Populasi Bakteri Pelarut Fosfat, P-Potensial dan Hasil Jagung yang Dipengaruhi oleh Aplikasi MPF pada Ultisols Jatinangor

Ultisol is low fertility soil and as low available P due to P fixation by Al and Fe. The phosphate solubilizing microbes (PSM) is the microbial group that enable realease fixed-P to soil solution and be absorbed by plant. This research was aimed to determine the effects of PSM biofertilizer and phosphate fertilizer dosage combination on soil potential P, total phosphate solubilizing bacteria (PSB) population and yield of maize (Zea mays L.) grown in Ultisols. This research used a Randomized Block Design that consist of nine treatments with three replications. The treatments were 100 kg ha-1 of SP-36 fertilizer, 50 kg ha-1 of PSM biofertilizer, SP-36 fertilizer (50 kg ha-1 and 100 kg ha-1) with PSM biofertilizer (25 kg ha-1, 50 kg ha-1 and 75 kg ha-1) repectively. The result showed that the combination of PSM and phosphate fertilizer dosage had significantly effect on PSB total population and maize yield, but did not not on potential P. This experiment suggested that SP-36 fertilizer with 50 kg ha-1 dosage and PSM biofertilizer with 50 kg ha-1 dosage is the best combination

Penerapan model discovery learning berbantukan LKPD untuk meningkatkan pemahaman konsep pada materi integral fungsi aljabar

This study describes the application of discovery learning model supported by worksheet/LKPD to improve conceptual understanding on integration algebra function material. This type of research is a Classroom Action Research (CAR) with Kemmis and Taggart spiral model. It was conducted in April-May 2023 for 3 weeks with the research subject being Class XI Religion 2 MAN Kota Blitar which amounted to 33 students. The object of research is conceptual understanding of students in mathematics subjects, especially the integral material of algebraic functions. Data collection techniques used are observation techniques, learning outcomes test questions, and field notes. The data analysis technique procedure used is data collection, reduction, processing data and drawing conclusions. Based on the results of the study, it shows that there is an increase in conceptual understanding by applying the discovery learning model supported by LKPD. The increase that occurred was, (1) the participation of students during learning using the discovery learning model supported by LKPD in Cycle I amounted to 60.606% and in Cycle II amounted to 84.848%, (2) conceptual understanding from the results of student learning evaluations that obtained scores higher than KKM in Cycle I of 57.575% and Cycle II of 81.818% so that there was an increase of 24.243%. It can be concluded that the application of the discovery learning model supported by LKPD can improve concept understanding

Respons Sitokin TNF-Α Dan Il-4 Pasca Stimulasi Antigen Fusi Resat-6-CFP-10

Abstract Protective immunity of tuberculosis (TB) infection is highly dependent on the balance of Th1 and Th2 cytokines. TNF-α cytokines produced by Th1 cell retain a latent status, and IL-4 produced by Th2 aids in the production of antibodies. The recent development of the vaccine candidates shows that rESAT-6- CFP-10 fusion antigen is specific to induce protective immune responses. The objective of the study was to determine the immune response. This study used a quasi experimental design in the laboratory in vitro with cultured PBMC of patients with new cases of pulmonary TB, latent TB and healthy individuals. Examination of TNF-α and IL-4 levels was done by ELISA. The highest TNF-α mean levels were 866,05 in the latent TB group, compared to 814,56 in active TB and 414,58 in healthy individuals, but they were not significantly different. The highest IL-4 mean levels were 1,39 in the active TB group, compared to 0,88 in latent TB and 0,74 in healthy individuals, but they were not significantly different. High levels of TNF-α and low levels of Il-4 in latent TB post-stimulation of rESAT-6-CFP-10 fusion antigen show that the candidate vaccine is capable of providing protective reponse against Mycobacterium tuberculosis infection. Key words : TNF-α, IL-4, PBMC, ELISA, rESAT-6-CFP-10 Abstrak Imunitas protektif terhadap infeksi tuberculosis sangat bergantung terhadap keseimbangan sitokin T-helper (Th)-1 dan Th2. Sitokin TNF-α yang disekresi oleh sel Th1 mampu mempertahankan status laten, dan IL-4 yang disekresi oleh Th2 membantu produksi antibodi. Pengembangan kandidat vaksin terbaru yaitu antigen fusi rESAT-6-CFP-10 bersifat spesifik terhadap respons imun protektif. Tujuan penelitian ini untuk mengetahui respons imun seluler melalui kadar TNF-α dan IL-4 pasca stimulasi antigen fusi rESAT-6-CFP-10. Penelitian ini menggunakan desain eksperimen semu di laboratorium secara in vitro pada kultur PBMC. Pemeriksaan kadar sitokin TNF-α dan IL-4 dengan metode ELISA. Rerata kadar TNF-α pasca stimulasi paling tinggi ditemukan pada kelompok TB laten 866,05, dibandingkan TB aktif 814,56 dan orang sehat 414,58, tetapi tidak berbeda bermakna. Reratakadar IL-4 pasca stimulasi paling tinggi ditemukan pada kelompok TB aktif, dibandingkan TB laten dan orang sehat, tetapi tidak berbeda bermakna. Kadar TNF-α yang tinggi dan kadar IL-4 yang rendah pada TB laten pasca stimulasi antigen fusi rESAT-6-CFP-10 menunjukkan bahwa kandidat vaksin mampu memberikan repons protektif terhadap infeksi Mycobacterium tuberculosis secara invitro. Kata kunci : TNF-α, IL-4, PBMC, ELISA, rESAT-6-CFP-10

CLINICAL PROFILE AND INCIDENCE OF INFECTION IN SYSTEMIC LUPUS ERYTHEMATOSUS PATIENTS AT MEDICAL INPATIENT INSTALLATION, DEPARTMENT OF INTERNAL MEDICINE, DR. SOETOMO GENERAL ACADEMIC HOSPITAL, SURABAYA, INDONESIA IN 2016

Background: Systemic Lupus Erythematosus (SLE) is an autoimmune disease with unknown aetiology. SLE attacks multiple organs with diverse clinical manifestations. Most patients get immunosuppressant therapy that suppresses immune system, causing the body to be susceptible to infection. Objective: to describe clinical manifestations, laboratory abnormalities, and incidence of infections in SLE patients hospitalized at Dr. Soetomo General Academic Hospital, Surabaya, Indonesia in 2016. Materials and Methods: Cross-sectional descriptive observational study used medical records of 273 SLE patients hospitalized at Dr. Soetomo General Academic Hospital, Surabaya, Indonesia in 2016. Results: Clinical manifestations found in this study were malar rash 7.33%, discoid rash 2.93%, oral ulcer 8.42%, allopecia 16.48%, arthritis 26.74%, serositis 13.19%, kidney 35.9%, neurology 24.91%, anemia 73.71%, leucopenia 32.67%, lymphopenia 76.89%, and thrombocytopenia 33.86%. Laboratory abnormalities found in this study were hematology (anemia 73.71%, leucopenia 32.67%, lymphopenia 76.89%, thrombocytopenia 33.86%), kidney function (high serum creatinine levels 39.66%, high BUN levels 41.2%, hypoalbuminemia 62.6%), urine (proteinuria 68.21%, hematuria 51.79%) and liver function (high ALT levels 36.65%, high AST levels 29.86%). Infection occurred in 33.7% patients. The most common infections were pneumonia (70.65%), urinary tract infections (51.09%), and sepsis (35.87%). Conclusion: The most common clinical manifestations experienced by SLE patients are hematological disorder, kidney disorder, and arthritis. Prominent laboratory abnormalities are anemia, lymphopenia, and proteinuria. Infection is a common complication, with the most common types pneumonia, urinary tract infection, and sepsis

PENGARUH AGLOMERASI DAN HUBUNGAN VERTIKAL INDUSTRI TERHADAP PRODUKTIVITAS INDUSTRI DI INDONESIA

Abstract : The research objectives is to analyze agglomeration over the company’s productivity of 2 important factors of agglomeration: interindustry (localization) and cross industry spillover (urbanization) and review its effect if those agglomeration derives from upstream or downstream industry. In addition to it, this research is determining on how geographic distance and economic distance against spillover strength. By means of the company‘s level panel data of heavy and medium industrial survey result by the National Statistical Bureau in local regency/municipality level ranging from 2008 to 2015 and 2010 output input table to see the vertical industry relation, the outcomes may show that both company accepting positive and significant impact on productivity spillover of the same industrial sector, and other industrial sector in the same region. Nevertheless, the more far the area geographically, the less its impact. Productivity spillover is also determined from upstream dan downstream industries concentrating in the same region. However, the economic distance effect is not identified on the upstream level. Hence, the policy implication of the research result is to encourage and shaping the downstream industries, facilitate technology transfer from upstream companies, and periodically evaluate industrial estates.Keywords: agglomeration, downstream, productivity, spillover, upstream.Abstrak : Penelitian ini bertujuan untuk menganalisis pengaruh aglomerasi terhadap produktivitas perusahaan dari dua faktor penting aglomerasi, yaitu intraindustry (lokalisasi) dan crossindustry spillover (urbanisasi) dan mengkaji bagaimana pengaruhnya jika aglomerasi tersebut berasal dari industri upstream atau downstream dari perusahaan tersebut. Selain itu penelitian ini juga ingin membuktikan pengaruh jarak geografis dan jarak ekonomi terhadap kekuatan spillover. Dengan menggunakan data panel level perusahaan dari hasil survei industri besar dan sedang BPS untuk tingkat kabupaten kota dengan rentang waktu tahun 2008-2015 dan Tabel input output 2010 untuk melihat hubungan vertikal industri, diperoleh kesimpulan bahwa perusahaan menerima dampak spillover produktivitas yang positif dan signifikan dari berkumpulnya perusahaan dari sektor industri yang sama, maupun dari sektor industri lain yang berada di wilayah yang sama. Namun makin jauh jarak geografisnya, pengaruh tersebut semakin kecil. Spillover produktivitas juga diperoleh dari perusahaan sektor upstream dan downstream yang berkumpul diwilayah yang sama dengan perusahaan tersebut. Makin dekat jarak ekonominya makin besar pengaruh spillover dari sektor downstream. Pengaruh jarak ekonomi ini tidak ditemukan pada sektor upstream. Dengan demikian implikasi kebijakan dari hasil penelitian yaitu mendorong terciptanya hilirisasi industri, memfalitasi transfer teknologi dari perusahaan upstream, dan melakukan evaluasi kawasan industri secara berkala.Kata kunci: aglomerasi, downstream, produktivitas, spillover, upstream

CD4+ AND CD8+ T-CELLS EXPRESSING INTERFERON GAMMA IN ACTIVE PULMONARY TUBERCULOSIS PATIENTS

Background: Tuberculosis (TB) is a global health problem. Immune response through CD4+ and CD8+ T cells is needed to produce Interferon gamma (IFN-γ), a cytokine eliminate Mycobacterium tuberculosis. We aimed to compare the cellular immune response based on the percentage of CD4+ and CD8+ T cells expressing interferon gamma in active pulmonary tuberculosis patients before and after 2 months of tuberculosis treatment. Methods: It is a longitudinal cohort study included 12 patients with new active pulmonary TB of the Pulmonary Hospital, Surabaya. The CD4+ and CD8+ T cells expressing interferon gamma was measured by flow cytometry method. Results: The mean CD4+ interferon gamma percentage of new active pulmonary TB before treatment was higher than 2 months after tuberculosis treatment (4.48% vs. 1.52%) and there was a significantly decreased (p = 0.025). The mean CD8+ interferon gamma percentage of new active pulmonary TB before treatment was higher than 2 months after tuberculosis treatment (3.56% vs. 2.89%) but not significantly decreased (p = 0.186). Conclusions: The mean CD4+ IFN-γ percentage of new active pulmonary TB before treatment was higher than 2 months after treatment, suggesting that CD4+ T cells expressing IFN-γ play a role in protection against pulmonary TB infecti

Diagnostic Value of Myeloperoxidase Index in Bacterial Infections

Infectious diseases remain a serious problem in Indonesia. Myeloperoxidase (MPO) is a substance released by neutrophils, which activates the synthesis of hypochlorous acid (HOCL) from hydrogen peroxide (H2O2) and chloride ion (Cl-). Hypochlorous acid plays a vital role in the body's defense against infection. Myeloperoxidase Index (MPXI) is a parameter in the hematology analyzer Advia 2120i based on the principle of flow cytometry. This study aimed to determine the diagnostic value of MPXI in patients with bacterial infections. The study was a cross-sectional observational analysis. The samples consisted of a group of patients with bacterial infection and a group of healthy subjects. The specimens used in this study were whole blood + anticoagulant (EDTA) in a purple tube with a volume of 3 mL to determine the MPXI value in both groups using ADVIA 2120i hematology analyzer. The study subjects consisted of a group of patients with bacterial infections (69 patients) and a group of healthy subjects (33 people). Analysis of the MPXI ROC curve with a cut-off ≥ -5.8 and < -5.8, showed AUC of 0.323 (CI=95%, p=0.004), sensitivity of 34.8%, specificity of 39.4%, Positive Predictive Value (PPV) of 54.5%, and Negative Predictive Value (NPV) of 22.4%. Due to its low diagnostic value, the MPXI value was not recommended to be used as a diagnostic instrument for bacterial infections. Also, further research was highly needed

TUBERCULIN SKIN TEST AND INTERFERON-γ RELEASE ASSAY ON THE DIAGNOSIS OF TUBERCULOUS SPONDYLITIS

Highlights                                                                                                                                      • TST and IGRA have a significant correlation with the diagnosis of patients with Tuberculous Spondylitis. • Various factors may affect the results of TST and IGRA. Thus, the use of TST and IGRA can be adjusted according to the condition of the hospital, the availability of diagnostic tools, the health worker’s physical examination results, and the patient's medical history. Abstract Background: Tuberculous spondylitis or Pott’s disease is extrapulmonary tuberculosis that is still a concern to health workers because of the broad spectrum of its clinical symptoms. Delay in diagnosis is very common in this disease. Therefore, its diagnostic tool needs to be thoroughly reviewed to determine its effectiveness. The diagnostic tools studied in this study were Tuberculin Skin Test (TST) and Interferon-γ Release Assay (IGRA). Objective:  To analyze the role of TST and IGRA as diagnostic tools for the diagnosis of tuberculous spondylitis. Material and Method: This study used a systematic review method to analyze topic-related kinds of literature written in English and Indonesian found on PubMed, Scopus, ProQuest, and Web of Science databases. The literature screening process was carried out based on the PRISMA 2020 Guidelines. Result:  Sixteen types of literature were included for a total of 116 patients. TST was detected positive in 45 (63%) and negative in 21 (30%) of a total of 66 patients with Pott’s disease. IGRA was detected positive in 51 (77%), negative in 8 (12%), and indeterminate in 2 (3%) of a total of 61 patients with Pott’s disease. Conclusion:  TST and IGRA results significantly correlate with the diagnosis of tuberculous spondylitis. Both tests are still relevant for use in the diagnosis of the disease. IGRA and TST are used according to the needs of health workers and patients’ health backgrounds

TINJAUAN PUSTAKA: PATOGENESIS DAN DIAGNOSIS SISTEMIK LUPUS ERITEMATOSUS

Sistemik Lupus Eritematosus (SLE) adalah penyakit inflamasi autoimun kronis dengan manifestasi klinis yang luas. Perjalanan penyakit dan prognosis dari SLE pun juga beragam. Faktor lingkungan, imunologi, hormonal, dan genetik diketahui memegang peranan dalam perkembangan SLE. Penyakit SLE lebih banyak menyerang wanita terutama usia produktif. Patogenesis SLE mengikutsertakan berbagai sel dan molekul yang berperan pada proses apoptosis, respons imun innate dan adaptif. Diagnosis SLE ditegakkan berdasarkan manifestasi klinis, yang harus memenuhi 4 dari 11 kriteria American Rheumatology Association (ARA) (1997), dan pemeriksaan laboratorium. Terapi SLE bersifat individual berdasarkan manifestasi klinis yang dialami pasien, aktivitas penyakit dan derajat keparahan penyakit serta komorbiditas. Prognosis SLE bervariasi mulai dari ringan hingga berkembang cepat menjadi berat disertai kegagalan multiorgan bahkan kematian. Studi pustaka ini diharapkan dapat memberikan informasi lebih mendalam mengenai patogenesis dan cara menegakkan diagnosis SLE sehingga dapat menjadi dasar dalam pengembangan penelitian mengenai SLE di masa yang akan datang

HLA-B 15:13 Positive in an Indonesian Patient with Phenytoin-Induced SJS/TEN

ABSTRACT Steven-Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN) are severe forms of delayed hypersensitivity reaction with an underlying immunologic mechanism involving the interaction between HLA and drug molecules. A-35-year-old Javanese-Indonesian-male, with a history of seizures, presented with skin peeling, mucosal erosions, and purulent eye discharges. He was clinically diagnosed as overlapping SJS/TEN, and both phenytoin and valproic acid became the suspected drugs. Unfortunately, the seizure relapsed and alternative antiepileptic drugs were urgently needed. HLA typing was then performed, revealing the presence of HLA-B*15:13, which has been proven to be correlated with phenytoin adverse reaction by previous study. Thus, phenytoin was totally discontinued and he only prescribed monotherapy valproic acid. Given the high prevalence and common use of phenytoin in clinical practice, HLA evaluation before phenytoin prescription in Indonesia is important. Further studies are recommended to provide more evidence regarding the role of HLA-B*15:13 in phenytoin-induced severe hypersensitivity reactions in Indonesia