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PENGARUH EKSTRAK ETANOL DAUN KELOR (MORINGA OLEIFERA) PADA EKSPRESI INSULIN DAN INSULITIS TIKUS DIABETES MELITUS Sulistyorini, Ratna; Sarjadi, -; Johan, Andrew; Djamiatun, Kis
Majalah Kedokteran Bandung Vol 47, No 2 (2015)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Kandungan quercetin pada Moringa oleifera secara ilmiah memiliki potensi sebagai antioksidan dan anti-inflamasi dengan menghambat aktivitas NF-?B, serta triterpenoid menstimulasi regenerasi sel ? pankreas dan meningkatkan sekresi insulin. Penelitian ini bertujuan melihat pengaruh pemberian ekstrak etanol daun Moringa oleifera terhadap insulitis dan ekspresi insulin pankreas tikus Sprague-Dawley jantan. Penelitian dilakukan di laboratorium Unit Pangan dan Gizi, Pusat Antar Universitas Universitas Gadjah Mada serta Laboratorium Histologi dan Biologi Sel Fakultas Kedokteran Universitas Gadjah Mada, periode Mei?Juli 2013. Penelitian ini menggunakan desain randomized post test only controlled group. Hewan coba sebanyak 24 ekor tikus, diperiksa kadar gula darahnya pada hari ketiga setelah induksi streptozotosin, untuk melihat tikus sudah dalam keadaan hiperglikemik. Tikus kemudian dibagi dalam tiga kelompok: satu kelompok kontrol dan dua kelompok perlakuan yang diberi ekstrak etanol daun Moringa oleifera dosis 250 dan 500 mg/kg/hari selama 21 hari. Gambaran histopatologik dinilai derajat insulitis pada pulau Langerhans dan dinilai ekspresi insulin dengan skor Allred. Uji statistik yang digunakan adalah Kruskal Wallis dilanjutkan Mann-Whitney dengan taraf kemaknaan p<0,05 karena data tidak berdistribusi normal. Derajat insulitis dan ekspresi insulin pankreas tikus pada kedua kelompok perlakuan menunjukkan perbedaan bermakna dibanding dengan kelompok kontrol (p<0,005). Pada penelitian ini dapat disimpulkan bahwa ekstrak etanol daun Moringa oleifera dosis 250 dan 500 mg/kg menyebabkan ekspresi insulin lebih tinggi dan derajat insulitis lebih rendah dibanding dengan kelompok kontrol.[MKB. 2015;47(2):69?76]Kata kunci: Ekspresi insulin, insulitis, Moringa oleifera, streptozotosinEffect of Ethanol Extract of Moringa oleifera Leaves on Insulin Expression and Insulitis in Diabetes Mellitus RatsAbstractQuercetin content in Moringa oleifera has scientific potential antioxidant and anti-inflammation effects by inhibiting the activity of NF-?B. In addition, triterpenoids stimulate pancreatic ? cell regeneration and increases insulin secretion. This study aimed to discover the effect of Moringa oleifera extract on insulitis and insulin expression in pancreas of Sprague-Dawley male rats. The study was performed at the laboratory of Food and Nutrition Unit of The Inter University Center of Gadjah Mada University and the laboratory of Histology and Cell Biology Faculty of Medicine Gadjah Mada University during May?July 2013. This was a randomized post test only controlled group study. Twenty four rats were included. Blood glucose test was performed on the third day after streptozotocin induction to ensure that all rats were in hyperglycemic condition. The rats were then divided into three groups: one control group and two treatment groups receiving Moringa oleifera ethanolic leaves extract for 21 days in doses of 250 and 500 mg/kg/day, respectively. Histopathological analysis of pancreas were performed by evaluating insulitis based on the infiltration of mononuclear inflammatory cells to the Langerhans islets. Insulin expression was evaluated using Allred score. Statistical analysis used was Kruskal-Wallis test, followed by Mann-Whitney with a level of significance of p<0.05. The insulitis degree and insulin expression of the two treatment groups were significantly different compared to the control group (p<0.005). It can be concluded that Moringa oleifera ethanolic leaf extract doses of 250 and 500 mg/kg/day cause higher insulin expression and lower insulitis degree than in the control group. [MKB. 2015;47(2):69?76]Key words: Insulin expression, insulitis, Moringa oleifera, streptozotocin DOI: 10.15395/mkb.v47n2.456

SENSITIVITAS, SPESIFISITAS DAN AKURASI PENGUKURAN KONTRAKSI UTERUS KALA I FASE AKTIF IBU BERSALIN MENGGUNAKAN TOKODINAMOMETER Bainuan, Lina Darmayanti; Husin, Farid; Anwar, Anita Deborah; Arifin, Achmad; Wirakusumah, Firman Fuad
Majalah Kedokteran Bandung Vol 50, No 1 (2018)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Pada umumnya, pemeriksaan kontraksi uterus dilakukan dengan menekan fundus uteri, namun demikian cara tersebut menyebabkan ketidaknyamanan dan hanya dapat mengetahui frekuensi kontraksi sedangkan durasi dan intensitas kontraksi pengukurannya bersifat subjektif. Cara lain yang digunakan adalah menggunakan Kardiotokografi, namun harganya mahal danl lebih sulit untuk menginterpretasikan hasil. Tokodinamometer dapat digunakan untuk menilai kemajuan persalinan karena dapat dibaca langsung, sederhana, dan harga terjangkau, sehingga dapat digunakan di komunitas. Penelitian ini bertujuan untuk mengukur sensitivitas, spesifisitas dan akurasi Tokodinamometer dalam mengukur kontraksi uterus kala I fase aktif pada ibu bersalin. Rancangan penelitian merupakan studi observasional analitik dengan desain Cross sectional (potong silang). Sampel penelitian berjumlah 47 orang yang memenuhi kriteria inklusi di Rumah Sakit Khusus Ibu dan Anak Kota Bandung, dengan teknik concecutive sampling. Pengambilan data dengan mengukur kontraksi uterus menggunakan Tokodinamometer dan Kardiotokografi (KTG) diukur secara bersamaan sebanyak 2 kali. Analisis menggunakan uji Wilcoxon?s, dan uji diagnostik. Hasil penelitian didapatkan, frekuensi dan intensitas kontraksi uterus tidak terdapat perbedaan (p>0,05), sedangkan durasi kontraksi terdapat perbedaan bermakna (p< 0,05) antara ibu bersalin kala I fase aktif yang diukur menggunakan Tokodinamometer dan KTG. Tokodinamometer memiliki nilai sensitivitas (90,47%), spesifisitas (78,26%) dan akurasi (87,21%). Tokodinamometer dapat digunakan untuk pemantauan kontraksi uterus di komunitas.Kata kunci : Fase aktif, Kontraksi uterus, Tokodinamometer Sensitivity, Specificity, and Accuracy Measurement of Stage I Active Labor Uterus Contraction Using TokodynamometerExamination of uterine contractions is generally done by pressing the uterine fundus. This method can cause discomfort and can only reveal the frequency of contraction while the duration and intensity of contraction measurement is subjective, leading to inaccurate decision making in early phase of labor. Labor monitoring should be done by cardiotocography. However, this device is expensive and interpretation of results needs specific skills. Since contraction assessment is important to understand the progress of labor, a device that can be used at the community level is needed. This study aimed to analyze the sensitivity, specificity and accuracy of Tokodynamometer in measuring uterine contraction in the first stage of active phase of labor. This was a crossectional analytic observational study on 47 women who met the inclusion criteria in Bandung City Maternal and Child Hospital t RSKIA Bandung, with concecutive sampling technique. Tokodynamometer and Cardiotocography were used to measure uterine contractions simultaneously. Each measurement was done twice or according to mother condition. Data collected were analyzed using Wilcoxon?s test and diagnostic test. The results showed that the frequency and intensity of uterine contractions did not differ (p>0.05), whereas the duration of contraction was significantly different with p=0.012 (p<0.05) between measurements taken using Tokodinamometer and CTG in active phase of labor. The Tokodynamometer has sensitivity specificity and accuracy values of 90.47 %, 78.26 %), and 87.21 %,, respectively. Tokodynamometer has almost similar sensitivity, specificity, and accuracy to Cardiotocography as the gold standard. Thus, Tokodynamometer can be used for monitoring uterine contractions in community setting.Key words: Active phase, uterine contractions, Tokodynamometer

Apakah Epidural Preemtif Menghambat Stres Pembedahan dengan Sempurna? Ahmad, Muh. Rumli; Bisri, Tatang
Majalah Kedokteran Bandung Vol 45, No 3 (2013)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Analgesia preemtif adalah pemberian regimen analgesik sebelum onset stimulus noksius. Kerusakan jaringan akibatÂ pembedahan menimbulkan rangsang noksius, melalui dua jalur input noksius ke susunan saraf pusat (SSP), melaluiÂ jalur neural dan jalur sirkulasi. Penelitian uji klinik tersamar ganda mengikutsertakan 48 pasien yang menjalaniÂ pembedahan orthopedi tungkai bawah. Dibagi 2 kelompok: kelompok I (n=24) diberikan bupivakain 0,25% 10 mLÂ dan kelompok II (n=24) diberikan NaCl 0,9% melalui epidural sebagai kontrol sebelum dilakukan induksi. KeduaÂ kelompok diberikan anestesi umum. Selama pembedahan pada kelompok I diberikan 5 mL bupivakain 0,25%Â selang 90 menit, sedangkan pada kelompok kontrol diberikan 5 mL NaCl 0,9% dengan selang waktu yang sama. Pascabedah kedua kelompok diberikan bupivakain 0,25% secara kontinu 4 mL/jam sampai 24 jam pascabedah.Â Pengukuran kadar sitokin: tumor necrosis factor- Î± (TNF-Î±), interleukin-1Î² (IL-1Î²), IL-6 dan IL-10 dilakukanÂ sebelum induksi anestesi, pascabedah dini, jam ke-4, 8, dan 24 pascabedah. Kelompok I memperlihatkan dinamikaÂ kadar proinflamasi lebih rendah dibandingkan dengan kelompok II namun secara statisik tidak bermakna (p>0,05). Sebaliknya, kadar sitokin antiinflamasi lebih tinggi pada kelompok epidural, namun tidak berbeda bermaknaÂ (p>0,05). Intensitas nyeri pada 4 jam, 8 jam, 24 jam pascabedah secara nyata lebih rendah pada kelompok IÂ (p<0,05). Respons hemodinamik juga ditemukan lebih rendah pada kelompok I walaupun tidak berbeda nyata ( p>0,05) kecuali pada pascabedah dini namun tidak secara sempurna. Simpulan, pemberian analgetik epiduralÂ preemtif menghasilkan analgesia disertai hemodinamik yang stabil dibandingkan tanpa epidural preemtif, namunÂ epidural premtif tidak dapat menekan produksi sitokin proinflamasi dan antiinflamasi. [MKB. 2013;45(3):147â€“54]Kata kunci: Epidural preemtif, hemodinamik, intensitas nyeri, sitokinÂ Does Preemptive Epidural Analgesia Completely Blok Surgical Stress Responses?Preemptive analgesia is initiating an analgesic regimen before the onset of the noxious stimulus. Damages to theÂ tissue caused by surgical trauma generate noxious response conveyed to the central nervous system (CNS) byÂ two pathways, neural pathway and circulatory pathway. This study is a double- blinded clinical trial that includedÂ 48 patients undergoing lower extremity orthopedic surgery. The subjects were divided into two groups: group IÂ (n=24) received 10 mL bupivacaine 0.25% from epidural route, and group II (n=24) received 10 mL NaCl 0.9%Â from epidural route as the control group before induction of anesthesia. Both groups were anesthetized under general anesthesia. Group I received 5 mL bupivacaine 0,5% every 90 minutes and group II received 5 mL NaClÂ 0,9 with similar time intraoperatively. Post-operatively, both groups received continuous bupivacaine 0,25% 4 mL/Â hour until 24 hours after surgery. Measurements of cytokine levels: tumor necrosis factor-Î± (TNF-Î±), interleukin-Â 1Î² (IL-1Î²), IL-6 and IL-10 were done before induction of anesthesia, in the early post-operative period, at 4, 8,Â and 24 hours after surgery. Group I showed lower level proinflammatory cytokines level compared with group IIÂ but the difference was not statistically significant (p>0.05). The level of anti-inflammatory cytokine was higher inÂ group I, but the difference was not statistically significant (p>0.05). Pain intensity at 4 hours, 8 hours, 24 jam hours post operative was lower significantly (p<0.05) Hemodynamic responses was lower in group I but not significantÂ (p>0.05) excepst at early postoperative period (p<0.05). Generally, preemptive epidural analgesia was able toÂ suppress the cytokine responses, but not completely. In conclusion, preemptive epidural analgesia is associatedÂ with better analgesia and better hemodynamic stability compared without preemptive epidural, but unable toÂ suppress the production of proinflammatory and anti-inflammatory cytokines. [MKB. 2013;45(3):147â€“54]Key words: Cytokines, hemodynamic, pain intensity, preemptive epiduralÂ DOI:Â http://dx.doi.org/10.15395/mkb.v45n3.144

KORELASI JUMLAH CLUSTER OF DIFFERENTIATION 4 DENGAN JENIS BAKTERI PENYEBAB INFEKSI PARU DARI KULTUR BILASAN BRONKOALVEOLAR PADA PASIEN HUMAN IMMUNODEFICIENCY VIRUS Melindah, Melindah; Santoso, Prayudi; Supriatna, Yana Akhmad; Turbawati, Dewi Kartika
Majalah Kedokteran Bandung Vol 48, No 1 (2016)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Infeksi paru bakteri adalah penyebab utama morbiditas dan mortalitas pasien human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS). Infeksi HIV menyebabkan disfungsi sistem kekebalan yang dimanifestasikan penurunan jumlah cluster of differentiation 4 (CD4). Tujuan penelitian menentukan hubungan jumlah CD4 dengan jenis bakteri penyebab infeksi paru dari kultur bilasan bronkoalveolar pasien HIV di RS Dr. Hasan Sadikin Bandung. Penelitian analitik observasional dengan rancangan potong lintang. Pengambilan sampel sejak November 2011 sampai Oktober 2013 di Departemen Ilmu Penyakit Dalam RS Dr. Hasan Sadikin Bandung. Subjek 39 orang memenuhi kriteria inklusi, didapatkan usia rata-rata 32 tahun. Jumlah median CD4 18 (rentang, 0?190) sel/mm3. Hasil kultur jenis bakteri batang gram negatif 29/39 sampel dan kokus gram positif 10/39 sampel. Spesies terbanyak Pseudomonas aeruginosa 11/39 sampel, Klebsiella pneumoniae 11/39 sampel dan Streptococcus viridans 10/39 sampel. Analisis statistik berdasarkan point biserial correlation terdapat korelasi lemah (r=0,232) dan tidak bermakna antara CD4 dan jenis bakteri penyebab dengan nilai p=0,209 (p>0,05). Arah korelasi menunjukkan semakin kecil jumlah CD4 semakin besar kemungkinan bakteri batang gram negatif sebagai penyebab infeksi paru. Penelitian ini menunjukkan korelasi lemah antara jumlah CD4 dan jenis bakteri penyebab infeksi paru dari bilasan bronkoalveolar pada pasien infeksi HIV di RS Dr. Hasan Sadikin Bandung. [MKB. 2016;48(1):32?8]Kata kunci: Bilasan bronkoalveolar, human immunodeficiency virus (HIV), infeksi paru bakteri, jumlah CD4Correlation between Cluster of Differentiation 4 Cell Counts and Types of Bacteria Causing Lung Infection from Cultured Washing of Bronchoalveolar Lavage in Human Immunodeficiency Virus PatientsAbstractBacterial lung infection is the leading cause of morbidity and mortality of patients with human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS). HIV infection causes immune system dysfunction, which is manifested by decreased cluster of differentiation 4 (CD4) cell counts. The purpose of this study was to determine the correlation between CD4 cell counts and the type of bacteria that caused lung infection from cultured washing of bronchoalveolar lavage in HIV patients in Dr. Hasan Sadikin Hospital Bandung. This was an observational analytic study with a cross-sectional design. Subjects were collected from November 2011 to October 2013 in Internal Departement Dr. Hasan Sadikin Hospital Bandung. There were 39 subjects enrolled with the average age of patients was 32 years. The median CD4 cell counts was 18 (range, 0?190) cell/mm3. The type of gram-negative rods bacteria was 29/39 samples and gram-positive cocci was 10/39 samples. Most species were Pseudomonas aeruginosa 11/39 samples, Klebsiella pneumoniae 11/39 samples and Streptococcus viridans 10/39 samples. Statistical analysis based on a point biserial correlation showed weak (r=0.232) and no significant correlation between CD4 cell counts and the type of bacteria (p>0.05). The weak correlation was the smaller the number of CD4 cell counts, the greater possibility of the gram-negative rod bacteria being the cause of the infection. This study concluded that there is only a weak and no correlation between the number of CD4 cell counts and the type of bacteria causing the lung infection obtained from bronchoalveolar lavage in patients with HIV in Dr. Hasan Sadikin Hospital Bandung. [MKB. 2016;48(1):32?8]Key words: Bacterial lung infection, bronchoalveolar lavage, CD4 cell counts, human immunodeficiency virus

APLIKASI KRIOPROTEKTAN EKSTRASELULER TUNGGAL SECARA EFEKTIF MEMPERTAHANKAN KUALITAS SPERMA MANUSIA PASCAVITRIFIKASI Widyastuti, Rini; Syamsunarno, Mas Rizky A. A.; Ghozali, Mohammad
Majalah Kedokteran Bandung Vol 50, No 4 (2018)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Pemilihan jenis krioprotektan merupakan salah satu kunci keberhasilan dalam mempertahankan motilitas dan viabilitas sperma pascavitrifikasi. Secara konvensional, vitrifikasi menggunakan konsentrasi krioprotektan dan laju kecepatan pembekuan yang tinggi untuk menghindari pembentukan kristal es intra dan ekstraseluler yang menyebabkan kerusakan dan kematian pada sel. Berdasar atas kemampuan menembus membran sel, krioprotektan dibedakan menjadi krioprotektan ekstra dan intraseluler. Sperma manusia memiliki struktur morfologi yang sangat padat dan sedikit mengandung sitoplasma sehingga perpindahan cairan selama proses vitrifkasi sangat kecil. Selain itu, sperma manusia juga mengandung beberapa jenis protein yang dapat berfungsi sebagai krioprotektan intraseluler. Berdasar atas kondisi tersebut, penggunaan krioprotektan pada vitrifkasi sperma manusia memerlukan studi lebih lanjut. Penelitian ini dilakukan di Laboratorium Sentral Universitas Padjadjaran dan dilaksanakan pada bulan Desember 2017?Januari 2018.Penelitian ini bertujuan mengetahui motilitas dan viabilitas sperma pascavitrifikasi dengan menggunakan tipe krioprotektan yang berbeda dan kombinasi keduanya. Earle?s balanced salt solution digunakan sebagai krioprotekan ekstraseluler, sementara EG 0,57% sebagai krioprotektan intraseluler. Sampel yang telah ditambahkan medium vitrifikasi diequilibrasi selama 10 menit, kemudian dikemas di dalam straw 0,25 mL dan langsung dipaparkan ke dalam nitrogen cair. Evaluasi dilakukan dengan melakukan thawing setelah 24 jam penyimpanan. Hasil menunjukkan bahwa motilitas dan viabilitas sperma tertinggi pada kelompok yang menggunakan media vitrifikasi krioprotektan ekstraseluler, walaupun secara statistik tidak berbeda nyata dengan kelompok lainnya (34%; 50%; p<0,05). Sebagai simpulan, krioprotektan ekstraseluler merupakan media vitrifikasi terbaik untuk menjaga motilitas dan viabilitas sperma pascavitrifikasiKata kunci: Krioprotektan, sperma manusia, vitrifikasi Single Extracellular Cryoprotectant Application Effectively Maintain Post-Vitrification Human Sperm QualitySelection of cryoprotectant is one of the keys to maintain sperm motility and viability after vitrification. Conventionally, vitrification uses cryoprotectants with high concentration and cooling rate to avoid the formation of intra- and extra-cellular ice crystals that can induce cell damage and cell death. Morphology structure of human sperm is very dense and contain less cytoplasm compartment; therefore mobilization of fluid is minimum during vitrification. In addition, human sperm also contains several types of protein that function as intracellular cryoprotectants. Based on this condition, the use of cryoprotectants in human sperm vitrification needs a further study. This study was conducted at the Central Laboratory of Universitas Padjadjaran in December 2017?January 2018. The aim was to determine the motility and viability of post-vitrification sperm by using different types of cryoprotectants. Samples that had been mixed with vitrification medium were equilibrated for 10 minutes, packed in a 0.25 mL straw, and directly exposed to liquid nitrogen. The evaluation was conducted by thawing after 24 hours of storage. The results showed that the highest sperm motility and viability was found in the group that used extracellular cryoprotectant vitrification media although it was not statistically different ( 34%; 50%, p <0.05) In conclusion, extracellular cryoprotectants are the best vitrification medium for maintaining motility and viability of post-vitrification sperm.Key words: Cryoprotectant, sperm, vitrification

KORELASI ANTARA IMUNOEKSPRESI P53 DAN RESPONS KEMOTERAPI NEOADJUVAN REGIMEN FLUORORASIL, ADRIAMISIN, DAN SIKLOFOSFAMID PADA KARSINOMA DUKTUS PAYUDARA INVASIF Muhartono, -; Hanriko, Rizki
Majalah Kedokteran Bandung Vol 44, No 1 (2012)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Karsinoma duktus payudara invasif (KDPI) stadium IIIB perlu penanganan multimodalitas. Kemoterapi neoadjuvan (KN) diberikan untuk menurunkan ukuran dan stadium tumor agar dapat dilakukan operasi. Regimen KN yang biasanya digunakan yaitu fluororasil, adriamisin, dan siklofosfamid (FAS). Kemoterapi FAS bekerja dengan cara merusak deoxyribonucleic acid dan menginduksi apoptosis sel kanker. Terjadinya kelainan protein atau gen yang berhubungan dengan apoptosis (p53) diduga mempengaruhi respons kemoterapi tersebut. Tujuan penelitian ini untuk mengetahui korelasi imunoekspresi p53 dengan respons kemoterapi neoadjuvan FAS. Penelitian ini merupakan penelitian analitik potong lintang terhadap 40 kasus KDPI yang diberikan KN FAS di Rumah Sakit Dr. Hasan Sadikin Bandung periode Maret 2008?Februari 2009. Respons KN FAS dinilai berdasarkan ukuran massa tumor setelah pemberian FAS. Blok parafin penderita dibuat pulasan hematoksilin-eosin dan imunohistokimia dengan menggunakan mouse monoclonal antibody p53 protein (Novocastra), kemudian ditentukan tingkat imunoekspresi p53. Uji statistik dengan Somers?d dan Gamma untuk menguji korelasi antar variabel. Nilai p<0,05 secara statistik dianggap bermakna. Pada 40 kasus KDPI, 20 berespons dan 20 kasus tidak berespons terhadap KN FAS; 13 kasus terekspresi p53>75%, 14 kasus p53=10?75%, 7 kasus p53<10%, dan 6 kasus tidak terekspresi p53. Terdapat korelasi bermakna antara imunoekspresi p53 dan respons kemoterapi FAS (p=0,000). Simpulan, semakin tinggi ekspresi p53, semakin tidak berespons terhadap KN FAS. Imunoekspresi p53 dapat memprediksi respons KN FAS pada KDPI stadium IIIB. [MKB. 2012;44(1):13?8].Kata kunci: Karsinoma duktus payudara invasif, imunoekspresi, p53 Correlation between p53 Immunoexpression and Fluorouracyl, Adriamycin and Cyclophosphamide Regimen Neoadjuvant Chemotherapy Responses in Invasive Ductal Breast CarcinomaInvasive ductal breast carcinoma (IDBC) stage IIIB need multimodality treatment. Neoadjuvant chemotherapy (NC) is given to reduce the size and stage of tumor so that surgery can be performed. Neoadjuvant chemotherapy regimens generally used was fluorouracil, adriamycin and cyclophosphamide (FAC). FAC chemotherapy works by damaging deoxyribonucleic acid and induce apoptosis of cancer cells. Abnormalities of proteins or genes associated with apoptosis (p53) is believed to affect the chemotherapy response. This study was purpose to determine correlation between immunoexpression of p53 and response of neoadjuvant FAC chemotherapy in invasive ductal breast carcinoma. The study was a cross sectional analytic study of 40 IDBC cases given FAC NC at Dr. Hasan Sadikin Hospital Bandung between March 2008?February 2009. Response of FAC NC judged on the size of tumor mass following administration of FAC. Haematoxylin-eosin and immunohistochemistry stain using a mouse monoclonal antibody to p53 protein (Novocastra) was made from paraffin blocks of patients, then determined the immunoexpression levels of p53. Somers?d and Gamma statistical were used to test the correlation between variables. The p-value <0.05 was considered statistically significant. In 40 IDCB cases, 20 cases were responded and 20 cases did not respond to FAC NC; 13 cases expressed p53>75%, 14 cases p53 10?75%, 7 cases p53<10%, and 6 cases were not expresed p53; There was a significant correlation between immunoexpression of p53 and the response of FAC chemotherapy (p=0.000). In conclusions, the higher expression of p53, the lower response to NC FAC. Immunoexpression of p53 can predict the response of FAC NC on IDBC stage IIIB. [MKB.2012;44(1):13?8].Key words: Immunoexpression, invasive ductal breast carcinoma, p53 DOI: http://dx.doi.org/10.15395/mkb.v44n1.209

POTENSI QUERCETIN-3-O-GLUCOSIDE (Q3G) DAN QUERCETIN-4-O-GLUCOSIDE (Q4G) DARI DAUN MIMBA (AZADIRACHTA INDICA A.JUSS) TERHADAP AMBILAN GLUKOSA Rohmawaty, Enny; Yunivita, Vycke
Majalah Kedokteran Bandung Vol 48, No 4 (2016)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Daun mimba (Azadirachta indica A.Juss) yang berasal dari BPT Situbondo memiliki zat aktif quercetin-3-O-glucoside (Q3G) dan quercetin-4-O-glucoside (Q4G) yang diketahui mempunyai kemampuan menghambat ambilan glukosa melalui membran usus halus. Penelitian ini bertujuan mengetahui potensi isolat dan dosis optimal Q3G dan Q4G dari daun mimba terhadap ambilan glukosa melalui membran usus halus tikus putih (Rattus rattus novergicus). Zat aktif Q3G dan Q4G dari daun mimba diisolasi secara kualitatif dengan metode Kromatografi Lapis Tipis (KLT). Penelitian ini dilakukan di beberapa tempat, antara lain: Laboratorium Kimia Organik FMIPA Unpad, Laboratorium Biokimia FK Unpad, serta Laboratorium Farmakologi dan Terapi FK Unpad. Penelitian dilakukan pada bulan Juni?Desember 2011. Penelitian laboratorium eksperimental dengan rancangan acak lengkap dilakukan terhadap 30 ekor tikus putih yang dibagi dalam 5 kelompok. Kelompok kontrol diberi larutan glukosa 3,0 x 10-3M, dan 4 kelompok perlakuan diberi larutan glukosa berturut-turut Q3G 1 mg/kgBB, Q3G 2 mg/kgBB, Q4G 1 mg/kgBB, dan Q4G 2 mg/kgBB menggunakan alat perfusi in situ. Kadar ambilan glukosa diamati setiap 15 menit selama 1 jam. Data dianalisis menggunakan one-way ANOVA dan tes Duncan dengan taraf kepercayaan 95% (?=0,05). Hasil penelitian menunjukkan sebanyak 53,1 mg isolat Q3G dan 14,4 mg Q4G diperoleh dari daun mimba BPT Situbondo sebanyak 1 kg. Isolat Q3G 1 mg/kgBB, Q4G 1 mg/kgBB, dan Q4G 2 mg/kgBB berbeda secara bermakna dalam menghambat ambilan glukosa melalui membran usus halus tikus dibanding dengan kontrol pada menit ke-45 (p<0,05). Simpulan, isolat Q3G dan Q4G dari daun mimba dapat menghambat ambilan glukosa melalui membran usus halus tikus putih. [MKB. 2016;48(4):222?7]Kata kunci: Ambilan glukosa, daun mimba, Q3G, Q4GPotential Influence of Quercetin-3-O-Glucoside (Q3g) and Quercetin-4-O-Glucoside (Q4g) from Mimba Leaves (Azadirachta indica a.juss) on Glucose UptakeAbstractMimba leaves (Azadirachta indica A.Juss), which was obtained from Brigade Proteksi Tanaman (BPT) Situbundo in this study, contain active compounds of quercetin-3-O-glucoside (Q3G) and quercetin-4?-O-glucoside (Q4G). These compounds were isolated using the Thin Layer Chromatography (TLC). From previous studies, Q3G and Q4G are known to inhibit the glucose uptake from intestinal membrane. This study was conducted to understand the potential influence of Q3G and Q4G isolated from mimba leaves in inhibiting glucose uptake in rat?s intestinal membrane (Rattus rattus norvegicus). This experimental study employed 30 male rats that met the inclusion criteria that were divided into 5 groups (n=6). Group I was the control group and only received glucose solution 3,0 x 10-3 M. Group II, III, IV, and V received glucose solution with Q3G 1 mg/kgBW, Q3G 2 mg/kgBW, Q4G 1 mg/kgBW, and Q4G 1 2 mg/kgBW, respectively. The inhibitory potentials of Q3G and Q4G on glucose uptake was measured every 15 minutes for one hour using in situ perfusion equipment. Data were analyzed using One-way ANOVA and Duncan test with a significance level 95% (?=0.05). From 1 kg fresh mimba leaves, 60.1 mg Q3G and 14.4 mg Q4G were isolated. This study showed that Q3G 1 mg/kgBW, Q4G 1 mg/kgBW, and Q4G 2 mg/kgBW significantly inhibited glucose uptake from rat intestinal membrane compared to negative control at 45th minute (p<0.05). Therefore, Q3G and Q4G isolated from mimba leaves have significantly inhibit glucose uptake from rat?s intestinal membrane (Rattus rattus norvegicus). [MKB. 2016;48(4):222?7]Key words: Glucose uptake, mimba leaves, Q3G, Q4G

RISIKO MASALAH PERKEMBANGAN DAN MENTAL EMOSIONAL ANAK YANG DIASUH DI PANTI ASUHAN DIBANDINGKAN DENGAN DIASUH ORANGTUA KANDUNG Riyadi, -; Rusmil, Kusnandi; Effendi, Sjarif Hidajat
Majalah Kedokteran Bandung Vol 46, No 2 (2014)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Anak tinggal di panti asuhan dihubungkan dengan terjadinya keterlambatan perkembangan. Anak yang memiliki waktu interaksi bermain bersama lebih lama dengan pengasuhnya lebih sedikit mengalami masalah perkembangan. Tujuan penelitian ini untuk mengetahui perbandingan masalah perkembangan dan mental emosional antara anak yang tinggal di panti asuhan dan orangtua kandung. Penelitian kuantitatif analitik komparatif desain potong lintang dengan uji chi-kuadrat untuk mengetahui perbedaan masalah perkembangan menggunakan kuesioner preskrining perkembangan (KPSP) yang menilai aspek motorik, bahasa, dan personal sosial, sedangkan masalah mental emosional menggunakan kuesioner masalah mental emosional (KMME) yang menilai perilaku, dilanjutkan penelitian kualitatif desain in depth interview untuk mengetahui faktor penyebab masalah perkembangan dan mental emosional. Penelitian dilaksanakan Juni 2011?Januari 2012, pada subjek 102 anak usia 3?6 tahun yang memenuhi kriteria inklusi. Pada 51 subjek kelompok panti asuhan terdapat 8 anak dengan masalah perkembangan, sementara pada kelompok orangtua kandung tidak ada. Kemungkinan masalah mental emosional pada dua kelompok sama masing-masing sebanyak 29 anak. Masalah perkembangan anak di panti asuhan lebih tinggi (p=0,002), terdapat hubungan bermakna waktu interaksi bermain bersama dengan terjadinya masalah perkembangan (p=0,003). Simpulan, anak di panti asuhan terjadi masalah perkembangan lebih tinggi, sedangkan masalah mental emosional tidak berbeda antara anak di kelompok panti asuhan dan diasuh orangtua kandung. [MKB. 2014;46(2):118?24]Kata kunci: Interaksi, mental emosional, orangtua, panti asuhan, perkembanganRisk of Developmental and Emotional Problems in Children Living in Orphanages Compared to Children Living with Their ParentsChildren living in orphanage are associated with delays in development. The children demostrate less developmental problems when they interact with caregivers. The aim of this study was to compare developmental and mental emotional problems between children living in orphanage and those who live with their parents. A comparative analytical cross sectional study by chi square to test the developmental problem using kuesioner preskrining perkembangan (KPSP) or the development pre-screening questionnaire, for motoric, language, and personal social assessment. The mental emotional problems are assessed using kuesioner masalah mental emosional (KMME) or mental emotional problem questionnaire for behavior assessment. These were followed by a qualitative study through interviews to evaluate the cause of developmental and mental emotional problems. Conducted from June 2011?January 2012, this study inclused children 3 to 6 years old who met the inclusion criteria as the subjects with a total of 102 subjects participated. From 51 children from the orphanages there were 8 children who had developmental problem while none was found in children living with their parents. The mental emotional problems in both group were equal (29 children). There was a higher number of developmental problem in children living in the orphanage (p=0.002), and a corelation between caregiver-children play time interaction and developmental problem (p=0.003) was found. In conclusion, children living in orphanage have higher risk for developmental problem while the risk for the mental emotional problems is not different between children living in orphanage and those who live with their parents. [MKB. 2014;46(2):118?24]Key words: Development, interaction, mental emotional, orphanage, parents DOI: 10.15395/mkb.v46n2.284

UJI AKTIVITAS ANTIBAKTERI EKSTRAK KASAR UMBI SARANG SEMUT (MYRMECODIA PENDENS) DIBANDING DENGAN KLORHEKSIDIN TERHADAP STREPTOCOCCUS SANGUINIS Attamimi, Fathimah Azzahra; Ruslami, Rovina; Maskoen, Ani Melani
Majalah Kedokteran Bandung Vol 49, No 2 (2017)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Streptococcus sanguinis merupakan bakteri pionir penyebab plak gigi. Penggunaan obat kumur klorheksidin merupakan tindakan untuk mengontrol pembentukan plak gigi, namun karena efek sampingnya, klorheksidin tidak dapat digunakan untuk jangka panjang. Umbi sarang semut (Myrmecodia pendens) merupakan tanaman obat yang memiliki banyak aktivitas biologis untuk kesehatan. Penelitian ini bertujuan menguji aktivitas antibakteri ekstrak kasar umbi sarang semut terhadap bakteri S. sanguinis dibandingkan dengan klorheksidin dan pengaruh pemberian konsentrasinya terhadap kematian sel bakteri. Metode penelitian menggunakan uji Kirby-Bauer untuk menentukan diameter hambat pertumbuhan bakteri, dilanjutkan dengan uji MIC untuk mengetahui nilai MIC dari sampel dan pengaruhnya terhadap kematian sel bakteri. Penelitian dilakukan pada bulan Agustus-Oktober 2015 di Laboratorium Kimia Organik Universitas Padjadjaran Hasil uji Kirby-Bauer ekstrak kasar umbi sarang semut menunjukkan aktivitas antibakteri. Zona hambat yang dihasilkan oleh ekstrak kasar tidak berbeda signifikan dengan klorheksidin (12 mm vs 15 mm, p>0,05). Nilai MIC ekstrak kasar berada diantara 9,77 ppm dan 19,53 ppm, nilai ini lebih kecil dibanding dengan klorheksidin, yaitu sebesar 1,935 ppm. Selain itu, terdapat korelasi positif dan kuat antara konsentrasi ekstrak kasar dan kematian sel bakteri S. sanguinis (r=0,867). Dapat disimpulkan ekstrak kasar umbi sarang semut memiliki efek antibakteri lebih kecil dibanding dengan klorheksidin. Peningkatan konsentrasi eksrak kasar umbi sarang semut memiliki korelasi positif dan kuat terhadap peningkatan kematian sel bakteri S. sanguinis. [MKB. 2017;49(2):94?101] Kata kunci: Antibakteri, ekstrak kasar, klorheksidin, S. sanguinis, umbi sarang semut Antibacterial Activity Test of Ant Nest Tuber (Myrmecodia Pendens) Crude Extract against Streptococcus Sanguinis Compared to Chlorhexidine Streptococcus sanguinis is a pioneer bacterium that causes dental plaque formation. The use of chlorhexidine mouthwash is one of the treatments to control dental plaque. However, due to its side effects, chlorhexidine cannot be used in a long period. Ant nest tuber (Myrmecodia pendens) is one of the medicinal plants with variousbiological activities that are beneficial to human health. The purpose of this study was to examine the antibacterial activity of ant nest tuber crude extract against bacteria S. sanguinis compared to chlorhexidine and measure the effect of increased concentration on bacterial cell death. This study was conducted using Kirby-Bauer method to measure the diameter of bacterial growth inhibition in August?October 2015 at the Organic Chemistry Laboratory of Universitas Padjadjaran. The MIC was then measured to determine the MIC values of the sample and the effect on bacterial cell death. Kirby-Bauer test showed that the inhibition zone produced by crude extract was not significantly different from the one produced by chlorhexidine (12 mm vs 15 mm, p>0.05) when both were used to inhibith the growth of S. sanguinis. The MIC value of crude extract was between 9.77 ppm and 19.53 ppm, smaller than the MIC value of the chlorhexidine of 1.93 ppm. In addition, there was a positive and strong correlation (r=0.867) between the concentration of crude extract and S. sanguinis cell death. Hence, crude extract from ant nest tuber has a lower antibacterial effect than chlorhexidine in inhibiting the growth of S. sanguinis. Additionally, there is a strong correlation between the increased concentration of crude extract and increased S. sanguinis cell death. [MKB. 2017;49(2):94?101] Key words: Antibacterial, ant nest tuber, chlorhexidine, crude extract, S. sanguinis

PENGARUH LATIHAN FISIK TERATUR TERHADAP KADAR GLUKOSA DARAH DAN HUBUNGANNYA DENGAN KADAR TESTOSTERON TOTAL PADA TIKUS MODEL DIABETES Zulkarnain, -; Satria, Darma; Yus, T. M.; Rezeki, Soraya
Majalah Kedokteran Bandung Vol 47, No 1 (2015)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Kondisi hiperglikemia kronik pada diabetes melitus dapat mengganggu fungsi reproduksi, salah satunya adalah penurunan kadar testosteron total. Latihan fisik teratur merupakan salah satu pendekatan nonfarmakologi untuk menurunkan kadar glukosa darah dan memperbaiki kadar testosteron total pada diabetes melitus. Penelitian bertujuan untuk menentukan pengaruh latihan fisik teratur terhadap kadar glukosa darah puasa (GDP) dan hubungannya dengan kadar testosteron total pada tikus diabetes melitus. Penelitian eksperimental murni rancangan pre-postest with control group design dilakukan di Laboratorium Fisiologi, Fakultas Kedokteran dan Laboratorium Riset, Fakultas Kedokteran Hewan Universitas Syiah Kuala, Banda Aceh, periode Juni?Oktober 2013. Lima belas tikus putih jantan Sprague-Dawley dibagi tiga kelompok: (I) kontrol, (II) kelompok diabetes melitus, dan (III) kelompok diabetes melitus yang diberi latihan fisik. Latihan fisik dilakukan pada intensitas ringan-sedang selama 9 minggu sesuai protokol Souza. Kadar GDP diukur setiap 3 minggu selama latihan fisik dan perubahannya dibandingkan antarkelompok. Kadar testosteron total diukur setelah 9 minggu menjalani latihan fisik. Kadar testosteron total rata-rata tikus diabetes melitus yang diberi latihan fisik berbeda dibanding dengan tanpa latihan fisik (p=0,032). Terdapat korelasi negatif antara perubahan kadar GDP dan kadar testosteron total (p=0,007; korelasi Pearson - 0,661). Simpulan, latihan fisik teratur dengan intensitas ringan-sedang dapat menurunkan kadar glukosa darah dan memperbaiki kadar testosteron total pada tikus diabetes. [MKB. 2015;47(1):16?21]Kata kunci: Hiperglikemia, kadar testosteron total, latihan fisik teratur Effects of Regular Physical Exercise on Blood Glucose Levels and Its Relationship to Total Testosterone Levels in Diabetic RatsA state of chronic hyperglycemia in diabetes mellitus may cause dysfunction of the reproductive system; one of these is the decrease in total testosterone level. A regular physical exercise is one of the non-pharmacological approaches to reduce blood glucose level and improve total testosterone level in diabetes mellitus. The study was aimed to determine the effects of regular physical exercise on fasting blood glucose (FBG) levels and its relationship to total testosterone levels in diabetic rats. Pre-postest experimental study with control group design, was conducted during June?October 2013 at Physiology Laboratory of Medical Faculty and Research Laboratory of Veterinary Medicine, Syiah Kuala University, Banda Aceh. Fifteen male Sprague-Dawley rats were divided into three groups: (I) control, (II) sedentary diabetic, and (III) exercise diabetic. The physical exercise was performed at low-moderate intensity for nine weeks according to Souza?s protocol. The levels of blood glucose were measured every three weeks during the regular physical exercise; the changes of blood glucose level were compared between groups, whereas the levels of total testosterone were measured after nine weeks of regular physical exercise. The mean of total testosterone level was different (p=0.032) between the group with physical exercise and without physical exercise. There was a negative correlation between changes in FBG levels and total testosterone levels (p=0.007, Pearson correlation -0.661). In conclusion, regular physical exercise with low-moderate intensity reduces blood glucose levels and improves total testosterone levels in diabetic rats. [MKB. 2015;47(1):16?21]Key words: Hyperglycemia, regular physical exercise, total testosterone level DOI: 10.15395/mkb.v47n1.393

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