79 research outputs found
PROTHROMBIN FRAGMENT 1.2 (F1.2) IN RELATION WITH PLASMA LEAKAGE DAN THROMBOCYTOPENIA IN DENGUE INFECTION
No full textLatar belakang: Manifestasi klinis demam berdarah Dengue (DBD) adalah kebocoran plasma dan trombositopenia. Salah satu teori penyebab kedua hal tersebut adalah kadar trombin yang meningkat akibat aktivasi koagulasi. Kadar trombin dapat diwakili oleh kadar F1.2. Tujuan penelitian ini adalah untuk mengetahui hubungan antara kadar F1.2 dengan kebocoran plasma dan trombositopenia pada infeksi Dengue. Metode: Desain penelitian ini adalah potong lintang, mengggunakan plasma EDTA dari pasien terinfeksi virus Dengue. Subyek penelitian adalah 10 subyek dengan kebocoran plasma dan 10 subyek tanpa kebocoran plasma pada infeksi Dengue, 6 sampel berpasangan untuk perbandingan fase kritis dan fase konvalesen, 26 sampel untuk uji korelasi antara kadar F1.2 dengan jumlah trombosit. Hasil: Penelitian menunjukkan kadar F1.2 pada pasien terinfeksi virus Dengue dengan kebocoran plasma (rerata ± 2SD) 147,4 ± 105,82 pg/mL lebih tinggi secara bermakna dibanding tanpa kebocoran plasma 51,3 ±39,92 pg/mL. Kadar F1.2 pada fase kritis dengan median 186,3 (108,6-223,2) pg/mL lebih tinggi secara bermakna dibanding fase konvalesen 46,5 (27,4-51,9) pg/mL. Terdapat korelasi negatif yang bermakna dengan kekuatan sedang antara kadar F1.2 dengan jumlah trombosit, nilai r = - 0,609. Kesimpulan: Terdapat peningkatan aktivasi koagulasi yang ditunjukkan dengan peningkatan kadar F1.2 pada fase kritis, berkaitan dengan kebocoran plasma dan trombositopenia pada pasien terinfeksi virus Dengue. Kata kunci: infeksi Dengue, kebocoran plasma, trombin, fragmen protrombin (F1.2), trombositopenia Background: Clinical manifestations of Dengue hemorrhagic fever are plasma leakage and thrombocytopenia. Both manifestations are thought to be caused by an increased thrombin level due to activation of coagulation. The aim of this study is to look for any association between F1.2 level and plasma leakage and also between F1.2 level and thrombocytopenia in Dengue infected patients. Methods: This study used EDTA plasma from patients infected with Dengue virus. The study design was cross sectional. The thrombin level was represented by the prothrombin fragment 1.2 (F1.2) level. Twenty subjects were enrolled in this study, consisted of 10 subjects with plasma leakage and 10 without plasma leakage, 6 pairs of samples in critical phase and convalescent phase, 26 samples for correlation test between F1.2 level and platelet count. Results: In this study, it was found that the F1.2 level in patients with plasma leakage (mean ± 2 SD) 147.4 ± 105.82 pg/mL is significantly higher compared to patients without plasma leakage 51.3 ±39.92 pg/mL, and the F1.2 level in critical phase has a median of 186.3 (108.6-223.2) pg/mL which is significantly higher compared to convalescent phase 46.5(27.4-51.9) pg/mL. Also it was found that a medium negative correlation between F1.2 level and the thrombocyte count existed, r = - 0.609. Conclusion: The results of the study suggest that there was increased coagulation activation at critical phase in patients infected with Dengue virus associated with plasma leakage and thrombocytopenia. Keywords: Dengue infection, plasma leakage, thrombin, prothrombin fragment (F1.2), thrombocytopenia </p
Opioid Use in Cancer Pain Management in Indonesia: a Call For Attention
No full textSevere pain is a major problem for cancer patients, and pain management often requires the use of opioids. Indonesia is one of the countries where the use of opioids for cancer patients is extremely low, and this calls for attention, as many cancer patients in the country undergo unnecessary suffering as the consequence of this opioid underuse. The inability to assess pain correctly, failure to determine the correct dose, fear of addiction, overly tight regulation, all contribute to the failure to implement rational use of opioids for cancer patients. Breakthrough pain, a problem which requires special attention not only because it is commonly found but also requires proper knowledge to handle them. These hurdles are discussed in the present review, in order to bring a better understanding about the correct use of opioids in severe cancer pain. Some examples where opiods are used inappropriately in cancer pain management are also discussed.
Key words: opioid, break through pain, cancer pain, morphine
THE INCONVENIENT PROBLEMS OF LAW ENFORCEMENT IN INDONESIA IN RELATION TO THE CASE OF BIBIT-CHANDRA
No full textIn this article, the author presents a description and analysis of recent developments in Indonesian law enforcement. The leaders of Corruption Eradication Commission (KPK), Bibit S. Rianto and Chandra M. Hamzah, are currently facing legal problems. Both have been accused of abuse of authority by issuing a travel ban letter preventing Anggoro Wodjojo and Joko Tjandra from leaving Indonesia. In addition, the two KPK leaders are also accused of corruption. In the following process of police investigation, Bibit S. Rianto and Chandra M. Hamzah were arrested by the police. Legal proceedings against Bibit S. Rianto and Chandra M. Hamzah then became a national issue, and the two accused gained support from people throughout Indonesia. Efforts to arrest Bibit S. Rianto and Chandra M. Hamzah were regarded as an attempt to criminalize the Corruption Eradication Commission (KPK). In order to quell increasingly vocal protests, President Susilo Bambang Yudhoyono formed an independent fact-finding team to make clarifications in connection with the case of Bibit S. Rianto and Chandra M. Hamzah. The independent team delivered recommendations to President Susilo Bambang Yudhoyono calling for an immediate stop to the investigation against Bibit S. Rianto and Chandra M. Hamzah, among others, by reason of insufficient evidence. This case then ended with the issuance of a Termination of Prosecution Assessment Letter (Surat Ketetapan Penghentian Penuntutan (SKPP)) from the Attorney General of the Republic of Indonesia
Implikasi Klinis Variasi Jumlah Copy Gen CYP2D6
No full textEnzim CYP2D6 adalah salah satu varian sitokrom P450 (CYP450) yang berperan dalam metabolisme obat di hati. Isoform ini berperan dalam memetabolisme 25% obat yang saat ini beredar di pasaran. Aktivitas CYP450 dapat dipengaruhi oleh berbagai faktor seperti usia, jenis kelamin, fungsi organ pemetabolisme, jenis dan derajat penyakit, serta variasi genetik. Salah satu faktor penentu aktivitas CYP2D6 adalah sifat gene CYP2D6 yang sangat polimorfik. Faktor penentu polimorfisme gen CYP2D6 adalah mutasi pada nukleotida tunggal (single nucleotide polymorphisms (SNPs)) dan variasi jumlah copy (copy number variation (CNV)) gen CYP2D6. Kejadian mutasi gen dan variasi jumlah copy gen CYP2D6 dapat meningkatkan atau menurunkan aktivitas enzim CYP2D6 yang selanjutnya dapat menurunkan atau meningkatkan efikasi obat yang merupakan substrat CYP2D6 ataupun dapat menimbulkan toksisitas obat. Berbagai penelitian telah dilakukan untuk mengevaluasi hubungan mutase SNPs gen CYP2D6 dengan efek obat. Dalam tinjauan kali ini akan dibahas mengenai pengaruh variasi jumlah copy (copy number variation) gen CYP2D6 terhadap efek terapi ataupun efek samping obat
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