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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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HUBUNGAN JUMLAH DARAH TRANSFUSI, PEMBERIAN DEFEROKSAMIN, DAN STATUS GIZI DENGAN KADAR SENG PLASMA PADA PENDERITA THALASSEMIA MAYOR ANAK Bachtiar, Ivan Rachmad; Fadil, R. M. Ryadi; M. S, Azhali
Majalah Kedokteran Bandung Vol 41, No 2
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Seng banyak berperan dalam berbagai aktivitas biologik penting. Beberapa penelitian sebelumnya menunjukkan kadar seng plasma yang rendah pada penderita thalassemia mayor anak. Tujuan penelitian ini untuk mengetahui hubungan jumlah darah transfusi, pemberian deferoksamin, dan status gizi dengan kadar seng plasma penderita thalassemia mayor anak. Penelitian ini menggunakan rancangan cross-sectional dengan subjek penelitian penderita thalassemia mayor berusia kurang dari 14 tahun yang berobat jalan di Poliklinik Thalassemia Anak RS Hasan Sadikin Bandung selama bulan Mei-Juni 2008. Dilakukan penghitungan jumlah darah transfusi, pemberian deferoksamin dibedakan antara optimal-tidak optimal, status gizi dibedakan menjadi gizi baik-gizi kurang. Analisis statistik dilakukan dengan uji korelasi Pearson dan uji Chi square, dengan interval kepercayaan 95%. Didapatkan 57 subjek terdiri dari 29 anak laki-laki dan 28 anak perempuan berusia antara 2 tahun 1 bulan dan 13 tahun 9 bulan. Kadar seng plasma berkisar antara 42 dan 91 g/dL (68,65;11,68) dan jumlah darah transfusi berkisar antara 1.680 dan 45.700 mL (17.913,25;10.404,18). Uji korelasi Pearson menunjukkan hubungan antara jumlah darah transfusi dan kadar seng plasma dinyatakan dengan r=-0,189; p=0,0795. Uji Chi square tentang hubungan pemberian deferoksamin dan status gizi dengan kadar seng plasma dinyatakan dengan x2=0,073; p=0,786 dan x2=0,468; p=0,494. Kesimpulan: Jumlah darah transfusi, pemberian deferoksamin, dan status gizi tidak memiliki hubungan dengan kadar seng plasma pada penderita thalassemia mayor anak.Kata kunci: Thalassemia mayor, darah tranfusi, deferoksamin, status gizi, seng plasmaCORRELATION THE AMOUNT OF BLOOD TRANSFUSION, DEFEROXAMINE USAGE, AND NUTRITIONAL STATUS WITH PLASMA ZINC LEVEL IN PEDIATRIC MAJOR THALASSEMIARoles of zinc have been known in many important biologic activities. Previous studies found that there were low plasma zinc level in children with major thalassemia. The aim of this study was to determinate correlation the amount of blood transfusion, deferoxamine usage and nutrition status with plasma zinc level in pediatric major thalassemia. The cross-sectional study was conducted from Mei to June 2008 at Clinic of Pediatric Thalassemia Dr. Hasan Sadikin Hospital Bandung with subjects below 14 years. The amount of blood transfusion was calculated, deferoxamine usage was divided into optimal and non-optimal, nutritional status was classified into well-nourished and undernourished. Statistical analysis were performed with Pearson correlation test and Chi square test, with 95% confidence interval. The amount of 57 subjects consisted of 29 boys and 28 girls, ages ranged from 2 years 1 month to 13 years 9 months. The plasma zinc levels ranged from 42 to 91 g/dL (68.65; 11.68) and the amount of blood transfusion ranged from 1,680 to 45,700 mL (17,913.25; 10,404.18). The Pearson correlation test which showed the correlation between plasma zinc level and the amount of blood transfusion was stated by r=-0.189; p=0.0795. Chi-square test showed the impact of deferoxamine usage and nutritional status on plasma zinc level were x2=0.073; p=0.786 and x2=0.468; p=0.494. We conclude that the amount of blood transfusion, deferoxamine usage, and nutritional status are not correlated with plasma zinc level in children with major thalassemia.Key words: Major thalassemia, blood tranfusion, deferoxamine, nutritional status, plasma zinc DOI:  http://dx.doi.org/10.15395/mkb.v41n2.261
Polimorfisme C1167T Gen Reseptor Tipe II Transforming Growth Factor-â, Kadar Soluble Endoglin, dan Vascular Cell Adhesion Molecule-1 pada Preeklamsia Anwar, Anita D.; Achmad, Tri Hanggono; Sukandar, Hadyana; Krisnadi, Sofie R.; Wirakusumah, Firman F.
Majalah Kedokteran Bandung Vol 42, No 3
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Transforming growth factor-â (TGF-â) diduga berperan pada preeklamsia. Reseptor TGF-â tipe II (TâR-II) dihasilkan dari transkripsi gen TGF-â receptor type II (TGFBR2). Polimorfisme gen TGFBR2 pada basa C1167T dapat menyebabkan hipoksia yang menginduksi iskemia serta meningkatkan produksi solubel endoglin (sEng) dan vascular cell adhesion molecule-1 (VCAM-1). Tujuan penelitian ini untuk mengetahui korelasi polimorfisme gen TGFBR2 pada basa C1167T dengan kadar sEng dan VCAM-1 ibu preeklamsia. Subjek adalah ibu preeklamsia usia kehamilan 28–42 minggu dan kehamilan normal sebagai kontrol, masing-masing 120 orang. Penelitian dilakukan di Rumah Sakit Hasan Sadikin, Bandung, September 2008–Mei 2009. Sampel berupa darah vena, pemeriksaan polimorfisme dilakukan dengan DNA Wizard® genomic DNA purification, kadar sEng dan VCAM-1 dengan imunoesai. Hasil penelitian menunjukkan polimorfisme CT pada kelompok preeklamsia 92 (76,7%) dan kontrol 70 (58,3%) {p<0,001; OR (95%CI): 2,35 (1,30–4,26)}. Kadar sEng (ng/mL) 12,46 berbanding 10,29 pada kelompok kontrol {p<0,001; OR (95%CI): 3,71 (2,11–6,57)}. Kadar VCAM-1 berbeda bermakna, yaitu 1.218,43 berbanding 705,59 {(p<0,001; OR (95%CI): 7,56 (4,11–14,0)}. Disimpulkan terdapat perbedaan proporsi dan korelasi polimorfisme C1167T gen TGFBR2, kadar sEng, dan VCAM-1 antara preeklamsia dan kehamilan normal. [MKB. 2010;42(3):115-22].Kata kunci: Polimorfisme gen TGFBR2, preeklamsia, sEng, VCAM-1C1167T Type II Transforming Growth Factor-â Receptor Gene Polymorphism, Soluble Endoglin and Vascular Cell Adhesion Molecule 1 Levels in PreeclampsiaTransforming growth factor-â (TGF-â) plays a role in preeclampsia. TGF-â receptor type II (TâR-II) is produced from the transcription of the type II TGF-â receptor gene (TGFBR2). Polymorphism of TGFBR2 gene on the base C1167T could cause hipoxia that induces ischaemia and product soluble endoglin (sEng) and vascular cell adhesion molecule-1 (VCAM-1). The aim was to find out the association of C1167T type II TGF-â receptor gene polymorphism with sEng and VCAM-1 levels in preeclampsia. The study was done at Hasan Sadikin Hospital, Bandung, September 2008–May 2009. Indicates that C1167T polymorphism events were found in the preeclampsia that were 92(76.7%) of 120 cases and 70 (58.3%) control of 120 normal pregnancies with the difference in the appearance polymorphism which means p<0.001 OR (95%CI):2,35 (1.30–4.26). There was a difference between sEng (ng/μL) 12.46 for preeclampsia and 10.29 for the control group p<0.001 OR (95%CI): 3.71 (2.11–6.57). There was also a difference between VCAM-1 (ng/μL) 1,218.43 for the preeclampsia and 705.59 for the control group {p<0.001 OR (95%CI): 7.56 (4.11–14.0)}. There was a result that in preeclamptic patient having polymorphism sEng level was 14.19 ng/mL and VCAM-1 level is 961,85 ng/mL. It is concluded that there are difference proportion and association of C1167T type II TGF-â receptor gene polymorphism with sEng and VCAM-1 levels between preeclampsia and normal pregnancy patients. [MKB. 2010;42(3):115-22].Key words: Preeclampsia, sEng, TGFBR2 gene polymorphism, VCAM-1 DOI: http://dx.doi.org/10.15395/mkb.v42n3.22
Perubahan Gambaran Histopatologi Paru pada Paparan Debu Batubara Memakai Alat Model 2010 Kania, Nia; Setiawan, Bambang; Nurdiana, Nurdiana; Widodo, M. Aris; Kusuma, HMS Chandra
Majalah Kedokteran Bandung Vol 43, No 3
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Tambang batubara di permukaan tanah mendorong pembuatan alat paparan debu batubara skala laboratorium. Optimasi alat paparan debu batubara model 2010 dilakukan untuk menentukan lokasi akumulasi debu batubara serta perubahan histopatologi paru. Penelitian eksperimental dilakukan pada kontrol (K), paparan debu batubara 14 hari (BB1), dan debu batubara 28 hari (BB2). Karakterisasi debu batubara dilakukan dengan scanning electron microscope (SEM) dan X-ray fluorescence (XRF) di Laboratorium Fisika Universitas Negeri Malang. Pemeriksaan histopatologis paru dilakukan di Laboratorium Patologi Anatomi RSUD Ulin Banjarmasin. Penelitian dilakukan periode Agustus−November 2010. Scanning electron microscope paru menunjukkan diameter partikel <10 mm dan akumulasi partikel di alveolus. Parenkim paru berupa struktur alveolus tipis (K), penebalan alveolus dan edema epitel edematous (BB1), peningkatan edematous dan penyempitan rongga alveolus (BB2). Epitel bronkus dilapisi epitel silindris, epitel goblet, sel radang yang minimal (K), perpanjangan epitel silindris, hiperplasia epitel goblet dan mukus (BB1). Sel epitel menjadi menipis, lebih banyak mukus dan morfologi epitel menjadi tidak jelas (BB2). Epitel bronkoalveolus dilapisi epitel silindris, minimal sel goblet dan sel radang (K). Hiperplasia epitel goblet yang mendominasi disertai mukus (BB1). Epitel silindris dengan proliferasi sel goblet, mukus, taburan sel radang, dan fibrosis (BB2). Simpulan, alat paparan model 2010 memicu akumulasi debu batubara di alveolus serta perubahan histopatologi berupa inflamasi, hiperplasia sel goblet, dan fibrosis. [MKB. 2011;43(3):127–33]. Kata kunci: Alveolus, debu batubara, histopatologi, paruLung Histopatology Changed in Coal Dust Exposure with Model 2010EquipmentCoal mining on surface ground stimulate to create coal dust exposure equipment on laboratory scale. Optimation of model 2010 coal dust exposure equipment focus on coal dust accumulation and histopathologic of lung. This experimental study was done in control (K), coal dust exposure for 14 days (BB1), and coal dust exposure for 28 days (BB2). Coal dust characterization was done by scanning electron microscope (SEM) and X-ray fluorescence in Physics Laboratory Malang State of University. Histopathologic analysis was done in Pathologic Laboratory Ulin General Hospital. Research was done August−November 2010. Lung SEM showed particle diameter 10 mm and particle accumulated in alveolus. Lung parenchym showed thin alveolus structure (K), thickenning of alveolus and edematous epithelial (BB1), increased edematous and narrower alveolus space (BB2). Epithelial in bronchus layering by cylindrical and goblet epithelial, inflammation cell (K), elongation of cylindrical epithelial, hyperplasia goblet epithelial and mucous (BB1). Epithelial became thick, more mucous, and epithelial morphology became unclear (BB2). Bronchoalveolus epithelial layering by cylindrical epithelial, minimal goblet cell and inflammation cell (K). Goblet cell hyperplasia and mucous (BB1). Cylindrical epithelial with goblet cell proliferation, mucous inflammation cell, and fibrosis (BB2). In conclusions, coal dust exposure with model 2010 equipment trigger coal dust accumulation in avelous and histopathologic changes of inflamation, goblet cell hyperplasia, and fibrotic. [MKB. 2011;43(3):127–33].Key words: Alveolus, coal dust, histopathologic, lung DOI: http://dx.doi.org/10.15395/mkb.v43n3.58
Prevalensi dan Faktor Risiko Anemia pada HIV-AIDS Sumantri, Rachmat; Wicaksana, Rudi; R. Ariantana, Agnes
Majalah Kedokteran Bandung Vol 41, No 4
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Anemia berperan dalam morbiditas dan mortalitas penderita HIV-AIDS. Penelitian mengenai anemia pada infeksiHIV di Indonesia belum banyak. Studi potong lintang dilakukan untuk mengetahui prevalensi dan faktor risikoanemia pada penderita HIV-AIDS di Poliklinik Teratai RS. Hasan Sadikin dari 1 Januari-30 Juni 2008. Hasilpenelitian: terdapat 534 penderita HIV-AIDS, anemia 222 penderita, prevalensinya 41,6%. Anemia ringan (Hb 10-14 g/dL laki-laki, 10-12 g/dL wanita) didapatkan pada 188 penderita (35%); anemia sedang (Hb 8-10 g/dL) pada 28penderita (5,2%), dan anemia berat (Hb &lt; 8 g/dL) terdapat pada 6 penderita (1,1%). Faktor risiko yaitu jenis kelamin,umur, indeks massa tubuh (BMI), intravenous drug user (IDU), stadium klinis WHO, kandidiasis oral, peradangankronik, pemberian kotrimoksazol, pemberian ARV, tuberkulosis, CD4, dan viral load. Uji statistik menunjukkanbahwa faktor risiko anemia yang penting adalah BMI antara 18,5-22,9 dengan OR 0,368 (95% CI 0,216-0,627).Kandidiasis oral dengan OR 1,793 (95% CI 0.99-3,248), pemberian ARV dengan OR 0,905 (95% CI 0,555-1,474),dan CD4 antara 1-50 dengan OR 8,66 (95% CI 4,407-13,522). Peluang kejadian terbesar untuk kejadian anemiaadalah kombinasi BMI yang rendah (&lt; 18,5) baik mendapat ARV ataupun tidak mendapat ARV dengan kandidiasisoral dan CD4 antara 1-50/mm3. Penelitian ini menunjukkan prevalensi anemia yang cukup tinggi (41,6%) dan faktorrisiko yang penting untuk kejadian anemia adalah BMI yang rendah, kandidiasis oral, ARV dan CD4 yang rendah. [MKB 2009;41(4):187-93].Kata kunci: HIV-AIDS, anemia, faktor risikoPrevalence and Risk Factors of Anemia in HIV-AIDSAnemia has an important role in morbidity and mortality among HIV-AIDS patients. The study of anemia amongHIV-AIDS patients in Indonesia was not much done. A cross-sectional study has been done in Teratai Clinic HasanSadikin Hospital Bandung to evaluate the prevalence and risk factors of anemia in HIV-AIDS patients between 1January to 30 June 2008. There were 534 HIV-AIDS patients, anemia occured in 222 patients, the prevalence was41.6%. Mild anemia or Hb level 10-14 g/dL in man or 10-12 g/dL in woman was found in 188 (35%), moderateanemia or Hb 8-10 g/dL in 28 (5,2%) and severe anemia or Hb less than 8 g/dL in 6 (1,1%) patients. Risk factors weregender, age, BMI, IDU, WHO staging, oral candidiasis, chronic inflammation, ARV, tuberculosis, CD4, and viralload. Statistical analysis showed that the important risk factors were BMI between 18.5-22.9 OR 0.368 (95% CI0.216-0.627), oral candidiasis OR 1.793 (95% CI 0.99-3.248), use of ARV OR 0.905 (95% CI 0.555-1.474), andCD4 1-50 OR 8.66 (95% CI 4.407-13.522). The chance of anemia was great in combination of BMI ≤ 18.5 with CD4≤ 50 , oral candidiasis with or without ARV. This study showed that the prevalence of anemia in HIV-AIDS patients isprominent and the important risk factors for anemia are BMI, oral candidiasis, ARV and CD4.[MKB. 2009;41(4):187-93]Key words: HIV-AIDS, anemia, risk factorsDOI: http://dx.doi.org/10.15395/mkb.v41n4.252
Karakteristik Gangguan Dengar Sensorineural Kongenital pada Anak yang Dideteksi dengan Brainstem Evoked Response Audiometry Dewi, Yussy Afriani; Agustian, Ratna Anggraeni
Majalah Kedokteran Bandung Vol 43, No 2
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Gangguan dengar merupakan salah satu kelainan yang sering timbul sejak lahir (kongenital), sehingga deteksi dan rehabilitasi dini yang tepat dapat meningkatkan perkembangan bicara dan berbahasa. Penelitian ini dilakukan untuk mengetahui berbagai aspek gangguan dengar kongenital dari segi klinik maupun sosiologik. Subjek penelitian adalah anak yang dilakukan brainstem evoked response audiometry (BERA) di Rumah Sakit Dr. Hasan Sadikin dengan gangguan dengar sensorineural bilateral kongenital selama periode April 2002–April 2005. Penelitian dilakukan secara deskriptif retrospektif. Sebanyak 286 anak termasuk dalam penelitian terdiri atas 149 (52,1%) laki-laki dan 137 (47,9%) perempuan. Sebanyak 58,7% terdeteksi pada usia >1–3 tahun. Usia anak saat dicurigai menderita gangguan dengar mulai dari usia 5 bulan sampai 14 tahun. Tenggang waktu antara usia pada saat mulai dicurigai adanya gangguan dengar dan dilakukan BERA adalah 82 (28,7%) <6 bulan, 72 (25,2%) antara >6 bulan sampai <1 tahun, dan 70 (24,4%) antara >1 sampai< 2 tahun. Penderita lebih banyak berasal dari daerah perkotaan, yaitu 149 (52,1%) anak dan sebagian besar dirujuk oleh spesialis THT sebanyak 129 (45,1%). Derajat gangguan dengar terbanyak adalah berat 181 (63,3%) dan sangat berat 96 (33,6%), sebagian besar bersifat simetris (71%). Faktor risiko terbanyak tidak teridentifikasi (51,1%), prematur/BBLR (13,6%), asfiksia (13,3%), hiperbilirubinemia (8,7%), dan rubela (7,3%). Simpulan, usia curiga pada saat anak dideteksi mengalami gangguan dengar masih tinggi. Agar deteksi dapat lebih dini, perlu peningkatan pengetahuan tenaga kesehatan dan masyarakat serta upaya pencegahan terhadap faktor risiko. [MKB. 2011;43(2):77–82].Kata kunci: Anak, brainstem evoked response audiometry (BERA), gangguan dengar sensorineural bilateral kongenital Characteristic of Congenital Bilateral Sensorineural Hearing Loss inChildren Diagnosed by Brain Evoked Response AudiometryHearing loss is one of the most common congenital anomalies, therefore early detection and rehabilitation might enhance speech ability. The purpose of this study was to explore the clinical and sociological characteristics of congenital bilateral sensorineural hearing loss. Subjects were children who suffered from congenital bilateral sensorineural hearing loss diagnosed by brainstem evoked response audiometry (BERA) in Dr. Hasan Sadikin Hospital from period of April 2002–April 2005. Data obtained retrospectively from patient’s record and presented descriptively. There were 286 children included in the study consisted of 149 (52.1%) males and 137 (47.9%) females. More (58.8%) children were detected by BERA at age of >1–3 years. Children’s age that first suspected to have hearing disorder was between 5 months and 14 years old. The delay between suspected and diagnosis was 82 (28.7%) <6 months, 72 (25.2%) between >6 months–<1 year, 70 (24.4%) between >1–<2 years. There were 52.1% (149) subjects came from urban area and 45.1% (129) of them were referred by otolaryngology-head and neck surgery specialists. The degrees of hearing loss were severe 181 (63,3%) and profound 96 (33.6%). Most cases (71%) were symmetrical. The cause of hearing loss in 51.1% of children couldn’t be determined, 13.6% were premature/low birth weight, 13.6% asphyxia, 8.7% hyperbilirubinemia, and 7.3% rubella. Conclusions, age of children when suspected to have hearing disorder is still high. Early detection needs knowledge from health provider officer, society, and prevention of the risk factors. [MKB. 2011;43(2):77–82].Key words: Brainstem evoked response audiometry (BERA), child, congenital bilateral sensorineural hearing loss DOI: http://dx.doi.org/10.15395/mkb.v43n2.47
PERBANDINGAN KADAR SOLUBLE fms-LIKE TYROSINE KINASE 1 (sFlt1) SERUM KEHAMILAN NORMAL DENGAN PREEKLAMSI BERAT SERTA HUBUNGANNYA DENGAN TEKANAN DARAH DAN DERAJAT PROTEINURIA Siddiq, Amillia; Mose, Johanes C.; Irianti, Setyorini
Majalah Kedokteran Bandung Vol 41, No 3
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Prediksi dan deteksi dini preeklamsi sangat diperlukan untuk mengurangi angka morbiditas dan mortalitas maternal dan perinatal. Penelitian ini bertujuan mengetahui perbedaan kadar sFlt1 serum kehamilan normal dengan preeklamsi berat (PEB) dan mengetahui hubungan antara kadar sFlt1 serum dan tekanan darah serta derajat proteinuria. Dilakukan studi observasional analitik secara potong silang. Kadar sFlt1 diperiksa dengan ELISA. Analisis statistik menggunakan uji chi kuadrat, uji t, uji Mann-Whitney, koefisien korelasi Rank Spearman, serta uji diagnostik untuk mencari nilai penentu kadar sFlt1. Karakteristik subjek penelitian pada kelompok PEB dan kelompok kontrol tidak berbeda bermakna (p>0,05). Terdapat perbedaan bermakna antara kadar sFlt1 serum kelompok PEB dan kelompok kontrol (3.827±471 pg/mL dan 2.708±441 pg/mL; p<0,05). Terdapat hubungan positif bermakna antara kadar sFlt1 dan tekanan darah sistolik (p=0,042; p<0,05) dan antara kadar sFlt1 dan tekanan darah diastolik (p=0,041; p<0,05). Terdapat hubungan bermakna antara kadar sFlt1 dan derajat proteinuria (p=0,012; p<0,05). Nilai penentu kadar sFlt1 untuk membedakan penderita PEB dengan hamil normal 2.815 pg/mL dengan sensitivitas 97,1%, spesifisitas 42%, dan akurasi 69,6%. Terdapat perbedaan bermakna antara kadar sFlt1 pada PEB dan kehamilan normal. Terdapat hubungan bermakna antara kadar sFlt1 dan tekanan darah sistolik, diastolik, serta dengan derajat proteinuria. Nilai penentu (cut-off point) kadar sFlt1 adalah 2.815 pg/mL.Kata kunci: sFlt1, preeklamsi berat, tekanan darah, proteinuria, hamil normalCOMPARISON OF SERUM SOLUBLE fms-LIKE TYROSINE KINASE 1 (sFlt1) LEVEL IN NORMAL PREGNANCY AND SEVERE PREECLAMPSIA AND ITS ASSOCIATION WITH BLOOD PRESSURE AND DEGREE OF PROTEINURIAPrediction and early detection of preeclampsia is very important to reduce maternal and perinatal morbidity and mortality. This research was to find out the difference of serum sFlt1 level between normal pregnancy and severe preeclampsia (SPE) and to determine the correlation of serum sFlt1 level with blood pressure as well as the degree of proteinuria. This was an analytic observational cross sectional study. Measurement of serum sFlt1 level using ELISA. >Statistical analysis was performed by using chi square, t test, Mann-Whitney test, Spearman Rank correlation coefficient and diagnostic test for cut-off point determination.The characteristics of the subjects in both groups were not statistically different (p>0.05). There was a significant difference in sFlt1 level between SPE group and control group (3,827±471 pg/mL and 2,708±441 pg/mL subsequently; p<0.05). There were significant association between sFlt1 level and systolic blood pressure (p=0.042; p<0.05 ); between sFlt1 level and diastolic blood pressure (p=0.041; p<0.05); and between sFlt1 level and degree of proteinuria (p=0.012; p<0.05). The cut-off point of sFlt1 level to differentiate SPE from normal pregnancy was 2,815 pg/mL with sensitivity of 97.1%, specificity 42% and accuracy of 69.6%.There is statistically significant difference of sFlt1 level in SPE compared to normal pregnancy. Significant association is noted between sFlt1 level and systolic and diastolic blood pressure, as well as degree of proteinuria. The cut-off point of sFlt1 level is 2,815 pg/mL.Keywords: sFlt1, severe preeclampsia, blood pressure, proteinuria DOI: http://dx.doi.org/10.15395/mkb.v41n3.241
Perbandingan Hispatologi Neovascular Tuft pada Retina Tikus yang Mengalami Oxygen-Induced Retinopathy dengan dan tanpa Pemberian L-Carnitine Rustam, Raihana; Sayuti, Kemala; Hendriati, Hendriati
Majalah Kedokteran Bandung Vol 50, No 4 (2018)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15395/mkb.v50n4.1393

Abstract

Retinopathy of prematurity (ROP) adalah salah satu penyebab kebutaan pada anak. Metode oxygen-induced retinopathy (OIR) pada tikus, menilai patogenesis dan terapi neovaskularisasi retina pada ROP. Hiperoksia retina berperan dalam patogenesis ROP dengan meningkatkan Reactive Oxygen Species (ROS). L-carnitine (LC) berpotensi melawan stres peroksidatif dengan mencegah pembentukan ROS. Tujuan penelitian ini mengetahui efek L-carnitine (LC) terhadap neovascular tuft pada retina tikus dengan oxygen induced retinopathy. Penelitian ini dilakukan dari Februari–April 2018 di Fakultas Kedokteran Universitas Andalas menggunakan 36 tikus baru lahir galur Wistar yang terbagi dalam 2 kelompok. Kelompok 1 diberi paparan oksigen 75% dan mendapat L-carnitine intraperitoneal 0,2 mg/gram/hari. Kelompok 2 hanya mendapat paparan oksigen 75%. Setelah tikus berusia 13 hari, kedua kelompok dipindahkan ke ruangan biasa dan usia 20 hari dilakukan enukleasi dan pemeriksaan histopatologi menggunakan imunohistokimia griffonia simplicifolia lectin (GSL) untuk menilai neovascular tuft. Bobot badan tikus kelompok OIR dengan LC rerata lebih berat daripada tikus OIR tanpa LC. Neovascular tuft yang dinilai adalah rerata jumlah neovascular tuft per 10-4 panjang penampang retina. Jumlah rerata neovascular tuft kelompok OIR tanpa LC sebanyak 62,98±14 dibanding dengan kelompok OIR dengan LC; 22,43±9,87 (p<0,05). Simpulan, L-carnitine berpengaruh terhadap perubahan histopatologi retina tikus dengan oxygen induced retinopathy. Kata kunci: L-carnitine, neovascular tuft, oxyge-induced retinopathy (OIR) Comparison of Retinal Neovascular Tuft Histopatological Features in Rats with Oxygen-Induced Retinopathy with and without L-Carnitine ProvisionRetinopathy of prematurity (ROP) is the leading cause of blindness in childhood. Oxygen-induced retinopathy (OIR) method in  rats can help in investigating  the  pathogcnesis and therapy for retinal neovascularization in ROP. Hyperoxia plays an important role in ROP pathogenesis with increased ROS levels. L-carnitine (LC) has protective effects on tissues through its mechanisms against peroxidative stress by preventing the formation of ROS. This study aimed to assess the effects of L-carnitine on rats with oxygen-induced retinopathy in terms of neovascular tuft formation. This study was performed in February–April 2018 at the Faculty of Medicine, Andalas University. xThirty six Wistar rat pups were randomly divided into 2 groups. Group 1 was exposed to 75% hyperoxygen and received 0,2 mg/gram/day LC intraperitoneally. Group 2 was only exposed to 75% hyperoxygen. Both groups were transferred to room air condition 13 after birth.  After postnatal day 20, enucleation was performed to investigate the retinal neovascular tuft formation. Ariffonia simplicifolia lectin immunohistochemistry (GSL) was used to assess the neovascular response. Analysis showed that the average weight of rats  in OIR group with LC was heavier than those in the group without LC. The mean ofneovascular tuft per 10-4 μm retinal section was 62.98 ± 14 neovascular tuft in OIR group without LC and 22.43 ± 9.87 neovascular tuft in OIR group with LC (p<0.05). Hence, LC has beneficial effects on the histopathological changes in oxygen-induced retinopathy in rats.. Key words: L-carnitine, neovascular tuft, OIR
Risk Factors to Growth Retardation in Major Thalassemia Uda, Riva; Idjradinata, Ponpon S.; Djais, Julistio TB
Majalah Kedokteran Bandung Vol 43, No 1
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

The increasing in the life span of patients with major thalassemia should be followed by increased quality of life. There are factors which can affect growth retardation in these patients. The aim of this study was to find out the risk factors for growth retardation in patients with major thalassemia. An analytical study with cross-sectional design was conducted at Pediatric Thalassemia Clinics of Dr.Hasan Sadikin Hospital, Bandung, in June to July 2006. The subjects of this study were patients with major thalassemia. Inclusion criteria’s were age under 14 years old, had no chronic diseases like tuberculosis, cerebral palsy with complete medical records. Risk factors were the timing of diagnosis, initial and dose of deferoxamine, volume of transfused blood, mean pretransfusion hemoglobin level, family income, and age. Antropometric measurement indices were used to assess the growth which expressed in Z score. Growth evaluated based on height/age (H/A) and growth retardation if H/A <-2 SD. Risk factors for growth retardation were analyzed separately using chi-square test and odds ratio (OR) with 95% confidence interval (CI). Then they were analyzed simultaneously with logistic regression method. Subjects consisted of 152 patients with major thalassemia. Seventy three thalassemia patients were stunted. Analysis showed that age (OR: 5.42, 95% CI:2.32–12.65, p <0.001), dosage of deferoxamine (OR: 4.0, 95% CI: 1.29–12.41, p: 0.016), and family income (OR: 2.32, 95% CI: 1.06–5.06, p: 0.036) were risks factors for growth retardation. Conclusion, risk factors for growth retardation in major thalassemia are age, dosage of deferoxamine, and family income. [MKB. 2011;43(1):21–5].Key words: Major thalassemia, risk factors, stuntedFaktor Risiko terhadap Gangguan Tumbuh pada Thalassemia MayorBertambahnya harapan hidup penderita thalassemia, seyogianya diikuti dengan kualitas hidup seperti anak normal. Terdapat berbagai faktor risiko yang mempengaruhi terjadinya gangguan tumbuh pada penderita thalassemia mayor. Tujuan penelitian ini untuk mengetahui berbagai faktor risiko terjadinya gangguan tumbuh pada penderita thalassemia mayor. Penelitian ini merupakan penelitian analitik dengan rancangan cross sectional di Poliklinik Anak thalassemia Dr. Hasan Sadikin, Bandung, pada bulan Juni–Juli 2006. Subjek penelitian ini adalah penderita thalassemia mayor. Kriteria inklusi adalah penderita berusia <14 tahun, tidak mempunyai penyakit kronik seperti tuberkulosis, palsi serebral, dan rekam medis yang lengkap. Faktor risiko adalah usia saat penegakan diagnosis, usia mulai menggunakan desferoksamin, dosis desferoksamin, volume darah yang telah diterima, kadar hemoglobin rata-rata sebelum transfusi, penghasilan keluarga, dan usia penderita. Dengan antropometri akan ditentukan pertumbuhan berdasarkan skor-Z. Pertumbuhan dinilai dari indeks tinggi badan/usia dan penderita yang mengalami gangguan tumbuh bila tinggi badan/usia <-2 SD. Faktor risiko gangguan tumbuh dianalisis menggunakan uji ki kuadrat dan rasio odds (RO) dengan interval kepercayaaan (IK) 95%, selanjutnya dilakukan analisis dengan metode regresi logistik. Subjek terdiri atas 152 penderita thalassemia mayor. Terdapat 73 penderita yang mengalami gangguan tumbuh. Hasil analisis menunjukkan usia penderita (RO 5,42; IK 95%: 2,32–12,65, p <0, 001), dosis desferoksamin (RO 4,0; IK95%:1,29–12,41, p: 0,016), dan penghasilan keluarga (RO 2,32; IK 95%:1,06–5,06, p: 0,036). merupakan faktor risiko terjadinya gangguan tumbuh. Simpulan, faktor risiko terjadinya gangguan tumbuh pada thalassemia mayor adalah usia, dosis desferoksamin, dan penghasilan keluarga. [MKB. 2011;43(1):21–5].Kata kunci: Faktor risiko, gangguan tumbuh, thalassemia mayor DOI: http://dx.doi.org/10.15395/mkb.v43n1.40
Perbedaan Kadar Liver Fatty Acid Binding Protein (L-FABP) Urine Penderita Diabetes Melitus Tipe 2 dengan Normoalbuminuria dan Mikroalbuminuria Wiharjo, Kristina; Permana, Hikmat; Noormartany, -; Rachmayati, Sylvia
Majalah Kedokteran Bandung Vol 46, No 2 (2014)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Diabetes melitus (DM) merupakan salah satu penyebab end stage renal disease (ESRD), 20−40% akan mengalami nefropati diabetik yang berkembang menjadi ESRD. Prevalensi nefropati diabetik meningkat pada DM tipe 2. Akumulasi stres oksidatif dapat menyebabkan peningkatan permeabilitas glomerulus sehingga menyebabkan peningkatan ekskresi albumin pada urine yang terbagi menjadi normoalbuminuria, mikroalbuminuria, dan makroalbuminuria. Kerusakan glomerulus terjadi setelah kerusakan tubulointerstisial ginjal yang menyebabkan penurunan aliran kapiler peritubular dan menyebabkan hipoksia. Liver fatty acid binding protein (L-FABP) berfungsi mengurangi hipoksia dengan mengikat stres oksidatif dan mengeluarkannya ke dalam urine. Penelitian ini bertujuan untuk menganalisis apakah terdapat perbedaan kadar L-FABP antara penderita DM tipe 2 normoalbuminuria dan mikroalbuminuria. Metode penelitian adalah observasional analitik dengan rancangan potong lintang. Subjek penelitian sebanyak 70 orang penderita DM tipe 2 dengan normoalbuminuria (38 orang) dan mikroalbuminuria (32 orang) yang diambil secara acak pada pasien yang datang ke Laboratorium Rawat Jalan Rumah Sakit Dr. Hasan Sadikin pada periode Juli−September 2012. Uji statistik menggunakan Uji Mann-Whitney. Hasil penelitian menunjukkan perbedaan bermakna kadar L-FABP urine pada normoalbuminuria dengan mikroalbuminuria dengan nilai ZM-W=3.513; p<0,001, median pada normoalbuminuria adalah 5, dan mikroalbuminuria adalah 7. Dari penelitian ini didapatkan kadar L-FABP urine meningkat karena kompensasi pembentukan stres oksidatif dan hipoksia yang terjadi sebelum kerusakan glomerulus. Simpulan, kadar L-FABP urine pada pasien DM tipe 2 dengan mikroalbuminuria lebih tinggi daripada pasien DM tipe 2 dengan normoalbuminuria. [MKB. 2014;46(2):83–7]Kata kunci: Diabetes melitus tipe 2, kadar L-FABP urine, mikroalbuminuria, nefropati diabetik, normoalbuminuria Comparison of Urinary Liver-Fatty Acid Binding Protein (L-FABP) in Normoalbuminuria and Microalbuminuria in Type 2 Diabetes Mellitus PatientsDiabetes mellitus (DM) is the leading cause of the end stage renal disease (ESRD). Around 20−40% patients with DM develop diabetic nephropathy and eventually progress into ESRD. Type 2 DM has a greater prevalence to develop diabetic nephropathy. Oxidative stress accumulation can increase permeability of the glomerulus which results in increased urine albumin excretion, which is divided into three groups: normoalbuminuria, microalbuminuria and macroalbuminuria. Glomerulus dysfunction occurs after tubulointerstisial renal dysfunction which decreases peritubular capillary flow that leads to tubulointerstisial hypoxia. Liver fatty acid binding protein function is to reduce hypoxia by binding oxidative stress and excretes it into urine. The aim of this study was to analyze the differences in the urine L-FABP level between normoalbuminuria and microalbuminuria type 2 DM patients. The study design was observational analytic using cross-sectional method. Subjects were 70 DM type 2 patients with normoalbuminuria (38 patients) and microalbuminuria (32 patients). Statistical analysis was performed using the Mann Whitney test The results found that there were significant differences in levels of urine L-FABP between normoalbuminuria and microalbuminuria type 2 DM patients (ZM-W=3.513, p<0.001) with medians of 5 and 7 in normoalbuminuria and microalbuminuria, respectively. The urine L-FABP level increased because of the oxidative stress and hypoxia that happened before the glomerulus dysfunction. In conclusion, urine L-FABP level in patients DM type 2 with microalbuminuria is higher than that of the normoalbuminuria. [MKB. 2014;46(2):83–7]Key words: diabetic nephropathy, L-FABP urine level, microalbuminuria, normoalbuminuria, type 2 DM DOI: 10.15395/mkb.v46n2.278
Peningkatan Kemampuan Berjalan dan Energy Expenditure pada Palsi Serebral yang Menjalani Latihan Penguatan dengan Metode Periodisasi Sari, Dian Marta; Shanti, Marietta; Hilmanto, Dany
Majalah Kedokteran Bandung Vol 49, No 1 (2017)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15395/mkb.v49n1.987

Abstract

Pada tahun 2014, Bandung memiliki angka kasus demam dengue (DD) tertinggi dari 27 kabupaten/kota di Jawa Barat. Upaya pengendalian DD telah dilaksanakan sejak beberapa dekade yang lalu. Salah satu upaya adalah dengan mengeliminasi tempat perkembangbiakan nyamuk melalui peran serta masyarakat. Penelitian ini bertujuan menilai partisipasi masyarakat Kota Bandung dengan mengetahui tempat-tempat perkembangbiakan Aedes aegypti baik di dalam maupun di luar rumah. Sampling dilakukan di 16 kelurahan di Kota Bandung yang telah dipilih berdasar atas angka kejadian DD, kepadatan penduduk, ketinggian permukaan, dan status sosial-ekonomi periode 2015. Populasi penelitian adalah rumah-rumah yang terdapat di 16 kelurahan tersebut. Jumlah sampel penelitian ini adalah 1.983 rumah yang merupakan perwakilan dari tiap kelurahan. Sampling jentik dilakukan pada berbagai tempat penampungan air, baik penampungan alami maupun buatan di sekitar pemukiman penduduk. Jentik yang ditemukan dimasukkan ke dalam wadah dan dibawa ke laboratorium untuk diidentifikasi dan dihitung jumlahnya. Hasil menunjukkan tempat perkembangbiakan nyamuk yang paling dominan adalah bak mandi (50%), talang air (24%), dan dispenser (15%). Data entomologi diperoleh hasil House index (HI) 24%, Container index (CI) 12%, dan Breteau index (BI) 36%. Hasil tersebut menunjukkan masih kurangnya peran serta masyarakat untuk mencegah DD dengan membasmi tempat perkembangbiakannya dan Kota Bandung masih berpotensi untuk terjadi penyebaran penyakit DD. [MKB. 2016;49(1):42–7]Kata kunci: Aedes aegypti, Bandung, demam dengue, tempat perkembangbiakan, partisipasi masyarakat Community Participation on Vector Control Based on Aedes aegypti’s Breeding Sites in BandungIn 2014, Bandung has the highest number of Dengue Fever cases of 27 districts and cities in West Java. Dengue Fever control efforts have been implemented for several decades. One of the efforts is the eradication of the vector breeding site with community participation. The aim of this study was to assess community participation by identifying Aedes aegypti’s breeding sites, both indoor and outdoor, in Bandung area. Sampling was conducted on houses in 16 villages throughout Bandung area. The sampling points were selected according to the Dengue Fever event number, population density, height, and socio-economic status. The total sample points were 1983 houses. Larvae from sample points were collected from various water containments, both natural and manmade, around the settlement. The larvae samples were then brought to the laboratory to be identified and counted. Results indicated the dominant breeding sites were bathtub (50%), gutter (24%), and dispenser (15%). Entomological survey resulted in 24% HI, 12% CI, and 36% BI. This indicates the lack of community participation in preventing DF by eradicating vector’s breeding sites and Bandung is still potential for DF outbreak. [MKB. 2016;49(1):42–7]Key words: Aedes aegypti, Bandung, breeding site, dengue fever, community pasticipation 

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