E-Journal Faculty of Medicine Universitas Padjadjaran / E-Jurnal Fakultas Kedokteran Universitas Padjadjaran
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Clinical Manifestations and Hematological Profiles of Pediatric Acute Myeloblastic Leukemia Patients: 3 Years Observational Study in A West Java Tertiary Hospital, Indonesia
Get PDFObjective: To determine and describe the clinical manifestations and hematological profiles of pediatric Acute Myeloblastic Leukemia (AML) in Dr. Hasan Sadikin General Hospital (RSHS), Bandung as a tertiary hospital in West Java, Indonesia.Methods: A retrospective cross-sectional study using the total sampling method was performed on the medical records of pediatric patients (0-18 years old)who were diagnosed as AML for the first time through bone marrow examination during the period of January 1, 2015 – December 31, 2017. Results: Of the 54 subjects who met the inclusion criteria, 42.6% were AML patients in the age group 6-12 years with male patients comprised 59.3% of the total number of subjects. Patients generally experienced pallor (83.3%), fever (75.9%), and decreased appetite (70.4%). The hematological profiles showed that 35.2% of patients had Hb 50,000 cells/mm3. The majority of the subjects had a platelet count of 50% (46.3%). Conclusion: Clinical manifestations and hematological profiles are important to diagnose AML, especially in pediatric patients. By assessing the manifestations and profiles, it is feasible to access and detect suspected cases of AML
Tata laksana Pasien Gravida 29–30 Minggu dengan Gagal Napas ec. Hypokalemic Periodic Paralysis yang Diperberat dengan Community Acquired Pneumonia
Get PDFPenatalaksanaan sakit kritis pada wanita hamil memiliki karakteristik yang unik karena perubahan fisiologi selama kehamilan dan janin yang berkembang dalam uterus yang mendapat implikasi yang signifikan. Pada kasus ini, seorang perempuan 27 tahun yang sedang hamil gemeli usia kehamilan 29–30 minggu datang ke Instalasi Gawat Darurat (IGD) Rumah Sakit Dr. Hasan Sadikin Bandung dengan keluhan utama kelemahan keempat anggota gerak. Hasil pemeriksaan laboratorium didapatkan kadar kalium sangat rendah dan didiagnosis dengan hypokalemic periodic paralysis. Pasien mengalami gagal napas sehingga dilakukan intubasi dan diberikan bantuan ventilasi mekanik, kemudian dirawat di Intensive Care Unit (ICU). Gagal napas disertai penyulit community acquired pneumonia. Tata laksana ventilasi mekanik pada wanita hamil di ICU bersifat suportif dengan teknik sama seperti pada pasien tidak hamil, namun memiliki target khusus yang berbeda. Monitoring fetal heart rate (FHR) dapat mencerminkan kesejahteraan janin dan kondisi ibu. Tujuan penulisan laporan kasus ini adalah mengetahui pentingnya target pemberian ventilasi mekanik dan melakukan monitoring FHR pada pasien hamil di ICU. Management of Respiratory Failure Due to Hypokalemic Periodic Paralysis Complicated with Community Acquired Pneumonia in 29–30 Weeks of GestationManagement of critically ill pregnant women in Intensive Care Unit (ICU) has unique characteristics due to the physiological changes during pregnancy and the presence of growing fetus in the uterine which may present significant implications. This study presented a case of a 27 years old woman with 29–30 weeks of gestation of twin pregnancy who came to Emergency Room (ER) with the chief complaint of weakness in both lower and upper extremities. Laboratory investigations showed a very low potassium level and the patient was diagnosed with hypokalemic periodic paralysis. Patient then experienced respiratory failure at the ER, intubated, and mechanically ventilated and was sent to the ICU. Community-acquired pneumonia was complicating the respiratory failure. Basically, mechanical ventilation management for pregnant patient in ICU is supportive in nature and uses the same techniques employed for the non-pregnant patient. However, the goals are different as it is important to monitor fetal heart rate (FHR) in pregnant woman as this does not only reflect the fetal well-being but also the maternal condition. This case report is intended to show the importance of mechanical ventilation goal and FHR monitoring in pregnant patients in ICU.Penatalaksanaan sakit kritis pada wanita hamil memiliki karakteristik yang unik karena perubahan fisiologi selama kehamilan dan janin yang berkembang dalam uterus yang mendapat implikasi yang signifikan. Pada kasus ini, seorang perempuan 27 tahun yang sedang hamil gemeli usia kehamilan 29–30 minggu datang ke Instalasi Gawat Darurat (IGD) Rumah Sakit Dr. Hasan Sadikin Bandung dengan keluhan utama kelemahan keempat anggota gerak. Hasil pemeriksaan laboratorium didapatkan kadar kalium sangat rendah dan didiagnosis dengan hypokalemic periodic paralysis. Pasien mengalami gagal napas sehingga dilakukan intubasi dan diberikan bantuan ventilasi mekanik, kemudian dirawat di Intensive Care Unit (ICU). Gagal napas disertai penyulit community acquired pneumonia. Tata laksana ventilasi mekanik pada wanita hamil di ICU bersifat suportif dengan teknik sama seperti pada pasien tidak hamil, namun memiliki target khusus yang berbeda. Monitoring fetal heart rate (FHR) dapat mencerminkan kesejahteraan janin dan kondisi ibu. Tujuan penulisan laporan kasus ini adalah mengetahui pentingnya target pemberian ventilasi mekanik dan melakukan monitoring FHR pada pasien hamil di ICU
Evaluasi Kepatuhan Pelaksanaan Standar Prosedur Operasional Manajemen Nyeri pada Pasien Luka Bakar di RSUP Dr. Hasan Sadikin Bandung
Get PDFNyeri didefinisikan sebagai pengalaman sensorik dan emosional yang tidak menyenangkan terkait dengan kerusakan jaringan aktual atau potensial. Manajemen nyeri pada luka bakar merupakan bagian yang tidak terpisahkan dari terapi luka bakar. Nyeri pada luka bakar merupakan nyeri akut, penanganan yang tidak baik akan menyebabkan komplikasi, salah satunya nyeri kronik. Rumah Sakit Umum Pusat (RSUP) Dr. Hasan Sadikin Bandung telah membuat Standar Prosedur Operasional (SPO) manajemen nyeri yang berguna untuk meningkatkan kepatuhan dalam pelaksanaan manajemen nyeri. Penelitian ini bertujuan mengevaluasi kesesuaian teknik pengkajian, tindak lanjut dan evaluasi ulang nyeri pada pasien luka bakar dengan SPO manajemen nyeri. Penelitian menggunakan metode deskriptif observasional retrospektif terhadap 99 rekam medis pasien luka bakar yang memenuhi kriteria inklusi di RSUP Dr. Hasan Sadikin Bandung pada tahun 2018. Hasil penelitian didapatkankan bahwa pengkajian nyeri yang dilakukan sesuai dengan SPO menggunakan numeric rating scale atau Wong Baker faces pain scale ditemukan pada 99 pasien (100%). Tindak lanjut hasil pengkajian nyeri luka bakar yang dilakukan sesuai dengan SPO sebanyak 71 pasien (72%). Evaluasi ulang setelah tindak lanjut pengkajian nyeri yang sesuai SPO pada 93 pasien (94%). Simpulan, pengkajian nyeri di RSUP Dr. Hasan Sadikin Bandung sudah sesuai dengan SPO manajemen nyeri, namun tindak lanjut dan evaluasi ulang pada nyeri luka bakar belum sesuai dengan SPO manajemen nyeri.Evaluation of Compliance to Standard Operating Procedures for Pain Management in Patients with Burns in Dr. Hasan Sadikin General Hospital BandungPain is defined as an unpleasant sensory and emotional experience related to actual or potential tissue damage. Pain management for burns is an integral part of burn therapy. Pain in burns is an acute pain and poor management will lead to health complications including chronic pain. Dr. Hasan Sadikin General Hospital Bandung has made a standard operating procedure (SOP) for pain management to improve compliance to pain management standard. This study aimed to evaluate the compliance to the standards in assessment techniques, follow-up, and re-evaluation of pain in patients with burn according to the applicable pain management SOP. This was a retrospective descriptive observational study on 99 medical records of burn patients who met the inclusion criteria in Dr. Hasan Sadikin General Hospital Bandung in 2018. The results of the study revealed that the pain assessment for these patient was carried out according to the SOP which refers to the use of a numeric rating scale or Wong Baker face pain scale in 99 patients (100%). In the follow-up, 71 were performed according to the SOP (72%) while the re-evaluation was performed in compliance with the SOP in 93 patients (94%). In conclusion, pain assessment in Dr. Hasan Sadikin General Hospital Bandung is performed in accordance with SOP on pain management but not all patients receive follow-up and re-evaluation of burn pain in accordance with the SOP on pain management. Nyeri didefinisikan sebagai pengalaman sensorik dan emosional yang tidak menyenangkan terkait dengan kerusakan jaringan aktual atau potensial. Manajemen nyeri pada luka bakar merupakan bagian yang tidak terpisahkan dari terapi luka bakar. Nyeri pada luka bakar merupakan nyeri akut, penanganan yang tidak baik akan menyebabkan komplikasi, salah satunya nyeri kronik. Rumah Sakit Umum Pusat (RSUP) Dr. Hasan Sadikin Bandung telah membuat Standar Prosedur Operasional (SPO) manajemen nyeri yang berguna untuk meningkatkan kepatuhan dalam pelaksanaan manajemen nyeri. Penelitian ini bertujuan mengevaluasi kesesuaian teknik pengkajian, tindak lanjut dan evaluasi ulang nyeri pada pasien luka bakar dengan SPO manajemen nyeri. Penelitian menggunakan metode deskriptif observasional retrospektif terhadap 99 rekam medis pasien luka bakar yang memenuhi kriteria inklusi di RSUP Dr. Hasan Sadikin Bandung pada tahun 2018. Hasil penelitian didapatkankan bahwa pengkajian nyeri yang dilakukan sesuai dengan SPO menggunakan numeric rating scale atau Wong Baker faces pain scale ditemukan pada 99 pasien (100%). Tindak lanjut hasil pengkajian nyeri luka bakar yang dilakukan sesuai dengan SPO sebanyak 71 pasien (72%). Evaluasi ulang setelah tindak lanjut pengkajian nyeri yang sesuai SPO pada 93 pasien (94%). Simpulan, pengkajian nyeri di RSUP Dr. Hasan Sadikin Bandung sudah sesuai dengan SPO manajemen nyeri, namun tindak lanjut dan evaluasi ulang pada nyeri luka bakar belum sesuai dengan SPO manajemen nyeri
Elderly’s Expectations of Services in Integrated Health Post (Posbindu): A Qualitative Study
Get PDFMany 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
Elevated Endothelin-1 in Intradialytic Hypertension
Get PDFObjective: To determine the relative change in endothelin-1 (ET-1) during hemodialysis procedure in Stage Five Dialysis-Dependent Chronic Kidney Disease (CKD-5D)patients with and without intradialytic hypertension (IDH).Methods: This was a cross-sectional, observational study involving 40 CKD-5D patients who received two hemodialysis per week for at least three months at the dialysis unit of Dr. Hasan Sadikin Hospital General Bandung, Indonesia during September 2016. Subjects were divided two groups: with IDH (n=20) and without IDH (n=20). Plasma ET-1 level was examined before and after hemodialysis.Results: There was a significant elevation of ET-1 level (mean±SD pg/mL) between pre- and post-dialysis state in patients with IDH (3.33±1.28 vs. 3.84±1.75; relative changes: 15.32%, p=0.013). No change was observed in patients without IDH (3.99±2.30 vs. 4.38±1.81; relative changes: 9.77% p=0.083). The post-dialysis absolute ET-1 level was significantly lower in CKD-5D patients with IDH (3.84±1.75 vs. 4.38±1.81; p=0.024).Conclusion: There was a significant elevation of ET-1 level in CKD-5D patients with IDH during hemodialysis procedure at the dialysis unit of Dr. Hasan Sadikin General Hospital Bandung
Post-Lumbar Puncture Chronic Intracranial Subdural Hematoma
Get PDFObjective: To desribe a case of cranial subdural hematoma as an atypically sporadic and potentially devastating complication of a lumbar puncture mimicking post-dural puncture headache which may lead to delayed diagnosis.Method: This is a a case report of chronic intracranial subdural hematoma as a complication of lumbar puncture for spinal anaesthesia in a forty-eight-year-old male underwent an uneventful ureterolithotomy. In the postoperative period, the patient complained of excruciating headache which partially subsided with symptomatic treatment. However, after four weeks, the patient presented with worsening headache and vomiting.Results: A contrast enhanced computer tomography study revealed a subdural haematoma in the left fronto-temporo-parietal-region. The patient underwent an immediate decompressive craniectomy for subdural hematoma. The postoperative period was uneventful and the patient was discharged without any neurological deficits.Conclusion: Intracranial complication such as subdural hematoma is rare after a dural puncture and is often masquerading as a post dural puncture headache. Imaging studies like computerized tomography and magnetic resonance imaging are to be considered in earlier stages of non-retractable headache to rule out such rare complications
Correlation between Ankle-Brachial Index Score and Diabetic Polyneuropathy Degree of Severity
Get PDFDiabetic polyneuropathy (DPN) is the most prevalent chronic microvascular complication of type 2 diabetes mellitus (DM). The severity of DPN is categorized based on symptoms, signs, and nerve conduction study (NCS) abnormality into grades 0, 1a, 2a, and 2b. Pathogenesis of DPN consists of metabolic and vascular processes. In addition, macrovascular factor also plays a role in the pathogenesis of DPN. Macrovascular diseases, such as peripheral arterial disease (PAD), could be diagnosed using the ankle brachial index (ABI). Several studies have proven a strong correlation between ABI and DPN; hence, this study aimed to examine the correlation between ABI score and DPN severity. This was a cross sectional analytic study on. 73 type 2 DM patients who met the inclusion and exclusion criteria and visited the outpatient Endocrine Clinic and Neurophysiology laboratory of the Department of Neurology Dr. Hasan Sadikin General Hospital Bandung, during the priod of June to October 2018. ABI examination were performed after DPN indication was evident from results of physical examination, lab tests, and NCS. Rank Spearman statistical analyses were performed to assess the correlation between ABI score with DPN severity and the result was considered significant if p value <0.05. No correlation was found between ABI score DPN severity and between ABI score and DPN symptoms, signs, and NCS abnormality. Hence, ABI score does not correlate with DPN severity stage. Hubungan Skor Ankle-Brachial Index dengan Derajat Keparahan Polineuropati DiabetikaKomplikasi kronis mikrovaskular diabetes mellitus (DM) tipe 2 yang sering ditemukan adalah polineuropati diabetika (PND). Derajat keparahan PND berdasar gejala, tanda, dan abnormalitas pemeriksaan konduksi saraf tepi (KST) dibagi atas derajat 0, 1a, 2a, dan 2b. Patogenesis PND terdiri atas proses metabolik dan vaskular. Faktor makrovaskular diduga memiliki peranan terhadap terjadinya PND. Penyakit arteri perifer oklusif (PAPO) adalah penyakit makrovaskular yang dapat dideteksi dengan pemeriksaan ankle brachial index (ABI). Beberapa penelitian membuktikan hubungan antara skor ABI dan PND. Penelitian ini bertujuan menilai hubungan antara skor ABI dan derajat keparahan PND. Penelitian bersifat observasi analitik studi potong lintang yang dilakukan pada 73 penyandang DM tipe 2 yang memenuhi kriteria inklusi dan eksklusi di Instalasi Rawat Jalan Klinik Endokrin dan Laboratorium Neurofisiologi KSM/Departemen Neurologi RSUP Hasan Sadikin Bandung periode Juni sampai Oktober 2018. Pemeriksaan ABI dilakukan setelah pemeriksaan klinis PND, laboratorium darah, dan KST. Korelasi antara skor ABI dengan derajat keparahan PND dinilai menggunakan analisis statistik Rank Spearman, signifikan jika p <0,05. Tidak terdapat korelasi antara skor ABI dan derajat keparahan PND. Tidak terdapat korelasi gejala PND, tanda PND, maupun abnormalitas uji KST dengan skor ABI. Skor ABI tidak berkorelasi dengan derajat keparahan PND, baik gejala PND, tanda PND, maupun abnormalitas uji KST. Diabetic polyneuropathy (DPN) is the most prevalent chronic microvascular complication of type 2 diabetes mellitus (DM). The severity of DPN is categorized based on symptoms, signs, and nerve conduction study (NCS) abnormality into grades 0, 1a, 2a, and 2b. Pathogenesis of DPN consists of metabolic and vascular processes. In addition, macrovascular factor also plays a role in the pathogenesis of DPN. Macrovascular diseases, such as peripheral arterial disease (PAD), could be diagnosed using the ankle brachial index (ABI). Several studies have proven a strong correlation between ABI and DPN; hence, this study aimed to examine the correlation between ABI score and DPN severity. This was a cross sectional analytic study on. 73 type 2 DM patients who met the inclusion and exclusion criteria and visited the outpatient Endocrine Clinic and Neurophysiology laboratory of the Department of Neurology Dr. Hasan Sadikin General Hospital Bandung, during the priod of June to October 2018. ABI examination were performed after DPN indication was evident from results of physical examination, lab tests, and NCS. Rank Spearman statistical analyses were performed to assess the correlation between ABI score with DPN severity and the result was considered significant if p value <0.05. No correlation was found between ABI score DPN severity and between ABI score and DPN symptoms, signs, and NCS abnormality. Hence, ABI score does not correlate with DPN severity stage. Hubungan Skor Ankle-Brachial Index dengan Derajat Keparahan Polineuropati DiabetikaKomplikasi kronis mikrovaskular diabetes mellitus (DM) tipe 2 yang sering ditemukan adalah polineuropati diabetika (PND). Derajat keparahan PND berdasar gejala, tanda, dan abnormalitas pemeriksaan konduksi saraf tepi (KST) dibagi atas derajat 0, 1a, 2a, dan 2b. Patogenesis PND terdiri atas proses metabolik dan vaskular. Faktor makrovaskular diduga memiliki peranan terhadap terjadinya PND. Penyakit arteri perifer oklusif (PAPO) adalah penyakit makrovaskular yang dapat dideteksi dengan pemeriksaan ankle brachial index (ABI). Beberapa penelitian membuktikan hubungan antara skor ABI dan PND. Penelitian ini bertujuan menilai hubungan antara skor ABI dan derajat keparahan PND. Penelitian bersifat observasi analitik studi potong lintang yang dilakukan pada 73 penyandang DM tipe 2 yang memenuhi kriteria inklusi dan eksklusi di Instalasi Rawat Jalan Klinik Endokrin dan Laboratorium Neurofisiologi KSM/Departemen Neurologi RSUP Hasan Sadikin Bandung periode Juni sampai Oktober 2018. Pemeriksaan ABI dilakukan setelah pemeriksaan klinis PND, laboratorium darah, dan KST. Korelasi antara skor ABI dengan derajat keparahan PND dinilai menggunakan analisis statistik Rank Spearman, signifikan jika p <0,05. Tidak terdapat korelasi antara skor ABI dan derajat keparahan PND. Tidak terdapat korelasi gejala PND, tanda PND, maupun abnormalitas uji KST dengan skor ABI. Skor ABI tidak berkorelasi dengan derajat keparahan PND, baik gejala PND, tanda PND, maupun abnormalitas uji KST.
Hepatoprotective and Antifibrotic Effects of Indonesian Propolis
Get PDFLiver cirrhosis is the irreversible stage in liver damage process which occurs after liver fibrosis due to necro-inflammatory activities and liver fibrosis. Therefore, inhibition of liver inflammation and fibrosis is very important to prevent liver cirrhosis. This study aimed to analyze the effect of ethanol extract of propolis (EEP) from mount Lawu, Indonesia to prevent liver damage and fibrosis progression in mice with hepatic cirrhosis. This study was performed during the period of June 2018 to May 2019 on a sample of 32 male Balb/C mice divided into control group (P1), induction of carbon tetrachloride (CCl4 ) group (P2), induction of 50 mg/BW CCl4 + EEP group (P3), and (induction of 100 mg/KgBW CCl4 + EEP (P4) with each group consisted of eight mice. The CCl4 in olive oil was administered intraperitoneally three times a week for six weeks. Mean differences between group was determined using ANOVA test with a significance level of 0.05. The induction of CCl4 increased liver cell damage and serum alanin aminotransferase (ALT) level. However, the addition of EEP significantly (p<0.001) reduced liver cell damage as seen in P3 (54.38±4.17 per 100 liver cells) and P4 (37.13±4.36 per 100 liver cells) groups and serum alanin aminotransferase (ALT) as seen in P3 (291.19±113.92 U/L) and P4 (229.38±73.45 U/L) groups. The APRI scores were also reduced after EEP as seen in P3 (0.738±0.292) and P4 (0.513±0.253) groups. Thus, EEP isolates from Gunung Lawu can reduce liver cell damage and fibrosis in mice model of hepatic cirrhosis. Efek Hepatoprotektif dan Antifibrotik Propolis IndonesiaSirosis hati (SH) merupakan tahap ireversibel dalam proses kerusakan hati yang terjadi setelah fibrosis hati sebagai hasil aktivitas nekroinflamasi dan fibrosis hati. Oleh karena itu, penghambatan inflamasi hati dan fibrosis sangat penting untuk mencegah terjadi SH. Penelitian ini bertujuan menganalisis efek ekstrak etanol isolat propolis (EEP) gunung Lawu dalam mencegah progresifitas kerusakan dan fibrosis hati pada mencit model SH. Penelitian dilakukan di Laboratorium Histolgis Fakultas Kedokteran Universitas Sebelas Maret Surakarta dan Lembaga Penelitian dan Pengujian Terpadu (LPPT) Universitas Gajah Mada Yogyakarta . Penilitian ini dilakukan periode Juni 2018 sampai Mei 2019, dengan sampel 32 ekor mencit Balb/C jantan dibagi menjadi kelompok (P1) kontrol negatif, (P2) induksi karbon tetraklorida (CCl4 ), (P3) induksi CCl4 +EEP dosis 50 mg.kgBB-1, dan (P4) induksi CCl4 +EEP dosis 100 mg.kgBB-1, dengan tiap-tiap sampel terdiri dari delapan ekor mencit Balb/C jantan. CCl4 dalam minyak zaitun diberikan pada tikus Balb/C tiga kali seminggu selama enam minggu secara intraperitoneal. Uji ANOVA digunakan untuk menentukan perbedaan rata-rata antar kelompok dengan tingkat kemaknaan sebesar 0,05. Namun, penambahan EEP secara signifikan (p<0,001) menurunkan tingkat kerusakan sel hati seperti yang terlihat pada P3 (54,38±4,17 per 100 sel hati) dan kelompok P4 (37,13±4,36 per 100 sel hati) dan serum alanin aminotransferase (ALT) seperti yang terlihat dalam kelompok P3 (291,19±113,92 U / L) dan P4 (229,38±73,45 U / L). Hasil skor APRI menunjukkan kelompok P1(0,213±0,113) dan P2 (0,863±0,534), EEP dapat menurunkan skor APRI pada kelompok P3 (0,738±0,292) dan P4 (0,513±0,253). Simpulan, EEP isolat Gunung Lawu menurunkan tingkat kerusakan sel hati dan fibrosis pada mencit model SH
Profile of Nutritional Status and Nutrient Intake among Children with Cerebral Palsy in Dr. Hasan Sadikin General Hospital Bandung
Get PDFBackground: Children with Cerebral Palsy have abnormalities in the motoric function that cause feeding problems and higher energy requirements compared to normal children. These problems put the patients at risk of getting inadequate nutrient intake, leading to malnutrition and thus affecting the health outcomes. This study aimed to explore the nutritional status and nutrient intake among children with Cerebral Palsy.Methods: Children with Cerebral Palsy who came for a rehabilitation program in the Department of Physical Medicine and Rehabilitation Dr. Hasan Sadikin General Hospital Bandung were recruited from September–October 2014. Descriptive quantitative study design was performed. Nutritional status was determined by body weight and body height or length if the children could not stand upright to calculate Z-scoreBMI-for-age and Length/Height-for-age according to WHO. Undernutrition was determined when Z-score≤ -2; stunting was designated as height below the average of their age; whereas wasting as a weight. A repeated 24 hours of food recall was used to measure nutrient intake.Results: There were 18 children with Cerebral Palsy, consisting of boys (n=7) and girls (n=11). Only 33.3% of patients had good nutritional status, the others (n12; 67.7%) were under nutrition; of whom stunting (n7) was found, followed by wasting (n3) and both stunting and wasting (n2). These under nutrition patients had predominantly a lower energy and carbohydrate intake.Conclusions: Most of the Cerebral Palsy children are in under nutrition status due to a low energy and carbohydrate intake, therefore, special attention in mother education for the food pattern of their children needs to be raised.
Strong Positive Correlation between Neutrophil-to-lymphocyte Ratio and C-reactive Protein in Early Onset Sepsis
Get PDFSepsis 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