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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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PERBANDINGAN VIABILITAS OOSIT PASCAVITRIFIKASI PADA DUA TINGKAT KONSENTRASI SUKROSA YANG BERBEDA Widyastuti, Rini; Khoirinaya, Candrani; Ridlo, M. Rosyid; Syamsunarno, Mas Rizky A. A
Majalah Kedokteran Bandung Vol 49, No 4 (2017)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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

Abstract

Vitrifikasi merupakan suatu teknik kriopreservasi tanpa disertai pembentukan kristal es, baik intraseluler maupun ekstraseluler. Tingkat keberhasilan vitrifikasi sangat dipengaruhi oleh jenis dan konsentrasi krioprotektan yang digunakan. Sukrosa merupakan krioprotektan ekstraseluler yang mempunyai peranan dalam menjaga kestabilan membran sel pada saat proses dehidrasi. Tujuan penelitian ini adalah mengkaji efek penambahan sukrosa dalam dua level konsentrasi yang berbeda pada morfologi dan persentase hidup oosit pascavitrifikasi dengan menggunakan oosit domba yang telah dimatangkan secara in vitro sebagai model. Penelitian dilaksanakan di Laboratorium Riset dan Bioteknologi, Fakultas Peternakan, Universitas Padjadjaran periode September 2016?Desember 2016. Penelitian menggunakan rancangan acak lengkap dengan dua kelompok perlakuan, yaitu penambahan 0,5 M sukrosa atau 0,65 M sukrosa pada media vitrifikasi. Parameter yang diamati adalah persentase oosit hidup dan morfologi oosit yang mati pascavitrifikasi-pencairan kembali. Hasil yang diperoleh menunjukkan bahwa persentase oosit hidup pascavitrifikasi meningkat 20% setelah penambahan sukrosa 0,65M. Fraktur zona pelusida merupakan kerusakan morfologi yang banyak ditemukan pada oosit yang divitrifikasi dengan penambahan 0,5 M sukrosa dalam larutan vitrifikasi. Hasil penelitian ini mengindikasikan bahwa penambahan sukrosa 0,65 M sebagai krioprotektan ekstraseluler meningkatkan peluang hidup oosit setelah proses vitrifikasi. Kata kunci: Krioprotektan, morfologi oosit, sukrosa, vitrifikasiComparison of Oocyte Viability after Vitrification with Two Different Sucrose Concentration LevelVitrification is a cryopreservation technique without the formation of ice crystals, both intracellular and extracellular. The success of vitrification depends on the type and concentration of cryoprotectants.  Sucrose is one of the extracellular cryoprotectants that play a role in maintaining cell membrane during dehydration process. The purpose of this study was to examine the effect of the addition of two different sucrose concentration levels on the morphology and viability of oocyte after vitrification using matured sheep oocytes as a model. This study was conducted at the Research and Biotechnology Laboratory, Faculty of Animal Husbandry, Universitas Padjadjaran during September?December 2016. The oocytes were randomly assigned into groups with two different concentrations of sucrose in vitrification media: i.e. 0.5 M and 0.65 M. The parameters observed were the percentage of live oocytes and the dead oocyte morphology after vitrification-thawing.  The results showed that the percentage of live matured oocytes post-vitrification increased by 20% after the addition of 0.65M sucrose. Fracture of pellucida zone was the major finding in the post-vitrification dead oocytes  in 0.5 M sucrose group. This indicates that vitrification using 0.65M sucrose as extracellular cryoprotectant presents a higher oocyte survival after vitrification-thawing. Key words: Cryoprotectant, oocytes morphology, sucrose, vitrification
Kadar N-Terminal Pro-Brain Natriuretic Peptide sebagai Prediktor Luaran Klinis Sindrom Koroner Akut Tandhana, Florencia Idajanti; Noormartany, Noormartany; Aprami, Toni M.; Tristina, Nina
Majalah Kedokteran Bandung Vol 44, No 2 (2012)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Kadar N-terminal pro-brain natriuretic peptide (NT-proBNP) plasma dapat menggambarkan tingkat keparahan iskemia walaupun tidak terjadi nekrosis, iskemia yang transien dapat meningkatkan peregangan dinding jantung yang akan menginduksi sintesis dan pelepasan brain natriuretic peptide (BNP) yang sebanding dengan tingkat keparahan iskemia. Tujuan penelitian untuk mengetahui apakah kadar NT-proBNP pada penderita sindrom koroner akut (SKA) dapat digunakan sebagai parameter prediktor luaran klinis. Penelitian dilakukan sejak bulan Januari hingga Maret 2010. Subjek penelitian penderita SKA yang datang ke Unit Gawat Darurat Rumah Sakit Dr. Hasan Sadikin Bandung dan telah didiagnosis klinis sesuai kriteria World Health Organization. Pada subjek yang memenuhi kriteria inklusi dilakukan pemeriksaan kadar NT-pro BNP dengan metode electrochemiluminescence immunoassay, cardiac troponin T (kuantitatif), dan creatine kinase muscle brain (enzimatik). Analisis data uji normalitas menggunakan one-sample Kolmogorov-Smirnov test, analisis regresi logistik multipel untuk mengetahui parameter prediktor luaran klinis penderita SKA. Dari 83 subjek yang ikut dalam penelitian, didapatkan nilai prediksi kadar NT-proBNP sebesar 1,00 sehingga bukan merupakan prediktor utama luaran klinis, koefisien β NTproBNP sebesar 0,001 menyatakan bahwa setiap penambahan 1.000 pg/mL variabel NT-proBNP akan menambah lama perawatan 1 hari. Pada subjek SKA dengan luaran (outcome) sembuh nilai prediksi cTnT lebih baik sebagai faktor prediktor dibandingkan dengan konsentrasi NT-proBNP (OR=32,53; 95%IK; 0,58–1.819,26). Simpulan, NT-proBNP bukan merupakan prediktor utama luaran klinis pada SKA. Kadar NT-proBNP lebih dari 826,7 pg/mLterdapat kemungkinan prognosis yang buruk sampai dengan kematian. [MKB. 2012;44(2):106–13].The Role of NT-proBNP as Clinical Outcome Predictor for Acute Coronary SyndromesPlasma levels of N-terminal pro-brain natriuretic peptide (NT-proBNP) levels may reflect the severity of ischemia, although there is no necrosis. A transient ischemia which can increase the heart wall stretch would induces BNP synthesis and release. Synthesis and release of BNP are comparable with the severity of ischemia. The aim of this study was to analyze whether NT-proBNP levels in patients with acute coronary syndrome (ACS) can be used as a predictor for clinical outcome. Studies was held since January to March 2010. Subject were patients with ACS who came to emergency room Dr. Hasan Sadikin Hospital Bandung and were clinically diagnosed according to World Health Organization criteria. Subjects which were suited with the inclusion criteria, stored until assayed. NT-pro BNP concentration was examined by electrochemiluminescence immunoassay method along with creatine kinase muscle brain (enzymatic method) and cardiac troponin T (quantitative method). Statistical analysis was performed using the one-sample Kolmogorov-Smirnov test for verifying normality, normally distributed data were analyzed using parametric analysis and abnormal distributed data was assayed using multiple logistic regression analysis to determine the parameters which can be used as predictor for clinical outcome in patients with ACS. Multiple logistic regression analysis on 83 subjects showed predictive value of NT-proBNP levels with OR=1.00, which mean there was no different likelihood in patients with high and low concentration of NT-proBNP to have longer hospitality duration. NT-proBNP β coefficient of 0.001 states that every addition of 1,000 pg/mL of NT-proBNP concentration will increase the length of hospitality duration for one day. On convalesce subjects, the most significant predictive value for predicting clinical outcome cTnT was more better than NT-proBNP concentration in patients with ACS (OR=32.53, 95%CI; 0.58–1,819.26). In conclusions, NT-proBNP is not a major predictor of clinical outome in ACS. NT-proBNP levels of >826.7 pg/mL implies a poor prognosis to death. [MKB. 2012;44(2):106–13]. DOI: http://dx.doi.org/10.15395/mkb.v44n2.132 
PERBEDAAN β-CROSSLAPS SERUM PENDERITA KARSINOMA PAYUDARA PASCAMENOPAUSE ANTARA YANG DIBERIKAN ANASTROZOL DAN TAMOKSIFEN Sebastian, Randy; Abdurahman, Maman; Rizki, Kiki A.
Majalah Kedokteran Bandung Vol 47, No 4 (2015)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Tamoksifen dan inhibitor aromatase sebagai terapi adjuvan memiliki peranan penting pada karsinoma payudara (KPD) pascamenopause dengan reseptor estrogen positif. Saat ini inhibitor aromatase dapat menggantikan tamoksifen karena memiliki keuntungan yang lebih baik dibanding dengan  tamoksifen. Inhibitor aromatase juga memiliki efek samping meningkatkan penyerapan tulang yang memicu osteoporosis dan fraktur dibanding dengan tamoksifen. Saat terjadi proses penyerapan tulang, matriks tulang yang 90% terdiri atas kolagen tipe I akan terurai sehingga salah satu hasil penguraiannya berupa ?-CrossLaps terdapat dalam darah dan dapat diukur kadarnya. Penelitian ini mengukur perbedaan kadar ?-CrossLaps serum baik pada pasien KPD pascamenopause yang diberikan anastrozol dan tamoksifen di Rumah Sakit Dr. Hasan Sadikin Bandung periode Januari?Juli 2013. Penelitian ini merupakan penelitian potong lintang. Terdapat 32 pasien, yaitu 16 pasien tiap kelompok. Hasil pengolahan data statistik dengan derajat kepercayaan 95% menunjukkan perbedaan yang bermakna kadar ?-CrossLaps serum KPD yang diberikan anastrozol dibanding dengan yang diberikan tamoksifen (p<0,05). Simpulan, kadar ?-CrossLaps rata-rata serum KPD yang diberikan anastrozol lebih tinggi dibanding dengan tamoksifen, artinya  pemberian obat anastrozol pada pasien KPD pascamenopause dalam jangka waktu >6 bulan meningkatan proses penyerapan tulang dibanding dengan yang diberikan tamoksifen. [MKB. 2015;47(4):207?11] DOI: 10.15395/mkb.v47n4.615Kata kunci: Anastrozol, ?-CrossLaps serum, tamoksifenComparison of ?-crosslaps Serum Levels between Postmenopausal Breast Carcinoma Patients Receiving Anastrozol and TamoxifenAbstractTamoxifen and inhibitor aromatases as adjuvant therapy plays an important role in postmenopausal breast cancer patients with positive estrogen receptor. Currently, inhibitor aromatases can replace tamoxifen because it has more advantages than tamoxifen. Inhibitor aromatases also have side effects which is increased bone resorption that triggers osteoporosis and fractures when compared to tamoxifen. During the process of bone resorption, bone matrix, composed of 90% type I collagen, were broken down resulting in ?-crosslaps content in the blood, which is measurable. This study measured the levels of serum ?-crosslaps in postmenopausal breast cancer patients who received anastrozol and tamoxifen in Dr. Hasan Sadikin General Hospital Bandung between January and July 2013. This was a cross-sectional study with comparative analytics to compare the mean levels of serum ?-crosslaps in postmenopausal breast cancer patients between the two groups. There were 32 patients in this study, 16 patients in each group. The results of data processing using statistical tests at 95% confidence level revealed that there was significant differences in serum levels of ?-crosslaps between the group who received anastrozol and those who received tamoxifen (p<0.05). In conclusion, the mean value of ?-crosslaps serum in anastrozol group is higher than in tamoxifen group. This means that postmenopausal breast cancer patients receiving anastrozol for more than 6 months could may experienced a higher degree of bone resorption compared to those receiving tamoxifen. [MKB. 2015;47(4):207?11]Key words: Anastrozol, serum ?-crosslaps, tamoxifen
PERAN DOKTER UMUM PADA PROGRAM PROMOSI KESEHATAN DI LAYANAN PRIMER Yuliyanti, Suryani; Sugeng, Purwito; Ratnawati, Ratnawati
Majalah Kedokteran Bandung Vol 50, No 3 (2018)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (185.272 KB) | DOI: 10.15395/mkb.v50n3.1340

Abstract

Fasilitas Kesehatan Tingkat Pertama (FKTP) sebagai ujung tombak pelayanan kesehatan perlu mengarus utamakan kegiatan Promosi kesehatan (Promkes). Dokter memiliki posisi strategis dalam kegiatan Promkes di FKTP melalui pemberian Komunikasi, informasi, dan edukasi (KIE) saat melakukan tatalaksana pasien maupun dalam manajemen kegiatannya. Penelitian ini bertujuan menggambarkan peran dokter dalam kegiatan Promkes di FKTP. Penelitian deskriptif dilaksanakan pada bulan Juni sampai Agustus 2017 dengan jumlah responden 48 dokter di FKTP yang bekerjasama dengan Badan Penyelenggara Jaminan Sosial Kesehatan (BPJSK) meliputi Puskesmas, Klinik Pratama, maupun praktik dokter perorangan. Data diambil melalui pengisian kuesioner, wawancara dan observasi, selanjutnya dianalisis secara deskriptif. Gambaran keterlibatan dokter dalam pelaksanaan promkes adalah sebanyak 98% telah melaksanakan promkes di FKTP, 82% melakukan promkes kepada semua pasien, 90% melaksanakan perencanaan promkes, dan konsisten dalam pelaksanaannya, 72% melakukan monitoring dan evaluasi, hanya 16% yang melakukan pengkajian data dalam perencanaan, dan jumlah yang berperan dalam strategi bina suasana, kemitraan dan advokasi masing masing adalah 4, 12, dan 28. Jenis kegiatan promkes yang dilakukan adalah pemberian KIE kepada pasien, keluarga, dan masyarakat. Dokter berperan dalam pemberian KIE bagi individu, keluarga dan masyarakat, tetapi perannya dalam perencanaan berbasis data dan strategi promkes masih perlu ditingkatkan untuk peningkatan pelayanan promkes di FKTP. Role of Physicians in Primary Health Care Health Promotion Program  in SemarangPrimary Health Care (PHC) is the first line  health care provider that has a duty, among others, to do  health promotion (HP). Physicians play a strategic role in health promotion by providing information, education and communication (IEC) to the patients during their practice and Health Promotion (HP) sessions. This study aimed to assess the knowledge, attitude, and role of physicians in HP program in PHC. A descriptive study was conducted between June and August 2017 among Health Social Insurance Agency (Badan Penyelenggara Jaminan Sosial Kesehatan, BPJSK) care provider partners (physicians) working for Public Health Center (Pusat Kesehatan Masyarakat, Puskesmas) and private primary clinics. Data were collected through questionnaire distribution, in-depth interview, and observation and were analyzed descriptively. Of all physicians involved in this study, 98% were involved in HP, 82% provided HP to their patient, 90% were involved in HP planning and its implementation, 72% were involved in monitoring and evaluation.  Only 16% were involved in the analysis of the data for planning and 4%, 12%, and 28% were involved in environment optimization, advocacy, and partnership, respectively. The HP approach implemented by the physicians was IEC to their patients, families, and community. The role of physicians in HP is particularly giving IEC to their patients, families, and community but this role should be improved by adding  HP evidence-based planning and strategy development to improve HP services in PHC.
Pengaruh Alfa Tokoferol pada Efek Ototoksik Sisplatin Santosa, Yanuar Iman; Samiadi, Dindy; Aroeman, Nur Akbar; Fianza, Pandji Irani
Majalah Kedokteran Bandung Vol 44, No 4 (2012)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Kemoterapi sisplatin memiliki efek samping ototoksik, diperantarai radikal bebas, mengakibatkan kematian sel rambut luar koklea, menyebabkan gangguan dengar. Alfa tokoferol memiliki efek otoprotektif terhadap sisplatin pada hewan coba. Diperlukan penelitian lebih lanjut pada manusia. Tujuan penelitian mengukur fungsi pendengaran untuk mengetahui pengaruh pemberian alfa tokoferol per oral pada pencegahan efek ototoksik sisplatin. Dilakukan penelitian uji klinis acak di Rumah Sakit Dr. Hasan Sadikin Bandung (RSHS) periode Desember 2011–Februari 2012 pada dua kelompok. Kelompok perlakuan menjalani pengobatan standar kemoterapi sisplatin dengan tambahan alfa tokoferol per oral dengan dosis 400 International Unit (IU) per hari sejak 1 hari sebelum kemoterapi selama 30 hari. Kelompok kontrol menjalani pengobatan standar kemoterapi sisplatin. Pemeriksaan fungsi pendengaran dilakukan dengan timpanometri, audiometri, dan distortion product otoacoustic emission (DPOAE) sebelum dan setelah kemoterapi siklus pertama dan kedua. Didapatkan hasil kejadian ototoksik setelah siklus pertama lebih rendah secara bermakna pada kelompok 1 (33,3%) dibandingkan dengan kelompok 2 (66,7%) (p=0,046; IK=95%). Demikian juga dengan kejadian ototoksik setelah siklus kedua lebih rendah secara bermakna pada kelompok 1 (50%) dibandingkan dengan kelompok 2 (88,9%) (p=0,027; IK=95%). Simpulan, terapi alfa tokoferol 400 IU per oral dapat mencegah efek ototoksik sisplatin. [MKB. 2012;44(4):205–12].Kata kunci: Alfa tokoferol, ototoksik, sisplatinEffects of Alpha Tocopherol Againts Cisplatin–Induced OtotoxicityOtotoxicity is a known side effect of cisplatin chemotherapy due to formation of free radicals causing death to cochlear outer hair cells, resulting in hearing loss. Alpha tocopherol has otoprotective effects towards cisplatin in animal studies. Further human studies are needed. The objective of this study was to measure hearing function to know the otoprotective effects of alpha tocopherol against cisplatin. A randomized control trial was performed at Dr. Hasan Sadikin Hospital Bandung in December 2011–February 2012 in 2 groups. The treatment group received standard cisplatin chemotherapy treatment and alpha tocopherol 400 International Unit (IU)/day since day 1 before a 30-day-treatment. the control group received standard cisplatin chemotherapy treatment. Hearing evaluation was done using tympanometry, audiometry and distortion product otoacoustic emission (DPOAE) before and after the first and second cycles of chemotherapy. Results showed that ototoxic incidence after the first cycle of chemotherapy was significantly lower in group 1 (33.3%) than group 2 (66.7%) (p=0.046, CI=95%). Ototoxic incidence after the second cycle of chemotherapy was significantly lower in group 1 (50%) than group 2 (88.9%) (p=0.027, CI=95%). In conclusion, oral alpha tocopherol 400 IU can prevent cisplatin-induced ototoxicity. [MKB. 2012;44(4):205–12]Key words: Alpha tocopherol, cisplatin, ototoxicity DOI: http://dx.doi.org/10.15395/mkb.v44n4.176
PENGARUH TRANSPLANTASI ALLOGRAF PANCREATIC STEM CELL TERHADAP KADAR INSULIN DAN C-PEPTIDE TIKUS PUTIH PENDERITA DIABETES MELITUS TIPE I Setiawan, Boedi; Plumeriastuti, Hani
Majalah Kedokteran Bandung Vol 48, No 3 (2016)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (541.957 KB) | DOI: 10.15395/mkb.v48n3.842

Abstract

Penyakit diabetes melitus merupakan salah satu penyakit degeneratif yang hingga kini masih belum tuntas terapinya dan masih menjadi ancaman serius bagi dunia kesehatan di Indonesia dan dunia. Tujuan penelitian ini adalah mengetahui kadar insulin dan C-peptide tikus putih penderita diabetes melitus tipe I yang diberikan transplantasi allograf pancreatic stem cell dengan laparotomi intrapankreatik. Penelitian ini dilakukan selama 6 bulan (Juli?Desember 2014) di lab. Stem Cell, Institute of Tropical Diseases, Universitas Airlangga, Surabaya. Dua belas tikus putih jantan Rattus novergicus galur Wistar dibagi secara acak menjadi dua kelompok . Kelompok pertama (P0) disuntik aloksan 150 mg/kg bobot badan tanpa terapi stem cell . Kelompok kedua disuntik aloksan dengan dosis 150 mg/kg bobot badan dan diterapi dengan 1x106/kg bobot badan stem cell pankreas secara laparotomi intrapankreatik (P1). Akhir penelitian adalah pada hari ke-31 percobaan. Hasil penelitian menunjukkan bahwa kadar glukosa darah pada akhir penelitian berbeda sangat nyata (p <0,01) antara kelompok perlakuan yang menerima terapi stem cell (P1) dengan P0 kontrol positif, meskipun nilai kadar glukosa darah rata-rata tidak senormal seperti pada hari ke-1. Tingkat C-peptide dan insulin P0 dan P1 berbeda sangat nyata (p<0,01). Dapat disimpulkan bahwa terapi stem cell secara laparotomi intrapankreatik dapat menurunkan kadar glukosa darah, serta meningkatkan kadar C-peptide dan insulin. [MKB. 2016;48(3):135?39]Kata kunci: Diabetes melitus, insulin, stem cell Insulin and C-peptide Levels in Diabetes Mellitus Type I White Rats  treated with  Pancreatic Stem Cell Allograft TransplantationDiabetes mellitus is one of the degenerative diseases in which the therapy still remains unresolved and is still a serious threat to the global health, including to the health of Indonesian people. The aim of this study was to describe the level of insulin and C-peptide in diabetes mellitus type I white rats treated with  pancreatic stem cell allograft through intrapancreatic laparotomy. This study was conducted at the Institute of Tropical Diseases, Universitas Airlangga, Surabaya in a 6 month period (July?December 2014). Twelve male white rats Rattus novergicus Wistar strain, were randomly divided into two groups. The first group (P0) was injected by alloxan, 150 mg/kg body weight, without stem cell therapy. Another group was injected by alloxan, 150 mg/kg body weight, and was treated with 1x106/kg body weight pancreatic stem cell throughintrapancreatic laparotomy (P1). The experiment was finalized on the 31th day of the experiment. The results showed that the blood glucose levels at the end of experiment were highly significantly different p<0.01 between the treatment group that received stem cell therapy (P1) and P0 positive control, although the average value of blood glucose levels was not as normal as on the first day. C-peptide and insulin levels of P0 and P1 group differed significantly (p<0.01). It can be concluded that stem cell therapy through intrapancreatic laparotomy can reduce blood glucose levels and increase the levels of C-peptide and insulin. [MKB. 2016;48(3):135?39]Key words: Diabetes mellitus, insulin, stem cell
Efektivitas Latihan Incentive Spirometry dengan Latihan Pernapasan Diafragma terhadap Fungsi Paru, Kapasitas Fungsional, dan Kualitas Hidup Penderita Asma Bronkial Alergi Nikmah, Sitti Nurun; Purba, Ambrosius; Defi, Irma Ruslina
Majalah Kedokteran Bandung Vol 46, No 1 (2014)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Prevalensi eksaserbasi asma alergi semakin mengalami peningkatan. Berbagai upaya dilakukan untuk dapat menurunkannya, antara lain dengan latihan pernapasan diafragma dan incentive spirometry, namun, perbandingan efektivitas kedua latihan masih belum jelas. Penelitan ini bertujuan untuk mengetahui perbandingan efektivitas kedua latihan tersebut. Penelitian dilakukan di Rumah Sakit Dr. Hasan Sadikin dan Rumah Sakit Paru Dr. H. A. Rotinsulu Bandung (September−Desember 2012). Sejumlah 20 orang perempuan, berusia 26−40 tahun, penderita asma bronkial alergi terkontrol sebagian yang mengikuti penelitian, dibagi ke dalam 2 kelompok. Tiap kelompok diberi latihan incentive spirometry dan pernapasan diafragma selama 8 minggu. Sebelum dan sesudah perlakuan, dilakukan pengukuran fungsi paru dengan forced expiratory volume in 1 second (FEV1), kapasitas fungsional dengan jarak tempuh (uji jalan 6 menit), dan kualitas hidup dengan St George’s Respiratory Questionnaire (SGRQ). Karakteristik penderita menunjukkan distribusi normal dan homogen. Uji-t independen menunjukkan bahwa latihan incentive spirometry lebih efektif dibandingkan dengan pernapasan diafragma dalam meningkatkan FEV1 (6,19±2,63 vs 0,40±0,33 % prediksi), jarak tempuh (229,07±21,84 vs 140,69±16,91 m) dan memperbaiki SGRQ (nilai total 1.036,51±341,14 vs 360,09±182,10). Simpulan, latihan incentive spirometry lebih efektif dalam meningkatkan fungsi paru, kapasitas fungsional, dan kualitas hidup dibandingkan dengan pernapasan diafragma pada penderita asma bronkial alergi. [MKB. 2014;46(1):39–47]Kata kunci: FEV1, Incentive spirometry, jarak tempuh, latihan pernapasan diafragma, SGRQEffectiveness of Incentive Spirometry and Diaphragmatic Breathing Exercise in Lung Function, Functional Capacity and Quality of Life of Bronchial Asthma Allergic PatientsExacerbation of allergic asthma prevalence is increasing. Various attempts were made to lower it with diaphragm breathing and incentive spirometry exercise. However, comparison of the effectiveness of both exercises are unclear. This study aims to compare those effects. Research conducted in Dr. Hasan Sadikin General Hospital and Dr. H. A. Rotinsulu Pulmonary Hospital (September–December 2012). Twenty female, aged 26−40 years, partially controlled bronchial asthma allergic patients who consented for this study were divided into 2 groups. Each group was given incentive spirometry and diaphragm breathing exercise for 8 weeks. Before and after treatment lung function with forced expiratory volume in 1 second - FEV1, functional capacity with walking distance (6 minute walking test) and quality of life (St George’s Respiratory Questionnaire-SGRQ) were assessed. The characteristics of the subjects were normally distributed and homogeneous. Independent T test results showed incentive spirometry compared to diaphragm breathing exercise was more effective in improving FEV1 (6.19±2.63 vs 0.40±0.33% predicted), walking distance (229.07±21.84 vs 140.69±16.91 m), and SGRQ (total value 1,036.51±341.14 vs 360.09 ±182.10). In conclusion, incentive spirometry is more effective in improving lung function, functional capacity, and quality of life compared to diaphragm breathing exercises in patients with allergic bronchial asthma. [MKB. 2014;46(1):39–47]Key words: Diaphragm breathing exercise, FEV1, incentive spirometry, SGRQ, walking distance DOI: 10.15395/mkb.v46n1.226
Ekspresi Reseptor-Estrogen pada Adenoma Pleomorfik Parotis Yazid, Achmad Syawqie
Majalah Kedokteran Bandung Vol 42, No 4
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Adenoma pleomorfik parotis (APP) merupakan tumor jinak yang umum terjadi pada kelenjar liur parotis, memiliki perilaku biologi beragam, yaitu sering rekurens setelah dioperasi, dapat berubah menjadi ganas, juga kadang bermetastasis ke kelenjar getah bening atau ke organ lain. Selayaknya untuk tumor APP ini dilakukan pencarian bentuk terapi alternatif lain selain terapi bedah yang diduga penyebab tingginya rekurensi tumor. Terapi alternatif lain dapat berupa hormonal yang memerlukan data dasar ekspresi reseptor estrogen oleh sel tumor APP. Untuk mengungkapkan ekspresi reseptor estrogen oleh sel tumor APP, dilakukan penelitian retrospektif eksperimental laboratoris pemeriksaan imunohistokimia teknik LsAB/labelled strepavidine-biotine terhadap ekspresi estrogen receptor (ER) pada 50 sampel tumor APP di Bagian Patologi Anatomi FKUP/RSHS pada tahun 1998–1999. Pengamatan ditujukan pada kelompok penyebaran tingkat imunoekspresi ER oleh sel tumor APP: 0=negatif; +1=fokal (>20%); +2=heterogen (20–50%); dan +3=difus (>50% sel tumor imunoreaktif). Hasil menunjukkan 40/50 sampel tumor APP (80%) imunoreaktif terhadap ER dengan komposisi imunoekspresi: 67,5% heterogen (27/40) dan 32,5% difus (13/40). Pola pulasan homogen teramati pada inti sel tumor. Sepuluh kasus memperlihatkan hasil negatif (negatif 8 kasus dan fokal 2 kasus). Komponen jaringan tumor APP yang positif meliputi sel epitel duktal/tubuloduktal, area miksomatosa, dan hiperselular. Simpulan, tumor APP berperan sebagai target hormon estrogen dan besar kemungkinannya responsif terhadap terapi hormonal. [MKB. 2010;42(4):181–6].Kata kunci: Adenoma pleomorfik, estrogen receptor, tumor parotisEstrogen-Receptor Expression in Parotid Pleomorphic AdenomaParotid pleomorphic adenoma (PPA) is a benign tumor frequently found in parotid salivary gland. This tumor has various biological behaviors including recurrence after surgery, ability to transform into the malignant form, and occasionally, metastasizes to lymph nodes or other organs. For this PPA tumor, it is appropriate to look for alternative therapy forms other than surgery which is assumed to be the cause of the high tumor recurrence. Other alternatives may include hormonal therapy that needs baseline data on estrogen-receptor expression by PPA tumor cells. To collect the baseline data, a laboratory experimental retrospective study on immunohistochemical study using LsAB/labelled strepavidine-biotine technique of estrogen receptor (ER) receptor on 50 PPA tumor samples at the Anatomic Pathology Department of the Faculty of Medicine, Padjadjaran University/Hasan Sadikin General Hospital during 1998–1999 has been conducted. The observation is focused on the grouping of ER immunoexpression level spread by PPA tumor cells: 0=negative; +1=focal (>20%); +2=heterogeneous (20–50%); and +3=diffuse (>50% immunoreactive tumor cells). The results showed that 40/50 PPA tumor samples (80%) were immunoreactive towards ER with an immunoexpression composition of: 67.5% heterogeneous (27/40) and 32.5% diffuse (13/40). A homogenous smear pattern was observed in tumor cell nucleus. Ten cases showed negative results (8 cases negative and 2 cases focal). The positive PPA tumor tissue components included ductal /tubuloductal epithels, mixomatose and hypercellullar areas. In conclusion, PPA tumor plays the role as target of estrogen hormone and there is a high possibility that it is responsive to hormonal therapy. [MKB. 2010;42(4):181–6].Key words: Estrogen receptor, parotid tumors, pleomorphic adenoma DOI: http://dx.doi.org/10.15395/mkb.v42n4.34
Efek Kombinasi Ekstrak Anamirta cocculus dan Artemisin terhadap Penurunan Jumlah Sel Apoptosis Jaringan Paru Mencit Malaria Fitri, Loeki Enggar; Syamsuri, Dara Dasawulansari; Simamora, Dorta; Soemarko, Soemarko; Mintaroem, Karyono
Majalah Kedokteran Bandung Vol 45, No 2 (2013)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Plasmodium dalam eritrosit akan menginduksi respons imun, berupa produksi radikal bebas yang dapat menyebabkan kerusakan jaringan paru. Kombinasi ekstrak Anamirta cocculus dan artemisin diharapkan dapat mencegah komplikasi akibat radikal bebas yang dihasilkan oleh sel imun maupun artemisin. Studi eksperimental dengan metode post test control group design only dilakukan di Laboratorium Parasitologi dan Biomedik Fakultas Kedokteran Universitas Brawijaya periode Juni–Oktober 2010 untuk membuktikan efek pemberian kombinasi ekstrak A. cocculus dan artemisin terhadap jumlah sel apoptosis jaringan paru mencit galur Balb/C yang diinfeksi Plasmodium berghei. Mencit dibagi dalam 6 kelompok, kelompok 1 terdiri atas 9 ekor mencit normal, kelompok 2 mencit yang diinfeksi P. berghei tanpa terapi, kelompok 3 mencit yang diinfeksi P. berghei dan diterapi artemisin dosis 0,04 mg/gBB, serta 3 kelompok perlakuan mencit diinfeksi P. berghei dan diterapi kombinasi artemisin 0,04 mg/gBB dengan ekstrak A. cocculus 0,01 mg/gBB; 0,1 mg/gBB; dan 1 mg/gBB. Sel apoptosis dihitung dari ekspresi caspase-3 pada pewarnaan imunohistokimia. Pemberian ekstrak A. cocculus dosis 0,01 mg/gBB; 0,1 mg/gBB; dan 1 mg/gBB serta artemisin selama 3 hari menurunkan jumlah sel apoptosis secara signifikan dibandingkan dengan kelompok artemisin monoterapi (p=0,00; 0,026; 0,000). Hubungan lama terapi dengan ekspresi caspase-3 menunjukkan pada kelompok terapi kombinasi ekstrak A. cocculus 0,01 mg/gBB dan artemisin 0,04 mg/gBB memiliki korelasi positif yang signifikan (p=0,013). Simpulan, terapi jangka pendek kombinasi ekstrak A. cocculus dan artemisin mempunyai efek yang lebih baik dibandingkan dengan pemberian artemisin monoterapi dalam hal penurunan jumlah sel apoptosis jaringan paru. [MKB. 2013;45(2):69–77]Kata kunci: Anamirta cocculus, apoptosis sel paru, artemisin,caspase-3, malariaThe Effect of Anamirta cocculus Extract and Artemisin Combination in Decreasing Number of Apoptotic Lung Cells of Malaria Infected MiceThe presence of Plasmodium in erythrocytes will induce immune responses, including the production of free radicals which can lead to lung tissue cells damage. Combination therapy of Anamirta cocculus extract and artemisin is expected to prevent complications caused by free radicals produced by immune cells and artemisin. This experimental study which using post test control group design only was done in Laboratory of Parasitology and Biomedic Faculty of Medicine, Brawijaya University on June–October 2010 to prove the effect of combination therapy of A. cocculus extract and artemisin towards the number of apoptotic lung tissue cells of Balb/C mice infected by Plasmodium berghei. Mice were divided into 6 groups, the first normal Balb/C mice, the second mice infected by P. berghei without treatment, the third mice infected by P. berghei and treated with artemisin 0.04 mg/g BW, and 3 combination contains mice infected by P. berghei and treated with a combination of artemisin 0.04 mg/ gBW and A.cocculus extract 0.01 mg/gBW, 0.1 mg/gBW, 1 mg/ gBW respectively. The apoptotic cells of lung tissue were counted from the expression of caspase-3 in immunohistochemical staining. In day 3 combination A. cocculus extract dose 0.01 mg/gBW, 0.1 mg/gBW, 1 mg/ gBW and artemisin reduced the number of apoptotic cells significantly compared to the artemisin monotherapy (p=0.00, 0.026, 0.000). There was a positive corelation between the length of treatment and the expression of caspase-3 (p=0.013) on group that treated with combination of A. cocculus extract 0.01 mg/gBW and artemisin 0,04 mg/gBB. In conclusion, the short treatment of combination A. cocculus extract and artemisin has a better effect than artemisin monotherapy in decreasing number of apoptotic lung tissue cells. [MKB. 2013;45(2):69–77]Key words: Anamirta cocculus, artemisinin, caspase 3, lung apoptotic cell, malaria DOI: http://dx.doi.org/10.15395/mkb.v45n2.91
ASPEK KUALITAS BAKTERIOLOGIS DEPOT AIR MINUM ISI ULANG (DAMIU) DI KABUPATEN BANDUNG BARAT Khoeriyah, Ari; Anies, -
Majalah Kedokteran Bandung Vol 47, No 3 (2015)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Kebutuhan manusia akan air minum semakin bertambah seiring dengan bertambahnya jumlah penduduk, sedangkan kuantitas dan kualitas air minum semakin berkurang sehingga masyarakat mencari alternatif untuk mendapatkan air minum, salah satunya mengonsumsi air minum siap pakai dari Depot Air Minum Isi Ulang (DAMIU). Namun, tidak semua DAMIU terjamin kualitasnya. Penelitian bertujuan menganalisis keberadaan bakteri Coliform pada DAMIU di wilayah kerja Puskesmas Cipendeuy dan Padalarang Kabupaten Bandung periode Juni 2013. Pengumpulan data dilakukan pada 8 DAMIU dengan observasi dan uji laboratorium untuk mengetahui keberadaan bakteri Coliform dalam air DAMIU. Hasil pemeriksaan kadar Coliform pada beberapa sumber air baku, diketahui bahwa seluruh sumber air baku (100%) memenuhi syarat walaupun ada 2 sumber air baku yang mengandung Coliform, tetapi dengan keadaan yang masih memenuhi baku mutu. Sementara itu, pemeriksaan air minum yang berasal dari 8 DAMIU, ternyata air minum yang berasal dari 6 DAMIU tidak memenuhi persyaratan (5 DAMIU mengandung Coliform sebesar 3 MPN/100 dan 1 DAMIU sebesar 4 MPN/100 mL), sedangkan air minum yang berasal dari 2 DAMIU lainnya memenuhi syarat. [MKB. 2015;47(3):137?43]Kata kunci: Coliform, Depot Air Minum Isi Ulang (DAMIU), sumber air bakuAspect of Bacteriological Quality in DWRD as a Refill Drinking Water Station in the District of West BandungAbstractThe human need for water is increasing with population growth.Meanwhile the quantity and quality of drinking water are decreasing that people look for alternatives for drinking water source. One of the alternatives is ready-to-drink water from the Drinking Water Refill Depot (DWRD). However, not all of DWRDs provide good quality drinking water. This study aims to analyze the existence of Coliform bacteria in the drinking water provided by DWRDs. Data were collected from 8 DWRDs to reveal the DWRDs sanitation through observation  and laboratory testings were performed to determine the presence of Coliform bacteria in the drinking water produced by DWRDs. Based on the examination on the Coliform  level on several raw water sources, the raw water was considered qualified (100%). However, 2 raw water sources contained Coliform, even though they were still considered meeting the requirements of quality standard. Testing  was also conducted on the  drinking water produced by 8 DWRDs. It was revealed  that 6 DWRDs did not qualify (drinking water from 5 DWRDs contained 3 MPN/100 mL of Coliform and drinking water from 1 DWRDs contained 4 MPN/100 mL of Coliform), while 2 other DWRDs were qualified for providing drinking water. [MKB. 2015;47(3):137?43]Key words: Coliform, Drinking Water Refill Depot (DWRD), raw water DOI: 10.15395/mkb.v47n3.594

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