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"Polimorfisme gen reseptor vitamin D (RVD) merupakan kandidat genetik yang dapat menjelaskan rentannya suatu populasi terhadap tuberkulosis. Namun, hingga kini, sejumlah penelitian yang mencoba membuktikan hal tersebut menunjukkan hasil bervariasi pada berbagai populasi. Studi ini merupakan studi kasus-kontrol yang mengikutsertakan 35 pasien pascatuberkulosis paru (14 laki-laki dan 21 perempuan, median usia 40) serta 35 kontrol serumah (14 laki-laki dan 21 perempuan, median usia 39) yang tinggal di Nusa Tenggara Timur, salah satu provinsi di Indonesia dengan prevalensi tuberkulosis paru yang tinggi. Polimorfisme genetik diperiksa melalui metode polymerase chain reaction restriction fragment length polymorphism (PCR-RFLP) dengan menggunakan enzim restriksi BsmI dari sampel darah yang diisolasi dan ditambahkan EDTA. Sebaran frekuensi genotipe BsmI RVD pada kelompok kasus adalah BB=9 (26%), Bb=24 (69%), dan bb=2 (5%) sementara pada kelompok kontrol adalah BB=5 (14%), Bb=25 (72%), dan bb=5 (14%) dengan p=0,232 (OR 2,07, IK 95% 0,62-6,98). Distribusi frekuensi alel pada kelompok kasus adalah B=42 (60%) dan b=28 (40%) sementara pada kelompok kontrol adalah B=35 (50%) dan b=35 (50%). Frekuensi alel varian (alel b) pada penelitian ini adalah 0,45. Distribusi genotipe pada penelitian ini tidak memenuhi persamaan Hardy-Weinberg. Sebagai kesimpulan, penelitian ini tidak menunjukkan adanya hubungan antara polimorfisme gen RVD terhadap kejadian tuberkulosis paru.

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Vitamin D receptor gene (VDR) polymorphism is a genetic candidate which may explain the susceptibility of tuberculosis (TB) in a single population. However, until now, some studies which had tried to prove this showed varied results in different populations. This is a case-control study involving 35 post pulmonary tuberculosis patients (14 males and 21 females, median age 40) and 35 healthy household controls (14 males and 21 females, median age 39) who dwelled in East Nusa Tenggara, one of the provinces in Indonesia with high prevalence of pulmonary tuberculosis. The genetic polymorphism was examined using polymerase chain reaction restriction fragment length polymorphism (PCR-RFLP) method with BsmI restriction enzyme from EDTA added-isolated blood sample. The distribution of VDR BsmI genotype frequency in case group was BB=9 (26%), Bb=24 (69%), and bb=2 (5%) whereas in control group was BB=5 (14%), Bb=25 (72%), and bb=5 (14%) with p=0.232 (OR 2.07, 95% CI 0.62-6.98). Furthermore, the distribution frequency of allele in case group was B=42 (60%) and b=28 (40%) whereas in control group was B=35 (50%) and b=35 (50%). Frequency of variant allele in this study was 0.45. Genotype distribution in this study did not meet the Hardy-Weinberg equilibrium. As conclusion, this study did not show any association between VDR gene polymorphism and pulmonary tuberculosis."

"ABSTRAKTujuan penelitian ini adalah untuk mengetahui suplernentasi vitamin B12 pada penderita HIV terhadap jumlah CD4, sehingga diharapkan dapat mencegah progresivitas penyakit HIV. Penelitiam ini merupakan uji klinis tanpa pembanding, terhadap 15 orang pasien HIV di poliklinik UPT HIV RSUPNCM Jakarta mulai satu Februari sampai dengan 20 April 2010. Subyek mendapat suplementasi vitamin B12 (metilkobalamin) 1000 pg/had, peroral, sclama enam minggu. Data dikumpulkan meliputi data demografi (usia dan jenis kelamin), adanya hepatitis gastroenteritis dan infeksi akut selama penelitian, status gizi (indeks massa tubuh), analisis asupan zat gizi dengan metode had record 3 x24 jam dan FFQ semikuantitatit2 lcadar vitamin B12 serum dan jumlah CD4. Analisis data menggunakan uji t berpasangan atau Wiicoxon dengan batas kemaknaan p < 0,05. Sebanyak 15 subyek mengikuti penelitian sampaj sclesai. Setelah enam minggu perlakuan, didapatkan adanya peningkatan yang bennakna terhadap kadar vitamin Bn serum awal 270,71 i 71,04 pmol/L, pada akhir perlakuan 419,11 =4= 122,95 pmol/L meningkat signiiikan (p > 0,001). Terdapat 11 dari 15 subyek mengalami peningicatan jumlah CD4 pada akhir penelitian. Median jumlah CD4 subyek pada awal penelitian 143 (23 - 372) sei/pL dibandingkan dengan median pada akhir pcrlakuan 166 (18 - 428) /pL, didapatkan perubahan signifikan (p = 0,03l). Uji korelasi Spearman, tidak menunjukan korelasi bermakna antara perbedaan jumlah CD4 dengan perbedaan kadar vitamin B12 serum (r= -0,375, p= 0,l68). Dcngan demikian dapat disimpulkan bahwa, walaupun tidak terdapat korelasi pada perbedaan jumlah CD4 dan kadar vitamin B12, namun suplementasi vitamin B12 menggunakan metilkobalamin 1000 pg/hari, peroral, selama enam minggu pada penderita HIV dapat meningkatkan secara bcrmakna kadar vitamin Bn serum dan terdapat perubahan bermakna jumlah CD4.

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ABSTRACT

The aim of this study is to find the effect of Vitamin B12 supplementation in HIV patients on the counts of CD4 so it would prevent the HIV progressiveness in RSUPNCM Jakarta. It is an one-armed clinical trial in 15 HIV patients in UPT HIV RSUPNCM Jakarta. The subjects received vitamin B12 (methylcobalamin) supplementation 1000 ug/day, per oral, for six weeks. The data was collected included demographic data (age and sex), the presence of hepatitis co-infection and gastroente1itis,and acute infection during nutritional status (body mass index), nutrition intake analysis with 3 x24 hours food record method and semi-quantitative FFQ, the level of serum vitamin B12 and CD4 counts. The study used paired t-test or Wilcoxon with significant value p < 0,05. There were I5 subjects who completely participated. After six weeks of intervention, there as a significant increment of early serum Vitamin Bl; level which was 270,71 1 71,04 pmol/L, and at the end ofthe intervention was 419,11 :h 122,95 pmol/L; increased significantly (p > 0,00l). There were ll of 15 subjects who had an increment at the end of the study. Early CD4 counts at the beginning of the study was 143 (23 - 372) cells/pL then changed significantly at the end of the study which was 166 (18 - 428) cells/pl., p = 0,03l. Though there was no significant correlation in CD4 counts difference to serum vitamin B12 level (r= -0,375, p= 0,l68)- It can be concluded that after six week intervention with vitamin B12 supplementation in methycobalamin form 1000 ug/day, per oral, in HIV patients would significantly increase serum vitamin B12 level and would significantly change CD4 counts, even-though there was no correlation on CD4 difference and vitamin Bl; level difference."

"Tujuan penelitian awal lni adalah untuk mengetahui pengaruh pemberian laktoferin sapi terbedap jumlah limfosit CD4+ penderita HIV positif dewasa. Penelitian dilakukan di POKDISUS AIDS RSUPNCM Jakarta, mulai bulan Februari 2010 sampai dengan bulan April2010. Dua puluh delapan subyak yang diseleksi dari pasien HIV positif dengan metode consecutive sampling mengikuti penelitian ini dari awal sampai akhir. Semua subyek diberi kapsul berisi 200 mg laktoferin sapL Kapsul diminum setiap hari satu butir selama enam minggu. Data dikumpulkan sebelum dan sesudah pemberian kapsul laktoferin melalui wawanoara, pengukuran antropometrik, dan pemerikarum laboratorium darah untuk penentuan jumiah limfosit CD4'. Data asupan makanan direntukan dengan menggunakan metode food recall lx24 jam dan food record 3x24 jam pada awal dan akhir penelitian.Nilai rerata jumlah limfosit CD4+ sebelum pemberian laktoferin adalah 231,85 ± 122,89 seVL (50,00-731,00 seVf!L) sesudah enam minggu perlakuan. Uji Wilcoxon terhadap kadua nilai tersebut, tidak berbeda bermakna (p=0,22). Sahelum diberikan laktoferin, nilai rerata jumlah limfusit CD4+ subyek yang belum mendapat ARV adalah 302,33 ± 132,79 seV tL dan meningkat menjadi 345,33 ± 202,33 sell tL pada akhir penelitian. Respon serupa ditemukan pula pada subyek yang telah mendapat ARV di mana jumiah limfosit CD4' sebelum pemberian laktoferin adalah 178,00 ± 84,77 seii L, 122,66 seV tL. Uji t be!pasangan terhadap peningkatan jumlah Jimfosit CD4+ antara subyek yang sudah dan belum mentiapat ARV, temyata tidak berbeda bermakna (p=0,12). Perbaikan jumlah limfosit CD4+ sesudah pemberian laktoferin terjadi pada 7 (58,33%) dari 12 subyek yang belum mendapat ARV dan pnda 9 (56,25%) dari 16 subyek yang mendapat ARV. Uji Chi-Square menunjukkan bahwa perbaikan jumlah limfosit CD4+ pada kedua kelompok.

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The aim of this preliminary study is to find out the effect of bovine lactoferin administration on CD4+ lymphocyte count of adult H!V-infected patients. "!he study was conducted from February to April 2010, at POKDJSUS AIDS Department of Internal Medicine, Central District Cipto Mangunkusumo National General Hospital (RSUPNCM) Jakarta. Subjects were selected from HIV-positive patients and only 2& were fully participated in the study. Capsules containing 200 mg of bovine lactoferrin were taken orally by all subjects once a day fur six weeks. Data were collected before and after bovine lactoferrin administration by interview, anthropometric measurement, and laboratory examination of blood for determining CD4+ lymphocyte count. Daily dietary intake data were determined by using I x 24 hour food recall and 3 x 24 hour food record at the beginning and at the end of the study.

Mean value of CD4.._ lymphocyte count before lactoferrin administration was 231.85 ± 122.89 cells/j.tL and increased to median value of 236.50 cells/j.tL (50.00-731.00 cellslj.tL) after six weeks intervention. Wilcoxon test on the above values showed no significant difference (IF0.22). Mean value of CD4+ lymphocyte count of untreated subjects with ARV before lactoferrin administration was 302.33 ± 132.79 cellsiJ.lL and increased to 345.33 ± 202.33 cells/j.!L at the end of study. 1he same response was also found in treated subjects with ARV where the mean value of CD4'" lymphocyte count increased from 78.00 ± 84.77 cells/).IL before lactoferrin administration to 204.38 ± 122.66 cells/J.tL, thereafter. Paired t-test on the increased CD4+ lymphocyte count between treated and untreated subjects with ARV showed no significant difference (JFO.I2). The improvement of CD4+ lymphocyte count after lactoferrin administration was seen in 7 out of 12 untreated subjects (58.33%) and in 9 out of 16 treated subject? with ARV (56.25%). Chi-Square's test showed that the improvement on both groups was not significant (p 0.91)."