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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 639 Documents
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Kadar Asam Urat Serum sebagai Biomarker Preeklamsi Sumanti, Neli; Noormartany, -; Alamsyah, Muhammad; Rostini, Tiene
Majalah Kedokteran Bandung Vol 45, No 2 (2013)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Preeklamsi masih merupakan masalah kesehatan yang menjadi salah satu penyebab kematian ibu selain akibat perdarahan dan infeksi. Etiologi dan patogenesis preeklamsi belum diketahui pasti. Peningkatan kadar asam urat serum timbul bersamaan dengan peningkatan tekanan darah dan terjadi sebelum timbul proteinuria sehingga dapat dipakai sebagai salah satu biomarker. Tujuan penelitian ini menganalisis perbandingan kadar asam urat serum pada kehamilan in partu normal dengan in partu preeklamsi. Penelitian potong lintang dilakukan di Rumah Sakit Dr. Hasan Sadikin Bandung pada bulan Maret–Mei 2011. Subjek penelitian 45 wanita hamil in partu normal sebagai kelompok kontrol dan 44 wanita in partu dengan preeklamsi sesuai dengan kriteria inklusi dan eksklusi. Kadar asam urat serum pada wanita hamil normal adalah 3,43±0,14 mg/dL. Pada penelitian ini nilai titik potong kadar asam urat serum 4,8 mg/dL dengan nilai sensitivitas 93% dan spesifisitas 80%. Simpulan,kadar asam urat pada in partu preeklamsi lebih tinggi dibandingkan dengan kehamilan normal. Peningkatan kadar asam urat dapat dipertimbangkan sebagai salah satu biomarker preeklamsi, sebaiknya kadar asam urat serum digunakan sebagai pemeriksaan serial pada ibu hamil saat pelayanan antenatal. [MKB. 2013;45(2):98–104]Kata kunci: Biomarker, kadar asam urat, preeklamsiSerum Levels of Uric Acid as a Biomarker in PreeclampsiaPreeclampsia remains a health problem that becomes one of the causes of maternal deaths besides bleeding and infection. The etiology and pathogenesis of preeclampsia are unclear. Increased serum uric acid levels is seen simultaneously with the increase of blood pressure and occurred before the onset of proteinuria. Therefore, the uric acid can be used as a biomarker. The aim of this study was to analyze the serum uric acid levels between normal and preeclampsia pregnancies. The study was conducted in Dr.Hasan Sadikin Hospital Bandung between March and May 2011, using cross sectional study design. Subjects were 45 inpartu normal pregnant women as control and 44 in partu pregnant women with preeclampsia accordance with inclusion and exclusion criteria. Levels of uric acid in normal pregnancy are 3,43 ±0.14 mg/dL. In this study uric acid levels resulting in cut-off levels of 4,8 mg/dL with a sensitivity value of 93%, and specificity 80%. Conclusions: uric acid levels in at term preeclampsia are higher compared with normal pregnancies. Increased levels of uric acid can be considered as one of biomarkers of preeclampsia, hence the serum uric acid levels used as serial examinations in pregnant women during antenatal care. [MKB. 2013;45(2):98–104]Key words: Biomarker, preeclampsia, uric acid level DOI: http://dx.doi.org/10.15395/mkb.v45n2.89
SUPINE HYPOTENSION SYNDROME PADA KEHAMILAN Bisri, Dewi Yulianti; Redjeki, Ike Sri; Bisri, Tatang
Majalah Kedokteran Bandung Vol 47, No 2 (2015)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Supine hypotension syndrome (SHS) dapat terjadi mulai kehamilan trimester 2 dan didefinisikan sebagai penurunan tekanan sistol ?30% pada posisi supine dibanding dengan lateral. Tujuan penelitian mengetahui insidensi SHS pada wanita hamil aterm di Indonesia. Penelitian observasional pada 200 wanita hamil aterm, kehamilan pertama dan kedua, usia 18?40 tahun, tidak memiliki penyakit sertaan, dan akan dilakukan seksio sesarea elektif di Rumah Sakit Ibu dan Anak Melinda dalam periode Maret?Juli 2012. Pasien diberikan 500 cc cairan kristaloid Ringer laktat sebagai pengganti puasa, kemudian dilakukan pemeriksaan tekanan sistol, diastol, rata-rata, laju nadi, dan saturasi oksigen selama 5 menit dengan jarak 1 menit pada posisi supine dan miring kiri 45O. Hasil pengukuran tekanan sistol supine 113,49 (13,20) mmHg, miring 105,20 (12,08) mmHg dengan nilai p=0,93. Tekanan diastol supine  69,05 (7,31) mmHg dan miring 58,58 (7,73) mmHg (p=0,51). Tekanan darah rata-rata supine 84,59 (8,38) mmHg dan miring 75,87 (8,82) mmHg (p=0,62). Laju nadi supine 88,95 (12,19) x/menit, dan miring 86,26 (11,47) x/menit, (p=0,86). SpO2 supine 99,95 (1,11)% dan miring 99,64 (0,67)% (p=0,07). Simpulan, tidak ada perbedaan tekanan sistol, diastol, rata-rata, laju nadi, dan SpO2 wanita hamil aterm pada posisi berbaring dengan posisi miring kiri 450. [MKB. 2015;47(2):102?8]Kata kunci: Posisi supine, posisi miring kekiri, supine hypotension syndrome, wanita hamil atermSupine Hypotension Syndrome in PregnanciesAbstractSupine hypotension syndrome (SHS) can occur starting from the second trimester of pregnancy and is defined as a reduction of systolic blood pressure of ?30% in the supine position compared to lateral position. The purpose of this study was to determine the incidence of SHS in full term pregnant women in Indonesia. An observational study on 200 full term pregnant women, first and second pregnancy, aged 18?40 years, no coexisting diseases, and was going to have an elective cesarean section in Melinda Woman and Child Hospital in the period of March?July 2012. Patients were given 500 cc of Ringer?s lactate crystalloid fluid instead of fasting. Systolic and diastolic blood pressure, mean blood pressure, pulse rate, and oxygen saturation for 5 minutes were then examined every  minute. The examination was conducted in the supine and left lateral position of 45O. The results show a systolic blood pressure in supine position of 113.49 (13.20) mmHg and in lateral position of 105.20 (12.08) mmHg (p=0.93). Meanwhile, the supine diastolic blood pressure was  69.05 (7.31) mmHg and lateral position was 58.58 (7.73) mmHg (p=0.51). The mean blood pressure in supine position was 84.59 (8.38) mmHg and 75.87 (8.82) mmHg (p=0.62) in lateral position . The pulse rates for supine and lateral position were 88.95 (12.19)x/min and 86.26 (11.47) x/min (p=0.86), respectively. Supine SpO­2 was 99.95 (1.11) % and lateral SpO2 was 99.64 (0.67) % (p=0.07). In conclusion, there is no differences in systolic, diastolic, mean blood pressure, pulse rate and SpO2 of full term pregnant women in supine or left lateral position of 45O. [MKB. 2015;47(2):102?8]Key words: Full term pregnant women, left lateral decubitus, supine hypotension syndrome, supine DOI: 10.15395/mkb.v47n2.461
Kepatuhan Minum Obat Pada Pasien Lupus Eritematosus Sistemik di RSUP Dr. Hasan Sadikin Bandung Sheba, Shiane Hanako; Djuhaeni, Henni; Setiabudiawan, Budi; Sunjaya, Deni K.; Mutyara, Kuswandewi; Rinawan, Fedri Ruluwedrata
Majalah Kedokteran Bandung Vol 50, No 1 (2018)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (496.569 KB) | DOI: 10.15395/mkb.v50n1.1229

Abstract

Lupus eritematosus sistemik (LES) merupakan penyakit autoimun kronik yang mengharuskan penyandangnya minum obat dalam waktu lama bahkan seumur hidupnya. Keadaan ini selain menimbulkan dampak fisik, psikis maupun sosial juga menyebabkab biaya tinggi sehingga LES digolongkan sebagai penyakit catastrophic. Ketidakpatuhan minum obat penyandang LES akan berpengaruh langsung terhadap memburuknya outcome penyakit lupus. Penelitian bertujuan mengeksplorasi pelaksanaan dan kepatuhan minum obat pada pasien LES dengan harapan terjadinya perbaikan penatalaksanaan LES yang berdampak pada peningkatan kualitas hidup serta penurunan angka kematian karena LES. Telah dilakukan penelitian kualitatif terhadap 6 informan pasien LES suku Sunda di klinik reumatologi RSUP Dr. Hasan Sadikin Bandung pada bulan Juli sampai September 2016 dengan menggunakan pedoman wawancara mendalam open question yang dikembangkan sesuai dengan jawaban informan. Paradigma penelitan adalah constructivism dengan triangulasi terhadap 2 orang keluarga pasien dan 3 dokter konsultan klinik reumatologi RSUP Dr. Hasan Sadikin Bandung. Data yang diperoleh dianalisis secara bertahap melalui proses transkripsi, reduksi, koding, kategorisasi, penyusunan tema, interprestasi data serta pembangunan konsep. Hasil penelitian menunjukkan ada 57 koding, 14 kategori, dan 3 tema yang mengarah kepada kepatuhan minum obat pasien LES. Ke-14 kategori kepatuhan tersebut terdiri dari: karakteristik individu, daya ingat, pengetahuan, eksperimen, dan manajemen konsumsi (faktor predisposing); karakteristik penyakit, karakteristik obat, biaya, kebijakan rumah sakit, akses ke rumah sakit, terapi alternatif dan enabler agent (faktor enabling); karakteristik tenaga kesehatan dan dukungan eksternal dari berbagai pihak (faktor reinforcing). Konsep dan konstruk yang ditemukan membangun konstruk lokal Jawa Barat berlatar belakang karakteristik masyarakat Sunda dan bersifat kontekstual terhadap penyakit lupus.Kata kunci: Kepatuhan minum obat, lupus eritematosus sistemik, odapusDrug Adherence Drug in Systemic Lupus Erythematosus Patients in Dr. Hasan Sadikin General Hospital BandungSystemic Lupus Erythematosus (SLE) is a chronic autoimmune disease that requires prolonged treatment. SLE creates physical, psychological, social, and economic burden for the patients; therefore, it is categorized as a catastrophic illness. Non-adherence to medication in SLE patient isan important factor that directly leads to poor outcome. The aim of this study was to explore the management and adherence of patients with SLE to improve the quality of life and to reduce the mortality rate. A qualitative study was undertaken to 6 sundanese SLE patients at the Rheumatology clinic in Dr. Hasan Sadikin General Hospital Bandung in July-September 2016 by using open-ended questions in in-depth interviews with probing based on informant answers. The paradigm used was constructivism with triangulation to family members of 2 patients and 3 rheumatologist consultants in Dr. Hasan Sadikin General Hospital Bandung. Data collected were analyzed gradually through transcription, reduction, coding, categorizing, theme analysis, data interpretation, and theorizing. The results showed 57 codes, 14 categories, 3 themes that focused on the medication adherence of Lupus patients.The themes were categorized as predisposing (individual characteristics, memory, knowledge, experimentation, and consumption management), enabling (drug characteristic, cost, hospital policies, access to hospital, alternative therapy, and enabler agent), and reinforcing (characteristics of health care professionals and social support) according to the predetermined theory. This study has also identified the local concepts and constructs Sundanese people in West Java, which is contextual to the lupus disease.Key words: Adherence, systemic lupus erythematosus, odapus
Perbandingan Derajat Hiperemis Pascabedah Pterigium Inflamasi antara Teknik Lem Fibrin Otologus dan Teknik Jahitan Rifada, Maula; Prawirakoesoema, Loekman; Dalimoenthe, Nadjwa Zamalek; Enus, Sutarya
Majalah Kedokteran Bandung Vol 45, No 3 (2013)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Tandur konjungtiva bulbi merupakan baku emas pada pembedahan pterigium yang secara umum metode penempelannya dengan menggunakan jahitan, namun memiliki beberapa kekurangan, di antaranya waktu pembedahan cukup lama, menimbulkan reaksi inflamasi, dan kemungkinan komplikasi. Saat ini dikembangkan penggunaan lem fibrin untuk penempelan tandur konjungtiva bulbi sebagai alternatif prosedur pengganti jahitan. Penelitian ini bertujuan untuk mengetahui derajat hiperemis pascabedah pterigium inflamasi antara teknik lem fibrin otologus (LFO) dan teknik jahitan. Penelitian ini merupakan uji klinis acak terkontrol tersamar tunggal yang dilaksanakan di Pusat Mata Nasional Rumah Sakit Mata Cicendo Bandung dari bulan Oktober−Desember 2010. Subjek penelitian dibagi menjadi dua kelompok secara acak dan hasilnya terdapat 12 penderita kelompok LFO dan 14 penderita kelompok jahitan. Pemantauan dilakukan pada minggu pertama, kedua, dan keempat pascabedah serta dilakukan pengambilan foto lampu celah biomikroskop digital. Benang jahitan disamarkan menggunakan perangkat lunak penyunting foto dan satu orang pengamat menilai secara objektif derajat hiperemis pada foto digital. Analisis statistik dilakukan menggunakan Uji Mann Whitney. Hasil penelitian menunjukkan bahwa derajat hiperemis secara bermakna lebih kecil pada minggu pertama, kedua, dan keempat pada kelompok teknik LFO (derajat hiperemis 2,5; 2; dan 1,5) dibandingkan dengan kelompok teknik jahitan (derajat hiperemis 4; 3; dan 2) (p<0,05). Simpulan, penggunaan LFO untuk melekatkan tandur konjungtiva bulbi pada pembedahan pterigium inflamasi menghasilkan derajat hiperemis yang lebih kecil dibandingkan dengan penggunaan jahitan. [MKB. 2013;45(3):174–9]Kata kunci: Lem fibrin otologus, pterigium inflamasi Comparison of Hyperemia Degree between Autologous Fibrin Glue and Suture Technique Post Inflammed Pterygium SurgeryConjunctival autograft is the gold standard in pterygium surgery which is regularly secured with suture, butthis method has few drawbacks of prolonged operating time, provoke ocular inflammation and potential risk for suture related complication. The use of fibrin glue has become an alternative procedure in conjuntival graft transplantation. The aim of this study was to compare hyperemia degree post inflamed pterygium surgery between autologous fibrin glue (AFG) and suture technique. This was a randomized, controlled, single blind clinical trial that conducted in National Eye Center, Cicendo Eye Hospital Bandung from October−December 2010. Subjects were randomly assigned to two groups and as result 12 patients belong to AFG group and 14 belong to suture group. Digital slit-lamp photographs were taken at 1st week, 2nd week and 4th week postoperatively for observation. Sutures were masked using photo-editing software and one masked observers objectively graded the digital photograph for degree of hyperemia. Statistical analysis was performed using Mann Whitney Test. The results of this study showed that the degree of hyperemia was significantly lower in AFG group (hyperemia degree 2.5, 2 and 1.5) than in suture group (hyperemia degree 4, 3 and 2) at 1st week, 2nd week and 4th week post operatively (p<0.05). In conclusion, the use of AFG for graft fixation in inflamed pterygium surgery produced significantly lower hyperemia degree. [MKB. 2013;45(3):174–9]Key words: Autologous fibrin glue, inflammed pterygium DOI: http://dx.doi.org/10.15395/mkb.v45n3.148
Teknik Rekonstruksi Turndown Flap Tendon Achilles dan Flap Fasiokutan Sural pada Ruptur Tendon Achilles yang Disertai Kerusakan Masif Jaringan Lunak: Laporan Kasus Hermawan Nagar Rasyid; Andri Primadhi; Renaldi Prasetia
Majalah Kedokteran Bandung Vol 48, No 1 (2016)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1204.203 KB) | DOI: 10.15395/mkb.v48n1.737

Abstract

Ruptur tendon achilles adalah cedera yang paling sering terjadi pada tendon ekstremitas bawah, meskipun merupakan tendon yang terbesar dan terkuat. Penelitian ini bertujuan menjelaskan teknik operasi dengan modifikasi augmentation pada penatalaksanaan ruptur tendon Achilles yang disertai kerusakan pada jaringan lunak yang luas. Kasus pada penelitian ini adalah seorang pasien (usia 30 tahun) dengan ruptur terbuka tendon Achilles akut dan terinfeksi, serta hilangnya tendon sampai dengan 5 cm, kecacatan tendon yang tidak menempel di bagian distal dan hilangnya sebagian tulang calcaneus. Kerusakan kulit diukur setelah dilakukan debridemen dengan rentan antara 8 cmx5 cm sampai dengan 15 cmx10 cm. Ruptur pada tendon dijahit dengan gastrosoleus turn down flap ke tulang calcaneus. Reverse sural artery digunakan untuk menutupi kulit. Flap yang dibuat berhasil hidup. Pasien dapat berjalan normal, dapat berdiri dengan ujung kaki, fleksi plantar yang aktif, dan dapat kembali beraktivitas dalam 2 bulan setelah operasi. Pasien memiliki rentang gerak penuh ke segala arah. Simpulan, debridemen, rekonstruksi tendon dalam satu tahap, dan reverse flow sural artery flap memberikan hasil yang memuaskan pada kasus robekan luas tendon Achilles dan kerusakan jaringan lunak yang luas. [MKB. 2016;48(1):58–62]Kata kunci: Gastrosoleus turn down flap, ruptur, sural artery flap, tendon Achilles Achilles Tendon Turndown Flap Reconstruction and Fasciocutanous Sural Flap in Severe Tendon Achilles Loss with Massive Tissue Defect: a Case ReportAbstractAchilles tendon rupture is the most common ruptur of tendon in the lower limb despite being one of the toughest tendons. This rupture presents a complex problem to the treating surgeon especially if it is associated with tendon and soft tissue loss. The case in this study is one patient (male, age 30-year old) with a spectrum of acute and infected open tendon-achilles rupture that includes loss of tendon of up to 5 cm, tendon defect with no distal attachment, and partial loss of the calcaneum. The skin defect measured after debridement ranged from 8 x 5 cm to 15 x 10 cm. The ruptured tendon was sutured using gastrocnemius-soleus turn down flap technic to calcaneus bone. A reverse sural artery was used to provide soft tissue cover. The flap survived. The patient had normal gait, were able to stand on tip toes, had active plantar flexion, and had returned to his original occupation 2 months after reconstruction. He had full range of movement at the ankle. Augmented repair of Achilles tendon rupture with large soft tissue defect using gastrocnemius- soleus turn down flap and sural artery flap are stable enough to allow early weight-bearing with favorable clinical result for this patient. Conclusions is single stage tendon reconstruction and reverse flow sural artery flap give good functional outcome in complex Achilles tendon rupture with tendon and soft tissue loss. [MKB. 2016;48(1):58–62] Key words: Achilles tendon, gastrocnemius-soleus turn down flap, rupture, sural artery flap
A New Beginning For Majalah Kedokteran Bandung (MKB) in 2019 Ahmad Faried; Reni Ghrahani
Majalah Kedokteran Bandung Vol 50, No 4 (2018)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (145.105 KB) | DOI: 10.15395/mkb.v50n4.1589

Abstract

[no abstract available]
KADAR D-DIMER PLASMA SEBAGAI PREDIKTOR KEMATIAN PENDERITA PNEUMONIA USIA 2–59 BULAN Saraswati, Retno; Lukmanul Hakim, Dzulfikar D.; Garna, Herry
Majalah Kedokteran Bandung Vol 44, No 1 (2012)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Pada pneumonia berat, terjadi koagulasi intravaskular dan intraalveolar yang merupakan respons proses inflamasi lokal dan sistemik infeksi paru. Konsekuensi klinis dari perubahan koagulasi ini yaitu peningkatan kadar D-dimer plasma sebagai petanda aktivitas koagulasi dan fibrinolisis serta meluasnya disfungsi organ bahkan kematian. Tujuan penelitian ini untuk mengetahui validitas kadar D-dimer plasma yang tinggi sebagai prediktor kematian penderita pneumonia usia 2 sampai 59 bulan. Penelitian ini merupakan penelitian observasional analitik dengan rancangan prospektif yang dilaksanakan di Rumah Sakit Dr. Hasan Sadikin Bandung. Subjek penelitian anak usia 2 sampai 59 bulan yang didiagnosis sebagai pneumonia dan berobat ke Instalasi Gawat Darurat Anak selama bulan Oktober?November 2009. Pemeriksaan D-dimer plasma dilakukan saat penderita datang dan kemudian dilakukan observasi sampai penderita meninggal atau dipulangkan dari rumah sakit. Empat puluh lima anak ikut serta dalam penelitian ini, 15 (33%) di antaranya meninggal selama observasi. Kadar D-dimer plasma menunjukkan hubungan yang bermakna (p=0,04) terhadap kematian penderita pneumonia dengan median dan rentang sebesar 0,60 mg/L (0,1?5,10 mg/L). Cut-off point D-dimer plasma >0,4 mg/L sebagai prediktor kematian penderita pneumonia memberikan sensitivitas 73,3% (IK 95%; 44,9?92,0) dan spesifisitas 70,0% (IK 95%; 50,6?85,2%) dengan akurasi 71,1%. Simpulan, kadar D-dimer plasma yang tinggi dapat memprediksi kematian penderita pneumonia usia 2 sampai 59 bulan. [MKB. 2012;44(1):57?62].Kata kunci: Kadar D-dimer plasma, koagulasi, pneumonia, prediktor kematianPlasma D-Dimer Level as Predictor of Mortality in 2?59-Month-Old Pneumonia PatientsIntravascular and intraalveolar coagulation can be found in severe pneumonia as a response to local and systemic inflammation process in severe pneumonia. Clinical consequences of this coagulation changes is an increase of plasma D-dimer levels as a marker of coagulation and fibrinolyis activation, the number of organ dysfunction even death. The aim of this study was to understand the validity of high plasma D-dimer levels as a predictor of mortality in 2 to 59-month-old pneumonia patients. This was a prospective observational analytic study which washeld in Dr. Hasan Sadikin Hospital Bandung. The subjects of this study were 2 to 59 months old children who were diagnosed as pneumonia and visited Pediatric Emergency Departement during October?November 2009. Plasma D-dimer assay was performed at admission and observed until the patient died or discharged from the hospital. Forty-five children were included in this study, 15 (33%) died during observation. Plasma D-dimer level showed significant correlations (p=0.04) with the mortality in 2 to 59-month-old pneumonia patients with median and range of 0.60 mg/L (0.1?5.10 mg/L). Plasma D-dimer cut-off point of >0.4 mg/L gave 73.3% sensitivity (CI 95%, 44.9?92.0%), and 70.0% specificity (CI 95%, 50.6?85.2%) with 71.1% accuracy for predicting mortality in 2 to 59-month-old pneumonia patients. In conclusions, there were significant correlations between elevated plasma Ddimer levels and mortality in 2 to 59-month-old patients with pneumonia. [MKB. 2012;44(1):57?62].Key words: Coagulation, plasma D-dimer levels, pneumonia, predictor of mortality DOI: http://dx.doi.org/10.15395/mkb.v44n1.213
Albumin Telur Sebagai Lem pada Operasi Cangkok Konjungtiva Kartiwa, R. Angga; Enus, Sutarya; Boediono, Arief; Miraprahesti, Retti N.
Majalah Kedokteran Bandung Vol 48, No 4 (2016)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15395/mkb.v48n4.925

Abstract

Cangkok konjungtiva sudah lama digunakan pada bidang oftalmologi. Metode yang digunakan saat ini untuk menempelkan cangkok konjungtiva adalah menggunakan teknik jahitan dan lem fibrin. Pada penelitian ini dilakukan uji coba menggunakan lem albumin pada cangkok konjungtiva kelinci sebagai alternatif lain selain menggunakan teknik jahitan dalam penempelan cangkok konjungtiva. Tujuan penelitian adalah membandingkan penyembuhan luka cangkok konjungtiva bulbi antara teknik lem albumin dan jahitan pada mata kelinci. Dilakukan animalexperimental study pada 32 mata (16 ekor kelinci) di PT. Bio Farma (Persero) dan laboratorium Histologi, Fakultas Kedokteran Universitas Padjadjaran dari bulan Maret 2014–Juli 2014, terbagi kelompok teknik lem albumin dan teknik jahitan. Dilakukan pemeriksaan meliputi perbandingan derajat perlekatan cangkok konjungtiva bulbi pada teknik lem albumin dan teknik jahitan yang diamati hari-1 pascabedah serta dilakukan pemeriksaan histologis secara mikroskopik untuk mendapatkan data celah luka yang diamati 10 menit dan hari-7 pascabedah. Analisis data dilakukan dengan Mann-Whitney test for small sample. Hasil penelitian memperlihatkan perlekatan cangkok konjungtiva bulbi secara bermakna lebih kuat pada teknik lem albumin (derajat 4) dibanding dengan teknik jahitan (derajat 2 dan 3) pada hari-1 pascabedah dengan nilai p=0,000 serta terdapat perbedaan celah luka (wound gap) bermakna antara teknik lem albumin (0–0,33 µm) dan jahitan (5,33–14 µm) (p=0,0005)pada cangkok konjungtiva dilihat sepuluh menit pascabedah dan pada hari-7 pascabedah untuk teknik lem albumin (0 µm) dan teknik jahitan (0,33–4 µm) dengan nilai p=0,0005. Simpulan penelitian ini adalah derajat perlekatan jaringan cangkok pada teknik lem albumin lebih baik dibanding dengan jahitan hari-1 pascabedah, sedangkan celah luka lebih kecil pada teknik lem albumin dibanding dengan teknik jahitan pada pengamatan 10 menit dan hari-7 pascabedah. [MKB. 2016;48(4):241–8]Kata kunci: Jahitan, lem albumin, penyembuhan luka konjungtivaEgg Albumin as Adhesive in Conjunctival Graft SurgeryCConjunctival graft has been frequently used in the field of ophthalmology. The frequently used methods to attach a conjunctival graft are suture technique and the use of fibrin glue. This study was to investigate albumin glue as an alternative to suture technique in attaching conjunctival grafts in rabbits. The aim of this study was to compare the conjunctival wound healing between albumin glue and suture technique in rabbit eye as a model. This was an experimental animal study that included 32 eyes (16 rabbits) conducted at PT. Bio Farma (Persero) and the Histology Laboratory, Faculty of Medicine, Universitas Padjadjaran from March 2014 to July 2104. The subjects in this study were divided into albumin glue group and suture technique group. The examinations were comparison of conjunctival graft attachment and histologic microscopic examination to assess the wound gap. Data analysis was performed statistically using Mann-Whitney test for small sample. The statistical analysis results showed that the graft attachment was significantly better when using albumin glue (grade 4) compared to suture (grade 2–3) on day-1 after surgery (p=0.000). The wound gap was smaller using albumin glue (0-0,33 µm versus 5,33-14 µm; p0.0005) 10 minutes after surgery and 0 µm versus 0.33–4 µm, p 0,0005, on day-7 after surgery. In conclusion, graft attachment using albumi n glue is better and the wound gap is smaller when using albumin glue compared to the suture technique. [MKB. 2016;48(4):241–8]Key words: Albumin glue, conjunctival wound healing, suture
Sekuens Gen Protein Kapsid Mayor L1 Human Papilomavirus 16 dari Isolat Klinik Asal Bandung Pradita, Anandayu; Sahiratmadja, Edhyana; Suhandono, Sony; Susanto, Herman
Majalah Kedokteran Bandung Vol 46, No 3 (2014)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Kanker serviks disebabkan oleh infeksi kronik human papillomavirus (HPV) dengan genotipe HPV-16 sebagai HPV tersering yang menginfeksi epitel serviks. Protein penyelubung virus yang disebut kapsid mayor (L1) mempunyai peranan penting dalam menginfeksi epitel serviks. Tujuan penelitian untuk mengisolasi dan menganalisis sekuens gen L1 HPV-16. Pengetahuan mengenai sekuens gen L1 dapat memberikan informasi yang berguna, salah satunya yaitu untuk pengembangan vaksin. Pada studi ini, deoxyribonucleic acid (DNA) virus diekstraksi dari sediaan biopsi pasien kanker serviks yang diambil pada bulan Juni sampai Oktober 2010 di Kebidanan dan Kandungan RS Dr. Hasan Sadikin Bandung. Gen diamplifikasi dengan polymerase chain reaction menggunakan primer spesifik. Infeksi HPV-16 pada jaringan kanker dikonfirmasi dengan menggunakan kit komersial untuk tes genotipe HPV. Fragmen L1 kemudian diklon dan diinsersikan ke dalam pJET1.2/L1-16, kemudian dipotong dengan enzim BamHI dan BgIII untuk kemudian divalidasi dan disekuensing. Hasil sekuensing menunjukkan amplikon gen L1 HPV-16 sebesar 1.595 pasang basa. Analisis dari dua amplikon gen L1 HPV-16 menggunakan software BIOEDIT dan Basic Local Alignment Search Tool menunjukkan kesamaan ho mologi 99% dan 97% dengan sekuens L1 HPV-16 asal Thailand yang terregistrasi pada GenBank. Simpulan, telah dilakukan kloning sekuens gen L1 HPV-16 dari dua isolat klinik Bandung. Hasil kloning HPV-16 pada penelitian ini memberikan informasi tentang variasi sekuens yang perlu dipertimbangkan bagi pengembangan vaksin terutama bagi daerah spesifik seperti penduduk asal Indonesia.Kata kunci: Human papillomavirus, kanker serviks, gen L1 HPV-16 Sequence of Human Papilomavirus 16 Major Capsid L1 Gene from Clinical Isolates in BandungCervical cancer is strongly associated with chronic human papillomavirus (HPV) infection. HPV-16 is the most prevalent genotype infecting cervical epithelium. The major coat protein of viral particle (L1) plays a key role in the infection process. Our study aimed to isolate the HPV-16 L1 gene and analyze its sequence. Samples used were samples collected from the Department of Obstetrics and Gynaecology, Dr. Hasan Sadikin General Hospital, Bandung during the period of June to October 2010. In this study, the HPV-16 L1 sequence was analyzed from the viral deoxyribonucleic acid (DNA) extracted from biopsy sample of cervical cancer patient biopsy samples.The HPV-16 L1 amplification was performed using the polymerase chain reaction with specific primer. The HPV infection in the cervical tissue was confirmed by commercial HPV genotyping test. The L1 fragment was cloned into plasmid and the insert of the recombinant clone pJET1.2/L1-16 was digested using BamHI and BgIII. The amplicon result showed HPV-16 L1 gene with a length of 1.595 base pairs. The sequence analysis of two samples using software BIOEDIT dan Basic Local Alignment Search Tool revealed a high level of sequence similarity to L1 HPV-16 from Thailand (99% and 97%) as registered in GenBank. In conclusion, the L1 HPV-16 gene from Bandung isolates revealed variations from published sequence. Knowledge on L1 gene sequence may give additional information to the development of vaccine. Further study on vaccine development is currently ongoing using this HPV-16 clone that may be specific to Indonesian population. Key words: Cervical cancer, human papillomavirus, L1 HPV-16 DOI: 10.15395/mkb.v46n3.317
Manifestasi Klinis Refluks Laringofaring: Studi pada Anak Usia 0–24 Bulan dengan Laringomalasia Sudiro, Melati; Saputri, R. Ayu Hardianti; Madiadipoera, Teti; Boesoirie, M. Thaufiq S.; Setiabudiawan, Budi
Majalah Kedokteran Bandung Vol 49, No 2 (2017)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (293.038 KB) | DOI: 10.15395/mkb.v49n2.1057

Abstract

Laringomalasia merupakan kelainan kongenital anomali laring yang banyak ditemukan pada bayi baru lahir dan penyebab tersering stridor serta obstruksi saluran napas. Pemeriksaan laringoskopi serat lentur memperlihatkan terlipat atau terhisapnya struktur supraglotik ke dalam laring selama inspirasi. Obstruksi saluran napas pada laringomalasia akan menyebabkan tekanan negatif intratorakal, menyebabkan asam lambung naik ke jaringan laringofaring dan diduga menimbulkan refluks laringofaring (RLF). Telah dilakukan penelitian dengan pendekatan potong lintang yang bertujuan mengidentifikasi dan menilai hubungan antara laringomalasia dan gambaran refluks laringofaring pada usia 0–24 bulan yang datang ke poliklinik THT-KL RSHS Bandung periode Januari 2012–Maret 2015 berdasar atas data rekam medis dan hasil pemeriksaan laringoskopi serat lentur.  Seratus tujuh pasien laringomalasia dengan keluhan stridor mengikuti penelitian ini, 69 laki-laki (64,5%) dan 38 perempuan (35,5%) dengan usia rata-rata 4,19 bulan. Laringomalasia tipe 1 merupakan tipe terbanyak (57,9%). Gambaran RLF yang berhubungan dengan tingkat berat laringomalasia adalah edema plika ventrikularis dengan OR 3,71 (IK 95%=1,07–12,91; p=0,039) dan edema aritenoid dengan OR 4,74 (IK 95%=1,19–18,89; p=0,027). Edema ventrikular dan aritenoid merupakan gambaran RLF yang berhubungan dengan tingkat berat laringomalasia pada pada anak usia 0–24 bulan. [MKB. 2017;49(2):115–21]Kata kunci: Edema aritenoid, edema plika ventrikularis, laringomalasia, refluks laringofaring Laryngopharyngeal Reflux Manifestation: a Case Study of Laryngomalacia in Children Aged 0–24 MonthsLaryngomalacia is the most common laryngeal anomaly of the newborn and the main cause of stridor and airway obstruction in infants. From a flexible laryngoscopy examination, this anomaly is observed as curled or collapsed supraglottic structures into larynx during inspiration. Airway obstruction in laryngomalacia creates a negative intra-thoracal pressure that causes acid reflux to laryngopharynx tissue and is suspected to cause laryngopharyngeal reflux (LPR). A cross-sectional study was conducted with the objectives of identifying and assessing the relationship between laryngomalacia and LPR in patients aged 0–24 months who visited the Ear, Nose, Throat, Head, and Neck Clinic of Dr. Hasan Sadikin General Hospital Bandung in the period of January 2012–March 2015, which was based on medical records and results of flexible laryngoscopy. A hundred and seven patients diagnosed with laryngomalacia  who experienced stridor symptoms in this study consisted of 69 males (64.5%) and 38  females (35.5%) with mean age of 4.19 months. Type-1 laryngomalacia represents the most cases (57.9%). Indication of LPR sign correlated with type of laryngomalacia is ventricular edema OR 3.71 (CI 95%=1.07–12.91; p=0.039) and arytenoid edema OR 4,74 (CI 95%=1.19-18.89; p=0.027). Ventricular and arytenoid edemas are signs of LPR that correlate with laryngomalacia level in patients  aged 0–24 months. [MKB. 2017;49(2):115–21]Key words: Arytenoid edema, laringomalacia, laringopharyngeal reflux, ventricular edema 

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