Journal Cover Journal of the Medical Sciences (Berkala ilmu Kedokteran)
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  This is an Open Access Journal Open Access journal
   ISSN (Print) 0126-1312 - ISSN (Online) 2356-3931
   Published by Universitas Gadjah Mada Homepage  [28 journals]
  • CORRELATION BETWEEN CD4 CELL COUNT WITH MUCOCUTANEOUS MANIFESTATIONS:
           STUDY OF PATIENTS WITH HIV IN DR. SARDJITO HOSPITAL, YOGYAKARTA

    • Authors: Nadia Akita Dewi
      Abstract: Introduction:Mucocutaneous disorders often seen in patients with HIV with varying morbidity. HIV progression is characterized by the declining of CD4 cell count and emergence of mucocutaneous manifestations.Objective:To determine the relationship between CD4 cell count with mucocutaneous manifestations in patients with HIV.Method:A cross-sectional study based on medical records at Dr. Sardjito Hospital during the period January 2011-December 2015. We gathered data from medical record such as patient’s age, sex, risk factors of transmission, most mucocutaneous manifestations and CD4 cell count. Cut-off point of CD4 count was 200 cells/mm3.Correlation with clinical manifestations CD4 counts were analyzed using Chi-Square test.Results:Total patients with HIV during the study period was 928 patients; more than half were male(65.4%). Mostly, the patients at a range 20-29 years old(38.69%).The main risk factors for HIV transmission were unsafe sex(75%).The highest CD4 count was 1094 cells/mm3 and the lowest was 1 cell/mm3. We found that there were 306 cases of mucocutaneous manifestations of 928 subjects. Most mucocutaneous manifestations was a fungal infection(40.4%) with the highest infection type was oral candidiasis(33.8%); then non-infection (28%) with the highest type was drug eruption(35.9%); and tumors(0.5%) that was only Kaposi sarcoma cases. We found sexually transmitted infections  (STIs)(18.85%) among the subjects with the highest cases was Condyloma acuminata(49.3%). Statistical analysis showed a significant relationship between CD4 cell count with a fungal infection (P <0.0001; OR 3.8; 95% CI 2.29 to 6.30), viral infection(P =0.0031 OR 0.4 95% CI 0.24-0.74) and parasitic infection(P =0.043 OR 0.2 95% CI 0.06 to 0.61).Conclusion:Alteration in CD4 cell count affect opportunistic infections occurence in patients with HIV.Lower CD4 counts (<200 cells/mm3) increases the risk of fungal infection as much as 3.8 times. Higher CD4 counts (>200 cells/mm3) increase the risk of viral infection by about 2.5 times and parasitic infections as much as 5 times.Keywords: CD4 cell count, mucocutaneous manifestations, HIV 
      PubDate: 2017-10-06
       
  • The effects of duration of mesenteric artery ligation to the ratio of
           TNF-/IL-10 in a rat model of Acute Mesenteric Ischemia (AMI)

    • Authors: Adeodatus Yuda Handaya
      Abstract: ABSTRACTBackground : Acute Mesenteric Ischemia (AMI) has a high mortality rate as a result of the delay in diagnosis in patients. Determination of potent biomarker for early AMI is the key to reducing the high mortality rate associated with AMI. As a proinflammatory cytokine, the level of TNF-α might be affected during the ischemia and reperfusion, with the prediction duration of 60-120 minutes. High level of TNF-α is estimated to stimulate the upregulation of IL-10 as an inhibitor of TNF-α in AMI. This provides a new opportunity for early diagnosis of AMI by measuring the ratio between the two cytokines. The purpose of this study was to investigate the effects of duration of  the mesenteric artery to the ratio of TNF-α/IL-10 in a rat model of AMI.Material and Methods : This was an experimental study using Wistar rat as the animal model. We performed mesenteric artery in 28 male rats to produce a model of AMI, with ligation duration of 0, 30, 60, 90, 120, 150, and 180 minutes. At the end of ligation of each group, blood samples were taken for examination of TNF-α and IL-10 using ELISA. As for the microscopic examination of tissue necrosis, intestinal organ samples were taken and made into paraffin blocks and stained using Haematoxylin-Eosin.Results : TNF-α was found increased in minute 120 compared to other treatment groups (p<0.05). IL-10 was found to be increased in minute 180 compared to control group (p<0.05). Microscopic examination showed that the duration of ligation affects the structure and morphology of intestinal mucosa characterized by discoloration of organs along with increasing the ligation duration.Conclusion : Ligation of the superior mesenteric artery was found to be significantly increased the expression TNF-α and offset by increased expression of IL-10. Besides, we expected the protective effect of IL-10 as a biomarker candidate of AMI. This can be seen at least in 180 minutes after an elevated level of TNF-α in ischemia duration of 120 minutes. ABSTRAK            Iskemik Mesenterik Akut (IMA) memiliki angka mortalitas yang tinggi akibat lambatnya diagnosis awal pasien. Penentuan biomarker poten yang terlibat pada awal proses IMA menjadi target di klinik. Kadar TNF-α sebagai sitokin prediktor poten di awal kasus dengan durasi prediksi berkisar 60-120 menit. Tingginya kadar TNF-α diestimasi akan menstimulasi peningkatan regulasi IL-10 sebagai inhibitor TNF-α  pada kasus AMI. Hal ini memberikan peluang baru diagnostik awal kejadian IMA dengan mengetahui rasio diantara kedua sitokin tersebut di area iskemia intestinal. Tujuan dari penelitian ini adalah untuk mengetahui pengaruh durasi ligasi arteri mesenterika superior dengan rasio TNF-α/IL-10 pada tikus model IMA. Pada 28 ekor tikus Wistar jantan dilakukan ligasi arteri mesenterika superior untuk menghasilkan suatu model IMA dengan durasi ligasi 0, 30, 60, 90, 120, 150, dan 180 menit. Pada akhir waktu dari masing-masing kelompok dilakukan pengambilan sampel darah untuk pemeriksaan kadar TNF-α  dan IL-10 secara imunologis dengan metode ELISA. Sedangkan untuk pemeriksaan mikroskopik nekrosis jaringan sampel oran intestinal diambil dan dibuat dalam paraffin blok dan dicat dengan Hematoxylin-Eosin. Didapatkan perbedaan yang secara statistik bermakna pada kenaikan kadar TNF-α pada menit ke-120 dibandingkan kelompok perlakuan lainnya (p<0,05). Didapatkan peningkatan bermakna kadar IL-10 pada kelompok perlakuan ligasi 180 menit dibandingkan kelompok kontrol (p<0,05). Hasil pemeriksaan mikroskopik menunjukkan bahwa lama ligasi mempengaruhi struktur morfologi mukosa. Efek ligasi arteri mesenterika superior mampu meningkatkan ekspresi TNF-α secara signifikan dan diimbangi dengan peningkatan ekspresi IL-10 pada tikus model iskemia mesenterika akut. Disamping itu muncul dugaan awal efek protektif IL-10 sebagai kandidat prediktor AMI dapat diketahui minimal pada rentang durasi 180 menit pasca peningkatan kadar TNF-α di durasi iskemia 120 menit. Keywords: Acute Mesenteric Ischemia – Mesenteric artery - TNF-α/IL-10 ratio
      PubDate: 2017-10-06
       
  • Comparison of Bcl-xL protein expression in placental trophoblast cells
           between pregnancy complicated by severe preeclampsia and normotensive
           pregnancy

    • Authors: Diah Rumekti Hadiati, Arsi Palupi, Mohammad Hakimi, Sofia Mubarika Haryana
      Abstract: Background: Preeclampsia is one of the main causes of maternal and perinatal mortality and morbidity. The pathogenesis of preeclampsia remains unclear but it is believed that the failure of spiral arteries remodeling will eventually leads to placental hypoxia. In pregnancy complicated by preeclampsia, trophoblast apoptosis is considered to be excessive. Although this hypothesis is still under study, it is believed that regulation of apoptosis in trophoblast cells plays a key role in the pathophysiology of preeclampsia. The mechanism of molecular apoptosis in human is very complicated and involves many signaling molecules, one of them is Bcl-2 protein. Bcl-2 protein group consists of proapoptosis (Bax) protein and apoptosis inhibitor (Bcl-2 and Bcl-xL) protein.Objective: To compare the expression of Bcl-xL protein in placental trophoblast cells between pregnancy complicated by severe preeclampsia and normotensive pregnancy.Methods: The design of this study was cross sectional design. The population were patients with severe preeclampsia and normotensive patients which were treated in Dr. Sardjito Hospital, Yogyakarta, Indonesia from October 2011 until March 2012. Placenta samples were obtained from 43 patients with pregnancy complicated by severe preeclampsia and 38 patients with normotensive pregnancy. Bcl-xL protein expression was observed using immunohistochemistry technique. Statistical analysis was conducted using independent t-test (p<0.05), bivariate analysis using chi-square test, and multivariate analysis using logistic regression.Results: There was significant difference in Bcl-xL protein expression in trophoblast cells between pregnancy complicated by severe preeclamptic group (1,29 ± 0,12) compared to normotensive group (1,71 ± 0,14) with p=0.00. Multivariate analysis using logistic regression showed that diagnosis of severe preeclampsia had a statistically significant role in Bcl-xL protein expression with p= 0.000.Conclusion: Expression of Bcl-xL protein is lower in pregnancy complicated by severe preeclampsia compared to normotensive pregnancy.
      PubDate: 2017-06-21
       
  • Cinnamomum burmannii improves insulin serum level in the normal obese
           subjects : preliminary study

    • Authors: Flori R. Sari, Hari Hendarto, Chris Adhyanto
      Abstract: ABSTRACTObesity is characterized with excessive accumulation of the body fat which occurs when the energy intake exceeds the expenditure. It is routinely associated with insulin resistance and hyperinsulinemia. Additionally, suppressing insulin level protects female mice from weight gaining. Cinnamon suppresses hyperinsulinemia condition in the type 2 diabetic rat suggesting the possible beneficial role of cinnamon in the obesity. We aimed to investigate the role of cinnamon in the normal obese subjects. In this preliminary cross-over clinical trial, 24 normal obese subjects were recruited and divided randomly into two groups, treatment and placebo. Two grams of Cinnamomum burmannii extract were given twice daily for 56 days in the treatment group. Normal obese subjects given placebo were allocated as the placebo group. After finishing the treatment, each of the group ran a one month run-in period, then the groups were cross-overed for the next 56 days. Body Mass Index (BMI), insulin serum level, cholesterol and triglyceride plasma level were measured at the beginning and at the end of the study. No diet restriction nor exercise intervention was given during the study. At the end of the study, BMI in the treatment group were slightly reduced when compared to the placebo group (58% vs. 33%), however, the results did not reach significancies in the statistical level. Moreover, significant reduction in the insulin serum level was observed in 63% subject in the treatment group compared to 33% subject in the placebo group (p < 0.05). Additionally, there were no significant differences of cholesterol and triglyceride plasma level observed in the both group.Conclusion. Cinnamon extract may give beneficial role in the normal obese subjects by suppressing the serum insulin level. Further studies are required to elucidate the specific role of cinnamon in preventing weight gain.Keywords: Cinnamomum burmannii, obesity, insulin, body mass index lipid profile
      PubDate: 2017-03-03
       
  • Comparing P-Selectin (CD62P) expression in patients receiving
           non-leukodepleted vs leukodepleted thrombocyte concentrates

    • Authors: Teguh Triyono
      Abstract: Thrombocyte concentrate (TC) transfusion is an important supportive therapy in patients with thrombocytopenia. The risks in platelet transfusions may be related to the content of TC including the contaminant leukocytes. The aim of this study was to assess the risk of increased level of P-Selectin (CD62P) expression of non-leukodepleted TC transfusions.This was a quasi-experimental study. Subjects were children patients aged 1-18 years who received a non-leukodepleted or a leukodepleted TC transfusions. Comparison of the proportion of  increased expression of CD62P in both groups expressed as relative risk. The subjects consisted of 51 patients who received non-leukodepleted and 52 patients who received leukodepleted TC transfusions. The risk of increased expression of CD62P in patients receiving non-leukodepleted TC transfusions were 2.38 (95%CI:1.60-3.53) times higher than those who received leukodepleted TC. Non-leukodepleted have significant higher risks of increased CD62P expression than leukodepleted  TC transfusions.
      PubDate: 2017-03-03
       
 
 
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