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Majalah Kedokteran Bandung
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Articles 5 Documents
Search results for , issue "Vol 42, No 3" : 5 Documents clear
Tuberkulosis Perinatal Bermanifestasi sebagai Tuberkulosis Milier dan Meningitis Nataprawira, Heda Melinda D.; Faisal, Faisal
Majalah Kedokteran Bandung Vol 42, No 3
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Tuberkulosis (TB) perinatal adalah kasus TB yang jarang dilaporkan karena manifestasi klinis tidak spesifik, serta terdapat permasalahan dalam pemeriksaan laboratorium dan radiologis sehingga tidak terdiagnosis. Istilah TB perinatal menjelaskan adanya infeksi Mycobacterium tuberculosis yang terjadi pada masa perinatal baik selama kehamilan, persalinan, maupun pascapersalinan dalam masa neonatus. Seorang bayi laki-laki usia tiga bulan dirujuk ke Emergensi Anak Rumah Sakit Hasan Sadikin dengan riwayat demam lama dan tidak mau menetek. Proses kelahiran tidak ada masalah. Pada pemeriksaan fisis ditemukan letargis, febris, takipnea, dan hepatosplenomegali. Pewarnaan Ziehl Neelsen aspirat lambung menunjukkan basil tahan asam positif. Uji kulit tuberkulin menunjukkan nonreaktif, foto toraks memperlihatkan gambaran milier, dan fungsi lumbal memberikan interpretasi TB meningitis. Berdasarkan penelusuran aktif sumber penularan TB serumah, ternyata ayah dan kakek bayi merupakan sumber penularan. Selain diberikan paduan oral antituberkulosis standar, juga diberikan antibiotik dan prednison. Dalam perjalanan penyakitnya, terjadi syok sepsis serta koagulasi intravaskular diseminata dan bayi meninggal. Dari kultur darah teridentifikasi Staphylococcus haemolyticus. Disimpulkan bahwa walaupun tidak terdapat permasalahan saat kelahiran bayi, diperlukan penelusuran aktif kemungkinan TB perinatal pada keluarga dengan sumber penularan TB positif. Diperlukan kewaspadaan terdapatnya TB pada wanita hamil di negara berkembang dengan jumlah kasus TB tinggi. [MKB. 2010;42(3):135-9].Kata kunci: tuberkulosis perinatal Perinatal Tuberculosis Presenting as Miliary Tuberculosis and MeningitisPerinatal tuberculosis (TB) is rarely reported, because the clinical manifestations are not specific and there is a problem in its laboratory and radiology examination which caused undiagnosed. Perinatal TB is the preferred description that encompasses TB acquired either intra uterine, during or post delivery in early newborn period. A-3- month old baby was transferred to Pediatric Emergency Hasan Sadikin Hospital because of prolong fever and unable to breastfeed. There was no problem with delivery. Lethargic, fever, tachypnea, and hepatosphlenomegali were found on physical examination. Ziehl Neelsen smear of gastric lavage yielded positive acid fast bacilli. Tuberculine test was non reactive, chest x-ray showed a miliary pattern, and cerebral spinal fluid analysis gave tuberculous meningitis interpretation. By active finding, his father and grandfather were detected as a source of TB transmission. In additon to oral antituberculosis regimen, antibiotics and prednison were also given. Septic shock and disseminated intravascular coagulation were occurred during his illness and the baby died. Staphylococcus haemolyticus was identified from blood culture. In conclusion, although there were no problems during labor, active investigation of perinatal TB possibility is required on the family with a source of TB. Caution on TB in pregnant women is necessary at developing country with high rates of TB. [MKB. 2010;42(3):135-9].Key words: Disseminated intravascular coagulation, miliary, meningitis, perinatal tuberculosis DOI: http://dx.doi.org/10.15395/mkb.v42n3.25
Radiasi Eksternal Karsinoma Nasofaring sebagai Penyebab Gangguan Dengar Sensorineural Haryanto, Rakhmat; Saefuddin, Ongka M.; Boesoirie, Thaufiq S.
Majalah Kedokteran Bandung Vol 42, No 3
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Radiasi berperan penting pada pengobatan kanker kepala leher karena reseksi bedah sering tidak memungkinkan, tetapi menimbulkan efek samping gangguan dengar sensorineural. Penelitian observasional rancangan longitudinal ini untuk mengetahui pengaruh radiasi terhadap gangguan dengar sensorineural penderita karsinoma nasofaring di Bagian THT-KL Rumah Sakit Hasan Sadikin Bandung periode Februari–Agustus 2006. Didapatkan 28 laki-laki dan 7 perempuan, yang satu atau kedua telinganya tidak terganggu pendengaran sensorineural, usia 12–72 tahun, dan memenuhi kriteria inklusi. Seluruh penderita mendapat radiasi dan pemeriksaan audiometri serta timpanometri sebelum, durante 2.000 cGy, 6.600 cGy, dan satu bulan pascaradiasi. Data dianalisis secara statistik menggunakan uji Chi-kuadrat, Mc-Nemar, dan eksak Fisher. Hasil penelitian menunjukkan kejadian gangguan dengar sensorineural durante 2.000 cGy adalah 7 kasus (10%), 6.600 cGy 22 kasus (31,4%), dan pascaradiasi 24 kasus (34,3%). Hubungan antara durante 6.600 cGy dan 2.000 cGy pada kelompok preradiasi normal sangat bermakna (p=0,001), sedangkan antara pascaradiasi dan durante 6.600 cGy tidak bermakna (p= 0,5). Pada usia >30 tahun gangguan dengar sensorineural 37,0% durante 6.600 cGy (p=0,031) dan 40,7% pascaradiasi (p=0,018). Simpulan, radiasi karsinoma nasofaring dapat menyebabkan gangguan dengar sensorineural selama dan pascaradiasi, serta usia >30 tahun merupakan faktor prognosis gangguan dengar sensorineural. [MKB. 2010;42(3):108-14].Kata kunci: Gangguan dengar sensorineural, karsinoma nasofaring, radiasiNasopharyngeal Carcinoma External Radiation As Causal of Sensorineural Hearing LossRadiation has an important role on nasopharyngeal carcinoma therapy because surgery is often difficult, however it cause sensorineural hearing loss as side effect. Longitudinal observational study was conducted to know the effect of radiation on sensorineural hearing loss of nasopharyngeal carcinoma patients at Ear, Nose, and Throat Department, Hasan Sadikin Hospital, February-August 2006. Twenty eight male and 7 female, with no sensorineural hearing loss in one or both ears, age 12–72 years, and met inclusion criteria, were included in this study. All patients received >radiation and underwent audiometry and tympanometry prior-,during-radiation with a 2.000 cGy and 6,600 cGy, and one month postradiation. Data was analyzed using Chi-square, Mc-Nemar, and exact Fisher test. The results showed that incidence of sensorineural hearing loss were 7 cases (10%) on 2,000 cGy, 22 cases (31.4%) on 6,600 cGy, and 24 cases (34.3%) on postradiation. The relationship between duration 6,600 cGy and 2,000 cGy in the normal preradiation group were significant (p= 0.001), whereas postradiation and duration with 6,600 cGy was not significant (p= 0.5). Sensorineural hearing loss on >30 years was 37.0% on duration 6,600 cGy (p=0.031) and 40.7% postradiation (p=0.018). In conclusion, radiation on nasopharyngeal carcinoma can induce sensorineural hearing loss during- or postradiation and age >30 years is prognostic factor for sensorineural hearing loss. [MKB. 2010;42(3):108-14].Key words: Nasopharyngeal carcinoma, radiation, sensorineural hearing loss
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
Kapasitas Fungsi Intelektual pada Berbagai Kelompok Interaksi Sosial Anak Autis Moekdas, Raddi; Sukadi, Abdurachman; Yuniati, Tetty
Majalah Kedokteran Bandung Vol 42, No 3
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Autis dikelompokkan berdasarkan interaksi sosial dan kapasitas fungsi intelektual. Penelitian ini bertujuan untuk mengetahui hubungan antara kelompok interaksi sosial dan kapasitas fungsi intelektual. Penelitian dilakukan Januari–Maret 2007 pada anak autis di pusat terapi Our Dream dan Indigrow Bandung dengan rancangan hybride selective prevalence. Anak autis dikelompokkan berdasarkan interaksi sosial serta kapasitas fungsi intelektual. Usia dan riwayat terapi perilaku merupakan faktor perancu kelompok interaksi sosial. Uji statistik pada penelitian ini menggunakan Kruskall-Wallis dan Kolmogorov-Smirnov dua populasi. Subjek penelitian yang memenuhi kriteria inklusi berjumlah 99 anak. Kelompok aloof, pasif, aktif tetapi aneh masing-masing sebanyak dua, 31, dan 66 anak autis. Kapasitas fungsi intelektual rendah sebanyak 70 dan tinggi 29 anak autis. Usia £5 dan >5 tahun ditemukan pada 58 dan 41 anak autis (pKW= 0,453). Riwayat pernah dan belum pernah mendapat terapi perilaku ditemukan pada 37 dan 62 anak autis (pKS = 1,00). Didapatkan 70 anak (71%) memiliki kapasitas fungsi intelektual rendah dan 29 anak (29%) dengan kapasitas fungsi intelektual tinggi. Kelompok interaksi sosial berhubungan bermakna dengan kapasitas fungsi intelektual anak autis (p= 0,04). Disimpulkan bahwa kelompok interaksi sosial aloof, pasif dan aktif tetapi aneh berhubungan dengan kapasitas fungsi intelektual rendah dan tinggi. [MKB. 2010;42(3):96-100].Kata kunci: Autis, kapasitas fungsi intelektual, kelompok interaksi sosial Intellectual Functioning in Social Interaction Subgroups of Autism ChildrenAutism classified based on social interaction and intellectual functioning. Aim of this study was to find out the association between social interaction and intellectual functioning. This hybride selective prevalence design study was conducted from January–March 2007 on autism children admitted to therapy center of Our Dream and Indigrow, Bandung. Subjects were classified based on social interaction and intellectual functioning. Age and history of behavior therapy were confounding factors. Data was analyzed using Kruskall-Wallis and two-sample Kolmogorov-Smirnov test. Subjects who fulfilled the inclusion criteria were 99 autism children. Subgroups aloof, passive, and active but odd were two, 31, 66 children, respectively. Low and high functioning were found in 70 and 29 children. Age of £5 and > 5 years were found in 58 and 41 children (pKW = 0.453). Classification of behavioral therapy were 37 and 62 children (pKS = 1.00). The association of social interaction with intellectual functioning autism showed significant value 0.04. In conclusion, this study showed association of social interaction aloof,passive, and active but odd with low and high intellectual functioning. [MKB. 2010;42(3):96-100].Key words: Autism, intellectual functioning, social interaction subgroups DOI: http://dx.doi.org/10.15395/mkb.v42n3.17
Nyeri Punggung pada Operator Komputer Akibat Posisi dan Lama Duduk Sumekar, Dyah Wulan; Natalia, Deny
Majalah Kedokteran Bandung Vol 42, No 3
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Salah satu nyeri yang sering terjadi pada manusia adalah nyeri punggung, umumnya terjadi pada orang dewasa usia 33–55 tahun. Dari data Rumah Sakit Umum Daerah Lampung Tengah tahun 2006, tercatat 32 pasien nyeri otot dan meningkat dua tahun berikutnya. Sebagian besar penderita bekerja sebagai operator komputer. Tujuan utama penelitian ini untuk mengetahui pengaruh posisi dan lama duduk terhadap nyeri punggung. Jenis penelitian adalah cross sectional terhadap 120 operator komputer di Kecamatan Bandar Jaya Kabupaten Lampung. Hasil penelitian menunjukkan pada posisi duduk baik 27/65 (41,5%) mengalami nyeri punggung, sedangkan pada posisi tidak baik 11/12 (91,7%), dengan p=0,011 dan risiko 15,481 kali. Pada lama duduk >4 jam didapatkan 37/63 (58,7%) nyeri punggung, sedangkan <4 jam 1/13 (7,1%), dengan p=0,006 dan risiko 18,497 kali. Gabungan posisi dan lama duduk berpengaruh secara bermakna terhadap nyeri punggung (p=0,017 dan 0,010) dan memberikan risiko 21,400 dan 24.607 kali. Disimpulkan posisi dan lama duduk masing-masing berpengaruh dan merupakan faktor risiko terhadap nyeri punggung. Gabungan posisi dan lama duduk meningkatkan pengaruh dan risiko. [MKB. 2010;42(3):123-7].Kata kunci: Lama duduk, nyeri pungung, posisi duduk Computer Operator's Low Back Pain Caused By Sitting Position and DurationOne of the pain that often occurs in human is low back pain, usually occurs in adults aged 33-55 years. According to data at regional hospital Lampung Tengah in 2006, there were 32 patients with low back pain, and increased in the next two years. Majority of patients were computer operator. The purpose of this study was to determine the effect of sitting position and duration on low back pain. This study was cross sectional study of 120 computer operators in Bandar Jaya Disctrict of Lampung. The results showed that 27/65 (41.5%) on good sitting position group experienced low back pain, while in the bad sitting position was11/12 (91.7%), with p = 0.011 and risk value 15.481 times. In> the >4 hours sitting duration group, 37/63 (58.7%) experienced low back pain, whereas in <4 hours group was 1 / 13 (7.1%), with p = 0.006 and risk value 18.497 times. Combination of -sitting position and duration has a significant effect on low back pain (p = 0.017 and 0.010) and gave 21.400 and 24 607 times risk. In conclusion, each sitting position and duration has influence on low back pain, and is a risk factor. Combination of sitting position and duration increase its impact and risk. [MKB. 2010;42(3):123-7].Key words: Low back pain, seating duration, seating position DOI: http://dx.doi.org/10.15395/mkb.v42n3.23

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