eJournal Kedokteran Indonesia
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Mikrobioma: Pemahaman Baru tentang Peran Mikroorganisme dalam Kehidupan Manusia
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Accuracy of Core Needle Biopsy for Musculoskeletal Lesion in Cipto Mangunkusumo Hospital Jakarta
No full textCore needle biopsy (CNB) is considered to have similar results with open biopsy in accuracy and already becomes a routine procedure to establish the diagnosis of musculoskeletal lesion. However, the accuracy of CNB for muskuloskeletal lesion in Indonesia has not been reported. The aims of the study to know the accuracy of CNB for muskuloskeletal tumor diagnoses. From January 2011 to August 2015, all patients with musculoskeletal lesion in dr. Cipto Mangunkusumo Hospital underwent CNB and subsequently, tumour excision were indentified and enrolled. Diagnostic accuracy was evaluated for both histopathology and clinicopathological conference (CPC) conclusion. A total of 86 samples were enrolled in this study. The accuracy of CNB compared to post excision histopathology is 74.4%. With CPC conclusion, the accuracy is 83.7% with sensitivity 98%, specificity 59% (p<0.001). The accuracy of CNB after immunohistochemistry was increased from 74.4% to 84.9% with sensitivity 98%. The accuracy of CNB was 97.1% and 82.7% for benign lesion and malignant lesion respectively (p<0.01). The accuracy of CNB to differ and to confirm diagnosis as primary or metastatic lesion was 97.2% and 85.7% respectively (p<0.001). Inconclusion, CNB is a reliable diagnostic method to establish musculoskeletal tumor diagnoses. CPC significantly provides better accuracy rate of CNB
Expression of NFkB in Locally Advanced Cervical Cancer and Its Relation to Radiotherapy Response
No full textOne of the expected elimination pathways of cancer cells in the process of radiation is apoptosis. Nuclear factor kappa-B (NFkB) is a transcription factor related to the mechanism of apoptosis resistance of a cell, which can affect the post-radiation response. The aim of this study is to assess the relative expression of NFkB in locally advanced cervical cancer and its relation to radiotherapy response. The study was conducted with observational cohort design on January-October 2015. Pre-radiotherapy cervical biopsy specimen was collected from 17 subjects, while only 10 subjects were willing to be taken mid-radiotherapy cervical biopsy specimen. We extracted and analyzed mRNA of NFkB by using qRT-PCR. NFkB relative expression was tested to its correlation with radiotherapy response. This study demonstrated that median of pra-radiotherapy relative expression on subjects with negative response (0.667; SD 0.413) was higher than positive response (0.315; SD 160.298), but not statistically significant (p=0.578). Alteration of mid-radiotherapy NFkB relative expression compared to pra-radiotherapy showed correlation to radiotherapy response. It is concluded that reduced expression of mid-radiotherapy NFkB relative expression plays a role in increasing radiotherapy response
Detection of Cryptosporidium sp Coproantigen in Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome Patient with Chronic Diarrhea
No full textCryptosporidium sp is one of protozoan that cause diarrhea in immunodeficient patients such as HIV/AIDS. Detection of coproantigen of Cryptosporidium sp is more sensitive than microscopic detection. The objective of this study is to detect cryptosporidiosis using coproantigen detection compare to microscopic detection from stool of HIV/AIDS patients with crhonic diarrhea. A Total of 95 stool specimens from HIV/AIDS patients with chronic diarrhea were received by Laboratorium klinik Parasitologi Faculty of Medicine UI. The stool was tested using coproantigen and microscopy detection for cryptosporidiosis. The frequency of cryptosporidiosis using koproantigen detection was 36.8% while the MTA method was only 11.6%. Sensitivity and specificity of coproantigen detection compared with the microscopic was 100% and 71.4%. Detection coproantigen necessary in patients with high suspicion of cryptosporidiosis but oocysts detection was negative.  
The Effectiveness of Clomiphene Citrate and Letrozole for Ovulation Induction Related to Endometrial Thickness and Number of Dominant Follicle
No full textThe aim of the study is to know the effectiveness of clomiphene citrate and letrozole for ovulationrelated to endometrial thickness and number of dominant follicle. Study design was cross sectional basedon medical records of women who underwent ovulation induction from January 2011-May 2015. A numberof 143 anovulation women were divided into clomiphene citrate 50mg, clomiphene citrate 100 mg, letrozole2.5mg and letrozole 5mg. Each group received the agent daily on 3rd-7th day of menstrual cycle. On 12thday of menstrual cycle, the transvaginal ultrasound was performed to measure endometrial thickness anddominant follicle number. From all subjects, 45 subjects (31.5%) were in 50mg clomiphene citrate groups, 29subjects (20.3%) in 100mg clomiphene citrate group, 23 subjects (16.1%) in 2,5mg letrozole group, and 46subjects (32.2%) in 5mg letrozole group. Subjects who received letrozole had thicker endometrium comparedto clomiphene citrate (p<0.05). Different doses were not associated with endometrial thickness betweensubjects who received either letrozole or clomiphene citrate. In addition, subjects receiving letrozole hadhigher proportion of having trilaminar endometrium morphology. We did not observe the difference in totalnumber of dominant follicle between groups. It is concluded that letrozole is more effective than clomiphenecitrate in terms of endometrial thickness but not for number of dominant follicles
Polymorphism of Human FcγRIIa and Its Association with P. falciparum Density and Efficacy of Dihydroartemisinin- Piperaquine
No full textFcγRlla dimorphism has been related to the ability of the host to eliminate malaria parasite so it is necessary to investigate the allele polymorphism FcγRlla of population in malaria-endemic areas in Indonesia in order to know the role of immunity in eliminating malaria parasite. A total of 120 samples of Dried Blood Spot (DBS) falciparum malaria acquired from DHP drug efficacy studies in 5 regions in Indonesia were analyzed by Polymerase Chain Reaction (PCR) and sequencing, to look at variants of FcγRIIa-131 allele and its Association with Parasite DensityandEfficacy ofDihydroartemisinin- Piperaquine. The FcγRIIa gene analysis indicated that genotype RH has the highest frequency (50.8%) compared to RR (17.5%) and HH (31.7%). Allele R131 showed a protective effect against High Density Parasitemia (HDP) (>5000 parasites/μL; odds ratio [OR]= 0.133, 95% confidence interval [CI]= 0.053–0.334, P< 0.001) and associated with longer gametocytes carrier clearance time (> 72 hours; Relative Risk [RR]= 1,571, 95% confidence interval [CI]= 1,005–2,456, P= 0.090).  
Akupunktur Manual sebagai Terapi pada Pasien Depresi
No full textDepresi adalah gangguan kejiwaan pada alam perasaan (affective/mood disorder), yang ditandai dengan kemurungan, ketiadaan gairah hidup, perasaan tidak berguna dan putus asa. Prevalensi gangguan depresi di dunia sekitar 8-20% dan perempuan lebih banyak menderita depresi dari pada laki-laki. Tatalaksana gangguan depresi dilakukan secara komprehensif berupa terapi farmakologis, terapi somatik, psikoterapi, psikoreligius dan akupunktur. Penelitian terakhir menunjukkan akupunktur dapat menimbulkan efek antidepresan dengan meningkatkan pelepasan serotonin dan norepinefrin di celah sinaps. Pada makalah ini dilaporkan pasien perempuan berusia 65 tahun yang menderita gangguan depresi selama 8 tahun dan mengalami perbaikan skor hamilton rating scale for depression 17 (HAM-D 17) setelah terapi akupunktur. Kata kunci: depresi, akupunktur, serotonin, norepinefrin Manual Acupuncture as Treatment for Depression Abstract Depression is a psychiatric disorder in the form of mood (i.e. affective or mood disorder), characterized by moodiness, lack of passion, feeling of uselessness and hopelessness. The prevalence of depressive disorder is 8-20% of the world population, with a higher prevalence in female than male. Treatment of depression is comprehensive and consists of pharmacologic therapy, somatic therapy, psychotherapy, psychoreligious theraphy and acupuncture. Recent research shows acupuncture can give antidepressant effect by increasing the release of serotonin and norepinephrine in the synaptic cleft. This paper reported a case of 65-year-old female patient who suffered from depression for eight years and had improved the hamilton rating scale for depression 17 (HAM-D 17) after acupuncture therapy. Key words: depression, acupuncture, serotonin, norepinephrin
Gambaran Hasil Terapi TB Paru pada Pasien TB-HIV di RSUP dr.Hasan Sadikin Bandung Tahun 2012-2014
No full textTuberkulosis (TB) merupakan penyakit infeksi oportunistik yang sering dijumpai pada pasien Human Immunodeficiency Virus (HIV). Berkaitan dengan tingginya kejadian TB pada penderita HIV World HealthOrganization (WHO) mencanangkan program penanggulangan TB-HIV. Penelitian ini bertujuan untukmengetahui hasil terapi TB Paru pada pasien TB-HIV yang dirawat inap dan rawat jalan di RSUP dr.HasanSadikin. Penelitian deskriptif kuantitatif ini menggunakan sumber data dari rekam medis pasien TB-HIV diinstalasi rawat inap dan rawat jalan RSUP dr.Hasan Sadikin Bandung Tahun 2012-2014. Karakteristik sosiodemografi meliputi usia, jenis kelamin, pendidikan, pekerjaan, status pernikahan, dan tempat tinggal. Terdapat60 (84,5%) subjek yang berusia 20-40 tahun, laki-laki 50 (70,4%) subjek, lebih banyak dari perempuan.Subjek dengan pendidikan SMA sebanyak 33 (46,4%) orang dan subjek yang tidak bekerja 20 (71,8%) orang,47 (66,2%) subjek sudah menikah dan subjek yang berdomisili di Bandung 56 (78,9%) orang. Luaran terapipada pasien ko-infeksi TB-HIV yang sembuh berjumlah 17 (23,9%) subjek, sembuh lengkap 14 (19,7%)subjek, putus pengobatan 24 (33,8%) subjek, pindah sebanyak 8 (11,3%) subjek, dan meninggal 8 (11,3%)subjek dan tidak terdapat luaran terapi gagal. Hasil luaran terapi TB paru pada pasien ko-infeksi TB-HIVdi instalasi rawat inap dan rawat jalan di RSUP dr.Hasan Sadikin yang banyak adalah putus pengobatandibandingkan dengan luaran terapi sembuh. Kata kunci: Koinfeksi, TB-HIV, luaran terapi TB. Overview Treatment Results of Pulmonary TB in TB-HIV Patients atdr. Hasan Sadikin Hospital Bandung In 2012-2014 Abstract Tuberculosis (TB) is commonly found as an opportunistic infection in patients with Human Immunodeficiency Virus (HIV). Due to the high incidence of TB in people with HIV, World Health Organization (WHO) declared TB-HIV program. This study aims to determine the results of pulmonary TB therapy inhospitalized and ambulatory TB-HIV patients at dr. Hasan Sadikin Hospital. This quantitative descriptivestudy was done by using the medical records of inpatient and outpatient TB-HIV data in 2012-2014. Sociodemographiccharacteristicsinclude age,gender,education,occupation, marital status, andresidence. Therewere60 (84.5%) subjects aged 20-40 years old, comprised of 50 male (70.4%) subjects, which more thanwomen. Subjects with a high school education were 33 (46.4%), unemployed were 20 subjects (71.8%), 47(66.2%) of subjects were married and lived in Bandung were 56 (78.9%) people. The outcomes therapy inpatients co-infected with TB-HIV were as followed 17 (23.9%) of subjects were cured, 14 (19.7%) of subjectsfully recovered, 24 (33.8%) of the subjects were dropped out from treatment, 8 (11.3%) of the subjects movedaway, 8 (11.3%) of the subjects passed away, and there was no failure therapy. More patients were found outto be dropping out of treatment compared with to the cured patients in Pulmonary TB treatment outcomes inpatients co-infected with TB-HIV at the inpatient and outpatient care of dr. Hasan Sadikin. Keywords: co-infection, TB-HIV, TB treatment outcomes
Pengaruh Akupunktur Pergelangan Tangan dan Kaki terhadap Nyeri Punggung Bawah
No full textNyeri punggung bawah (NPB) adalah nyeri yang dirasakan di daerah punggung bagian bawah. Akupunktur memiliki efek analgesi. Banyak metode dan teknik rangsang dalam akupunktur, salah satunya akupunktur pergelangan tangan dan kaki. Penelitian ini bertujuan untuk mengetahui pengaruh akupunktur pergelangan tangan dan kaki terhadap nyeri punggung yang diukur dengan skor numeric analog scale (NAS) pada pasien NPB. Desain penelitian adalah uji klinis acak tersamar tunggal dengan kontrol yang mengikutsertakan 42 pasien NPB. Pasien dibagi menjadi 2 kelompok yaitu kelompok perlakuan (n=21) yang dilakukan akupunktur pergelangan tangan dan kaki area 5 dan 6 pergelangan kaki; kelompok kontrol (n=21) yang dilakukan akupunktur tubuh pada titik BL23 Shenshu, BL40 Weizhong, dan LI4 Hegu. Akupunktur dilakukan 2x seminggu selama 3 minggu. Di akhir terapi Terdapat penurunan skor NAS pada kedua kelompok setelah terapi ke-6. Perubahan skor NAS setelah terapi ke-6 pada kelompok perlakuan berbeda bermakna bila dibandingkan dengan kelompok kontrol (p=0.041). Akupunktur pergelangan tangan dan kaki memiliki pengaruh terhadap penurunan nyeri yang signifikan. Kata kunci: nyeri punggung bawah, akupunktur pergelangan tangan dan kaki, Numeric Analog ScaleEffect of Wrist and Ankle Acupuncture for Low Back Pain Abstract Low back pain (LBP) is pain felt in the lower back area. Acupuncture has an analgesic effect There are many methods and stimulation techniques used in acupuncture, one of which is wrist and ankle acupuncture (WAA). This study aimed to assess the efficacy of WAA in the treatment of pain in LBP. The Numeric Analog Scale (NAS) score was used to assess pain. The design was a single-blinded randomized control trial. The study involved 42 patients with LBP who were divided into 2 groups: treatment group (n = 2) which underwent wrist and ankle acupuncture to the Lower 5 and Lower 6 bilaterally; control group (n = 21) which underwent body acupuncture BL23 Shenshu, BL40 Weizhong, and LI4 Hegu. The treatment was applied twice a week for 3 weeks. The results showed a decline in the NAS scores significantly in both group after 6th therapy. Changes in the NAS score after 6th therapy in the treatment group was significantly different when compared with the control group (p = 0.041). Wrist and ankle acupuncture has significant effect on reducing LBP. Key words: low back pain, wrist and ankle acupuncture, Numeric Analog Scal
Fragmentasi DNA Spermatozoa: Penyebab, Deteksi, dan Implikasinya pada Infertilitas Laki-Laki
No full textPrediksi fertilitas laki-laki dapat dilakukan dengan analisis semen. Analisis semen konvensionalmerupakan pemeriksaan sederhana dan tidak mahal, tetapi memiliki variabilitas yang tinggi.Integritas DNA spermatozoa penting untuk transmisi informasi genetik. Fragmentasi DNAspermatozoa sebagai akibat gangguan spermatogenesis, maturasi spermatozoa, stres oksidatifdan infeksi, dapat menyebabkan infertilitas laki-laki, gangguan perkembangan embrio dan abortusberulang. Hubungan fragmentasi DNA spermatozoa dengan luaran teknologi reproduksi berbantu(TRB) mengarahkan fragmentasi DNA spermatozoa sebagai pemeriksaan infertilitas laki-laki. Dariberbagai metode fragmentasi DNA spermatozoa yang umum dilakukan, sperm chromatin dispersion(SCD) merupakan metode pemeriksaan fragmentasi DNA spermatozoa yang sederhana, akuratdan tidak mahal, sehingga dapat dilaksanakan di laboratorium andrologi. Selain menghasilkandiagnosis yang lebih baik, pemeriksaan fragmentasi DNA spermatozoa juga menggambarkanprognosis infertilitas termasuk luaran program TRB. Kata kunci: infertilitas laki-laki, fragmentasi DNA spermatozoa, SCD Sperm DNA Fragmentation: Etiology, Detection and Implicationto Male Infertility Abstract The prediction of male fertility is determined by semen analysis. The conventional semenanalysis is simple and inexpensive but prone to variability. The integrity of sperm DNA is essentialfor the transmission of genetic information. Fragmentation of sperm DNA as result of disruptionin spermatogenesis and sperm maturation, oxidative stress, and infection may lead to maleinfertility, abnormal embryonic development and recurrent abortion. The association betweensperm DNA fragmentation and diminished reproductive outcomes has led to the introduction ofsperm DNA fragmentation testing on the clinical assessment of male infertility. Of all the spermDNA fragmentation tests, sperm chromatin dispersion (SCD) test is quite simple, accurate, andinexpensive to be conducted on andrology laboratory. Besides having better diagnostic outcome,sperm DNA fragmentation test also give better infertility prognosis including the prediction ofassisted reproductive technology (ART) program outcome. Keywords : male infertility, sperm DNA fragmentation, SCD metho