Journal of the Medical Sciences (Berkala ilmu Kedokteran)
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The administration of long-term high-fat diet in ovariectomized wistar rat (Study on Daily Food Intake, Lee Index, Abdominal Fat Mass and Leptin Serum Levels)
No full textABSTRACT Leptin and estrogen have an important role in energy homeostasis through anorexic effects on the central nervous system. These hormones can decrease food intake, increases energy expenditure and thermogenesis. Long-term high-fat diet can lead to impaired leptin function. Moreover, estrogen, deficiency is a risk factor of obesity in menopause. The aim of this study is to investigate the effect of long-term high-fat diet on leptin serum levels in ovariectomized rats. Twenty-eight female Wistar rats (Rattus norvegicus) aged 6-8 weeks with body weight 120-150 g were used in this study. Rats were divided into 4 groups i.e. OVXSC groups: rat were ovariectomized and given a standard diet; OVXH groups: rat were ovariectomized and given a high-fat diet; SHAMSC groups: rat were not ovariectomized and given a standard diet; SHAMHF groups : rat were not ovariectomized and given a high-fat diet. Pre-post test with control group design for measurement of serum leptin levels, food intake, and Lee index. While post-test only control group design for measurement of abdominal fat mass. Pearson test was used to analyze the correlation between leptin serum levels, food intake, Lee index and abdominal fat mass. Paired t-test was used to analyze the differences between values before and after being treated. The daily food intake dropped in rat fed a high-fat diet although it was not statistically significant (p>0.05). Ovariectomy significantly increase Lee index (p<0.05). Obesity occurs in ovariectomized group, both of high-fat diet and standard diet. Abdominal fat mass was significantly higher in high-fat compared to standard diet group (p<0.05). Increase in levels of serum leptin highest in OVX-HF group (16.45 ± 8.75 ng/mL), and the lowest in the SHAM-SC (2.98 ± 1.61 ng/mL). In conclusion, serum leptin levels positively correlated with Lee index and abdominal fat mass, but negatively correlated with daily food intake
The effect of proton pump inhibitors and clopidogrel combination to the risk of recurrent stroke
No full textRecurrent stroke is very common among stroke survivors. Clopidogrel is one of the drugs used in the prevention of recurrent stroke. Because clopidogrel may cause gastrointestinal bleeding, the use of proton pump inhibitors may elicite the side effect, but unfortunately this combination may interfere the antiplatelete activity of clopidogrel since both are metabolized by the same enzyme, liver CYP2C19. The aim of this study was to know the effect of proton pump inhibitors on the efficacy of clopidogrel in the prevention of recurrent stroke in Bethesda Hospital, Yogyakarta. This study was a case control study. The sample size of treatment case was 392 patients and control case was 784 patients. The case group was patients with recurrent stroke and the control group was the patients who come to outpatient clinics of Department of Neurology. In this study, matching was made for treatment and control groups on sex, age and their index date. The exposure of the combination was investigated in the last 6 months and categorized as current use (<2 month before index date) and recent use (2-6month before index date). Multivariate analysis showed that there was no association between clopidogrel and proton pump inhibitors to the risk of recurrent stroke OR 1.05 (95% CI 0.56-1.785). Omeprazole was the most used, although there was no significantly increased risk OR 0.46 (95% CI 0.56-3.70). The effect of proton pump inhibitors to the efficacy of clopidogrel has not been known yet in this study, because the amount of total sample that used the combination of this drug was too small.Keywords: clopidogrel - proton pump inhibitors - recurrent stroke - interactio
Basic principles and diagnostic of colposcopy
No full textABSTRACTThe colposcope is an optical system that offers illumination and magnifications between 10 and 16 times. Colposcopy is the diagnostic test to evaluate patients with an abnormal cervical cytological smear, abnormal VIA (visual inspection with acetic acid application) or VILI (visual inspection with Lugo’s Iodine application), abnormal appearing cervix and directing biopsies. The colposcopic examination of the cervix starts with “General Assessment” to immediately recognize the level of examination reliability. Examination should assessed for three variables: 1) adequate or inadequate, with the reason given; 2) squamocolumnar junction visibility; and 3) transformation zone type. Colposcopic features and patterns will correspond with underlying specific histological features. The greater the expertise and experience of the colposcopist, the greater the confidence in the assessment of the atypical transformation zone (TZ). For practical purposes, the most important aspect is always the recognition or exclusion of underlying actual invasive disease. The presence or absence of precancerous lesions can confirm with colposcopy
Ondansetron serum concentration and polymorphisms of CYP2D6, ABCB1 and 5-HT3B receptor genes in the treatment of chemoterapy induced nausea and vomiting
No full textThis study was aimed to understand differences of ondansetron serum concentrationin each antiemetic responses, polymorphisms of 5HT3B receptor, CYP2D6 and ABCB1genes in Indonesian cancer patients treated with high emetogenic cytostatics. We recruitedcancer patients in Dr Sardjito Hospital treated with cisplatin (≥ 50 mg/m 2) as monotherapyor combination therapy. Patients were treated with ondansetron 8 mg intravenously anddexamethasone 8 mg intravenously and metoclopramide (10 mg orally) after cytostaticadministration until 5 days after chemotherapy. We cathegorized the nausea and vomitinggrade according to the National Cancer Institute Common Toxicity Criteria v.3. We alsodetermined some SNPs of ABCB1, 5HT3B and CYP2D6 genes using realtime PCR. Werecruited 191 cancer patients in this study with the average of ondansetron serumconcentration reached 33.48 ng/ml (SD: 18.54). According to the patients’ response tothe antiemetic, during the acute phase, 21.8% patients experienced acute nausea and30.2% patients experienced acute vomiting. Only the haplotype of CTG-CTG of ABCB1which have significant association with ondansetron serum concentration. EM patients ofCYP2D6 and patients with haplotype of delAG of 5HT3B had lower ondansetron serumconcentration. However, IM patients of CYP2D6 showed higher ondansetron serumconcentration and lower grade of nausea and vomiting. Variations of ABCB1, CYP2D6and 5HT3B may be used as pharmacogenetic marker in predicting antiemetic response incancer patients receiving highly emetogenic cytostatic
Ekspresi EBNA-1 pada diffuse large B cell lymphoma serta Small lymphocytic lymphoma tipe nodal dan ekstranodal
No full textEBNA-1 expression in nodal and extranodal type of diffuse large B cell lymphoma and small lymphocytic lymphoma Background : Diffuse large B cell lymphoma is the most common type of non-Hodgkin lymphoma. Epstein-Barr Virus infection has been suggested to be involved in the pathogenesis of non-Hodgkin lymphoma. Objective : To know the expression of EBNA-1 in diffuse large B cell lymphoma and small lymphocytic lymphoma and its association with nodal and extranodal location of B cell non-Hodgkin lymphoma Methods : Thirty five cases of B cell non-Hodgkin lymphoma from embedding parafin tissue were constituted the basis of the study. Immunohistochemical examination using CD20 and EBNA-1 monoclonal antibody was done. The difference of EBNA-1 expression between diffuse large B cell lymphoma and small lymphocytic lymphoma and the difference of EBNA-1 expression between nodal and extranodal locations of B cell non-Hodgkin lymphoma were analized by chi square test Result and Conclusion : Sixteen cases of B cell non-Hodgkin lymphoma showed positivity of EBNA-1 expression. There was significant difference between the number of cases with positivity of EBNA-1 expression in nodal and extranodal location of B cell non-Hodgkin lymphoma. There was not significant difference between the number of cases with positivity of EBNA-1 expression in diffuse large B cell lymphoma and small lymphocytic lymphoma. The result supported that latency EBV related lymphoma frequently occurs in extranodal location Key words : EBNA-1, diffuse large B cell lymphoma, small lymphocytic lymphoma, nodal, extranoda
Addition of conjugated linoleic acid in whole milk improves lipid profile in high fat diet induced hypercholesterolemia of rats
No full textConjugated linoleic acid (CLA) is an isomer of linoleic acid that has been shown to havemany beneficial effects in prevention of atherosclerosis, hypertension, cardiovasculardiseases and improve immune function. Although majority of CLA in the diet are derivedfrom dairy product such as milk, however, the content of CLA in milk is affected by cow’sdiet. The aim of this study was to investigate the beneficial effect of CLA supplementationin milk for improving lipid profile in high fat diet of rats. Twenty four male Sprague Dawleyrats aged 8 weeks were given high fat diet for 3 weeks to induce hypercholesterolemia.Six rats were maintained in standard diet as control. Rats then were divided into 4 groupsi.e. normal control, negative control, high fat diet+CLA 0.5%, high fat diet + CLA 0.5%supplemented skim milk, and high fat diet + CLA 0.5% supplemented whole milk. Bloodsample was drawn after high fat diet induced hypercholesterolemia and after 4 weeksof treatment for total cholesterol, triglyceride, low-density lipoprotein cholesterol (LDLcholesterol), and high density lipoprotein cholesterol (HDL cholesterol) analysis. Bodyweight was measured each week. Results showed that body weight was significantlyincrease in all groups received high fat diet (p0.05). Total cholesterol, triglyceride, andLDL cholesterol was significantly decrease in whole milk followed by significant increasein HDL cholesterol level. Skim milk supplemented with CLA had only modest effect ontriglyceride and HDL cholesterol level. In conclusion, CLA supplementation in whole milkimproves lipid profile in high fat diet
Could CD8/38 predict virological response to antiretroviral therapy (ART) in human immunodeficiency virus (HIV) infected patients?
No full textABSTRACT The success rate of antiretroviral therapy (ART) depends on the efficacy of the drug and the immune system’s ability to control virus replication. Viral load (VL) examination is a standard test for ART monitoring. Unfortunately, this test is still very limited, especially in Indonesia. CD38 expression has been studied as a predictor for disease progression and decreases once ART is initiated. The aim of this study was to evaluate the possible usage of declining CD8/38 T-cell percentages in predicting the VL. Forty-five subjects naïve to ART were evaluated in this observational analytic study with a prospective design. Data collected included the medical history, physical examination, WHO clinical staging, complete blood counts, CD4 cell count, and plasma VL. These data then reevaluated six months after ART initiation. A paired t-test, and correlation test were used to analyze the data. Significant differences were found in all of the laboratory parameters between pre and post ART. There was a weak significant positive correlation between declining CD8/38 T-cell percentages and declining VL after 6 months of ART (r=0.33; p=0.026), with r2 = 0.11. Therefore despite the linear relationship, CD38 has limited value for prediction of VL
Microbiological profile and antimicrobial susceptibility in children with perforated appendicitis at Dr. Sardjito General Hospital, Yogyakarta
No full textAcute appendicitis is the most common surgical cause of acute abdominal pain in children.Perforated appendicitis is the major complication of acute appendicitis with incidencein children of 30-40%. Perforated appendicitis should be operated immediately alongwith the administration of broad-spectrum antibiotics. The aim of this study isto analyzethe microbiological profile and determine the antimicrobial susceptibility in childrenwith perforated appendicitis at Dr. Sardjito General Hospital, Yogyakarta, Indonesia.Weanalyzed the pus from the perforated appendicitis patients who underwent surgery at Dr.SardjitoGeneral Hospital from January 2005 to September 2009. Escherichia coli (43%)was the most common aerobic bacteria found in children with perforated appendicitis,followed by Pseudomonas aeruginosa (26%), Klebsiellapneumonia (11%), Streptococcus(11%), and Proteus mirabilis (3%).The most sensitive antibiotics were imipenem,phosphomycin, amikacin and netilmicin, followed by the 4th and the 3rd generation ofcephalosporin, amoxicillin, ampicillin, and trimethoprim/sulfamethoxazole. In addition,there was no statistically significant difference in terms of resistant and sensitivity betweenthe 4th generation cephalosporin compared to phosphomycin, netilmicin, or imipenem(p > 0.05). In conclusion, the most common bacteria found in perforated appendicitisin Dr. Sardjito General Hospital is E.coli. The administration of the 4th generation ofcephalosporin might be appropriate for the children with perforated appendicitis
The role of virulence factors inCandida albicanspathogenicity
No full textCandida albicans is a classical example of causative agent for opportunistic fungalinfection. Normally, it colonizes skin, gastrointestinal tract, genital, and mucosalmembranes, but in certain condition it may responsible for diseases. This phenomenonwas mainly associated with immunological status of the host. However, there werefindings that showed the possibility of putative virulence factors work on the transitionof commensally to pathogenic role of the yeast. In this review, some virulence factorswere discussed. Indeed, there were factors that may be considered as putative virulencefactors of C. albicans
Diffuse Large B-Cell Lymphoma Complicated by Small Bowel Obstruction after Radiotherapy: a Case Study
No full textABSTRACTAlthough the spleen is frequently involved in disseminated non-Hodgkin’s lymphoma (NHL), splenic presentation as the initial or only site of disease is uncommon. Treatment modalities include surgery, chemotherapy, and radiation therapy. The priority of cancer follow up is to perform surveillance for recurrent cancer and evaluation of treatment response. Side effects of treatment are frequently missed or overlooked. A 66-year-old woman was presented to our hospital with a month history of spleen enlargement. On physical examination the spleen was palpated at Schuffner 2. Abdominal MSCT scan was suggestive of lymphoma. Surgery revealed adhesion and obstruction of the stomach. Biopsy and gastrojejunostomy shunting were done, but splenectomy was difficult. The pathology anatomy findings confirmed the diagnosis of diffuse non Hodgkin’s lymphoma large B-cell type. Immunohistochemistry showed positive CD3 and CD20. She underwent 6 cycles of rituximab, cyclophosphamide, adriamycin, vincristine, and prednisolone (RCHOP) chemotherapy. CT evaluation done 7 months later revealed that the hilus lienalis lymph nodes and spleen has decrease in size. However, a lumbosacral x-ray done due to back pain revealed metastasis on her 1st and 2nd lumbal spine. After a single fraction of radiotherapy, nausea, vomiting and abdominal distension occurred. A 3 position abdominal x-ray revealed signs of small bowel obstruction. After surgery she has received 9 cycles of zoledronic acid and remained in good condition and ambulatory. Splenic presentation as the initial or only site of non-Hodgkin’s lymphoma (NHL) is uncommon. Acute small bowel obstruction and fistula due to palliative radiation therapy for bone metastasis needs prompt and appropriate treatment