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"Latar Belakang Stres oksidatif mendorong penuaan ginjal, yang mengakibatkan penurunan fungsi. Penuaan ginjal ditandai dengan peningkatan stres oksidatif, yang dapat diukur melalui aktivitas enzim SOD. Spirulina, kaya akan antioksidan, dapat mengurangi stres oksidatif. Studi ini meneliti efek Spirulina pada aktivitas superoksida dismutase di ginjal tikus untuk mengevaluasi potensinya dalam mengurangi penuaan ginjal. Metode Penelitian ini menggunakan desain eksperimen analitik dengan 30 tikus Wistar, yang dikategorikan menjadi kelompok kontrol dan Spirulina pada tiga kelompok usia (12, 18, dan 24 minggu). Kelompok Spirulina menerima Spirulina dengan dosis 250 mg/kg berat badan per hari secara oral melalui tabung lambung selama 29 hari. Ginjal tikus diekstraksi dan dihomogenisasi untuk menentukan aktivitas SOD. Hasil dianalisis menggunakan uji ANOVA satu arah. Hasil Dalam uji ANOVA satu arah, perbedaan signifikan ditemukan dalam aktivitas spesifik SOD antara kelompok Spirulina dan kontrol pada tiga kelompok usia yang berbeda (12, 18, 24 minggu) (p<0,05). Post-hoc Tukey menunjukkan bahwa aktivitas spesifik SOD pada kelompok Spirulina 24 minggu secara signifikan lebih rendah dibandingkan dengan kelompok kontrol dengan perbedaan rata-rata sebesar 0,09, (p<0.05). Kesimpulan Spirulina secara signifikan memengaruhi aktivitas SOD, karena perbedaan diamati antara kelompok Spirulina dan kontrol di semua kategori usia. Selain itu, manfaat Spirulina berbeda di antara kelompok usia, karena variasi dalam aktivitas spesifik SOD di antara kelompok-kelompok ini signifikan. Oleh karena itu, Spirulina dapat digunakan untuk menghambat perkembangan penuaan pada ginjal.

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Introduction Oxidative stress promotes renal aging, resulting in functional deterioration. The aging of kidneys is characterized by increased oxidative stress, which can be assessed by SOD enzyme activity. Spirulina, abundant in antioxidants, may mitigate oxidative stress. This study examines the effect of Spirulina on superoxide dismutase activity in the kidneys of rats to evaluate its potential in mitigating kidney aging. Method This research employed an analytical experimental design with 30 Wistar rats, categorised into control and Spirulina groups over three age cohorts (12, 18, and 24 weeks). The Spirulina group received 250 mg/kg body weight per day of Spirulina orally via a gastric tube for 29 days. Rat kidneys were extracted and homogenised to determine the SOD specific activity. The outcomes were evaluated using a one-way ANOVA. Results In the one-way ANOVA, significant differences were found in SOD specific activity between Spirulina and control groups across three different groups (12-, 18-, 24-weeks) (p<0.05). Post-hoc Tukey indicated that the SOD specific activity in the 24-weeks spirulina group is significantly lower than the control one with the highest mean difference of 0.09, (p<0.05). Conclusion Spirulina significantly affects SOD activity, as differences were observed between the Spirulina and control groups across all age categories. The benefits of Spirulina are different across age groups, as the variation in the SOD specific activity among these groups is significant. Therefore, Spirulina may be used to mitigate the advancement of kidney aging."

"Pendahuluan: Tuberkulosis (TB) adalah penyebab utama kematian akibat infeksi di dunia. Sejak tahun 2008 - 2017 terdapat penurunan angka keberhasilan pengobatan TB di Indonesia (< 90%). Rekomendasi pengobatan TB di Indonesia adalah paduan obat antituberkulosis (OAT) dosis berselang sebagian (2RHZE/4R3H3) atau harian (2RHZE/4RH). Menurut WHO, paduan OAT RHZE/R3H3 mempunyai angka kegagalan dan kekambuhan yang lebih tinggi. Namun, penelitian meta-analisis RCT menyatakan bahwa kedua paduan OAT mempunyai angka kegagalan dan kekambuhan yang sama. Oleh karena itu, dilakukan penelitian untuk membandingkan hasil pengobatan dan efek samping antara paduan OAT 2RHZE/2RH dengan 2RHZE/4R3H3.Metode: Penelitian ini merupakan studi analitik observasional dengan desain cross sectional yang membandingkan hasil pengobatan dan efek samping antara paduan OAT 2RHZE/4RH dengan 2RHZE/4R3H3 pada pasien TB paru kategori I di RSUP Persahabatan periode Januari 2015 sampai Juni 2018. Data sekunder diambil dari rekam medik. Hasil pengobatan dinilai sesuai definisi dalam pedoman nasional penanggulangan TB di Indonesia dan WHO. Efek samping dinilai dari seluruh efek samping terkait OAT yang tercatat dalam rekam medik.Hasil: Terdapat 175 pasien pada masing-masing kelompok. Pada kelompok paduan OAT 2RHZE/4RH terdapat 89.1% pasien berhasil, 13.1% sembuh,76.0% pengobatan lengkap, 10.6% putus berobat, 0.6% gagal, dan tidak ada yang meninggal. Pada kelompok paduan OAT 2RHZE/4R3H3 terdapat 91.4% pasien berhasil, 39.4% sembuh, 52.0% lengkap, 8% putus berobat, tidak ada yang gagal, dan 0.6% meninggal. Tidak ada perbedaan bermakna untuk keberhasilan pengobatan (p=0.470, OR=1.299, IK95%;0.637-2.648), putus berobat (p=0.659 ,OR=0.758, IK95%;0.365-1.577), gagal (p=1.000), dan meninggal (p=1.000) di antara kedua kelompok. Namun, terdapat perbedaan bermakna untuk kesembuhan (p=0.003, OR=2.358, IK95%;1.375-5.206) dan pengobatan lengkap (p=<0.001, OR=0.342, IK95%;0.217-0.540). Sebagian besar pasien mengalami efek samping pengobatan (51.1%) terutama di tahap intensif (73.2%). Pada tahap lanjutan tidak ada perbedaan bermakna kejadian efek samping antara kedua kelompok (p= 0.324, OR=1.386, IK95%; 0.723-2.657).Kesimpulan: Kesembuhan kelompok paduan OAT 2RHZE/4R3H3 lebih baik daripada 2RHZE/4RH, sedangkan pengobatan lengkap sebaliknya. Tidak ada perbedaan bermakna untuk keberhasilan pengobatan, putus berobat, kegagalan, meninggal, dan kejadian efek samping pada tahap lanjutan di antara kedua kelompok.

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Introduction: Tuberculosis (TB) is the main cause of death for infectious disease in the world. Since 2008 - 2017, there was a decline of TB success rate (< 90%) in Indonesia. Treatment of TB in Indonesia are using antituberculosis drugs with part daily dose combination (2RHZE/4R3H3) or daily dose combination (2RHZE/4RH). WHO concluded that 2RHZE/4R3H3 combination had higher failure and recurrence rate. However, a meta-analysis study showed that both combinations had same failure and recurrence rate. Therefore, this study is conducted to compare treatment outcomes and adverse effects between 2RHZE/4RH combination and 2RHZE/4R3H3 combination.

Method: This was an observational analytic study with cross sectional design which compared treatment outcomes and adverse effects between 2RHZE/4RH combination and 2RHZE/4R3H3 combination in pulmonary tuberculosis patient at RSUP Persahabatan period January 2015 until June 2018. Secondary data was taken from medical record. Treatment outcomes were assessed using definition in Indonesia National Guideline of TB and WHO. Adverse effects were assessed from all adverse effects that written in medical record.

Result: There are 175 patients in each group. In 2RHZE/4RH combination group, there were 89.1% patients succeed, 13.1% cured, 76.0% completed treatment, 10.6% lost to follow up, 0.6% failed and no one died. In 2RHZE/4R3H3 combination group, there were 91.4% patients succeed, 39.4% cured, 52.0% completed treatment, 8% lost to follow up, no one failed, and 0.6% died. There was no significant difference for success (p=0.470, OR=1.299, IK95%;0.637-2.648), loss to follow up (p=0.659, OR=0.758, IK95%;0.365-1.577), failure (p=1.000), and death rate (p=1.000) between two groups. However, there was a significant difference for cure (p=0.003, OR=2.358, IK95%;1.375-5.206) and complete treatment rate (p=<0.001, OR=0.342, IK95%;0.217-0.540) between two groups. Most patients had adverse effects (51,5%), especially in intensive phase (73,2%). In continuation phase, there was no significant difference of adverse effects event between two groups (p = 0.324, OR= 1.386, IK95%; 0.723-2.657).

Conclusion: Cure rate was better in 2RHZE/4R3H3 group than 2RHZE/4RH group, for completed treatment on the contrary. There was no significant difference for success rate, loss to follow up rate, failure rate, death rate, and adverse effects event in continuation phase between two groups."

"Leukemia granulositik kronik (LGK) merupakan salah satu penyakit keganasan hematologi yang prevalensinya dapatterus meningkat di masa depan. Terapi LGK saat ini adalah imatinib yang merupakan tirosin kinase inhibitor. Meskipun imatinib memiliki kemampuan klinis superior, diperkirakan sekitar 20-30% pasien LGK resisten terhadap terapi imatinib,yang salah satu penyebabnya terkait ekspresi P-gp berlebih, sehingga memompakan imatinib intraseluler ke domain ekstraseluler. P-gp disandi oleh gen ABCB1 yang bersifat sangat polimorfik, tiga single nucleotide polymorphism (SNP) telah diteliti pada pasien LGK, yaitu C1236T, C3435T dan G2677T/A. Mutasi yang paling umum terjadi untuk memprediksi respons klinis terapi imatinib pada pasien LGK Asia adalah mutasi C1236T. Penelitian ini bertujuan untuk mengetahui hubungan mutasi C1236T gen ABCB1 dengan pencapaian MMR pada pasien LGK fase kronik yang mendapat imatinib.Metode: Penelitian ini merupakan penelitian potong lintang (cross-sectional) menggunakan 120 sampel darah pada pasien LGK fase kronik yang mendapat imatinib mesilat selama ≥ 12 bulan yang memenuhi kriteria seleksi. Dilakukan amplifikasi dengan metode PCR dilanjutkan dengan sekuensing metode Sanger untuk penentuan mutasi C1236T gen ABCB1.Hasil: Dari 120 sampel darah yang memenuhi kriteria seleksi dan dianalisis. Terdapat 28,3% pasien LGK fase kronik yang mencapai MMR. Mutasi C1236T adalah 72 pasien (60%). Tidak terdapat hubungan mutasi dengan pencapaian MMR (risiko prevalensi 0,717 [0,275-1,461], p = 0,282).Kesimpulan: Tidak terdapat hubungan antara mutasi C1236T gen ABCB1 pada pasien LGK fase kronik yang mendapat imatinib 12 bulan dengan pencapaian MMR.

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Chronic myeloid leukemia (CML) is one of the hematological malignancy disease which prevalence may continue to increase in the future. The treatment option of CML recently is imatinib, the tyrosine kinase inhibitor. Despite its superior clinical performance, imatinib drug resistance is developed in 20-30% patient, one of the causes is related to over expression of P-gp that transfer intracelluler imatinib to the extracelluler domain. P-gp is encoded by ABCB1 gene which is highly polymorphic. Three ABCB1 gene single nucleotide polymorphism (SNP), has been studied in CML patient; C1236T, C3435T, and G2677T/A. The most common mutation that can predict the clinical respond of imatinib therapy in Asian CML patient is C1236T mutation. This study purpose is to find the association between C1236T mutation in ABCB1 gene to the achievement of MMR in chronic phase.

Methods: This is a cross-sectional study using 120 blood samples of chronic phase CML patient who received imatinib mesylate for up to 12 months and met the selection criteria. The amplification process with PCR methods was performed, followed by Sanger methods of sequencing to determine the C1236T gene ABCB1 mutation.

Results: A total of 120 blood samples that met the selection criteria was obtained and analyzed. About 28,3% of chronic phase CML patient achieved the MMR. C1236T mutation was found in 72 patients (60%). There was no association between mutation and MMR achievement (prevalence risk 0,717 [0,275-1,461] p = 0,282]).

Conclusion: There was no association between C1236T gene ABCB1 mutation of chronic phase CML patient who received imatinib 12 months with the MMR achievement."

"Latar Belakang dan tujuan: penyakit ginjal stadium akhir (End Stage Renal Disease/ESRD) prevalensinya meningkat secara signifikan di seluruh dunia, termasuk di Indonesia. Pada penyakit ginjal kronik dan ESRD mudah sekali terjadi asidosis metabolik, guna mencegahnya diberikan suplemen NaHCO3 oral atau hemodialisis. Sebagian klinisi tetap memberikan suplementasi NaHCO3 oral pada pasien ESRD yang sudah menjalani hemodialisis rutin, namun sebagian lagi tidak. Penelitian ini bertujuan mengevaluasi apakah masih diperlukan suplementasi NaHCO3 oral pada pasien yang sudah menjalani hemodialisis rutin dua kali seminggu.Metode: Penelitian observasional analitik dengan desain potong lintang dilakukan di Unit Hemodialisis Rumah Sakit Pusat Pertamina Jakarta pada Desember 2019 hingga Februari 2020. Sampel secara konsekutif dipilih dari pasien dengan hemodialisis rutin 2 kali per minggu minimal 3 bulan dan tidak dalam kondisi hemodinamik yang tidak stabil; 30 orang yang mendapat suplementasi NaHCO3 oral dan 30 orang yang tidak. Sampel darah vena pre dialisis diambil untuk pemeriksaan analisis gas darah guna mengukur kadar HCO3.Hasil: Rerata lama HD per kali tindakan pada kelompok tanpa suplementasi (4 jam 14 menit), dan kelompok dengan suplementasi NaHCO3 (4 jam 26 menit) tidak berbeda signifikan ( p =0.051 , CI= -0,4006 - 0,0006). Proporsi pasien ESRD dengan hemodialisis rutin tanpa suplementasi NaHCO3 oral yang mencapai kadar HCO3 pre dialisis dalam rentang normal adalah 26,7%, sedangkan yang mendapat suplementasi NaHCO3 Toral proporsinya secara signifikan lebih tinggi yaitu 53,3% (p=0,035, PR= 1,57; IK=1,013-2,438).

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Background and aim: the prevalence of end-stage renal disease (ESRD) has increased significantly worldwide, including in Indonesia. In chronic kidney disease and ESRD metabolic acidosis is very easy to occur, to prevent it given oral NaHCO3 supplements or hemodialysis. Some clinicians continue to provide oral NaHCO3 supplementation to ESRD patients who are already undergoing routine hemodialysis, but some do not. This study aims to evaluate whether oral NaHCO3 supplementation is still necessary in patients who have undergone routine hemodialysis twice a week.

Methods: An analytic observational study with cross-sectional design was carried out in the Hemodialysis Unit of Pertamina Central Hospital Jakarta from December 2019 to February 2020. Samples were consecutively selected from patients with routine hemodialysis twice per week for at least 3 months and were not in a hemodynamically unstable condition; 30 people who received oral NaHCO3 supplementation and 30 people who did not. Pre-dialysis venous blood samples were taken for blood gas analysis to measure HCO3 levels.

Results: The mean length of HD per action in the group without supplementation (4 hours 14 minutes), and the group with NaHCO3 supplementation (4 hours 26 minutes) was not significantly different (p = 0.051, CI = -0.4006 - 0.0006). The proportion of ESRD patients with routine hemodialysis without oral NaHCO3 supplementation who achieved pre-dialysis HCO3 levels in the normal range was 26.7%, while those who received oral NaHCO3 supplementation were significantly higher at 53.3% (p = 0.035, PR = 1, 57; IK = 1,013-2,438).

Conclusion: In ESRD patients with routine HD 2 times per week (8 hours / week, HCO3 supplementation is still needed to maintain predialysis HCO3 levels within the normal range."