Vol. 26 No. 1, Page 1-56

January 1, 2007

Detection and resistance of Mycobacterium tuberculosis on rifampicin using nested polymerase chain reaction and sequencing method

By Maria Lina Rosilawati

Background
The rpob (RNA polymerase sub unit b) DNA of Mycobacterim tuberculosis can be specifically amplified by using a nested PCR. The nested PCR linked to DNA sequencing was applied directly to detect M. tuberculosis and determine the rpob gene mutation related with the rifampicin resistance either in clinical isolates or sputa.

Methods
Samples used in this research were 20 clinical isolates and 30 sputa which were amplified with the region of rpob DNA of M. tuberculosis. DNA of clinical isolates and sputum samples were extracted by means of fenol-kloroform and Boom’s methods, respectively. Sequencing method was only applied for sputum samples.

Results
Of 20 clinical isolates, 15 isolates were positive for M. tuberculosis with nested PCR, 4 isolates were Mycobacteria other than tuberculosis (MOTT) and 1 isolate was non-Mycobacteria. The nested PCR could detect 21 sputum samples of 30 samples consisted of 25 samples with positif acid fast bacilli (AFB) and 5 samples with negative AFB. First-round and second-round PCR products were 205 bp and 157 bp, respectively.

Conclusion
Nested PCR in the sequencing was more sensitive and specific to detect M. tuberculosis and it resistance to rifampicin.

Language : Indonesia

Comparison between high density lipoprotein, lipoprotein(a) and small dense low lipoprotein as a risk marker of coronary heart disease

By Adi Priyana

Background
Coronary heart disease (CHD) is still the primary cause of death in Indonesia and most industrialized countries. Atherosclerosis is the most common cause of CHD. The conventional risk factor for atherosclerosis and CHD are diabetes mellitus, hypertension, dyslipidemia and smoking. On the other hand, Lp(a) and small dense LDL (sd-LDL) have been considered as novel risk factors for CHD. High density lipoprotein (HDL) cholesterol (HDL-c), as part of dyslipidemia, has been considered as independent risk factor for CHD. The principal objective of the present study was to compare between HDL-c, Lp(a) and sdl LDL as a risk marker of CHD.

Methods
The study subject were divided into two groups, risk group consist of 94 subjects who had ³ 2 CHD risk factors and control group recruited 49 subject who had no CHD risk factors. Both groups had fasted for 10-12 hours before their sera were collected. The sera were examined for HDL-c, Lp(a) and sd-LDL. Three alternative multivariate models were compared sd-LDL, sd-HDL + HDL-c, and sd-LDL, HDL-c + Lp(a).

Results
Result of this study showed that the sd-LDL had the most significant and accurate as risk marker for CHD. Lp(a) and HDL-c were less accurate if used as risk marker for CHD compare with sd-LDL.

Conclusions
Small dense LDL is an accurate risk marker for CHD. Further study must be done using larger sample size of CHD subjects with similar age between risk and control groups.

Language : Indonesia

Prevalence of diabetes mellitus and the relationship with quality of life of older people in the community

By Rita Khairani

 Background
Diabetes mellitus (DM) is a common condition associated with greater risks of illness and death. Elderly who suffered from DM will also has other disease such as physical disability, psycho-social disorder and cognitive function disorder, it is also increase the admission to hospital. Finally, the complication of DM will influence the quality of life in elderly. The study objective was to obtain data of DM prevalence and the association with quality of life in older people.

Methods
A cross-sectional study was done in 101 older people by a structured interview, physical examination, anthropometry, blood glucose measurement, and quality of life based on WHOQOL-BREF.

Results
This study showed that domain 4 (environment) has the highest score (14.1 ± 1.8) and domain 2 (psychological) has the lowest score (12.9 ± 1.9). Men has the higher score than women in domain 1 (physical health) and domain 3 (social relationship). The prevalence of DM was 15.8% and has found in age group of 60-70 year old and women has higher prevalence than men. Mean score of domain 4 (environment) was significantly higher in older people thas has no DM compare with older people with DM. Mean score of domain 1 (physical health) was significantly higher in older people with obesity. The higher score of body mas index will increase domain 1 (physical health) significantly and the higher score of fasting blood glucose levels will decrease domain 4 (environment) significantly.

Conclusions
High blood glucose levels decreased quality of life of the elderly. Interventions for older adults with DM could be designed to improve the quality of life of the elderly.

Language : Indonesia

Validity and reliability of World Health Organization Quality of Life -BREF to assess the quality of life in the elderly

By Oktavianus Ch. Salim, Novia I.S., Rina K.Kusumaratna, dan Adi Hidayat

Background
The population of elder people are increasing and life expectancy has been extended due to improved public health services and medical interventions. Because increased life expectancy in the elderly has been assured, it is important to improve their quality of life (QOL). In measuring QOL, the World Health Organization (WHO) has developed the WHO Quality of Life–BREF (WHOQOL-BREF). The WHOQOL-BREF was developed in the context of four domains of QOL: physical, psychological, social and environmental. The objective of this study was to evaluate the validity and reliability of the WHOQOL-BREF to assess the QOL in the elderly.

Methods
A cross-sectional design was conducted in Mampang Sub-district, South Jakarta. During 2 months (October and November 2005) assessment, 306 elderly (age ³60 years, mobile, well communication and not in terminal condition) agreed to participate in the study. Information on age, gender, education, marriage status, and quality of life were collected by ten trained interviewers.

Results
This study showed that the score distribution in each domain of the WHOQOL-BREF was symmetrical with no floor or ceiling effect. Furthermore, all domain scores indicated excellent discriminant validity, construct validity, and good internal consistency. Nevertheless, two items related to negative feelings and sexual activity had a weak correlation with psychological and social domain. The two items may need to modify to avoid misunderstanding for older people.

Conclusion
With few modification the WHOQOL-BREF assessment was valid and reliable for measuring QOL in the elderly.

Language : Indonesia

Risperidone for the treatment for disruptive behaviors in autistic disorder: a critical appraisal

By Rizaldy Pinzon, Lucas Meliala, Sri Sutarni

Autism is a clinical syndrome characterized by qualitative impairment of social interaction, verbal and nonverbal communication, imaginative activity, and a markedly restricted repertoire of activities and interests. No specific treatment is available that alters the course of the illness. The pharmacological treatments are used for decreasing aggressiveness, obsessive-compulsive behaviors and self-stimulating behaviors. This review showed that risperidone seems to be effective and well tolerated for the treatment of tantrums, aggression, or self-injurious behavior in children with autistic disorder. Risperidone did not significantly change their deficit in social interaction and communication. Further research is necessary to develop effective treatments for the core social and communicative impairments of autism. The encouraging efficacy outcomes achieved with this agent offer new hope for the management of behavioral symptoms exhibited by children with autism.

Language : Indonesia

Global aspects of antimicrobial – resistance of enteric bacterial

By Yenny dan Elly Herwana

Bacterial resistance to antimicrobial agents is a global public health problem and becoming important in the treatment of enteric infections. In developing countries, resistance to the first-line drugs has been observed among the enteric pathogens due to the uncontrolled usage of antimicrobial agents. In some cases, the level of resistance has forced a change to more expensive second or third-line drugs. Resistance has emerged even to newer and more potent antimicrobial agents which caused economic burden and multiple resistance. In many developing countries, few data are available on the prevalence of antimicrobial resistance. The lack of laboratory facilities are major constrains to the development of effective surveillance. To maintain the useful life of antimicrobial drugs, especially in developing countries, there needs to be improved access to diagnostic laboratories, improved surveillance of the emergence of resistance, better regulation of the use of antimicrobial and better education of the public.

Language : Indonesia