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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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Correlation Between Tumor Cell Differentiation and CEA Levels in Patients with Adenocarcinoma of the Rectum Rudiman, Reno; Lukman, Kiki; Barr, Tubagus Izzul
Majalah Kedokteran Bandung Vol 52, No 4 (2020)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15395/mkb.v52n4.2028

Abstract

Adenocarcinoma of the rectum is the most common colorectal cancer in Indonesia. This cancer has the highest recurrence after curative surgical therapy with or without adjuvant therapy. With the advancing modern histopathology and molecular biology, the prognosis after therapy can be predicted through surveillance using tumor cell differentiation and carcinoembryonic antigen (CEA). The aim of this study was to analyze the correlation between tumor cell differentiation and serum CEA level in patients with adenocarcinoma of the rectum in Dr. Hasan Sadikin General Hospital Bandung, Indonesia. This was a retrospective observational analytic study conducted from January 2018- January 2019. There were 36 patients involved in this study consisting of 3 patients (8.3%) diagnosed with Stage II, 10 patients (27.7%) with Stage IIIA, 20 patients (55.5%) with stage IIIB, and 3 patients (8.3%) with stage IIIC. On histopathological examination, it was demonstrated that19 patients (52.8%) were well-differentiated, 15 patients (41.7%) were moderately differentiated, and 2 patients (5.6%) were poorly differentiated. The mean CEA level (CI 95%) for well-differentiated patients before surgery was 138.18 (15.99-260.38) ng/ml while the same level for the moderately differentiated patients was 64.34 (34.34-163.02) ng/ml. The mean CEA level for poorly differentiated patients was 1.55 (6.71-9.81) ng / ml. The result of the Kruskal Wallis test showed a p-value of 0.004. There is a strong correlation between the level of tumor cell differentiation and CEA level. Hubungan Tingkat Diferensiasi Sel Tumor dengan Kadar Ekspresi CEA Pada Pasien Adenokarsinoma Rektum Di Indonesia adenokarsinoma rektum memiliki rekurensi yang tinggi setelah terapi bedah kuratif dengan atau tanpa terapi adjuvan. Prognosisnya setelah terapi dapat  diketahui melalui surveilens dengan menggunakan Tingkat diferensiasi sel tumor dan carcinoembryonic antigen (CEA). Penelitian ini bertujuan menilai hubungan diferensiasi sel tumor dengan tingkat ekspresi CEA pada pasien adenokarsinoma rektum di RSUP Dr. Hasan Sadikin Bandung. Penelitian ini merupakan penelitian analitik observasional secara retrospektif. Pengambilan data dilakukan dari rekam medik Poliklinik Bedah Digestif dengan diagnosa adenokarsinoma rektum. Dari 36 pasien, 3 pasien (8,3%) stadium II, 10 pasien (27.7%) Stadium IIIA, 20 pasien (55,5%) stadium IIIB dan 3 pasien (8,3%) sisanya stadium IIIC. Sebanyak 19 pasien (52.8%) memiliki hasil histopatologi well differentiated, 15 pasien (41.7%) moderately differentiated dan 2 pasien (5.6%) poorly differentiated. Mean (CI 95%) kadar CEA sebelum operasi untuk well differentiated adalah 138.18(15.99-260.38) ng/mL, moderately differentiated 64.34(34.34-163.02)ng/ml, poorly differentiated 1.55(6.71-9.81)ng/mL. Uji Kruskal Wallis didapatkan nilai p=0,004 sehingga dapat disimpulkan bahwa terdapat hubungan antara tingkat diferensiasi sel tumor dengan kadar CEA  serum sebelum terapi pada pasien adenokarsinoma rektum di RSUP Hasan Sadikin Bandung. Pasien adenokarsinoma rektum preoperatif di RSUP Hasan Sadikin Bandung menunjukkan bahwa semakin baik tingkat diferensiasi sel tumornya semakin tinggi kadar CEAnya di dalam serum.
Soil-Transmitted Helminth Infections, Anemia, and Undernutrition Among School-Children in An Elementary School in North Jakarta, Indonesia Sari, Monica Puspa; Nathasaria, Tabita; Majawati, Esther Sri; Pangaribuan, Helena Ullyartha
Majalah Kedokteran Bandung Vol 52, No 4 (2020)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar

Abstract

The strategy to control soil-transmitted helminth (STH) is through periodic deworming to eliminate infective worms among children. Helminthiasis is known to impair the nutrition and physical status of infected children. This study aimed to determine the prevalence and relationship between nutritional status and infection among School-Age Children (SAC) following deworming campaigns in Public Elementary School 6 Cilincing, North Jakarta, Indonesia. This study was a cross-sectional analytical observation on 82 children sampled using the Kato Katz approach during the period of August and November 2019. Nutritional status was determined using the standardized AnthroPlus Software while the Kolmogorov Smirnov test was used to statistically analyze the data. A structured questionnaire was used to collect data on hygiene and deworming pill consumption. Results showed that 7.3% of 82 children were infected with at least one of the following STH parasites: Ascaris lumbricoides accounts (n=3, 3.7%), Trichuris trichiura (n=2, 2.4%), and Enterobius vermicularis (n=1, 1.2%). Anemia was defined as a hemoglobin concentration of <8-11.9 g/dL for the age group of 8-13 years old. Of all participants, 10 (12%) were anemic. The proportion of children representing mild and moderate anemia were 4% and 6%, respectively. The prevalence of infection was not associated with anemia and STH infection did not present significant association with undernutrition statusAlmost children practiced hand washing before eating (93.9%). About 96% of children had pit latrines and only 24 children (29.5%) took deworming pills in the last 6 months. Thus, routine anthelminthic treatment for school children in urban areas is necessary. Infeksi Cacing yang ditularkan melalui Tanah, Anemia dan Gizi Buruk pada Anak Sekolah Dasar di Jakarta Utara, Indonesia Strategi pengendalian cacingan melalui pemberian obat cacing  berkala untuk memberantas cacingan pada anak. Anak terinfeksi dapat mengalami gangguan gizi dan fisik. Penelitian bertujuan mengetahui prevalensi STH dan hubungan status gizi anak sekolah pasca kampanye pemberantasan cacing di SDN 6 Cilincing, Jakarta Utara. Observasional analitik dengan desain studi potong lintang digunakan dalam sampel kato-katz dari 82 anak sekolah. Penelitian dilakukan dari Agustus-November 2019. Status gizi ditentukan menggunakan software AnthroPlus. Uji Kolmogorov smirnov untuk menganalisis data. Hasil penelitian menunjukkan  7,3% dari 82 anak terinfeksi setidaknya satu parasit STH. Parasit yang teridentifikasi, Ascaris lumbricoides sebanyak 3 (3,7%). Trichuris trichiura 2 (2.4%) diklasifikasikan infeksi ringan dan Enterobius vermicularis 1 (1,2%). Anemia didefinisikan bila konsentrasi Hb <8-11,9 g/dL untuk anak 8-13 tahun. Secara total, 10 (12%) anak anemia. Proporsi anak mewakili anemia ringan dan sedang masing-masing adalah 4%, dan 6%. Prevalensi infeksi tidak berhubungan dengan anemia. Anak positif STH tidak menunjukkan hubungan yang signifikan dengan kekurangan gizi pada anak. Pengumpulan data kuesioner dilakukan menggunakan kuesioner terstruktur. Hampir semua anak mempraktikkan kebersihan tangan yang benar, mencuci tangan sebelum makan (93,9%). Memiliki jamban 96% dan hanya 24 anak (29,5%) minum obat cacing 6 bulan terakhir. Hasil ini mendukung antihelmintik rutin pada anak sekolah di daerah perkotaan.
Accuracy of SVS-WIfI Classification in Predicting Major Amputation in Critical Limb Ischemic Patients Teguh Marfen Djajakusumah; Rani Septrina; Putie Hapsari; Rendy Susanto
Majalah Kedokteran Bandung Vol 52, No 4 (2020)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15395/mkb.v52n4.2029

Abstract

In 2014, The Society for Vascular Surgery revealed a new classification system for Critical Limb Ischemia (CLI) referred as the Society for Vascular Surgery Lower Extremity Threatened Limb Classification System based on Wound, Ischemia, and foot Infection (SVS WIfI). This scoring system was created to stratify major amputations risk within 1 year and benefit of revascularization for the patient. This study aimed to assess the accuracy of SVS WIFi in predicting major amputations in patients with lower limb ischemia underwent revascularization at Department of Surgery, Faculty of Medicine, Universitas Padjadjaran-Dr. Hasan Sadikin General Hospital in 2016 - 2019. This was a retrospective observational analytic study with cohort design. Patients who fulfilled the inclusion criteria were assessed with SVS WIfI and results after 1 year of revascularization were identified. Data were analyzed statistically using the Chi-square test. 0f 56 subjects, 39 had limb salvage and 17 underwent major amputations within 1 year. In high revascularization benefit group, 31 had limb salvage and 7 underwent amputation. Meanwhile, in moderate-low revascularization benefits group, 8 had limb salvage and 10 underwent amputation. The accuracy of the SVS WIfI recommendation was 73.2%. Therefore, WIfI SVS classification accurately predicts the incidence of major amputations in patients with lower limb ischemia who underwent revascularization. Akurasi Klasifikasi SVS-WIfI dalam Memprediksi Amputasi Mayor pada Pasien Iskemik Tungkai BawahPada tahun 2014, The Society for Vascular Surgery mengemukakan sistem klasifikasi baru untuk CLI yaitu SVS-WIfI. Sistem skoring ini dibuat untuk menstratifikasi risiko amputasi mayor dalam 1 tahun bila dilakukan revaskularisasi pada pasien. Penelitian ini dilakukan untuk melihat akurasi SVS WIfI dalam memprediksi kejadian amputasi mayor pada pasien iskemia tungkai bawah yang menjalani revaskularisasi dan di lakukan di Departemen Ilmu Bedah Fakultas Kedokteran Universitas Padjadjaran/Rumah Sakit Dr. Hasan Sadikin pada tahun 2016-2019. Penelitian ini merupakan penelitian observasional analitik dengan rancangan retrospective cohort study. Pasien yang memenuhi persyaratan dilakukan penilaian dengan SVS WIfI dan di-follow up selama 1 tahun, hasil hasilnya dianalisis menggunakan tes Chi-square dan dilakukan perhitungan sensitivitas, spesifisitas, dan akurasi. Berdasarkan penelitian yang dilakukan terhadap 56 pasien yang menjalani revaskularisasi, didapatkan sebanyak 39 pasien yang tidak mengalami amputasi mayor dan 17 pasien yang mengalami amputasi mayor dalam 1 tahun. Dari penelitian ini kelompok pasien dengan manfaat revaskularisasi yang tinggi didapatkan 31 pasien tidak mengalami amputasi, sedangkan 7 pasien mengalami amputasi, pada kelompok pasien dengan manfaat revaskularisasi sedang-rendah, 8 pasien tidak mengalami amputasi, sedangkan 10 pasien mengalami amputasi dan didapatkan hasil uji chi square berdasarkan manfaat vaskularisasi dan kejadian amputasi diperoleh nilai P=0,005, dan Akurasi dari rekomendasi SVS WIfI adalah 73,2%. Dari hasil penelitian didapatkan Klasifikasi SVS WIfI akurat dalam memprediksi kejadian amputasi mayor pada pasien iskemia tungkai bawah yang menjalani revaskularisasi.
Association between Rainy Season and Diarrhea in 13- to 24-Month-Old Toddlers Jeceline Sutarto; Edward Surjono
Majalah Kedokteran Bandung Vol 52, No 4 (2020)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15395/mkb.v52n4.2139

Abstract

Diarrhea is the second leading cause of death in children under five year and is considered a prevailing problem in many developing countries, including in Indonesia. Diarrhea is a multifactorial disease and season is suggested as one of the attributing factors of this disease. This study aimed to identify the association between the rainy season and diarrhea in 13- to 24-month-old toddlers. This was a cross-sectional analytical observational study on medical records of 13- to 24-month-old-toddlers with infectious diarrhea who visited Penjaringan I Sub-district Public Health Center, North Jakarta, Indonesia from 2016 to 2019 that included three cycles of the rainy and dry seasons. Data collection was performed in March 2020 and 286 medical records were included in the study. The relationship between the independent and dependent variables was analyzed using chi-square. Of the total cases, 83 cases occurred in rainy season and 203 cases occurred in dry season (p=0.291). Diarrhea was seen in girls aged13–16 months. There is no significant association between rainy season and diarrhea.Hubungan Musim Hujan dengan Diare pada Balita Usia 13–24 Bulan Diare merupakan penyebab kematian balita nomor dua di dunia yang masih menjadi masalah pada banyak negara berkembang, termasuk Indonesia. Diare adalah sebuah penyakit multifaktorial. Musim merupakan salah satu faktor yang mempengaruhi diare melalui dampaknya pada lingkungan. Penelitian ini bertujuan mengetahui hubungan musim hujan dengan kejadian diare pada usia 13–24 bulan. Penelitian ini merupakan penelitian analitik observasional dengan metode potong lintang. Pengumpulan data dilakukan pada bulan Maret 2020 di Puskesmas Kelurahan Penjaringan I, Jakarta Utara, dengan menggunakan rekam medis periode tahun 2016–2019, yang meliputi masing-masing tiga siklus musim hujan dan musim kemarau. Sampel penelitian adalah usia 13–24 bulan yang didiagnosa dengan diare infeksi. Hubungan antara variabel independen dan dependen diuji menggunakan chi-square. Dari 286 rekam medis yang digunakan, 83 kasus terjadi sewaktu musim hujan dan 203 kasus terjadi sewaktu musim kemarau (p=0,291). Kejadian diare paling tinggi pada perempuan kelompok usia 13–16 bulan. Tidak terdapat hubungan bermakna antara musim hujan dengan kejadian diare.
Potential Vector Shelter for Malaria in South Central Timor Regency in Indonesia Nisa Fauziah; Arie Galih Mohamad; Naufal Fakhri Nugraha; Lia Faridah; Jontari Hutagalung
Majalah Kedokteran Bandung Vol 52, No 4 (2020)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15395/mkb.v52n4.2092

Abstract

More than half of the areas in East Nusa Tenggara province, a province in the eastern part of Indonesia, are planned to be free from malaria by the end of 2030. However, one of the critical indicators for malaria elimination is still lacking, i.e. vectors’ environment and  breeding place indicators. South Central Timor (SCT) District is one of the areas with the highest Annual Parasite Incidence (API) >2‰ with the majority of the population works as farmers. The purpose of this study was to capture the relationship between environmental factors and the prevalence of malaria. This study was a cross-sectional analytic retrospective study using data from a previous malaria study conducted in August 2013 to September 2014 in 5 sub-districts of SCT district. All respondents were selected using the systematic random sampling approach from the population of healthy people. Data were collected using a standard questionnaire and an observation environment form. Malaria was confirmed through microscopic and Polymerase Chain Reaction (PCR) examinations. Data were then analyzed using the bivariate and multivariate analysis with 95% CI and α:0.05. Of 357 data collected, 35% (125/357) were malaria positive based on PCR examination. Two variables (living nearby lagoon and nearby rice field) were significant (p-value<0.05) as vector shelters for Anopheles sp. Thus, these have to be included as inputs to formulate effective and efficient malaria elimination strategies and programs in 2030. Lokasi Potensial Perkembangbiakan Vektor Malaria di Kabupaten Timor Tengah Selatan, IndonesiaLebih dari setengah Provinsi Nusa Tenggara Timur di Indonesia timur akan menghadapi bebas malaria pada akhir tahun 2030. Namun, salah satu indicator penting untuk eliminasi malaria adalah pengukuran lingkungan dan tempat berkembang biak vector masih kurang. Kabupaten Timor Tengah Selatan adalah daerah dengan salah satu Insidensi Parasit Tahunan tertinggi di Indonesia dan mayoritas penduduknya bekerja sebagai petani. Tujuan dari penelitian ini adalah mencari hubungan antara faktor lingkungan dengan prevalensi malaria. Penelitian ini menggunakan studi potong lintang metode analitik, menggunakan data retrospektif dari penelitian sebelumnya yang dilakukan pada Agustus 2013 hingga September 2014 di 5 kecamatan di Kabupaten Timor Tengah Selatan pada. Responden dipilih secara acak sistematik dari orang sehat. Pengumpulan data dengan kuesioner standar dan formulir observasi lingkungan. Konfirmasi malaria dengan menggunakan metode mikroskopis dan PCR. Data dianalisis dengan bivariat dan multivariate dengan 95% CI dan α: 0,05. Total 357 data dikumpulkan, 35% (125/357) positif malaria dengan pemeriksaan PCR. Dua variabel (dekat dengan laguna dan dekat dengan sawah) signifikan (nilai-p<0,05) sebagai tempat perlindungan vector untuk Anopheles sp. Penelitian ini diharapkan dapat memberikan informasi rinci untuk merumuskan strategi dan program eliminasi malaria pada tahun 2030 yang efektif dan efisien.
Comparison of Interpretation between Pyrosequencing and Xpert MTB/RIF Assay in Multidrug-Resistant Tuberculosis Linda Choerunnisa; Coriejati Rita; Anna Tjandrawati; Lidya Chaidir; Ida Parwati
Majalah Kedokteran Bandung Vol 52, No 4 (2020)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15395/mkb.v52n4.2141

Abstract

Indonesia is one of the countries with the highest multidrug-resistant tuberculosis cases in the world. Rapid molecular test using the Xpert MTB/RIF assay is one of the detection methods for MDR-TB. Early detection of MDR-TB is crucial for early initiation of treatment. However, Xpert MTB/RIF assay only detects the rpoB gene mutations associated with Rifampicin resistance. Recently, WHO recommends the use of Pyrosequencing, a DNA sequencing method that can detect not only the rpoB gene but also katG and/or inhA gene mutations associated with Isoniazid resistance. The aims of this study were to compare the interpretation between the two methods  and to determine the differences in codon mutation position detection of the rpoB gene and mutation detection of the katG and/or inhA gene. This was a cross-sectional comparative observational study on patients ≥18 years old interpreted as RR-TB patients based on Xpert MTB/RIF assay results who had not received MDR-TB drugs at Dr. Hasan Sadikin General Hospital, Bandung, Indonesia. Results showed there were 40 Rifampicin-resistant TB subjects interpreted by Xpert MTB/RIF assay while Pyrosequencing interpreted 30 MDR-TB, 9 RR-TB and one Isoniazid-resistant TB subjects in January - February 2020. The detection of rpoB gene codon mutation position between Xpert MTB/RIF assay and Pyrosequencing methods was not significantly different (p=0.389). Pyrosequencing had detected 27 katG gene mutations, 3 inhA gene mutations, one katG and inhA gene mutation. To conclude, Pyrosequencing can be used for accurate detection of Rifampicin and Isoniazid resistance in MDR-TB. Perbandingan Hasil Interpretasi antara Pyrosequencing dengan Xpert MTB/RIF Assay pada Multidrug-Resistant TuberculosisIndonesia merupakan salah satu negara dengan kasus multidrug-resistant tuberculosis terbanyak. Penegakan diagnosis MDR-TB saat ini menggunakan tes cepat molekular Xpert MTB/RIF assay sehingga pasien segera mendapatkan pengobatan. Namun Xpert MTB/RIF assay hanya mendeteksi mutasi gen rpoB penyandi resistansi Rifampisin. World Health Organization merekomendasikan Pyrosequencing, metode sequencing nukleotida yang dapat mendeteksi mutasi gen rpoB, gen katG dan/atau inhA penyandi resistansi Isoniazid. Tujuan penelitian ini adalah menentukan apakah kedua alat ini memberikan hasil interpretasi yang sama, apakah ada perbedaan deteksi posisi mutasi kodon gen rpoB dan apakah ditemukan mutasi gen katG dan/atau inhA. Penelitian ini merupakan studi observasional komparatif dengan rancangan cross-sectional. Subjek penelitian adalah pasien usia ≥18 tahun yang diinterpretasi RR-TB berdasarkan Xpert MTB/RIF assay di RSUP Dr. Hasan Sadikin Bandung dan belum mendapat pengobatan. Xpert MTB/RIF assay menginterpretasi 40 subjek Rifampicin-resistant TB sedangkan Pyrosequencing menginterpretasi 30 subjek MDR-TB, 9 subjek RR-TB dan satu subjek Isoniazid-resistant TB pada bulan Januari-Februari 2020. Deteksi posisi mutasi kodon gen rpoB antara Xpert MTB/RIF assay dan Pyrosequencing tidak berbeda bermakna (p=0,389). Pyrosequencing mendeteksi 27 mutasi gen katG, 3 mutasi gen inhA, satu mutasi gen katG dan inhA. Kesimpulan, Pyrosequencing dapat digunakan untuk deteksi resistansi Rifampisin dan Isoniazid pada MDR-TB secara lebih akurat.
Gallic Acid Content and Antioxidant Activity of Pomegranate Peel Ethanol Extract Diah Dhianawaty; Latifah Rahman Nurfazriah; Andri Rezano
Majalah Kedokteran Bandung Vol 52, No 4 (2020)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15395/mkb.v52n4.2108

Abstract

Ethanol extract of Pomegranate peel is proven to have the ability to inhibit the proliferation of cervical cancer HeLa cells. It was reported that this extract contains ellagic acid, gallic acid, and punicalagin which are identified as major effectors of antitumor activity. Gallic acid has been demonstrated to have an antioxidant activity that can influence cancer cell proliferation. The aim of the study was to identify the gallic acid content in pomegranate peel ethanol extract and to measure its antioxidant. This study was an experimental study performed at the Biochemistry and Molecular Biology Laboratory and Central Laboratory of Universitas Padjadjaran Bandung, Indonesia during September-December 2019. Gallic acid concentration was measured by using a high-performance liquid chromatography method (HPLC) and the antioxidant activity was measured by using 1,1-diphenyl-2-picrylhydrazyl (DPPH). The extract contained 616.97 mg/kg of gallic acid with an antioxidant activity of IC50 6.1 µg/mL. In conclusion, gallic acid has cytotoxic and antitumor effects from its ability to modulate antioxidant/pro-oxidant balance and inhibit reactive oxygen species (ROS). Therefore, both gallic acid content and antioxidant activity parameters can be used as markers in pomegranate peel extract which shows activities that inhibit HeLa cell proliferation. Kandungan Asam Galat dan Aktivitas Antioksidan Ekstrak Etanol Kulit DelimaEkstrak etanol kulit buah delima terbukti dapat menghambat proliferasi sel kanker serviks (sel HeLa). Ekstrak ini telah dilaporkan mengandung asam ellagat, asam galat, dan punicalagin yang diidentifikasi sebagai  efektor utama dari aktivitas anti-tumor. Berdasarkan pernyataan sebelumnya, pemeriksaan ekstrak akan dilakukan dengan mengidentifikasi salah satu senyawa tersebut yaitu asam galat. Aktivitas antioksidan dapat mempengaruhi proliferasi sel kanker, oleh karena itu, akan ditentukan pada ekstrak. Penelitian ini dilakukan di Laboratorium Biokimia dan Biologi Molekuler dan Laboratorium Sentral Universitas Padjadjaran periode September-Desember 2019. Kandungan asam galat diukur dengan metode kromatografi cair kinerja tinggi (KCKT) dan aktivitas antioksidan diukur dengan metode 1,1-difenil-2-pikrilhidrazil (DPPH). Ekstrak mengandung asam galat 616,97 mg/kg dan memiliki aktivitas antioksidan IC50 6,1 μg/mL. Berdasarkan aktivitasnya, asam galat mempunyai efek sitotoksik dan antitumor yang dihasilkan oleh kemampuannya untuk memodulasi keseimbangan antioksidan/pro-oksidan dan menghambat spesies oksigen reaktif. Aktivitas antioksidan yang sangat kuat dari ekstrak juga disebabkan oleh adanya asam galat; asam galat dikenal sebagai antioksidan kuat. Antioksidan mampu melindungi sel normal dengan menurunkan level ROS, sehingga memproteksi sel dari kerusakan. Dengan demikian, kedua parameter tersebut dapat digunakan sebagai bagian dari penanda untuk ekstrak kulit delima yang mempunyai aktivitas menghambat proliferasi sel HeLa.
Nuclei DNA Damage Due to Extreme High-Temperature Exposure during Forensic Identification Examination Ahmad Yudianto; Masniari Novita; Ariyanto Wibowo; Fery Setiawan
Majalah Kedokteran Bandung Vol 52, No 4 (2020)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15395/mkb.v52n4.2143

Abstract

Accurate personal identification is important in investigations because an error in the identification process may bring fatal consequences during trial. The most common identification process is the Deoxyribonucleic acid [DNA] analysis. Degraded DNA sample due to extremely high-temperature exposure may limit DNA analysis. This study aimed to analyze DNA damage patterns caused by an extremely high temperature using STR (short tandem repeat) CODIS marker. This study was conducted at the Forensic and Medicolegal Department, Laboratorium Balai Besar Kesehatan Surabaya, Ministry of Health of the Republic of Indonesia, Human Genetic Study Group of Universitas Airlangga, and Faculty of Science and Technology of Universitas Brawijaya Malang from July until October 2009. Results of PCR visualization using STR CODIS for costae demonstrated that the THO1 detection (+) in 1,2500C - 40’: 25% and the TPOX detection (+) in 1,0000C - 30’: 50% whereas the results from molar teeth showed that the THOI locus detection (+) in 1,2500C - 30’: 25% and TPOX in 1,0000C - 40’: 50%. Results for PCR visualization using mini-STR CODIS for the costae presented that the mini-THOI in 1,2500C - 20’: 50% (+) while for the molar tooth the mini-THOI in 1,2500C - 30’ : 25% (+) and mini-TPOX in 1,0000C - 40’ : 50% (+). All loci were detected on costae and second molar teeth samples of the control group. Thus, extreme high-temperature exposure significantly decreased the DNA level of second costae and second molar tooth. Sequence patterns of STR loci successfully detected were TPOX, THO1, and CSF1PO.Kerusakan DNA Inti Karena Paparan Suhu Tinggi Selama Proses Identifikasi ForensikIdentifikasi melalui DNA secara tepat penting dalam penyelidikan karena kesalahan akan berakibat fatal selama proses persidangan. Salah satu keterbatasan adalah DNA yang terdegradasi karena paparan suhu yang sangat tinggi. Penelitian ini bertujuan menganalisis pola kerusakan DNA akibat suhu sangat tinggi menggunakan penanda CODIS STR (short tandem repeat). Penelitian dilakukan di Instalasi Kedokteran Forensik, Laboratorium Kemenkes, Human Genetic Study Group, dan Universitas Brawijaya Malang pada periode Juli sampai Oktober 2009. Visualisasi PCR menggunakan STR CODIS untuk costae adalah sebagai berikut: deteksi THO1 (+) pada 12500C - 40’: 25%, deteksi TPOX (+) pada 10000C - 30’: 50%, sedangkan hasil dari gigi molar adalah sebagai berikut: THOI locus detection (+) di 12500C - 30’: 25% dan TPOX di 10000C - 40’: 50%. Hasil visualisasi PCR menggunakan mini-STR CODIS untuk costae adalah sebagai berikut: mini-THOI pada 12500C - 20’: 50% (+) dan untuk gigi molar: mini-THOI pada 12500C-30': 25% (+ ) dan mini-TPOX di 10000C - 40’ : 50%  (+). Semua lokus terdeteksi pada kelompok kontrol pada sampel costae dan gigi molar kedua. Kesimpulannya, paparan suhu tinggi yang ekstrim secara signifikan menurunkan tingkat DNA kosta dan gigi molar kedua. 
Hubungan Persentase Sel Leukosit Polimorfonuklear dalam Cairan Serebrospinal dan Luaran Pasien Meningitis Tuberkulosis di RSUP Dr. Hasan Sadikin Bandung Amanda Widayanti; Ahmad Rizal Ganiem; Ida Parwati
Majalah Kedokteran Bandung Vol 52, No 4 (2020)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15395/mkb.v52n4.1563

Abstract

Tuberculous (TB) meningitis is the most severe type of extrapulmonary TB with high morbidity and mortality rates. Many factors affect patient outcome, including the intracranial inflammation process. In acute inflammation, recruitment of a high number of polymorphonuclear (PMN) cells can cause edema which may eventually increase the intracranial pressure. This increase in intracranial pressure may lead to functional decline, disability, and even death. This study aimed to explore the association between the PMN percentage in cerebrospinal fluid (CSF) and TB meningitis patient outcome as measured by the Glasgow Outcome Scale at Dr. Hasan Sadikin General Hospital Bandung, which is a tertiary hospital in Indonesia. This was a retrospective cohort study using patient medical record data from 2017. All TB meningitis patients over 18 years old were included. Patients with missing PMN results in medical record were excluded, which led to a total 88 subjects participating in this study. Variables analyzed were PMN percentage in CSF and patient outcome that were categorized as poor, moderate, and good. Analysis were performed using theKruskal-wallis test. An increase in PMN median as the patient outcome declined were observed, but the association between the PMN percentage in CSF and patient outcome was insignificant (p=0.186). Hence,  no association between PMN percentage in CSF and TB meningitis patient outcome was identified in this study. Hubungan Persentase Sel Leukosit Polimorfonuklear dalam Cairan Serebrospinal dan Luaran Pasien Meningitis Tuberkulosis di RSUP Dr. Hasan Sadikin BandungMeningitis tuberkulosis (TB) merupakan merupakan jenis TB ekstraparu paling berat dengan morbiditas dan mortalitas tinggi. Berbagai faktor memengaruhi luaran pasien, salah satunya proses inflamasi intrakranial. Pada inflamasi akut, terjadi peningkatan sel polimorfonuklear (PMN) dan bila dalam jumlah tinggi dapat menimbulkan efek edema yang meningkatkan tekanan intrakranial. Peningkatan tekanan intrakranial ini menyebabkan penurunan fungsi otak, disabilitas, bahkan kematian. Penelitian ini bertujuan mengetahui hubungan persentase PMN dalam cairan serebrospinal (CSS) dan luaran Glasgow Outcome Scale pada pasien meningitis TB di RSUP Dr. Hasan Sadikin Bandung. Penelitian ini merupakan studi retrospektif cohort menggunakan data rekam medik tahun 2017. Kriteria inklusi adalah pasien terdiagnosis meningitis TB dan berusia ≥18 tahun. Kriteria eksklusi adalah data rekam medik yang tidak lengkap untuk hasil PMN. Variabel yang diteliti adalah persentase PMN dan luaran pasien yang dikategorikan menjadi GOS buruk, sedang, dan baik kemudian dianalisis dengan uji Kruskal-wallis. Didapatkan 88 subjek yang memenuhi syarat. Terdapat peningkatan median PMN seiring derajat perburukan luaran namun hasil analisis menunjukkan tidak terdapat hubungan yang bermakna antara PMN dan luaran GOS pasien (p=0,186). Simpulan, tidak terdapat hubungan antara persentase PMN dalam CSS dengan luaran GOS pasien meningitis TB.
Effects of Ethanolic Extract of Curcuma Longa on Cardiac Biomarkers of Doxorubicin-Induced Rats Lydia Ernawati Rahayu; Linda Chiuman; Chrismis Novalinda Ginting; Sahna Ferdinand Ginting
Majalah Kedokteran Bandung Vol 52, No 4 (2020)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15395/mkb.v52n4.2121

Abstract

Cardiotoxicity is a condition where damages caused by toxic chemical exposure are observed in heart and blood vessels. Doxorubicin is the most common chemotherapy agents for various types of cancer therapy. However, doxorubicin is converted into doxorubicinol known to trigger cardiac disfunctions and release of several cardiac biomarkers, such as CK-MB and LDH. Turmeric is known to be an alternative medical treatment that has the effect of neutralizing oxidative stress. This study aimed to evaluate CK-MB and LDH levels in doxorubicin-induced rats (20 mg/kgBW) that received turmeric ethanolic extract from curcuma. This was an experimental study conducted in February 2020 in the Faculty of Pharmacy Universitas Sumatera Utara. The rats were divided into six group and each group consisted of wistar albino male rats. The groups were normal (CMC-Na), positive control (Vitamin E 1%+Dox 20 mg/kgBW), negative control (Dox 20 mg/kgBW), treatment I (EEC 100 mg/kgBW+Dox 20 mg/kgBW), treatment II (EEC 300 mg/kgBW+Dox 20 mg/kgBW), and treatment III (EEC 500 mg/kgBW+Dox 15 mg/kgBW). Doxorubicin was given 5 mg/kgBW once a week for four weeks. Results showed that the groups that received 100 mg/kg BW, 300 mg/kgBW, and 500 mg/kgBW of turmeric ethanol extract demonstrated a reducing effect on the biomarkers of cardiac damage, i.e. CK-MB and LDH. Statistically, serum CK-MB and LDH levels at dose 500 mg/kgBW showed no significant differences (p>0.05) with the normal and positive treatment group. In conclusion, turmeric has a cardioprotective effect. Pengaruh Kardioprotektif Ekstrak Etanol Curcuma Longa pada Tikus yang Diinduksi DoxorubicinKardiotoksisitas adalah kondisi terjadinya jantung dan pembuluh darah akibat paparan kimia. Doxorubicin diubah menjadi doxorubicinol yang diketahui menyebabkan gangguan fungsi jantung dan pelepasan biomarker jantung sseperti CK-MB dan LDH. Kunyit dikenal sebagai pengobatan alternatif yang memiliki efek menetralkan stres oksidatif. Penelitian ini dilakukan pada Februari 2020 di Fakultas Farmasi Universitas Sumatera Utara. Tujuan penelitian ini adalah mengevaluasi kadar CK-MB dan LDH pada tikus yang diberi ekstrak etanol kunyit yang diinduksi doksorubisin (20 mg/kgbb). Penelitian dibagi menjadi enam kelompok dan tiap-tiap kelompok terdiri atas 4 ekor tikus wistar albino jantan: normal (CMC-Na), kontrol positif (Vitamin E 1%+Dox 20 mg/kgBB), kontrol negatif (Dox 20 mg/kgBB), group I (EEC 100 mg/kgBB+Dox 20 mg/kgBB), group II (EEC 300 mg/kgBB+Dox 20 mg/kgBB), dan group III (EEC 500 mg/kgBB+Dox 15 mg/kgBB). Doxorubicin 5 mg/kgBB diberikan 4 kali. Hasil penelitian menunjukkan bahwa kelompok yang diberi ekstrak etanol kunyit dengan dosis 100 mg/kgBB, 300 mg/kgbb, 500 mg/kgBB memiliki efek penurunan biomarker kerusakan jantung yaitu CK-MB dan LDH. Berdasar atas hasil uji statistik kadar CK-MB dan LDH serum pada dosis 500 mg/kgBB tidak terdapat perbedaan yang bermakna (p>0,05) dengan kelompok normal dan positif, dapat disimpulkan bahwa kunyit memiliki efek kardioprotektif.

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