Vol. 25 No. 1, Page 1-52

January 1, 2006

Inhibition effect of zinc sulfate on growth of Shigella spp.

By Elly Herwana*, Julius E. Surjawidjaja**, Murad Lesmana**, dan Adi Hidayat***

Shigella is increasingly recognized as an important enteric pathogen causing diarrhea. The incidence of shigellosis is highest in developing countries where standard of living and sanitary conditions are usually poor. Over the years, Shigella spp. have developed resistance to most antimicrobial agents used for treatment of diarrhea. We conducted an in vitro study to evaluate the inhibition effect of zinc sulfate on Shigella spp. The study shows that of 135 Shigella isolates tested, 60-80% were inhibited by zinc sulfate at concentration of 1.4 mg/ml. At this concentration of zinc sulfate, 80% of S. dysenteriae, 77.5% of S. flexneri, 83.4% of S. sonnei and 66.7% of S. boydii, were inhibited. While S. dysenteriae and S. boydii were completely inhibited at the concentration of zinc sulfate 1.6 mg/ml, S. flexneri and S. sonnei required a higher concentration of zinc sulfate for a complete inhibition, which was 2 mg/ml. However, the majority of S. flexneri (88.8%) and S. sonnei (93.7%) have been inhibited by zinc sulfate at concentration of 1.6 mg/ml. This study also shows that among the Shigella species, S. dysenteriae was the most sensitive to zinc sulfate with 70% inhibition at zinc sulfate concentration of 1.2 mg/ml. Therefore further study needed to evaluate the effect of zinc sulfate as an adjuvant of antibiotic therapy in diarrhea patients since many Shigella spp. have shown multi-resistance to antibiotics.

Language : Indonesia

Serotype distribution and antibiotic resistance pattern of nontyphoid Salmonella in Jakarta

By Murad Lesmana*, Julius E. Surjawidjaja*, Elly Herwana**,

Salmonellosis is an important medical problem worldwide. Although infection with nontyphoid Salmonella often causes mild self-limited illness, serious sequelae including death may occur, especially in immunocompromised hosts. A study to detect nontyphoid Salmonella species in diarrheal patients was conducted involving 1810 rectal swab samples examined from February 2002 through August 2004. A number of 135 (7.5%) samples were positive for Salmonella. Salmonella ser. Typhimurium and Salmonella ser. Enteritidis were found most frequent among the patients with an isolation rate of 29.6% and 23.1%, respectively. Antimicrobial susceptibility test which included 8 antibiotics showed low (4%) to moderate (39%) number of the microorganisms resistant to nalidixic acid, ampicillin, trimethoprim-sulfamethoxazole, tetracycline and chloramphenicol. Although the majority of Salmonella isolates were still susceptible to ciprofloxacin and norfloxacin, the emergence of a small number of resistance of Salmonella ser. Typhimurium resistant to norfloxacin (1.0%) and to ceftriaxone (9.0%) was noted. In conclusion of this study showed that Salmonella spp. is the frequent cause of diarrheal disease.

Language : Indonesia

Small dense low density lipoprotein as a risk factor of atherosclerosis

By Pusparini

            Some epidemiological studies showed that low density lipoprotein (LDL) cholesterol is the most important risk factor for atherosclerosis and LDL cholesterol remains the primary target of therapy for the prevention of coronary heart disease (CHD). CHD often occurs in subject with normal LDL cholesterol levels. In such patients, serum triglyceride, is now considered to be an important factor in the disease. Increasing triglyceride levels was associated with decreasing LDL size. LDL particles have variety in size, density and chemistry component. LDL cholesterol pattern has divided into phenotype A and phenotype B. Phenotype B was the phenotype called an atherogenic lipoprotein phenotype. Association between phenotype and small dense LDL showed greater significant if we estimate age, sex and obesity. About 30-44% adult men have been reported to have Phenotype B LDL, although in men aged under 20 year and menopause women the prevalency are about 5-10% The prevalency in post menopause women are about 15-25%. Information on LDL diameter may inprove the ability to predict CHD risk accurately over traditional lipid variables.

Language : Indonesia

Knee height as a predictor for stature in the elderly

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

In the year of 2025, Indonesia will be the one of the five countries with the highest number of the elderly people in the world after China, India, USA and Mexico. Height and body weight are two anthropometric measures frequently used to determine nutritional status. Height of an elderly person is not always obtained; it may be systematically biased due to skeletal compression. Knee height has been recommended by the World Health of Organization to estimate the stature in the elderly. Chumlea et al had developed equations to estimate the stature of elderly Caucasian subjects using knee height. However, the ability of such equations to successfully predict stature in other ethnic groups seems questionable. The purpose of this study was to validate the use of the Caucasian equations in predicting stature and to develop ethnic-specific regression models for stature in Indonesian elderly. A cross sectional study was conducted with 116 elderly women and 34 men to validate the use of Caucasian model equations. One hundred ninety two elderly women and 84 men were included to formulate ethnicity specific equations in one sub-district in South Jakarta. This study showed that the measured of stature predicted by the Caucasian-based equation were significantly different in elderly women but not in men. New regression models are being developed to predict the stature of elderly using knee height.

Language : Indonesia

Pain management in the elderly

By Suharko Kasran* dan Rina K. Kusumaratna**

Pain is a common complain of elderly who visits a physician. Ineffective pain management can have a significant impact on the quality of life of the elderly. Assessment of pain in older adults requires special attention and strategies to assure accurate information is collected. Given that there are no objective biologic markers for pain, the patient report is crucial for assessing pain parameters (intensity, duration, chronicity) and identifying potential sources or causes. The World Health Organization pain management ladder advocates initiating conservatively and gradually in treating pain for the elderly. Acetaminophen, nonsteroidal anti-inflammatory drugs (NSAIDs), cyclo-oxygenase 2 (COX-2) specific NSAIDs are the most commonly used first-line analgesics therapies for management of pain. Weak opioids such as codeine and tramadol are used for moderate to severe pain. Opiods such as oxycodone and morphine are effectively relieves pain in patient with severe pain. Adjuvant medications are often used to treat chronic pain in older adults. Steroids, anticonvulsants, topical local anesthetics, and antidepressant are adjuvant agents. Non-pharmacologic interventions should be incorporated to treat pain whenever possible. Cognitive behavioral therapy effective in reducing pain. Good care for the elderly involves proper diagnosis of chronic pain syndrome, and the initiation of appropriate pharmacologic and non-pharmacologic therapy.

Language : Indonesia

Aflatoxin and aflatoxicosis in human

By Yenny

        Aflatoxin is the most potent toxic substance and has been recognized as a cause of liver cancer. It can also cause other additional toxic effects. The four major aflatoxin are called B1, B2, G1 dan G2. Aflatoxin B1 is the most potent natural carcinogen and is usually the major aflatoxin produced by toxigenic strains.Chronic exposure to aflatoxin compromises immunity and interferes with protein metabolism and multiple micronutrients that are critical to health. It was estimated that approximately 4.5 billions persons living in developing countries are chronically exposed to largely uncontrolled amounts of the toxin. Aflatoxin affects human immunity and nutritional status. There is a reasonable probability that the 6 top WHO risk factors [which account for 43,6% of the disability-adjusted life years (DALYs)]are modulated by aflatoxin. Outbreaks of acute aflatoxicosis have reported from countries in Africa and Asia and caused high morbidity and mortality. Preventing exposure to aflatoxin in developing countries has been achieved by regulation that have required low concentration of the toxin in traded foods and with chemoprotection, enterosorption to minimize biological exposure.

Language : Indonesia