Vol. 28 No. 3, Page 133-204

December 1, 2009

Duration of rhegmatogenous retinal detachment predicts recovery of retinal sensitivity

By Rose

The decision to treat a disease is often based on the presence or absence of symptoms, one prototype case being rhegmatogenous retinal detachment. Detachment of the neural retina from the pigment epithelium is a major cause of anatomical and functional dysfunction of the retina, where retinal recovery is inversely related to duration of detachment. The purpose of retinal reattachment is to effect recovery of the photoreceptors and pigment epithelium from degeneration. The aim of this study was to determine the critical duration of rhegmatogenous retinal detachment resulting in optimal retinal recovery after reattachment. A prospective study was conducted at a private hospital in Yogyakarta. Thirty five eyes were involved in this study. Three months after reattachment, central retinal recovery was measured by means of a Goldmann manual kinetic perimeter. The results showed that retinal recovery developed three months after surgery if the onset of rhegmatogenous retinal detachment was less than 28 days before surgery. The results were not significant if the onset of rhegmatogenous retinal detachment was more than 35 days. Although the Goldmann manual kinetic perimeter can efficiently detect central retinal sensitivity, it should be supported by more sensitive tools to evaluate the anatomy and function of the retina. Keywords: Duration, rhegmatogenous retinal detachment, reattachment surgery, retinal sensitivity
Language : English

Hepatic enzyme concentrations as indicators of nonalcoholic fatty lever disease

By Alvina

Nonalcoholic fatty liver disease (NAFLD) has emerged as a world-wide problem because it runs an asymptomatic course, ultimately leading to cirrhosis of the liver and portal hypertension, resulting in death. The prevalence of the disease accounts for 3-24% of the population in several countries. Generally there are increased concentrations of hepatic enzymes as markers of liver damage, such as serum glutamic oxaloacetic transaminase (SGOT), serum glutamic pyruvic transaminase (SGPT) and gamma glutamyl transferase (GGT). The aim of the present study was to determine the concentrations of hepatic enzymes as markers of NAFLD. The study design was cross-sectional, involving 90 subjects meeting the inclusion and exclusion criteria. The degree of severity NAFLD was determined by ultrasonography and the concentrations of SGOT, SGPT and GGT by automated clinical chemistry analyzer. The results indicated that there were 32 subjects with mild NAFLD (35.6%), 35 subjects with moderate NAFLD (38.9%) and 23 subjects with severe NAFLD (25.6%). There was a significant difference in degree of NAFLD by gender (p<0><0.05). The conclusion is that SGOT, SGPT and GGT concentrations are indicators of degree of NAFLD. Keywords: Nonalcoholic fatty liver disease, liver enzyme concentrations, ultrasonography
Language : English

Body mass index as predictor of carpal tunnel syndrome among garment workers

By Lie T Meriyanti S

Of the nerve entrapment syndromes the most well-known is the carpal tunnel syndrome (CTS) involving the median nerve. In the field of occupational medicine this condition is categorized as an occupational disease, for which industrial workers may claim compensation if the CTS occurs as a consequence of their job. However, although several occupational risk factors have been suggested as causing the development of CTS, a definitive role of work activities as the central cause of CTS is unclear. The aim of the present study was to evaluate both non-occupational and occupational factors associated with CTS in garment home-industry workers. A cross-sectional study was performed from April to June 2008 in the garment home industry in North Jakarta. A total of 99 workers, consisting of 45 males and 54 females were included in this study. Historical data were obtained from a self-administered detailed questionnaire, while anthropometric and provocative median nerve test variables were measured directly. The results showed that body mass index (BMI) was a significant predictor of CTS in male workers (p=0.031), while the risk of CTS was three-fold higher in female workers using hormonal contraceptives (Prevalence Ratio/PR = 3.3 ; 95% Confidence of Interval/CI = 1.0 – 10.5). In conclusion it appears that BMI and hormonal contraceptive use were CTS predictors. Keywords: Carpal tunnel syndrome, garment home industry, body mass index, hormonal contraceptive
Language : English

Anemia decreases quality of life of the elderly in Jakarta

By Meiyanti, Joice Viladelvia Kalumpiu and Julius I Mulia

Anemia is a very common disorder both in clinical practice and in the community. The recent rise in the population of the elderly has become the focus of attention in developing countries, because of the increasing longevity of the elderly, whilst the prevalence of anemia increases with age. The objective of this study was to determine the prevalence of anemia and its association with the quality of life in the elderly. A cross-sectional study was conducted from April to June 2008, located in the Mampang Prapatan district, South Jakarta. A total of 298 elderly persons participated in this study, comprising 109 (36.6%) males and 189 (63.4%) females. Anemia was measured by the parameters of hemoglobin and quality of life was assessed by the WHOQOL-BREF instrument, a short version of the WHOQOL-100 instrument. The results of the study showed the prevalence of anemia to be 26.2%, with a higher prevalence rate in females compared with males. The quality of life in the physical, psychological, social and environmental domains differed significantly with decreasing hemoglobin levels, whereas the physical and mental quality of life declined significantly with age. Anemia is thus indicative of a reduction in the quality of life of the elderly. Keywords: Anemia, elderly, quality of life
Language : English

Cataract surgical coverage rate among adults aged 40 years and older

By Lusianawaty Tana

Cataract is a leading cause of curable blindness. Hence, in its global declaration of ‘Vision 2020 Right to Sight’, the World Health Organization (WHO) encouraged its member countries to address the problem of incident cataract. Many factors are related to the cataract surgical coverage rate, such as gender and diabetes mellitus. The objective of this study was to determine the cataract surgical coverage rate and investigate the determinants factors of cataract surgical coverage rate among adults 40 years old and above with cataract. A cross sectional study was conducted using National Basic Health Research (Riskesdas) 2007 data. Cataract surgery was defined as surgery conducted within the last 12 months before the survey was performed. There were 6939 subjects (3105 male, 3834 female) who fulfilled the study criteria. The cataract surgical coverage rate was 19.3%. The cataract surgical coverage rate was lower in subjects with low education, in the group of farmers/fishermen/laborers, in the 40-49 years age group, in rural areas, and in subjects of low socioeconomic status (p<0>0.05). Determinants that were related to cataract surgical coverage rate were age, type of area of residence, socioeconomic status, and region of residence (p<0.001). The implementation of educational programs and reforms to local ophthalmic health services may improve the cataract surgical coverage rate. Keywords: Coverage rate, cataract surgery, health services accessibility
Language : English

Manual handling as risk factor of low back pain among workers

By Ridwan Harrianto, Diana Samara, Purnamawati Tjhin and Magdalena Wartono

Disorders of the musculoskeletal system constitute a considerable health problem in industrialized societies. Low back pain (LBP) remains a common and costly problem among the workers. Workplace injuries, primarily musculoskeletal disorders, are a persistent problem for nursing. A cross-sectional study was conducted to investigate prevalence of LBP as well as the potential risk factors associated with LBP. These potential risk factors include individual characteristics, job duration, type of work, and manual handling knowledge and practice. Seventy-six subjects consisting of 30 nurses and 46 administrative workers were recruited into the study. Symptoms of LBP cases were assessed by means of a simple questionnaire, and the diagnosis of LBP was confirmed by clinical examination. The study showed that the overall point prevalence rate of LBP was 42.1%, while the overall 12-month prevalence rate was 69.7%. Occupational group and manual handling practice were independent predictors for point prevalence of LBP. Nursing occupation significantly increased the risk of point prevalence rate of LBP by 2.703 (95% C.I. OR 1.046 – 6.984) compared to administrative workers. Nurses with frequent manual handling practice had a 2.917-fold higher risk of developing a point prevalence of LBP, although this risk was statistically not significant (OR=2.917;95% C.I. 0.094-3.003). The study indicates that an association exists between manual handling practice and LBP prevalence. Keywords: Low back pain, manual material handling, working pattern
Language : English

Pterygium: degeneration, exuberant wound healing or benign neoplasm?

By Nurbuanto Tradjutrisno

Pterygium is a condition characterized by the encroachment of a fleshy triangle of conjunctival tissue into the cornea. Despite various studies, the pathogenesis of pterygium remains unclear. Chronic exposure to sun is the only factor of which the role has been clearly documented by epidemiologic and in vitro studies. Recent studies have provided data such as loss of heterozygosity and microsatellite instability, decreased apoptosis, increased growth factors, increased p53 expression, telomerase activity, and presence of oncogenic viruses, which support the concept that pterygia can be considered a neoplastic condition. Some of results are contradictory and some features were only found in a proportion of pterygia; this may be due to differences in methodology and study population, but may also be indicative of multiple causative factors. This implies that the pterygium should be viewed as a final common outcome of various etiological factors, such as geography and ethnicity, with ultraviolet radiation-induced damage as the main factor. Thus the pterygium remains an enigma, having the features of an exuberant growth but also those of a benign neoplasm. In this connection there is a need for a unifying theory capable of explaining all of the characteristics of the pterygium. Keywords: Pterygium, apoptosis, growth, neoplasm
Language : English

Pharmacokinetic interactions between rifampicin and efavirenz in HIV-TB coinfections

By Yenny

The increased percentage of patients with HIV-TB coinfection leads to inevitable interactions between rifampicin and efavirenz. Efavirenz is a potent non-nucleoside reverse transcriptase inhibitor (NNRTI) for the treatment of HIV infection. The use of this drug combination with rifampicin causes problems in determination of the optimal dosage of efavirenz when administered concomitantly with rifampicin. Efavirenz is metabolized by the enzyme cytochrome P-450 (CYP), i.e. the CYP2B6 and CYP3A4 isozymes, of which rifampicin is an inducer. The induction of cytochrome P-450 by rifampicin is mediated by pregnane X (PXR) and constitutive androstane receptors (CAR) in the cell nucleus, resulting in a wide variation in the plasma efavirenz concentrations, such that a therapeutic failure or the occurrence of toxic effects are to be expected. The optimal dosage of efavirenz is commonly determined through pharmacokinetic studies, but this is problematic in the combined use of the drug with rifampicin, due to the wide variation in study design, method, and sample size of each study. Ethnic factors and genetic polymorphism of the enzymes that metabolize efavirenz contribute to the problem of determining the optimal dose of this drug. Pharmacokinetic studies with good measurement parameters and methods are still necessary as the basis for determining the optimal dose of efavirenz in the Indonesian population. Keywords: Drug interaction, efavirenz, rifampicin, HIV, TB
Language : English