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Search results for , issue "Vol 51, No 4 (2019)" : 10 Documents clear
Knowledge Improvement on Burn Injury Prevention and First Management after One-Day Health Promotion Event Hasibuan, Lisa; Soedjana, Hardisiswo; Hilmanto, Dany; Tarawan, Vita Murniati; Muliawan, Benny; Lubis, Putra Haqiqie Adnantama
Majalah Kedokteran Bandung Vol 51, No 4 (2019)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1796.304 KB) | DOI: 10.15395/mkb.v51n4.1747

Abstract

Burns causes a significant number of mortality and morbidity globally with a higher number found in developing countries, such as Indonesia. A study conducted in Indonesia discovered that the majority of burns were caused by flame LPG-related (liquefied petroleum gas) burns (33%), which is understandable because LPG is the main cooking fuel used in Indonesian homes. Since the first management of burn will influence the outcome of burn injuries, health promotion efforts to improve knowledge, attitude, and practice to prevent burns and to provide first aid for burn are considered important to reduce burn-related morbidity and mortality. This was a descriptive study conducted in Babakan Sari Sub-district, Antapani, Bandung, Indonesia which involved a one-day community health promotion event as the intervention. The aim of this study was to compare the level of knowledge regarding burn prevention and first management before and after a one-day community health promotion event. As many as 61 respondents were recruited through purposive sampling and these respondents were asked to fill out a pre-event questionnaire consisting of questions regarding demographic data and knowledge on burn prevention and management. Demographic data collected showed that 31% of participants had experienced burns; 100% of participants used 3kg LPG gas tank in their home; 98% of participants had never been taught on how to handle an emergency situation or how to arrange an evacuation route; and 100% of participants felt that their neighborhood did not provide facilities for burn management. A post-event questionnaire was distributed after the one-day health promotion event, which was conducted in October 2018, and the results were compared with the pre-event questionnaire results. A significant improvement of knowledge was seen, as evident from the increase of a median score from 2.0 before the event to 9.0 after the event (p<0.001). In conclusion, despite the fact that all participants of this study used 3kg LPG gas tank, they do not have proper knowledge regarding prevention or management of burns and that a one-day health promotion event can increase this knowledge significantly. Thus, an effective community health promotion program should be implemented at the community level in Indonesia, especially for areas where the majority of residents use 3 kg LPG gas tank, in order to reduce the incidence of burns due to 3 kg LPG tank explosion.Peningkatan Pengetahuan Melalui Penyuluhan Mengenai Pencegahan dan Penanganan Dini pada Luka BakarLuka bakar merupakan sebuah masalah yang menyebabkan morbiditas dan mortalitas tinggi di negara berkembang, termasuk Indonesia. Mayoritas luka bakar (33%) diakibatkan oleh api dari ledakan tabung gas LPG (liquefied petroleum gas) 3 kg dan mayoritas rumah tangga menggunakannya. Pelaksanaan penyuluhan mengenai pencegahan dan penanganan awal diharapkan dapat menurunkan angka morbiditas dan mortalitas akibat luka bakar. Penelitian deskriptif ini bertujuan membandingkan tingkat pengetahuan tentang pencegahan luka bakar dan manajemen pertama sebelum dan setelah acara promosi kesehatan Penelitian ini dilakukan di Kelurahan/Desa Babakan Sari, Antapani, Bandung pada bulan Oktober 2018 untuk mengedukasi dan meningkatkan pengetahuan responden. Dari total 61 responden (45 wanita dan 16 pria) dengan mayoritas responden berusia di atas 60 tahun (45.9%), didapatkan 32.8% responden pernah mengalami luka bakar, 100% responden menggunakan gas LPG 3 kg, 98% peserta tidak pernah mendapatkan penyuluhan mengenai penanganan luka bakar, dan 100% peserta merasa tidak ada fasilitas penanganan kebakaran di wilayah mereka. Pengetahuan responden dinilai sebelum dan sesudah dilakukan penyuluhan dan didapatkan peningkatan secara signifikan dan bermakna (p<0.001). Simpulan, meskipun semua responden yang menggunakan tangki gas LPG 3 kg tidak memiliki pengetahuan yang memadai pencegahan atau pengelolaan luka bakar, penyuluhan ini efektif dapat menurunkan angka kejadian luka bakar.
PHYSICAL ACTIVITIES DECREASE FASTING BLOOD GLUCOSE LEVEL IN DIABETES MELLITUS TYPE 2 PATIENTS: USE OF INTERNATIONAL PHYSICAL ACTIVITY QUESTIONNAIRE (IPAQ) IN RURAL AREA Putri, Mirasari; Persariningrat, Rd.Tiara Indah; Surialaga, Samsudin; Syamsunarno, Mas Rizky A. A.
Majalah Kedokteran Bandung Vol 51, No 4 (2019)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15395/mkb.v51n4.1765

Abstract

An increase in the incidence of diabetes mellitus type 2 (DM-2) has been observed from 1.1% in 2007 to 1.5% in 2018 with incidents occur in both urban areas and rural areas of Indonesia. Garut as one of the rural areas in Indonesia is the fourth district with the highest DM-2 incidence in West Java Province, Idnonesia. Physical activity is considered to affect the glycemic control and weight loss in DM-2 patients. Therefore, the purpose of this study was to determine the relation between the physical activity level and blood glucose level in DM-2 patients in Garut, Indonesia. This was a cross-sectional observational analytic study on 46 DM-2 patients who were the members of the Garut Branch of the Indonesian Diabetes Association (PERSADIA), in May 2018. The physical activity level was measured using the International Physical Activity Questionnaire (IPAQ) while the blood glucose level was measured using fasting blood glucose level test. Data were then analyzed using analysis of variance test. Results showed that most participants had a low level of physical activity (52.2%) while the lowest fasting blood glucose was obtained from patients with high physical activity (98.63±11.6), compared to those with moderate and low physical activity levels (123.43±20.16 and 164.21±19.04 mg/dL, respectively) with p=0.000 (p<0.05). Lifestyle changes, especially in the form of the lack physical activity, were seen alsonin the rural area in Indonesia. High physical activity level is the most effective measure to lower fasting blood glucose level in DM-2 patients. Aktivitas Fisik Menurunkan Kadar Glukosa Darah Puasa pada Pasien Diabetes Mellitus Tipe 2: Menggunakan the International Physical Activity Questionnaire (IPAQ) di Rural AreaKejadian pasien diabetes mellitus tipe 2 (DM-2) pada tahun 2018 (1,5%) mengalami peningkatan dibandingkan tahun 2007 (1,1%), terjadi baik di daerah perkotaan dan pedesaan di Indonesia. Garut sebagai salah satu daerah pedesaan di Indonesia adalah salah satu kabupaten dengan insidens DM-2 terbesar keempat di Jawa Barat-Indonesia. Aktivitas fisik dianggap memengaruhi kontrol glikemik dan penurunan berat badan pada pasien DM-2. Oleh karena itu, tujuan dari penelitian ini adalah mengetahui hubungan tingkat aktivitas fisik dengan kadar glukosa darah pada pasien DM-2 di Garut-Indonesia. Subjek penelitian ini adalah 46 pasien DM-2 yang tergabung dalam Persatuan Diabetes Indonesia (PERSADIA), cabang Kabupaten Garut, pada Mei 2018. Metode penelitian yang digunakan adalah analitik observasional dengan metode cross-sectional. International Physical Activity Questionnaire (IPAQ) sebagai alat untuk mengukur tingkat aktivitas fisik, selain itu dilakukan pengukuran kadar glukosa darah puasa. Data dianalisis menggunakan analysis of variance test. Hasil penelitian menunjukkan bahwa sebagian besar peserta memiliki tingkat aktivitas fisik yang rendah (52,2%) dan glukosa darah puasa terendah diperoleh dari pasien dengan aktivitas fisik yang tinggi (98,63±11,6) dibandingkan dengan aktivitas fisik sedang dan rendah (123,43±20,16 dan 164,21±19,04 mg/dL), dengan p=0.000 (p<0,05). Perubahan gaya hidup terutama kurangnya aktivitas fisik juga terjadi di daerah pedesaan di Indonesia dan aktivitas fisik yang tinggi adalah tipe yang paling efektif menurunkan kadar glukosa darah puasa pada pasien DM-2.
EFFECT OF DIETARY SODIUM ON α, β, AND γ EPITHELIAL SODIUM CHANNEL (ENAC) GENE EXPRESSION IN KIDNEY TUBULES OF WISTAR RATS Lesmana, Ronny; Laudza, Genta Syaifrin; Kusuma, Trianing Tyas; Goenawan, Hanna; Sofiatin, Yulia; Pratiwi, Yuni Susanti; Sylviana, Nova; Setiawan, Setiawan
Majalah Kedokteran Bandung Vol 51, No 4 (2019)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (249.233 KB) | DOI: 10.15395/mkb.v51n4.1764

Abstract

Hypertension is a condition of persistently high blood pressure. It is currently a big health issue as its prevalence is high in Indonesia and its complications are numerous and deadly. Salt intake is one of the modifiable factors of hypertension. According to a study by Indonesian Ministry of Health, salt consumption in Indonesia is almost two times greater than the recommended salt diet from WHO. Sodium reabsorption in kidney plays a role in regulating blood pressure. Epithelial sodium channel (ENaC) is one of the structures that function in sodium reabsorption in kidney tubules. This study was conducted at the Central Laboratory and Animal Laboratory of the Faculty of Medicine Universitas Padjadjaran from June to Desember 2018. The aim of this study was to analyze the effect of high sodium diet on the expression of ENaC gene in kidney tubules of rats. Twelve Rattus norvegicus wistar rats were divided into two groups of control and treatment. Treatment group was given daily 2 mL NaCl solution treatment using gavage for 8 weeks. The expression of ENaC ?, ?, and ? was obtained by running tissue samples from kidney cortex and medulla in polymerase chain reaction and electrophoresis. The result showed that there was an insignificant decrease in ENaC ?, ?, and ? gene expressions in both kidney cortex and medulla of the treatment group when compared to control groupThis study concludes that ENaC gene expression is not significantly affected by high sodium diet.Pengaruh Diet Tinggi Natrium terhadap Perubahan Ekspresi Gen Epithelial Sodium Channel (ENaC) pada Tubulus Ginjal TikusHipertensi merupakan kondisi tekanan darah tinggi dalam waktu lama. Prevalensi dan komplikasi hipertensi menyebabkan hipertensi menjadi isu kesehatan yang cukup besar. Jumlah asupan garam merupakan faktor hipertensi yang dapat dimodifikasi. Berdasar studi Kementrian Kesehatan Indonesia, konsumsi garam di Indonesia rerata dua kali lipat lebih banyak daripada rekomendasi WHO. Reabsorpsi natrium pada ginjal berperan penting pada regulasi tekanan darah. Fungsi ini diperankan oleh epithelial sodium channel (ENaC) yang berfungsi untuk reabsorpsi natrium. Penelitian ini dilakukan di Laboratorium Sentral dan Laboratorium Hewan Fakultas Kedokteran pada Juni?Desember 2018. Tujuan penelitian ini menganalisis efek diet tinggi natrium pada ekspresi gen dari ENaC di tubulus ginjal pada tikus. Duabelas ekor tikus Rattus norvegicus dibagi menjadi dua kelompok, yaitu kontrol dan perlakuan. Kelompok perlakuan diberikan 2 mL larutan NaCl setiap hari selama 8 minggu. Larutan diberikan melalui paksa (gavage). Ekspresi gen ENaC ?, ?, ? dari korteks dan medula ginjal diamplifikasi dengan PCR dan dideteksi dengan elektroforesis. Pita protein dari gel elektroforesis dinilai intensitasnya dengan software ImageJ. Hasil dari elektroforesis menunjukkan penurunan ekspresi gen ENaC ?, ?, ? di korteks dan medulla pada kelompok perlakuan dibanding dengan kontrol. Studi ini menyimpulkan ekspresi gen ENaC pada korteks dan medulla ginjal tidak signifikan dipengaruhi oleh diet tinggi natrium.
PROFILE OF MEDICOLEGAL CASES AT DEPARTMENT OF FORENSICS AND LEGAL MEDICINE OF DR. HASAN SADIKIN GENERAL HOSPITAL BANDUNG, INDONESIA Windasari, Noverika; Yosiati, Naomi
Majalah Kedokteran Bandung Vol 51, No 4 (2019)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15395/mkb.v51n4.1524

Abstract

The increasing number of criminal cases in Indonesia indirectly affects the number of cases handled in the Department of Forensics and Legal medicine. Forensic specialists play an important role in criminal investigation process by conducting medical examination of the corpse. This study aimed to present the profile of the corpses examined in the Department Forensic and Legal Medicine of Dr. Hasan Sadikin General Hospital, Bandung, Indonesia, during 2013-2017. This was a descriptive retrospective study based on data of the corpses examined at the Department of Forensics and Legal Medicine of Dr. Hasan Sadikin General HospitalBandung, Indonesia, in 2013?2017. During the period of study, 1,692 corpses were handled with 1,258 males (74%), 430 females (25%), and 4 with unidentified sex (1%). most of the corpses were 46?65 years old (30%) and 26?45 years old (29%) when they died. There were 24 corpses with multiple cases, making a total number of cases of 1,716 cases with an average number of cases handled each month of 29 cases. From these cases, 1,303 cases (76%) only involved external examination and 413 cases (24%) underwent autopsy (external and internal examinations). The highest number of cases was seen in 2014 (432 cases, 25%). Regarding the type of cases, Death on Arrival (DOA) cases was the most frequently seen (28%), followed by traffic accidents (26%), sudden death (22%), infanticide (7%), train accident (5%), and murders (5%). The most frequent cause of death in murder cases was sharp trauma. In conclusion, DOA and traffic accident are the dominant cases handled at the Forensics and Legal Medicine Department of Dr. Hasan Sadikin General Hospital. The high number of DOA indicates the high number of patients who come late for treatment. This needs further studies to clarify the situation in order to avoid future DOA cases. In addition, the risk factors related to the death due to traffic accidents in Indonesia need to be determined to reduce the number of fatalities in traffic accidents. Profil Kasus Medikolegal di Departemen Ilmu Kedokteran Forensik dan Medikolegal Rumah Sakit Dr. Hasan Sadikin BandungMaraknya kasus kriminal di Indonesia secara tidak langsung berefek pada jumlah kasus yang diperiksa di Departemen Ilmu Kedokteran Forensik dan Medikolegal. Dokter forensik berperan penting dalam mengungkap kasus kematian dengan melakukan pemeriksaan medik untuk kepentingan peradilan. Tujuan penelitian ini mengetahui profil kasus jenazah di Departemen Forensik dan Medikolegal RSUP Dr. Hasan Sadikin Bandung yang diperiksa selama tahun 2013-2017. Penelitian ini bersifat dekskriptif retrospektif berdasarkan data kasus jenazah yang diperiksa di Departemen Ilmu Kedokteran Forensik dan Medikolegal RSUP Dr. Hasan Sadikin Bandung tahun 2013-2017. Selama periode penelitian, terdapat 1.692 jenazah yang ditangani, terdiri dari 1.258 jenazah laki-laki (74%), 430 perempuan (25%), dan 4 jenazah (1%) tidak teridentifikasi jenis kelaminnya. Kelompok usia terbanyak adalah usia 46-65 tahun (30%) dan usia 26-45 tahun (29%). Terdapat 24 jenazah dengan kasus ganda, sehingga didapatkan total 1716 kasus, dengan rata-rata jumlah kasus setiap bulan adalah 29 kasus. Dari total kasus tersebut, yang dilakukan pemeriksaan luar saja 1.303 kasus (76%) dan yang dilakukanotopsi (pemeriksaan luar dan dalam)413 kasus (24%). Jumlah kasus terbanyak pada tahun 2014, 432 kasus (25%). Jenis kasus terbanyak adalah kasus Death on Arrival (DOA) 28%, diikuti secara berturut-turut kasus Kecelakaan Lalu Lintas 26%, Mati Mendadak 22%, Infantisid 7%, Kecelakaan Kereta Api 5% dan Pembunuhan 5%. Kasus pembunuhan terbanyak diakibatkan oleh trauma tajam. Simpulan, didapatkan kasus terbanyak pada tahun 2014 (25%), jenazah terbanyak berjenis kelamin laki-laki (76%), kelompok usia terbanyak adalah usia 46-65 tahun (30%), jenis kasus terbanyak adalah kasus DOA (28%), dan hanya 24% kasus yang dilakukan otopsi.
Hepatoprotective Effect of Citrus sinensis (L.) Osbeck Ethanol Extract in Paracetamol-Induced Rats Mutia, Maya Sari; Chiuman, Linda
Majalah Kedokteran Bandung Vol 51, No 4 (2019)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15395/mkb.v51n4.1794

Abstract

Based on data from the National Poison Data System of the American Association of Poison Control Center, it is reported that there is a high number of death and liver transplantation due to paracetamol and other combination drugs of paracetamol toxicity. Citrus sinensis (L.) Osbeck (Sunkist) is a fruit that has been widely studied for its various therapeutic effects. This study aimed to explore the potential of Sunkist peels as a hepatoprotection agent against the toxicity of paracetamol. This was an experimental study conducted in May 2019 at the Pharmacy Biology Laboratory of Pharmacy Faculty, University of North Sumatera on 15 rats that were divided into 5 groups of treatment (negative, positive, and 300, 450, and 600 mg/kgBW Sunkist ethanol extract) and received treatment for 14 days. The AST and ALT was assessed using the dyasis manual assay. Data were then analyzed using one-way ANOVA, followed by Post-hoc test. The results of this study showed that the ALT and AST levels were significantly different (P-value<0.05) between the negative (ALT: 438.73 U/L; AST: 334.37 U/L) group and the positive (ALT: 152.34 U/L; AST: 49.7 U/L). Futhermore, these levels were also significantly different between the negative group and the group that received 600 mg/kg BW of Sunkist peel ethanol extract (ALT: 189.15 U/L; AST: 69.25 U/L). Hence, Sunkist peels have a potential to provide hepatoprotection effects just like catechin rutin. Efek Hepatoprotektif Ekstrak Etanol Citrus sinensis L. Osbeck pada Tikus yang Diinduksi ParasetamolBerdasar data dari American Association of Poison Control Centers’ National Poison Data System dilaporkan angka kematian dan transplantasi hati yang tinggi akibat toksisitas parasetamol atau dalam bentuk kombinasi. Citrus sinensis L. Osbeck (sunkist) sebagai produk alami secara luas diteliti untuk berbagai efek terapi. Penelitian ini bertujuan mengeksplorasi potensi kulit sunkist sebagai perlindungan terhadap efek toksik dari parasetamol. Penelitian ini merupakan penelitian eksperimental yang dilakukan pada Mei 2019 di Laboratorium Biologi Farmasi, Fakultas Farmasi, Universitas Sumatera Utara. Penelitian ini dilakukan terhadap 15 tikus yang dibagi menjadi 5 kelompok perlakuan (kontrol negatif, kontrol positif, ekstrak sunkist dengan dosis, 300, 450, dan 600 mg/kgBB). Perlakuan yang didapat pada tiap-tiap kelompok dilakukan selama 14 hari. Uji AST dan ALT menggunakan prosedur dari dyasis. Analisis data menggunakan one way ANOVA dan diikuti Post-Hoc Test. Hasil penelitian ini menunjukkan bahwa kadar ALT dan AST memiliki perbedaan yang signifikan (nilai p<0,05) antara kontrol negatif (ALT: 438.73 U/L; AST: 334.37 U/L) dengan kelompok kontrol positif (ALT: 152.34 U/L; AST: 49.7 U/L) dan kelompok tikus yang menerima ekstrak etanol kulit jeruk sunkist 600 mg/kg BB (ALT: 189.15 U/L; AST: 69.25 U/ L). Oleh karena itu, kulit sunkist memiliki efek hepatoproteksi potensial seperti katekin rutin.
Analysis of Geometric Relation between Cerebral Contusion and Site of Impact in Traumatic Brain Injury Patients Karima, Amira Puti; Kusdiansah, Muhammad; Faried, Ahmad; Arifin, Muhammad Z.
Majalah Kedokteran Bandung Vol 51, No 4 (2019)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15395/mkb.v51n4.1498

Abstract

Cerebral contusion is found in 17–34% of traumatic brain injury (TBI) cases. The inertial and contact effects responsible for this injury makes the presence and location of contusion almost impossible to detect without appropriate imaging techniques. This study aimed to identify the geometric association between site of impact and cerebral contusion in patients with TBI. Data were collected retrospectively from Dr. Hasan Sadikin Hospital Bandung, Indonesia from January 2016–December 2017. TBI patients were scanned for diagnosis of cerebral contusion on the initial CT scan and the presence of soft tissue swelling as the site of impact. The locations were then geometrically classified into four groups; frontal, right temporoparietal, left temporoparietal, and occipital. Analysis was then performed using the multinomial logistic regression method with α=0.05 and 95% confidence interval (CI). Right temporoparietal contusion was associated with contrecoup impact compared to frontal impact (p=0.008, OR 6.8, 95% CI: 1.6–28.7) and occipital impact (p=0.002, OR 6.8, 95% CI: 1.7–26.8) while left temporoparietal contusion was associated with contrecoup impact compared to frontal (p=0.006, OR 6.8, 95% CI: 1.7–26.8) and occipital impact (p=0.016, OR 10, 95% CI: 1.3-17) and with coup impacts compared to frontal impacts (p=0.025, OR 5.3, 95% CI: 1.2–23.3). It is concluded that temporal contusion has a statistically significant correlation with contrecoup impacts. Hubungan Analisis Geometris antara Kontusi Serebral dan Lokasi Benturan pada Pasien Cedera Otak TraumatisKontusi serebral ditemukan pada 17–34% kasus cedera otak traumatika (TBI). Efek inersia dan kontak yang bertanggung jawab untuk cedera ini membuat keberadaan dan lokasi benturan hampir mustahil untuk dideteksi tanpa teknik pencitraan yang tepat. Penelitian ini bertujuan untuk menemukan hubungan geometris antara kontusi serebral dan lokasi benturan yang terjadi pada pasien TBI. Data dikumpulkan secara retrospektif dari Rumah Sakit Dr. Hasan Sadikin Bandung, dari Januari 2016–Desember 2017. Pasien TBI dipindai untuk diagnosis kontusio serebral menggunakan CT scan awal dan adanya pembengkakan jaringan lunak sebagai tempat terjadinya benturan. Lokasi itu kemudian secara geometris diklasifikasikan menjadi empat kelompok; frontal, temporoparietal kanan, temporoparietal kiri, dan oksipital, kemudian dianalisis menggunakan metode regresi logistik multinomial dengan α=0,05 dan interval kepercayaan (IK) 95%. Kontusio temporoparietal kanan dikaitkan dengan impact contrecoup dibanding dengan impact frontal (p=0,008, OR 6,8, IK 95% 1,6–28,7) dan impact oksipital (p=0,002, OR 6,8, IK 95% 1,7–26,8), sementara kontusi temporoparietal kiri dikaitkan dengan impact contrecoup dibandingkan dengan impact frontal (p=0,006, OR 6,8, IK 95% 1,7–26,8) dan impact oksipital (p=0,016, OR 10, IK 95% 1,3–17) dan dengan impact coup dibanding dengan impact frontal (p=0,025, OR 5,3, IK 95% 1.2–23.3). Simpulan, bahwa kontusio temporal memiliki korelasi yang signifikan secara statistik dengan impact contrecoup.
Effect of Acute Physical Exercise with Moderate Intensities on FGF23 Gene Expression in Wistar Rat Heart Tarawan, Vita Murniati; Gunadi, Julia Windi; Br. Subekti, Tiodora Arimenda; Widowati, Wahyu; Goenawan, Hanna
Majalah Kedokteran Bandung Vol 51, No 4 (2019)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (175.265 KB) | DOI: 10.15395/mkb.v51n4.1844

Abstract

A myokine is one of the proteins that are produced and released by myocytes in response to muscular contractions when doing physical exercise. One protein that is thought to function as myokine is FGF23.The purpose of this study was to determine the effect of acute physical exercise with moderate intensity on the expression of FGF23 gene in Wistar rat heart. This was an animal experimental study using 24 male Wistar rats that were divided into 4 groups:treatment groups that performed 30 minute acutephysical exercise with moderate intensity (20 m/min) for 3 days, 6 days, and 15 days and a control group without physical exercise. The study was conducted in the Animal Laboratory and Central Laboratory of Universitas Padjadjaran during the period of February to July 2019. Data observed were the FGF23 gene expressions in Wistar rats heart. Data were analyzed using Kruskal-Wallis and Mann-Whitney tests. The results from the Kruskal-Wallis test showed that acute physical exercise with moderate intensity did not increase the FGF23 gene expression in Wistar rat heart (p>0.05), and the average of relative ratios of FGF23/GAPDH gene expression were as follows: control (0.970±0,03), 3 days (0.992±0.03), 6 days (1.014±0.05), and 15 days (1.056±0.02). GAPDH was used in this study as a housekeeping gene since its expression is very constant. This study proves that FGF23 is more likely to take a role in the cardiac remodeling process, especially those associated with cardiac hypertrophy after chronic exercise with no effect observed after acute physical exercise with moderate intensity in Wistar rat heart. Pengaruh Latihan Fisik Akut Intensitas Sedang terhadap Ekspresi Gen FGF23 pada Jantung Tikus Galur WistarMiokin diproduksi dan dilepaskan oleh miosit sebagai respons terhadap latihan fisik. Salah satu protein yang diduga berfungsi sebagai miokin adalah FGF23. Penelitian ini bertujuan mengetahui pengaruh latihan fisik akut intensitas sedang terhadap ekspresi gen FGF23 pada jantung tikus galur Wistar. Penelitian ini menggunakan desain eksperimental dengan tikus galur Wistar jantan yang berjumlah 24 tikus. Tikus dibagi menjadi 4 kelompok untuk diberi perlakuan latihan fisik intensitas sedang (20 meter/menit) dengan durasi 30 menit, selama 3 hari, 6 hari, dan 15 hari serta kelompok tanpa latihan fisik. Penelitian ini dilakukan di Lab Hewan dan Lab Sentral Universitas Padjadjaran pada bulan Februari hingga Juli 2019. Ekspresi gen FGF23 pada jantung tikus galur Wistar dilihat dengan PCR. Analisis data menggunakan uji Kruskal-Wallis dan Mann-Whitney. Uji statistik tidak mendapatkan peningkatan ekspresi gen FGF23 setelah dilakukan latihan fisik akut intensitas sedang selama 3 hari, 6 hari dan 15 hari (p>0,05) dan didapatkan rasio relatif ekspresi gen FGF23/GAPDH otot jantung pada : kontrol (0,970±0,03), hari 3 (0,992±0,03), hari 6 (1,014±0,05), hari 15 (1,056±0,02). GAPDH digunakan dalam studi ini sebagai gen ‘housekeping’ karena ekspresinya yang sangat konstan. Studi ini membuktikan bahwa FGF23 mungkin lebih berperan dalam proses remodeling jantung, terutama yang berhubungan dengan hipertrofi jantung setelah latihan fisik kronik. Simpulan, tidak terdapat pengaruh latihan fisik akut intensitas sedang terhadap ekspresi gen FGF23 pada jantung tikus galur Wistar.
Strong Positive Correlation between Neutrophil-to-lymphocyte Ratio and C-reactive Protein in Early Onset Sepsis Ghrahani, Reni; Yuniati, Tetty; Judistiani, Raden Tina Dewi; Setiabudiawan, Budi
Majalah Kedokteran Bandung Vol 51, No 4 (2019)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15395/mkb.v51n4.1421

Abstract

Sepsis is a life-threatening disease with a high number of mortality in premature infants. Premature infants have immature immune systems, with less pool neutrophils and imperfect ability to destroy pathogen. Neutrophil function is  supported by lymphocyte’s ability to form antibody or specific cell-surface receptors for particular antigens. This underlies the use of neutrophil-to-lymphocyte ratio (NLR) as an inflammation marker to detect and assess the severity of sepsis. C-reactive protein (CRP) is known as an acute phase reactant. Neutrophil-to-lymphocyte ratio is an easier, fast, and inexpensive method when compared to CRP. The aim of this study was to evaluate the correlation between NLR and CRP in detecting early-onset sepsis (EOS) in premature infants. A cross-sectional study was conducted on 53 premature infants born and hospitalized in a hospital in Indonesia who were recruited during the period of April to October 2018.  Blood was sampled from the umbilical cord at birth for laboratory examination. The NLR was determined as the ratio of neutrophil to lymphocyte count. The Tollner scoring system was used to identify sepsis. Mann Whitney-U test and Spearman Correlation test were computed for the statistical analysis. neutrophil-to-lymphocyte ratio which results showed a strong positive correlation with CRP (r= 0.702, 0=0.001) in premature infants with EOS. Leukocyte count was lower in infants with EOS than those without EOS group (median; IQR, x103: 8.9 (6.3-13.8) vs 12.5 (10.1- 16.1); p=0.016). Neutrophil-to-lymphocyte ratio and CRP tended to be lower in EOS group when compared to  that of the non-EOS group. In conclusion, NLR has a strong positive correlation with CRP in premature infants with EOS. Korelasi Positif Kuat antara Neutrophil-to-lymphocyte dan C-reactive protein pada Sepsis Awitan DiniSepsis pada bayi prematur adalah keadaan mengancam jiwa dengan mortalitas tinggi. Bayi prematur memiliki sistem imun imatur, sedikit persediaan neutrofil serta fungsi  belum sempurna untuk melawan patogen. Fungsi neutrofil didukung limfosit membuat antibodi serta reseptor permukaan spesifik untuk antigen tertentu. Neutrophil-to-lymphocyte ratio (NLR) diajukan untuk petanda inflamasi, mendeteksi dan menentukan derajat sepsis, sedangkan C-reactive protein (CRP) telah diketahui sebagai protein fase akut. Neutrophil-to-lymphocyte ratio adalah pemeriksaan yang lebih mudah, cepat, murah dibandingkan dengan CRP. Penelitian potong lintang ini bertujuan mengevaluasi korelasi NLR dengan CRP untuk mendeteksi sepsis awitan dini pada 53 bayi prematur, yang lahir dan dirawat di rumah sakit kami, selama April-Oktober 2018. Sampel darah dari tali pusat pada saat lahir. Neutrophil-to-lymphocyte ratio adalah rasio jumlah neutrofil terhadap limfosit. Skoring Tollner digunakan untuk mengidentifikasi sepsis. Analisis statistik menggunakan Uji Mann-Whitney dan korelasi Spearman. Korelasi positif antara NLR dengan CRP di antara bayi prematur dengan sepsis awitan dini adalah r=0,702, p=0,001. Bayi dengan sepsis awitan dini memiliki jumlah leukosit lebih rendah dibanding bayi non-sepsis (median; IQR, x103: 8,9 (6,3-13,8) vs 12,5 (10,1- 16,1); p=0,016). Neutrophil-to-lymphocyte ratio dan CRP lebih rendah pada kelompok sepsis dibanding non-sepsis. Simpulan, NLR memiliki korelasi positif kuat dengan CRP pada bayi prematur dengan sepsis awitan dini.
Differences in Physical Activity, Lactic Acid Concentration, and Quality of Life between Gender among First Year Medical Students Rachmawati, Maria Regina; Sidarta, Nuryani; Mediana, Dian
Majalah Kedokteran Bandung Vol 51, No 4 (2019)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15395/mkb.v51n4.1636

Abstract

Medical students have fewer opportunities to do physical activities (PA) that may increase the risk for chronic diseases. The aim of this study was to assess the correlation between PA, as assessed using the International Physical Activity Questionnaire (IPAQ), and Lactic acid (LA) concentration, as well as the differences in IPAQ, LA, and quality of life (QoL) between genders. This was a cross-sectional study conducted in April - November 2017 by a private university in West Jakarta. Subjects of the study were selected using simple random sampling approach with female subjects as the more dominant gender ( n=76, 60%) from the 126 subjects recruited. The median of IPAQ, La- 1, and La-2 in male and female were 707 (474–944) vs 423 (392–501) Mets (p=0.7), 4.6 (3.8–5.4) vs 2.8 (2–3) mmol/L (p=0.001), and 8.4 (7.7–8.9) vs 10 (9.3-10.5) mmol/L (p<0.001) respectively. The higher the IPAQ, the lower of the La- 2 concentration (p=0.012) was when analyzed using Kruskal-Wallis test. Total score of QoL in males and females were 2628.6 (2,496-2757) and 2,765 (2,687–2,859) (p=0.067), respectively, while the concepts of Role Limitation due to Physical Health was higher in female (p=0.006), as shown by Mann-Whitney test. In conclusion, subjects arephysically inactive with females are less active and have a higher La-2 concentration than males. However, the QoL concept of the RLPH is better in female students.Perbedaan Aktivitas Fisik, Asam Laktat, dan Kualitas Hidup antara Jenis Kelamin pada Mahasiswa Kedokteran Tahun PertamaMahasiswa Fakultas Kedokteran memiliki sedikit kesempatan untuk melakukan aktivitas fisik yang dapat meningkatkan terjadi penyakit kronis. Tujuan penelitian menemukan korelasi aktivitas fisik (PA) yang dinilai menggunakan the International Physical Activity Questionnaire (IPAQ) dengan kadar asam laktat (LA), serta perbedaan IPAQ, LA dan kualitas hidup (QoL) antar jenis kelamin. Desain penelitian adalah potong lintang, seleksi subjek secara acak sederhana, pada April–November 2017, pada universitas swasta di Jakarta Barat. Hasil penelitian diperoleh 126 subjek, 76 (60%) perempuan. Rerata IPAQ, LA -1, dan LA -2 pada laki-laki dan perempuan secara berurutan adalah; 707(474–944) vs 423 (392–501) Mets (p=0,7), 4,6 (3,8–5,4) vs 2,8 (2–3) mmol/L (p=0,001), dan 8,4 (7,7–8,9) vs 10 (9,3-10.5) mmol/L (p<0,001). Semakin tinggi IPAQ, semakin rendah LA (p=0,012), dengan Uji Kruskal-Wallis. Skor total QoL pada pria dan wanita adalah 2.628.6 (2496–2.757) vs 2.765 (2.687–2.859) (p=0,067), sementara nilai konsep Role Limitation due to Physical Health (RLPH) pada perempuan lebih tinggi (p=0,006) dengan Uji Mann-Whitney. Kesimpulan, subjek memiliki PA tidak aktif, sementara perempuan lebih tidak aktif dan memiliki LA-2 lebih tinggi. Namun, QoL pada konsep RLPH lebih baik pada mahasiswa perempuan.
Elderly’s Expectations of Services in Integrated Health Post (Posbindu): A Qualitative Study Azana, Destyana Wulandari; Gondodiputro, Sharon; Didah, Didah
Majalah Kedokteran Bandung Vol 51, No 4 (2019)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15395/mkb.v51n4.1786

Abstract

Many factors influence the compliance of the elderly to visit the Integrated Health Post (Posbindu). One factor that needs to be explored is the expectation of the elderly on the services in this post. Expectations that are met with performance will create satisfaction, leading to a regular visit to the Posbindu. This study aimed to explore the expectations of the elderly towards services provided in the Posbindu. A qualitative phenomenology study using a in-depth interview was conducted to 8 elderly informants from 7 Posbindu from 7 public health centers (Pusat Kesehatan Masyarakat, Puskesmas) who were selected by purposive sampling in Bandung City. Posbindu and Puskesmas was selected in a simple random manner. The study was conducted from July to October 2018. Explored concepts were structure, process, and output of expectations. The collected data was processed by coding and categorization.This study discovered that the structural expectation covered three subthemes, namely accessibility, human resources, and facilities. The process expectation was formed by three subthemes: behavior and communication skills of the cadres; behavior and communication skills of the health providers; consultation and treatment. The output expectation was formed by three categories, including information about their illness, controlled disease, and the desire to stay healthy. This study discovered 3 new categories from several subthemes of the health care provided in the Posbindu, i.e. free services, attendance of a doctor, and medicine prescription. In conclusion, the expectation of the elderly towards the health services at the Posbindu has been identified. Ekspektasi Lansia terhadap Pelayanan di PosbinduBanyak faktor yang mempengaruhi kepatuhan lansia untuk datang ke Pos Pembinaan Terpadu (Posbindu). Salah satu faktor yang perlu digali adalah harapan para lansia. Harapan sesuai dengan kenyataan akan menciptakan kepuasan, yang mengarah ke kunjungan rutin ke Posbindu. Tujuan dari penelitian ini adalah mengeksplorasi harapan para lansia terhadap layanan di Posbindu. Penelitian fenomenologis kualitatif dilakukan dengan menggunakan wawancara mendalam kepada 8 informan lansia dari 7 Posbindu (dari 7 Puskesmas) yang dipilih secara purposive sampling di Kota Bandung. Pemilihan Posbindu dan Puskesmas dilakukan secara acak sederhana. Studi ini dilakukan dari Juli hingga Oktober 2018. Konsep yang dieksplorasi adalah struktur, proses, dan output dari harapan. Data yang dikumpulkan, diproses dengan pengkodean dan kategorisasi. Penelitian ini menemukan harapan struktural dicakup oleh tiga sub-tema, yaitu aksesibilitas, sumber daya manusia, dan fasilitas. Harapan proses dibentuk oleh tiga sub-tema, yaitu perilaku dan komunikasi kader; perilaku dan komunikasi tenaga kesehatan; konsultasi dan perawatan. Harapan masukan dibentuk oleh tiga kategori, termasuk informasi tentang penyakit mereka, penyakit terkendali, dan keinginan untuk tetap sehat. Studi ini menemukan 3 kategori baru dari beberapa subtema yaitu tidak perlu membayar , kehadiran dokter, dan pemberian obat. Simpulan, harapan lansia terhadap layanan kesehatan di Posbindu telah diidentifikasi.

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