of Medicine, University of Riau, between July to August 2015. A total of 160 students who met the criteria were selected through simple random sampling. Exclusion criteria were lip anatomic abnormalities (labiochisis/labiopalatochisis), post trauma experience, and allergic to lipstick. The Vahanwal-Nayak-Pagare method was used for printing the lip pattern. Lip print pattern was established using Suzuki and Tsuchihashi classification on eight lip quadrants. Most subjects were non-Malay Riau 111 (69.4%) with the remainings were identified as (n=49, 30.6%). The statistical test showed a significant relation only in Quadrant 3 (p=0,04). It is concluded that lip print pattern can be used as an alternative method in personal identification; however, it cannot be used to distinguish the pure strains of the Riau Malay ethnics from the non-Riau Malay ethnics in the study population. Key words: Lip print, Riau Malay ethnic, Suzuki and Tsuchihashi classification
Adaptasi Budaya, Alih Bahasa Indonesia, dan Validasi Sino-Nasal Outcome Test (SNOT)-22 Juanda, Ichsan Juliansyah; Madiadipoera, Teti; Ratunanda, Sinta Sari
Majalah Kedokteran Bandung Vol 49, No 4 (2017)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (115.2 KB) | DOI: 10.15395/mkb.v49n4.1145

Abstract

Kuesioner untuk menilai kualitas hidup saat ini semakin meningkat penggunaannya dalam penelitian klinis hasil intervensi medis, baik operatif maupun medikamentosa. SNOT-22 dianggap sebagai alat ukur yang paling sesuai untuk menilai kualitas hidup pasien rinosinusitis kronik.Tujuan penelitian ini melakukan adaptasi budaya, alih bahasa, dan validasi SNOT-22 ke dalam bahasa Indonesia. Penelitian deskriptif analitik potong lintang pada 50 pasien rinosinusitis kronik di Poliklinik Rinologi Alergi Departemen Ilmu Kesehatan Telinga Hidung dan Tenggorok Bedah Kepala dan Leher (THT-KL) Fakultas Kedokteran Universitas Padjadjaran/Rumah Sakit Dr. Hasan Sadikin Bandung periode November 2015–Februari 2016. Diagnosis berdasar atas anamnesis, tingkat berat penyakit, nasoendoskopi berdasa Lund-Kennedy, dan penilaian kualitas hidup dengan SNOT-22. Validasi kuesioner dalam bahasa Indonesia dilakukan dengan menerjemahkan kuesioner SNOT-22 versi bahasa Inggris ke bahasa Indonesia oleh ahli bahasa Indonesia dan diterjemahkan kembali ke bahasa Inggris oleh ahli bahasa Inggris. Dilakukan uji reabilitas menggunakan Cronbach’s alpha dan uji validitas menggunakan Rank Spearman’s. Uji Cronbach’s alpha =0,936 (sangat andal), andal jika ≥0,7 menunjukkan konsistensi yang baik. Uji Rank Spearman’s: rs=0,961 dan rs=0,978 (valid); dan keandalan (korelasi skor genap dengan skor ganjil) rs=0,900. Simpulan, hasil uji statistik menunjukkan bahwa kuesioner SNOT-22 versi bahasa Indonesia merupakan alat ukur yang valid dengan konsistensi yang baik untuk menilai kualitas hidup pasien dengan rinosinusitis kronik. Kata kunci: Bahasa Indonesia, kualitas hidup, rinosinusitis kronik, SNOT-22, validasiIndonesian Cross-cultural Adaptation,  Translation, and Validation of Sino-Nasal Outcome Test (SNOT)-22Questionnaires for quality of life (QoL) have been increasingly used in clinical trials to evaluate the impact of medical and surgical procedures. Among these, SNOT-22 was considered as the most suitable tool for assessing QoL in chronic rhinosinusitis. The purpose of this study was to conduct cross-cultural adaptation, translation, and validation of the Indonesian version of SNOT-22. This was a descriptive analitical cross-sectional study on 50 patients with chronic rhinosinusitis at the Rhinology-Allergy Clinic of the ORL-HNS Department, Faculty of Medicine Universitas Padjadjaran/Dr. Hasan Sadikin General Hospital Bandung, during the period of November 2015–February 2016. Diagnosis was made based on anamnesis while the severity of the disease was determined using nasoendoscopic findings (Lund-Kennedy). QoL was measured using SNOT-22. The validation process of the Indonesian questionnaire included translation of original SNOT-22 in to Indonesian by independent Indonesian translators, and backtranslation to English by English translators. The reliability of the questionnaire was measured using Cronbach’s alpha and the discriminant validity was assessed using Rank Spearman’s. Results showed a Cronbach’s alpha of 0,936, suggesting good internal consistency while the Rank Spearman’s correlation results suggested that the translation was valid (rs=0.961 and rs=0.978). Correlation for each individual QoL itemwas also reliable (rs=0.900). Therefore, the Indonesian version of the SNOT-22 is a valid instrument with good internal consistency and validity for assessing QoL in patients with CRS.Key words: Indonesian, chronic rhinosinusitis, quality of life, SNOT-2, validation
Karakteristik Penderita Dakriosistitis di Pusat Mata Nasional Rumah Sakit Mata Cicendo Dahlan, Rinaldi; Boesoirie, M. Kautsar; Boesoirie, Shanti F.; Kartiwa, Angga; Puspitasari, Helda
Majalah Kedokteran Bandung Vol 49, No 4 (2017)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15395/mkb.v49n4.626

Abstract

Infeksi sistem lakrimal yang paling umum adalah dakriosistitis. Infeksi biasanya didahului oleh obstruksi duktus nasolakrimalis dan dapat terjadi pada semua kelompok usia. Tujuan penelitian ini adalah mencari jumlah kasus, karakteristik demografi dan klinis, serta pengelolaan dakriosistitis di RS Mata Cicendo periode 1 Maret 2014 sampai dengan 30 September 2014. Metode yang digunakan, yaitu dengan meninjau secara retrospektif rekam medis penderita dakriosistitis di Rumah Sakit Mata Cicendo Bandung selama periode 1 Maret 2014 sampai dengan 30 September 2014. Jumlah kasus, karakteristik demografi dan klinis, serta manajemen kasus ini ditinjau. Terdapat 13 pasien (13 mata) yang didiagnosis sebagai dakriosistitis. Sebagian besar pasien adalah perempuan. Usia rata-rata adalah 41,3 tahun. Semua kasus adalah unilateral. Infeksi akut adalah dominan dari pada infeksi kronik. Sebelas kasus diterapi dengan obat-obatan dan dua kasus kronik diterapi dengan dacryocystorhinostomy (DCR). Sebagai kesimpulan, terdapat 13 pasien (13 mata) yang didiagnosis sebagai dakriosistitis akut dan kronik. Sebagian besar pasien adalah wanita di usia pertengahan, kasus unilateral, serta penatalaksanaan dengan obat-obatan dan DCR. Kata kunci: Dakriosistitis, karakteristik, penatalaksanaanCharacteristics of Dacryocystitis Patients in National Eye Center of Cicendo Eye HospitalThe most common infection of the lacrimal apparatus is dacryocystitis. Infection is usually preceded by obstruction of the nasolacrimal duct and may occur in any age group.The aim of this study was to discover number of cases, demographic and clinical characteristics, and management of dacryocystitis in Cicendo Eye Hospital during the period of March 1, 2014 to September 30, 2014.Medical records of dacryocystitis patients attending Cicendo Eye Hospital during the period of March 1, 2014 to September 30,2014 were retrospectively reviewed. Number of cases, demographic and clinical characteristics, and the management of these cases were reviewed.There were 13 patients (13 eyes) diagnosed as suffering from dacryocystitis with most of them were female patients (92.31%). The mean age was 41.3 years old. All cases were unilateral. Acute infection was predominant than chronic infection. Eleven cases were treated with medication therapy and two chronic cases were treated with dacryocystorhinostomy (DCR). Hence, there were 13 patients (13 eyes) diagnosed as acute and chronicdacryocystitis. Most of them were  middle age female patients with  unilateral cases and treated with medication therapy and DCR. Key words: Characteristic, dacryocystitis, treatment 

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