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"Latar Belakang: Penelitian mengenai petanda inflamasi akut terkait pajanan uap las pada pekerja las sudah banyak dilakukan. Akan tetapi, tidak semua penelitian tersebut sepakat terjadi perbedaan jumlah petanda inflamasi akut sesudah terpajan uap las. Penelitian ini ingin mengetahui apakah terjadi perbedaan jumlah petanda inflamasi akut akibat pajanan uap las dengan sel netrofil mukosa hidung sebagai petanda inflamasinya.Metode:Pada penelitian longitudinal ini, 110 pekerja di sebuah perusahaan pembuat knalpot diperiksa jumlah sel netrofil mukosa hidungnya sebelum dan sesudah terpajan uap las serta diukur kadar logam Kromium, Besi, Mangan, dan Aluminium dalam darah pada 40 pekerja diantaranya. Dilakukan pengukuran kadar logam Cr, Fe, Mn, dan Al di lingkungan kerja untuk menilai kadar pajanan.Hasil:Pengukuran lingkungan menunjukkan kadar Kromium, Besi, Mangan, dan Aluminium udara berada di bawah Nilai Ambang Batas. Sel netrofil sediaan apus sebelum dan sesudah terpajan uap las 8 jam sama – sama berjumlah 2 sel/10 lpk (p = 0,233). Pada penelitian ini juga ditemukan kadar dalam darah logam Cr sebesar 1,03 µg/l; logam Fe sebesar 283.787,73 µg/l; logam Mn sebesar 14,96 µg/l; dan logam Al sebesar 25,68 µg/l.Kesimpulan:Tidak ditemukan perbedaan jumlah sel netrofil mukosa hidung yang bermakna secara statistik akibat pajanan uap las.

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Background and Objective: Many studies about acute inflammation marker regarding metal fume exposure have been conducted but not all agree that metal fume exposure will raise acute inflammation response. One of the acute inflammation markers is nasal mucous neutrophil and this study was conducted to investigate the difference of neutrophil count after being exposed to metal fume as acute inflammation response.

Methods: This study used a longitudinal design with 110 welders as subjects. Nasal mucous neutrophil data was collected before and after 8 hours metal fume exposure. Metal fume (i.e. Chromium, Iron, Manganese, and Aluminum) exposure in the work place was measured with AAS while blood metal level in 40 subjects among them was with ICP-MS.

Results: Chromium, Iron, Manganese, and Aluminum fume level in the work place was under Threshold Limit Value while Chromium, Iron, Manganese, and Aluminum blood level was 1,03 µg/l; 283.787,73 µg/l; 14,96 µg/l; and 25,68 µg/l respectively.Neutrophil count before and after 8 hours metal fume exposure didn’t show any difference with statistically significance (p = 0,233)

Conclusions: There was no statistical significant increase of nasal mucous neutrophil regarding metal fume exposure"

"[ABSTRAKLatar belakang : Pada masa sekarang, reperfusi miokardium dengan trombolitikatau intervensi koroner perkutan primer ( IKPP) adalah terapi utama pada pasienyang mengalami IMA EST. Tujuan utama IKPP untuk mengembalikan patensiarteri epikardial yang mengalami infark dan mencapai reperfusi mikrovaskularsecepat mungkin. Namun keberhasilan mengembalikan patensi dari arteri koronerepikardial setelah oklusi tidak selalu menjamin cukupnya reperfusi ke levelmikrovaskular, yang disebut sebagai fenomena no reflow atau microvascularobstruction (MVO). Terdapat dua mekanisme yang berperan pada no reflowyaitu disfungsi mikrovaskular dan kerusakan intergritas mikrostruktur endotel.Kerusakan endotel dapat diakibatkan berbagai hal, diantara nya jejas reperfusiyang akan mengaktivasi netrofil. Netrofil teraktivasi akan mengeluarkan radikalbebas oksigen, enzim proteolitik dan mediator proinflamasi yang secara langsungmenyebabkan kerusakan jaringan dan endotel. Trimetazidine adalah obatantiangina yang dapat menurunkan netrofil yang dimediasi oleh trauma jaringansetelah jantung mengalami iskemia. Akan tetapi belum diketahui secara luaspengaruh pemberian trimetazidine terhadap akumulasi netrofil pada kejadian IMAEST yang dilakukan tindakan IKPP.Metode : Sebanyak 68 pasien IMA EST yang menjalani IKPP dipilih secarakonsekutif sejak Januari 2015 sampai Juni 2015 diambil saat masuk UGD,dilakukan pengambilan darah vena perifer untuk menghitung jumlah netrofilsebelum IKPP, kemudian pasien menjalani IKPP. Setelah 6 jam paska IKPPdilakukan pengambilan kembali darah vena perifer untuk menghitung kembalijumlah netrofil paska IKPP. Hitung netrofil diperiksa dengan Sysmex 2000i.Perhitungan statistik dinilai dengan SPSS 17.Hasil : Dari 68 subyek, dibagi menjadi 28 subyek pada kelompok yang diberikantrimetazidine dan 40 subyek yang diberikan plasebo. Tidak didapatkan perbedaanjumlah netrofil pada kelompok perlakuan dan kelompok kontrol baik sebelummaupun sesudah IKPP, netrofil pre IKPP pada trimetazidine vs plasebo 10.71 ±3.263 vs 10.99 ± 3.083,nilai p:0,341. Nilai netrofil post IKPP pada trimetazidinevs plasebo 9.49 ± 3.135 vs 9.92 ± 3.463,nilai p:0,664.Kesimpulan : Tidak terdapat penurunan jumlah netrofil pasca pemberiantrimetazidine pada pasien IMA EST yang menjalani IKPP.

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ABSTRACTBackgroundNowadays, reperfusion strategy, either with thrombolytic or Primary PercutaneousCoronary Intervention (PPCI), is the core treatment for Acute ST-SegmentElevation Myocardial Infarct (STEMI). The goal of PPCI is to restore the patencyof infarcted epicardial artery and establish microvascular reperfusion as soon aspossible so that necrotic myocardial area can be reduced. However, successfulrestoration of infarcted epicardial artery is not always followed by enoughreperfusion to the microvascular part. Trimetazidine is an antianginal drug, canreduce neutrophil which was mediated by tissue trauma during ischemic heartcondition. Trimetazidine is currently approved and widely known as antianginaldrug which affect metabolism. Unfortunately, its influence over neutrophilaccumulation in acute STEMI patients which undergo PPCI is not wellunderstood.MethodThere were 68 consecutive-selected acute STEMI patients which undergo PPCIsince January 2015 until Juni 2015. They were admitted in emergency department.Peripheral vein blood sampling was taken to measure neutrophil before PPCI wasperformed. Six hour after PPCI was conducted, another peripheral vein bloodsampling was taken for another neutrophil measurement. Neutrophil measurementwas performed with Sysmex 2000i. Statistical analysis was performed by usingSPSS 17.ResultAmong 68 patients, divided in two groups, trimetazidine 28 patients and plasebo40 patients. There were no differences amount of neutrophils in trimetazidine orplasebo group, before or after PPCI. Neutrophil pre PPCI in trimetazidine vsplasebo group 10.71 ± 3.263 vs 10.99 ± 3.083, p:0,341. Neutrophil post PPCI intrimetazidine vs plasebo group 9.49 ± 3.135 vs 9.92 ± 3.463, p:0,664.ConclusionThere were no reducing amount of neutrophils after trimetazidine was given inpatients STEMI which underwent PPCI., BackgroundNowadays, reperfusion strategy, either with thrombolytic or Primary PercutaneousCoronary Intervention (PPCI), is the core treatment for Acute ST-SegmentElevation Myocardial Infarct (STEMI). The goal of PPCI is to restore the patencyof infarcted epicardial artery and establish microvascular reperfusion as soon aspossible so that necrotic myocardial area can be reduced. However, successfulrestoration of infarcted epicardial artery is not always followed by enoughreperfusion to the microvascular part. Trimetazidine is an antianginal drug, canreduce neutrophil which was mediated by tissue trauma during ischemic heartcondition. Trimetazidine is currently approved and widely known as antianginaldrug which affect metabolism. Unfortunately, its influence over neutrophilaccumulation in acute STEMI patients which undergo PPCI is not wellunderstood.MethodThere were 68 consecutive-selected acute STEMI patients which undergo PPCIsince January 2015 until Juni 2015. They were admitted in emergency department.Peripheral vein blood sampling was taken to measure neutrophil before PPCI wasperformed. Six hour after PPCI was conducted, another peripheral vein bloodsampling was taken for another neutrophil measurement. Neutrophil measurementwas performed with Sysmex 2000i. Statistical analysis was performed by usingSPSS 17.ResultAmong 68 patients, divided in two groups, trimetazidine 28 patients and plasebo40 patients. There were no differences amount of neutrophils in trimetazidine orplasebo group, before or after PPCI. Neutrophil pre PPCI in trimetazidine vsplasebo group 10.71 ± 3.263 vs 10.99 ± 3.083, p:0,341. Neutrophil post PPCI intrimetazidine vs plasebo group 9.49 ± 3.135 vs 9.92 ± 3.463, p:0,664.ConclusionThere were no reducing amount of neutrophils after trimetazidine was given inpatients STEMI which underwent PPCI.]"

"Latar Belakang : Non-alcoholic fatty liver disease (NAFLD) adalah penyakit hati kronik yang ditandai dengan akumulasi lemak berlebihan di hati. Elastografi Transien (ET) dan metode Controlled Attenuation Parameter (CAP) merupakan metode pemeriksaan non-invasif untuk menilai derajat fibrosis dan steatosis, namun tidak tersedia di seluruh rumah sakit di Indonesia. Rasio Neutrofil Limfosit (RNL) merupakan penanda peradangan sederhana yang berpotensi memprediksi luaran penyakit. Tujuan : Mengetahui nilai diagnostik RNL sebagai indikator derajat keparahan steatosis dan fibrosis NAFLD. Metode : Penelitian ini adalah studi potong lintang menggunakan data sekunder dari data rekam medis tahun 2016-2018. Analisis statistik deskriptif dan analitik berupa uji korelasi, Receiver Operating Curve (ROC) dan Area Under The Curve (AUC) dipakai untuk mengetahui luaran studi. Hasil : Dari 106 subjek penelitian, kebanyakan pasien adalah perempuan (62,3%) berusia rata-rata 57,29 tahun dan menderita sindrom metabolik (77,4%). Sebagian besar pasien memiliki derajat steatosis sedang-berat (66%) dengan rerata ET 6,14 (2,8-18,2). Terdapat korelasi antara nilai CAP (r=0,648; p<0,001) dan ET (r=0,621; p<0,001) dengan RNL. Penggunaan RNL untuk menilai derajat steatosis sedang-berat memiliki titik potong 1,775 dengan sensitivitas, spesifisitas, NDP dan NDN sebesar 81,5%, 80,6%, 89,1%, dan 69,1%; titik potong 2,150 untuk menilai fibrosis signifikan dengan sensitivitas, spesifisitas, NDP dan NDN berurutan sebesar 92.3 %, 87.5%, 70.6%, dan 97.2%. Simpulan : RNL memiliki korelasi positif terhadap derajat steatosis dan fibrosis dengan sensitivitas dan spesifisitas yang tinggi.

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Introduction : Non-alcoholic fatty liver disease (NAFLD) is a chronic inflammatory disease with excessive fat accumulation in the liver. Transient Elastography (TE) with Controlled Attenuation Parameter (CAP) is a device and method to examine the degree of fibrosis and steatosis. However, this device is not widely available across Indonesia. Neutrophil and Lymphocyte Ratio (NLR) is a simple marker for inflammation which has a potency to predict disease outcome.

Objective : To know the diagnostic value of RNL as the indicator of steatosis and fibrosis severity.

Methods : This was a cross-sectional study using secondary data from the medical record, starting from 2016-2018 with the respective inclusion and exclusion criteria. A descriptive and analytic statistic, including correlation test, Receiver Operating Curve (ROC) and Area Under The Curve (AUC) were done to know the outcome of the study.

Result: Out of 106 subjects, 62.3% patients were women with aged mean 57.29 years old and 77.4% had metabolic syndrome. Most patients had average-severe steatosis degree (66%) with the mean of ET mean 6.14 (2.8-18.2). There was a positive correlation between CAP and TE compared with NLR with r = 0.647 (p<0.001) and r = 0.621 (p<0.001) respectively. The use of NLR to assess moderate-severe steatosis has a cutoff point of 1.775 with sensitivity, specificity, PPV and NPV of 81,5%, 80,6%, 89,1%, and 69,1%; cutoff point 2,150 to assess significant fibrosis with sensitivity, specificity, PPV and NPV of 92.3 %, 87.5%, 70.6%, 97.2% respectively.

Conclusion : NLR has a positive correlation with the degree of steatosis and fibrosis with high sensitivity and specificity."

"Latar Belakang: Tuberkulosis paru (TB) masih menjadi salah satu penyebab morbiditas dan mortalitas di seluruh dunia. Dalam dua dekade terakhir penyakit TB resisten obat (TBRO) telah muncul sebagai ancaman bagi kesehatan masyarakat seluruh dunia. NGAL merupakan partikel granulosit neutrofil yang mengalami pematangan dan menjadi gelatinase. NGAL terlibat dalam kekebalan bawaan untuk menghalangi bakteri mengambil zat besi untuk pertumbuhan. Pada pasien dengan komorbid anemia akan terjadi penurunan kekebalan bawaan sehingga pada TBRO dengan anemia bakteri Mtb akan mendapat zat besi dari tubuh manusia untuk bereplikasi. Namun masih belum terdapat data kadar protein serum NGAL pada pasien TBRO dengan anemia.Metode : Penelitian ini merupakan penelitian analitik observasional menggunakan desain potong lintang yang dilakukan di poliklinik dan ruang rawat inap MDR RSUP Persahabatan pada bulan Juli-September 2023. Jumlah subyek penelitian adalah 73 pasien TBRO yang belum memulai pengobatan dengan anemia dan tanpa anemia yang memenuhi kriteria inklusi dan eksklusi. Sampel darah subyek diambil sebanyak 3cc.Serum darah diambil lalu disimpan dalam lemari es suhu -200C. selanjutnya dilakukan pemeriksaan ELISA teknik sandwich dan diambil kadar protein NGAL. Variabel lainnya diambil dari rekam medis RSUP Persahabatan.Hasil : Pada penelitian ini didapatkan pasien TBRO dengan anemia memiliki IMT yang menunjukkan tingkat malnutrisi yang bermakna (p:0,026, OR 2,9(1,1-7,5). Penelitian ini juga mengidentifikasi peningkatan jumlah neutrofil (p:0,002, OR 0,2(0,06-0,5) dan penurunan jumlah limfosit (p:0,006, OR (4,2 (1,4-9,8) pada kelompok pasien anemia, yang tercermin dalam NLR yang meningkat (p:0,028, OR 0,3(0,09-0,9). Hasil yang ditemukan juga menunjukkan bahwa pasien TBRO dengan anemia memiliki lesi paru yang lebih luas secara statistik (p:0,048, OR 2,7(0,9-7,3). Kadar NGAL menunjukkan hasil median 82,76 (67,59) yang lebih tinggi dibandingkan dengan kelompok pasien TBRO anemia dan kelompok TBRO tanpa anemia 59,24(91,98) namun tidak bermakna (p: 0,26). Terdapat korelasi yang bermakna kadar NGAL dengan leukosit (r:0,295, p:0,011), neutrofil (r:0,297, p:0,011), limfosit (r:-0,343,p:0,003) dan NLR (r:0,336,p:0,004).Kesimpulan: Terdapat peningkatan kadar NGAL pada pasien TBRO dengan anemia dibandingkan tanpa anemia namun tidak bermakna secara statistik.

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Background: Pulmonary tuberculosis (TB) remains one of the leading causes of morbidity and mortality worldwide. In the last two decades, drug-resistant tuberculosis (DR-TB) has emerged as a global health threat. NGAL is a neutrophil granulocyte- derived protein that undergoes maturation and becomes gelatinase. NGAL is involved in innate immunity by blocking bacteria from acquiring iron for growth. In patients with anemia, there is a reduction in innate immunity, in patient DR-TB with anemia allowing Mtb bacteria to obtain iron from the human body for replication. However, there is currently no data on serum NGAL protein levels in DR-TB patients with anemia.

Methods: This study is an observational research using a cross-sectional design conducted in the outpatient clinic and inpatient ward of MDR RSUP Persahabatan in July-September 2023. The research subjects were 73 subject DR-TB patients who not yet started treatment with or without anemia and met the inclusion and exclusion criteria. Blood samples of the subjects were collected as much as 3cc. The blood serum was separated and stored in a -20°C freezer. Furthermore, ELISA examination using the sandwich technique was performed, and NGAL protein levels were measured.

Results: In this study, DR-TB patients with anemia had BMI indicating significant malnutrition (p: 0.026, OR 2.9(1.1-7.5). This study also identified an increase in the number of neutrophils (p: 0.002, OR 0.2(0.06-0.5) and a decrease in the number of lymphocytes (p: 0.006, OR 4.2(1.4-9.8) in the anemia patient group, as reflected in the increased NLR (p: 0.028, OR 0.3(0.09-0.9). The findings also showed that DR-TB patients with anemia had statistically larger lung lesions (p: 0.048, OR 2.7(0.9-7.3). NGAL levels showed a higher median result between the DR-TB patient group with anemia 82,76 (67,59) and the group without anemia 59,24 (91,98), but it was not statistically significant (p: 0.26). NGAL have significant corelation among leukocyte (r:0,295, p:0,011), neutrophil (r:0,297,p:0,011), limphocyte (r:-0,343,p:0,003) and NLR (r:0,336,p:0,004)

Conclusion: There is a increase in NGAL levels in DR-TB patients with anemia compared to those without anemia. However, this findings do not reach statistical significance."

"Latar Belakang: Tumor sistem saraf pusat (SSP) merupakan salah satu penyebab utama morbiditas di seluruh dunia yang menyebabkan disabilitas dan penurunan kualitas hidup. Tumor SSP menyebabkan defisit neurologis dan berisiko terjadinya kaheksia. Kaheksia dihubungkan dengan penurunan respons pengobatan dan penurunan kesintasan. Peradangan sistemik merupakan ciri khas kaheksia. Rasio neutrofil limfosit (RNL) merupakan penanda inflamasi sistemik yang mudah dan rutin diperiksa dengan harga yang tidak mahal. Belum diketahui hubungan antara RNL dengan kejadian kaheksia pada tumor SSP.Metode: Studi potong lintang ini dilakukan pada subjek berusia 18–65 tahun di RSUPN Dr. Cipto Mangunkusumo, yang dirawat dengan diagnosis tumor SSP pada bulan November hingga Desember 2023. Nilai RNL diambil dari pemeriksaan darah perifer lengkap dan dilakukan penegakan diagnosis kaheksia berdasarkan kriteria Evans. Dilakukan analisis hubungan RNL dengan kejadian kaheksia.Hasil: Terdapat 50 subjek dengan diagnosis tumor SSP. Median RNL adalah 4,13 (1,26; 23,22). Nilai RNL secara signifikan lebih tinggi pada kelompok subjek yang mengalami kaheksia (median RNL 7,19 (1,26; 23,22)) dibandingkan tanpa kaheksia (median RNL 3,10 (1,40; 8,48)) (p<0,001).Simpulan: RNL berhubungan dengan kejadian kaheksia pada tumor SSP. Subjek yang mengalami kaheksia memiliki RNL yang lebih tinggi dibandingkan dengan yang tidak kaheksia.

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Background: Central nervous system (CNS) tumors are one of the leading causes of morbidity worldwide, causing disability and decreased quality of life. Central nervous system tumors cause neurological deficits and are at risk of developing cachexia. Cachexia is associated with decreased treatment response and reduced survival. Systemic inflammation is the hallmark of cachexia. Neutrophil lymphocyte ratio (NLR) is a systemic inflammation that included in routine laboratory examination and inexpensive. The association between NLR and the incidence of cachexia in CNS tumors remain unknown.

Methods: This cross-sectional study was conducted on subjects aged 18–65 years old at RSUPN Dr. Cipto Mangunkusumo Hospital, who were admitted with CNS tumor diagnosis from November to December 2023. The NLR value was taken from the complete peripheral blood examination and the diagnosis of cachexia was based on Evans criteria. The relationship between NLR and the incidence of cachexia was analyzed.

Results: There were 50 subjects with CNS tumor diagnosis. The median NLR was 4,13 (1,26; 23,22). The mean NLR was significantly higher in the group of subjects with cachexia (median NLR 7,19 (1,26; 23,22)) than without cachexia (median NLR 3,10 (1,40; 8,48)) (p<0,001).

Conclusion: NLR is associated with the incidence of cachexia in CNS tumors. Subjects with cachexia had higher NLR compared to those withoit cachexia."

"Penyakit kardiovaskular (PKV) merupakan penyebab utama kematian di dunia dan diperkirakan akan terus meningkat. Infark miokardium akut dengan elevasi segmen ST (IMA-EST) merupakan kejadian iskemia miokardium transmural yang mengakibatkan cedera atau nekrosis miokardium akibat ketidakseimbangan dari asupan dan kebutuhan oksigen. Kondisi ini diakibatkan oleh proses aterogenesis kronik dengan peran inflamasi kompleks menahun yang dipengaruhi oleh berbagai faktor risiko penyebab disfungsi endotel. Terapi intervensi koroner perkutan primer (IKPP) merupakan terapi revaskularisasi pasien IMA-EST dengan keberhasilan pengembalian aliran koroner >95% pada praktik klinis yang secara paradoks dapat menyebabkan cedera dan kematian kardiomiosit atau cedera iskemia reperfusi. Kolkisin telah lama dikenal sebagai obat murah dengan efek antiinflamasi yang menginhibisi polimerisasi tubulin dan pembentukan mikrotubulus serta memiliki efek terhadap adesi molekul selular, kemokin inflamasi, dan inflamasom. Hingga saat ini, belum ada studi secara spesifik membahas efek pemberian kolkisin terhadap rasio neutrofil-limfosit (RNL) dalam cedera iskemia reperfusi miokardium. Parameter RNL merupakan penanda inflamasi yang didapatkan dari perhitungan hitung jenis leukosit darah perifer. Pemeriksaan ini sederhana, mudah, dan relatif murah serta dinilai mampu mengkonjugasikan sistem imun bawaan dan adaptif dalam kondisi inflamasi. Penelitian ini mengkaji perubahan RNL pada 24 jam dan 48 jam pascatindakan IKPP pada pasien IMA-EST yang mendapatkan intervensi kolkisin. Desain penelitian uji klinik tersamar ganda, dengan total 79 pasien IMA-EST yang menjalani IKPP, terdiri dari 36 subjek kelompok yang mendapatkan plasebo dan 43 subjek kelompok yang mendapatkan kolkisin. Tidak didapatkan perbedaan bermakna antara subjek IMA-EST dengan intervensi kolkisin dan plasebo pada penurunan RNL 24 jam dan 48 jam pascatindakan IKPP. Penelitian lebih lanjut diperlukan dengan berbagai pertimbangan rentang pemberian obat dan lama pemantauan untuk dapat menilai penurunan RNL.

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Cardiovascular disease (CVD) is the leading cause of death in the world and is expected to continue to increase. Acute ST elevation myocardial infarction (STEMI) is a transmural myocardial ischemia event that results in myocardial injury or necrosis due to an imbalance of oxygen intake and demand. This condition results from a chronic atherogenesis process with the role of chronic complex inflammation influenced by various risk factors that cause endothelial dysfunction. Primary percutaneous coronary intervention therapy (PPCI) is a revascularization therapy for STEMI patients with >95% coronary flow restoration success in clinical practice that paradoxically can cause cardiomyocyte injury and death or ischemia reperfusion injury. Colchicine has long been known as an inexpensive drug with anti-inflammatory effects that inhibits tubulin polymerization and microtubule formation and has effects on cellular molecular adhesion, inflammatory chemokines, and inflamasomes. To date, no study has specifically addressed the effect of colchicine administration on the neutrophil-lymphocyte ratio (NLR) in myocardial reperfusion ischemia injury. The parameter of NLR is an inflammatory marker obtained from the calculation of peripheral blood leukocyte differential count. This examination is simple, easy, and relatively inexpensive and is considered to be able to conjugate the innate and adaptive immune systems in inflammatory conditions. This study examined the changes in NLR at 24 hours and 48 hours after PPCI in STEMI patients who received colchicine intervention. The study design was a double-blind clinical trial, with a total of 79 STEMI patients undergoing IKPP, consisting of 36 subjects in the placebo group and 43 subjects in the colchicine group. There was no significant difference between IMA-EST subjects with colchicine and placebo intervention on the decrease of NLR 24 hours and 48 hours after PPCI. Further studies are needed with various considerations of the time span and the length of monitoring to be able to assess the decrease in NLR."

"Background : Metal workers in Indonesia are susceptible to metal fume exposure. One of them is exposure to manganese and aluminum metal fumes that can increase the risk of decline in memory function. Nevertheless, the influence of metal exposure from welding fumes containing manganese and aluminum are still not conclusive. This study was conducted to determine differences in memory function between metal workers exposed and not exposed to metal fume. Methods : This research using a cross-sectional study design with a comparative analysis based on differences in exposure to welding fumes. Metal fume exposure is measured by the levels of manganese and aluminum in the air within work environment using Atomic Absorption Spectrophotometer (AAS) and in the blood using Inductive Coupled Plasma Mass Spectrometry (ICP-MS). Subject’s memory function were examined with Rey Osterrieth Complex Figure, the Beck Depression Inventory II, Digit Span Backward. Results : Manganese and aluminum levels are 0,00001 mg/m3 and 0,000016 mg/m3 and it below the threshold value of the environment nationwide. Median scores on memory function welding worker group is 23.75 (4-34) and non-welding workers was 19.5 (7-35) were not statistically different (p = 0.06). The memory function in the group of workers with blood manganese levels above normal {median 26 (4-34)} is higher than normal {median of 20 (5-35)} (p = 0.005). Conclusions : The differences of memory function is obtained in the group of workers by category of blood manganese levels. The median difference of memory function scores did not differ based on worker exposure to welding fumes.

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ABSTRACTBackground : Metal workers in Indonesia are susceptible to metal fume exposure. One of them is exposure to manganese and aluminum metal fumes that can increase the risk of decline in memory function. Nevertheless, the influence of metal exposure from welding fumes containing manganese and aluminum are still not conclusive. This study was conducted to determine differences in memory function between metal workers exposed and not exposed to metal fume. Methods : This research using a cross-sectional study design with a comparative analysis based on differences in exposure to welding fumes. Metal fume exposure is measured by the levels of manganese and aluminum in the air within work environment using Atomic Absorption Spectrophotometer (AAS) and in the blood using Inductive Coupled Plasma Mass Spectrometry (ICP-MS). Subject’s memory function were examined with Rey Osterrieth Complex Figure, the Beck Depression Inventory II, Digit Span Backward. Results : Manganese and aluminum levels are 0,00001 mg/m3 and 0,000016 mg/m3 and it below the threshold value of the environment nationwide. Median scores on memory function welding worker group is 23.75 (4-34) and non-welding workers was 19.5 (7-35) were not statistically different (p = 0.06). The memory function in the group of workers with blood manganese levels above normal {median 26 (4-34)} is higher than normal {median of 20 (5-35)} (p = 0.005). Conclusions : The differences of memory function is obtained in the group of workers by category of blood manganese levels. The median difference of memory function scores did not differ based on worker exposure to welding fumes."

"Uap logam merupakan agen penyebab atopi golongan berat molekul rendah yang menyebabkan terjadinya Metal Fume Fever(MFF). Adanya mekanisme alergi pada MFF belum diketahui dengan jelas. Penelitian ini bertujuan untuk mengetahui peran atopi dan faktor lain yang mempengaruhi terjadinya MFF. Desain potong lintang dengan analisis komparatif digunakan untuk mengetahui hubungan atopi serta faktor lain terhadap terjadinya MFF pada pekerja las.Subjek penelitian adalah 234 pekerja las di industri suku cadang otomotif PT X di Bekasi, Indonesia.Pengumpulan data dilakukan melalui kuesioner, pemeriksaan klinis, uji tusuk kulit, serta pengukuran arus puncak ekspirasi. 108 dari 234 sampel (46%) mengalami MFF.Tidak ditemukan adanya perbedaan proporsi yang bermakna antara subjek dengan atopi dan subjek tanpa atopi terhadap terjadinya MFF. Berdasarkan RRsuaian dengan melakukan penyesuaian antar variabel yaitu atopi, masa kerja dan APD tidak diperoleh adanya variabel yang merupakan faktor determinan, walaupun pada perhitungan RRkasar ditemukan masa kerja > 5 tahun dan tidak menggunakan APD meningkatkan risiko MFF dengan masing-masing RRkasar (1.46, 95%IK=1.03-2.09) dan (1.5, 95%IK=1.05-2.15). Sebagai simpulan yaitu prevalensi MFF pada pekerja las sebesar 46%. Tidak terdapat perbedaan secara statistik antara proporsi subjek dengan faktor atopi untuk mengalami MFF dengan subjek tanpa faktor atopi.

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Metal fume is low molecular weight atopy agent which cause Metal Fume Fever (MFF). The allergic mechanisms of MFF is still unclear. This study aims to determine role of atopy and other factors influence MFF.This was a cross-sectional study with a comparative analysis to determine assosiation between atopy and other influencing factors with occurrence of MFF on welder. Subjects were 234 workers in PT X an automotive sparepart industry in Bekasi, Indonesia. Data collected through questionnaires, clinical examination, skin prick test and peak expiratory flow measurements. 108 of 234 samples (46%) experienced MFF. There were no significant differences proportion between subjects with atopy and non atopy to the occurrence of MFF. Based on adjusted Relative Risk (adjusted RR) by making adjustments between variables atopy, working period and usage of PPE, this study wasn?t obtained the existance of a variable which act as determinant factor. Although crude relative risk analysis was found work period over 5 years and not using PPE increases the risk of MFF, which for working periode (RRcrude=1.46; 95%CI=1:03-2:09) and a habit of not using Personal Protective Equipment (PPE) (RRcrude =1.5; 95%CI=1:05-2:15).The prevalence of MFF on welder was46%. No statistic significant differance between proportion of subjects with atopy and subjects without atopy for experiencing MFF."

"Latar belakang: Formaldehida sebagian besar diinhalasi melalui saluran pernafasan bagian atas dan mempengaruhi mukosa hidung. Penelitian ini bertujuan untuk mencari hubungan pajanan formaldehida yang ada di industri kain ban terhadap eosinofil dan neutrofil swab hidung. Metode: Penelitian menggunakan desain potong lintang komparatif. Analisis yang dilakukan menggunakan uji regresi logistik. Responden berjumlah 100 orang laki-laki, terdiri dari 50 responden di bagian dipping dan 50 responden di bagian weaving. Metode pengukuran formaldehida dengan menggunakan metode NIOSH 3500. Metode pengambilan sampel menggunakan total population pada bagian dipping dan simple random sampling pada bagian weaving. Hasil: Kadar formaldehida lingkungan di bagian dipping adalah 0,032 mg/m3. Prevalensi eosinofil positif pada pekerja weaving dan dipping didapatkan 30% sedangkan neutrofil positif didapatkan sebesar 80 %. Tidak ada hubungan yang bermakna antara pajanan formaldehida dengan eosinofil dan neutrofil swab hidung. Variabel independent yang paling berpengaruh terhadap neutrofil positif adalah kebiasaan merokok dengan OR 4,680; 95% CI 1,52 – 14,44; p = 0,007. Kesimpulan: Formaldehida tidak berhubungan bermakna dengan eosinofil dan neutrofil swab hidung, namun pengaruh formaldehida terhadap eosinofil swab hidung belum dapat disingkirkan mengingat adanya gambaran degranulasi eosinofil sehingga diperlukan penelitian lebih lanjut di tingkat seluler.

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Background: Most of formaldehyde exposure is inhaled in upper respiratory track which affecst the nasal mucosa. This study aims at exploring the correlation between formaldehyde exposure in tire cord industry with nasal swab eosinophil and neutrophil.

Methods: The design of the study is comparative cross sectional. Analysis conducted was logistic regression. Total respondents are 100 male consisting of 50 respondents from dipping area and 50 respondents from weaving area. The method for formaldehyde level used NIOSH 3500. The method for collection sample used total population in dipping area and simple random sampling in weaving area.

Results: Formaldehyde level in dipping area was 0,032 mg/m.3. The results of the study showed that eosinophils positive at weaving and dipping area were 30% and neutrophils positive were 80%. No significant correlation was found between formaldehyde exposure and eosinophils and neutrophils nasal swab. Independent variable that mostly influence positive neutrophils was smoking with OR 4.680, 95% CI 1.52–14.44, p = 0.007.

Conclusions: Formaldehyde has no significantly correlation with eosinophils and neutrophils nasal swab, but the effect of formaldehyde on eosinophil nasal swab can not be ignored because of eosinophils degranulation, so further research is still needed at the cellular level."

"Penelitian ini bertujuan untuk mengetahui efektivitas NNP dan Mini FESS sebagai modalitas terapi pasien hidung tersumbat dengan SDB. Digunakan rancangan pre eksperimental sebelum dan sesudah NNP dan Mini FESS dengan menilai perubahan pemeriksaan kualitatif menggunakan Epworth Sleepiness Scale (ESS), Skor Analog Visual (SAV), Peak Nasal Inspiratory Flow (PNIF), nasoendoskopi dan Polisomnografi (PSG). Pengambilan subyek penelitian secara berurutan (consecutive sampling) selama 6 bulan di poli THT-RSCM. Sebanyak 7 pasien dengan keluhan hidung tersumbat disertai sleep disordered breathing menunjukkan perbaikan pasca operasi berdasarkan ESS dengan delta 48,28±1,99% nilai p=0,017, SAV median delta 100%(80% - 100%) nilai p=0,018, PNIF delta 52,03±2,69% p=0.017 dan 85,71% (6 dari 7) perbaikan ukuran konka inferior menjadi normal. Seluruh parameter PSG tidak didapatkan adanya perubahan yang bermakna dengan p>0,05. NNP dan mini FESS efektif untuk mengatasi hidung tersumbat yang disertai SDB berdasarkan perbaikan parameter pemeriksaan kualitatif. Hipereaktifitas parasimpatis yang mengakibatkan hipertrofi konka inferior merupakan hipotesis yang dapat dibuktikan pada penelitian ini dan memperkaya kerangka teori pada patofisiologi obstruksi nasal sebagai penyebab SDB.

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This study aims to determine the effectiveness of PNN and Mini FESS as a therapeutic modality for patients with nasal congestion and SDB. This pre- experimental study evaluated the efficacy of PNN and mini FESS in management of nasal obstruction with SDB subjects. The evaluation performed by assessing changes in qualitative examination using Epworth Sleepiness Scale (ESS), Visual Analog Score (VAS) of nasal obstruction symptom Peak Nasal Inspiratory Flow (PNIF), nasoendoscopic examination. and Polysomnography (PSG). The subjects were included consecutively for 6 months at ENT clinic-Cipto Mangunkusumo Hospital. A total of 7 patients with nasal obstruction and sleep disordered breathing showed post-operative improvement in evaluations by using ESS (delta 48.28 ± 1.99% p-value = 0.017), VAS of nasal obstruction with median delta of 100 % ( 80 % - 100 % ) and p-value = 0.018, PNIF (delta 52.03 ± 2.69% p-value = 0.017) and regaining normal size of inferior turbinate in 85,71% (6 of 7) subjects. While all of the PSG parameters did not had any significant changes with p > 0.05. PNN and mini FESS is effective to overcome nasal obstruction with SDB based on an improvement in the qualitative evaluations. Parasympathetic hyperreactivity resulting in inferior turbinate hypertrophy is a proven hypothesis; thus may enrich the theoretical framework on the pathophysiology of nasal obstruction in SDB."