Journal of the Medical Sciences (Berkala ilmu Kedokteran)
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The SLCO1B1*15 haplotype associated with lower clinical outcome in Indonesian tuberculosis patients
No full textRifampin is one of first-line drugs for the treatment of tuberculosis. In Indonesia nearly alltuberculosis patients show lower rifampin plasma concentrations possibly due to genetics.Rifampin is a substrate of the organic anion-transporting polypeptide 1B1 (OATP 1B1)encoded by the solute carrier organic anion transporter family member 1B1 (SLCO1B1).This study aimed to identify haplotype polymorphisms of tuberculosis drug transporterswith an impact on clinical outcome in tuberculosis patients. Thirty-six patients from AbdulWahab Sjahranie General Hospital, Samarinda, East Kalimantan were involved in thestudy. Buffy coat from patient blood samples were tested for SLCO1B1 and SLCO1B3polymorphisms by RFLP and ARMS PCR, whereas the clinical outcome was examinedbased on the sputum conversion. The frequency of patients with SLCO1B1*15 haplotypewas 63.9%. The SLCO1B1*15 haplotype was associated with susceptibility to failureof clinical outcome (p=0.005; RR=4.52; 95% CI: 1.22-16.64). The OATP1B1*15haplotype revealed that the failure of clinical outcome was markedly increased comparedto the three other haplotypes. These results suggest that the SLCO1B1*15 haplotypeis an important predisposing factor for lower clinical outcome. Our data indicate thatindividualized treatment should be considered for Indonesian tuberculosis patients basedon genetics characteristics of patients
Food poisoning at a Javanese wedding tradition at Wirogunan Building on July 23rd 2017
No full textsuspected food poisoning outbreak of 5 cases was reported from Mergangsan primary health care to the Yogyakarta Health Office on July 24th 2017. Objective of this study were to ensure food poisoning outbreak and identify source and route of transmission. A total of 166 respondent was included. All of 83 cases got diarrhea. Epidemic curve showed a common source with incubation period 1-23,5 hours and median incubation was 12 hours. Based on its clinical symptoms and incubation period, this outbreak suspected caused by S.aureus contamination. Statistical analysis showed that the greatest attack rate ratio and odds ratio was found in rendang (AR 3,15 and OR 6,6135; 95% CI 2,7812-16,874). Limitation of this study was there were no sample of food/feces/vomit to confirm the agent
The role of isoflavon in reducing blood glucose levels
No full textPlants provide excellent sources of medicinal compounds. Over 5000 flavonoids havebeen isolated and identified from plant sources. Flavonoids are polyphenolic compoundsmainly recognized as pigments which produce the colors found in flowers, fruit and leaves.Dietary polyphenols are commonly found in plants and are abundant in fruit, vegetables,chocolate, and nuts. These polyphenols also found in beverages including tea, coffee,wine, and soy milk. Flavonoids are known to lower glucose levels, decrease cholesteroland triglycerides, and increase liver enzyme levels most likely by stimulating pancreaticinsulin release. By activating cell-signaling pathways involved in controlling blood glucoselevels, flavonoids aid in carbohydrate digestion, and adipose deposition. Flavonoidscontaining isoflavones, flavanols, flavanones, flavonols, flavones, and anthocyaninshave been studied from clinic study until pre clinic study. However, not all of the studiesconducted had adequate results. Isoflavone is one of the potential flavonoids that still canbe explored for future research. Research on isoflavone supplementation in animals andhumans in reducing blood glucose levels is still limited. Short-term supplementation didnot improve blood glucose levels in postmenopausal women, while other studies suggestthat the long-term isoflavone supplementation can reduce postmenopausal blood glucoselevels. These findings found that isoflavone is a component of flavonoids that have potencyin reducing blood glucose levels
Systematic Review: Pre-Stroke Use of Angiotensin Receptor Blockers and Stroke Outcomes
No full textBackground: Hypertension is the major risk factor and the most important modifiable risk factor for stroke. Angiotensin Receptor Blockers (ARB) are widely used in patient at high risk of cardiocerebrovascular events. The objective of this literature review was to determine the efficacy of pre-stroke use of ARB on stroke outcomes.Methods: Major medical databases (PubMed, MEDLINE, Clinical Key, Cochrane Library, EMBASE) were systematically searched using keyword: “hypertension”, “ARB”, “stroke”, and “outcome”. The search were limited to clinical trials published within the last 10 years, written in English, with full-text availability. We used GRADE Working Group to measure the quality of evidence.Results: Four clinical studies, three retrospective studies and one nationwide population-based cohort study met our inclusion criteria with total of 102.644 patients for analysis. The scientific quality of the studies varied from poor (1 study), moderate (1 study), and high quality (2 studies). Generally, the subjects of the studies were acute ischemic stroke patients. Three studies showed pre-stroke use of ARB were significantly associated with better stroke outcomes. Only one study found different result whereas pre-stroke use of ARB did not appear to affect stroke outcomes. Outcome of the studies was explored according to morbidity (severity and functional status upon discharge) and mortality (30-days mortality or in-hospital mortality). Several limitations were present, including non-random treatment assignment, retrospective study design, and lack of data for longitudinal medication exposure in observational studies.Conclusions: This systematic review shows evidence that there is possible benefit of pre-stroke ARB treatment in relation to better ischemic stroke outcomes. However, further studies with better research method quality are still needed. The efficacy of ARB treatment in relation to other type of stroke outcomes also needs to be furtherly examined.Keywords: ARB, pre-stroke, benefit, prognosis Makalah ini dipresentasikan dalam Poster Session 11th Scientific Meeting of Indonesian Society of Hypertension, 24-26 February 201
Precocious puberty in McCune-Albright syndrome: a case report
No full textMcCune-Albright syndrome (MAS) is a rare disease characterized by a triad of fibrousdysplasia, cafe-au-lait spots and peripheral precocious puberty. We reported a 5-year-8-month old girl with MAS who has been followed-up for 2 years and 8 months. Shewas referred to pediatric endocrinology clinic in our hospital for vaginal bleeding at ageof 2 years 11 months. She had peripheral precocious puberty, i.e. increased estrogenlevel associated with very low gonadotropins, and cafe-au-lait spots on her face and wasdiagnosed as MAS. The patient was treated with estrogen receptor blocker (tamoxifen).She had no menses during the 2 years and 8 months of tamoxifen treatment. Her growthrate and bone maturation were also in normal ranges. However, at the end of tamoxifentreatment she had an episode of vaginal bleeding so that we had to change to othertreatment modalities
The effects of ethanolic extract of Phaleria macrocarpa (Scheff.) Boerl leaf on macrophage phagocytic activity in diabetic rat model
No full textDiabetic patients suffer inflammation and immune deficiency as a consequence of the decrease in macrophage phagocytic activity, thus making them vulnerable to infection. The ability of Ethanolic Extract of Phaleria macrocarpa Leaf (EEPML) to increase macrophage phagocytic activity has also a potential in the diabetic case. EEPML also has anti-inflammatory effect. In this study the EEPML potential to increase peritoneal macrophage phagocytic activity and change M1 and M2 macrophage percentage in diabetic rat model is investigated. This was a quasi experimental study with post test only control group design. Fourty five male Sprague Dawley rats within the age of 8 weeks were classified into normal control group, diabetic control group with solvent, diabetic with 7mg/200g, 14mg/200g, and 28mg/200g of EEPML peroral administration, once a day. The diabetic rat model was made with streptozotocin and nicotinamide injection. The rats were terminated in 3rd, 14th and 25th day of extract administration. Peritoneal fluid was isolated then cultured for macrophage phagocytic activity assay with latex beads. M1 and M2 macrophage percentage was analyzed using flow cytometry with anti CD40 and CD206 antibody. Result of statistical analysis show that active macrophage and phagocytic index mean of EEPML rat groups on day 3, 14 and 25 was significantly higher than the control group. The mean of M1 macrophage percentage of EEPML rat groups was significantly higher than control on day 3 and 14, and lower on day 25, while mean of M2 macrophage percentage didn’t show any significant difference within groups. Conclusion of this study is administration of EEPML increases peritoneal macrophage phagocytic activity on day 3, 14 and 25. This is also increases M1 macrophage percentage on day 14, decrease M1 macrophage percentage on day 25, and doesn’t change peritoneal M2 macrophage percentage in diabetic rat model
Ethanolic extract of the Centella asiatica (L.) Urb. leaf decreases cerebellar brain-derived neurotrophic factor (BDNF) levels in rats after chronic stress
No full textChronic stress produces glucocorticoid-induced neurotoxicity that may lead to alterations of the brain-derived neurotrophic factor (BDNF) concentration in the brain. Cerebellum is known to be severely affected by glucocorticoids-associated oxidative damage. Centella asiatica (L.) Urb. may protect neurons from oxidative damage. This study aimed to investigate the effect of ethanolic extract of C. asiatica (L.) Urb. leaf on the rat cerebellar BDNF levels following stress. Twenty young-adult male Sprague Dawley rats were randomly assigned into four experimental groups. The stress control group received aquadest, and the other groups were treated with different doses of the C. asiatica (L.) Urb. extract i.e 150 (CeA150), 300 (CeA300) and 600 (CeA600) mg/kg body weight/day orally, respectively and followed by chronic footshock stress for 28 days. Upon completion of the experimental period, all animals were sacrificed and the cerebellar was isolated. The BDNF levels from the cerebellar tissue lysate was measured using ELISA. The mean BDNF levels of the cerebellar tissue in the stress control, CeA150, CeA300 and CeA600 groups were 1217.10±301.40; 771.46±241.45; 757.05±268.29; and 627.00±246.02 pg/mL, respectively. Post-hoc analysis showed a significant difference between the control and treatment groups (p< 0.05). In conclusion, the ethanolic extracts of the C. asiatica (L.) Urb. leaf decrease the cerebellar BDNF levels in rats after chronic stress
Correlation between specific rubella immunoglobulin G (Ig G) and response evoked brainstem audiometry examination on confirmed congenital rubella syndrome (CRS) patients
No full textCongenital rubella syndrome (CRS) is a health problem that can cause deaf child. Itsdiagnosis is based on clinical manifestation, specific rubella Immunoglobulin M (IgM) andIgG examination. The aim of this study was to evaluate the correlation between the specificrubella IgG level and the brainstem evoked response audiometry wave V. This was across sectional study involving congenital rubella syndrome (CRS) child patients at Dr.Sardjito General Hospital, Yogyakarta from 2011 to December 2016. The inclusion criteriawere 1) aged less than 24 months; 2) wave V of brainstem evoked response audiometryexamination has been identified. The exclusion criteria were 1) the patient’s parents refusedto participate and 2) incomplete data. Based on α: 5%, β: 20% and coefficient correlationestimation 0.04, minimal sample size were 47 subjects. All of subjects was underwentspecific rubella IgG examination. Statistical analysis by using Spearman`s correlation test.Wave V at the level 81db in 32 (68.1%) patients. A significant positive linear correlation between IgG levels (4-400 IU/mL) and wave V of brainstem evoked response audiometry was reported (p<0.05;r = 0.432). In conclusion, there is a positive correlation between specific rubella IgG leveland brainstem evoked response audiometry test results
Effect of tonsillectomy with or without adenoidectomy on formant sound frequency
No full textABSTRACT Vocal tract resonance characteristics are reflected by formant frequencies which determined by the size and shape of the vocal tract. Tonsillectomy may cause changes in the structure of the oral cavity as a resonator in the speech process. The aim of this study is to determine the effect of tonsillectomy on formant sound frequency. This study used a pre-test and post-test only design experimental. The study underwent in the Otorhinolaryngology Department between August up to November 2012. Inclusion criteria were: 1) chronic tonsillitis, 2) tonsil size was T3-T4, 3) age up to 5 years. The exclusion criteria were craniofacial abnormality and neurological disorders. All patients performed a sound analysis by recording vowel / a /, / e /, / i /, / o /, and / u / in 1 day before and 4 weeks after surgery. The sample consisted of 24 (60%) women and 16 (40%) men. The T3-T3 tonsil size were 25 (62.5%) samples and the lowest than T3-T4/T4-T3 were 6 (15%) samples. Based on paired T test there was a statistically significant increase of all F1 vowels (p 0,05) and decrease of F2 / e / and F3 / u / (p >0,05). Based on these results it can be concluded that tonsillectomy affects the F1 mean difference almost in all vowel except the vowels / i /, F2 & F3
Sepsis risk factor in mount Merapi eruption victims with 2nd or 3rd degree of burn injury
No full textSepsis is one of the fatal complications of burns. It is the most common cause of deathfrom burns. Burn sepsis usually occurs after a burn injury develops into infection. Thisstudy was conducted to determine correlation between age, burn area, inhalation trauma,enteral nutrition start time, escarotomy time, and albumin level of sepsis in patientswith 2nd or 3rd degree burn injury. This was a cross sectional study during May to June2012. The subjects in this study were 39 victims of mount Merapi eruption in 2010 whosuffered 2nd or 3rd degree of burns injury. The result showed the correlation betweenwidespread burns, inhalation trauma, time of escarotomy, and albumin levels with sepsis(p 50%), inhalation trauma, time of escarotomy (> 72hours), and albumin levels (<3.5g/dL)