Berbagai Keluhan Fisik yang Dialami Pasien Osteoartritis Akibat Terapi Natrium Diklofenak Dibandingkan Kurkuminoid Ekstrak Rimpang Kunyit

Background: The prevalence of osteoarthritis (OA) in the community is high and this disease is the second largest cause of physical disability in the world. Degeneration and joint inflammation occurred in OA. Curcuminoid is a secondary metabolite present in the rhyzome of turmeric and ginger. Curcuminoid could be used to treat rheumatic diseases. Diclofenac sodium is able to inhibite the production of prostaglandin-E2 (PG-E2) by inhibition the cycloxygenase-2 (COX-2) activity. On the other hand diclofenac sodium also inhibite the physiologic enzyme cycloxygenase-l (COX-I) activity, this inhibition may produce some complaints to the patients since the COX-l is important in body equilibrium. Objective: To assess some complaints of patients with osteoarthritis in treatment using curcuminoid from Curcuma domestica Val. rhyzome extract compared to diclofenac sodium. Method: This study was conducted with the prospective randomized open end blinded evaluation (PROBE) design. A total of 80 patients with knee osteoarthritis were included in this study (39 patients received 3x30 mg daily of curcuminoid from Curcuma domestica Val. rhyzome extract for 28 days treatment and 41 patients received 3x25 mg daily of diclofenac sodium for 28 days). The number needed to harm analysis was conducted in comparing the symptoms of head, chest, gastrointestinal and urinary tract complaints. Results: The number needed to harm (NNH) for headache was 500, palpitation was 42, shortness of breath was 42, nausea was 21, diarrhea was 42 and micturition complaints was 500. Conclusion: Although the number of patient who have chest and gastrointestinal complaints was higher in using diclofenac sodium, but no statistically significant difference either of head, chest, gastrointestinal and urinary tract complaints between the curcuminoid and diclofenac sodium treatment groups

Pengaruh Terapi Kurkuminoid Ekstrak Rimpang Kunyit Dibandingkan dengan Natrium Diklofenak terhadap Fungsi Ginjal Penderita Osteoartritis

Background: Osteoarthritis is a joint disease most often found in the community. Patients with osteoarthritis are frequently drink non steroidal anti inflammatory drugs such diclofenac sodium. Data has shown too many side effects of diclofenac sodium especially to the kidney function. A research data in Malang shows that people who use herbs were 476 persons in city area and 580 persons in distric area per thousand patients with arthritis. Curcuma domestica Val. is one of Asia's native plants used to make herbal medicine mainly used to reduce inflammation. The purpose of this study was to assess the safety of curcuminoid from Curcuma domestica Val. rhizome extract compared to diclofenac sodium to the kidney function of patients with osteoarthritis. Methods: This was a prospective randomized open and blinded evaluation (PROBE) study. Subjects with knee osteoarthritis were divided randomly into two groups: the group who received 30 mg 3 times daily of curcuminoid from Curcuma domestica Val rhizome extrac (curcuminoid group) and group who received 25 mg 3 times daily of diclofenac sodium (diclofenac group). Assessment of results including serum blood urea nitrogen (BUN) and creatinine level was performed before and after 4 weeks period of treatment. Data analysis compared the change of those levels in each group during the treatment period by student t test analysis. Results: In the curcuminoid group there was no significant decrease of serum BUN level (p=0.52) and there was a significant decrease of serum creatinine level (p=0.03). In the diclofenac group there was a significant increase of serum BUN level (p<0.01) and no significant increase of serum creatinine level (p=0.39). Increasing the serum level of BUN and creatinine in diclofenac group were significantly different compared to decreasing of those level in the curcuminoid group with p=0.01 and p=0.03 respectively. Conclusion: Treatment with Curcuminoid from Curcuma domestica Val. rhizome extract was significantly decreased the serum BUN and creatinin level compared to those increased level in diclofenac sodium treatment

Investigating Aggressive Driving Behavior in Reducing Traffic Congestion on Bandung City

. Traffic congestion reflects waste of time and energy that must be eliminated. Many methods have been employed by past studies to solve this problem. The approach utilized by those studies is mostly macroscopic that consider vehicles and drivers in aggregate. This study argues that a more microscopic approach is also required to depict and solve the congestion problem. Hence, agent-based simulation is brought forward to help identify the cause of congestion problem. In this study, drivers are assumed to have their own motives that might drive them to resort to aggressive behaviors that ultimately lead to traffic congestion. As a preliminary investigation, this study aims to discover type of aggressive driving behavior on Bandung City. The results demonstrate that aggressive dirivng behaviors on Bandung City can be categorized into five factors namely improper speed, inattentiveness, display of hostility, impatience, and disobedience of traffic sign/signals. This study also found that different composition of driving behaviors leads to different degree of congestion. Impatience behavior is found to be the factor that must be eliminate to remedy congestion on Bandung City

CD4, CD8 and MHC Class I Expression in Epstein-Barr Virus-Associated Nasopharyngeal Carcinoma: An Immunohistochemical Study

Aim: The exact immunopathogenesis of Epstein-Barr virus (EBV)- associated nasopharyngeal carcinoma (NPC) remains unclear. The aim of the present study was to assess the expression of CD4, CD8, and MHC class I molecules in NPC. Method: Biopsies were obtained from patients with NPC as well as the Epstein Barr virus (EBV)-seronegative patients as a control. Nasopharyngeal carcinoma patients were classified using the World Health Organization (WHO) pathological assessment and clinical stag- ing of NPC. The expression of CD4, CD8, and MHC class I in the biop- sies were assessed immunohistochemically. Result: The results showed that the number of CD4 positive, CD8 pos- itive, and MHC class I positive cells in NPC patients were higher than those in EBV-negative subjects (p<0.05). The number of these positive cells in NPC patients with WHO Type II or early clinical stage was not significantly differences with those with WHO Type III or late clinical stage, respectively (p>0.05). No statistical differences between the number of CD4 positive and CD8 positive cells in NPC patients could be found (p>0.05). Conclusion: The results of the present study suggest, therefore, that the expression of CD4, CD8 and MHC class I molecules may not be as- sociated with the pathologic classification and clinical staging of NPC and that the CD4:CD8 ratio in nasopharyngeal carcinoma may indicate decreased functions of these infiltrating T cell subsets. Key words: CD4; CD8; MHC class I; NP

Pertumbuhan Jamur, Sifat Organoleptik dan Aktivitas Antioksidan Tempe Kedelai Hitam yang Diproduksi dengan Berbagai Jenis Inokulum

Kualitas tempe dipengaruhi oleh bahan baku, proses pengolahan dan jenis inokulum yang digunakan. Kedelai hitamdapat digunakan sebagai bahan baku pembuatan tempe yang mempunyai kualitas seperti halnya tempe yang terbuat dari kedelai kuning. Penelitian ini bertujuan untuk mengetahui pengaruh jenis inokulum dan lama inkubasi terhadap pertumbuhan jamu, sifat organoleptik dan aktivitas antioksidan tempe kedelai hitam. Penelitian ini menggunakan kedelai hitam varietas mallika sebagai bahan baku pembuatan tempe. Kedelai hitam yang telah dibuang kulitnya, direndam dan dikukus kemudian dicampur dengan inokulum yang berasal dari biakan murni Rhizopus stolonifer, R. oligosporus dan R. oryzae. Setelah itu diinkubasi selama 24, 30, 36 dan 42 jam pada suhu 25-27 oC. Parameter yang diamati adalah pertumbuhan jamur, sifat organoleptik dan aktivitas antioksidan tempe kedelai hitam. Hasil penelitian menunjukkan perlakuan jenis inokulum dan lama inkubasi berpengaruh terhadap pertumbuhan jamur, sifat organoleptik dan aktivtas antioksidan. Pertumbuhan jamur meningkat sampai lama inkubasi 36 jam, kemudian turun. Panelis memberikan nilai tertinggi pada tempe yang diinkubasi selama 36 jam. Ada kecenderungan lama inkubasi tempe meningkat aktivitas antioksidannya. Kesimpulan dari penelitian ini Rhizopus stolonifer mempunyai karakteristik relatif lebih tinggi pertumbuhan jamur, sifat organoleptik dan aktivitas antioksidan dibandingkan jenis jamur yang lain pada lama inkubasi 30 jam

Pengaruh Implantasi Subkutan Logam Kobalt Kromium Sebagai Bahan Alternatif Mini Screw Orthodontics Terhadap Reaksi Jaringan Kelinci Albino

Mini screw orthodontics merupakan alat yang digunakan dalam perawatan ortodonsia untuk kasus yang membutuhkan absolute anchorage. Mini screw yang tersedia terbuat dari logam nikel titanium atau stainless steel yang pada beberapa pasien menyebabkan reaksi pada jaringan. Uji implantasi adalah uji yang dilakukan untuk menentukan biokompatibilitas medical device yang berkontak langsung dengan jaringan hidup. Respon jaringan terhadap jejas pasca implantasimempengaruhi derajat pembentukan jaringan granulasi, reaksi benda asing, dan fibrosis. Penelitian ini bertujuan untuk mengetahui efek lokal implantasi kobalt kromium sebagai alternatif bahan mini screw orthodontics terhadap jaringan subkutan kelinci albino. Subjek penelitian berupa 20 ekor kelinci jantan albino yang digunakan untuk 2 kelompok(perlakuan dan kontrol negatif). Kobalt kromium dibuat lempengan diameter 10 mm dan ketebalan 1 mm. Pada kelompok perlakuan, material diimplankan pada jaringan subkutan dorsum kelinci dengan insisi sampai terbentuk poket subkutan, dasar poket tidak lebih dari 10 mm dari garis awal insisi dan dilakukan suturing. Kelompok kontrol hanya dilakukanincisi kemudian disuturing. Secara makroskopis 24 jam pasca implantasi, daerah implan diamati terjadinya edema, hematoma, enkapsulasi dan tanda-tanda inflamasi. Evaluasi secara mikroskopis pada hari ke 14 pasca implantasi, diamati Perubahan histopatologis infiltrasi sel-sel inflamasi, kemudian rerata hasil diuji dengan uji independent samplet-test untuk mengetahui apakah ada perbedaan jumlah sel-sel inflamasi pada kelompok perlakuan dan kontrol. Hasil pengamatan makroskopis, kelompok perlakuan maupun kontrol hanya terlihat tanda inflamasi ringan berupa eritema. Rerata dan Simpangan baku jumlah PMN, limfosit, sel plasma, makrofag, giant cell, neovaskularisasi, fibrosis kobalt kromium dan kontrol berturut turut yaitu (0,6 ± 0,49; 0,7 ± 0,48); (0,9 ± 0,87; 1,0 ± 0,67); (0,6 ± 0,24; 0,6 ± 0,21); (1,4 ± 0,84; 0,9 ± 0,74); (0,5 ± 0,27; 0); (0,6 ± 0,33; 0,7 ± 0,48); (0,5 ± 0,27; 0,1 ± 0,02). Hasil t-test menunjukkan perbedaan yang tidak signifikan (p>0,05) pada 6 parameter inflamasi sedangkan parameter giant cell menunjukkan perbedaan yang signifikan (p0.05). The conclusion of this study is that the cobalt chromium alloy can affect the subcutaneous tissue by inducing giant cell infiltration on day 14 post-implantation as the result of foreign body reactions

Studi Kasus; “Koreksi Terhadap Pengukuran Polutan Di Udara Unit Perajin Logam Dan Dampaknya Terhadap Kesehatan”

Understanding on the reaction of various air pollutants until today continues to grow, even it is hard to find information about the results of the reaction of various air pollutants standard. The aim of the research was to analyze and to correct of the the various air pollutants as well as to determine the health impact of blacksmith in 2014. The samples consisted of 38 blacksmith from 38 working units in Hulu Sungai Selatan of South Kalimantan. Analytical approach of the examination of air pollutants, blood samples and pulmonary functions of selected workers was applied in this study. The results showed a decrease in lung function and abnormalization workers immune response, as a result of exposure to various air pollutants. It is very difficult to determine and predict the causality of air pollution and health impact since there must be various factors contributing to the the health impact. because it is caused by pollutants singly or may be caused from the various reactions of these pollutants, for that, the correction need on the measurement and analysis of air pollutants that made so far, including its impact on the human body. The benefit of this research as a form of correction to use the Threshold Limit Value (TLV) and measurement of air pollutants, including the impact of the target organ in the human body

Ability of Curcuminoid from Curcuma domestica Val. in Reducing the Secretion of Reactive Oxygen Intermediates by Synovial Fluid Monocytes in Patients with Osteoarthritis

Increasing the secretion of reactive oxygen intermediates (ROI) by monocytes in the synovial fluid is an indicator to determine the severity of joint inflammation. Previous studies have shown that curcumin inhibit the osteoarthritis progression with its ability to inhibite the activity of the nitric oxide synthase (NOS) enzyme from macrophages. In this prospective randomized open end blinded evaluations = PROBE study, 80 patients with knee osteoarthritis were eligable. The subject were devided in to two group: group who received 3 x 30 mg of curcuminoid from Curcuma domestica Val. extract (curcuminoid group) and group who received 3 x 25 mg of diclofenac sodium (diclofenac group) as comparison. The treatment was for 4 weeks time. The secretion of ROI by sinovial fluid monocytes was calculated by scoring the amount of formazan formation after neutral red staining in nitrobleu tetrazolium reduction assay. The result of this study showed that the secretion of ROI by synovial fluid monocytes was significantly decreased in both groups (p <0.001) respectively. There was no significant difference in decreasing of ROI secretion of synovial fluid monocytes between both treatment groups (p = 0.92)

Faktor HLA-DRB pada Penderita Tuberkulosis Paru dengan Pengobatan Strategi DOTS

HLA-DRB factor in pulmonal tuberculosis with DOTS strategic treatmentBackground: Tuberculosis remains one of the world's greatest public health problems, especially in developing countries. In Indonesia the results of DOTS strategic treatment and conversion have not been fruitful results. Many factors play important roles in the success of DOTS strategic treatment, but a little attention was given to the immuno genetics aspects. This study was aimed at theassociation between HLA-DRB factors and clinical output on DOTS strategic treatment (after first 2 months of treatment):conversion of sputum smear positive.Method: A nested case control study was carried out. The exposure variables were alleles of HLA-DRB (result of PCR examination), while the independent variables were sputum smear positive and negative (result of laboratories examination with Ziehl Neelsen staining, Niacin test). Body mass index (BMI) and sex were confounding variables. Odds ratio (OR) was calculated using bivariate and logistic regression for multivariate analysis.Result: A total sample of 73 new patients with active tuberculosis (sputum smear positive) in developing treatment with DOTS strategic treatment, consist of 34 cases and 39 controls. The odds ratio (OR) of HLA-DRB1*1502 and HLA-DRB5*01 were 3.2 (95%CI: 1.103-9.287). The OR of HLA-DRB1*1201 was 0.305 (95% CI: 0.117-0.798), OR of HLA-DRB3*01 was 0.214 (95% CI: 0.077- 0.592). The PAR (population attributable rate) of HLA-DRB1*1502 and HLA-DRB%*01 were 42.64%. While confounding variables were analyzed, only allele HLA-DRB1*1502 was significant, OR 4.9 (95% CI: 1.234-15.617), the probability was 70.57%.Conclusion: HLA-DRB1*1502 is an allele is a risk factor for the conversion of sputum smear positive after 2 months of treatment

Evaluasi Komplikasi Plate Exposure Pasca Reseksi Amelobl Astoma Mandibula Dengan Rekonstruksi Pelat Titanium Di Rsup Dr. Sardjito YOGYAKARTA

Resection of the jaw is a primary option of treatment in mandibular ameloblastoma with bone damage. Mandibular resection will cause mandibular stability disturbance due toloss of some part of the bone. Instability of the mandible can cause aesthetic, physiological, and psychological malfunctioning. To restore its stability, installment of mandibular reconstruction plate on the remaining mandibular by using screws. However, it is not uncommon that plate exposure occurs following mandibular reconstruction, caused by inaccurate adaptation of the plates to the mandibular bone. A 3D stereolithography modelcan help provide the best assesment on the bone defect, plan the making of the more easily pre-operative curved plates and provide more accurate faster surgery time. Objective: To evaluate plate exposure after mandibular resection with titanium reconstruction plates in Dr. SardjitoHospital. Case report: A case was reported on mandibular reconstruction after resection of ameloblastoma with titanium plate performed in Dr. Sardjito Hospital that experienced intra-oral plate exposure and oro-cutaneous fistula on the left mandible. The clinical evaluation showed the curved titanium plate did not adapt well with the remaining mandibular bone; therefore, the titanium plate was removed without replacing it with a new plate. Inappropriate adaptationof curved titanium plate is one of the main causes of plate exposure. The use of a 3D stereolithography model is very helpful for the success of mandibular reconstruction