Journal of the Medical Sciences (Berkala ilmu Kedokteran)
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Filariasis klinis yang disebabkan oleh Brugia malayi nonperiodik pada penduduk asli Dayak di Kalimantan Timur
No full textKeyword : Brugia malayi -- nonperiodic form -- filarial attack -- elephantiasis -- lymphatic filariasi
Improvement of marital intimacy scale and a study of this instrument on measuring the result of psychotherapy
No full textMuchlas 1 has adapted marital intimacy scale (10 questions) from 36-items of PAIR (Personal Assessment of Intimacy in Relationships) to suit with Javanese culture. In his dissertation, the scale was used to describe that one of the ways to increase the condition of mental health of mothers attending a course on mental health is by improving their marital intimacy. The result is not like what was expected, although the scale had been approved in the reliability and validity test. In his study on this scale, Sudiyanto2 said that although it had significant validity, the scale still had low internal consistency; there were normative questions, asking about morality instead of intimacy; several statements were inappropriate and the ten questions might not represent marital intimacy dimensions. The demand to revise this scale became urgent, as the scale is the only one planned for Indonesians and its practicality is required to evaluate the results of consultations on marital problems as well as mental health conducted by existing institutions, especially the Advisory Board of Marital and Separation Problems (BP4). Later Muchlas and Sudiyanto3 revised this scale of marital intimacy, and it became the revised scale of Marital Intimacy (15 questions). This new scale had better validation and internal consistency. In this study the revision of the scale of marital intimacy was used to measure the marital intimacy of worried patients who visited BP4 for consultation concerning with their separaty. Through an experimental study using psychotherapy, 100 random samples were divided into two groups; 50 samples belonged to a group provided with psychotherapy and 50 other samples belonged to a control group without psychotherapy. Their marital intimacy was measured using the new instrument before and after they were provided with psychotherapy. The result showed significant difference between the two groups and the validity of the marital intimacy scale used in this study was adequately good.Keyword : marital intimacy -- validity of the MIS -- REMIS -- psychotherap
Atypical carcinoid of the lung: A case report
No full textA 3D-year old woman came to Dr Sardjito Hospital with chief complain of dyspneu that she had since 1 month before her visit. Clinicalexamination revealed a dull percussion below. The second intercostal of the left chest. The chest X ray revealed massive pleural effusion in the left chest, could not exclude a mass in left lung. Thoracoscopic biopsy of the left lung mass was done. Macroscopic examination of lung tissue sample revealed fragmented tissue, with volumeof 0.25 cc, blackcolour, and rubberyconsistency. The diagnosis of atypicalcarcinoid with small cell carcinoma as a differential diagnosis was determined based on morphological pattern. Immunohistochemical staining examination showed expression of cytokeratin, CAM5.2, and synaptophysin, but showed negative expression of chromogranin, CD56, and TTF-1 .A diagnosis of an atypical carcinoid was confirmed based on the immunohistochemicalexamination. A very rare case of atypical carcinoid of the lung in a non-smoker 3D-yearoldwoman with morphologicaldiagnostic problem solved by immunohistochemical staining was reported
Body Composition in Javanese Adult: Some Anthropometric Dimensions Related to Body Fat
No full textBackground: Body composition is an integral component of entirely health and physical fitness. Measurement of fat component in assessing body composition is necessary on account of its relation to several health risks. Some anthropometric measurements such as waist to hip ratio (WHR), waist and hip circumferences, skinfold thickness, and sagittal abdominal diameter are demonstrated to be valuable for evaluating body composition, and further for identifying some health risk factors. Objectives: This study is addressed to know body composition and some anthropometric measurements related to percent body fat in Javanese adults living in Yogyakarta province. Methods: As many as 201 (98 males and 103 females) Javanese adults living in Yogyakarta province, aged 18 to 65 years were entrolled in this study. Measurements of body weight, height, waist, abdominal, and hip circumferences, sagittal abdominal diameter, and total skinfold thickness of triceps, biceps, subscapular, suprailiac were performed on the subjects. Body composition was assessed based on those measurements included percent body fat, body density, and skeletal muscle mass. Body mass index and waist-to-hip ratio were determined and categorized. The data then were analysed using independent Hest, Pearson correlation of product moment, linear regression, and chi-square test. Results: The result indicated that in a general sense, Javanese adults in Yogyakarta province had thin to medium body constitution and risk factor categorized of low to medium risk for males and medium to high risk for females. Javanese adult males were considerably heavier, taller, had greater means of body density, WHR, and muscle mass. By contrast, Javanese adult females were significantly higher in BMI, percentage of BF, and hip circumference. Statistically, there is no significant difference in total skinfold, abdominal circumference, and SAD, however, females indicated to a certain greater than the males. In the same manner, males had larger waist circumference. Conclusions: All of anthropometric dimensions including skinfold thickness, body density, waist circumference, abdominal circumference, WHR, sagittal abdominal diameter, and muscle mass are strongly correlated with body composition assessed with BMI and % BF. However, associations with BMI are fairly better than those of with percentage of BF. Among those measurements WHR showed the weakest correlation. There was also a different tendency in the power of correlation between anthropometric dimension with BMI and percentage of BF in males and females. Yet, all the measurements were supposed to be performed to incorporate evaluation on human body composition. Key words: body composition - Javanese adults - anthropometric measurements - percentage of body fat
The Change of Retinal Sensitivity in Diabetic Retinopathy after Photocoagulation
No full textBackground: Panretinal photocoagulation is used to destroy new blood vessel growth which develops on large areas of retina. Burns that occur would cause scars, that would stop bleeding. Laser has shown benefit in decreasing advance visual loss. Several studies stated that panretinal photocoagulation also decreased the light sensitivity, peripheral visual acuity, and night visual, paracentral scotoma, choroidal neovascularization (rare). submacular fibrosis, and laser injury cycatrical widening, Study on this problem is needed. Objective: To find out the influence of panretinal photocoagulation on retinal sensitivity in diabetic retinopathy patients. Methods: This study used pretest-posttest design. Subjects were diabetic retinopathy patients who visited Ophthalmology Outpatient Clinic Unit Dr. Sardjito Hospital and Dr. Yap Eye Hospital, Yogyakarta from March 2008 to January 2009. All subjects underwent panretinal laser photocoagulation and visual field was examined before treatment and 1 month (4 weeks) after treatment. Data were analyzed descriptively. The difference of retinal sensitivity before and after treatment were analyzed with paired Hest. Result: 19 patients (34 eyes) were included in the study. Average duration of diabetes mellitus in the subjects was 10.44 + 5.26 years. Most (82.4%) subjects had no history of hypertension. The number of laser given to subjects were 826-1850 burns (the average was 1164+218.95). There was improvement in the retinal sensitivity after photocoagulation, although it was statistically insignificant (p > 0.05). There was no significant difference between old and new parameters on visual acuity improvement (p = 0.72 Conclusion: There was no significant change in retinal sensitivity between before and 4 weeks after panretinal photocoagulation in diabetic retinopathy patients. Key words: retinal sensitivity - panretinal photocoagulation - diabetic retinopath
On-admission serum soluble CD40 ligand level predicts subsequent myocardial damage in acute myocardial infarction
No full textBackground: Platelet activation plays an important role in plaque rupture and thrombus formation. Activated platelets release soluble CD40 ligand (sCD40LI. It has coagulation and inflammation properties. Enhanced sCD40L activity has been found in acute myocardial infarction, especially in ST-elevation myocardial infarction. The impact of this enhancement on the degree of myocardial damage remains uncertain, although evidence suggests association between sCD40L level and high burden coronary thrombus.Objective: The aim of this study was to find out whether serum sCD40L level on-admission is predictive of subsequent myocardial damage following acute myocardial infarction.Methods: This study was a cross-sectional study. We consecutively enrolled patients with acute myocardial infarction admitted to ICCU Dr. Sardjito Hospital with onset < 24 hours. Blood collection for analysis of sCD40L was withdrawn on-admission before revascularization and heparinization. Serial measurement of creatine kinase (CK-MBllevel in first 24 hours of admission was conducted, the highest level was considered a peak level that reflected myocardial damage. Troponin I was measured in single sample during 72 hours of admission. The association between serum sCD40L and peak CK-MB level was analyzed with Pearson correlation test. Statistical significancy was determined by p value < 0.05.Result: We enrolled 54 consecutive subjects, among them 37 subjects was STEM!. There was a significantly positive correlation between on-admission sCD40L and peak CK-MB level (r = 0.320 ; p value = 0.0201. Nonetheless, sCD40L did not correlate with troponin I level. In STEM I, this correlation was stronger (r = 0.424; p value = 0.0101 and even more stronger in patients with STEMI who underwent revascularization therapy (r = 0.515 ; p value = 0.0291.Conclusion: On-admission serum sCD40L level is predictive of subsequent myocardial damage following acute myocardial infarctionKey words: soluble CD40 ligand - platelet activation - acute myocardial infarction - peak CK-MB myocardial damag
The effect of chronic ethanol administration on total number of pyramidal cells in CA 1 and CA3 of hippocampus and spatial working memory in adolescent rats (Rattus norvegicus)
No full textBackground: Adolescent brain may be more susceptible to damage by ethanol. Chronic ethanol administration may cause morphological changes in the hippocampus, followed by deficit in the hippocampal function, including the impairment of memory.Objective: The aim of this study were to investigate the changes in the total number of pyramidal cells in CA 1 and CA3 of hippocampus, and the relationship between these changes with spatial working memory of rats after chronic ethanol administration at adolescent age.Methods: Twenty five adolescent (30 days of agel male rats (Rattus norvegicusl were classified randomly into 5 groups, that is, namely control without treatment (C1 I, control with treatment (C21, treatment 1(11 I, treatment 2 (T2), and treatment 3 (T31 groups. Each group consisted of 5 rats. C2 group was given physiological saline, while 11, T2, and T3 groups were given ethanol at various doses of 1, 2, and 3 gl kgBW/day, repectively, for 30 days by intraperitoneal injection. After chronic ethanol administration, the spatial working memory of 5 groups were tested using 8 arms radial maze for 12 days. At the end of the experiment, the rats were sacrified and the brains were taken out for histological examination, by paraffin method and Cresyl violet staining.Result: Chronic ethanol administration on adolescent rats caused a decrease in spatial working memory (especially in group T31 (p 0.051. Analysis with product moment correlation test showed that there was a positive correlation between the total number of pyramidal cells in CA 1 of hippocampus with spatial working memory of the rats after chronic ethanol administration at adolescent age (p < 0.051.Conclusion: Chronic ethanol administration on adolescent rats caused a decrease in the spatial working memory and the number of pyramidal cells in CA 1 of hippocampus. There was a positive correlation between the number of pyramidal cells in CA 1 and spatial working memory of the rats after chronic ethanol administration at adolescent age.Key words: ethanol - pyramidal cells - spatial working memory - adolescen
Diabetic retinopathy diagnostic with ophthalmoscope by trained doctor
No full textIntroduction. Diabetes mellitus patient is in high risk to be complicated by retinopathy. Visual loss and decrease of visual acuity become a significant social burden. Early detection is essensial for treatment. Ophthalmoscopy was highly effective for screening, easily used and accessed by ophthalmologist and other physician and has been applied in many developed countriesPurpose : This study was aimed to know the validity of ophthalmoscopic test done by a trained doctor in diagnosing diabetic retinopathy..Materials and methods : The subjects were diabetic patients without cataracts. The examiner was a resident of Internal Medicine Department who had been trained in ophthalmoscopy. After the training, the resident was assessed and the result was compared with the trainer and showed agreement with kappa 1.00.Results: The study was done from February to May 2007. Total subjects were 98 patients (196 eyes I consisted of 50 females (51%1 and 48 males (49%1 with mean age of 61 :t7.92 years old. Mean diabetes duration was 6.6:t 5.94 years and all of them were diabetes type 2. Some patients had hypertension (44.9%1, dyslipidemia (17.7%1, heart disease (6.1%), and kidney disease (5.1%1. From 196 eyes, 6 (6.1 %1 eyes had cataract and were excluded. Mean visual acuity was 0.7726 :to.31 08. Diabetic retinopathy was found in 41 eyes among 190 eyes (21.57%1, consisted of 22 eyes with mild NPDR (53.65%1, 7 eyes with moderate NPDR (17.07%), 7 eyes with severe NPDR (17.07%1, 5 eyes with advance PDR (12.19%1. Sensitivity, specificity, PPV, NPV and accuracy resulted by 5 hour trained doctor examinations were 63.41%, 67.78%, 36.62%, 67.78%, and 66.78% respectively R (+1 and LR (-I were 1.968 and 0.5397, respectively.Conclusion: Direct ophthalmoscopic examination by a trained doctor to detect retinopathy is promisalble in Indonesia.Keywords : diabetic retinopathy, direct ophthalmoscopy, diagnostic value, traineddocto
ytotoxic effect of n-hexane insoluble fraction obtained from kloroform extract of kembang bulan leaves [Tithonia diversifolia (Hemsley) A. Gray] on HeLa cells and mechanism detection by Hoechst 33342
No full textBackground: Tithonia diversifolia (Hemsley) A.Gray is a plant traditionally used to cure various diseases. The previous study indicated that n-hexane insoluble fraction of chloroform extract of T. diversifolia's leaves showed cytotoxic effect on Hela cells. Separation of n-hexane insoluble fraction into several fractions was conducted in order to simplify the components. Therefore, compounds responsible for cytotoxiceffect and their mechanism of action can be determined. .Objectives: To determine fraction having the most cytotoxic effect and its mechanism of action obtained from n-hexane insoluble fractions of T.diversifolia leaves on Hela cells.Materials and methods: Fractionation of n-hexane insoluble fraction from chloroform extract of T. diversifolia leaves was done by using vacuum liquid chromatography. By MTT assay, the cytotoxic effect of fractions on Hela cells in vitro was determined. and doxorubicin was used as positive control. Each group was tested for 3 times In = 3) and the growth inhibition percentage of Hela cells was counted. The data was analyzed by probit regression, and mechanism of action of the active fraction is conducted by staining with hoechst 33342.Results: Fractionation gave five fractions IF1-5). The ICso levels obtained of those fractions were : F1 having ICso = 32.168 :!: 12.513; F2 = 11.416 :!: 0.535; F3 III = 6.223 :!: 1.303; F4 = 94.308 :!: 7.843; and F5 = 41.740 :!: 6.381Ig/ml; while the ICso value of doxorubicin was 0.241 :!: 0.170 Iglml. Conclusions: Fraction 3 of the n-hexane insoluble displayed the highest cytotoxic effect on Hela cells with ICso= 6.223:!:: 1.303 Iglml. Fraction 3 at the concentration of 3.93 uglml caused chromatin condensation and fragmentation of DNA on Hela cells.Key words: T. diversifolia, cytotoxic effect. Hela cells, insoluble n-hexane fraction
Effect of C677T Mutation in Methiylenetetrahydrofolate Reductase Gene and Blood Folate on Hypertension Risk
No full textBackground: The prevalence of hypertension risk factor varies among race or ethnic groups. The varied prevalence is associated with culture or genetic differences or interaction between genetic and environment or nutrition factorsObjective: The aim of this study was to identify relationship between polymorphism of C677T in MTHFR gene and folate status towards the risk of hypertension among Javanese population.Methods: This study was case-control nested, in "Surveillance of Non-Communicable Diseases" in Purworejo, Central Java. The subjects were men with essential hypertension and 20-60 years old that had normal value of urine creatinine, blood glucose, cholesterol and triacylglycerol. They didn't take antihypertension drugs. The analysis of C677T polymorphism in MTHFR gene was done according to Frosst et al. (1995) method. The blood folate level was determined by Delfia-Folate Kit (PerkinElmer). The methods of Pfeiffer et al. (1999) was used to identify plasma total homocysteine level.Results: Odds ratio for subjects with CT genotype was 1.36 ICI: 95%:0.50;3.70); folate deficiency was 1.40 ICI: 95%:0.57;3.451; and both CT genotype and folate deficiency was 2.30 (CI: 95%:0.45;15.001. Homocysteine level of the cases with both folate deficiency and CT genotype was 45.28 .:!:. 30.39; and only folate deficiency was 17.94.:!:. 12.77; whereas in the control with both folate deficiency and CT genotype was 21.44.:!:. 10.71 and only folate deficiency was 11.79.:!:. 5.28.Conclusions: The effect of folate deficiency to homocysteine level and hypertension risk was slighly stronger than the genetic effect of C677T in MTHFR gene. In subjects with normal folate level, the CT genotype did not influence homocysteine level.Kata kunci:polymorphism, methylenetetrahydrofolate reductase, folate, hypertensio