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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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Perbedaan Kadar Osteoprotegerin Serum Penderita Diabetes Melitus Tipe 2 tanpa dan dengan Penyakit Jantung Koroner Nestiti, Ratri Dwitiya; Noormartany, -; Dewi, Nina Susana; Rachmayati, Sylvia
Majalah Kedokteran Bandung Vol 47, No 4 (2015)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Diabetes melitus (DM) tipe 2 merupakan diabetes yang disebabkan oleh resistensi insulin dan atau gangguan sekresi insulin sehingga menyebabkan hiperglikemia yang merupakan penyebab disfungsi endotel. Disfungsi endotel merupakan proses awal aterosklerosis dan merupakan salah satu faktor risiko yang menyebabkan penyakit jantung koroner (PJK). Sampai saat ini angiografi koroner digunakan sebagai baku emas PJK. Pemeriksaan osteoprotegerin (OPG) merupakan pemeriksaan alternatif sebagai penanda disfungsi endotel, kurang invasif, lebih dini, dan murah. Osteoprotegerin berhubungan dengan perkembangan plak arteri pada penderita DM tipe 2. Tujuan penelitian ini mengetahui perbedaan kadar OPG dalam serum penderita DM tipe 2 tanpa dan dengan PJK. Penelitian dilakukan pada September–Desember 2012 di Poliklinik Endokrin dan Instalasi Gawat Darurat RSUP Dr. Hasan Sadikin Bandung. Subjek penelitian sebanyak 102 orang, 51 orang penderita telah didiagnosis oleh klinisi sebagai penderita DM tipe 2 dengan PJK dan 51 orang penderita DM tipe 2 tanpa PJK, berusia 35–75 tahun. Pemeriksaan OPG menggunakan metode enzyme linked immunosorbent assay (ELISA). Bentuk penelitian adalah observasional komparatif dengan rancangan penelitian studi perbandingan potong lintang. Analisis statistik menggunakan uji Shapiro Wilk’s, independent T, dan Mann Whitney. Nilai median kadar OPG serum untuk penderita DM tipe 2 dengan PJK lebih tinggi, yaitu sebesar 6,1 pmol/L dan penderita DM tipe 2 tanpa PJK, yaitu sebesar 2,6 pmol/L (p=0.0001). Simpulan, terdapat perbedaan kadar OPG serum antara kelompok DM tipe 2 tanpa dan dengan PJK. [MKB. 2015;47(4):218–23]Kata kunci: Disfungsi endotel, DM tipe 2, osteoprotegerinDifferences of Osteoprotegerin Levels in Patients with Type 2 Diabetes Mellitus with and without Coronary Arterial DiseaseAbstractType 2 diabetes mellitus (DM) is caused by insulin resistance and/or impaired insulin secretion, thus causing hyperglycemia leading to endothelial dysfunction. Endothelial dysfunction is an early process of atherosclerosis and is one of the risk factors for coronary arterial disease (CAD). Currently, coronary angiography is used as the gold standard for diagnosing CAD. Examination of osteoprotegerin (OPG) is an alternative assay for endothelial dysfunction marker which is less invasive, has the ability to detect earlier, and less expensive. Osteoprotegerin is associated with the development of arterial plaque in patients with type 2 DM. The aim of this study was to determine the differences in serum OPG levels in patients with type 2 DM with and without CAD. The study was conducted in September–December 2012 in the Endocrine Clinic and Emergency Unit of Dr. Hasan Sadikin General Hospital Bandung on 102 patients aged between 35–75 years, with 51 subjects type 2 DM patients with CAD and 51 subjects with type 2 DM without CAD, both diagnosed by clinician. The method used was, OPG enzyme linked immunosorbent assay (ELISA) examination method. The study was an observational cross-sectional comparative study. Statistical analysis was performed using normality test with Shapiro Wilk’s, independent T and Mann Whitney test. The median value for patients with type 2 DM with CAD equaled to 6.1 pmol/L and the value for type 2 diabetic patients without CAD was 2.6 pmol/L. In this study, the OPG levels obtained in patients type 2 DM with CAD were higher than those without CAD. In conclusion, there is a significant difference in OPG levels between type 2 DM with and without CAD groups. [MKB. 2015;47(4):218–23]Key words: Endothelial dysfunction, type 2 diabetes, osteoprotegerin DOI: 10.15395/mkb.v47n4.616
Model Program Demam Berdarah Dengue. Peran Serta Masyarakat, serta Sanitasi Dasar di Kota Bandung Respati, Titik; Raksanagara, Ardini; Djuhaeni, Henni
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 (40.6 KB) | DOI: 10.15395/mkb.v50n3.1239

Abstract

Munculnya kembali demam berdarah sebagai masalah kesehatan masyarakat yang utama menunjukkan sulitnya mempertahankan kelangsungan program pencegahan dan pemberantasan penyakit ini. Pengetahuan yang memadai mengenai demam berdarah dengue (DBD) dan metode untuk mencegahnya harus dapat dimengerti oleh masyarakat sebelum mereka mau berpartisipasi aktif. Penelitian ini bertujuan menggambarkan faktor-faktor yang memengaruhi DBD berdasar atas peran serta masyarakat, sanitasi dasar, dan program pencegahan dan pemberantasan demam berdarah dengue  Penelitian ini adalah survei pada 2.035 rumah tangga di 12 kecamatan dan 16 kelurahan di Kota Bandung pada bulan Mei – Juni 2015 yang dilakukan dengan metode stratified random sampling. Kuesioner digunakan untuk mengetahui karakteristik, pengetahuan mengenai DBD, pengalaman, persepsi risiko dan sikap dalam kejadian DBD, program DBD yang tersedia, serta fasilitas sanitasi dasar. Analisis data menggunakan partial least square (PLS). Hasil menunjukkan bahwa DBD dipengaruhi oleh keberadaan tempat perindukan nyamuk, fasilitas sanitasi dasar terutama sistem pembuangan air limbah (SPAL), Program DBD serta peran serta masyarakat terutama mengenai pengetahuan. Upaya paling efektif untuk mengurangi tempat perindukan ini adalah dengan menyediakan sarana sanitasi dasar yang dapat diakses oleh seluruh masyarakat serta upaya pemberantasan sarang nyamuk PSN yang sebaiknya dilakukan secara serentak.  Dengue Hemorrhagic Fever Program Model, Community Participation, and Basic Sanitation in Bandung CityThe reemergence of dengue fever as a major public health problem presents difficulties in the sustainability of prevention and eradication programs for this disease. Community must have adequate knowledge on dengue hemorrhagic fever (DHF) and methods to prevent it before they have the willingness to participate actively. This study aimed to describe factors that influence DHF program  ased on community participation, basic sanitation, and prevention and eradication. This was a survey on 2,035 households in 12 sub-districts and 16 villages in Bandung City in May - June 2015. Sampling was perfomed using stratified random sampling method. The questionnaire was used to determine the characteristics, knowledge on DHF, experience, risk perception, and attitudes towards the incidence of DHF; available DHF programs; and basic sanitation facilities. Data analysis was performed using Partial Least Square (PLS). The results showed that DHF was affected by the presence of mosquito breeding sites, basic sanitation facilities, especially sewage disposal systems (SPAL), DHF programs, and community participation especially knowledge. The most effective effort to reduce the breeding place is by providing basic sanitation facilities accessible to the entire community along with simultaneous efforts to eradicate mosquito breeding places.   
Hubungan Kadar Seng Plasma dengan Derajat Penyakit Pneumonia Winarni, Paramita Diah; Rachmadi, Dedi; Sekarwana, Nanan
Majalah Kedokteran Bandung Vol 44, No 4 (2012)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Pneumonia merupakan masalah kesehatan utama anak di dunia dan sebagai penyebab terbanyak morbiditas dan mortalitas anak di negara berkembang. Anak dengan defisiensi mikronutrien termasuk seng berisiko tinggi terjadi pneumonia, karena gangguan sistem imun. Penelitian ini bertujuan mengetahui hubungan kadar seng plasma dengan pneumonia, pneumonia berat, dan sangat berat pada anak usia 2–59 bulan. Penelitian observasi analitik dengan rancangan potong lintang dilakukan bulan Agustus sampai November 2009 di Departemen Ilmu Kesehatan Anak RS Dr. Hasan Sadikin Bandung, RS Ujung Berung, dan RS Cibabat. Subjek harus memenuhi kriteria diagnosis klinis pneumonia menurut World Health Organization (WHO) Indonesia dan berusia 2–59 bulan. Pengambilan sampel darah untuk pemeriksaan kadar seng plasma dilakukan saat penderita datang. Analisis data menggunakan uji eksak Fisher dan untuk melihat hubungan kadar seng plasma dengan derajat pneumonia menggunakan uji Mann-Whitney. Dari total 42 subjek yang memenuhi kriteria inklusi, didapatkan 1 (2%) anak pneumonia, 32 (76%) pneumonia berat, dan 9 (22%) pneumonia sangat berat. Terdapat perbedaan bermakna (p=0,032) kadar seng plasma antara kelompok pneumonia berat dan sangat berat dengan median 96,685 μg/dL (57,32–195,66 μg/dL) untuk penumoia berat dan 80,240 μg/dL (63,01–111,84 μg/dL) untuk pneumonia sangat berat. Penelitian ini menunjukkan bahwa bahwa kadar seng plasma memiliki hubungan dengan pneumonia berat dan sangat berat pada anak usia 2–59 bulan. [MKB. 2012;44(4):213–17].Kata kunci: Pneumonia, seng plasma, sistem imun Association Plasma Zinc Level with Severity of PneumoniaPneumonia is a major health problem affecting children all over the world and remains a major cause of childhood morbidity and mortality in developing countries. Children with micronutrients deficiency including zinc, which might cause immune system disorder, have higher risk to have pneumonia. The aim of this study was to investigate the association between plasma zinc level and pneumonia, severe, and very severe pneumonia in children aged 2–59 months. This observational analytic with cross-sectional study was performed at the Pediatric Department of Dr. Hasan Sadikin General Hospital, Ujung Berung Hospital and Cibabat Hospital, in August to November 2009. Subjects of this study were 2–59-month-old children who meet the WHO Indonesian classification for pneumonia. Blood samples for plasma zinc examination were collected on admission. Data were analysed using exact Fisherand Mann-Whitney test for the association between plasma zinc level and severity of pneumonia. A total of 42 subjects were enrolled, 1 (2%) child were classified as having pneumonia, 32 (76%) children with severe, and 9 (22%) with very severe pneumonia. There were significant differences (p=0.032) in plasma zinc levels between severe and very severe pneumonia with a median of 96.685 μg/dL (57.32–195.66 μg/dL) for severe pneumonia and 80.240 μg/dL (63.0–111.84 μg/dL) for very severe pneumonia. This study shows an association between plasma zinc levels and severe and very severe pneumonia in children aged 2–59 months. [MKB. 2012;44(4):213–17].Key words: Pneumonia, plasma zinc, immune system DOI: http://dx.doi.org/10.15395/mkb.v44n4.177
Pemberian Ekstrak Bayam Merah (Amarantus Tricolor linn) Memperbaiki Ekspresi BDNF dan GLUR1 pada Area Hipokampus Tikus Muda yang Terpapar Anestesi Inhalasi Halothane dan Sevoflurane Argarini, Raden; Wigati, Kristanti Wanito; Herawati, Lilik; Riawan, Wibi; Rehatta, Nancy M.
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 (1578.665 KB) | DOI: 10.15395/mkb.v48n3.844

Abstract

Otak dalam tahap perkembangan memiliki tingkat kerentanan lebih tinggi terhadap zat anestesi dibanding dengan otak orang dewasa. Penelitian ini bertujuan mengamati pengaruh pemberian ekstrak bayam merah terhadap penanda biologis fungsi kognitif dan neuroplastisitas, yaitu Brain Derived Neurotrophic Factor (BDNF) dan AMPA Glutamate Receptor subunit 1 (Glur1) pada area hipokampus tikus yang terpapar anestesi inhalasi halothane dan sevoflurane. Rancangan penelitian adalah randomized posttest only control group. Penelitian ini dilakukan di Departemen Biokimia Fakultas Kedokteran Universitas Airlangga dan prosedur anestesi dilakukan di Rumah Sakit Hewan Fakultas Kedokteran Hewan Universitas Airlangga pada bulan Mei 2014–Oktober 2014. Subjek penelitian adalah 23 ekor tikus putih jantan (Rattus norvegicus) galur Wistar, umur 1–1,5 bulan, bobot kurang lebih 60–100 gram dengan kondisi sehat fisik. Subjek dibagi menjadi 5 kelompok, yaitu K (kontrol); K1 (halothane 1 MAC); K2 (bayam merah 800 mg/kgBB+Halothane 1 MAC); K3 (sevoflurane 1MAC) dan K4 (bayam merah 800 mg/kgBB+ Sevoflurane 1 MAC). Hasil penelitian menunjukkan adanya penurunan ekspresi BDNF pada pemberian halothane dan sevoflurane serta peningkatan kembali ke normal pada kelompok yang sebelumnya telah diberikan bayam merah sebelum terpapar gas anastesi (p=0,000). Ekspresi GLUR1 meningkat pada pemberian halothane dan sevoflurane dan penurunan kembali ke normal pada kelompok yang sebelumnya telah diberikan bayam merah sebelum terpapar gas anestesi (p=0,000). Simpulan penelitian ini adalah pemberian ekstrak bayam merah memiliki potensi untuk mencegah neurotoksisitas pada fungsi kognitif tikus yang terpapar gas anastesi. [MKB. 2016;48(3):148–54]Kata kunci: AMPA Glutamate Receptor subunit 1 (GLUR1), Brain Derived Neurotrophic Factor (BDNF), ekstrak bayam merah, halothane, sevofluraneRed Spinach Extract Administration (Amarantus Tricolor linn) in Young Rats Exposed to Inhalation Anesthetic Halothane and Sevoflurane Improves BDNF and GLUR1 Expressions in Hippocampus AreaIn the development stage, brain has a higher level of vulnerability than the adult brain to anesthetic agents. The aim of this study was to investigate the effects of red amaranth extract to brain derived neurotrophic factor (BDNF) and AMPA glutamate receptor subunit 1 (Glur1) expressions as biomarkers of cognitive and neuroplasticity in rat hippocampus areas exposed to inhaled anesthetics halothane and sevoflurane. The design of this study was a randomized posttest only control group. This study was conducted at the Department of Biochemistry Faculty of Medicine, Universitas Airlangga, and the anesthetic procedures were performed at the Veterinary Hospital, Faculty of Veterinary Medicine Universitas Airlangga during the period of May–October 2014. The subjects of this study were 23 white male rats (Rattus norvegicus) wistar strain, aged 1–1.5 months, weighted approximately 60–100 grams in a healthy physical condition. The subjects were divided into 5 groups, K (control); K1 (1 MAC halothane); K2 (red amaranth 800 mg/kgBW + 1 MAC halothane); K3 (1 MAC sevoflurane); and K4 (red amaranth 800mg/kgBW+1 MAC sevoflurane). The results of this study showed a decrease in the expression of BDNF when halothane and sevoflurane were administered. Red amaranth treatment prior to anesthetic gases exposure preserved and increased BDNF expression (p=0.000) while GLUR1 expression increased in the group that received halothane and sevoflurane administration and decreased back to normal in the group that received red amaranth treatment prior to exposure to anesthetic gases (p=0.000). In conclusion, red amaranth extract has the potential effect to prevent cognitive neurotoxicity on the cognitive function in rats exposed to anesthetic gases. [MKB. 2016;48(3):148–54]Key words: AMPA Glutamate Receptor subunit 1 (GLUR1), Brain Derived Neurotrophic Factor(BDNF), halothane, sevoflurane, red amaranth extract 
Hypercoagulable State dan Diabetes Melitus Tipe 2: Korelasi antara Fibrinogen dan HbA1c Aprijadi, Hery; Sumantri, Rachmat; Heri, Trinugroho; Irani, Pandji; Oehadian, Amaylia; Arifin, Augusta Y. L.
Majalah Kedokteran Bandung Vol 46, No 1 (2014)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Hiperkoagulabilitas merupakan penyebab kelainan vaskular pada diabetes melitus tipe 2 (DM tipe 2). Fibrinogen merupakan petanda hiperkoagulabilitas akibat inflamasi sistemik. Kadar HbA1c dipakai untuk menilai kadar gula darah jangka panjang dan berhubungan dengan petanda inflamasi. Terdapat perbedaan hasil penelitian terdahulu tentang bagaimana hubungan antara kadar fibrinogen dan HbA1c. Ada yang menyatakan hubungan bermakna dan ada pula yang tidak. Tujuan penelitian ini untuk melihat adakah korelasi antara fibrinogen dan HbA1c. Penelitian ini merupakan penelitian potong lintang pada penderita rawat jalan DM tipe 2 di RS Dr. Hasan Sadikin Bandung selama Januari−Juli 2010. Kriteria inklusi penderita DM tipe 2 yang baru didiagnosis, normotensi, kadar hemoglobin normal, serta tes fungsi hati dan ginjal normal. Dilakukan pemeriksaan kadar fibrinogen, trigliserida, dan HbA1c. Kriteria eksklusi yaitu mendapat obat antiagregasi trombosit, obat antidiabetik oral, atau menderita penyakit autoimun. Analisis statistik berupa Spearman dan regresi digunakan pada penelitian ini. Terdapat 63 subjek yang diikutkan dalam penelitian. Semua subjek memiliki kadar HbA1c lebih dari 6,5% (rata-rata 8,21±2,5%). Terdapat 33 penderita (53%) dengan kadar fibrinogen di atas harga normal (rata-rata 416,75±102,7 mg/dL). Tidak terdapat korelasi yang bermakna antara kadar fibrinogen dan HbA1c. Simpulan, tidak terdapat korelasi antara kadar fibrinogen dan HbA1c. Meskipun demikian subjek dengan diabetes melitus cenderung mempunyai kadar fibrinogen yang tinggi. [MKB. 2014;46(1):48–51]Kata kunci: Diabetes melitus tipe 2, fibrinogen, HbA1c, hypercoagulable state Hypercoagulable State and Type 2 Diabetes Mellitus: the Correlation between Fibrinogen and HbA1cHypercoagulability has been suggested as a result of type 2 diabetic mellitus vascular disease. Fibrinogen is a marker of hypercoagulability due to systemic inflammation. HbA1c level is used to measure long-term blood glucose level. There was inconsistent findings about the correlation between fibrinogen level and HbA1c. Previous study found a significant correlation between fibrinogen levels and HbA1c, while other study showed different results for this finding. The aim of this study was to determine the correlation between fibrinogen and HbA1c. A cross-sectional study was performed in outpatients type 2 diabetes mellitus (DM) in Dr. Hasan Sadikin General Hospital Bandung during January−July 2010. Patients with newly diagnosed type 2 DM, normotension, normal hemoglobin level, normal liver function test and normal kidney function test were included in this study. Fibrinogen, trigliseride, and HbA1c levels were examined. The exclusion criteria were patients taking antiplatelet drugs or oral antidiabetic and had autoimmune diseases. Spearman and regression analysis were used in this study. Sixty three subjects were included in this study. All subjects had HbA1c level more than 6.5% (mean 8.21±2.5%). Thirty three patients (53%) had fibrinogen level of more than the normal limit (mean 416.75±102.7 mg/dL). The mean of trigliseride level was 235.32±131.3 mg/dL. No significant correlation between fibrinogen and HbA1c. In conclusion, there is no correlation between the fibrinogen levels and HbA1c. However, subjects with diabetes mellitus tend to have high fibrinogen levels. [MKB. 2014;46(1):48–51]Key words: Fibrinogen, HbA1c, hypercoagulable state, type 2 diabetes mellitus DOI:  10.15395/mkb.v46n1.227
Polimorfisme FokI, BsmI, ApaI, dan TaqI Gen Reseptor Vitamin D pada Kejadian Tuberkulosis Anak Setiabudiawan, Budi; Kartasasmita, Cissy B.; Garna, Herry; Parwati, Ida; Maskoen, Ani Melani
Majalah Kedokteran Bandung Vol 42, No 4
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Tuberkulosis (TB) adalah penyakit infeksi yang disebabkan oleh Mycobacterium tuberculosis. Faktor kuman saja tidak dapat menjadi faktor tunggal dalam kejadian TB. Varian polimorfisme gen reseptor vitamin D (RVD) dianggap penting hubungannya dengan kerentanan dan resistensi terhadap TB. Penelitian ini bertujuan untuk mengetahui peran polimorfisme FokI, BsmI, ApaI, dan TaqI gen RVD terhadap kejadian TB anak. Penelitian observasional analitik dengan rancangan kasus kontrol ini dilakukan di Bagian Ilmu Kesehatan Anak RSUP Dr. Hasan Sadikin Bandung dan Rumah Sakit Umum Cibabat Cimahi sejak Mei 2008–Maret 2009. Sampel terdiri dari 42 anak TB (kelompok kasus) dan 42 anak non-TB (kelompok kontrol) yang memenuhi kriteria penelitian dan diambil secara consecutive sampling. Dilakukan pemeriksaan polimorfisme FokI, BsmI, ApaI, dan TaqI gen RVD. Analisis dengan uji Chi-kuadrat, uji Mann-Whitney, menghitung rasio Odds (OR) dan 95% CI. Kejadian polimorfisme FokI gen RVD pada kelompok kasus TB 66,7% dan kontrol 40,5% (p=0,016) dengan OR (95% CI): 2,94 (1,21–7,16). Kejadian polimorfisme FokI gen RVD untuk kelompok kasus TB adalah 2,94 kali lebih banyak dibandingkan dengan kontrol. Polimorfisme BsmI, ApaI, dan TaqI gen RVD tidak terdapat perbedaan bermakna antara kelompok kasus TB dibandingkan dengan kontrol (p >0,05). Disimpulkan bahwa polimorfisme FokI gen RVD merupakan faktor risiko terjadinya TB anak. [MKB. 2010;42(4):187–94].Kata kunci: Gen reseptor vitamin D, polimorfisme, tuberkulosis anakPolymorphism of FokI, BsmI, ApaI, and TaqI Vitamin D Receptor Gene on Child TuberculosisTuberculosis (TB) is a infection disease caused by Mycobacterium tuberculosis. Mycobacterium tuberculosis itself is not the only factor of TB. Polymorphism of vitamin D receptor (VDR) gene is important on the susceptibility of TB. The aim was to find out the role of FokI, BsmI, ApaI, and TaqI VDR gene polymorphism on child TB. The observational analytic study with case control design was done in RSUP Dr. Hasan Sadikin Bandung and RSU Cibabat Cimahi, May 2008–March 2009. The subjects consisted of 42 children each for case (TB) and control (non TB) group, enrolled by consecutive sampling. The blood was analyzed for polymorphism of FokI, BsmI, ApaI, and TaqI VDR gene. Chi-square test, Mann-Whitney test, to calculate odds ratio (OR) and 95% confidence interval (CI) were used. The incidence of FokI VDR gene polymorphism in TB case group was 66.7% and 40.5% in control group (p=0.016), OR (95% CI): 2.94 (1.21–7.16). The FokI VDR gene polymorphism for TB group was 2.94 times greater than that for control group; while for BsmI, ApaI, and TaqI VDR gene polymorphism, there was no significant difference between TB case and control (p>0.05). It is concluded, FokI VDR gene polymorphism is a risk factor of child TB. [MKB. 2010;42(4):187–94].Key words: Child tuberculosis, polymorphism, vitamin D receptor gene DOI: http://dx.doi.org/10.15395/mkb.v42n4.35
Multidrug Resistant Tuberculosis (MDR-TB): Tinjauan Epidemiologi dan Faktor Risiko Efek Samping Obat Anti Tuberkulosis Reviono, -; Kusnanto, P.; Eko, Vicky; Pakiding, Helena; Nurwidiasih, Dyah
Majalah Kedokteran Bandung Vol 46, No 4 (2014)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Kasus multi drug resistant tuberculosis (MDR TB) terus meningkat. Penatalaksanaan klinis MDR TB lebih rumit dibandingkan dengan TB sensitif karena menggunakan obat anti-TB lini I dan lini II, sehingga menyebabkan permasalahan toleransi dan efek samping. Desain penelitian ini kohort yang bertujuan untuk mengetahui jenis, frekuensi, dan faktor risiko efek samping obat. Pelaksanaan penelitian dilakukan antara Januari 2011–Juni 2013. Suspek MDR TB diambil sputum, dilakukan pengecatan Ziehl Nielsen, dilanjutkan pemeriksaan Xpert MTB/RIF pada regio gen rpoB untuk menentukan resistensi rifampisin. Selanjutnya  uji resistensi obat anti-TB dengan menggunakan media padat (Lowenstein Jensen) dan media cair Mycobacteria growth indicator tube test (MGIT). Penelitian dilakukan di RS Dr. Moewardi. Jumlah pasien yang terkonfirmasi MDR TB adalah 114 orang: 56 laki-laki dan 58 perempuan. Efek samping terbanyak gangguan gastrointestinal: mual 79,8%, muntah 78,9%. Sebagian besar efek samping derajat ringan 76,3%. Terdapat hubungan antara riwayat pengobatan TB dan gangguan renal (p=0,026), antara jenis kelamin dan gangguan renal (p=0,033) serta gangguan pendengaran (p=0,039). Tidak terdapat hubungan antara jenis kelamin dan gangguan psikiatri (p=0,062), antara riwayat pengobatan TB dan gangguan pendengaran (p=0,115) serta hipokalemia (p=0,968). Simpulan, efek samping terbanyak adalah gangguan gastrointestinal. Kata kunci: Efek samping, gangguan gastrointestinal, MDR TB, pendengaran, renalMultidrug Resistant Tuberculosis (MDR-TB): Epidemiologic Review and Adverse Events Risk Factors of Anti Tuberculosis Drugs  Abstract The number of Multi drug resistant tuberculosis (MDR-TB) cases is predicted to be increasing. The management of MDR-TB is more complex than susceptible TB due to the resistance to the first and second lines of anti tuberculosis drugs. Leading to anti tuberculosis drugs  tolerance and adverse event issues. This study was a cohort study conducted between January 2011 and June 2013 to describe the type, frequency, and risk factors of adverse events caused by drugs. Sputum samples of patients who were suspected to have MDR TB were collected and examined as sputum smears using Ziehl Nielsen staining and Gene Xpert MTB/RIF segment amplification of rpoB gene region methods to assess resistance towards rifampicin. Samples with positive results were cultured in solid medium (Lowenstein Jensen) and liquid medium (Mycobacteria growth indicator tube test,MGIT). This study was conducted in Moewardi General Hospital. The number of confirmed MDR-TB patients was114 subject consisting of 56 males and 58 females. The most common adverse events were gastrointestinal disturbances including nausea 79.8% and vomiting 78.9%. Minor adverse events also found in 76.3% patients.  There was a significant relationship between previous anti tuberculosis medication and renal impairment (p=0.026); between sex and  renal impairment (p=0.033); and between sex and hearing impairment (p= 0.039). There was no significant relationship between sex and mental illnesses (p=0.062) as well as between previous anti tuberculosis medication and  hearing impairment (p=0.115)  and  between previous anti tuberculosis medication and hypopotassemia (p=0.968),. In conclusion, the major adverse events in MDR-TB cases are gastrointestinal disturbances Key words: Adverse events, gastrointestinal disturbance, hearing impairment,  MDR-TB,  renal impairment DOI: 10.15395/mkb.v46n4.336
Perbedaan Intensitas Penyengatan Meningeal Hasil MRI antara Sekuens T2 FLAIR Post Contrast dan T1WI Post Contrast Gadolinium-DTPA dalam Mendeteksi Penyangatan Meningeal pada Kasus Meningitis Tuberkulosis Hendarin, Arie; Soetikno, Rista D.; Nugraha, Harry Galuh
Majalah Kedokteran Bandung Vol 49, No 3 (2017)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1379.365 KB) | DOI: 10.15395/mkb.v49n3.1117

Abstract

Diagnosis meningitis TB terutama pada kasus possible dan probable sulit ditegakkan. Pemeriksaan MRI kepala dengan kontras Gadolinium-DTPA adalah modalitas radiologi yang paling sensitif untuk membantu mendiagnosis penyakit ini. Penyangatan meningeal di daerah basal merupakan gambaran MRI yang paling banyak ditemukan pada meningitis TB. Tujuan penelitian ini adalah mengetahui perbedaan peningkatan intensitas sinyal meningen sekuens T2-FLAIR dengan T1WI pada pasien meningitis tuberkulosis menggunakan pemeriksaan MRI kepala dengan kontras Gadolinium-DTPA di RSUP Dr. Hasan Sadikin Bandung pada bulan Januari 2015–Juni 2016. Subjek penelitian sebanyak 21 orang dengan meningitis TB dilakukan pemeriksaan MRI kepala dengan kontras Gadolinium-DTPA. Analisis statistik komparatif dilakukan untuk menguji perbedaan peningkatan intensitas sinyal meningen sekuens T2-FLAIR post contrast dengan T1WI post contrast. Hasil penelitian menujukkan rerata peningkatan intensitas sinyal meningen sekuen T2-FLAIR (∆T2-FLAIR) sebesar 360,59±182,19 aμ sedangkan T1WI (∆T1WI) sebesar 126,47±72,57 aμ. Hasil uji statistik menggunakan uji T pada derajat kepercayaan 95% menunjukkan perbedaan yang bermakna ∆T2-FLAIR dengan ∆T1WI pada nilai p=0,000. Sebagai simpulan didapatkan peningkatan intensitas sinyal meningen sekuens T2-FLAIR post contrast lebih besar daripada T1WI post contrast pada kasus meningitis TB.  [MKB. 2017;49(3):172–78]Kata kunci: Meningitis tuberkulosis, MRI sekuens T1WI dan T2-FLAIR, penyangatan meningealDifference between Gadolinium-DTPA Enhanced T2 FLAIR Sequence and T1WI Sequence MRI in Detecting Meningeal Enhancement in Tuberculous MeningitisThe diagnosis of TB meningitis, especially in possible and probable cases, is difficult. Contrast-enhanced MRI of the head with Gadolinium-DTPA is the most sensitive imaging modality that supports diagnosis of this disease. The most common presentation of TB meningitis in MRI is basal meningeal enhancement. The objective of this study was to determine the difference in the increase of T2-FLAIR and T1WI sequence meningeal signal intensity of in patients with tuberculous meningitis using contrast-enhanced MRI of the head with Gadolinium-DTPA in Dr. Hasan Sadikin General Hospital from January 2015–June 2016. Contrast enhanced MRI examination was conducted in 21 subjects with TB meningitis. Statistical analysis was performed to examine the difference in the increase in meningeal signal intensity of post contrast T2-FLAIR and post contrast T1WI. The result showed that the mean increases in meningeal signal intensity of T2-FLAIR (ΔT2-FLAIR) and T1WI (ΔT1WI) were  360.59±182.19 au and 126.47±72.57 aμ respectively. Statistical test results using T test at 95% confidence level indicated that there was a difference between ΔT2-FLAIR and ΔT1WI at p-value=0.000. In conclusion, the mean increase in meningeal signal intensity of post contrast T2-FLAIR is greater than in the post contrast T1WI in TB meningitis. [MKB. 2017;49(3):172–78]Key words: Meningeal enhancement, T1WI and T2-FLAIR sequence MRI, tuberculous meningitis
Probiotik Indigenus Meningkatkan Profil Kesehatan Usus Halus Tikus yang Diinfeksi Enteropathogenic E. coli Wresdiyati, Tutik; Laila, Sri Rahmatul; Setiorini, Yeni; Arief, Irma Isnafia; Astawan, Made
Majalah Kedokteran Bandung Vol 45, No 2 (2013)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Telah dilaporkan bahwa probiotik dapat memelihara keseimbangan mikroflora usus dan meningkatkan sistem imun usus. Penelitian ini bertujuan untuk menganalisis pengaruh pemberian probiotik indigenous Lactobacillus fermentum dan Lactobacillus plantarum pada profil kesehatan usus halus tikus yang diinfeksi Enteropathogenic E. coli (EPEC). Penelitian ini dilaksanakan pada bulan Agustus–November 2011 di Institut Pertanian Bogor. Sebanyak 90 ekor tikus jantan galur Sprague Dawley telah digunakan dan dibagi menjadi enam kelompok perlakuan, yaitu kelompok kontrol negatif (A), perlakuan Lactobacillus plantarum (B), perlakuan Lactobacillus fermentum (C), perlakuan Lactobacillus plantarum dan EPEC (D), perlakuan Lactobacillus fermentum dan EPEC (E), dan perlakuan EPEC (F). Perlakuan dilaksanakan selama 21 hari. Setelah tikus dikorbankan, usus halus diproses menggunakan metode embedding standar dengan parafin dan diwarnai memakai hematoksilin eosin. Data hasil penelitian dianalisis secara statistik dengan rancangan acak lengkap analysis of variance (ANOVA). Hasil penelitian menunjukkan bahwa perlakuan L. fermentum dan L. plantarum dapat menurunkan persentase kerusakan vili usus halus 14–62% dan meningkatkan tebal mukosa usus halus 14–29%. Simpulan, perlakuan probiotik indigenous L. fermentum dan L. plantarum dapat meningkatkan kesehatan usus halus. L. fermentum lebih baik dalam menghambat kerusakan usus halus tikus yang diinfeksi EPEC. [MKB. 2013;45(2):78–85]Kata kunci: Enteropathogenic E. coli (EPEC), probiotik, usus halus Indigenous Probiotic Increased the Health Profile of Small Intestine in Enteropathogenic E. coli Infected RatsIt was reported that probiotics could maintain the balance of intestinal microfloral and increase intestinal immune system. The objective of this study was to analyze the influence of indigenous probiotic Lactobacillus fermentum and Lactobacillus plantarum on the morphological profile of small intestine of Enteropathogenic E. coli (EPEC)- infected rats. This study was done from August to November 2011 at Bogor Agricultural University. A total of 90 male rats Sprague Dawley were used in this study. They were devided into 6 groups; negative control (A), Lactobacillus plantarum treated (B), Lactobacillus fermentum treated (C), Lactobacillus plantarum and EPEC treated (D), Lactobacillus fermentum and EPEC treated (E), and EPEC infected group (F). The treatments were done for 21 days. Small intestine tissues were processed using paraffin embedding standard method and stained with haematoxylin eosin. The data were analyzed using analysis of variance (ANOVA). The results showed that L. fermentum and L. plantarum treatments decreased percentage of small intenstine villi damage (14 to 62%) and increased the thickness of small intestine mucosa (14 to 29%). In conclusions, treatment of indigenous probiotic L. fermentum and L. plantarum increase the health of small intestine. L. fermentum give better effect in inhibiting the damage of small intestine of rats, which under EPEC infection. [MKB. 2013;45(2):78–85]Key words: Enteropathogenic E. coli (EPEC), probiotic, small intestine DOI: http://dx.doi.org/10.15395/mkb.v45n2.110
Protektivitas, Reaksi Lokal dan Sistemik Pascaimunisasi dengan Vaksin Campak (Bio Farma) dari Bets Vaksin yang Berbeda pada Anak Sekolah Dasar di Sumatera Barat Sundoro, Julitasari; Bachtiar, Novilia Sjafri; Syafriyal, Syafriyal; Sari, Rini Mulia
Majalah Kedokteran Bandung Vol 47, No 3 (2015)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Post Marketing Surveillance perlu dilakukan secara berkala untuk memastikan produk yang telah dipasarkan tetap dalam kualitas yang baik. Tujuan penelitian ini adalah mengetahui protektivitas, serta reaksi sistemik dan lokal setelah memperoleh dosis boster vaksin campak dari bets vaksin yang berbeda yang diproduksi pada fasilitas yang berbeda. Penelitian ini menggunakan desain kohort pada anak sekolah dasar di Sumatera Barat. Subjek di Kabupaten Agam  mendapatkan vaksin dengan nomor bets 250210, sedangkan subjek di Kabupaten Limapuluh Kota  vaksin campak bets 253080. Darah diambil sebelum dan 28 hari setelah imunisasi. Pengukuran antibodi menggunakan metode uji netralisasi dengan batas proteksi > 200 mIU/mL. Reaksi lokal dan sistemik dicatat pada kartu harian hingga 28 hari setelah imunisasi. Pengamatan berlangsung dari November 2010 hingga Maret 2011 melibatkan 170 anak di Kabupaten Agam dan 166 anak di Kabupaten Limapuluh Kota. Sebanyak 1,18–1.2% anak mengalami demam pada 3 hari pertama setelah imunisasi dan 1 (0,6%) timbul  pada 14 hari setelah imunisasi dengan instensitas  ringan. Reaksi lokal terbanyak adalah kemerahan pada tempat suntikan (14,46%). Tidak ditemukan kejadian pascaimunisasi serius. Sejumlah 96,99% dan 96,77% anak mempunyai antibodi campak protektif 28 hari pascaimunisasi imunisasi di Kabupaten Agam dan Limapuluh Kota dengan kenaikan GMT dari 329,66 IU/mL menjadi 983,43 IU/mL dan dari 198,00 menjadi 535,10 IU/mL (p=0,000) di Kabupaten Agam dan Limapuluh Kota. Simpulannya adalah kedua bets vaksin campak menunjukkan keamanan dan respons imun yang baik. [MKB. 2015;47(3):144–51]Kata kunci: Campak, Post Marketing Surveillance (PMS), reaksi lokal, reaksi sistemik, vaksinProtectiveness, Local Reaction, and Systemic Reaction after Measles Immunization using Different Batches of Bio Farma Vaccine in Elementary School Students in West Sumatra AbstractPost Marketing Surveillance should be conducted periodically to monitor whether the quality of marketed products is still favorable. The objectives of this study were to evaluate the protectiveness, local reaction, and systemic reaction after receiving booster dose of measles vaccine from different batch numbers. This study was a cohort study on elementary students in West Sumatra. Subjects from Agam District received measles vaccine with  a batch number of 250210 while subjects from Limapuluh Kota District received measles vaccine with a batch number of 253080. Blood samples were collected before and 28 days after immunization. Antibody titers were measured using neutralization assay with a protective level of >200 mIU/mL. Local and systemic reactions were recorded within 28 days after immunization. The observation was held from November 2010 to March 2011 and involved 336 students: 170 students from Agam District and 166 students from Limapuluh Kota District. There were 1.2% students who experienced fever in the first three days after immunization, and 1(0.6%) student experienced mild fever 14 days after immunization. The most common local reaction was redness in the injection site, contributing approximately 14.48%. There were no serious adverse events after immunization. About 96.99% and 96.77% students were protected against measles 28 days after immunization in Agam and Limapuluh Kota Districts with an increase in GMT from 329.66 IU/mL to 983.43 IU/mL and from 198.00 IU/mL to 535.10 IU/mL (p=0.000). In conclusion, both measles vaccine batches show good safety and immune response. [MKB. 2015;47(3):144–51]Key words: Local reaction, measles, Post Marketing Surveillance (PMS), systemic reaction, vaccine DOI: 10.15395/mkb.v47n3.595

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