Vol. 25 No. 3, Page 105-147

July 1, 2006

Number of pre-treatment seizure as prognostic factor of convulsive epilepsy in childhood and young adult onset

By Rizaldy Pinzon*, Harsono**, dan Imam Rusdi**

        Epilepsy is one of the most common neurological disorders with complex problem. The role of number of pre-treatment seizure is not conclusive yet. A historical cohort design was conducted to evaluate the role of number of pre-treatment seizure as predictive factor of remission. The subjects were epilepsy patients with onset 2-25 years old with convulsive seizure manifestation that at least had taken medication for 2 years. This study included 110 epilepsy patients, consisted of 42.7% male and 57.3% female. Six months remission with 2 years medication were achieved in 86 patients (78.2%). The significant predictive factors for not achieving 6 months remission are seizure type, number of pre treatment seizure, and the presence of neurological deficit. Twelve months remission were only achieved by 48 patients (43.6%). The significant predictive factors for not achieving 12 months remission were high number of pre-treatment seizure, the presence of neurological deficit, and the incompliance of treatment program. The average numbers of breakthrough seizure were significantly higher in patients with high number of pre treatment seizure, presence of neurological deficit, partial type of epilepsy, and non-compliance patients. Most epilepsy patient achieved 6 months remission with treatment, but only about half of them achieved 12 months remission. High number of pre treatment seizure was significant poor predictive factors for achieving remission. The strongest poor prognostic factors were the presence of neurological deficit.

Language : English

Hypoglycemic effect of mahkota dewa mesocarp fruit (Phaleria macrocarpa (Scheff.) Boerl) on glucose blood level in glucose loading healthy volunteers

By Meiyanti*, Hedi R. Dewoto**, dan Fransiscus D. Suyatna**

            Several studied in experimental animals showed that Phaleria macrocarpa fruit reduced the blood glucose levels, but there is no information about experimental study in human. The objective of this study was to evaluate the effect of Phaleria macrocarpa fruit powder on blood glucose levels in glucose loading healthy volunteers, and to determine its effective dose. The study was a sequential experimental design and autocontrol. Fifteen healthy volunteers were induced hyperglycemic by oral 75 gram glucose to measure the blood glucose levels at baseline. They were re-induced by glucose together with 250, 500 and 1000 mg MD. In order to examine the response, blood glucose levels were observed in 0 minute, and 15, 30, 60, 120, 180, 240 minutes after being induced by glucose only and by glucose + MD. Subsequently, the area under the curve of blood glucose level aligned with 4 hour time axis (AUC0-4 hour) was calculated. The results showed that the AUC value was not significantly decreased (3,81 ± 8,87%) in volunteers receiving MD mesocarp fruit powder of 250 mg, whereas it was decreased significantly (14,32 ± 9,91%, p<0,05) in volunteers receiving MD of 500 mg. It was concluded that MD mesocarp fruit powder of 500 mg reduced blood glucose level in healthy volunteers.

Language : Indonesia

Effect of aerobic exercise on serum estradiol in postmenopausal women: a 12-weeks randomized controlled trial

By Martiem Mawi*, Reza Tandean**, Jemmy Hermawan*, Maria R. Rahmawati***,

            Elevated circulating estrogens and sedentary lifestyle increase risk for breast cancer. Sedentary behavior is modifiable although the effect of increasing physical activity on breast cancer biomarkers is unknown The objective of this study was to examine the effects of a 12-weeks exercise intervention on serum estradiol. A randomized controlled trial was conducted in 42 postmenopausal women ages was 50-71 years, not using hormone therapy, living in East Jakarta , and willing to randomly assigned in an exercise intervention or control group. The exercise presciption consisted of at least 25 minutes moderate-intensity exercise using Monarch ergocycle, 3 times per week for 12 weeks. The heart rate during exercise was 60% of maximal heart rate with maximal weight of 1kp. At baseline, the intervention and control groups were similar with regards to demographic characteristics, duration of menopause and serum estradiol concentration. After 12 weeks aerobic exercise, the concentration of estradiol in the exercise group (11.59 ± 3.87 pg/ml) decreased significantly compared to the control group (16.75 ± 6.83 pg/ml) (p=0.004). The exercise group experienced 54.9% decline in estradiol at 12 weeks. A-12 weeks moderate exercise intervention in postmenopausal women resulted in significant decreases in serum estradiol concentration.

Language : Indonesia

The relationship between maternal blood zinc level and the size of newborn baby

By Widagdo*, Harmon Mawardi* , Firda Fairuza*, Meiharty B. Zulkifli**,

        The high incidence of low birth weight is the major problem in Indonesia. The effects of zinc to fetal growth were reported with different results. The objective of this study is to investigate the relationship between maternal zinc level and the newborn size. A cross-sectional design was conducted involving the parturient at Budhi Asih Hospital, Jakarta. Serum zinc level (mmol/L) was measured with Cobas Mira Plus Colorimeter (1997) using 5-BR-PAPS. Eighty-eight mothers attending the hospital seeking for delivery assistance were enrolled into the study. This study showed that the serum zinc level of mothers was 8.96 ± 7.45 μ mol / L (range 0.15 - 53.22 μ mol/L) and 48% of them had the level < 8.15 μ mol/L. The weight of the newborn was 3064 ± 450 g and incidence of LBW was 9.3%. There correlation between maternal zinc with newborn size (birth weight, height and head circumference) was not significant (p >0.05). The evidence of preterm and low birth weight babies each in low and normal zinc were also not significant (p>0.05). This study documented a limited role of zinc on newborn size.

Language : English

Diagnosis and management of hand-arm vibration syndrome in workers who use vibrating tools

By Diana Samara

            Epidemiologie studies showed that extensive, long-lasting exposure to manual work involving the use of vibrating power tools has been associated with persistent hand function disturbances. A disorders of the peripheral microcirculation, cold induced Raynauds’s phenomenon or vibration white fingers and neurological disorders in the peripheral nervous system are summarized collectively as hand-arm vibration syndrome (HAVS). The burden of HAVS is underreported, and the syndrome is often misdiagnosed as carpal tunnel syndrome. It is important to distinguish the two syndromes , however since some surgeries that are effective with carpal tunnel syndrome do not alleviate HAVS. Diagnosis is based on history of exposure to hand or arm vibration and sensorineural or vascular symptoms. Treatment includes physiobanneotherapy, medications (vasodilator, calcium channel blockers, pentoxyphylline), nerve blocking, and surgical interventions. The most important way to improve the health of HAVS is efforts to prevent the origin of the syndrome. There are four main-prevention for HAVS: i) job modification to reduce vibration exposure, ii) health evaluation, iii) life style of working, and iv) education for workers. If we do not prevent those injuries and have no strategies for dealing with new injury manifestations, so the risk for next days is to meet more cases of HAVS.

Language : Indonesia

Nutrition and immune system in the elderly

By Rina K. Kusumaratna

The number of individuals aged 60 years or older is projected to double as a proportion of the world’s population and to more than triple in number over the next 50 years. Aging is often associated with a dysregulation in immune function, particularly in T-cell responses, even in the healthy elderly. Adequate nutrition is important for optimal immune function. Specific nutrient deficiencies can aggravate the age-associated dysfunction in immune function and increase the risk of illness. Several micronutrients such as iron, zinc, and selenium are essential to specific and non-specific immune function and thus influence the susceptibility of the elderly to infectious diseases. Free radicals and oxidative stress have been recognized as important factors in the biology of aging and of many age-associated degenerative diseases. Therefore, dietary components with antioxidant activity have received particular attention because of their potential role in modulating oxidative stress associated with aging and chronic conditions. The nutritional deficiency impairs the immune response, exposure to viral pathogens, and will result in an increase in the severity of diseases. Nutritional deficiency in the elderly must be treated to reduce the risk of infection and possibly slow the aging process.

Language : English