Higher Risk of Probable Mental Emotional Disorder in Low or Severe Vision Subjects

Background: Severe visual impairments are able to induce psychological stress, especially among adults, which may stimulate mental emotional disorder (MED). Eye health problems are not a health problem priority in Indonesia. This paper presents an assessment of severe visual impairments related to the risk of MED. Methods: This paper assessed a part of Basic Health Research (Riskesdas) 2007 data. For this assessment, subjects 15 years old or more had their visual acuity measured using the Snellen chart and their mental health status determined using the Self Reporting Questionnaire (SRQ) 20. A subject was considered to have probable MED if the subject had a total score of 6 or more on the SRQ. Based on the measure of visual acuity, visual acuity was divided into 3 categories: normal/mild (20/20 to 20/60); low vision (less than 20/60 to 3/60); and blind (less than 3/60 to 0/0). Results: Among 972,989 subjects, 554,886 were aged 15 years or older. 11.4% of the subjects had probable MED. The prevalence of low vision and blindness was 5.1% and 0.9%, respectively. Compared to subjects with normal or mild visual impairments, subjects with low vision had a 74% increased risk for probable MED [adjusted relative risk (RRa)=1,75; 95% confidence interval (CI)=1,71-1,79]. Blind subjects had a 2.7-fold risk to be probable MED (RRa=2.69; 95% CI=2.60-2.78] compared to subjects with normal or mild visual impairments. Conclusion: Visual impairment severity increased probable MED risk. Therefore, visual impairment subjects need more attention on probable MED. (Health Science Indones 2011;2:9-13

KAJIAN INDUCED PLURIPOTENT STEMCELL (iPS) (HARAPAN DAN TANTANGAN)

<p>Abstract</p><p>Induced Pluripotent Stemcell (iPS) are adult cells which the genetic information in the nucleus of those cells being reprogrammed (reprogram) by inserting exogenous pluripotential genes. The exogenous gene transduction is using vectors, such as lentivirus, retrovirus, or adenovirus, which suppressed the gene expression of the original cells, so they will express the transduced exogenous gene. Viral vectors are then used to reprogramming and producing iPS clones that are pluripotent. iPS derived from adult cells of patient with certain diseases will be used as a tool to study the mechanisms of those specific diseases and the effects of selected drugs against the diseases. Several previous studies have shown that iPS clones developed from specific genetic disease have its original genotype and retain the character of the response to the drug that similar as the original adult cells. Opportunities for the utilization of autologous iPS cell therapy in the future is wide open as expected iPS transplant will not be rejected when transplanted back to the patient. Behind all its potential, iPS production is still facing some problems to be applicable clinically. The use of viruses as vectors may cause problems due to virus gene sequences may be integrated into the genome of the DNA donor cell, thereby causing mutations of the iPS clones. Several subsequent studies have succeeded in replacing the use of viruses as vectors, but the level of efficiency obtained is still very low. Another problem that arises is that epigenetic changes may occur in iPS cultures. Many advanced research related to iPS may be developed in Indonesia and is necessary to improve the production efficiency of iPS and solve iPS clones epigenetic changes problems in the future.</p><p>Keywords: iPS, pluripotency, transduction, transfection.</p><p>Abstrak</p><p>Induced Pluripotent Stemcell (iPS) adalah sel somatic dewasa yang informasi genetika dalam inti selnyadiprogram ulang (reprogram) dengan cara memasukkan gen-gen eksogen yang memberikan ciri pluripotensial. Transduksi gen eksogen ini menggunakan vektor, seperti lentivirus, retrovirus, atau adenovirus, yang ditekan ekspresi gen aslinya, sehingga akan mengekspresikan sel eksogen yang ditransduksikan.Virus vektor tersebut selanjutnya digunakan untuk reprogram dan membuat klon iPS yang bersifat pluripoten. Sel dewasa yang akan dijadikan iPS diambil dari penderita penyakit tertentu dan selanjutnya klon iPS dapat dimanfaatkan sebagai alat untuk mempelajari mekanisme terjadinya penyakit dan efek obat terpilih terhadap penyakit tersebut. Beberapa penelitian terdahulu telah membuktikanbahwa kloni PS yang dikembangkan dari penderita penyakit genetik tertentu tetap memiliki karakter genotip dan respon terhadap obat yang sama dengan sel dewasa asalnya. Peluang pemanfaatan iPS otologus untuk terapi sel dimasa mendatang terbuka lebar karena diperkirakan iPS tidak akan mengalami proses rejeksi saat ditransplantasikan kembali kepada penderita yang bersangkutan. Dibalik segala potensinya, iPS masih memiliki beberapa kekurangan untuk diaplikasikan secara klinis. Penggunaan virus sebagai vektor dapat menimbulkan masalah karena sekuens gen virus mungkin berintegrasi dengan genom DNA sel donor, sehingga akan menyebabkan risiko terjadinya mutasipada klon iPS yang dihasilkan. Beberapa penelitian selanjutnya berhasil mengganti penggunaan virus sebagai vektor, namun tingkat efisiensi yang didapat masih sangat rendah. Masalah lain yang timbul adalah perubahan epigenetik yang dapat terjadi pada kultur iPS.Banyak penelitian lanjutan terkait iPS yang dapat dikembangkan di Indonesia dan sangat diperlukan untuk meningkatkan efisiensi produksi iPS dan mengatasi masalah perubahan epigenetik klon iPS dimasa mendatang.</p><p>Kata Kunci: iPS, pluripotensi, transduksi, transfeksi.</p

THE EXPRESSION OF NESTIN IN THE INDUCED DIFFERENTIATION INTO NEURONS OF RAT BONE MARROW MESENCHYMAL STEM CELLS BY NEUROTROPHIN-3 (NT-3)

Objective: The aim of this study was to examine the role of NT-3 as a single neurotrophic factor in the expression of nestin in the neural differentiation of MSCs. Methods: MSCs were isolated from rat bone marrow and induced with NT-3 at concentrations of 20, 25, and 30 ng/ml for 7 and 14 d (the control was no NT-3). Nestin underwent immunocytochemical analysis on days 7 and 14. Five high-power random fields were documented. Results: A post-hoc analysis using LSD after one-way ANOVA test yielded a statistically significant difference in the percentage of nestin-positive cells in MSCs with NT-3 at concentrations of 20, 25, and 30 ng/ml for 7 d compared to the control group (p&lt;0.05). The percentages of nestin-positive cells at concentrations of 20, 25, and 30 ng/ml, and in the control data on day 7 were 14.55±1.26%, 16.20±1.07%, 13.78±1.19%, and 9.81±0.79%, respectively. NT-3 at 25 ng/ml induced the highest MSCs neural differentiation on day 7 and remained constant until day 14. Conclusion: NT-3 plays a role in the early stage of differentiating MSCs from rat bone marrow into neurons, with the optimal concentration being 25 ng/ml

Higher risk of probable mental emotional disorder in low or severe vision subjects

Latar belakang: Gangguan penglihatan berat dan kebutaan, belum menjadi prioritas masalah kesehatan di Indonesia, dapat menimbulkan gangguan mental emosional. Pada tulisan ini disajikan penilaian gangguan mental emosional yang berkaitan dengan gangguan penglihatan berat. Metode: Analisis ini menggunakan sebagian data Riset Kesehatan Dasar (Riskesdas) 2007. Subjek untuk keperluan analisis ini ialah yang berusia 15 tahun atau lebih. Gangguan mental emosional diukur dengan Self  Reporting Questionnaire (SRQ) 20. Subjek yang mungkin menderita gangguan mental emosional, jika hasil SRQ sebesar 6 atau lebih, dan sebaliknya. Tajam penglihatan  ditentukan berdasarkan tes Snellen chart.  Visus normal/ringan ialah 20/20 to 20/60, visus rendah ialah kurang dari 20/60-3/60, sedangkan buta dengan visus kurang dari 3/60 sampai 0/0. Hasil: Di antara 972,989 subjek data Rskesdas 2007 terdapat 46,7% (554,886) yang berusia 15 tahun atau lebih. Subjek yang menderita gangguan mental emosional sebesar 11,4% (63,279/554,886),  prevalensi visus rendah sebesar 5,1% dan kebutaan 0,9%. Subjek yang menderita visus rendah dibandingkan subjek yang normal atau dengan gangguan tajam penglihatan ringan mempunyai 75% lebih besar menderita risiko gangguan mental emosional [risiko relatif (RRa)=1,75; 95% interval kepercayaan (CI)=1,71-1,79]. Sedangkan subjek yang buta dibandingkan subjek yang normal atau dengan gangguan tajam penglihatan ringan mempunyai risiko 2,7 kali lipat menderita gangguan mental emosional (RRa= 2,69; 95% (CI)=2.60-2.78). Kesimpulan: Subjek dengan gangguan penglihatan makin berat mempunyai risiko menderita gangguan mental emosional. Oleh karena itu subjek yang menderita gangguan penglihatan berat perlu diperhatikan mental emosionalnya. (Health Science Indones 2011;2:9-13) Abstract Background: Severe visual impairments are able to induce psychological stress, especially among adults, which may stimulate mental emotional disorder (MED). Eye health problems are not a health problem priority in Indonesia. This paper presents an assessment of severe visual impairments related to the risk of MED. Methods: This paper assessed a part of Basic Health Research (Riskesdas) 2007 data. For this assessment, subjects 15 years old or more had their visual acuity measured using the Snellen chart and their mental health status determined using the Self Reporting Questionnaire (SRQ) 20. A subject was considered to have probable MED if the subject had a total score of 6 or more on the SRQ. Based on the measure of visual acuity, visual acuity was divided into 3 categories: normal/mild (20/20 to 20/60); low vision (less than 20/60 to 3/60); and blind (less than 3/60 to 0/0). Results: Among 972,989 subjects, 554,886 were aged 15 years or older. 11.4% of the subjects had probable MED. The prevalence of low vision and blindness was 5.1% and 0.9%, respectively. Compared to subjects with normal or mild visual impairments, subjects with low vision had a 74% increased risk for probable MED [adjusted relative risk (RRa)=1,75; 95% confidence interval (CI)=1,71-1,79].  Blind subjects had a 2.7-fold risk to be probable MED (RRa=2.69; 95% CI=2.60-2.78] compared to subjects with normal or mild visual impairments. Conclusion: Visual impairment severity increased probable MED risk. Therefore, visual impairment subjects need more attention on probable MED. (Health Science Indones 2011;2:9-13)</em

Higher risk of probable mental emotional disorder in low or severe vision subjects

Latar belakang: Gangguan penglihatan berat dan kebutaan, belum menjadi prioritas masalah kesehatan di Indonesia, dapat menimbulkan gangguan mental emosional. Pada tulisan ini disajikan penilaian gangguan mental emosional yang berkaitan dengan gangguan penglihatan berat. Metode: Analisis ini menggunakan sebagian data Riset Kesehatan Dasar (Riskesdas) 2007. Subjek untuk keperluan analisis ini ialah yang berusia 15 tahun atau lebih. Gangguan mental emosional diukur dengan Self  Reporting Questionnaire (SRQ) 20. Subjek yang mungkin menderita gangguan mental emosional, jika hasil SRQ sebesar 6 atau lebih, dan sebaliknya. Tajam penglihatan  ditentukan berdasarkan tes Snellen chart.  Visus normal/ringan ialah 20/20 to 20/60, visus rendah ialah kurang dari 20/60-3/60, sedangkan buta dengan visus kurang dari 3/60 sampai 0/0. Hasil: Di antara 972,989 subjek data Rskesdas 2007 terdapat 46,7% (554,886) yang berusia 15 tahun atau lebih. Subjek yang menderita gangguan mental emosional sebesar 11,4% (63,279/554,886),  prevalensi visus rendah sebesar 5,1% dan kebutaan 0,9%. Subjek yang menderita visus rendah dibandingkan subjek yang normal atau dengan gangguan tajam penglihatan ringan mempunyai 75% lebih besar menderita risiko gangguan mental emosional [risiko relatif (RRa)=1,75; 95% interval kepercayaan (CI)=1,71-1,79]. Sedangkan subjek yang buta dibandingkan subjek yang normal atau dengan gangguan tajam penglihatan ringan mempunyai risiko 2,7 kali lipat menderita gangguan mental emosional (RRa= 2,69; 95% (CI)=2.60-2.78). Kesimpulan: Subjek dengan gangguan penglihatan makin berat mempunyai risiko menderita gangguan mental emosional. Oleh karena itu subjek yang menderita gangguan penglihatan berat perlu diperhatikan mental emosionalnya. (Health Science Indones 2011;2:9-13) Abstract Background: Severe visual impairments are able to induce psychological stress, especially among adults, which may stimulate mental emotional disorder (MED). Eye health problems are not a health problem priority in Indonesia. This paper presents an assessment of severe visual impairments related to the risk of MED. Methods: This paper assessed a part of Basic Health Research (Riskesdas) 2007 data. For this assessment, subjects 15 years old or more had their visual acuity measured using the Snellen chart and their mental health status determined using the Self Reporting Questionnaire (SRQ) 20. A subject was considered to have probable MED if the subject had a total score of 6 or more on the SRQ. Based on the measure of visual acuity, visual acuity was divided into 3 categories: normal/mild (20/20 to 20/60); low vision (less than 20/60 to 3/60); and blind (less than 3/60 to 0/0). Results: Among 972,989 subjects, 554,886 were aged 15 years or older. 11.4% of the subjects had probable MED. The prevalence of low vision and blindness was 5.1% and 0.9%, respectively. Compared to subjects with normal or mild visual impairments, subjects with low vision had a 74% increased risk for probable MED [adjusted relative risk (RRa)=1,75; 95% confidence interval (CI)=1,71-1,79].  Blind subjects had a 2.7-fold risk to be probable MED (RRa=2.69; 95% CI=2.60-2.78] compared to subjects with normal or mild visual impairments. Conclusion: Visual impairment severity increased probable MED risk. Therefore, visual impairment subjects need more attention on probable MED. (Health Science Indones 2011;2:9-13

Slit-lamp calibration, crucial but neglected

AbstrakLatar belakang: Kalibrasi berkala alat diagnostik sangat esensial untuk diagnosis yang akurat. Riset fasilitas kesehatan (Rifaskes) 2011 mengumpulkan data termasuk kalibrasi lampu celah (slit-lamp) pada sampel rumah sakit (RS) di Indonesia. Tujuan analisis ialah untuk mengidentifikasi faktor dominan yang berpengaruh terhadap pelaksanaan kalibrasi berkala lampu celah di RS.Metode: Analisis memakai sebagian data Rifaskes 2011 di antara 442 RS yang menyediakan layanan kesehatan mata. Risiko relatif dipergunakan untuk menilai kemungkinan tidak dilakukannya kalibrasi lampu celah di RS.Hasil: Di antara 248 RS sampel yang memenuhi kriteria inklusi, hanya 25,8% RS yang melakukan kalibrasi lampu celah tepat waktu. Dibandingkan dengan rumah sakit yang dimiliki oleh Badan Usaha Milik Negara (BUMN), rumah sakit yang dimiliki lembaga lain memiliki risiko yang lebih tinggi tidak mengkalibrasi lampu celah. Menurut tipe RS, RS non-pendidikan dibandingkan dengan RS -pendidikan berisiko 40% lebih tinggi tidak mengkalibrasi lampu [risiko relatif suaian (RRa) = 1,40; 95% interval kepercayaan (CI) = 1,02-1,91].Kesimpulan: Kalibrasi tepat waktu lampu-celah masih menjadi masalah di sebagian besar RS. Dibandingkan dengan rumah sakit yang dimiliki oleh BUMN, rumah sakit yang dimiliki oleh instansi lain berisiko yang lebih tinggi tidak mengkalibrasi lampu celah. (Health Science Indones 2012;2:xx-xx)Kata kunci:kalibrasi, lampu celah, rumah sakitAbstractBackground: Periodical diagnostic tool calibration is essential for accurate diagnosis. Health Facilities Research (Rifaskes) in 2011 collected data on the slit-lamp calibration of all registered general hospitals in Indonesia.Methods: Analysis using a part Rifaskes 2011 data among 442 hospitals that provide eye health services. Relative risk was used to assess the risk of performing calibration slit lamp.Results: Out of 442 hospitals, 248 hospitals met the inclusion study criteria, and only 25.8% calibrating the slit-lamp on schedule. Ownership and type of hospital were the dominant factors on the risk of not performing on schedule slit- lamp calibration. Compared to hospital owned by government public company, the hospitals owned by the other institution had higher risk did not calibrate their slit-lamp. In term of hospital type, nonteaching hospital compared with teaching hospital had 40% higher risk did not calibrate their slit-lamp [adjusted relative risk [adjusted relative risk (RRa) = 1.40; 95% confidence interval (CI) = 1.02-1.91].Conclusion: On schedule slit-lamp calibration was still a problem in most of hospitals. Compared to hospital owned by government public company, the hospitals owned by the other institution had higher risk did not calibrate their slit-lamp. (Health Science Indones 2012;2:xx-xx)Key words:calibration, slit-lamp, hospital</p

Slit-lamp calibration, crucial but neglected

AbstrakLatar belakang: Kalibrasi berkala alat diagnostik sangat esensial untuk diagnosis yang akurat. Riset fasilitas kesehatan (Rifaskes) 2011 mengumpulkan data termasuk kalibrasi lampu celah (slit-lamp) pada sampel rumah sakit (RS) di Indonesia. Tujuan analisis ialah untuk mengidentifikasi faktor dominan yang berpengaruh terhadap pelaksanaan kalibrasi berkala lampu celah di RS.Metode: Analisis memakai sebagian data Rifaskes 2011 di antara 442 RS yang menyediakan layanan kesehatan mata. Risiko relatif dipergunakan untuk menilai kemungkinan tidak dilakukannya kalibrasi lampu celah di RS.Hasil: Di antara 248 RS sampel yang memenuhi kriteria inklusi, hanya 25,8% RS yang melakukan kalibrasi lampu celah tepat waktu. Dibandingkan dengan rumah sakit yang dimiliki oleh Badan Usaha Milik Negara (BUMN), rumah sakit yang dimiliki lembaga lain memiliki risiko yang lebih tinggi tidak mengkalibrasi lampu celah. Menurut tipe RS, RS non-pendidikan dibandingkan dengan RS -pendidikan berisiko 40% lebih tinggi tidak mengkalibrasi lampu [risiko relatif suaian (RRa) = 1,40; 95% interval kepercayaan (CI) = 1,02-1,91].Kesimpulan: Kalibrasi tepat waktu lampu-celah masih menjadi masalah di sebagian besar RS. Dibandingkan dengan rumah sakit yang dimiliki oleh BUMN, rumah sakit yang dimiliki oleh instansi lain berisiko yang lebih tinggi tidak mengkalibrasi lampu celah. (Health Science Indones 2012;2:xx-xx)Kata kunci:kalibrasi, lampu celah, rumah sakitAbstractBackground: Periodical diagnostic tool calibration is essential for accurate diagnosis. Health Facilities Research (Rifaskes) in 2011 collected data on the slit-lamp calibration of all registered general hospitals in Indonesia.Methods: Analysis using a part Rifaskes 2011 data among 442 hospitals that provide eye health services. Relative risk was used to assess the risk of performing calibration slit lamp.Results: Out of 442 hospitals, 248 hospitals met the inclusion study criteria, and only 25.8% calibrating the slit-lamp on schedule. Ownership and type of hospital were the dominant factors on the risk of not performing on schedule slit- lamp calibration. Compared to hospital owned by government public company, the hospitals owned by the other institution had higher risk did not calibrate their slit-lamp. In term of hospital type, nonteaching hospital compared with teaching hospital had 40% higher risk did not calibrate their slit-lamp [adjusted relative risk [adjusted relative risk (RRa) = 1.40; 95% confidence interval (CI) = 1.02-1.91].Conclusion: On schedule slit-lamp calibration was still a problem in most of hospitals. Compared to hospital owned by government public company, the hospitals owned by the other institution had higher risk did not calibrate their slit-lamp. (Health Science Indones 2012;2:xx-xx)Key words:calibration, slit-lamp, hospital</p

KAJIAN INDUCED PLURIPOTENT STEMCELL (iPS) (HARAPAN DAN TANTANGAN)

AbstractInduced Pluripotent Stemcell (iPS) are adult cells which the genetic information in the nucleus of those cells being reprogrammed (reprogram) by inserting exogenous pluripotential genes. The exogenous gene transduction is using vectors, such as lentivirus, retrovirus, or adenovirus, which suppressed the gene expression of the original cells, so they will express the transduced exogenous gene. Viral vectors are then used to reprogramming and producing iPS clones that are pluripotent. iPS derived from adult cells of patient with certain diseases will be used as a tool to study the mechanisms of those specific diseases and the effects of selected drugs against the diseases. Several previous studies have shown that iPS clones developed from specific genetic disease have its original genotype and retain the character of the response to the drug that similar as the original adult cells. Opportunities for the utilization of autologous iPS cell therapy in the future is wide open as expected iPS transplant will not be rejected when transplanted back to the patient. Behind all its potential, iPS production is still facing some problems to be applicable clinically. The use of viruses as vectors may cause problems due to virus gene sequences may be integrated into the genome of the DNA donor cell, thereby causing mutations of the iPS clones. Several subsequent studies have succeeded in replacing the use of viruses as vectors, but the level of efficiency obtained is still very low. Another problem that arises is that epigenetic changes may occur in iPS cultures. Many advanced research related to iPS may be developed in Indonesia and is necessary to improve the production efficiency of iPS and solve iPS clones epigenetic changes problems in the future.Keywords: iPS, pluripotency, transduction, transfection.AbstrakInduced Pluripotent Stemcell (iPS) adalah sel somatic dewasa yang informasi genetika dalam inti selnyadiprogram ulang (reprogram) dengan cara memasukkan gen-gen eksogen yang memberikan ciri pluripotensial. Transduksi gen eksogen ini menggunakan vektor, seperti lentivirus, retrovirus, atau adenovirus, yang ditekan ekspresi gen aslinya, sehingga akan mengekspresikan sel eksogen yang ditransduksikan.Virus vektor tersebut selanjutnya digunakan untuk reprogram dan membuat klon iPS yang bersifat pluripoten. Sel dewasa yang akan dijadikan iPS diambil dari penderita penyakit tertentu dan selanjutnya klon iPS dapat dimanfaatkan sebagai alat untuk mempelajari mekanisme terjadinya penyakit dan efek obat terpilih terhadap penyakit tersebut. Beberapa penelitian terdahulu telah membuktikanbahwa kloni PS yang dikembangkan dari penderita penyakit genetik tertentu tetap memiliki karakter genotip dan respon terhadap obat yang sama dengan sel dewasa asalnya. Peluang pemanfaatan iPS otologus untuk terapi sel dimasa mendatang terbuka lebar karena diperkirakan iPS tidak akan mengalami proses rejeksi saat ditransplantasikan kembali kepada penderita yang bersangkutan. Dibalik segala potensinya, iPS masih memiliki beberapa kekurangan untuk diaplikasikan secara klinis. Penggunaan virus sebagai vektor dapat menimbulkan masalah karena sekuens gen virus mungkin berintegrasi dengan genom DNA sel donor, sehingga akan menyebabkan risiko terjadinya mutasipada klon iPS yang dihasilkan. Beberapa penelitian selanjutnya berhasil mengganti penggunaan virus sebagai vektor, namun tingkat efisiensi yang didapat masih sangat rendah. Masalah lain yang timbul adalah perubahan epigenetik yang dapat terjadi pada kultur iPS.Banyak penelitian lanjutan terkait iPS yang dapat dikembangkan di Indonesia dan sangat diperlukan untuk meningkatkan efisiensi produksi iPS dan mengatasi masalah perubahan epigenetik klon iPS dimasa mendatang.Kata Kunci: iPS, pluripotensi, transduksi, transfeksi