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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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Eosinofil Kerokan Mukosa Hidung Sebagai Diagnostik Rinitis Alergi Sudiro, Melati; Madiadipoera, Teti HS; Purwanto, Bambang
Majalah Kedokteran Bandung Vol 42, No 1
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Rinitis alergi merupakan gangguan fungsi hidung, terjadi setelah pajanan alergen melalui inflamasi mukosa hidung yang diperantarai IgE. Walaupun rinitis alergi bukan penyakit yang berat, penyakit ini dapat menurunkan kualitas hidup penderita. Allergic Rhinitis and Its Impact on Asthma (ARIA-WHO) menganjurkan tes kulit tusuk (TKT) sebagai pemeriksaan penunjang diagnostik, tetapi tidak semua sarana kesehatan memiliki fasilitas tersebut, oleh karena itu perlu dipilih pemeriksaan alternatif yang sesuai atau setara yaitu eosinofil kerokan mukosa hidung. Suatu uji diagnostik dilakukan pada 50 subjek tersangka rinitis alergi periode Februari-April 2005 di poliklinik alergi Bagian THT-KL FKUP–RSHS. Sebanyak 78% penderita menunjukkan TKT positif, 76% terdapat eosinofil pada mukosa hidung, 64% positif terhadap kedua pemeriksaan. Uji statistik menunjukkan hubungan bermakna antara TKT positif dan eosinofil positif (X2= 3,559; p = 0,03), sensitivitas eosinofil kerokan mukosa hidung 82,1% (95%CI: 82,02-82,18), spesifisitas 64,3% (95% CI: 63,52-65,08), dan akurasi 74% (95% CI: 73,94–74,06). Penelitian ini menunjukkan pemeriksaan eosinofil kerokan mukosa hidung dapat digunakan sebagai pengganti tes kulit tusuk pada sarana kesehatan yang tidak mempunyai fasilitas tersebut. [MKB. 2010;42(1):6-11].Nasal Scrapping Eosinophil As a Diagnostic Test for Allergic RhinitisAllergic rhinitis is clinically defined as a symptomatic disorder of the nose induced by IgE mediated inflammation. Allergic Rhinitis and Its Impact on Asthma (ARIA-WHO) recommended the use of skin prick test (SPT) as a diagnostic test, but the facility to acquire this method is not always available at some of the health centres, therefore alternative diagnostic test should be performed such as nasal smear eosinophil count. The aim of this study was to assess the usefulness of nasal smear eosinophilia compared with SPT for the diagnosis of allergic rhinitis. A diagnostic study using the cross sectional design, conducted in Department of ORL-HNS at FKUP-RSHS (February-April 2005). Fifty patients with a clinical history suggestive of nasal allergy were studied. A positive SPTwas demonstrated in 78% of the study population, 76% of the patients demonstrated positive eosinophil count. There was 64% correlation between positive SPT and nasal eosinophil and it was statistically significant (X2= 3.559;p=0.03). The sensitivity of nasal smear eosinophilia count was 82.1% (95% CI 82.02-82.18), specificity 64.3% (95%CI 63.52-65.08), and accuracy 74% (95% CI 73.94-74.06). The eosinophil count of nasal scrapping can be used as the replacement of the SPT at the health centre which do not have the SPT facility. DOI: http://dx.doi.org/10.15395/mkb.v42n1.2
MIKRODONT IA INSISIF LATERAL SEBAGAI SALAH SATU MANIFESTASI ORAL PENDERITA SINDROM DOWN TIPE MOSAIK DAN PENUH Syarif, Willyanti
Majalah Kedokteran Bandung Vol 41, No 1
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Mikrodontia adalah kelainan ukuran gigi yang merupakan lebih kecilnya ukuran gigi dari normal disertai bentuk gigi yang mengerucut atau meruncing disebut conical teeth. Mikrodontia umumnya menyertai sindrom di antaranya sindrom Down. Tujuan penelitian ini adalah melihat manifestasi oral sindrom Down tipe mosaik dan penuh berdasarkan jumlah mikrodontia (conical teeth). Dilakukan studi kasus pada 33 penderita sindrom Down berusia 18–90 bulan yang terdiri dari 10 tipe mosaik dan 23 tipe penuh. Pemeriksaan gigi meliputi pemeriksaan bentuk dan ukuran gigi secara visual, dan disesuaikan dengan tabel ukuran gigi sulung menurut Wheeler. Hasil penelitian menunjukkan bahwa 6,1% penderita sindrom Down tipe mosaik dan penuh mempunyai mikrodontia insisif lateral sejumlah satu gigi, 3% penderita mosaik dan 45,5% penderita tipe penuh memiliki mikrodontia insisif lateral sejumlah lebih dari satu gigi. Mikrodontia insisif lateral pada gigi sulung lebih banyak terdapat pada penderita tipe penuh (p=0,02). Hal ini menunjukkan bahwa hambatan pertumbuhan gigi pada anak sindrom Down tipe penuh lebih besar daripada tipe mosaik.Kata kunci: Mikrodontia, sindrom Down mosaik, penuhINCISIVE LATERAL MICRODONTIA AS ORAL MANIFESTATION FOR FULL AND MOSAIC TYPE DOWN SYNDROME Microdontia is the term when tooth size is smaller than normal, also called conical teeth. Etiology is multifactorial. Microdontia, commonly follow the syndromes. Down syndrome is common followed by microdontia. The aim of this study was to find out oral manifestation of mosaic and full trisomy based on the amount of microdontia in incisive lateral. Case study were done in 33 Down syndrome patients, aged 18-90 months consisted of 10 mosaic and 23 full types. Teeth examinations were done by visual examinations of size and form, and referred to Wheeler primary teeth table. The results showed 6.1% of mosaic and full trisomy have one conical teeth in insisifus lateral and 45.5% full trisomy and 3% mosaic have more than one conical teeth ini insisifus lateral. The percentage of the subject showed 60.60% had microdontia and 3.940% had normal size (p=0.02). It is Significant that the conical teeth in full Down syndrome is more than mosaic patient. It shows that full type trisomy has more delayed teeth development.Key words: Microdontia, mosaic, full Down syndrome DOI: http://dx.doi.org/10.15395/mkb.v41n1.182
Diet-Induced Changes in Serum Ganglioside Spectrum Patterns in 6-Month-Old Infants Gurnida, Dida A.; Idjradinata, Ponpon; Muchtadi, Deddy; Sekarwana, Nanan; Fong, Bertram; McJarrow, Paul; Rowan, Angela; Norris, Carmen
Majalah Kedokteran Bandung Vol 44, No 4 (2012)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Human milk contains higher levels of gangliosides when compared to infant formula. Gangliosides play a role in neuronal growth, migration, maturation, sinaptogenesis, and myelination. Seven of the identified gangliosides (GM1, GM2, GM3, GD3, GD1a, GD1b, and GT1b) are dominant gangliosides with different specific functions. Thus, the aim of the study was to understand the effects of ganglioside-enhanced diet and to compare the spectrum patterns of those seven classes of serum gangliosides in infants consuming standard infant formula (IF group), ganglioside-fortified infant formula (GA group) and exclusive breastfeeding (BF group). This study used liquid chromatography–mass spectrometry (LC-MS) method. This was a prospective study involving 30 infants in IF group, 29 in GA group and 32 in BF group. Subject recruitment was performed using consecutive admission  approach from March 2008 to February 2009 in Bandung. Statistical analyses using Wilcoxon test showed that there was a significant change in the spectrum patterns of GD3, GM1, GM2 and GT1b in IF group; of GD1a, GM1 and GM2 in GA group and of GD1a, GD1b, GM1 and GM3 in BF group. It is concluded that ganglioside-enriched diet extends spectrum patterns of gangliosides especially in seven of them, i.e. GM1, GM2, GM3, GD3, GD1a, GD1b, and GT1b, in 6-month old infants. [MKB. 2012;44(4):240–44]..Key words: Gangliosides, human milk, infants, infant formula, LC-MSPerubahan Pola Spektrum Gangliosida Serum yang Diinduksi Makanan pada Bayi Usia 6 BulanAir susu ibu (ASI) mengandung gangliosida yang kadarnya lebih tinggi dibandingkan dengan susu formula. Gangliosida berperan dalam pertumbuhan, migrasi, maturasi saraf, sinaptogenesis, dan mielinisasi. Tidak kurang dari 100 tipe gangliosida telah ditemukan, tujuh di antaranya (GM1, GM2, GM3, GD3, GD1a, GD1b, dan GT1b) merupakan kelas utama dengan fungsi yang berbeda. Penelitian ini bertujuan untuk mengetahui efek penambahan diet gangliosida serta membandingkan pola spektrum tujuh kelas gangliosida serum tersebut pada bayi yang mengonsumsi susu formula standar (kelompok infant formula/IF), susu formula difortifikasi gangliosida (kelompok GA), dan ASI eksklusif (kelompok breastfeeding/BF). Penelitian ini menggunakan metode liquid chromatography-mass spectrometry (LC-MS) untuk menghitung kadar ketujuh kelas gangliosida tersebut. Penelitian ini adalah penelitian prospektif yang melibatkan 30 bayi kelompok IF, 29 bayi kelompok GA, dan 32 bayi kelompok BF. Perekrutan subjek penelitian dilakukan dengan cara consecutive admission dari bulan Maret 2008 sampai bulan Februari 2009 di Bandung. Analisis statistik tes Wilcoxon menunjukkan perubahan bermakna pada pola spektrum GD3, GM1, GM2 dan GT1b pada kelompok IF; GD1a, GM1, dan GM2 pada kelompok GA; GD1a, GD1b, GM1, dan GM3 pada kelompok BF. Kesimpulan, penambahan diet gangliosida akan meningkatkan 7 spektrum gangliosida yaitu GM1, GM2, GM3, GD3, GD1a, GD1b, dan GT1b pada anak usia 6 bulan. [MKB.2012;44(4):240–44].Kata kunci: ASI, bayi, gangliosida, LC-MS, susu formula DOI: http://dx.doi.org/10.15395/mkb.v44n4.217
Ekspresi Bcl-2 dan Caspase-3 Pascapaparan Hipoksia Hipobarik Intermiten Hidayat, Achmad; Wiradisastra, Kahdar; Hernowo, Bethy S.; Achmad, Tri Hanggono
Majalah Kedokteran Bandung Vol 43, No 4
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Hipoksia hipobarik intermiten sering dialami oleh awak pesawat, karena selama di dalam kabin pesawat bernapas dengan tekanan udara yang lebih rendah. Tubuh akan beradaptasi dengan cara mengikat oksigen lebih banyak dan juga mengurangi dampak hipoksia. Fungsi mitokondria akan terganggu pada hipoksia, yaitu permiabilitas membran luar mitokondria karena protein Bcl-2 menurun. Jika hipoksia berlanjut akan terjadi kebocoran membran mitokondria, pelepasan sitokrom-c, dan proses apoptosis berlangsung. Penelitian ini bertujuan menganalisis protein Bcl-2 sebagai antiapoptosis dan caspase-3 sebagai indikator apoptosis akibat paparan hipoksia hipobarik intermiten. Dilakukan penelitian eksperimental pada tikus jantan Spraque Dawley periode Januari–April 2010 dengan melakukan paparan hipoksia hipobarik intermiten satu sampai empat kali dengan interval satu minggu. Jantung tikus dijadikan spesimen untuk dilakukan pemeriksaan ekspresi protein dengan pulasan imunohistokimia di Departemen Patologi Anatomi RS Dr. Hasan Sadikin Bandung dan western blot di Bagian Biomolekuler FK Universitas Indonesia Jakarta. Ekspresi protein Bcl-2 meningkat sesuai dengan frekuensi paparan hipoksia hipobarik intermiten, sebaliknya ekspresi protein caspase-3 menurun (rs=-0,448, p=0,013). Dari penelitian ini dapat disimpulkan bahwa terjadi penurunan tingkat apoptosis akibat paparan hipoksia hipobarik intermiten, hal ini disebabkan mekanisme adaptasi natural yang ditandai dengan menurunnya apoptosis sel dan secara tidak langsung akan memberi efek kardioprotektif. [MKB. 2011;43(4):166–70].Kata kunci: Apoptosis, Bcl-2, caspase-3, hipoksia hipobarik intermitenBcl-2 and Caspase-3 Expression Post Exposure of Intermittent Hypobaric HypoxiaIntermittent hypobaric hypoxia often suffered by cabin crew due to the fact that they are breathing lower pressured air inside the plane cabin. Human body will adapt by binding more oxygen and reducing hypoxia effect. Mitochondria function will be irritated by hypoxia which affect, outer mithochondrial membrane permeability due to decrease of Bcl-2 protein. Later on if hypoxia continues mitochondrial membrane will leaked cytocrome-c will released and apoptotic pathway will occur. The purpose of this study was to analyze Bcl-2 protein as antiapoptosis and caspase-3 as apoptosis indicator of intermittent hypobaric hypoxia exposure. Experimental study >was subjected to Spraque Dawley male mice during January–April 2010 by exposing them to several intermittent hypobaric hypoxias (one to four treatment) in an interval of one week. Protein expression on mice heart cell were detected by immunohistochemistry in the Department of Pathology Anatomy Padjadjaran University-RS Dr. Hasan Sadikin Bandung and western blot methods in Department Biomolecullar Indonesia University Jakarta. Bcl-2 protein expressions increased according with the frequency of intermittent hypobaric hypoxia exposures while a reverse trend was found for caspase-3 protein expressions (rs=-0.448, p=0.013). From the study it can be concluded that apoptosis will be decreased as a result of intermittent hypobaric hypoxia exposures, which occurred from natural adaptation mechanism indicated by decrease of cell apoptosis and cardio protective effect will be emerged. [MKB. 2011;43(4):166–70].Key words: Apoptosis, Bcl-2, caspase-3, intermittent hypobaric hypoxia DOI: http://dx.doi.org/10.15395/mkb.v43n4.64
HUBUNGAN ANTARA ATOPI DENGAN RIWAYAT PENYAKIT ALERGI DALAM KELUARGA DAN MANIFESTASI PENYAKIT ALERGI PADA BALITA Weninggalih, Endah; Kartasasmita, Cissy B.; Setiabudiawan, Budi
Majalah Kedokteran Bandung Vol 41, No 1
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Prevalensii penyakit alergi cenderung meningkat dalam dekade terakhir. Hal ini disebabkan karena faktor genetik dan lingkungan. Faktor genetik dibuktikan dengan riwayat penyakit alergi dalam keluarga. Penyakit alergi merupakan gejala alergi pada individu yang atopi. Penelitian ini bertujuan untuk mengetahui apakah atopi dan riwayat penyakit alergi dalam keluarga merupakan faktor risiko timbulnya manifestasi penyakit alergi. Penelitian dilakukan di Puskesmas Garuda, Babakan Sari dan Padasuka Bandung selama bulan Februari-Maret 2007 dengan rancangan cross sectional. Subjek yang telah mempunyai data hasil uji tusuk kulit (UTK) dan ada tidaknya riwayat penyakit alergi dalam keluarga dilakukan pengisian kuesioner standar The International Study of Asthma and Allergies in Childhood (ISAAC) dan pemeriksaan fisis. Subjek dinyatakan atopi bila hasil UTK positif. Hubungan antara variabel dianalisis dengan metode Ki kuadrat dan rumus Mantel Haenszel untuk mengkontrol confounding variabel. Jumlah subjek sebanyak 260 anak (92%), terdiri dari 130 anak dengan riwayat penyakit alergi dalam keluarga dan 130 anak tanpa riwayat penyakit alergi dalam keluarga. Berdasarkan UTK didapat 70 anak atopi dan 190 anak nonatopi. Manifestasi penyakit alergi terdapat pada 86 anak (33,08%). Manifestasi terbanyak adalah rinitis alergika 41 anak (15,77%),kemudian dermatitis atopik 18 anak (6,92%), dan asma 5 anak (1,92%). Kejadian manifestasi penyakit alergi terdapat pada 57,1% anak atopi dan 24,2% anak nonatopi. Kejadian manifestasi penyakit alergi terdapat pada 41,5% anak dengan riwayat penyakit alergi dalam keluarga dan 24,6% anak tanpa riwayat penyakit alergi dalam keluarga. Atopi mempunyai hubungan yang lebih kuat dengan manifestasi penyakit alergi pada balita, namun riwayat penyakit alergi dalam keluarga juga mempunyai hubungan sehingga merupakan hal yang penting untuk ditanyakan kepada orang tua.Kata kunci: Manifestasi penyakit alergi, atopi, riwayat penyakit alergi dalam keluargaASSOSIATION BETWEEN ATOPY WITH ALLERGIC HISTORY IN THE FAMILY AND ALLERGIC DISEASE IN UNDER FIVE YEAR OLD CHILDRENThere was an increase in prevalence of allergic diseases in the last decade. This was because of genetic and environmental factors. Genetic factor were proven by allergic history in the family. Allergic reaction in individu with atopy determined as allergic disease.The aim of this study was to know whether atopy and family allergic disease were risk factors for the occurrence of allergic disease manifestation. This study was conducted at Garuda, Padasuka and Babakan Sari Primary Health Center in Bandung, Indonesia, during February-March 2007, with cross sectional designed. Subjects with skin prick test (SPT) result and history or no history allergic disease data were questioned by The International Study of Asthma and Allergies in Childhood (ISAAC) and physical examination. Data were analyzed >using chi square and Mantel Haenszel test for confounding variables. A total of 260 (92%) children joined the third phase; consisted of 130 children with family history of allergic and 130 children without family history of allergic. Based of SPT consisted of 70 children with positive results and 190 children with negative results. The incidence of allergic disease was confirmed in 86 (33.08%) children: 41 (15.77%) children with allergic rhinitis, 18 (6.92%) children withatopic dermatitis, and 5 (1.92%) with asthma. Allergic diseases manifestation were confirmed in 57.1% atopy children and 24.2% nonatopy children. Allergic diseases manifestation were confirmed in 41.5% children with and 24.6% children without family history of allergic. Atopy has stronger association with allergic disease manifestation in under five children, but family history of allergic also has association so it's important to ask parents.Key words: Allergic diseases manifestation, atopy, family history of allergic
Correlation Between Tumor Cell Differentiation and CEA Levels in Patients with Adenocarcinoma of the Rectum Rudiman, Reno; Lukman, Kiki; Barr, Tubagus Izzul
Majalah Kedokteran Bandung Vol 52, No 4 (2020)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15395/mkb.v52n4.2028

Abstract

Adenocarcinoma of the rectum is the most common colorectal cancer in Indonesia. This cancer has the highest recurrence after curative surgical therapy with or without adjuvant therapy. With the advancing modern histopathology and molecular biology, the prognosis after therapy can be predicted through surveillance using tumor cell differentiation and carcinoembryonic antigen (CEA). The aim of this study was to analyze the correlation between tumor cell differentiation and serum CEA level in patients with adenocarcinoma of the rectum in Dr. Hasan Sadikin General Hospital Bandung, Indonesia. This was a retrospective observational analytic study conducted from January 2018- January 2019. There were 36 patients involved in this study consisting of 3 patients (8.3%) diagnosed with Stage II, 10 patients (27.7%) with Stage IIIA, 20 patients (55.5%) with stage IIIB, and 3 patients (8.3%) with stage IIIC. On histopathological examination, it was demonstrated that19 patients (52.8%) were well-differentiated, 15 patients (41.7%) were moderately differentiated, and 2 patients (5.6%) were poorly differentiated. The mean CEA level (CI 95%) for well-differentiated patients before surgery was 138.18 (15.99-260.38) ng/ml while the same level for the moderately differentiated patients was 64.34 (34.34-163.02) ng/ml. The mean CEA level for poorly differentiated patients was 1.55 (6.71-9.81) ng / ml. The result of the Kruskal Wallis test showed a p-value of 0.004. There is a strong correlation between the level of tumor cell differentiation and CEA level. Hubungan Tingkat Diferensiasi Sel Tumor dengan Kadar Ekspresi CEA Pada Pasien Adenokarsinoma Rektum Di Indonesia adenokarsinoma rektum memiliki rekurensi yang tinggi setelah terapi bedah kuratif dengan atau tanpa terapi adjuvan. Prognosisnya setelah terapi dapat  diketahui melalui surveilens dengan menggunakan Tingkat diferensiasi sel tumor dan carcinoembryonic antigen (CEA). Penelitian ini bertujuan menilai hubungan diferensiasi sel tumor dengan tingkat ekspresi CEA pada pasien adenokarsinoma rektum di RSUP Dr. Hasan Sadikin Bandung. Penelitian ini merupakan penelitian analitik observasional secara retrospektif. Pengambilan data dilakukan dari rekam medik Poliklinik Bedah Digestif dengan diagnosa adenokarsinoma rektum. Dari 36 pasien, 3 pasien (8,3%) stadium II, 10 pasien (27.7%) Stadium IIIA, 20 pasien (55,5%) stadium IIIB dan 3 pasien (8,3%) sisanya stadium IIIC. Sebanyak 19 pasien (52.8%) memiliki hasil histopatologi well differentiated, 15 pasien (41.7%) moderately differentiated dan 2 pasien (5.6%) poorly differentiated. Mean (CI 95%) kadar CEA sebelum operasi untuk well differentiated adalah 138.18(15.99-260.38) ng/mL, moderately differentiated 64.34(34.34-163.02)ng/ml, poorly differentiated 1.55(6.71-9.81)ng/mL. Uji Kruskal Wallis didapatkan nilai p=0,004 sehingga dapat disimpulkan bahwa terdapat hubungan antara tingkat diferensiasi sel tumor dengan kadar CEA  serum sebelum terapi pada pasien adenokarsinoma rektum di RSUP Hasan Sadikin Bandung. Pasien adenokarsinoma rektum preoperatif di RSUP Hasan Sadikin Bandung menunjukkan bahwa semakin baik tingkat diferensiasi sel tumornya semakin tinggi kadar CEAnya di dalam serum.
Effect of Iron Supplementation in Anti-Tuberculosis Drug Treatment on Interferon-γ Level in Tuberculosis Spondylitis Patients Perdana, M. F. Nanda; Rasyid, Hermawan Nagar; Ramdan, Ahmad; Ismiarto, Yoyos Dias
Majalah Kedokteran Bandung Vol 52, No 3 (2020)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15395/mkb.v52n3.1712

Abstract

Tuberculosis (TB) is still one of the major health problems in the community. Micronutrients, including iron, are crucial in the body's defense mechanism. Iron modulates the activation of IFN-γ, which in turn will activate the macrophages. This study explores the effect of iron supplementation given with anti-tuberculosis drug therapy on the IFN-γ level in tuberculosis spondylitis patients. This was a single-blind randomized control trial study at Dr. Hasan Sadikin General Hospital Bandung, from December 2018 to March 2019, using the consecutive sampling approach. Thirty-four respondents with category 1 TB spondylitis and an sTfR level of> 21.7 pg /µL were recruited and randomized into control and experimental groups. The control group (n=17) was treated with 2 RHZE for 2 months while the experimental group (n=17) received 2 RHZE and iron tablet for 2 months. An increase in the IFN-γ level of the experimental group was observed from an average of 21.7 pg/ml before therapy to an average of 72.39 pg/mL after therapy. Meanwhile, the IFN-γ level in the control group increases from an average of 22.5 pg/mL to an average of 35.35 pg/mL. This difference was statistically significant based on the analysis using the independent t-test (p-value <0.05). Therefore, the administration of anti-tuberculosis drugs with the addition of iron can increase the body's immune response, which is indicated by the increasing level of IFN-γ.Pengaruh Penambahan Zat Besi Pada Pengobatan Obat Anti Tuberkulosis Terhadap Kadar Interferon-γ Pada Pasien Spondilitis Tuberkulosis Tuberkulosis (TB) masih merupakan salah satu masalah kesehatan yang cukup besar di masyarakat. Gangguan imunitas tubuh penderita berperan dalam proses terjadinya infeksi tuberculosis. Mikronutrient yang penting dalam pertahanan tubuh salah satunya adalah zat besi. Pada penelitian ini akan dipelajari mengenai pengaruh penambahan zat besi pada terapi OAT terhadap kadar IFN-γ pada pasien spondilitis tuberkulosis. Penelitian ini merupakan penelitian dengan metode single blind randomized control trial di Rumah Sakit Dr. Hasan Sadikin Bandung pada Desember 2018 hingga Maret 2019, dengan metode pengambilan sampel consecutive sampling. Dilakukan randomisasi pada 34 responden. Responden yaitu: penderita spondilitis TB kategori 1 dengan kadar sTfR >21,7 pg/µL. Kelompok kontrol 17 responden diterapi 2 RHZE. Kelompok eksperimen 17 responden diterapi 2 RHZE dengan tablet besi selama 2 bulan. Pada penelitian ini didapatkan peningkatan kadar IFN-γ rata-rata kelompok eksperimen (pemberian obat anti tuberkulosis dengan penambahan zat besi) dari 21,7 pg/mL sebelum dilakukan pemberian terapi menjadi rata-rata 72,39 pg/mL setelah dilakukan pemberian terapi diuji dengan uji t sampel independen (nilai p<0,05), secara statistik berbeda signifikan dengan kelompok kontrol (pemberian obat anti tuberkulosis), yaitu dari 22,5 pg/mL sebelum dilakukan pemberian terapi menjadi rata-rata 35,35 pg/mL setelah dilakukan pemberian terapi.  Simpulan, pemberian obat anti tuberkulosis dengan penambahan zat besi dapat meningkatkan respon imun tubuh, yang ditandai dengan meningkatnya kadar IFN-γ.
Rare Case of Periampullary Duodenal Carcinoma Maghfirah, Desi; Abubakar, Azzaki; Yusuf, Fauzi; Riswan, Muhammad
Majalah Kedokteran Bandung Vol 53, No 1 (2021)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15395/mkb.v53n1.1988

Abstract

Periampullary carcinoma is a malignancy that appears around the vatteri ampulla. This malignancy can originate from the pancreas, duodenum, and distal choledochal duct. Duodenal cancer is a very rare case, only about 0.3% of the gastrointestinal malignancies. Reported cases are increasing with the increasing use of esophagogastroduodenoscopy. The most frequently found carcinomas of the duodenum include adenocarcinoma, carcinoid, lymphoma, and leiomyosarcoma. The symptoms of these carcinomas are often not specific so the diagnosis is often late, leading to a poor prognosis. Early diagnosis and proper therapy provide a good prognosis.  The case reported here representeda 52-year-old woman presented with hematemesis melena, anemia, jaundice, epigastric mass, right hypochondrial pain, and weight loss. From the esophagogastroduodenoscopy, the mass was found to obstruct half of the duodenum lumen and bleeding, which was easily triggered, was observed in the second part of the duodenum. CT scan revealed a mass in the head of the pancreas with gall bladder hydrops and obstruction of the intra and extra-hepatic billier system. After a Whipple operation Laparotomy, the histology showed papillary adenocarcinoma duodenum. Patients then underwen chemotherapy with 5 fluorouracil regimen. Patient's clinical condition is currently improving and no complaint is conveyed by the patient.
Soil-Transmitted Helminth Infections, Anemia, and Undernutrition Among School-Children in An Elementary School in North Jakarta, Indonesia Sari, Monica Puspa; Nathasaria, Tabita; Majawati, Esther Sri; Pangaribuan, Helena Ullyartha
Majalah Kedokteran Bandung Vol 52, No 4 (2020)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar

Abstract

The strategy to control soil-transmitted helminth (STH) is through periodic deworming to eliminate infective worms among children. Helminthiasis is known to impair the nutrition and physical status of infected children. This study aimed to determine the prevalence and relationship between nutritional status and infection among School-Age Children (SAC) following deworming campaigns in Public Elementary School 6 Cilincing, North Jakarta, Indonesia. This study was a cross-sectional analytical observation on 82 children sampled using the Kato Katz approach during the period of August and November 2019. Nutritional status was determined using the standardized AnthroPlus Software while the Kolmogorov Smirnov test was used to statistically analyze the data. A structured questionnaire was used to collect data on hygiene and deworming pill consumption. Results showed that 7.3% of 82 children were infected with at least one of the following STH parasites: Ascaris lumbricoides accounts (n=3, 3.7%), Trichuris trichiura (n=2, 2.4%), and Enterobius vermicularis (n=1, 1.2%). Anemia was defined as a hemoglobin concentration of <8-11.9 g/dL for the age group of 8-13 years old. Of all participants, 10 (12%) were anemic. The proportion of children representing mild and moderate anemia were 4% and 6%, respectively. The prevalence of infection was not associated with anemia and STH infection did not present significant association with undernutrition statusAlmost children practiced hand washing before eating (93.9%). About 96% of children had pit latrines and only 24 children (29.5%) took deworming pills in the last 6 months. Thus, routine anthelminthic treatment for school children in urban areas is necessary. Infeksi Cacing yang ditularkan melalui Tanah, Anemia dan Gizi Buruk pada Anak Sekolah Dasar di Jakarta Utara, Indonesia Strategi pengendalian cacingan melalui pemberian obat cacing  berkala untuk memberantas cacingan pada anak. Anak terinfeksi dapat mengalami gangguan gizi dan fisik. Penelitian bertujuan mengetahui prevalensi STH dan hubungan status gizi anak sekolah pasca kampanye pemberantasan cacing di SDN 6 Cilincing, Jakarta Utara. Observasional analitik dengan desain studi potong lintang digunakan dalam sampel kato-katz dari 82 anak sekolah. Penelitian dilakukan dari Agustus-November 2019. Status gizi ditentukan menggunakan software AnthroPlus. Uji Kolmogorov smirnov untuk menganalisis data. Hasil penelitian menunjukkan  7,3% dari 82 anak terinfeksi setidaknya satu parasit STH. Parasit yang teridentifikasi, Ascaris lumbricoides sebanyak 3 (3,7%). Trichuris trichiura 2 (2.4%) diklasifikasikan infeksi ringan dan Enterobius vermicularis 1 (1,2%). Anemia didefinisikan bila konsentrasi Hb <8-11,9 g/dL untuk anak 8-13 tahun. Secara total, 10 (12%) anak anemia. Proporsi anak mewakili anemia ringan dan sedang masing-masing adalah 4%, dan 6%. Prevalensi infeksi tidak berhubungan dengan anemia. Anak positif STH tidak menunjukkan hubungan yang signifikan dengan kekurangan gizi pada anak. Pengumpulan data kuesioner dilakukan menggunakan kuesioner terstruktur. Hampir semua anak mempraktikkan kebersihan tangan yang benar, mencuci tangan sebelum makan (93,9%). Memiliki jamban 96% dan hanya 24 anak (29,5%) minum obat cacing 6 bulan terakhir. Hasil ini mendukung antihelmintik rutin pada anak sekolah di daerah perkotaan.
Anxiety in Pregnant Women During Coronavirus (Covid-19) Pandemic in East Java, Indonesia Zakkiyatus Zainiyah; Eny Susanti
Majalah Kedokteran Bandung Vol 52, No 3 (2020)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15395/mkb.v52n3.2043

Abstract

The 2019 coronavirus pandemic has been recognized as a trigger for anxiety, especially in pregnant women. Pregnant women are among those with a high-risk for contracting coronavirus, not only for themselves but also for the unborn child. Continuous information is needed for pregnant women to avoid anxiety because anxiety will result in complications for both mother and child, such as low birth weight baby and postpartum psychological disorder. The purpose of this study was to identify the prevalence of anxiety in pregnant women during the Coronavirus pandemic in Madura, East Java, Indonesia. This study was a cross-sectional descriptive study conducted from April 13 to May 8, 2020. Data were collected using a Google form distributed to all pregnant women in the Madura Region based on the list of pregnant women from the midwives in each city in this region. Seventy pregnant women returned the completed form, and data were analyzed using frequency tables and percentages. Results showed that 31.4% of pregnant women experienced very severe anxiety, 12.9% experienced severe anxiety, and the remainings did not experience anxiety. In conclusion, the coronavirus pandemic indeed increases anxiety in pregnant women which will need to be addressed to avoid negative impacts on the mother and unborn child. Counseling is needed to reduce anxiety by asking the women to stay at home, wash their hands, wear masks, eat nutritious food, have their pregnancy checked, perform exercise for pregnant women at home, and seek for help when facing emergencies. Tingkat Kecemasan Ibu Hamil pada Masa Pandemi Viruscorona (Covid-19) di  Jawa Timur, Indonesia Pandemi virus corona 2019 ini menyebabkan kecemasan, terutama pada ibu hamil, karena ibu hamil merupakan kelompok risiko tinggi untuk tertular virus corona, terutama pada janin yang dikandungnya, sehingga diperlukan informasi secara terus menerus kepada ibu hamil supaya tidak terjadi kecemasan, karena kecemasan ini akan berakibat komplikasi pada ibu dan janinnya. Dampak kecemasan pada ibu hamil dan janin adalah Berat Badan Lahir Rendah dan gangguan psikologis pada ibu setelah melahirkan. Tujuan penelitian ini mengidentifikasi tingkat kecemasan ibu hamil di masa pandemi virus Corona di wilayah Madura, Jawa Timur. Penelitian ini dilakukan tanggal 13 April sampai dengan 8  Mei 2020  dan merupakan penelitian desktriptif dengan menggunakan google form yang disebarkan ke seluruh ibu hamil di Wilayah Madura melalui bidan yang ditunjuk setiap kota yang ada di Madura. Tujuh puluh ibu hamil mengembalikan formulir yang telah diisi dan data dianalisis menggunakan tabel frekuensi dan persentase. Hasil penelitian menunjukkan bahwa 31.4% mengalami kecemasan sangat berat, 12.9% mengalami kecemasan berat, dan sisanya ibu tidak mengalami kecemasan atau dalam keadaan normal. Simpulan, pandemi virus corona memang meningkatkan kecemasan pada ibu hamil yang perlu diatasi untuk menghindari dampak negatif pada ibu dan janinnya. Konseling diperlukan untuk mengurangi kecemasan dengan meminta ibu-ibu untuk tinggal di rumah, mencuci tangan, memakai masker, makan makanan bergizi, memeriksakan kehamilannya, melakukan senam ibu hamil di rumah, dan mencari pertolongan saat menghadapi keadaan darurat.

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