Journal of the Medical Sciences (Berkala ilmu Kedokteran)
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Pharmacokinetic profile of iron serum after ingestion of ferrous sulfate tablet 2 300 mg taken shortly after meal and 2 hours after meal in women with iron deficiency anaemia
No full textBackground: Iron supplementation is a common strategy used to control iron deficiency anaemia in developing countries. Despite of that, the prevalence of anaemia is still high. Several factors causing the failure of iron supplementation program were reported. The increase in haemoglobin concentration after iron supplementation was determined by several factors, that is, the dose, iron absorption, body iron store, diet, food, and pregnancy. There had been studies on iron pharmacokinetic profile after ingestion of iron tablet taken shortly after meal compared to 2 hours after meal in healthy women, but there was no study on women with iron deficiency anaemia.Aim: The aim of this study was to find out the effect of ferrous suphate @ 300 mg taken shortly after meal and 2 hours after meal on the iron pharmacokinetic profile in women with iron deficiency anaemia.Materials and method: This study was conducted with cross-over design, so that every subject had 2 interventions with an interval (washed-out period) of 7 days. In intervention 1, ferrous sulfate tablet @ 300 mg was taken shortly after meal, and in intervention 2, the tablet was taken 2 hours after meal. Serum samples were taken serially at 0, 0.25, 0.5, 1, 1.5. 2, 2.5, 3, 4, 6, 8, 10 and 12 hours after taking iron tablets. Ferric iron concentration in serum was determined by Vitros Fe Slides method, and iron pharmacokinetic profile was determined using non-compartmental method.Result: The values of pharmacokinetic parameter from the first and second interventions were compared by t test, and the result (mean:t SEMI were: Cmox 274.25 :t 28.18 and 232.92 :t 33.25 ug/dl, T mox 3.21:t 0.30 and 4.25 :t 0.64 hours, K.0.437 :t 0.0011 and 0.3808 :t 0.0065 hour'" Kel 0.1375 :t 0.0132 and 0.1855 :t 0.0048 hour". T'/2e' 5.76 :t 0.74 and 5.81 :t 1.16 hours and AUCO-,2 2157.37 :t 264.55 and 1869.54 :t 330.60 ug/dl.hours. There are no significant differences in all pharmacokinetic parameters between both interventions.Conclusion: There are no differences in iron pharmacokinetic profiles after ferrous sulfate tablet @ 300 mg taken after meal and 2 hours after meal in women with iron deficiency anaemiaKata kunci:iron concentration, pharmacokinetics, ferrous sulfate, anemia, effect of foo
Sexual dimorphism of pelvic girdle: pelvimetry and pelvic types in Javanese
No full textBackground: Each population has certain phenotypic traits that are unique compared to other populations. Pelvis's size and morphology are two of them. A western formula of obstetric conjugate = diagonal conjugate - 1.5 to 2.0 em; may not be applicable to Javanese population; and sexual traits in Western pelves may not entirely be the same with Indonesians.Objective: to get a formula for obstetric conjugate, and conduct various pelvic measurements in order to find out the metric pattern as well as the distribution of pelvic types in Javanese.Material and Methods: 27 pelves consisting of 6 females and 21 males housed at the Department of Anatomy, Embryology and Anthropology were studied by connecting the sacrum with the right and left pelvis forming pelvic girdles. Superior inlet, diagonal conjugate, angle of greater sciatic notch, diameter and width of pelves were among the metric studied.Results: Widely used traits such as greater sciatic notch that are used in Western literature to differentiate male and female pelves in Caucasian is not consistent for Javanese pelves. The most consistent skeletal traits for sexing female pelvis are wide subpubic angle (> 75 degree), preauricular sulci, flat posterior pubic symphisis, and short ischiopubic rami. The common type of ginecoyd pelvis in Javanese (48%) is in accord with western pelvis reaching 50%. Compared to the western obstetric conjugate, Javanese obstetric conjugate has a slightly different formula = diagonal conjugate - 1 to 2.6 cm.Conclusions: Several traits in sexual dimorphic of pelvic bone in Javanese do not match with skeletal traits widely used in Western literature, portraying the importance of studying regional human biological variation. The obstetric conjugate of Javanese pelves is not entirely the same with Western formula, though the difference is not significant.Key words: Javanese, pelves, sexual dimorphism, obstetric conjugat
The Korean and Indonesian variant of nocturnally periodic form of Brugia malay! (Nematoda:Filarioidea) the causative agent of filariasis.
No full textBackgound: The nocturnally periodic form of B.malay/ was reported as health problem both in Cheju, Korea and Bireuen, Aceh, Indonesia. The filarial worm was transmitted respectively by Ae.togoi in Korea and An.barbirostris in Indonesia.Objectives: To know any difference of microfilarial behaviour in peripheral blood by meta-analisis on available data published by previous workers.Methods: Using Aikat and Das formula of statistical analysis.Results: B.malayi' s microfilariae tend to present at peripheral blood at day time among cases in Cheju, Korea more than those in Bireuen, Aceh, IndonesiaConclusion: B.malayi's microfilariae in Cheju, Korea still had tendency to show (nocturnally) subperiodicmore than those in Bireuen, Aceh. Key words: filariasis - B.ma/ayi's microfilaria variant - nokturnally periodic - nocturnally subperiodi
Differentiation and identification of Aedes albopictus Skuse from several population in Indonesia based on genetic polymorphisms
No full textBackground: Aedes albopictus play important role in the spread dengue virus, it is spread widely in Indonesia. Geographical condition of Indonesia which shows varying climatology, biogeography and environmental factors seem to be very possible to cause the difference in the genetic structure of Ae. albopictus.Objective: The aim of this study is to determine the genetic polymorphism of each Ae. albopictus population.Methods: Genomic DNA was extracted from individual mosquitoes from 4 geographic populations of Ae, albopictus and amplified in PCR reactions using single primers of arbitrary nucleotide sequence.Result: The DNA polymorphism level of Ae. albopictus population originated from Yogyakarta is 80.77%, followed by population originated from Padang is 57.14%, Banjar is 40.74% and Timika is 37.50%. Conclusion: The genetic structure of the Ae. albopictus populations shows obvious differences, and they shows that they are from different group and separated with the various difference percentage.Key words: genetic polymorphism - population - Ae. albopictus - dengue virus - RAPD-PCR
Risk predictor for ma/aria in pregnancy and the role of chloroquine in /ow endemic area
No full textBackground: Pregnant women in malaria-endemic areas are uniquely susceptible to infection with Plasmodium falciparum and this susceptibility is greatest during first pregnancies. Malaria causes serious complications in pregnant women, especially in those who have a low level of acquired immunity before pregnancy.Objective: to assess the risk predictors for malaria during pregnancy and the role of chloroquine in low endemic area of malaria in Jepara districtDesign: A longitudinal study of all pregnant mother was carried out in Batealit and Mayong I subdistricts of Jepara district between June 1997-August 1999. All pregnant women were screened for peripheral parasitaemia through active surveillance. Women who had parasitaemia were treated with chloroquine for 3 days. Blood smears were then examined on days 4, 7, 14 and 21 after completion of the chloroquine course. All women irrespective of the blood smear results at enrolment were followed up once every two weeks until delivery.Results: Among 3099 pregnant women enrolled in the study, only 58 women had malaria infection, giving an incidence rate of 1.9/100 pregnant women. In this study low income is a significant risk predictor for malaria (OR= 11.03; 95%Cl: 3.91-31.08). Women who had reported a history of malaria or history of taking antimalarial drugs 6 months before their last menstrual period (LMP) showed an increased risk of developing malaria during pregnancy (OR= 10.56; 95%Cl: 4.57-23.72 and OR = 10.90; 95%Cl: 4.4825.61) respectively. Among those infected by P.falciparum and P. vivax and treated with chloroquine, complete parasite clearance was found in day 7.Conclusions: This study shows that low income, history of malaria within 6 months before LMP and history of taking antimalarial drugs within 6 months before LMP are best predictor for malaria in pregnancy in low endemic area. This study also shows that chloroquine is still effective for treating malaria falciparum in pregnancy in Batealit and Mayong I subdistricts, JeparaKeyword: malaria - pregnancy - low endemic area - risk-predictor - chloroquin
Potency of Anticandida extract combine by in vitro and in vivo
No full textBackground: Antifungal agents are routinely used for the treatment of fungal infections. It is very likely however, that resistance of fungi to antifungal agents will emerge in the near future and the development new antifungal agent is very slow. To cope with the problem, it is important to search new antifungal agent from natural resources for yhe treatment of various diseases. It was also reported that bee honey has antibacterial property.Objective: To know the in vitro and in vivo effect of crude honey, aether-extracted honey and its residual part on Candida albicansMethods: Samples used in this experiment were crude honey, aether-extracted honey and residual part of extracted honey. Each sample was tested for its anticandidal activity with macrobroth dilution method using casein-yeast extract-glucose medium. Minimal inhibitory concentration and minimal fungicidal concentration were determined for each sample.Result: The result showed that extracted honey anticandidal effect in vitro at minimal inhibitory concentration was 0.3125% v/v and its residual was 25%, whereas crude honey has no inhibitory in vitro effect on Candida albicans. Minimal fungicidal concentration of extracted honey and its residual were 0.31255 and 50% v/v respectively. In vivo study showed that treatment group recovered faster than control group.Conclusion: Aether extracted honey and its residual have anticandidal activity in vitro. The extract have effect on recovery of candidal infected mice.Key words: Candida albicans - bee honey - antifungal-minimal inhibitory concentration - candidal infection recovery
Profile of patients diagnosed as sepsis (ICD X: A41.9) in the Internal Medicine Ward Sardjito Hospital in 2002
No full textBackground: Sardjito Hospital as the top referral hospital for the Yogyakarta Special Province and the southern part of Central Java has a mortality rate of 56.83% of patients diagnosed as sepsis (ICD X A41.9). The overall hospital sepsis case in the year 2002 was 275, with 50.54% (139) of which was treated in the Internal Medicine ward. Out of the 139 cases, 44.60% was man and 55.40% was woman. Method: This study was focused on the identification of demographic and clinical factors of patients diagnosed as sepsis (ICD X A41.9) in Internal. Medicine ward Sardjito Hospital in 2002. Demographic data include sex, age, system of hospital admission (referral or self admition. Clinical data include the concomitant disease(s), causes of death, and type of cultured microorganism(s). The identification of these factors may be beneficial for designing an early warning system for fatal cases of patients with sepsisResults: Only 120 (86.33%) out of 139 medical records were eligible for further analysis. Seventy-one (59.17%) patients died in the hospital, whereas 49 (40.83%) were discharged from the hospital, but mostly were forced leave (only 6 patients were discharged in a good condition). The median ± SD age was 53.5 ± 15.99 years old with the youngest age was 17 and the oldest was 98. More than 50% of patients were above 50 years old. As many as 72 (60%) patients were admitted to the hospital referred by other hospitals (a few numbers were referred by private physicians), and only 48 (40%) patients were self-admitted. The average length of hospitalization was 6.96 ± 5.43 days, with the range of 1-25 days. The cause of death of these patients were mostly septic shock (61.97%), followed by respiratory failure (19.72%), intracranial process (14%), cardiac arrest (2.8%) and MOFS (1.4%). The underlying/concomitant diseases are:. gastrohepatology (mostly hepatic cirrhosis and hepatocellular carcinoma); hematology (acute leukemia, multiple myeloma), pulmonology (TB, COPD, pneumonia), oncology (Ca mammae, Ca cervix); endocrinology (DM type 2 with ulcus diabeticum), nephrology (chronic renal failure), cardiology (congestive heart failure), obsgyn (septic puerpuralis) and trop-med (urinary tract infection, malaria), etc.Conclusion: We report here research on medical record of patients diagnosed as sepsis (ICD X: A41.9) in Internal Medicine ward Dr. Sardjito Hospital in 2002. There were 139 cases with only 120 were eligible for analysis. Mortality reached 59.17% of cases with median of age 53.5 years and average length of hospitalization of 6.96 days. The most common cause of death was septic shock and gastrohepatology as the most common comorbid disease.Key words: sepsis-demographic-clinical presentation-cause of deat
The effectiveness of piper betel solution and combination of sodium hypochlorite and hydrogen peroxide in root canal irrigation for endodontic treatment: A scanning electron microscope study.
No full textBackground: Root canal irrigation is a step needed in endodontic treatment, after extirpation of dental nerves, to clean the debris in the root canal in infected tooth pulp. The cleaned root canal was then filled with synthetic nerves and thus allowed the tooth crown to be preserved and function normally in the oral cavity.Objective: This study was aimed to compare the effectiveness of piper betel solution with the combination of sodium hypochlorite and hydrogen peroxide as irrigation material in dental root canal treatment. Material and Method: The material of study consisted of 6 upper incisors that were sectioned longitudinally into 12 parts. This study used in vitro method, by applying standard root canal treatment: preparation, extirpation, and irrigation of the root canal of incisor teeth. After irrigation (one group of teeth used piper betel solution; and the other group used combination of sodium hypochlorite and hydrogen peroxide), the tooth was longitudinally cut becoming mesial and distal parts. These parts were examined under scanning electron microscope with 500 magnification, and photographed using electron micrograph on the apical, middle, and coronal sections. The amount of debris was calculated (pm2) in each of those sections.Results: Irrigation using piper betel solution showed less amount of debris (n = 12, mean = 565 pm2) in the root canal, compared to combination of sodium hypochlorite and hydrogen peroxide (n = 12, mean =703,um2). However, the t test statistical analysis showed no significant difference between the two.Conclusion: Because of the toxicity of combination of sodium hypochlorite and hydrogen peroxide, no significant difference in irrigation material for root canal treatment, and the cleaner effect of piper betel solution, I suggest piper betel solution to be used widely as irrigant in endodontic treatment.Key words: root canal, piper betel, sodium hypochlorite, hydrogen peroxide, incisor teet
The glucose uptake velocity and ability of target tissue cells in the elderly men (in vivo)
No full textBackground: Age is one of the impaired glucose tolerance risks. Impaired glucose tolerance may be caused by the decrease of pancreatic B cells insulin secretion, or by the decrease of target tissue cell glucose uptake. Glucose tolerance tests which were conducted in the elderly, showed that plasma insulin concentrations at 120th minute were still higher than at minute-0 (at fasting time), while blood glucose levels were still high. It generated an impression that insulin inefficiency exist in the elderly.Objective: To reveal that the cause of insulin inefficiency in the elderly is due to the decrease of target tissue cell glucose uptake velocity and/or in decrease uptake ability.Methods: Elderly men subjects and young men comparable controls were given 130mU/kg L8M/hour insulin and 20g% dextrose infusion, while blood glucose level have to be maintained in euglycemic situations (euglycemic clamp test). In 30 minutes with stable blood glucose level, the amount of 20% dextrose infusion were calculated as glucose uptake in 30 minute (euglycemic clamp time). From this results the glucose uptake velocity and ability (glucose uptake ability = ratio between glucose uptake velocity and plasma insulin concentration = insulin sensitivity index) between the elderly and the young men were compaired by t-test.Results: Euglycemic clamp tests were conducted to 4 elderly men of 65-74 years old, and 4 young men of 21-30 years old as controls. The results showed that the velocity of glucose uptake by the target tissue cells in those elderly men were significantly (p<0.05) lower (10.08 f 2.34 mg/kg LBM/min.) than young men group (17.78 ± 5.49 mg/kg LBMlmin.). One elderly men showed the lowest difference (0) of insulin sensitivity index compared to one control subject. In the remaining three (75%) subjects the average of insulin sensitivity index (0.11 f 0.03) showed a significant difference (p<0.05) compared to young men group 10.19 f 0.04).Conclusions: The result of this study indicated that the cause of insulin inefficiency in the elderly men was due to the decrease of glucose uptake velocity and ability.Key words: impaired glucose tolerance - pancreas B cells insulin secretion - velocity of glucose uptake ability of glucose uptake - euglycemic clamp technique
Lipid profiles and fibrinogen levels in coronary heart disease and dyslipidemic patients in Dr. Sardjito Hospital Yogyakarta
No full textEpidemiological studies indicated that fibrinogen and dyslipidemia were important risk factors for cardiovasculardisease (CVD). For several populations in theworld, increase in cholesterol level and decrease in high-density lipoproteincholesterol (HDL-C) were risk factors for coronary heart disease (CHD). The role of elevated fibrinogen in thrombosissuggests that it may be the causal pathway for certain risk factors of CHD. The aim of this study is to determine therole of lipid profile and fibrinogen level as risk factors of coronary heart disease. Blood samples were obtained fromCHD patients, dyslipidemic patients, and controls after they had fasted. Lipid profiles and fibrinogen level of CHDand dyslipidemic patients were determined and compared with controls. There were 92 subjects in this study,consisted of 35 CHD patients, 31 dyslipidemic patients, and 26 controls. There were significant difference intriglyceride level between CHD and dyslipidemic patients, also between dyslipidemic patients and controls (p<0.05).Significant difference in level of cholesterol also existed between CHD patients and dyslipidemic patients, alsobetween CHD patients and controls (p<0.05). In dyslipidemic patients, decreased in HDL-C level was risk factorfor CHD. Meanwhile for controls, high level of cholesterol and LDL-C also low level of HDL-C were risk factor forCHD, but fibrinogen level was not risk factor for CHD. In conclusion, lipid profile was risk factor for CHD whereasfibrinogen level was not risk factor for CHD.Keywords: lipid profile – fibrinogen - coronary heart disease - dyslipidemi