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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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Articles 651 Documents
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erbandingan Positivitas Metode MODS, Pewarnaan ZN, dan GeneXpert untuk Mendeteksi M. tuberculosis pada Pasien Meningitis TB Paramitha, Niken Ayu; Sribudiani, Yunia; Rizal, Ahmad
Majalah Kedokteran Bandung Vol 50, No 4 (2018)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (458.693 KB) | DOI: 10.15395/mkb.v50n4.1267

Abstract

Salah satu permasalahan dalam diagnosis meningitis tuberkulosis (TB) adalah rendahnya positivitas metode yang digunakan. Berbagai metode telah dikembangkan, mulai dari metode kultur MODS (microscopic observation drug susceptibility), pewarnaan Ziehl-Neelsen (ZN), hingga GeneXpert. Penelitian ini dilakukan untuk menentukan metode diagnostik terbaik mendeteksi M. tuberculosis berdasar atas nilai positivitasnya. Penelitian ini merupakan observasional analitik dengan rancangan potong lintang. Data berasal dari penelitian kohort dan ReDEFINe meningitis TB di Rumah Sakit Umum Pusat Dr. Hasan Sadikin Bandung. Data diambil dari case report form pasien dengan diagnosis meningitis TB pada periode Juli 2014–Juni 2016. Kriteria inklusi penelitian ini adalah usia ≥18 tahun dan memiliki hasil pemeriksaan MODS, pewarnaan ZN, dan GeneXpert. Analisis data menggunakan Uji Cochran’s Q dan uji lanjut dengan Uji McNemar. Sebanyak 135 subjek penelitian memenuhi kriteria inklusi dan didapatkan positivitas deteksi M. tuberculosis menggunakan MODS, pewarnaan ZN, dan GeneXpert berturut-turut adalah 46,7%; 20,0%; dan 37,8%. Nilai positivitas antara ketiga metode tersebut secara statistik berbeda bermakna dengan nilai p<0,05. Sensitivitas dan spesifisitas GeneXpert dibanding dengan MODS berturut-turut mencapai 68,3% dan 88,9%, sedangkan sensitivitas pewarnaan ZN sebesar 34,9% dan spesifisitas 93.1%. Berdasar atas nilai positivitas dan sensitivitas, hasil penelitian ini menunjukkan bahwa metode MODS masih merupakan metode diagnostik terbaik untuk meningitis TB.  Kata kunci: Diagnosis, GeneXpert, meningitis tuberkulosis, MODS, pewarnaan Ziehl- Neelsen  Comparison of Positivity Rate of MODS, Ziehl-Neelsen Staining, and GeneXpert Methods in M. tuberculosis Detection among Tuberculous Meningitis PatientsOne of the problems in the diagnosis of tuberculous meningitis (TBM) is the low positivity rate of the diagnostic methods. Various methods have been developed, starting from culture MODS (microscopic observation drug susceptibility) to Ziehl-Neelsen (ZN) staining and to GeneXpert. This study was conducted to determine the best diagnostic method to detect M. tuberculosis based on its positivity rate. This cross-sectional analytic observational study was conducted on TBM cohort of the ReDEFINe study in Dr. Hasan Sadikin General Hospital. Data were collected from the case reports of TBM inpatients during the period of  July 2014–June 2016. Patients ≥18 years who had complete result from MODS, ZN staining, and GeneXpert were included. Data were analyzed using Cochran’s Q test and post-hoc analysis using McNemar test. In total, 135 subjects were included in this study. The positivity rates of M. tuberculosis  detection using MODS, ZN staining, and GeneXpert were 46.7%, 20.0%, and 37.8%, respectively. The positivity rate differences among the three diagnostic methods were statistically significant with a p-value of <0.05. The sensitivity and specificity of GeneXpert compared to those of MODS were 68.3% and 88.9%,respectively. Meanwhile the sensitivity and specificity of ZN staining were 34.9% and 93.1%, respectively. Based on the positivity rate and sensitivity, the results of this study indicates that the MODS method is still the best diagnostic method for TB meningitis.Key words: Diagnosis, GeneXpert, MODS, tuberculous meningitis, ziehl-neelsen Staining 
Ketebalan Tunika Intima dan Media Arteri Karotis Komunis pada Karsinoma Nasofaring Pra dan Pascaradioterapi Sofyan, Ferryan; Samiadi, Dindy; Soeseno, Bogi; Boesoirie, M. Thaufiq; Lasminingrum, Lina
Majalah Kedokteran Bandung Vol 44, No 3 (2012)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Radioterapi eksternal merupakan pengobatan utama karsinoma nasofaring. Radioterapi  eksternal menyebabkan disfungsi endotel arteri karotis komunis yang menurunkan produksi nitrogen oksida dan prostasiklin di sel endotel sehingga terjadi penebalan dinding pembuluh darah. Tujuan penelitian ini untuk mengetahui perubahan ketebalan intima media dan diameter lumen arteri karotis komunis akibat radioterapi eksternal  pada penderita karsinoma nasofaring. Tipe penelitian adalah  studi deskriptif dengan rancangan pre-post design. Penelitian dilakukan di Departemen Telinga Hidung Tenggorok-Bedah Kepala Leher-Rumah Sakit Dr. Hasan Sadikin Bandung mulai Maret 2009–Februari 2010. Pada penelitian ini dilakukan pemeriksaan  ultrasonografi  gray scale praradioterapi, pascaradioterapi, dan 10 minggu pascaradioterapi.  Hasil penelitian ini menggunakan uji Fischer dan T berpasangan. Terdapat 25 subjek karsinoma nasofaring dan hasil penelitian ditemukan peningkatan ketebalan intima media sebesar 0,1 mm di intima media arteri karotis komunis kanan dan 0,09 mm di intima media arteri karotis komunis kiri (p<0,001), juga ditemukan pengurangan diameter lumen arteri karotis komunis kanan sebesar 0,384 mm dan 0,342 mm di arteri karotis komunis kiri (p<0,001).  Simpulan, radioterapi eksternal menunjukkan ketebalan intima media dan pengurangan diameter lumen arteri karotis komunis pada penderita karsinoma nasofaring. [MKB. 2012;44(3):179–85].Kata kunci: Diameter lumen, karsinoma nasofaring, ketebalan intima media, radioterapi eksternal                     Intima and Media Tunica Thickness of Common Carotid Artery in Nasopharyngeal Carcinoma Pre and Post External RadiotherapyExternal radiotherapy is the main treatment for nasopharyngeal carcinoma. External radiotherapy  can cause endothelial dysfunction of common carotid artery and reduces nitrogen oxide and prostacyclin by endothelial cell and cause thickening of the vessels walls. Purpose of this study was to find out changes in intima-media thickness and lumen diameter of common carotid artery due to radiotherapy in patients with nasopharyngeal carcinoma. This research was descriptive with pre and post design and performed from March 2009 to February 2010 in the Ear Nose Throat-Head Neck Surgery Department of Dr. Hasan Sadikin Hospital Bandung. Gray scale ultrasound examination was performed before, after and ten weeks after radiotherapy and calculated by using Fischer’s test and paired T test.  They were 25 subjects and was found out 0.1 mm additional thickness in right intima media and 0.09 mm in left intima media common carotid artery (p<0.001), also found reduction in lumen diameter of common carotid artery in which 0.384 mm in the right and 0.342 mm in the left (p<0.001). In conclusions, external radiotherapy can cause increase intima media thickness  and reduction lumen  diameter  in common  carotid artery  in patients with nasopharyngeal carcinoma. [MKB. 2012;44(3):179–85].Key words: External beam irradiation, intima media thickness, lumen diameter, nasopharyngeal carcinoma DOI: http://dx.doi.org/10.15395/mkb.v44n3.206
Serum Otologus dan human Epidermal Growth Factor (hEGF) Mempercepat Proliferasi dan Migrasi Keratinosit pada Proses Re-Epitelisasi Sari Agung, Syennie; Maksum, Iman Permana; Subroto, Toto
Majalah Kedokteran Bandung Vol 48, No 4 (2016)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (448.611 KB) | DOI: 10.15395/mkb.v48n4.911

Abstract

Penggunaan serum otologus merupakan pendekatan terapeutik yang direkomendasikan untuk mengobati beberapa jenis penyakit yang bersifat kronis, menahun bahkan dapat bertahan seumur hidup. Serum otologus mengandung epidermal growth factor (EGF) yang dapat menstimulasi proses migrasi dan proliferasi keratinosit pada proses re-epitelisasi dalam penyembuhan luka. Penambahan hEGF pada serum otologus dilakukan sebagai upaya untuk mempercepat proses penyembuhan luka. Pengujian aktivitas dilakukan dengan mengukur proliferasi dan migrasi sel keratinosit menggunakan cell line HaCaT. Proliferasi sel diukur dengan metode Water Soluble Tetrazolium-8 (WST-8) dan migrasi sel diukur dengan metode Scratch Assay. Variasi konsentrasi hEGF yang ditambahkan adalah 0,5; 1; 5; 10; 25 dan 50 ng/mL. Terdapat perbedaan yang bermakna pada hasil proliferasi sel HaCaT yang ditambahkan hEGF dan konsentrasi optimal pada penambahan hEGF 25 ng/mL (p<0,05), sedangkan penambahan variasi konsentrasi hEGF pada serum otologus tidak menunjukkan perbedaan yang bermakna terhadap proliferasi sel HaCaT (p>0,05). Penambahan hEGF pada serum otologus terlihat peranannya dalam mempercepat laju migrasi sel. Dalam waktu 18 jam, persentasi migrasi sel HaCaT yang diberikan hEGF dan serum otologus adalah 55–70% kemudian menjadi 65–80% dalam waktu 24 jam, sedangkan yang diberikan hEGF saja 25–45% dan dalam waktu 24 jam meningkat menjadi 35-70%. [MKB. 2016;48(4):205–10]Kata kunci: hEGF, proliferasi dan migrasi, re-epitelisasi, serum otologusAutologous Serum and human Epidermal Growth Factor (hEGF) Accelerate Keratinocyte Proliferation and Migration during Re-epithelialization ProcessAbstractAutologous serum is used as a therapeutic approach recommended to treat certain types of chronic diseases that can even last a lifetime. Autologous serum contains Epidermal Growth Factor (EGF), which can stimulate the migration and proliferation of keratinocytes in the re-epithelialization process in wound healing. The addition of hEGF on autologous serum is a part of efforts to accelerate the wound healing process. Tests were performed by measuring proliferation and migration activities of keratinocytes cells using HaCaT cell line. The cell proliferation was measured using Water Soluble Tetrazolium-8 (WST-8) method while the cell migration was measured using Scratch Assay method. Variations in the concentration of hEGF added were 0.5, 1, 5, 10, 25, and 50 ng / mL. There were significant differences in the results of cell proliferation in hEGF-added HaCaTcells and the optimum concentration was seen in 25 ng/mL hEGF group (p <0.05). On the contrary, the addition of various concentrations of hEGF in autologous serum resulted in no significant difference in HaCaT cell proliferation (p>0 , 05). The addition of hEGF and autologous serum showed a visible role in accelerating the pace of cell migration. Within 18 hours, the percentage of cell migration in HaCaT cells added by hEGF and autologous serum reaches 55-70% and then 65-80% within 24 hours while HaCaT cells that receive hEGF only only reaches 25-45% cell migration which increases to 35-70% within 24 hours. [MKB. 2016;48(4):205–10]Key words: Autologous serum, hEGF, proliferation and migration, re-epithelialization
Hubungan Imunoekspresi NF-kB dengan Sinus Rokitansky Aschoff pada Kolesistitis Kronik Yulianti, Herry; Hernowo, Bethy S.
Majalah Kedokteran Bandung Vol 46, No 2 (2014)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Karsinoma kandung empedu relatif jarang, tetapi merupakan penyakit yang sangat mematikan. Keganasan kandung empedu merupakan 3−4% dari seluruh lesi ganas dan menempati urutan ke-5 di antara tumor sistem pencernaan. Karsinoma kandung empedu sulit dideteksi dan didiagnosis pada stadium awal, karena biasanya gejalanya sangat sedikit atau tanpa gejala. Oleh karena itu sangat penting menegakkan diagnosis secara dini dan mendeteksi pasien risiko tinggi, termasuk batu dan riwayat kolesistitis kronik. Kolesistitis kronik merupakan peradangan kronik pada kandung empedu dan disertai kolelitiasis pada lebih dari 90% kasus. Batu empedu merupakan faktor etiologi yang penting pada karsinoma kandung empedu. Pada gambaran histopatologi kolesistitis kronik ditemukan sinus Rokitansky Aschoff. Pendekatan genetik telah membuktikan komponen inflamasi berperan dalam karsinogenesis, seperti primary inflammatory cytokines, interleukin-1 (IL-1), tumor necrosis factor (TNF), IL-6, dan nuclear factor-kappaB (NF-kB). Tujuan penelitian ini untuk mengetahui hubungan imunoekspresi NF-kB dengan sinus Rokitansky Aschoff pada kolesistitis kronik. Metode penelitian adalah potong lintang terhadap 30 kasus kolesistitis kronik yang berasal dari Departemen Patologi Anatomi Rumah Sakit Dr. Hasan Sadikin Bandung/Fakultas Kedokteran Universitas Padjadjaran tahun 2010−2011. Potongan blok parafin dari jaringan kolesistitis kronik setebal 4 µm diwarnai dengan hematoksilin eosin untuk evaluasi gambaran histopatologi dan pemeriksaan imunohistokimia menggunakan polyclonal NF-kB antibody. Perhitungan sel yang imunoreaktif dilakukan di bawah mikroskop cahaya dengan pembesaran 400x, dihitung rata-rata pada 5 tempat. Hasil penelitian menunjukkan hubungan yang signifikan antara imunoekspresi NFkB dan sinus Rokitansky Aschoff (p=0,000). Simpulan, terdapat hubungan imunoekspresi NFkB dengan sinus Rokitanski Aschoff, semakin tinggi imunoekspresi NFkB semakin banyak sinus Rokitansky Aschoff. [MKB. 2014;46(2):106–11]Kata kunci: Kolesistitis kronik, NFkB, sinus Rokitansky AschoffCorrelation between Immunoexpression of NF-kB and Rokitansky Aschoff Sinuses in Chronic CholecystitisCarcinoma of the gallbladder is relatively uncommon but it is a very lethal disease. Gallbladder cancer constitutes 3−4% of all malignant lesions and ranks 5th among the digestive system tumors. Gallblader carcinoma is difficult to detect and diagnose in early stage because it usually has very slight symptoms or asymptomatic. It becomes increasingly necessary to make early diagnosis and identification of high-risk patient,as well as gallstone and history of chronic cholecystitis. Chronic cholecystitis is a chronic inflammation of gallbladder associated with cholelithiasis in more than 90% of cases. Cholelithiasis is one of the important etiological factors in carcinoma of the gallbladder. The histological examination of chronical cholecystitis shows the presence of Rokitansky Aschoff sinuses. Genetic approaches have proven that the components of inflammation such as primary inflammatory cytokines, interleukin-1 (IL-1), tumor necrosis factor (TNF), IL-6 and nuclear factor-kB (NF-kB) play the key roles in carcinogenesis. The purpose of this study was to understand the correlation between the immunoexpression of NF-kB and Rokitansky Aschoff sinuses in chronic cholecystitis. The method was cross sectional of 30 cases of chronic cholecystitis from Department of Pathology Anatomy of Dr. Hasan Sadikin General Hospital Bandung/Faculty of Medicine Universitas Padjadjaran in 2010−2011. A section from 4 µm-thick paraffin embedded tissue of chronic cholecystitis was stained with hematoxylin eosin for histopatological evaluation and immunohistochemical using polyclonal NF-kB antibody. Immunoreactive cells was counted in five tumor areas of 400x field by light microscopy. The result showed a significant correlation between the immunoexpression of NFkB and Rokitansky Aschoff sinuses (p=0.000). In conclusion, there is a correlation between immunoexpression of NFkB and Rokitansky Aschoff sinuses because as the immunoexpression of NFkB increase, more Rokitansky Aschoff sinuses will be formed. [MKB. 2014;46(2):106–11]Key words: Chronic cholecystitis, NFkB, Rokitansky Aschoff sinuses DOI:  10.15395/mkb.v46n2.282
Pengaruh Puguntano terhadap HOMA-IR Pada Pasien Diabetes Melitus yang Baru Didiagnosis Siahaan, Billy Stinggo; Lindarto, Dharma
Majalah Kedokteran Bandung Vol 49, No 2 (2017)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (254.352 KB) | DOI: 10.15395/mkb.v49n2.1051

Abstract

Resistensi insulin sangat penting pada diabetes melitus sebagai prediktor yang kuat terhadap perkembangan diabetes melitus dan target terapi saat hiperglikemia sudah terjadi. HOMA-IR merupakan suatu metode yang telah tervalidasi dalam menilai resistensi insulin pada pasien diabetes melitus. Puguntano suatu tanaman budidaya yang terdapat di Sumatra Utara diketahui memiliki efek antidiabetes. Sampel diambil dari tahun 2015-2016 di Rumah Sakit Haji Adam Malik Medan. Studi ini mencoba menilai pengaruh puguntano sebagai tanaman budidaya di Sumatera Utara terhadap resistensi insulin pada pasien Diabetes Melitus tipe 2. Untuk mengetahui pengaruh pemberian serbuk puguntano terhadap HOMA-IR pada pasien DM tipe 2 yang baru didiagnosis. Dilakukan uji klinis terbuka dengan desain paralel selama 12 minggu pada 24 pasien (12 pasien dan 12 kontrol) Diabetes Mellitus tipe 2 yang baru terdiagnosa  yang dibagi dalam 2 grup masing-masing diberikan puguntano dan metformin selama 12 minggu. HOMA-IR dan HbA1c diperiksa pada awal dan akhir pengobatan (minggu ke 12). Didapatkan penurunan HOMA-IR rata-rata pada grup puguntano 1,71 (±2,29) (p=0,034). Tidak didapatkan perbedaan penurunan HOMA-IR rata-rata antara kedua grup puguntano vs metformin 1.71 (±2,29) vs 0,80 (±1,47) (p=0,402). Didapatkan penurunan nilai HOMA-IR dengan pemberian puguntano pada penderita Diabetes Mellitus tipe 2 yang baru didiagnosis. Simpulan, efek puguntano dalam mengontrol gula darah terutama dalam perannya memperbaiki sensitifitas insulin tidak jauh berbeda dengan metformin yang telah menjadi obat standar dalam pengobatan lini pertama diabetes melitus tipe 2. [MKB. 2017;49(2):67–72] Kata kunci: Diabetes melitus, HOMA-IR, puguntano  Effect of Puguntano on HOMA-IR in Newly Diagnosed Type 2 Diabetes Mellitus Insulin resistance is important not only as a powerful predictor of future development of type 2 diabetes mellitus but also as a therapeutic target once hyperglycemia is present. HOMA-IR is a method for assessing insulin resistance that has been validated worldwide. Puguntano is one of the traditional plants found in North Sumatera that has been recognized for its anti-diabetic effect. Samples were taken from 2015–2016 at H. Adam Malik General Hospital Medan. This study tried to assess the effect of puguntano as a traditional plant in North Sumatera on insulin resistance in type 2 diabetes melitus patients and aimed to determine the effect of puguntano treatment on HOMA-IR in newly diagnosed type 2 diabetes mellitus patients. This was a randomized open clinical trial on 24 newly diagnosed type 2 diabetes mellitus patients (12 patients and 12 controls) divided into 2 groups who were assigned to receive  puguntano or Metformin for 12 weeks. HOMA-IR and Hba1c were determined at baseline and at the end of 12 weeks. In puguntano group, the mean decrease of HOMA-IR was 1.71 (± 2.29) (p=0.034). There was no difference in terms of the mean decrease of HOMA-IR between the puguntano and Metformin group, which was 1.71 (±2.29) vs 0.80 (±1.47) (p=0.402). There was a decrease mean of HOMA-IR level with puguntano treatment in newly diagnosed type 2 diabetes mellitus patients which was statistically significant. In conclusions, the effect of puguntano in controlling blood sugar especially in its role of improving insulin sensitivity is not much different from metformin which has become a standard drug in the first-line treatment of type 2 diabetes mellitus. [MKB. 2017;49(2):67–72] Key words: Diabetes mellitus, HOMA-IR, puguntano
IDENTIFIKASI STAPHYLOCOCCAL CASSETTE CHROMOSOME MEC METHICILLIN RESISTANT STAPHYLOCOCCUS AUREUS DENGAN POLYMERASE CHAIN REACTION Yuwono, -; SA, Sunarjati; Masria, Sadeli; Supardi, Imam
Majalah Kedokteran Bandung Vol 43, No 2
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Methicillin resistant Staphylococcus aureus (MRSA) merupakan salah satu galur multiresisten yang menjadi masalah kesehatan global sejak 50 tahun terakhir. Secara genetik, resistensi MRSA didasari adanya insersi mecDNA atau Staphylococcal cassette chromosome mec (SCCmec) pada kromosom S. aureus. Sejauh ini telah diidentifikasi 5 tipe SCCmec, yaitu SCCmec tipe I?V yang berasal dari isolat di seluruh dunia. Akhir-akhir ini ditemukan perubahan pola penyebaran, pola kepekaan terhadap antimikrob, dan perubahan kandungan SCCmec. Oleh karena itu identifikasi SCCmec menjadi demikian penting untuk mengetahui adanya perubahan tersebut. Tujuan penelitian ini adalah untuk mengidentifikasi tipe SCCmec dari isolat MRSA yang diperoleh di rumah sakit. Penelitian dilakukan di Laboratorium Mikrobiologi Klinik RSUP Moh. Hoesin Palembang dalam rentang waktu Oktober 2008?Maret 2009. Metode yang digunakan untuk mengidentifikasi SCCmec tersebut adalah metode polymerase chain reaction (PCR) multipleks. Hasil penelitian menunjukkan bahwa 33 isolat (83%) memiliki SCCmec tipe III dan 7 isolat (17%) memiliki SCCmec tipe IV. Hasil ini berbeda dengan penelitian sebelumnya yang menemukan 100% MRSA di Indonesia memiliki SCCmec tipe III. Kesimpulan dari penelitian ini adalah teridentifikasi adanya perubahan kandungan SCCmec pada isolat MRSA yang berasal dari rumah sakit. [MKB. 2011;43(2):60?5].Kata kunci: Methicillin resistant Staphylococcus aureus, polymerase chain reaction, SCCmecIdentification of Staphylococcal Cassette Chromosome of Mec  Methicillin Resistant Staphylococcus aureus Using Polymerase Chain ReactionMethicillin resistant Staphylococcus aureus (MRSA) is one of the multiresistant strains that trigger global health problem during the last 50 years. Resistance of MRSA is based on the insertion mobile genetic element mecDNA or Staphylococcal cassette chromosome mec (SCCmec) into chromosome of S. aureus. Researchers had isolated five types of SCCmec-type i.e. I?V. In the last ten years, alterations in the spreading pattern, susceptibility pattern, and content of SCCmec have been found . Identification of SCCmec is important to elucidate these alterations. The aim of this research was to identify the type of SCCmec from hospital isolates of MRSA. The research was performed in Moh. Hoesin General Hospital (RSUP MH) Palembang in the period October 2008 to March 2009. Polymerase chain reaction (PCR) multiplex method was used to identify SCCmec. The result showed that 33 isolates (83%) had type III of SCCmec and 7 isolates (17%) had type IV of SCCmec. These results were different from other researcher?s  founding that in Indonesia, all of MRSA have SCCmec.It is concluded that the content of SCCmec from hospital isolates of MRSA has already changed. [MKB. 2011;43(2):60?5].Key words: Methicillin resistant Staphylococcus aureus, polymerase chain reaction, SCCmecDOI: http://dx.doi.org/10.15395/mkb.v43n2.52
Profil Fenotipik Plasmodium falciparum Galur Papua 2300 Akibat Paparan Antimalaria Artemisinin in Vitro Maslachah, Lilik; Dachlan, Yoes Prijatna; Nidom, Chairul A.; Fitri, Loeki Enggar
Majalah Kedokteran Bandung Vol 47, No 1 (2015)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Resistensi parasit P. falciparum dan penurunan efikasi terhadap artemisinin mengakibatkan masalah malaria menjadi semakin  kompleks. Hal ini menjadi salah satu permasalahan kesehatan di dunia  yang belum dapat diselesaikan sampai saat ini karena belum ada obat baru pengganti artemisinin. Penelitian ini untuk membuktikan bahwa paparan obat antimalaria artemisinin berulang in vitro dapat menyebabkan perubahan profil fenotipik P. falciparum galur Papua 2300. Waktu penelitian Februari sampai dengan November 2013. Tempat penelitian di Biomedik Universitas Brawijaya Malang dan Fakultas Kedokteran Hewan Universitas Airlangga. Desain penelitian experimental design dengan post test only control group design. Kultur P. falciparum galur Papua 2300 dipapar artemisinin berulang dengan dosis IC50. Pengamatan dilakukan terhadap viabilitas dan nilai IC50 dengan menggunakan analisis probit. Kelompok kontrol tidak menunjukkan perubahan nilai IC50 juga pada kelompok perlakuan PO1. Nilai IC50 terjadi peningkatan setelah perlakuan PO2. Paparan artemisinin berulang pada PO2, PO3, dan PO4 menyebabkan waktu viabilitas P. falciparum galur Papua 2300 lebih pendek daripada PO1. Viabilitas stabil setelah perlakuan PO3. Simpulan, paparan artemisinin berulang berpengaruh pada perubahan peningkatkan nilai IC50 dan waktu viabilitas P. falciparum galur Papua 2300.  [MKB. 2015;47(1):1–9]Kata kunci: Artemisinin, fenotipik, P. falciparum galur Papua 2300, resistensiPhenotypic Profile of  Plasmodium falciparum Papua 2300 Strain Exposed to in Vitro Antimalarial Artemisinin The presence of the P. falciparum resistance and decreased of efficacy against artemisinin and its derivatives result in increasingly complex malaria issues. Malaria has become one of the currently unresolved world’s health problems due to the lack of  new artemisinin replacement drugs. This study aimed to provide evidence that the repeated exposure of in vitro artemisinin may cause a change in P. falciparum Papua 2300 strain phenotypic. This study was conducted during the period of  February to November 2013 in Biomedics Brawijaya University and the Faculty of Veterinary Medicine, Airlangga University. A post-test control only experimental design was used. In vitro cultures of  P. falciparum Papua 2300 strain were treated by repeated artemisin in IC50 concentration and were observed for their viability and IC50 using probit analysis. The control group did not show any changes after IC50value and PO1 treatment. An increase in IC50 value was occurred after PO2. Repeated exposures of artemisinin in PO2, PO3 and PO4 had shorter viability periods than PO1. The viability of was stable after PO3 in this group. In conclusion, repeated exposures of artemisinin influence changes in  IC50 value and viability period of  P. falciparum Papua 2300 strain. [MKB. 2015;47(1):1–9]Key words: Artemisinin, phenotypic, P. falciparum Papua 2300, resistance DOI: 10.15395/mkb.v47n1.390   
Adaptasi Budaya, Alih Bahasa Indonesia, dan Validasi Sino-Nasal Outcome Test (SNOT)-22 Juanda, Ichsan Juliansyah; Madiadipoera, Teti; Ratunanda, Sinta Sari
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 (115.2 KB) | DOI: 10.15395/mkb.v49n4.1145

Abstract

Kuesioner untuk menilai kualitas hidup saat ini semakin meningkat penggunaannya dalam penelitian klinis hasil intervensi medis, baik operatif maupun medikamentosa. SNOT-22 dianggap sebagai alat ukur yang paling sesuai untuk menilai kualitas hidup pasien rinosinusitis kronik.Tujuan penelitian ini melakukan adaptasi budaya, alih bahasa, dan validasi SNOT-22 ke dalam bahasa Indonesia. Penelitian deskriptif analitik potong lintang pada 50 pasien rinosinusitis kronik di Poliklinik Rinologi Alergi Departemen Ilmu Kesehatan Telinga Hidung dan Tenggorok Bedah Kepala dan Leher (THT-KL) Fakultas Kedokteran Universitas Padjadjaran/Rumah Sakit Dr. Hasan Sadikin Bandung periode November 2015–Februari 2016. Diagnosis berdasar atas anamnesis, tingkat berat penyakit, nasoendoskopi berdasa Lund-Kennedy, dan penilaian kualitas hidup dengan SNOT-22. Validasi kuesioner dalam bahasa Indonesia dilakukan dengan menerjemahkan kuesioner SNOT-22 versi bahasa Inggris ke bahasa Indonesia oleh ahli bahasa Indonesia dan diterjemahkan kembali ke bahasa Inggris oleh ahli bahasa Inggris. Dilakukan uji reabilitas menggunakan Cronbach’s alpha dan uji validitas menggunakan Rank Spearman’s. Uji Cronbach’s alpha =0,936 (sangat andal), andal jika ≥0,7 menunjukkan konsistensi yang baik. Uji Rank Spearman’s: rs=0,961 dan rs=0,978 (valid); dan keandalan (korelasi skor genap dengan skor ganjil) rs=0,900. Simpulan, hasil uji statistik menunjukkan bahwa kuesioner SNOT-22 versi bahasa Indonesia merupakan alat ukur yang valid dengan konsistensi yang baik untuk menilai kualitas hidup pasien dengan rinosinusitis kronik. Kata kunci: Bahasa Indonesia, kualitas hidup, rinosinusitis kronik, SNOT-22, validasiIndonesian Cross-cultural Adaptation,  Translation, and Validation of Sino-Nasal Outcome Test (SNOT)-22Questionnaires for quality of life (QoL) have been increasingly used in clinical trials to evaluate the impact of medical and surgical procedures. Among these, SNOT-22 was considered as the most suitable tool for assessing QoL in chronic rhinosinusitis. The purpose of this study was to conduct cross-cultural adaptation, translation, and validation of the Indonesian version of SNOT-22. This was a descriptive analitical cross-sectional study on 50 patients with chronic rhinosinusitis at the Rhinology-Allergy Clinic of the ORL-HNS Department, Faculty of Medicine Universitas Padjadjaran/Dr. Hasan Sadikin General Hospital Bandung, during the period of November 2015–February 2016. Diagnosis was made based on anamnesis while the severity of the disease was determined using nasoendoscopic findings (Lund-Kennedy). QoL was measured using SNOT-22. The validation process of the Indonesian questionnaire included translation of original SNOT-22 in to Indonesian by independent Indonesian translators, and backtranslation to English by English translators. The reliability of the questionnaire was measured using Cronbach’s alpha and the discriminant validity was assessed using Rank Spearman’s. Results showed a Cronbach’s alpha of 0,936, suggesting good internal consistency while the Rank Spearman’s correlation results suggested that the translation was valid (rs=0.961 and rs=0.978). Correlation for each individual QoL itemwas also reliable (rs=0.900). Therefore, the Indonesian version of the SNOT-22 is a valid instrument with good internal consistency and validity for assessing QoL in patients with CRS.Key words: Indonesian, chronic rhinosinusitis, quality of life, SNOT-2, validation
PERBANDINGAN PENYEMBUHAN LUKA BAKAR DERAJAT DUA ANTARA REBUSAN DAUN SIRIH DAN MOIST EXPOSED BURN OINTMENT Ihsan, -; Hasibuan, Lisa; Lukman, Kiki
Majalah Kedokteran Bandung Vol 44, No 2 (2012)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Penggunaan obat topikal merupakan salah satu faktor utama dalam terapi luka bakar. Moist exposed burn ointment (MEBO) menjadi standar pengobatan luka bakar di Rumah Sakit Dr. Hasan Sadikin Bandung, tidak setiap tempat di Indonesia dapat mempergunakannya. Daun sirih sudah menjadi obat tradisional untuk pengobatan luka, termasuk luka bakar. Penelitian eksperimental membandingkan penggunaan rebusan daun sirih, MEBO, dan NaCl fisiologis (kontrol) dalam penatalaksanaan luka bakar derajat dua. Masing-masing kelompok terdiri atas 10 ekor tikus (Wistar sp.). Penelitian dilakukan selama 14 hari (25 Agustus?8 September 2009) di laboratorium hewan Departemen Farmakologi Fakultas Kedokteran Universitas Padjadjaran. Variabel yang diukur berupa diameter luka, timbulnya pus, cairan serosa, dan eritema pada hari ke-4, 7, dan 14. Pemeriksaan histopatologik dilakukan pada hari ke-14 untuk melihat jumlah fibroblas, kolagen, dan epitel. Berdasarkan variabel diameter (kelompok daun sirih 17,4 mm) lebih kecil bermakna (p<0,001) daripada kelompok lainnya. Timbulnya pus kelompok kontrol bermakna dibandingkan dengan kelompok lainnya (p=0,043). Pemeriksaan patologi anatomi memperlihatkan kelompok kontrol dalam fase inflamasi, kelompok rebusan daun sirih dalam fase proliferasi, dan kelompok MEBO dalam fase remodeling (skor epitelisasi kelompok MEBO 1,9) berbeda bermakna (p<0,001). Simpulan, penggunaan rebusan daun sirih pada luka bakar derajat dua memberikan proses penyembuhan luka yang lebih baik dibandingkan dengan penggunaan NaCl fisiologis, tetapi tidak sebaik penggunaan MEBO. [MKB. 2012;44(2):63?9].Kata kunci: Luka bakar, moist exposed burn ointment, sirihThe Comparison of Second Degree Burn Injury Wound Healing between Boiled Piper Betle Leaves and Moist Exposed Burn OintmentThe use of topical agent is one of the main strategies in management of burn injury. At Dr. Hasan Sadikin Hospital, moist exposed burn ointment (MEBO) is the first line topical agent for treating burn injury, not all places in Indonesia able to use it. Piper betle is one of the traditional agent to treat wound including that caused burn injury. Our experimental study was to compare the second grade burn injury healing process by using Wistar sp. for boiled piper betle leaves, MEBO and as control physiologic sodium chloride for fourteen days (August 25th?September 8th 2009) at Animal Pharmacology Laboratory of Faculty of Medicine Padjadjaran University. The variables which measured were diameter of injury, pus development, evidence of serous and erythematous skin, at 4th, 7th and 14th day of studied. Histopathologic examination was conducted at day 14 to determine the amount of fibroblast, collagen and epithelial. The results according to the measurement of diameter (piper betle leaves group 17.4 mm) was smaller than other groups (p<0.001). In pus development control group was higher than other groups (p=0.043). In pathological findings, the control group was at inflammation phase, while in boiled piper betle leaves group was at proliferation phase and in MEBO group at remodeling phase (with epithel score 1.9 which higher than other groups (p<0.001)). In conclusions, application of boiled piper betle leaves in treating second degree burn injury gives a better result than physiologic sodium chloride, although MEBO is better for second degree burn injury healing process. [MKB. 2012;44(2):63?9].Key words: Moist exposed burn ointment, piper betle, second degree burn injury DOI: http://dx.doi.org/10.15395/mkb.v44n2.81
Hubungan antara Imunoekspresi Ki-67 dan Risiko Agresivitas Tumor pada Gastrointestinal Stromal Tumor Yulianti, Herry; Hernowo, Bethy S.
Majalah Kedokteran Bandung Vol 47, No 4 (2015)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Gastrointestinal stromal tumor (GIST)  merupakan tumor mesenkimal yang paling sering terjadi pada traktus gastrointestinal dan berasal dari intestinal cells of Cajal yang terdapat pada lapisan muskularis traktus gastrointestinal yang berfungsi sebagai pacemaker cell dalam mengatur motilitas intestinal. Diperkirakan insidensi GIST 3−5% dari seluruh soft tissue sarcoma. Gastrointestinal stromal tumor  dapat terjadi sepanjang traktus gastrointestinal, terbanyak pada usia pertengahan dan lebih tua, dengan usia rata-rata 50−60 tahun. Secara histologi, terdapat tiga kategori morfologi GIST, yaitu spindle cell, epitheloid, dan mixed type. Marker spesifik GIST adalah cluster of differentiation (CD117) yang mempunyai sensitivitas baik dan imunoreaktif pada 95% GIST. Ekspresi Ki-67 berhubungan dengan aktivitas proliferasi dan dapat dideteksi pada fase G1, S, G2, dan M dari siklus sel, kecuali pada fase G0. Tujuan  penelitian ini adalah mengetahui hubungan risiko agresivitas dengan aktivitas proliferasi yang diukur dengan Ki-67 pada tumor yang telah dikonfirmasi sebagai GIST dengan CD117. Penelitian ini merupakan penelitian analitik potong lintang terhadap 29 kasus GIST dari Departemen Patologi Anatomi Rumah Sakit Dr. Hasan Sadikin/Fakultas Kedokteran Universitas Padjadjaran, Rumah Sakit Santo Borromeus, Rumah Sakit Immanuel, dan Rumah Sakit Santosa Bandung pada tahun 2007−2012. Potongan blok parafin dari 55 kasus GIST diwarnai dengan hematoksilin eosin untuk evaluasi histologi dan evaluasi imunohistokimia menggunakan monoclonal CD117 antibody untuk konfirmasi diagnosis GIST. Terdapat 29 kasus  positif dengan CD117, kemudian diwarnai dengan monoclonal Ki-67 antibody. Sel yang dikategorikan positif CD117 memperlihatkan partikel coklat di dalam sitoplasma dan imunoekspresi Ki-67 dinilai dengan warna coklat pada inti sel tumor. Hasil penelitian  menunjukkan hubungan bermakna antara risiko agresivitas tumor dan imunoekspresi Ki-67 (p<0,001). Simpulan, semakin tinggi nilai ekspresi Ki-67 semakin tinggi skor risiko agresivitas sehingga pada GIST, pemeriksaan imunohistokimia Ki-67 dapat membantu menentukan apakah pasien akan mempunyai prognosis yang buruk. [MKB. 2015;47(4):231–7]Kata kunci: CD117, gastrointestinal stromal tumor, Ki-67Correlation between Ki-67 Immunoexpression and the Tumor Aggressivity Risk in Gastrointestinal Stromal TumorAbstractGastrointestinal stromal tumor (GIST) is the most common mesenchymal tumor of the gastrointestinal tract, and arises from intestinal cells of Cajal localized in the muscular layer of the digestive tract, which functions as pacemaker cells in regulating intestinal motility. The incidence of GIST is about 3−5% of all soft tissue sarcomas. Gastrointestinal stromal tumor can occur along the gastrointestinal tract and predominantly in middle-aged and older persons, with a median age between 50 and 60 years. Histologically, there are three categories of GIST morphology such as spindle cells, epitheloid, and mixed type. A spesific marker of GIST is cluster of differentiation (CD117), which has good sensitivity and immunoreactive in 95% of GIST. The expression of Ki-67 correlates with proliferative activities and can be detected in G1, S, G2, and M phases of cell cycle but not in G0 phase. The aim of this study was to assessthe correlation between the risk of aggressive behaviors and proliferative activities as measured by Ki-67 in tumors confirmed as GIST by CD117. The method of this study was cross-sectional, performed on 29 cases of GIST from the Department of Pathology Anatomy Dr. Hasan Sadikin General Hospital/Faculty of Medicine Universitas Padjadjaran, Santo Borromeus Hospital, Immanuel Hospital, and Santosa Hospital between 2007−2012. A section from paraffin embedded tissue of 55 cases of GIST was stained with hematoxylin eosin for histological and immunohistochemical evaluations using monoclonal antibody CD117 to confirm the diagnosis of GIST. There were 29 positive cases for CD117. Further staining was performed using monoclonal antibody Ki-67. The categorized positive cells of immunoexpression of CD117 showed brown particles inside cytoplasma and the immunoexpression of Ki-67 was assessed by identification of nuclear brown staining of neoplastic cells. The result showed that there were significant correlations between the risk of tumor aggressive behaviors and immunoexpression of Ki-67 (p<0.001). In conclusion, as the immunoexpression of Ki-67 value increases, the aggressivity risk score becomes higher. Therefore, in GIST, the Ki-67 immunohistochemical analysis may help to decide which patients will have the worst prognosis. [MKB. 2015;47(4):231–7]Key words: CD117, gastrointestinal stromal tumor, Ki-67 DOI: 10.15395/mkb.v47n4.617

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