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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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Association between Neutrophil-Lymphocyte Count Ratio and Matrix Metalloproteinase-9 in Patients with Acute Myocard Infarction Tiksnadi, Badai Bhatara; Akbar, Muhammad Rizki; Yahya, Achmad Fauzi; Hidayat, Syarief; Purnomowati, Augustine; Aprami, Toni Mustahsani
Majalah Kedokteran Bandung Vol 51, No 1 (2019)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (614.44 KB) | DOI: 10.15395/mkb.v51n1.1405

Abstract

The correlation between metalloproteinase-9 (MMP-9) level and neutrophil-lymphocyte count ratio (NLCR) in AMI patients has not been studied despite the fact that they are both known to predict ventricular remodeling. This study aimed to evaluate the correlation between the MMP-9 level and NLCR in patients with acute myocardial infarction. A cross-sectional study was conducted by recruiting acute coronary syndrome patients (onset within 24 hours) who were admitted to the emergency department in several hospitals around Bandung during October-December 2012. The relationship between the MMP-9 level and NLCR was analyzed using Pearson correlation test. Linear regression analysis was used to measure the strength of NLCR in MMP-9 level prediction. Thirty seven patients aged 55.8 + 11 years old were included in this study with mostly male patients (78%). Seventy-six percents of the sample were ST-elevation myocardial infarct (STEMI) patients with the onset of symptoms of 6 (3-14) hours. The mean lymphocyte-neutrophil ratio was 5.24 (1σ±2.4) and the MMP-9 plasma concentration was 370 (240-530) ng/mL. One-sided Pearson correlation showed a positive correlation between the two variables (r=0.44, p=0.003). The linear regression analysis conceived the formula of MMP-9 = 40.87 (NLCR) + 211.3 which was used to show the relationship between the MMP-9 level and lymphocyte-neutrophil ratio. There was a positive moderate correlation between the MMP-9 level and NLCR in patients with AMI. Linear regression analysis shows that NLCR is the only independent variable to predict the MMP-9 plasma level.Key words: Acute myocardial infarct, left ventricular remodeling, matrix metalloproteinase (MMP)-9, neutrophyl-lymphocyte count Ratio (NLCR) Korelasi Rasio Neutrofil-Limfosit (NLCR) dengan Kadar Matriks Metaloproteinase-9 pada Penderita Infark Miokardium AkutKorelasi antara matriks metaloproteinase-9 (MMP-9) dan rasio netrofil-limfosit masih belum pernah dipelajari, meskipun kedua variable tersebut diketahui dapat memprediksi remodeling ventrikel kiri. Studi ini bertujuan mengevaluasi korelasi antara kadar MMP-9 dan rasio netrofil-limfosit pada penderita infark miokardium akut. Penelitian dilakukan secara potong lintang menggunakan sampel darah pasien dengan diagnosis kerja infark miokardium akut (IMA) (onset nyeri dada <24 jam) yang diambil dari beberapa rumah sakit di sekitar Kota Bandung dari periode Bulan Oktober–Desember 2012. Hubungan antara kadar MMP-9 dan rasio neutrofil leukosit dianalisis menggunakan uji korelasi Pearson. Analisis regresi linier digunakan untuk mengukur kekuatan pengaruh konsentrasi rasio neutrofil-limfosit pada kadar MMP-9. Sebanyak 37 pasien berusia 55,8 +11 tahun, dan 78% di antaranya adalah pria menjadi subjek dalam penelitian ini. Tujuh puluh enam persen sampel diantaranya merupakan pasien infark miokardium dengan elevasi ST dengan onset gejala 6 (3–14) jam.  Rerata rasio limfosit-neutrofil adalah 5,24 (1σ ±2,4), dan kadar konsentrasi MMP-9 sebesar 370 (240–530) ng/ml. Uji Korelasi Pearson menunjukkan hubungan positif antara kedua variabel tersebut dengan nilai r=0,44 (p=0,003).  Dari analisis regresi linier didapatkan rumus MMP-9= 40,87 (NLCR) + 211,3, yang digunakan untuk menunjukkan hubungan antara kadar MMP-9 dan rasio limfosit-netrofil. Terdapat hubungan positif antara kadar MMP-9 dan rasio neutrofil-limfosit pada pasien penderita IMA. Analisis regresi linier menunjukkan bahwa hanya rasio neutrofil-limfosit yang menjadi variabel prediktor independen kadar MMP-9.Kata kunci: Infark neutrofil akut, matriks-metaloproteinase 9 (MMP-9), rasio limfosit-neutrofil, remodeling ventrikel kiri
COMPARISON OF HISTOLOGICAL CHARACTERISTICS OF DRIED AND FRESH AMNION MEMBRANES AND DURA MATER IN NON-HUMAN PRIMATE (MACACA FASCICULARIS) Indah, Astrina Rosaria; Bolly, Hendrikus Masang B.; Faried, Ahmad; Arifin, Muhammad Zafrullah; Achadiyani, Achadiyani; Wirakusumah, Firman Fuad
Majalah Kedokteran Bandung Vol 51, No 1 (2019)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (303.785 KB) | DOI: 10.15395/mkb.v51n1.1651

Abstract

This study aimed to characterize the histological properties of dry-lyophilized amniotic membrane, fresh amniotic membrane (AM), and duramater membrane in search for a biologically-derived material suitable for meninges surface reconstruction. This descriptive study was conducted at the Unit-3 Laboratory of Animal Test of PT. Bio Farma (Persero), Bandung and Cell Biology Laboratory of the Faculty of Medicine, Universitas Padjadjaran Bandung. This study was conducted from 2018-2019. Fresh Macacafascicularis placenta from healthy donors,classified as specific pathogen-free for TB, SIV, SV40, Polio type 1,2,3, Foamy virus and Herpes B virus, were obtained from selected caesarean sections.The harvested dried and fresh AM and duramater membrane were stained with hematoxylin-eosin and prepared for characterization. Histological examination of dry-lyophilized and fresh AM showed similar results. Histologically, AM is represented by a single layer of metabolically-active cuboidal to columnar epithelium with microvilli firmly attached to a basement membrane and an avascular and relatively sparsely populated stroma. Meninges layers consists of 3 layers: duramater, arachnoid membrane, and piamater. Most of these cells have the same characteristics as fibroblasts, including long organelles and nuclei with various levels of fibril formation. The histological study of amniotic membrane and duramater membrane shows comparable results. The AM is a biologically-derived material suitable for meninges surface reconstruction since its histological structure is somewhat similar to that of the duramater. Its structure is ideal for replacing duramater since it has several characteristics, such as having hygroscopic properties, good biocompatibility, relatively easy to apply, and inexpensive. Key words: Dried and fresh amnion membranes, duramater membranes, non-human primate Karakteristik Histologis Membran Amnion Jenis Kering dan Segar dengan Membran Duramater pada Primata Non-Human Macaca fascicularisPenelitian ini bertujuan mengetahui karakteristik histologis membran amnion kering yang diliofilisasi, membran amnion segar, dan duramater, dalam rangka mencari bahan biologis yang cocok untuk rekonstruksi permukaan meninges. Penelitian deskriptif dilakukan di Laboratorium Hewan Uji PT. Bio Farma dan Laboratorium Biologi Sel FK Universitas Padjadjaran periode 2018-2019. Plasenta Primata non-human Macaca fascicularis segar dari donor sehat, yang bebas dari pathogen spesifik TB, SIV, SV40, Polio tipe 1, 2, 3, virus Foamy dan virus Herpes B, diperoleh dari seksio sesarea. Kemudian, dilakukan pewarnaan dengan hematoxylin-eosin untuk membran amnion kering dan segar, serta membran duramater untuk mengetahui karakterisasi histologisnya. Pemeriksaan histologis membran amnion kering-yang aktif bermetabolisme hingga kolumnar dengan mikrovili; melekat kuat pada membran basal dan stroma yang avaskular dan relatif jarang. Lapisan Meninges terdiri dari 3 lapisan: duramater, arachnoid dan piamater. Sebagian besar sel-sel ini memiliki karakteristik yang sama dengan fibroblas. Studi histologis membran amnion dan membran duramater memiliki struktur yang relatif serupa. Membran amnion adalah material yang secara biologis cocok untuk rekonstruksi permukaan meningen, karena struktur histologinya agak mirip dengan duramater. Oleh karena itu secara struktur, membran amnion ideal untuk menggantikan duramater karena memiliki beberapa karakteristik seperti sifat higroskopis, biokompatibilitas baik, mudah diterapkan, dan murah.Kata kunci: Membran amnion segar dan kering, membran duramater, primate non-human
EFFECT OF ACUTE AEROBIC PHYSICAL ACTIVITY ON SKELETAL MUSCLE MYOD GENE EXPRESSION OF WISTAR RATS Setiawan, Setiawan; Aldo, Mochammad; Goenadi, Julia Windi; Goenawan, Hanna; Pratiwi, Yuni Susanti; Lesmana, Ronny
Majalah Kedokteran Bandung Vol 51, No 1 (2019)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (459.745 KB) | DOI: 10.15395/mkb.v51n1.1665

Abstract

Aerobic physical activity is known to induce skeletal muscle adaptation. Some genes, including MyoD, are known to have a major role in the process of muscle adaptation. Several studies has stated that the expression of MyoD increases during the aerobic activity process; however, the studies were carried out in a single bout. Studies on the effects of acute phase exercise (<2 weeks) are still rare, especially those regarding the difference effect of acute training phase at different times. This study was performed in 2018 at the Central Laboratory and Animal Physiology Laboratory, Faculty of Medicine, Universitas Padjadjaran. The aim of this study was to determine the different effects of MyoD gene expression in a two-week acute aerobic physical activity. The effects were measured in the skeletal muscle in day 3, 7, and 14 of the activity. Twenty four male rats (rattus novergicus) were divided into 4 groups. Those rats in the treatment groups were run on an animal treadmill (P1=3 days, P2=7 days, and P3=14 days). On the last day of ran, rats were sacrificed and the soleus and gastrocnemius muscles were dissected. The expression of the MyoD gene in both muscles was then amplified using reversed PCR and detected by agarose gel electrophoresis. This study showed that there were differencesin MyoD gene expression levels in both muscles and that the level increased with days of treatment, although it was statistically insignificant. This study concludes that the MyoD gene expression level is not significantly affected by an acute aerobic physical activity in certain periods (3, 7 and 14 days).Key words: Acute, Aerobic physical activity, gastrocnemius, MyoD, rats, soleus Perbedaan Pengaruh Aktivitas Aerobik Akut Intensitas Sedang terhadap Ekspresi Gen MyoD pada Otot Rangka Tikus Galur WistarAktivitas fisik aerobik diketahui menginduksi adaptasi otot rangka. Beberapa gen diketahui memiliki peran utama dalam proses adaptasi otot termasuk MyoD. Dalam beberapa penelitian diketahui bahwa ekspresi MyoD meningkat selama proses aktivitas aerobik, tetapi penelitian dilakukan dalam pertarungan tunggal. Penelitian tentang efek latihan fase akut (<2 minggu) masih belum banyak dilakukan, terutama mengenai perbedaan efek fase latihan akut pada periode tertentu (3, 7, dan 14 hari). Penelitian ini dilakukan pada tahun 2018 di Laboratorium Sentral dan Laboratorium Fisiologi Hewan Fakultas Kedokteran Universitas Padjadjaran. Tujuan penelitian ini adalah mengetahui perbedaan efek ekspresi gen MyoD dalam aktivitas fisik aerobik akut pada berbagai hari (3, 7, 14 hari) pada otot rangka. 24 tikus jantan Rattus novergicus dibagi menjadi 4 kelompok. Kelompok perlakuan dijalankan dengan treadmill hewan (P1=3 hari, P2=7 hari, dan P3=14 hari). Pada hari terakhir, tikus dikorbankan dengan soleus dan otot gastroknemius dibedah. Ekspresi gen MyoD pada kedua otot kemudian diamplifikasi menggunakan PCR terbalik dan dideteksi dengan elektroforesis gel agarosa. Penelitian ini menunjukkan perbedaan level ekspresi gen MyoD pada kedua otot, hasil ini menunjukkan bahwa ada peningkatan level perawatan per hari, walaupun secara statistik tidak signifikan. Penelitian ini menyimpulkan bahwa pada otot gastrocnemius tidak terlihat efek yang berbeda dari durasi aktivitas fisik aerobik terhadap tingkat ekspresi gen MyoD, hanya otot soleus menunjukkan perubahan dan peningkatan ekspresi konsisten terlihat pada hari ke 14 (3, 7, dan 14 hari).Kata kunci: Aktivitas fisik aerobik, akut, gastroknemius, MyoD, soleus, tikus   
TNF-α-ACTIVATED MSC-CM TOPICAL GEL EFFECTIVE IN INCREASING PDGF LEVEL, FIBROBLAST DENSITY, AND WOUND HEALING PROCESS COMPARED TO SUBCUTANEOUS INJECTION COMBINATION Kuntardjo, Novalia; Dharmana, Edi; Chodidjah, Chodidjah; Nasihun, Taufiq R; Putra, Agung
Majalah Kedokteran Bandung Vol 51, No 1 (2019)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15395/mkb.v51n1.1479

Abstract

Mesenchymal stem cells (MSCs) are multipotent stromal cells that have the capacity to regenerate tissue damage. However, they have several limitations. MSC-CM as a new approach treatment is widely used to solve the limitation of MSC in wound healing. The aim of this study was to evaluate the effectiveness of TNF-?-activated MSC-CM topical gel compare to topical-subcutaneous injection combination on wound healing acceleration. This study was conducted between April and August 2018 at the Stem Cell and Cancer Research Laboratory (SCCR), Faculty of Medicine, Sultan Agung Islamic University, Semarang. Experimental post-test only control group design was performed by involving 36 animal models randomly divided into six groups; T1, T2 (MSC-CM in topical gel 100 ?L; 200 ?L); ST1, ST2 (MSC-CM in subcutaneous injection : topical gel = 80 ?L:20 ?L; 160 ?L:40 ?L); CT (200 ?L medium free TNF-?); CST (PBS in subcutaneous injection : topical gel = 160 ?L :40 ?L). The measurement of PDGF level on day 3 and 6 was conducted using ELISA assay while the fibroblast density was analyzed by light microcopy. It was found that there was was a significant increase in PDGF and fibroblast density on day 6 in the topical group when compared to the combination group (p<0,05). It is concluded that the MSC-CM topical gel is more effective than combination of topical-subcutaneous injection.Key words: Combination, fibroblast, MSC-CM, PDGF, subcutaneous MSC-CM, topical MSC-CM MSC-CM Topikal yang diaktivasi TNF-? Efektif Dalam Peningkatan Level PDGF, Densitas Fibroblast, dan Mempercepat Penyembuhan Luka dibanding dengan Kombinasi Injeksi SubkutanMesenchymal stem cells (MSCs) merupakan sel stroma multipoten yang memiliki kemampuan untuk meregenerasi kerusakan jaringan. Namun, MSC memiliki beberapa keterbatasan. MSC-CM sebagai terapi pendekatan baru digunakan untuk mengatasi keterbatasan MSC dalam penyembuhan luka. Tujuan penelitian ini adalah menilai efektivitas MSC-CM topikal yang diaktvasi TNF-? dibandingdengan kombinasi topikal-injeksi subkutan pada percepatan penyembuhan luka. Penelitian ini dilaksanakan pada bulan April?Agustus 2018 di Laboratorium Stem Cell and Cancer Research (SCCR), Fakultas Kedokteran, Universitas Islam Sultan Agung, Semarang. Penelitian menggunakan eksperimen laboratorium dengan rancangan post-test only control group, menggunakan 36 tikus galur wistar yang dibagi secara acak menjadi 6 kelompok; T1, T2 (MSC-CM gel topikal 100?L; 200?L); ST1, ST2 (MSC-CM injeksi subkutan : gel topikal = 80 ?L:20 ?L; 160 ?L:40 ?L); CT (200 ?L medium tanpa TNF-?); CST (PBS injeksi subkutan: gel topikal = 160 ?L :40 ?L). Pengukuran kadar PDGF pada hari ke-3 dan ke-6 mengunakan ELISA, sedangkan jumlah fibroblas dilihat mengunakan mikroskop cahaya. Hasil penelitian ini menunjukkan peningkatan kadar PDGF dan jumlah fibroblas yang signifikan dihari ke-6 pada MSC-CM gel topikal dibanding dengan kombinasi topical-injeksi subukutan (p <0.05). Simpulan penelitian ini adalah pemberian MSC-CM secara topical lebih efektif dibanding dengan kombinasi topikal-injeksi subkutan.Kata kunci: Fibroblas, konditional medium, MSC-CM kombinasi, MSC-CM topikal, PDGF
COMPLETE REMISSION OF ACUTE MYELOID LEUKEMIA IN INDUCTION AND CONSOLIDATION CHEMOTHERAPY WITHOUT BONE MARROW TRANSPLANTATION: LESSONS LEARNED FROM GOOD PRESENTATION CASE Sri Hastuti, Tuti; Sumantri, Rachmat; Wijaya, Indra
Majalah Kedokteran Bandung Vol 51, No 1 (2019)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (2625.916 KB) | DOI: 10.15395/mkb.v51n1.1634

Abstract

Acute myeloid leukemia (AML) is a clinically morphologically and genetically heterogeneous disease with variable responses to therapy. The majority of the patients eventually relapse and succumb to the disease. Therapeutic modalities of induction chemotherapy, consolidation, and bone marrow transplantation are intended to achieve complete remission. Induction therapy with cytarabine and anthracycline remains thestandard of care in AML. Consolidation treatment is necessary to prevent recurrence, which may reach 90% without this treatment. Options for consolidation therapy are conventional chemotherapy and bone marrow transplantation. Bone marrow transplantation represents the only realistic chance of long-term remission in patients with a high cytogenetic risk. The risk of recurrence of AML is determined mainly by the patient?s age and genetic factors. In younger patients, complete remission (CR) rates of ?80% may be achieved, with 5-year overall survival (OS) of 40%. InDr. Hasan Sadikin Hospital Bandung during the period of 2013-2018, 12 cases of LMA underwent chemotherapy. This case study discusses a young patient with AML who has successfully reached complete remission using induction and consolidation chemotherapy without bone marrow transplantation.    Key words: Acute myeloid leukemia, chemotherapy, complete remission Remisi Lengkap Pasca Kemoterapi Induksi dan Konsolidasi Tanpa Transplantasi Sumsum Tulang pada Leukemia Mieloblastik AkutLeukemia mieloblastik akut adalah sekelompok penyakit yang memiliki gejala klinis, morfologi sel darah, kelainan genetik, dan respon terhadap terapi yang sangat bervariasi. Sebagian besar pasien leukemia mieloblastik akut (LMA) biasanya akan mengalami kekambuhan dalam perjalanan penyakitnya. Kejadian kekambuhan dalam 5 tahun sebesar 9% untuk kekambuhan di ekstramedulari dan 29% kekambuhan di sumsum tulang. Tujuan terapi pada LMA adalah mencapai remisi lengkap dan mencegah kekambuhan melalui modalitas kemoterapi dan transplantasi sumsum tulang. Transplantasi sumsum tulang diindikasikan pada pasien LMA dengan risiko sitogenetik yang tinggi. Tingkat remisi lengkap ?80% dapat dicapai, terutama pada pasien yang lebih muda dengan kelangsungan hidup keseluruhan 5 tahun 40%. Di Rumah Sakit Hasan Sadikin Bandung, selama kurun waktu 2013-2018 didapatkan 12 kasus LMA yang menjalani kemoterapi. Pada artikel ini didiskusikan 1 pasien LMA usia muda yang berhasil mencapai remisi lengkap dengan kemoterapi induksi dan konsolidasi tanpa menjalani transplantasi sumsum tulang dengan terapi pendukung yang optimal selama pemberian kemoterapi.Kata kunci : Leukemia mieloblastik akut, kemoterapi, remisi lengkap
Inspiratory Muscle Trainer Effectiveness in Chronic Obstructive Pulmonary Disease Rehabilitation Program Nusdwinuringtyas, Nury; Islamadina, Balqis; Rumende, Cleopas Martin; Kamelia, Telly
Majalah Kedokteran Bandung Vol 51, No 1 (2019)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (625.998 KB) | DOI: 10.15395/mkb.v51n1.1600

Abstract

Chronic obstructive pulmonary disease (COPD) is marked by persistent respiratory disturbance which results in altered health status as well as functional capacity. Pulmonary rehabilitation (PR) is a part of comprehensive therapy in patients suffering from respiratory disturbance. This study focused on inspiratory muscles exercise using the inspiratory muscle trainer(IMT), which is a form of a weight training exercise. This experiment was conducted at the COPD outpatient clinic of Dr. Cipto Mangunkusumo Hospital during the period of September 2017 until April 2018. Patients were recruited consecutively. The criteria for inclusion were stable COPD patient with GOLD criteria A-D and never received prior exercise for pulmonary rehabilitation. Patients underwent interview about their medical history followed by spirometry testing using Carefusion® and  inspiratory muscle strength assessment using Micro RPM Carefusion®. The St George Respiratory Questionnaire (SGRQ) was used to assess the health status and the 6-minute walking test (6MWT) was conducted to assess the functional capacity. Subject exercised using IMT (Philips Respironic®) for eight weeks. Data were analyzed using paired t-test in statistical package for social sciences (SPSS) version 21. A total of 15 subjects with and average age of 65.6±8.40 years old were recruited. Pre-Post difference in inspiratory muscle strength was 11.31 cmH2O, showing a statistically significant impact. The significant impact was also shown clinically through the results of the Minimal Clinical Important Difference (MCID) on health status and functional capacity. The health status was evaluated using SGRQ with p exceeding 4%. A combined Pulmonary Rehabilitation (PR) and inspiratory muscles exercise program is proven to improve the health status and functional capacity.Key words: COPD, inspiratory muscle trainer, pulmonary rehabilitation, SGRQ, 6MWT Keefektifan Inspiratory Muscle Trainer Pada Program Rehabilitasi  Penyakit Paru Obstruktif KronikPenyakit paru obstruktif kronik (PPOK) ditandai dengan gangguan pernapasan yang persisten yang mengganggu status kesehatan dan kapasitas fungsional. Pulmonary rehabilitation (PR) merupakan bagian dari terapi komprehensif pasien dengan ganguan respirasi. Penelitian ini memfokuskan pada latihan otot inspirasi menggunakan inspiratory muscle trainer (IMT), suatu bentuk latihan otot pernapasan dengan pemberian beban. Eksperimen ini dilakukan di Rumah Sakit Cipto Mangunkusumo selama periode September 2017 hingga April 2018. Pasien direkrut secara consecutive sampling. Kriteria inklusi adalah pasien PPOK yang stabil dengan kriteria GOLD A-D yang belum pernah menerima latihan sebelumnya untuk rehabilitasi paru. Pasien menjalani wawancara, diuji dengan spirometri Carefusion®, dan kekuatan otot inspirasi dinilai menggunakan Micro RPM Carefusion®. St George Respiratory Questionnaire (SGRQ) digunakan untuk menilai status kesehatan dan 6-minute Walking Test (6MWT) dilakukan untuk menilai kapasitas fungsional. Subyek menggunakan alat IMT (Philips Respironic®) selama 8 minggu. Data dianalisis menggunakan SPSS versi 21 dengan uji T berpasangan. Subjek penelitian berjumlah 15 orang dengan rerata usia 65,6 ± 8,40 tahun. Kekuatan otot inspirasi awal didapatkan perubahan sebesar 11,31 cmH2O, yang memberikan dampak bermakna dilihat dengan pencapaian minimal clinical important difference (MCID) pada status kesehatan dan kapasitas fungsional. PR bersama dengan program latihanotot inspirasiterbukti memberikan hasil perbaikan status kesehatan dan kapasitas fungsional.Kata kunci: COPD, inspiratory muscle trainer, pulmonary rehabilitation, SGRQ, 6MWT 
Comparison between Use of Antibiotics and Argentum (Ag) in Infected Wound Healing Ismiarto, Yoyos Dias; Husain, Fadlyansyah Farid; Farry, Farry
Majalah Kedokteran Bandung Vol 51, No 1 (2019)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (5307.8 KB) | DOI: 10.15395/mkb.v51n1.1429

Abstract

Infected wound is a common problem encountered in the field of Orthopedics. Various procedures have been applied in order to achieve the effective treatment for wound infection. However, until recently, the biomolecular responses to those remain unclear. This study aimed to compare the effectiveness of antibiotics and argentum in infected wound healing by analyzing the FGF-2 and FGF-7 expressions; fibroblasts; bacteria colonization; and wound contraction rate during the proliferation phase of wound healing. This study was performed from May to September 2016 at the Pharmacology Research Laboratory, Faculty of Medicine, Padjadjaran  University. A randomized clinical laboratory experimental trial with repetitive measures was performed in male rabbits that had been wounded and inoculated by 0.5 MF Staphylococcus aureus. Sample was collected before(Day 6) and after (Day 14) the application of antibiotics and argentum. The consecutive sampling method was used to determine the two treatment groups: (I) antibiotic group and (II) argentum group.  The argentum group showed higher FGF-2 protein level, FGF-7 protein level, fibroblast count, and wound contraction rate with p<0.05 when compared to the antibiotic group. The use of argentum gave excellent responses to wound repair as indicated by elevated FGF-2 and FGF-7 levels; fibroblast counts; and wound contraction rate. The combination of both treatments might give synergistic responses and  better results in healing infected wound. Argentum is more effective than antibiotics to increase the FGF-2 and FGF-7 levels; fibroblasts count; and wound contraction rate in the proliferative phase of infected wound healing. Antibiotics are more effective than argentum to decrease bacteria colonization.Key words: Bacteria colonization, FGF-2 protein, FGF-7 protein, fibroblast count, wound contraction rate Perbandingan antara Penggunaan Antibiotik dan Argentum (Ag) dalam Penyembuhan Luka Terinfeksi Luka terinfeksi sering kali kita temui dalam permasalahan di bidang orthopedi. Berbagai jenis prosedur ditemukan untuk mengurangi angka kejadian infeksi, namun belum sesuai dengan yang diharapkan. Tujuan penelitian ini adalah membandingkan efektivitas antibiotik dengan argentum dengan menilai ekspresi dari FGF-2, FGF-7, fibroblasts dan rerata kotraksi luka saat fase proliferasi penyembuhan luka. Penelitian ini dilakukan selama bulan Juni hingga September 2017 di Laboratorium Penelitian Farmakologi Fakultas Kedokteran Universitas Padjadjaran. Dilakukan pada kelinci jantan yang telah terluka dan diinokulasi oleh Staphylococcus aureus sebanyak 0,5 MF. Sampel diambil hari ke-6 dan ke-14 aplikasi antibiotik dan argentum. Dengan metode sampling berurutan di tiap-tiap kelompok perlakuan: (I) kelompok antibiotik; dan (II) kelompok argentum. Kelompok Argentum menunjukkan tingkat protein FGF-2, protein FGF-7, jumlah fibroblas dan tingkat kontraksi luka yang lebih tinggi dengan p <0,05 dibanding dengan kelompok Ab. Penggunaan argentum memberikan respons yang sangat baik terhadap perbaikan luka seperti yang ditunjukkan oleh peningkatan kadar FGF-2, FGF-7, jumlah fibroblast, dan tingkat kontraksi luka. Kombinasi kedua pengobatan mungkin memberikan respons sinergis dan memberikan hasil yang lebih baik dalam penyembuhan luka yang terinfeksi. Argentum lebih efektif daripada antibiotik untuk meningkatkan kadar FGF-2 dan FGF-7, jumlah fibroblas, dan tingkat kontraksi luka dalam fase proliferatif dari penyembuhan luka yang terinfeksi. Antibiotik lebih efektif daripada argentum untuk menurunkan kolonisasi bakteri.Kata kunci : FGF-2 protein, FGF-7 protein, jumlah fibroblast, kolonisasi bakteri , rata-rata penyembuhan luka
Correlation between Vertebral Length and Body Height (Os. Vertebralis) in Indonesian People Yudianto, Ahmad; Wibowo, Ariyanto
Majalah Kedokteran Bandung Vol 51, No 1 (2019)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (556.325 KB) | DOI: 10.15395/mkb.v51n1.1472

Abstract

Identification of unidentified living and dead human bodies can be carried out for the purposes of criminal investigation and other police duties. Among the most important information to identify one’s identity is the one obtained from the results of measuring the victim’s height. Thus, it is necessary to determine the height of a body of unidentified identity during the examination. To date, the correlation between the body height and vertebrae has not been widely known. The purpose of this present study was to determine the correlation between the body height and the length of the vertebrae. The study was conducted in Dr. Soetomo General Hospital from January to July 2018. This was an observational analytical study on 57 samples consisting of 32 male and 25 female samples. Results indicated that the correlation between the vertebral length (thoracic vertebra (X1) and lumbar vertebra (X2)) and the body height as determined using the following equations: Y=47.428+2.991 X1+2.13 X2 cm (male); Y=-32.496+3.800 X1+5.549 X2cm (female); show that there are quite strong when analyzed using t-test (r=0.799 for male and r=0.908 for female). In conclusions, this regression formula can be used in estimating the height found only in bones without other long bones.  Korelasi Antara Panjang Tulang Belakang (OS.Vertebralis) dengan Tinggi Badan pada Orang Indonesia  Identifikasi tubuh manusia yang tidak dikenal, baik yang masih hidup maupun yang sudah meninggal dapat dilakukan bagi kepentingan penyidikan perkara pidana dan bagi tugas kepolisian yang lain. Salah satu informasi yang sangat penting dapat digunakan untuk melacak identitas seseorang adalah informasi yang didapatkan dari hasil pengukuran tinggi badan korban. Oleh karena itu, pada waktu dilakukan pemeriksaan jenasah yang tidak diketahui identitasnya, perlu ditentukan tinggi badannya. Sejauh ini korelasi tinggi badan dengan panjang ruas tulang belakang belum banyak diketahui. Penelitian bertujuan mengetahui korelasi tinggi badan dengan panjang ruas tulang belakang. Penelitian dilakukan di RSUD Dr. Soetomo periode Januari sampai Juli 2018. Metode penelitian yang digunakan observasional analitik yang dilakukan pada 57 sampel dengan rincian 32 sampel pria dan 25 sampel wanita. Hasil penelitian, korelasi panjang tulang belakang (vertebra torakalis (X1) dan vertebra lumbalis (X2) dengan tinggi badan dengan uji t didapatkan persamaan regresi: Y=47,428+2,991 X1+2,13 X2 cm (laki-laki); Y=-32,496+3,800 X1+5,549 X2 cm (wanita). Nilai korelasi yang cukup kuat, r untuk laki-laki: 0,799 sedangkan untuk wanita 0,908. Simpulan, Formula regresi ini dapat digunakan untuk memperkirakan ketinggian yang ditemukan hanya pada tulang tanpa tulang panjang lainnya.
Influence of Adolescents’ Smartphone Addiction on Mental and Emotional Development in West Java, Indonesia Dhamayanti, Meita; Dwiwina, Resti Gradia; Adawiyah, Rubiah
Majalah Kedokteran Bandung Vol 51, No 1 (2019)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15395/mkb.v51n1.1577

Abstract

Smartphone useis widespread globally, including in Indonesia. The excessive useand ubiquity of smartphone technology raise concerns on addiction and its effects on mental and emotional development ofadolescents. This study aimed to analyze the correlation between smartphone addiction and mental-emotional disorders inearly adolescents aged 11–12 years old in several primary schools in Bandung City and Sumedang District. This study was conducted October to December 2018 .Thiswas a cross-sectional study using convenient sampling technicwith unpaired categorical data for subject selection. Subjects were assessed with the Smartphone Addiction Scale Short Version (SAS-SV) and Strength and Difficulties Questionnaire (SDQ)which were self-administered by subjects. Subjects were classified into low level and high level smartphone user groups. Data were analyzed usingChi Square test. Out of 206 subjects, only 178 met the inclusion criteria with 44.9% (n=80) and 55.10% (n=98) were in  high- and low-level of smartphone addiction. The percentage of mental and emotional problems based on SDQ that was included in thenormal, borderline, and abnormal category was 60.7, 21.9, 17.4, respectively. Those with high-level smartphone addiction had mental and emotional problems with 1.425 prevalence ratio and CI95% 1.141–1.779. In conclusion, there is a correlation between smartphone addiction on mental and emotional problems of early adolescent.Key words: Early adolescent, mental and emotional, smartphone addiction, West Java, Indonesia Pengaruh Kecanduan Gawai pada Perkembangan Mental dan Emosional Remaja di Jawa Barat, IndonesiaPemakaian gawai sudah menyebar ke berbagai negara termasuk Indonesia. Pemakaian gawai sendiri memiliki dampak positif serta negatif. Salah satu dampak negatif yaitu mengalami kecanduan gawai sehingga mempengaruhi emosi dan perilaku dan juga dapat menurunkan produktifitas serta kualitas hidup. Tujuan penelitian ini adalah untuk menganalisis hubungan pengaruh kecanduan gawai terhadap gangguan mental emosional pada remaja awal usia 11 – 12 tahun. Metode penelitian analitik pontong lintang dilakukan pada subjek usia 11 – 12 tahun dari beberapa Sekolah Dasar Kota Bandung dan Kabupaten Sumedang pada Oktober sampai Desember 2018 . Subjek dipilih dengan metode convenient data kategori tidak berpasangan Subjek mengisi kuesioner yang berisi data sosiodemografi, Strength Difficulties Questionnaire (SDQ) dan Smartphone Addiction Scale – Short Version (SAS-SV). Subjek dibagi 2 kelompok tingkat kecanduan rendah dan tinggi. Data yang diperoleh dianalisis dengan menggunakan uji Chi Square. Dari 206 sebanyak 178 memenuhi kriteria. Subjek dengan tingkat kecanduan gawai tinggi sebanyak 80 (44,9%) dan rendah 98 (55,1%). Persentase gangguan mental emosional normal (60,7), borderline (21,9) dan abnormal (17,4). sebanyak 31 responden atau 17,4%. Terdapat hubungan bermakna Tingkat kecanduan gawai yang tinggi dan masalah mental emosi (rasio prevalens 1,45 (IK 1,141–1,779). Simpulan terdapat hubungan tingkat kecanduan gawai dan masalah mental emosio remaja awal usia 11 – 12 tahun.Kata kunci: Gawai, mental emosional, remaja awal
Combination Effect of Cecendet (Physalisangulata L.) Extract and Methylprednisolone in Reducing Inflammation and Improving Renal Functions in Pristane-induced Lupus Rat Models Sheba, Shiane Hanako; Setiani, Nur Asni; Sutjiatmo, Afifah B.; Vikasari, Suci Nar; Sukandar, Elin Yulinah
Majalah Kedokteran Bandung Vol 51, No 1 (2019)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15395/mkb.v51n1.1599

Abstract

Cecendet (Physalis angulata L.) is a herbal plant commonly used for traditional remedies in Indonesia to prevent inflammation in rheumatic disease. Several studies have determined that cecendet has an immunosuppressant activity towards pristane-induced lupus animal model. A preliminary study has proven that its use is safe in animals based on acute and sub-chronic toxicity tests. In management of lupus, methylprednisolone is used for primary immunosuppressant agent. This study aimed to investigate the effect of cecendet ethanolic extract in combination with methylprednisolone on inflammation, urinalysis, and serum creatinine level of rats as pristane-induced lupus animal models. This study was conducted at the Pharmacology Laboratory of Pharmacy Faculty of Jenderal Ahmad Yani University in January 2016. Four groups of female rats were used i.e. normal group, control group, 62.5 mg/kg body weight (BW) cecendet ethanolic extract group, and group receiving 62.5 mg/kg bw cecendet ethanolic extract combined with 0.36 mg/kg body weight methylprednisolone for six weeks, followed by thirty days of 0.5 mL pristine-induced. Examinations on anti-inflammation effect, urinalysis, and serum creatinine level  were performed in week 3 and 6 during the intervention. The results showed that the administration of cecendet ethanolic extract alone and in combination with methylprednisolone could inhibit inflammation and reduce proteinuria and serum creatinine level when compared to the control group.Key words: Anti-inflammation, cecendet, creatinine, methylprednisolone, Physalis angulata L. Pengaruh Pemberian Kombinasi Ekstrak Cecendet (Physalisangulata L.) dan Metilprednisolon terhadap Penurunan Radang dan Perbaikan Fungsi Ginjal Pada Model Tikus Lupus yang Diinduksi PristanaTanaman cecendet (Physalis angulata L.) sering digunakan sebagai obat tradisional di Indonesia, antara lain sebagai antiradang untuk mengobati reumatik. Penelitian terdahulu menunjukkan bahwa cecendet memiliki aktivitas imunosupresan pada hewan model lupus yang diinduksi pristana dan aman berdasar s ata uji toksisitas akut dan subkronis. Pada penanganan lupus, metilprednisolon digunakan sebagai obat utama imunosupresan. Penelitian ini bertujuan menguji khasiat ekstrak etanol herba cecendet dalam penggunaan tunggal dan kombinasi dengan metilprednisolon terhadap radang, urinalisis, dan kadar kreatinin serum pada tikus yang diinduksi pristana sebagai model hewan lupus. Penelitian dilaksanakan di Laboratorium Farmakologi Fakultas Farmasi Universitas Jenderal Ahmad Yani pada bulan Januari 2016.  Tikus betina sebagai hewan uji dibagi menjadi 4 grup, yaitu: grup normal, grupkontrol, grup diberi sediaan ekstrak etanol herba cecendet 62,5 mg/kg BB tunggal, dan grup hewan uji diberi sediaan ekstrak etanol herba cecendet 62,5 mg/kg BB kombinasi dengan metilprednisolon 0,36 mg/kg BB selama enam minggu, setelah tiga puluh hari diinduksi 0,5mL pristana. Tiga dan enam minggu setelah pemberian sediaan uji, dilakukan uji efek antiradang, pemeriksaan urin, dan pengukuran kadar kreatinin serum. Hasil penelitian menunjukkan bahwa pemberian ekstrak etanol herba cecendet tunggal maupun sebagai komplemen dengan metilprednisolon selama enam minggu memperlihatkan pengaruh penghambatan pembentukan radang, menurunkan proteinuria dan menurunkan kadar kreatinin serum jika dibanding dengan kelompok kontrol.Kata kunci: Anti-radang, Cecendet, kreatinin, metilprednisolon, Physalis angulata L.

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