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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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Efek Pemberian Niasin terhadap Glukosa Darah pada Tikus Wistar dengan Obesitas Hermawan, Robby; Sitorus, Trully D.; Sastramihardja, Herri S.
Majalah Kedokteran Bandung Vol 43, No 1
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Niasin memiliki kontroversi mengenai efeknya terhadap pengaturan glukosa darah. Penelitian bertujuan untuk mengetahui efek niasin terhadap kadar glukosa darah pada tikus Wistar dengan obesitas yang diinduksi diet. Penelitian ini merupakan penelitian eksperimental laboratorik dengan desain paralel yang menggunakan randomisasi di laboratorium Farmakologi Fakultas Kedokteran Unpad periode Juli 2008–Maret 2009. Penelitian dilakukan pada tikus jantan galur Wistar. Pertama, semua subjek penelitian diinduksi menjadi obesitas dengan diet tinggi lemak selama 10 minggu. Tikus yang memenuhi kriteria dibagi dalam dua kelompok secara acak. Kelompok pertama diberikan plasebo. Kelompok kedua diberikan niasin. Niasin dan plasebo diberikan selama 20 hari. Dosis niasin yang diberikan sebesar 0,135 mg/gBB/hari. Glukosa darah puasa (GDP) dan tes toleransi glukosa oral (TTGO) diukur pada hari ke-21. Hasil penelitian menunjukkan bahwa tidak terdapat perbedaan yang bermakna antara kelompok kontrol dan perlakuan baik pada GDP maupun TTGO. GDP kelompok niasin lebih rendah 4,0 mg/dL (IK95% -0,342–8,4) dibandingkan dengan kelompok kontrol, dengan p=0,068, sedangkan hasil TTGO kelompok niasin lebih tinggi 0,8 mg/dL (IK95% -5,6–7,1) dibandingkan dengan kelompok kontrol, dengan p=0,800. Disimpulkan pemberian niasin tidak menyebabkan perbedaan kadar GDP dan TTGO pada tikus jantan galur Wistar dengan obesitas yang diinduksi diet. [MKB. 2011;43(1):16–20].Kata kunci: Glukosa darah puasa, niasin, obesitas, tes toleransi glukosa oralThe Effect of Niacin to the Blood Glucose in Obese Wistar RatsNiacin has many controversies about its effect to the management of the blood glucose. The objective of the research was to know the effect of niacin to the blood glucose in obese wistar rats. This research was an experimental laboratory study with a parallel design using randomization. Male Wistar rats were used in this research. All rats were induced to be obesed with high-fat feeding for 10 weeks. Rats that fulfill the criteria were randomly divided into two groups. The first group was given the placebo. The second group was given the niacin. The niacin and the placebo were given for the next 20 days. The niacin dose was 0.135 mg/g body weight/day. Fasting blood glucose (FBG) and oral glucose tolerance test (OGTT) were taken on the 21st day. The results showed that there were not any significant differences in FBG and OGTT between control and treated group. The FBG of the niacin group was 4.0 mg/dL (95% CI -0.342–8.4) lower than the control group, with p=0.068. The OGTT result of the niacin group was 0.8 mg/dL (95% CI -5.6 –7.1) higher than the control group, with p=0.800. This study concludes that taking niacin does not cause differences in FBG and OGTT results in the male Wistar rats with diet induced obesity. [MKB. 2011;43(1):16–20].Key words: Fasting blood glucose, niacin, obesity, oral glucose tolerance test DOI: http://dx.doi.org/10.15395/mkb.v43n1.39
HUBUNGAN LAJU FILTRASI GLOMERULUS DENGAN STATUS NUTRISI PADA PENDERITA PENYAKIT GINJAL KRONIK PREDIALISIS Pura, Lukman; Supriyadi, Rudi; Nugraha, Gaga Irawan; Bandiara, Ria; Soelaeman, Rachmat
Majalah Kedokteran Bandung Vol 41, No 1
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Malnutrisi banyak terjadi pada penderita penyakit ginjal kronik (PGK). Prevalensi malnutrisi pada penderita predialisis sekitar 44%. Penyebab malnutrisi pada penderita PGK predialisis bersifat multifaktorial. Hubungan laju filtrasi glomerulus (LFG) dengan status nutrisi gabungan menggunakan albumin serum, indeks massa tubuh (IMT) dan subjective global assessment (SGA) masih belum banyak diteliti. Penelitian ini bertujuan mencari hubungan LFG dengan parameter nutrisi gabungan pada subjek PGK predialisis yang berkunjung ke poliklinik ginjal hipertensi RS Hasan Sadikin Bandung dari bulan September sampai Oktober 2008. Data sekunder dan primer dikumpulkan secara konsekutif. Pemeriksaan meliputi penilaian klinis, laboratorium, dan LFG dengan metode in vivo. Analisis statistik menggunakan uji Mann-Whitney untuk melihat hubungan LFG dengan status nutrisi gabungan dengan multiple utility assessment criteria (MUAC). Tujuh puluh dua subjek terdiri dari 48 laki-laki dan 24 perempuan memenuhi kriteria penelitian. Sebanyak 79,2% subjek dengan usia di atas 50 tahun dan 54,2% dengan penyebab sakit hipertensi. Rata-rata LFG 32,62 mL/mnt, albumin serum 4,10 g/dL dan IMT 23,87 kg/m2 . Terdapat 80,6% subjek dengan status gizi buruk dan 19,4% dengan gizi baik. Menggunakan metode MUAC, 70 subjek dengan kategori gizi baik dan 2 subjek dengan gizi buruk. Hubungan LFG terhadap parameter nutrisi ditentukan dengan uji Rank-Spearman dan hasil tidak bermakna terhadap semua variabel nutrisi (p >0,05). Hubungan LFG terhadap parameter nutrisi gabungan memberikan hasil tidak bermakna (p> 0,05). Kesimpulan: terdapat hubungan yang sangat kecil antara LFG terhadap perubahan parameter nutrisi gabungan, dengan jumlah sampel 72 subjek tidak dapat mendeteksi adanya hubungan yang bermakna.Kata kunci: PGK, LFG, albumin serum, IMT, SGATHE CORRELATION BETWEEN GLOMERULAR FILTRATION RATE (GFR) AND NUTRITIONAL STATUS INPEDIALYTIC CHRONIC KIDNEY DISEASE PATIENTSProtein-energy malnutrition (PEM) is common in chronic kidney disease (CKD) patients. The prevalence of malnutrition in predialytic patients was approximately 44%. The causes of malnutrition in CKD patients are multifactorial. The correlation of glomerular filtration rate (GFR) and combined nutritional parameter such as serum albumin, body mass index (BMI) and subjective global assessment (SGA) is more need to study. The study aimed to find the correlation GFR and the combined nutritional parameter in predialytic CKD patients who attended the Nephrology-Hypertension Clinic of Hasan Sadikin Hospital between September and October 2008. The secondary and primary data were collected consecutively. The evaluation consisted of clinical assessment of nutritional status, laboratory values, and GFR by in vivo method. The combined nutritional parameter was classified into two groups using multiple utility assessment criteria (MUAC). Statistical analysis with Mann-Whitney test was used to find the correlation. Seventy two subjects (48 men and 24 women) fulfilled the criteria. The majority (79.2%) were older than 50 years old and 54.2% the causes of CKD were hypertension. The median GFR was 32.62 mL/mnt, serum albumin was 4.10 g/dL, and BMI was 23.87 kg/m2 . There were 80.6% subjects with malnourished status, 19.4% with normal status. Using MUAC assessment, 70 subjects with normal nutritional status and 2 with severe malnutrition.We found no significant correlation between GFR and any nutritional parameter (p>0.05). The correlation of GFR and combined nutritional parameter was not significant (p>0.05). Conclusion: There is minimal correlation of GFR and combined nutritional parameter, with 72 samples size the correlation cannot be detectedsignificantly.Key words: CKD, GFR, serum albumin, BMI, SGA DOI: http://dx.doi.org/10.15395/mkb.v41n1.180
Efek Rimpang Kunyit (Curcuma longa L.) dan Bawang Putih (Allium sativum L.) terhadap Sensitivitas Insulin pada Tikus Galur Wistar Sovia, Evi; Sukandar, Elin Yulinah; Sigit, Joseph I.; N. Sasongko, Lucy Dewi
Majalah Kedokteran Bandung Vol 43, No 4
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Ekstrak kunyit dan bawang putih telah diketahui mempunyai efek antidiabetik, tetapi mekanisme kerjanya belum diketahui. Penelitian ini mengamati efek tiga ekstrak rimpang kunyit (Curcuma longa L.) dan bawang putih (Allium sativum L.), yaitu ekstrak heksan, etil asetat, dan etanol terhadap kadar glukosa darah dengan tes toleransi glukosa. Selanjutnya, ekstrak yang paling efektif dan komponen aktifnya (kurkuminoid dan S-metil sistein) diuji dengan tes toleransi insulin. Empat puluh ekor tikus galur Wistar dibagi menjadi 8 kelompok, yaitu kelompok normal, kelompok yang hanya diberi emulsi tinggi lemak (kontrol), dan sisanya selain diberi emulsi tinggi lemak juga masing-masing diberi ekstrak kunyit dengan dosis 50 mg/kgBB, ekstrak bawang putih dengan dosis 50 mg/kgBB, kurkuminoid dengan dosis 25 mg/kgBB, S-metil sistein dengan dosis 25 mg/kgBB, kombinasi ekstrak kunyitbawang putih dengan dosis masing-masing 25 mg/kgBB, dan kombinasi kurkuminoid-S-metil sistein dengan dosis masing-masing 12,5 mg/kgBB selama 10 hari. Resistensi insulin dievaluasi dengan tes toleransi insulin.Penelitian dilakukan pada bulan Agustus–Oktober 2010 di Sekolah Ilmu dan Teknologi Hayati (SITH) InstitutTeknologi Bandung (ITB). Hasil penelitian ini menunjukkan bahwa KTTI (konstanta tes toleransi insulin) hewankelompok ekstrak bawang putih (7,2±0,84), kurkuminoid (7,14±0,74), dan kombinasi kurkuminoid-S-metil sistein(7,46±0,64) secara bermakna (p<0,05) lebih besar dibandingkan dengan kelompok kontrol positif (3,2±1,92).Simpulan, ekstrak bawang putih, kurkuminoid, dan kombinasi kurkuminoid-S-metil sistein meningkatkan sensitivitas insulin. [MKB. 2011;43(4):153–9].Kata kunci: Ekstrak bawang putih, ekstrak kunyit, tes sensitivitas insulin Effect of Turmeric Extract (Curcuma longa L.) and Garlic Extract (Allium sativum L.) on Insulin SensitivityStudies have shown the antidiabetic effect of turmeric and garlic. However their mechanism of action remain unknown. In this study, we investigated the effect of three turmeric (Curcuma longa L.) and garlic extracts (Allium sativum L.), that are, hexane, ethyl acetate and ethanol extract on blood glucose levels with glucose tolerance test. Furthermore the most effective extracts and its active compound (curcuminoid and S-methyl cysteine) tested with insulin tolerance test. Forty Wistar rats were divided into 8 groups that was normal group, group that treated with a high fat emulsion (control group) and remaining groups were treated with a high fat emulsion and turmeric extract 50 mg/kgBW, garlic extract 50 mg/kgBW, curcuminoid 25 mg/kgBW, S-methyl cysteine 25 mg/kgBW, turmeric-garlic extract combination each 25 mg/kgBW and curcuminoid-S-methyl cysteine combination each 12,5 mg/kgBW for 10 days. Insulin resistance was evaluated by insulin tolerance test. This study conducted from August–October 2010 at Sekolah Ilmu dan Teknologi Hayati (SITH) Institut Teknologi Bandung (ITB). Results of this study showed that insulin tolerance test constanta (KITT) were bigger in animals that treated with garlic extract (7.2±0.84), curcuminoid (7.14±0.74) and combination of curcuminoid-S-methyl cysteine (7.46±0.64) compared with positive control group (3.2±1.92). In conclusions garlic extract, curcuminoid and combination of curcuminoid and S-methyl cysteine improve insulin sensitivity. [MKB. 2011;43(4):153–9]Key words: Garlic extract, insulin sensitivity test, turmeric extract DOI: http://dx.doi.org/10.15395/mkb.v43n4.62
Optimalisasi Persalinan Non-institusional Untuk Menurunkan Angka Kematian Ibu Era Millenium Development Goals Sastrawinata, Ucke S.
Majalah Kedokteran Bandung Vol 41, No 4
Publisher : Faculty of Medicine, Universitas Padjadjaran

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The Millennium Development Goals (MDGs) adalah delapan target yang harus dicapai pada tahun 2015 sebagai respons terhadap tantangan pembangunan utama dunia. MDGs dalam bidang kesehatan maternal diukur dengan indikator angka kematian ibu (AKI) dan persentase persalinan yang dilakukan oleh penolong persalinan terlatih (skilled birth attendant). Artikel ini membahas kembali program yang sangat baik dan ada di Indonesia namun belum terlaksana dengan sempurna melihat Indonesia merupakan negara dengan AKI tertinggi di Asia Tenggara. AKI nasional memang menunjukkan penurunan dalam beberapa tahun terakhir, tetapi di beberapa daerah masih sangat tinggi, sementara proporsi persalinan yang ditolong oleh penolong persalinan terlatih memang menunjukkan peningkatan tapi dukungan sistem dan keterampilan penolong dianggap masih belum memenuhi harapan. Sebagian besar proses persalinan di Indonesia terjadi di rumah (non-institusional), beberapa faktor yang saling berkaitan dengan karakteristik proses persalinan di Indonesia adalah psikologis, keluarga, dan ekonomi. Upaya menurunkan AKI di Indonesia merupakan gabungan dari penolong persalinan terlatih, asuhan obstetrik emergensi, dan sistem rujukan emergensi. Intervensi di atas tidak harus dilakukan di fasilitas kesehatan, tapi dapat diimplementasikan oleh penolong persalinan terlatih saat persalinan di rumah, harus didukung oleh: lingkungan yang menunjang, rujukan emergensi, dan juga perbaikan akses kontrasepsi. Optimalisasi persalinan non-institusional dengan desa SIAGA dan Gerakan Sayang Ibu (GSI). GSI menggalakkan kesiapan persalinan dan kesiagaan komplikasi dengan “desa SIAGA” yang mempunyai komponen: Sistem Dana, Sistem Transportasi, Sistem Donor Darah, Sistem Pemberitahuan, dan Kemitraan pertolongan persalinan dukun paraji dan bidan. Kata kunci: MDGs, AKI, persalinan non-institusional, desa SIAGA, GSIOptimalization Non-institutional Delivery in Reducing Maternal Mortality Ratios To Achieve Millenium Development GoalsThe Millennium Development Goals are goals that must be achieved in 2015 as a responds to world development challenges. MDGs in maternal healthcare were measured by indicators such as maternal mortality ratios and percentage of births attended by skilled birth attendants (SBA). This article focuses on very good programs inIndonesia but still not being done perfectly because Indonesia's MMR is still the highest among south east asian countries. National MMR is declining over decades, but in several provinces MMR still high. Deliveries by SBA proportion show promising trends although with low system support and skill monitoring support. Most of deliveries were non-institutional, several aspects known to play important roles were psychological, families, and economics aspects. Efforts on lowering maternal mortality in Indonesia actually are combinations between SBA, emergency obstetric care, and emergency referral system. Interventions can be done by SBA at home whileworking, with an adequate support from community system, emergency referral system, and improvement of contraception  access. Non-institutional delivery optimalization with des SIAGA and GSI (Safe Motherhood Activities) which had 5 components; Funding System, Transportation System, Blood Donor System, Information System, and partnership in midwives and traditional birth attendant (TBA). Key words: MDGs, MMR, non-institutional deliveries, desa SIAGA, GSI DOI: http://dx.doi.org/10.15395/mkb.v41n4.256
Perbandingan Pemberian Susu Kedelai Bubuk dan Susu Kedelai Rumah Tangga terhadap Glukosa Darah Puasa pada Tikus Diabetes Melitus Hasil Induksi Aloksan Monohidrat Khrisna, Ramon; Sudjatno, H. R. Muchtan; Firmansah, Abdullah
Majalah Kedokteran Bandung Vol 43, No 2
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Berbagai penelitian menemukan bahwa kedelai dan produk olahannya memiliki banyak manfaat terhadap berbagai kelainan metabolisme, salah satunya terhadap diabetes melitus (DM). Tujuan penelitian ini adalah untuk mengetahui dan membandingkan penurunan kadar glukosa darah puasa sesudah pemberian susu kedelai bubuk dan susu kedelai rumah tangga pada tikus DM hasil induksi aloksan. Penelitian ini dilakukan di Departemen Farmakologi Klinik RS Dr. Hasan Sadikin Bandung periode Oktober−Desember 2008 dengan metode eksperimental di laboratorium, menggunakan 30 ekor tikus yang dibagi secara acak dalam lima kelompok, salah satunya kelompok kontrol positif. Kadar glukosa darah puasa (GDP) masing-masing kelompok diperiksa setelah 14 hari perlakuan. Hasil penurunan kadar GDP rata-rata tertinggi adalah pada kelompok tikus yang mendapatkan susu kedelai rumah tangga 2 kali/hari, yaitu sebesar 297,67 mg/dL, diikuti kelompok yang mendapatkan susu kedelai bubuk 2 kali/hari (270,17 mg/dL), kelompok yang mendapatkan susu kedelai bubuk 3 kali/hari (232,67 mg/dL), dan kelompok yang mendapatkan susu kedelai rumah tangga sebanyak 3 kali/hari (178 mg/dL), sedangkan hasil penurunan kadar GDP rata-rata kontrol positif adalah 16,17 mg/dL. Hasil penurunan kadar GDP rata-rata kelompok perlakuan berbeda signifikan terhadap kelompok kontrol positif (p=0,003), namun tidak terdapat perbedaan penurunan kadar GDP yang signifikan antara masing-masing kelompok perlakuan (p=0,425). Simpulan, kedua jenis susu kedelai, baik susu kedelai bubuk maupun susu kedelai rumah tangga dapat menurunkan kadar GDP pada tikus DM hasil induksi aloksan, namun tidak terdapat perbedaan antara pemberian susu kedelai bubuk dan susu kedelai rumah tangga. Frekuensi pemberian kedua jenis susu kedelai tidak memberikan perbedaan penurunan glukosa darah. [MKB. 2011;43(2):98–104].Kata kunci: Glukosa darah, susu kedelai bubuk, susu kedelai rumah tangga, tikus diabetes melitusThe Comparison of Powdered Soymilk and Domestic Soymilk Administration on Fasting Blood Glucose Level on Induced Diabetic Melitus Rats Aloxan MonohydrateSeveral researches had proven that soybean and its processed goods have many benefits for several metabolism disorders, one of which is diabetes mellitus (DM). The objective of this research was to determine and compare the decrease in fasting blood glucose level after administration of powdered soymilk to domestic soymilk which was injected into diabetic rats caused by aloxan injection. This research study was conducted in Farmacology Clinic Department Dr. Hasan Sadikin Hospital Bandung on October−December 2008, with as a randomized, positivecontrolled clinical trial. Thirty mice were randomly divided into 5 groups, one of which was a control group. Fasting blood glucose (FBG) level from each group were measured after 14 days of soymilk administration. The group which was administered domestic soymilk twice daily had the highest mean decrease of FBG level (297.67 mg/dL), followed by the group powdered soymilk twice daily (270.17 mg/dL), the group with powdered soymilk three times daily (232.67 mg/dL), and the group with domestic soymilk three times daily (178 mg/dL), meanwhile the positive-controlled group had mean decrease of FBG level as 16,67 mg/dL. The result was significant compared to positive-controlled group (p=0.003). However, the difference between each group was not significant (p=0.425). It is concluded that two types of soymilk, powdered and domestic, decrease the FBG level in diabetic rats, however, the difference between the two types are insignificant. The frequency of administration of the two types of soymilk also do not give difference in decreasing the blood glucose level. [MKB. 2011;43(2):98–104].Key words: Blood glucose level, diabetic mellitus rat, domestic soymilk, powdered soymilk DOI: http://dx.doi.org/10.15395/mkb.v43n2.51
PERBANDINGAN KADAR MIKROALBUMINURIA PADA STROKE INFARK ATEROTROMBOTIK DENGAN FAKTOR RISIKO HIPERTENSI DAN PASIEN HIPERTENSI Putri, S A; Nurimaba, Nurdjaman; Sadeli, Henny Anggraini; Syamsudin, Thamrin
Majalah Kedokteran Bandung Vol 41, No 3
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Mikroalbuminuria berhubungan dengan kerusakan vaskular di sistem glomerular ginjal yang disebabkan oleh faktorfaktor risiko vaskular antara lain: tekanan darah tinggi, diabetes melitus, profil lipid, merokok, usia lanjut, faktor genetika, dan proses aterosklerosis. Mikroalbuminuria juga menggambarkan kerusakan vaskular di tempat lain termasuk di serebral. Hubungan mikroalbuminuria dengan penyakit serebrovaskular belum banyak diketahui. Penelitian ini merupakan penelitian kasus kontrol dengan pendekatan analitik observasional yang dilakukan di Rumah Sakit Hasan Sadikin Bandung periode Desember 2007–Juli 2008. Pemeriksaan mikroalbuminuria dilakukan pada kelompok kasus (35 subjek stroke infark aterotrombotik dengan faktor risiko hipertensi saja) dan kelompok kontrol (35 subjek dengan hipertensi). Perbandingan kadar mikroalbuminuria antara kedua kelompok dianalisis dengan uji T Independen. Sementara untuk faktor penentu kejadian stroke digunakan uji regresi logistik multipel. Rata-rata kadar miroalbuminuria pada kelompok kasus lebih tinggi (54,76 mg/24 jam) dibanding kelompok kontrol (23,56 mg/24 jam) dengan perbedaan yang bermakna (p=0,013). Hasil analisis regresi logistik multipel menunjukkan miroalbuminuria merupakan faktor penanda independen kejadian stroke infark aterotrombotik pada pasien denganfaktor risiko hipertensi (p=0,032; OR=2,91;CI95%). Pasien hipertensi dengan mikroalbuminuria memiliki potensi terjadinya stroke infark aterotrombotik 2,91 kali dibandingkan pasien hipertensi tanpa mikroalbuminuria. Disarankan pemeriksaan mikroalbuminuria sebagai pemeriksaan rutin pada pasien hipertensi untuk preventif primer stroke infark aterotrombotik.Kata kunci: Stroke infark aterotrombotik, faktor risiko hipertensi, mikroalbuminuriaCOMPARISON OF MICROALBUMINURIA LEVEL BETWEENATHEROTROMBOTIC INFARCTION STROKE WITH HYPERTENSION RISK FACTOR AND PATIENT WITH HYPERTENSIONMicroalbuminuria is a marker of vascular damage in glomerular system caused by vascular risk factors : hypertension, diabetes mellitus, lipid profile, smoking, older age, genetic and atherosclerosis. Microalbuminuria is a window of vasculature damage in cerebrovascular system. Correlation between microalbuminuria and cerebrovascular disease is not well established. This was an observational analytical case control study, conducted on December 2007 to July 2008 in Hasan Sadikin Hospital Bandung. Measurement of microalbuminuria level was done in case group (35 subjects atherotrombotic infarction stroke with hypertension as the risk factor) and control group (35 subjects with hypertension). Comparison of microalbuminuria level were analyzed with independent T test. Determinant factor for atherotrombotic infarction stroke incidence was analyzed with multiple regression logistic. Mean rate of microalbuminuria level in case group was higher (54.76 mg/24 hours) compared with control (23.56 mg/24 hours) and comparison was significant (p=0.013). Multiple logistic regression analyzed that microalbuminuria as an independent determinant factor for atherotrombotic infarction stroke in patients with hypertension (p=0.032, OR=2.91, CI95%). Patients with hypertension and microalbuminuria had an increased risk for atherotrombotic infarction stroke 2,91 times than hypertension without microalbuminuria. Microalbuminuria level suggested as a routine examination in patients with hypertension for primary prevention of atherotrombotic infarction stroke.Key words: Atherotrombotic infarction stroke, hypertension, microalbuminuria DOI: http://dx.doi.org/10.15395/mkb.v41n3.244
Prothrombin Time, Activated Partial Thromboplastin Time, Fibrinogen, dan D-dimer Sebagai Prediktor Decompensated Disseminated Intravascular Coagulation Sisseminated pada Sepsis Fenny, -; Dalimoenthe, Nadjwa Zamalek; Noormartany, -; Pranggono, Emmy; Dewi, Nina Susana
Majalah Kedokteran Bandung Vol 43, No 1
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

AbstrakSepsis adalah respons sistemik terhadap infeksi dan terutama terjadi pada pneumonia. Sepsis dapat menyebabkan komplikasi disseminated intravascular coagulation (DIC) yang dibedakan menjadi compensated dan decompensated DIC. Tujuan penelitian ini adalah untuk menentukan apakah nilai prothrombin time (PT), activated partial thromboplastin time (aPTT), kadar fibrinogen, dan D-dimer dapat digunakan sebagai prediktor decompensated DIC pada penderita sepsis. Penelitian dilakukan di Laboratorium Patologi Klinik Rumah Sakit Hasan Sadikin Bandung mulai September 2008 sampai Juni 2010. Subjek penelitian adalah penderita sepsis yang disebabkan pneumonia. Nilai PT, aPTT, kadar fibrinogen, dan D-dimer semua subjek sepsis dicatat kemudian dilakukan pengamatan sampai subjek dinyatakan mengalami decompensated atau non-decompensated DIC; selanjutnya dilakukan analisis nilai PT, aPTT, kadar fibrinogen, dan D-dimer pada kelompok decompensated dan non-decompensated DIC. Penelitian menggunakan rancangan cohort. Subjek berjumlah 39 orang (58%) penderita sepsis dengan luaran decompensated DIC dan 28 orang (42%) penderita sepsis dengan luaran non-decompensated DIC. Dari parameter hemostasis yang diperiksa, didapatkan bahwa nilai PT, aPTT, dan fibrinogen merupakan prediktor decompensated DIC pada penderita sepsis dengan risiko relatif (RR) masing-masing 240,500; 7,157; dan 6,421. Simpulan, prothrombin time, aPTT, dan fibrinogen merupakan pemeriksaan untuk mengetahui aktivasi koagulasi. Parameter hemostasis yang merupakan prediktor decompensated DIC pada penderita sepsis adalah nilai PT dan aPTT yang memendek serta kadar fibrinogen yang meningkat. [MKB. 2011;43(1):49–54].Kata kunci: Activated partial thromboplastin time, D-dimer, disseminated intravascular coagulation, fibrinogen, prothrombin time, sepsisProthrombin Time, Activated Partial Thromboplastin Time, Fibrinogen, and D-dimer as a Predictor of Decompensated Disseminated Intravascular Coagulation in SepsisSepsis is a systemic response to infection especially in pneumonia case. Sepsis can cause complications such as disseminated intravascular coagulation (DIC) which can be divided into compensated and decompensated DIC. The purpose of this study was to assess whether the value of prothrombin time (PT), activated partial thromboplastin time (aPTT), fibrinogen, and D-dimer levels can be used as predictors of decompensated DIC in sepsis patients. This study was conducted at the Laboratory of Clinical Pathology Rumah Sakit Hasan Sadikin Bandung since September 2008 to June 2010. Subjects were patients with sepsis caused by pneumonia. PT and aPTT values, fibrinogen, and D-dimer levels was recorded from all sepsis patients then patients were observed until diagnosed decompensated or non-decompensated DIC, then the value of PT, aPTT, fibrinogen and D-dimer levels in the group of decompensated DIC and non-decompensated DIC were analysed. This study used cohort design. Subjects were 39 sepsis patients (58%) with outcome decompensated DIC and 28 sepsis patients (42%) with outcome non-decompensated DIC. From the hemostasis parameter test out, it was found that PT, aPTT, and fibrinogen were the predictor of decompensated DIC in patients with sepsis with relative risk 240.500, 7.157, and 6.421; respectively. Conclusions, prothrombin time, aPTT, fibrinogen are the test to know coagulation activation. Hemostasis parameter to predict decompensated DIC in sepsis patients are the shorten PT, aPTT, and the increased fibrinogen. [MKB. 2011;43(1):49–54].Key words: Activated partial thromboplastin time, D-dimer, disseminated intravascular coagulation, fibrinogen, prothrombin time, sepsi DOI: http://dx.doi.org/10.15395/mkb.v43n1.44
Kematian Neonatal dan Bayi Lahir Mati serta Hubungannya dengan Kepercayaan dan Perilaku Masyarakat Machmud, Rizanda; Yunarti, Yunarti
Majalah Kedokteran Bandung Vol 42, No 1
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Kabupaten Cirebon memiliki angka kematian ibu dan bayi yang tinggi. Berbagai upaya sudah dilakukan untuk menurunkan angka tersebut, namun belum berhasil. Penelitian ini bertujuan untuk menggali informasi yang lebih mendalam tentang keterkaitan kematian bayi lahir mati dan neonatal dengan latar belakang perilaku serta kepercayaan masyarakat tentang kehamilan, persalinan, dan perawatan bayi baru lahir di desa pesisir dan pedalaman. Pendekatan penelitian menggunakan paradigma gabungan antara kualitatif dan kuantitatif (mixed paradigm) dengan menggali informasi secara mendalam mengenai faktor predisposing, faktor enabling, dan faktor reinforcing kepercayaan serta perilaku masyarakat. Penelitian dilakukan di desa Weru Lor (pedalaman) dan Suranenggala (pesisir) di kabupaten Cirebon, Jawa Barat pada tahun 2006. Hasil penelitian menunjukkan adanya stigma-stigma yang melatarbelakangi perilaku tidak rasional dalam hubungannya dengan kematian bayi lahir mati dan neonatal. Tidak terdapat perbedaan kepercayaan antara desa pedalaman dan desa pesisir. Kesimpulan penelitian ini adalah perlunya kompetensi petugas kesehatan dalam penyebarluasan informasi rasional sehingga mampu menghilangkan stigma-stigma yang tumbuh dalam masyarakat.Relationship Between Neonatal Mortality and Still Birth with Believe and Behavior of Health SocietyCirebon's district is one of highest infant mortality and maternal mortality rate. So many efforts have been done to reduce this rate but, it's no effect yet. The etiology of these problems isn't known. The aim of research was to discover deeper information about relationship between neonatal mortality and social behavior background and believe of health society in pregnancy, delivery and antenatal care in mainland and coastal district. A qualitative and quantitative methods were used to exploring deeper information about predisposing, enabling, and reinforcing factors in health believe and behavior in society. Location of the study were in mainland (Weru Lor) and costal village (Suranenggala) in Cirebon-West Java in 2006. This research answered the reseach question, why neonatal death are happened and why health behavior in society seems irrational. There were stigmas in society that affect infant mortality rate. The result of research showed there were existence of stigmas which was irrational background in its relation with infant and neonatal mortality. There were no difference of local culture, knowledge, and believe among mainland and coastal countryside. Conclusion of this research is the importance of provider of health competence in dissemination of rational information so that can eliminate stigmas which grow in society.DOI: http://dx.doi.org/10.15395/mkb.v42n1.5
BINDING OF ENDOTHELIN-1 TO HUMAN BLOOD MONOCYTE Achmad, Tri Hanggono; S. Rao, Govind
Majalah Kedokteran Bandung Vol 41, No 2
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Monocyte attachment to the endothelium and migration into the vessel intima are the initiating steps in atherogenesis. This is thought to be facilitated by endothelin-1 (ET-1) as a potent chemoattractant to human blood monocytes. To explore the presence of ET-1 receptor(s) on the monocyte, we studied the binding of ET-1 to freshly isolated human blood monocytes, in the laboratory of the Institute of Clinical Biochemistry, University of Bon, Germany in 1995. Radioligand binding studies revealed the presence of two distinct subclasses of binding sites with apparent dissociation constants, K s, of 10.3 pM and 3.5 nM and maximal binding capacities, B s, of 0.027 fmol and 0.63 d max fmol/1.5x105 cells. Using monocyte migration as a response to ET-1, and ET-1 receptor antagonists BQ-123, BQ- 18257B and IRL-1038, the presence of two ET receptor subtypes, ET and ET , were detected. These results suggest A B that the chemotactic stimulus introduced by ET-1 can be activated ET-1 specific receptors on the monocytes.Key words: Endothelin-1, monocyte, receptor-bindingIKATAN ENDOTELIN-1 PADA MONOSIT DARAH MANUSIAMenempelnya monosit ke permukaan endotel dan bermigrasi kedalam tunika intima merupakan langkah awal pada aterogenesis. Hal ini diduga diperantarai oleh peran endotelin-1 (ET-1) yang dikenal sebagai chemoattractant poten bagi monosit. Untuk mengungkapkan adanya reseptor ET-1 pada monosit, dilakukan penelitian ikatan ET-1 pada monosit yang diisolasi dari darah manusia, di laboratorium Institute of Clinical Biochemistry, Universitas Bonn, Jerman pada tahun 1995. Penilaian ikatan radioligand menunjukkan adanya dua subkelas berbeda dari tempat ikatan dengan konstanta disosiasi (K ) masing-masing 10,3 pM dan 3,5 nM, serta kapasitas ikatan maksimal (B ) d max masing-masing sebesar 0,027 fmol dan 0,63 fmol/1,5x105 sel. Dari hasil penilaian tingkat migrasi monosit sebagai respons terhadap ET-1 dengan atau tanpa beberapa antagonis reseptor ET-1, BQ-123, BQ-18257B dan IRL-1038, terdeteksi adanya dua subtipe reseptor ET, yaitu ET dan ET . Hasil ini menunjukkan bahwa rangsangan kemotaksis A B yang ditimbulkan ET-1 dapat mengaktifkan reseptor spesifik ET-1 pada monosit.Kata kunci: Endotelin-1, monosit, ikatan-reseptor DOI: http://dx.doi.org/10.15395/mkb.v41n2.185
Peran Lem Fibrin Otologus pada Penempelan Tandur Konjungtiva Bulbi Mata Kelinci terhadap Ekspresi Gen Fibronektin dan Integrin Enus, Sutarya; Natadisastra, Gantira; Shahib, M. Nurhalim; Sulaeman, Rachmat
Majalah Kedokteran Bandung Vol 43, No 4
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Penempelan jaringan dan penyembuhan luka pada cangkok konjungtiva lebih cepat pada teknik lem fibrin otologus (LFO) dibandingkan dengan teknik jahitan. Kedua proses tersebut memerlukan interaksi fibronektin (FN) dan integrin α5 yang mengaktivasi alur persinyalan intraselular. Tujuan penelitian untuk menentukan kekuatan ekspresi gen FN serta integrin α5 pada kelompok teknik LFO dan jahitan. Uji eksperimental hewan pada kelinci New Zealand White yang terbagi kelompok teknik LFO dan jahitan masing-masing 8 kelinci bertempat di Laboratorium Sentral (Biologi Molekuler) FK Unpad Bandung, periode Mei–Oktober 2008. Sampel jaringan untuk pemeriksaan reverse transcriptase polymerase chain reaction (RT-PCR) diambil dari eksterpasi satu hari sesudah jaringan cangkok konjungtiva bulbi. Analisis data untuk uji hipotesis dengan Mann Whitney for small sample. Ekspresi gen messenger ribonucleic acid (mRNA) FN secara bermakna lebih kuat pada teknik LFO dibandingkan dengan teknik jahitan (1,9 vs 1,0; p=0,014). Tidak terdapat perbedaan bermakna ekspresi gen (mRNA) integrin α5 antara teknik LFO dan teknik jahitan (1,2 vs 1,0; p=0,235). Sebagai simpulan ekspresi gen FN lebih kuat pada teknik LFO dibandingkan dengan jahitan, sedangkan ekspresi gen integrin α5 pada teknik LFO lebih kuat dibandingkan dengan teknik jahitan namun secara statistik tidak bermakna satu hari pascabedah. [MKB. 2011;43(4):183–8].Kata kunci: Fibronektin, integrin α5, lem fibrin otologus, RT-PCRThe Role of Autologous Fibrin Glue on Attachment Rabbit Conjungtival Graft Based on Fibronectin and Integrin Gene ExpressionThe tissue attachment and wound healing in conjunctional transplantation was more rapid with autologous fibrin glue (AFG) than suture techniques. Both tissue attachment and wound healing process need interaction between fibronectin (FN) dan integrin α5 activating the intra cellular signal transduction pathway. The aim of this study was to evaluate the gene expression, i.e. FN and integrin in conjunctival transplantation, comparing between AFG and suturing techniques. Animal experimental study was done in New Zealand White rabbits, which divided into AFG and suturing technique at Laboratorium Sentral (Biologi Molekuler) FK Unpad Bandung during May–October 2008, each 8 rabbits, respectively. The tissue sample for reverse transcriptase polymerase chain reaction (RT-PCR) examination was taken from the tissue excision one day after conjunctival bulbi transplantation. Data analysis was tested using Mann Whitney for small sample. The FN gene expression power of messenger ribonucleic acid (mRNA) in the AFG technique was stronger than that in suturing technique (1.9 vs 1.0, p=0.014). There was no significant difference in integrin α5 gene expression of mRNA between AFG and suturing techniques (1.2 vs 1.0, p=0.235). In conclusions, FN gene expression in AFG technique is stronger than suturing technique. There is no difference in integrin α5 gene expression between two techniques, however there is a tendency of increased integrin α5 gene expression one day after surgery. [MKB. 2011;43(4):183–8].Key words: Autologous fibrin glue, fibronectin, integrin α5, RT-PCR DOI: http://dx.doi.org/10.15395/mkb.v43n4.67

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