"Organofosfat adalah pestisida yang sering dipakai di Indonesia. Penggunaan Pestisida organofosfat yang tidak tepat dapat mengakibatkan gangguan fungsi paru restriksi pada petani padi. Tujuan penelitian ini adalah untuk mengetahui aktivitas enzim asetilkolinesterase dalam sel darah merah, prevalensi gangguan fungsi paru pada petani padi, dan hubungan asetilkolinesterase dalam sel darah merah dengan gangguan fungsi paru.Desain penelitian adalah potong lintang dengan besar sampel 61 orang petani padi yang terpajan organofosfat yang diambil dengan cara cluster random sampling. Penelitian dilakukan pada bulan Oktober 2017 hingga Desember 2017 di Desa Padaasih, Kecamatan Cibogo, Kabupaten Subang, Provinsi Jawa Barat. Pengumpulan data dilakukan dengan wawancara, pemeriksaan aktivitas enzim asetilkolinesterase dalam sel darah merah, pemeriksaan spirometri dan pemeriksaan foto thoraks. Variabel yang diteliti adalah usia, masa kerja, eksposure rate, IMT, kebiasaan merokok, persepsi pemakaian APD pernapasan, dan aktivitas enzim aseltilkolinesterase dalam sel darah merah.Aktivitas AChE dalam sel darah merah dengan nilai tengah 2138.97 IU/l dengan nilai minimum 201.17 IU/l dan nilai maksimum 6979.35 IU/l. Prevalensi gangguan fungsi paru restriksi adalah 18%. Tidak terdapat variabel faktor risiko yang memiliki hubungan bermakna dengan gangguan fungsi paru restriksi.Prevalensi gangguan fungsi paru restriksi cukup tinggi dan tidak terdapat hubungan yang bermakna antara aktivitas enzim asetilkolinesterase dalam sel darah merah dengan gangguan fungsi paru. Perlu dilakukan pemeriksaan kesehatan berkala terutama bagi petani dengan gangguan fungsi paru.

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Organophosphates are commonly used pesticides in Indonesia. The use of improper organophosphoric pesticides can lead to impaired lung function in rice farmers. The purpose of this study was to know the activity of acetylcholinesterase enzyme in red blood cells, the prevalence of impaired lung function in rice farmers, and the association of acetylcholinesterase in red blood cells with lung function.The study design was cross sectional, 61 rice farmers who were exposed to organophosphates were taken by cluster random sampling. The study was conducted in October 2017 to December 2017 in Padaasih Village, Cibogo Sub-district, Subang District, West Java. Data collection was done by interview, examination of enzyme acetylcholinesterase in red blood cells, spirometry examination and examination of thoracic photo. The variables studied were age, years of work, exposure rate, BMI, smoking habit, perception of using respiratory PPE, and activity of aseltylcholinesterase in red blood cells.AChE activity in red blood cells with a median value of 2138.97 IU/l with a minimum value of 201.17 IU/l and a maximum value of 6979.35 IU/l. The prevalence of restrictive lung function is 18%. There were no risk factors that had significant association with restrictive lung function.The prevalence of restrictive lung function impairment is quite high and the activity of acetylcholinesterase in red blood cells with restrictive lung function has no significant association. Periodic health checks are necessary, especially for farmers with restrictive lung function."

"Latar Belakang: Organofosfat (OP) merupakan pestisida yang paling banyak digunakan di dunia. Sebagai substansi kimia, zat ini memiliki efek toksik bagi manusia yang terpapar. Salah satu dampak OP adalah penurunan fungsi kognitif. Berdasarkan penelitian Bosma, et al, prevalensi gangguan kognitif ringan pada pekerja yang terpapar pestisida adalah 35%. Di Indonesia, penelitian dari Dewi RM menunjukkan bahwa 39,1% petani jeruk yang terpapar pestisida mengalami gangguan kognitif ringan. Sampai saat ini belum ada penelitian di Indonesia yang mengukur efek samping pestisida pada petani bunga. Padahal, penggunaan pestisida pada tanaman bunga diperkirakan lebih besar dibandingkan komoditas lain, sehingga risiko dan dampak paparan pada petani pun menjadi lebih besar. Tujuan penelitian ini adalah untuk mengetahui hubungan asetilkolinesterase (AChE) dalam sel darah merah terhadap fungsi kognitif pada petani bunga laki-laki penyemprot pestisida. Metode: Desain potong lintang dengan besar sampel 40 orang. Penelitian dilakukan di Kecamatan Parongpong, Kabupaten Bandung Barat. Pengambilan sampel menggunakan consecutive sampling dengan instrumen wawancara, MMSE, dan pemeriksaan AChE eritrosit. Hasil: Aktivitas AChE dalam sel darah merah memiliki median 4599.06 (1760-6828). Prevalensi penurunan fungsi kognitif pada petani bunga laki-laki penyemprot pestisida mencapai 75%. Tidak terdapat hubungan antara AChE sel darah merah terhadap fungsi kognitif (p=0,87). Namun, terdapat hubungan yang bermakna antara variabel masa kerja (p=0,007), tingkat pendidikan (p=0,001), komposisi pestisida (p=0,014), dan exposure rate (p<0,001) terhadap fungsi kognitif. Tidak ada perbedaan bermakna antara perbandingan rerata AChE pada kelompok yang mengalami penurunan fungsi kognitif dan kelompok yang normal (OR=1 dengan 95% CI 0,2-4,1). Kesimpulan Saran: Prevalensi penurunan fungsi kognitif pada petani bunga laki-laki yang terpajan pestisida OP cukup tinggi (75%). Penelitian ini menunjukkan ada hubungan yang bermakna antara fungsi kognitif responden dengan faktor risiko okupasi, terutama dalam hal masa kerja. Untuk mencegah terjadinya dampak penggunaan pestisida yang lebih berat, perlu adanya program pengendalian bagi petani pengguna pestisida serta pengawasan pada produsen pestisida.

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Background: Organophosphate (OP) is the most widely used pesticide in the world. As a chemical substance, this substance has toxic effects for humans who are exposed. One of the effects of OP is a decline in cognitive function. Based on the research of Bosma, et al, the prevalence of mild cognitive impairment in workers exposed to pesticides is 35%. In Indonesia, research from Dewi RM shows that 39.1% of citrus farmers exposed to pesticides experience mild cognitive impairment. Until now there has been no research in Indonesia that measures the side effects of pesticides on cut-flower farmers. In fact, the use of pesticides in flower plants is estimated to be greater than other commodities, so that the risk and impact of exposure on farmers becomes even greater. The purpose of this study was to determine the relationship of acetylcholinesterase (AChE) in red blood cells to cognitive function in male cut-flower farmers spraying pesticides.

Method: Cross-sectional design with a sample size of 40 people. The study was conducted in Parongpong District, West Bandung Regency. Sampling using consecutive sampling with interview instruments, MMSE, and erythrocyte AChE examination. Results. AChE activity in red blood cells has a median of 4599.06 (1760-6828). The prevalence of cognitive decline in male cut-flower farmers spraying pesticides reaches 75%. There was no relationship between red blood cell AChE and cognitive function (p = 0.87). However, there was a significant relationship between variables of years of work (p = 0.007), level of education (p = 0.001), pesticide composition (p = 0.014), and exposure rate (p <0.001) on cognitive function. There was no significant difference between the average comparison of AChE in the group that experienced a decline in cognitive function and the normal group (OR = 1 with 95% CI 0.2-4.1).

Conclusion and Suggestions: The prevalence of cognitive impairment in male cut-flower farmers exposed to OP pesticides is quite high (75%). This study shows that there is a significant relationship between the cognitive function of the respondents with occupational risk factors, especially in terms of years of work. To prevent the impact of the use of pesticides, it is necessary to have a control program for farmers using pesticides and supervision of pesticide producers."

"ABSTRAKPajanan pestisida organofosfat terhadap mata dapat melalui pernafasan, pencernaan, absorbsi melalui kulit dan pajanan langsung pada mata. Efek toksik organofosfat akut yang utama pada mata adalah konstriksi pupil (miosis) melalui mekanisme menghambat aktivitas enzim kolinesterase di neuromuscular junction. Penelitian ini bertujuan untuk mengetahui hubungan penurunan diameter pupil dengan persentase penurunan aktivitas asetilkolinesterase plasma sesudah pajanan organofosfat pada petani penyemprot padi laki-laki. Penelitian ini menggunakan disain cross sectional dengan dua kali pengukuran sebelum dan sesudah penyemprotan pestisida di Desa X, Jawa Barat. Pengambilan sampel menggunakan metode cluster random sampling pada tingkat RT. Pengumpulan data dilakukan dengan wawancara menggunakan kuesioner, pemeriksaan fisis, pemriksaan darah dan pengamatan cara kerja. Pemeriksaan diameter pupil dan AChE plasma dilakukan sebelum dan sesudah penyemprotan. Dari 72 responden penelitian sebesar 64 responden (88,89%) mengalami penurunan diameter pupil baik secara unilateral maupun bilateral sesudah melakukan penyemprotan pestisida organofosfat. Nilai median perubahan aktivitas AChE plasma adalah 2,2 % dengan nilai minimum -4,26% dan maksimum 9,75%. Penurunan diameter pupil dan penurunan aktivitas asetilkolinesterase plasma secara statistik bermakna (paired t-test; p<0,001). Tidak ditemukan hubungan bermakna antara penurunan diameter pupil dengan persentase perubahan aktivitas asetilkolinesterase plasma (p=0,052). Pada penelitian ini tidak ditemukan hubungan antara penurunan diameter pupil dengan persentase perubahan asetilkolinesterase plasma dan faktor resiko lainnya seperti usia, IMT, masa kerja dan lama waktu penyemprotan pestisida. "

"ABSTRAKNama : Eval HeriansyahProgram Studi : S2 Magister Kedokteran KerjaJudul : Hubungan Perubahan Akut Gambaran EKG Dengan Penurunan Aktivitas Asetilkolinesterase Plasma Pada Petani Penyemprot Laki-Laki Yang Menggunakan OrganofosfatPembimbing : Astrid Sulistomo dan Budhi SetiantoLatar Belakang. Petani di Indonesia masih banyak menggunakan pestisida golongan organofosfat. Organofosfat memiliki efek toksik terhadap berbagai sistem tubuh, salah satunya sistem kardiovaskuler. Pestisida organofosfat yang masuk ke dalam tubuh manusia memengaruhi fungsi saraf dengan jalan menghambat kerja enzim kolinesterase. Penelitian ini bertujuan untuk mengetahui hubungan perubahan akut gambaran EKG sebelum dan sesudah pajanan organofosfat pada petani penyemprot padi laki-laki.Metode. Penelitian ini menggunakan disain potong lintang dengan rancangan pre- dan post-test tanpa kontrol di desa Pada Asih, Kecamatan Cibogo, Kabupaten Subang dengan cara pengambilan sampel menggunakan cluster random sampling. Pengumpulan data dilakukan dengan wawancara menggunakan kuesioner, pemeriksaan fisis, dan pengamatan cara kerja. Pemeriksaan AChE dan EKG dilakukan sebelum dan sesudah penyemprotanHasil. Dari 80 subjek petani penyemprot padi, 20 subjek 25 mengalami perubahan gambaran EKG sesudah melakukan penyemprotan pestisida organofosfat. Jenis perubahannya, berupa sinus bradikardia 6,25 , pemanjangan interval QT 3,75 , peninggian gelombang T 2,5 , dan pembesaran atrium kiri 12,5 . Penurunan aktivitas AChE ditemukan rata-rata -2,29 3,25 . Tidak ditemukan hubungan bermakna antara semua faktor risiko yang diteliti usia, persentase perubahan AChE, merokok saat menyemprot, status gizi, penggunaan APD, masa kerja, lama penyemprotan, dan tugas kerja dengan perubahan gambaran EKG.Kesimpulan. Perubahan akut gambaran EKG yang terjadi pada populasi petani penyemprot padi laki-laki sebesar 25 . Perubahan aktivitas asetilkolinesterase terjadi berkisar -2,29 3,25 . Tidak ditemukan faktor risiko yang berhubungan.Kata kunci. Elektrokardiografi, asetilkolinesterase, petani, pestisida, organofosfat.

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ABSTRACTABSTRACTName Eval HeriansyahProgram Master of Occupational MedicineTitle Acute ECG Changes Associated with Decreased Plasma Acetylcholinesterase Activity Among Male Pesticide Spraying Farmers using OrganophosphateCounselors Astrid Sulistomo and Budhi SetiantoBackground. Many farmers in Indonesia are still using organophosphorus pesticides. Organophosphates have toxic effects on various body systems, one of them is the cardiovascular system. Organophosphate pesticides that enter the human body affect the function of the nerves by inhibiting the action of cholinesterase enzymes. This study aims to determine the relationship of acute changes of ECG images before and after exposure of organophosphates among male paddy sprayers.Method. This study used cross sectional with pre and post test design without control in Pada Asih Village, Cibogo Sub district, Subang Regency. Using cluster random sampling method for sample selection. Data were collected using questionnaires, physical examination, and observation of working process. Acetylcholinesterase and EKG examination was conducted before and after spraying,Results. From 80 rice spray farmers recruited, a total of 20 subjects 25 showed changes in ECG picture after spraying with organophosphorus pesticides. The types of changes include bradycardia sinus 6.25 , QT interval lengthening 3.75 , heightening of T wave 2.5 , and left atrial enlargement 12.5 . Decrease in activity of AChE was 2,29 3,25 . No significant association between changes in ECG graph and studied risk factors age, percentage of plasma AChE changes, smoking while spray, BMI, using PPE, working period, duration of spray, and work assignment could be identified.Conclusion. Acute change in ECG picture occurred in 25 of male pesticide spraying farmers. Changes in AChE were 2,29 3,25 . No association with studied risk factors could be found."

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A B S T R A K

Nama	:  Helmi Rosa Gunadi
Program Studi	:  S-2 Magister Kedokteran Kerja
Judul	: Hubungan  Pemanjangan  Waktu  Reaksi  dengan  Persentase  Penurun   Aktivitas  Asetilkolinesterse   Plasma   Sesudah  Pajanan  Organofosfat   pada Petani Penyemprot Padi Laki-Laki.
Pembimbing	: Astrid Sulistomo dan  Joedo Prihartono

 

 

Latar Belakang. Pestisida golongan organofosfat masih menjadi pilihan bagi sebagian besar petani di Indonesia untuk meningkatkan produktivitas hasil tanamnya, namun di lain pihak organofosfat memiliki efek toksik terhadap berbagai sistem tubuh, salah satunya adalah sistem syaraf. Pestisida organofosfat yang masuk kedalam tubuh kemudian mempengaruhi kerja enzim kolinesetrase. Penelitian ini bertujuan untk mengetahui korelasi antara pemanjangan waktu reaksi dengan persentase penurunan aktivitas asetilkolinesterase plasma pada petani padi laki-laki penyemprot padi yang terpajan organofosfat.

 

Metode. Penelitian ini menggunakan gabungan dua jenis disain yakni kohort tanpa pembanding untuk menilai perubahan kedua waktu reaksi dan aktivitas asetilkolinesterase plasma. Sedangkan korelasi di antara kedua variabel tersebut dilakukan secara potong lintang. Penelitian dilaksanakan di desa “PA”, Kabupaten Subang dengan cara cluster random sampling. Pengumpulan data dilakukan dengan wawancara menggunakan kuesioner, pemeriksaan fisis, dan pengamatan cara kerja. Pemeriksaan AchE plasma dan waktu reaksi dilakukan sebelum dan sesudah aktivitas penyemprotan.

 

Hasil. Dari 65 responden petani penyemprot padi, 64 responden (98,46%) mengalami pemanjangan waktu reaksi suara serta 62 responden (95,4%) mengalami pemanjangan  waktu reaksi cahaya sesudah melakukan penyemprotan pestisida organofosfat. Median persentase penurunan aktivitas AchE plasma adalah 3,41 (0,22 – 9,75)%. Terdapat perbedaan yang bermakna terhadap perubahan AchE Plasma sebelum dan sesudah pajanan organofosfat. Tidak terdapat korelasi antara pemanjangan kedua waktu reaksi dengan persentase perubahan aktivitas asetilkolinesetrase plasma sebelum dan sesudah pajanan organofosfat dan tidak ditemukan hubungan bermakna antara pemanjangan waktu reaksi suara dan pemanjangan waktu reaksi cahaya dengan semua faktor resiko yang diteliti (usia, persentase penurunan AchE plasma, merokok pada saat menyemprot, status gizi, penggunaan APD pada saat menyemprot, durasi lama menyemprot, dan tugas kerja)

 

Kesimpulan. Tidak terdapat korelasi antara persentase penurunan aktivitas AchE Plasma dengan pemanjangan kedua waktu reaksi, dan tidak ditemukan fakto resiko yang berhubungan.

 

Kata kunci. Waktu Reaksi, Asetilkolinesterase, Petani, Pestisida, Organofosfat.

 

 

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A B S T R A C T

Name	:  Helmi Rosa Gunadi
Program	:  Master of Occupational Medicine
Judul	:  Prolonged of  Reaction  Time and Percentage Acethylcholinesestrase     Plasma  Activity   Decrease After Organophosphate Exposure Among   Male Rice Farmer.
Pembimbing	: Astrid Sulistomo and Joedo Prihartono

 

 

Background. Organophosphate pesticides are still the only option for most farmers in Indonesia to increase the productivity of their crops, but on the other hand organophosphates have toxic effects on various body systems, one of which is the nervous system. Organophosphate pesticides that enter the body, will inhibit the action of cholinesterase enzymes. This study aims to determine the correlation of prolonged reaction time with the percentage of acetylcholinesterase plasma activity decrease among rice farmers after exposure of organophosphat.

Method. The study using a combination of two types of design, that is cohort without comparison to asses both of the reaction time and acethylcholinesterase plasma activity, while the correlation between the two variables using crosssectional. The subjects worked as usual without  any intervention during this study. Samples were selected using cluster random sampling method at the neighbourhood association level. Data were collected using questionnaires, physical examination, blood examination and observation of working process. Acetylcholinesterase measurement and Time Reaction examination was conducted before and after spraying. Data analysis was performed using SPSS Statistic 20.0 statistic program.

 

Results. From 65 rice spray recruited, a total 64 subject (98,46%) showed prolonged sound  reaction time and 62 subject (95,4%) had prolonged light reaction time after spraying with organophosphate pesticide. There is significant difference between changes of AchE plasma before and after organofosfat exposure. There is no correlation between both of delayed reaction time with the percentage activity decrease of AchE plasma. Decrease in activity of AchE was 3,41 (0,22-9,75)%.  No significant association was found  between prolonged reaction time and  percentage decrease of plasma AchE and other studied risk factors (age, smoking while spraying, BMI, and duration of spray).

 

Conclusion. There was no correlation between prolonged time reaction with percentage of activity plasm acethylcholinesterase decrease among male rice farmer after exposure to organophosphate.

 

Keywords: Reaction time, acethylcholinesterse, farmer, pesticide, organophosphates

 

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"Latar belakang: Produktivitas pertanian yang tinggi di Kabupaten Brebes berpotensi untuk menimbulkan berbagai gangguan kesehatan akibat pestisida pada pekerja tani. Beberapa penelitian sebelumnya pada lokasi yang sama menunjukan bahwa terdapat beberapa efek kesehatan, baik akut maupun kronis yang dialami pekerja tani akibat pajanan pestisida. Tujuan: Penelitian ini bertujuan untuk mengetahui gambaran golongan pestisida yang banyak digunakan, aktivitas enzim kolinesterase darah, gejala gangguan saraf, dan gejala gangguan kulit serta hubungannya dengan faktor lama pajanan dan karakteristik individu. Metodologi: Penelitian ini dilakukan di Kecamatan Kersana, Kabupaten Brebes. Sampel merupakan petani dan buruh tani pada lima desa di Kecamatan Kersana yang berjumlah 121 responden. Pengambilan sampel dilakukan dengan metode quota sampling. Data dikumpulkan melalui wawancara terstruktur, pengukuran status gizi, dan pengukuran enzim kolinesterase darah. Hasil: Penelitian ini menunjukan bahwa pestisida yang paling banyak digunakan adalah golongan piretroid dan avermektin (26%). Terdapat hubungan yang signifikan antara jumlah gejala gangguan saraf dengan lama pajanan per minggu (p=0,015). Hubungan yang signifikan juga terdapat antara jumlah gejala gangguan kulit yang dialami dengan faktor lama bekerja (p=0,045), lama pajanan per minggu (p=0,005), umur (p=0,002), jenis kelamin (p=0,044), dan kebiasaaan cuci tangan setelah bekerja dengan pestisida (p=0,000). Kesimpulan: Pestisida yang paling banyak digunakan adalah golongan piretroid dan avermektin. Terdapat hubungan yang bermakna antara jumlah gejala gangguan saraf dengan lama pajanan per minggu. Hubungan yang signifikan juga terdapat antara jumlah gejala gangguan kulit yang dialami dengan faktor lama bekerja, lama pajanan per minggu, umur, jenis kelamin, dan kebiasaaan cuci tangan setelah bekerja dengan pestisida.

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Backgrounds: Brebes Region is one of various region which has high productivity in agricultural products, so this region has a potency for any health effects due to pesticide exposure. Several studies have shown that many health effects has occured in agirucultural workers in Brebes.

Objectives: This research’s objectives are knowing the groups of pesticide that commonly used, red blood cell cholinesterase activity, symtomps of neurological and skin disorders and their associatons with length of exposure and individual characteristics.

Methods: This research is located on Kersana sub-District, Brebes District, Central Java. Samples are farmers and fam labourers who live in five village on Kersana District. The number of samples is 121 persons. Quota sampling methods hava chosen by researchers to collect the samples. Data collecting was done by structured-interview, cholinesterase measurement, and nutritional status measurement.

Results: The result has shown that pesticide group which commonly used are phyretroid and avermectin. There is an significant association between the number of neurological disorders and length of exposure in week (p=0,015). There are also significant association between the number of skin disorders with working periods (p=0,045), length of exposure in week (p=0,005), age (p=0,002), gender (p=0,044), and hand-washing behaviours after working with pesticides (p=0,000).

Conclusions: Pesticide group which commonly used are phyretroid and avermectin. There is an significant association between the number of neurological disorders and length of exposure in week. There are also significant association between the number of skin disorders with working periods, length of exposure in week, age, gender, and hand-washing behaviours after working with pesticides."

"[ABSTRAKLatar belakang. Pemberian transfusi darah merupakan salah satu tindakan medis untuk penyelamatan nyawa (live saving) dan penyembuhan penyakit, tetapi disisi lain tindakan ini juga memiliki risiko atau komplikasi. Salah satu komplikasiyang dikenal adalah Transfusion-Associated Graft-vs-Host Disease (TAGVHD). TAGVHD ini akan menyebabkan berproliferasinya limfosit T yangkemudian akan diikuti oleh proses engraft (tertanam) didalam tubuh resipien yang umumnya berada dalam kondisi imunokompeten. Kondisi ini umumnya dialami oleh pasien-pasien dengan gangguan sistem imunologi seperti pada pasien kanker atau penyakit-penyakit autoimun. Saat ini, satu ? satunya metode yang dapat diterima untuk mencegah komplikasi itu dengan cara melakukan iradiasi darah. Bervariasinya rekomendasi tentang dosis iradiasi dan waktu penyinaran untukmenurunkan jumlah CD 3+ dan CD 4+ sebagai penyebab terjadinya TAGVHD, menjadi latar belakang dilakukannya penelitian ini. Hasil penelitian ini akan dijadikan rekomendasi untuk prosedur iradiasi terhadap komponen sel darah merah pekatyang akan diberikan pada pasien-pasien imunokompeten di RS Kanker Dharmais Jakarta.Metodologi. Penelitian ini menggunakan disain penelitian eksperimental dengan pemeriksaan time series yang dilakukan terhadap 54 kantong komponen sel darah merah pekat yang memenuhi kriteria inklusi dan ekslusi yang ditetapkan oleh peneliti. Dilakukan pengujian terhadap jumlah CD 3+ dan CD 4+ dalam tiga dosis dengan tiga serial waktu berbeda.Hasil. Terjadi penurunan jumlah CD 3+ dan CD 4+ pada komponen sel darah merah pekat yang dilakukan iradiasi pada dosis iradiasi dan waktu penyinaran yang berbeda.Simpulan. Penurunan jumlah CD 3+ bermakna atau signifikan pada dosis 2500 pada waktu 5 jam setelah penyinaran.

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ABSTRACTBackground Blood transfusion is a medical treatment for a life saving and cure the disease On the other hand these treatment also have risks or complications one of which is known with Transfusion Associated Graft vs Host Disease TAGVHD This will cause proliferation T lymphocytes and then will be followed by a process engraft embedded in the recipient 39 s body is in a state of immunocompetent This condition is commonly experienced by patients with impaired immunological systems such as cancer patients or autoimmune diseases Currently one the only acceptable method to prevent such complications by way of blood irradiation Variations recommendation on irradiation dose and exposure time in reducing the amount of CD 3 and CD 4 which is the cause of the TAGVHD be doing background research The results of this study will be a recommendation for action to the irradiation of packedred cell that will be given in immunocompetent patients in Jakarta Dharmais Cancer Hospital Methodology This study used an experimental research design time series with the examination conducted on 54 bags of packed red cell that meet the inclusion and exclusion criteria set by the researcher Conducted tests on the number of CD 3 and CD 4 in three doses with three different time series Results A decline in the number of CD 3 and CD 4 in packed red cell irradiation at certain doses of irradiation and different irradiation times Conclusion The decrease in CD 3 meaningful or significant at doses of 2500 in 5 hours after irradiation.; ABSTRACTBackground Blood transfusion is a medical treatment for a life saving and cure the disease On the other hand these treatment also have risks or complications one of which is known with Transfusion Associated Graft vs Host Disease TAGVHD This will cause proliferation T lymphocytes and then will be followed by a process engraft embedded in the recipient 39 s body is in a state of immunocompetent This condition is commonly experienced by patients with impaired immunological systems such as cancer patients or autoimmune diseases Currently one the only acceptable method to prevent such complications by way of blood irradiation Variations recommendation on irradiation dose and exposure time in reducing the amount of CD 3 and CD 4 which is the cause of the TAGVHD be doing background research The results of this study will be a recommendation for action to the irradiation of packedred cell that will be given in immunocompetent patients in Jakarta Dharmais Cancer Hospital Methodology This study used an experimental research design time series with the examination conducted on 54 bags of packed red cell that meet the inclusion and exclusion criteria set by the researcher Conducted tests on the number of CD 3 and CD 4 in three doses with three different time series Results A decline in the number of CD 3 and CD 4 in packed red cell irradiation at certain doses of irradiation and different irradiation times Conclusion The decrease in CD 3 meaningful or significant at doses of 2500 in 5 hours after irradiation.; ABSTRACTBackground Blood transfusion is a medical treatment for a life saving and cure the disease On the other hand these treatment also have risks or complications one of which is known with Transfusion Associated Graft vs Host Disease TAGVHD This will cause proliferation T lymphocytes and then will be followed by a process engraft embedded in the recipient 39 s body is in a state of immunocompetent This condition is commonly experienced by patients with impaired immunological systems such as cancer patients or autoimmune diseases Currently one the only acceptable method to prevent such complications by way of blood irradiation Variations recommendation on irradiation dose and exposure time in reducing the amount of CD 3 and CD 4 which is the cause of the TAGVHD be doing background research The results of this study will be a recommendation for action to the irradiation of packedred cell that will be given in immunocompetent patients in Jakarta Dharmais Cancer Hospital Methodology This study used an experimental research design time series with the examination conducted on 54 bags of packed red cell that meet the inclusion and exclusion criteria set by the researcher Conducted tests on the number of CD 3 and CD 4 in three doses with three different time series Results A decline in the number of CD 3 and CD 4 in packed red cell irradiation at certain doses of irradiation and different irradiation times Conclusion The decrease in CD 3 meaningful or significant at doses of 2500 in 5 hours after irradiation., ABSTRACTBackground Blood transfusion is a medical treatment for a life saving and cure the disease On the other hand these treatment also have risks or complications one of which is known with Transfusion Associated Graft vs Host Disease TAGVHD This will cause proliferation T lymphocytes and then will be followed by a process engraft embedded in the recipient 39 s body is in a state of immunocompetent This condition is commonly experienced by patients with impaired immunological systems such as cancer patients or autoimmune diseases Currently one the only acceptable method to prevent such complications by way of blood irradiation Variations recommendation on irradiation dose and exposure time in reducing the amount of CD 3 and CD 4 which is the cause of the TAGVHD be doing background research The results of this study will be a recommendation for action to the irradiation of packedred cell that will be given in immunocompetent patients in Jakarta Dharmais Cancer Hospital Methodology This study used an experimental research design time series with the examination conducted on 54 bags of packed red cell that meet the inclusion and exclusion criteria set by the researcher Conducted tests on the number of CD 3 and CD 4 in three doses with three different time series Results A decline in the number of CD 3 and CD 4 in packed red cell irradiation at certain doses of irradiation and different irradiation times Conclusion The decrease in CD 3 meaningful or significant at doses of 2500 in 5 hours after irradiation.]"

"Latar belakang: Thalassemia merupakan kelainan hemoglobinopati yang cukup banyak di Indonesia. Terapi utama thalassemia mayor adalah transfusi seumur hidup. Transfusi berulang memiliki efek samping. Salah satunya adalah terbentuknya aloantibodi sel darah merah. Prevalens dan faktor-faktor yang memengaruhi aloantibodi pada pasien thalassemia masih belum ada di Indonesia. Uji Coombs sebagai standar diagnosis merupakan pemeriksaan yang mahal dan hanya tersedia di pusat tertentu. Metode lain yang lebih mudah diperlukan untuk memprediksi terbentuknya aloantibodi tersebut. Tujuan: Untuk mengetahui prevalens aloantibodi sel darah merah di populasi Indonesia dan mendapatkan faktor-faktor yang memengaruhinya. Membuat sistem skoring untuk memprediksikan probabilitas terbentuknya aloantibodi sel darah merah berdasarkan faktor-faktor tersebut. Metode: Analisis terhadap 162 rekam medis subjek yang telah dilakukan uji Coombs di Pusat Thalassemia Jakarta pada tahan 2005-2013. Hasil: Dari 162 subjek didapatkan 31 (19%) subjek memiliki aloantibodi dan 4 (2,4%) subjek menderita AIHA. Jenis aloantibodi terbanyak yang terdeteksi adalah anti-M (29%). Faktor-faktor yang memengaruhi terbentuknya aloantibodi adalah tingginya volume transfusi, jarak antar transfusi, lama transfusi, kadar leukosit dan pajanan PRC biasa. Berdasarkan faktor-faktor risiko tersebut, sistem skoring didisain untuk memprediksi kemungkinan terbentuknya aloantibodi. Kesimpulan: Prevalens aloantibodi pada pasien thalassemia di Indonesia cukup tinggi. Pemberian PRC leukodeplesi pelu direkomendasikan pada pasien dengan transfusi berulang. Prediksi terbentuknya aloantibodi dapat dilakukan melalui sistem skoring terutama di tempat yang tidak tersedia uji Coombs.

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Background: Thalassemia major is a common genetic disease in Indonesia. The principal treatment of thalassemia major is lifelong blood transfusion, which is frequently complicated by alloantibody. Limited data are available on the frequency of RBC alloantibody and factors influencing in major β-thalassemia patients. Coombs test, as a standard tool to diagnose alloantibody, is only available on particular Red Cross Centre. Therefore, it is necessary to find another tool to predict the probability of alloantibody formation.

Aim: To investigate the prevalence of RBC alloantibody among thalassemia major patients in Thalassemia Centre Jakarta. To describe factors influencing RBC alloantibody production and develop scoring system to predict its probability.

Methods: We analyzed the clinical and transfusion records of 162 thalassemia major patients who have been examined for Coombs test. All of the patients were registered in Thalassemia Center, Cipto Mangunkusumo hospital from 2005 until 2013.

Results: Of the 162 subjects, 31 (19%) developed RBC alloantibody and four patients (2,4%) developed autoimmune hemolytic anemia. The most common alloantibody was anti-M (29%).Several factors were found to contribute to high alloantibody rate in this study, including high volume of transfusion, duration of transfusion, white blood count level, transfusion interval, and PRC exposure. From those factors, scoring system has been developed to predict alloantibody formation in thalassemia patients.

Conclusion: We concluded that there is a high rate of RBC alloantibody in major thalassemia patients in our center. We also suggest that leukocyte-poor PRC should be given to all patients with multiple transfusions. In remote area where Coombs test is not available, scoring system can be used to predict the probability of alloantibody formation."

"Telah dilakukan penelitian yang bertujuan untuk mengetahui pengaruh fortifikan NaFeEDTA dalam tepung tahu terhadap jumlah sel darah merah tikus putih Rattus norvegicus L. jantan galur Sprague-Dawley. Metode penelitian menggunakan Rancangan Acak Lengkap RAL , terdiri atas 25 ekor tikus putih jantan yang dibagi ke dalam 5 kelompok perlakuan, yaitu KK 1 yang diberi larutan CMC 0,5 ; KK 2 yang diberi CMC 0,5 dan suspensi tepung tahu tanpa fortifikan; dan KP 1, 2 dan 3 diberi CMC 0,5 dan tepung tahu dengan fortifikan NaFeEDTA dosis 2,7 mgFe/kgBB; 5,4 mgFe/kgBB; dan 10,8 mgFe/kgBB selama 14 hari. Pengambilan darah dilakukkan pada hari ke-0 dan setelah perlakuan pada hari ke-14. Jumlah sel darah merah dihitung menggunakan alat hematology analyzer. Hasil uji ANAVA satu arah P < 0,05 menunjukkan pengaruh nyata pemberian fortifikan NaFeEDTA dalam tepung tahu terhadap jumlah sel darah merah antar kelompok perlakuan. Hasil uji LSD P < 0,05 menunjukkan bahwa terdapat perbedaan jumlah sel darah merah yang nyata antara KK 1 dengan semua kelompok perlakuan KP 1, KP 2 dan KP 3 ; KK 2 dengan semua kelompok perlakuan pada t14 dan antar semua kelompok perlakuan. Peningkatan jumlah sel darah merah tertinggi terjadi pada KP 2 yaitu 22,26 terhadap KK 1; dan 20,24 terhadap KK 2.

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The effect of fortificant NaFeEDTA inserted in tofu flour intake on red blood cell count in male Sprague Dawley rats Rattus norvegicus L. has been studied. Twenty five rats were divided into five groups, consist of normal control group KK 1 which was administered with CMC 0,5 , treatment control group KK 2 which was administered with CMC 0,5 and tofu flour non fortificant, and three treatment groups which was administered with CMC 0,5 and tofu flour added with fortificant NaFeEDTA 2,7 mgFe kgbw KP 1 5,4 mgFe kgbw KP 2 and 10,8 mgFe kgbw KP 3 . All the five groups were treated for 14 consecutive days. Red blood cell count was measured by automatic hematology analyzer. One way ANOVA test P 0,05 showed significant effect of fortificant NaFeEDTA inserted in tofu flour intake red blood cell count in all treatment groups. LSD test P 0,05 showed that the red blood cell count significantly different between KK 1 towards all treatment groups KK 2 towards all treatment groups and all the treatment groups. The highest increase of red blood cell count was detected on KP 2 at t14 which is 22,26 to KK 1 and 20,24 to KK 2. "

"Telah dilakukan penelitian yang bertujuan untuk mengetahui pengaruh fortifikan NaFeEDTA dalam susu kedelai terhadap jumlah sel darah merah tikus Rattus norvegicus L. jantan galur Sprague-Dawley. Metode penelitian menggunakan Rancangan Acak Lengkap RAL . Sebanyak 25 ekor tikus jantan yang dibagi ke dalam 5 kelompok perlakuan, yaitu KK 1 yang diberi pakan dan minum standar tanpa pemberian susu kedelai dan fortifikan; KK 2 yang diberi pakan minum standar dan susu kedelai tanpa fortifikan; dan KP 1, 2, dan 3 yang diberi pakan minum standar dan susu kedelai dengan fortifikan NaFeEDTA dosis 2,7 mgFe/kgBB, 5,4 mgFe/kgBB, dan 10,8 mgFe/kgBB selama 21 hari berturut-turut. Pengambilan darah dilakukan pada hari ke-0 dan setelah perlakuan pada hari ke-21. Pengukuran jumlah sel darah merah tikus menggunakan alat hematology analyzer. Hasil uji ANAVA satu arah dan uji LSD P le; 0,05 menunjukkan bahwa setelah pemberian perlakuan selama 21 hari berturut-turut, terdapat perbedaan jumlah sel darah merah yang nyata antara seluruh kelompok perlakuan KP 1, KP 2, dan KP 3 terhadap jumlah sel darah merah KK 1 dan KK 2. Peningkatan jumlah sel darah merah tertinggi terjadi pada KP 2 di hari ke-21 yaitu 19,70 terhadap KK 1; dan 17,27 terhadap KK 2.

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The effect of fortificant NaFeEDTA in soy milk on red blood cell count of male Sprague Dawley rats Rattus norvegicus L. had been studied. By using Complete Random Design CRD, twenty five rats were divided into five groups. Normal control group KK 1 which was administered with standard feeding and drinking without the addition of soy milk and fortificant. Treatment control group KK 2 which was administered with extra soy milk without fortificant, and three treatment groups which were administered with extra soy milk added with NaFeEDTA fortificant 2.7 mg Fe kgbw KP 1 5.4 mg Fe kgbw KP 2 and 10.8 mg Fe kgbw KP3 . All of the five groups were treated for 21 days consecutively. Measurement of rat red blood cell count uses the hematology analyzer. One way ANOVA test and post hoc LSD test P le 0.05 showed that after 21 days of consecutive treatment, there was a significant effect on red blood cell count in all treatment groups KP 1, KP 2 and KP 3 compared to KK 1 and KK 2. The highest increase of red blood cell count was detected on KP 2 at t21 which is 19,70 to KK 1 and 17,27 to KK 2."