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Abstrak :
[ABSTRAK
Latar Belakang. Penilaian derajat kesadaran penting dilakukan pada pasien di Unit Gawat Darurat untuk memperkirakan prognosis. Banyak sistem penilaian dipakai untuk mengevaluasi pasien, masing-masing dengan kelebihan dan kekurangannya. Sistem penilaian yang baru, yaitu Full Outline of Unresponsiveness (FOUR )Score, dapat digunakan menilai derajat kesadaran dan memprediksi prognosis pasien. FOUR Score dapat memberikan data neurologis yang lebih detail dan dapat digunakan pada pasien yang terintubasi. Belum ada penelitian yang menilai validitas FOUR Score sebagai prediktor outcome pada pasien dengan penurunan kesadaran di IGD RSCM sebelumnya. Metode. Penelitian kohort prospektif observasional pada pasien dengan penurunan kesadaran yang dirawat di IGD RSCM. Evaluasi FOUR Score dilakukan terhadap 120 pasien baru yang dirawat di IGD RSCM. Outcome pasien dicatat setelah perawatan 72 jam. Analisis bivariat digunakan untuk menentukan hubungan FOUR Score terhadap outcome. Analisis regresi logistik untuk menentukan hubungan komponen FOUR Score terhadap outcome. Nilai area di bawah kurva (AUC) digunakan untuk sebagai uji dsikriminasi FOUR Score terhadap outcome. Hasil. Terdapat hubungan yang bermakna antara nilai FOUR Score dengan outcome (p <0,001). Komponen respon membuka mata (FOUR-E) dan pola respirasi (FOUR-R) adalah komponen yang mempunyai nilai prediksi terhadap outcome. AUC FOUR Score adalah 0,864 (95% IK 0,784-0,928).Uji kesesuaian antarpenilai antara dokter dan perawat menunjukkan kesesuaian yang sangat baik dengan κ = 0,836 (95% IK 0,786- 0,894), p <0,001.

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ABSTRACT
Background. Asssessment of conciousness is important in patients in emergency room to estimate prognosis. Many scoring systems used to evaluate patients? level of conciousness, each with their advantages and disadvantages Full Outline of Unresponsiveness (FOUR) Score is a new system to assess patients?s level of conciousness and future prognosis. FOUR Score can provide a detailed neurological data and can be used in patients who are intubated. There have never been done a research on validity of FOUR Score as a predictor of outcome in RSCM?s ER before. Method. Observational, prospective cohort study in patients with decreased of conciousness treated in the RSCM?s ER. FOUR Score?s evaluation conducted on 120 new patients. Patient?s outcome was recorded after 72 hours of treatment, and classified as dead or alive. Bivariate analysis conducted to determine the relation between FOUR Score and outcome. Logistic regression analysis was performed to determine the relation between components of the FOUR Score and the outcome, and the value of area under the curve (AUC) of the FOUR Score to outcome was determined to measure discrimination of FOUR Score. Results. There is a significant correlation statistically between the value of the FOUR Score with the outcome (p <0.001). From all the components had been measured, the eye response (FOUR-E) and respiratory pattern (FOUR-R) had predictive value related to the outcome. AUC of the FOUR Score is 0,864 (95% CI 0,784-0,928). Inter-rater agreement between doctor and nurse shows a very good strength of agreement wtith κ = 0,836 (95% CI 0,786- 0,894), p <0,001. Conclusion. FOUR Score can accurately predict the outcome of patients with decreased of consciousness in the RSCM?s ER after 72 hours of treatment.;Background. Asssessment of conciousness is important in patients in emergency room to estimate prognosis. Many scoring systems used to evaluate patients? level of conciousness, each with their advantages and disadvantages Full Outline of Unresponsiveness (FOUR) Score is a new system to assess patients?s level of conciousness and future prognosis. FOUR Score can provide a detailed neurological data and can be used in patients who are intubated. There have never been done a research on validity of FOUR Score as a predictor of outcome in RSCM?s ER before. Method. Observational, prospective cohort study in patients with decreased of conciousness treated in the RSCM?s ER. FOUR Score?s evaluation conducted on 120 new patients. Patient?s outcome was recorded after 72 hours of treatment, and classified as dead or alive. Bivariate analysis conducted to determine the relation between FOUR Score and outcome. Logistic regression analysis was performed to determine the relation between components of the FOUR Score and the outcome, and the value of area under the curve (AUC) of the FOUR Score to outcome was determined to measure discrimination of FOUR Score. Results. There is a significant correlation statistically between the value of the FOUR Score with the outcome (p <0.001). From all the components had been measured, the eye response (FOUR-E) and respiratory pattern (FOUR-R) had predictive value related to the outcome. AUC of the FOUR Score is 0,864 (95% CI 0,784-0,928). Inter-rater agreement between doctor and nurse shows a very good strength of agreement wtith κ = 0,836 (95% CI 0,786- 0,894), p <0,001. Conclusion. FOUR Score can accurately predict the outcome of patients with decreased of consciousness in the RSCM?s ER after 72 hours of treatment., Background. Asssessment of conciousness is important in patients in emergency room to estimate prognosis. Many scoring systems used to evaluate patients? level of conciousness, each with their advantages and disadvantages Full Outline of Unresponsiveness (FOUR) Score is a new system to assess patients?s level of conciousness and future prognosis. FOUR Score can provide a detailed neurological data and can be used in patients who are intubated. There have never been done a research on validity of FOUR Score as a predictor of outcome in RSCM?s ER before. Method. Observational, prospective cohort study in patients with decreased of conciousness treated in the RSCM?s ER. FOUR Score?s evaluation conducted on 120 new patients. Patient?s outcome was recorded after 72 hours of treatment, and classified as dead or alive. Bivariate analysis conducted to determine the relation between FOUR Score and outcome. Logistic regression analysis was performed to determine the relation between components of the FOUR Score and the outcome, and the value of area under the curve (AUC) of the FOUR Score to outcome was determined to measure discrimination of FOUR Score. Results. There is a significant correlation statistically between the value of the FOUR Score with the outcome (p <0.001). From all the components had been measured, the eye response (FOUR-E) and respiratory pattern (FOUR-R) had predictive value related to the outcome. AUC of the FOUR Score is 0,864 (95% CI 0,784-0,928). Inter-rater agreement between doctor and nurse shows a very good strength of agreement wtith κ = 0,836 (95% CI 0,786- 0,894), p <0,001. Conclusion. FOUR Score can accurately predict the outcome of patients with decreased of consciousness in the RSCM?s ER after 72 hours of treatment.]

Abstrak :
[ABSTRAK
Doksorubisin merupakan salah satu antikanker golongan antrasiklin yang efektif, untuk keganasan di darah. Akan tetapi, seperti antikanker konvensional pada umumnya, penggunaan doksorubisin dapat menyebabkan berbagai efek samping pada organ lain, misalnya pada testis sehingga penggunaannya di klinis menjadi terbatas. Hal ini disebabkan karena mekanisme antikanker doksorubisin dapat juga menimbulkan toksisitas pada testis. Peningkatan stress oksidatif adalah salah satu mekanisme dapat menyebabkan kerusakan pada organ tersebut. Mangiferin sebagai zat antioksidan alami, terkandung dalam Mangifera Indica L. diperkirakan dapat digunakan untuk mengurangi toksisitas testis. Namun sampai saat ini, belum ada penelitian yang mengeksplor efek proteksi mangiferin terhadap kerusakan oksidatif testis yang diinduksi doksorubisin. Penelitian ini menggunakan tikus jantan Sprague Dawley, yang dibagi menjadi empat kelompok. Masing-masing kelompok terdiri dari enam ekor tikus. Tikus pada kelompok kontrol negatif diberikan doksorubisin secara intraperitoneal (dosis total 15 mg/kgBB) dan kelompok normal diberikan NaCl 0,9%. Mangiferin (dosis 30 dan 60 mg/kg BB) diberikan oral selama tujuh minggu. Setelah, tujuh minggu tikus dimatikan dan testis dikumpulkan untuk analisis parameter stress oksidatif biokimia kadar MDA (malonedyaldehide), aktivitas SOD (Superoxide Dysmutase), perubahan histologi dan apoptosis kaspase-9 dan kaspase-12. Hasil penelitian menunjukkan bahwa pemberian doksorubisin selama dua minggu dapat meningkatkan kadar MDA, menyebabkan kerusakan sel spermatogenik, sel Sertoli dan penciutan diameter tubulus seminiferus testis, peningkatan ekspresi kaspase-9 di sisi luminal yang diberikan doksorubisin. Pemberian mangiferin dosis 30 dan 60 mg/kg BB selama tujuh minggu dapat mengurangi kerusakan sel spermatogenik dan sel Sertoli tubulus seminiferus testis, penurunan kadar MDA dan penurunan ekspresi kaspase-9 pada kelompok perlakuan diberikan doksorubisin dan mangiferin. Perbaikan parameterparameter ini mengindikasikan bahwa mangiferin mempunyai efek proteksi terhadap kerusakan sel spematogenik dan sel sertoli tubulus seminiferus testis tikus yang diberikan doksorubisin.

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ABSTRACT
Doxorubicin, one of the anthracycline anticancer class, is effective especially in blood malignancy. However, as in the general use of the conventional anticancer-drugs. Doxorubicin can cause various side effects in other organs, such as the testes so that its use in clinical become limited. This is because of the anticancer mechanism can cause cytotoxicity on testes. The increased oxidative stress is the main mechanism that can be the causal. Mangiferin as a natural antioxidant substance, contained in Mangifera Indica L., is expected to reduce the toxicity. The Antioxidants are expected to reduce the toxicity of the testes. But until now, no studies have explored the effects of mangiferin protection against oxidative damage induced testicular doxorubicin. This study used male Sprague Dawley rats, which were divided into four groups. Each group consisted of six mice. Rats in the negative control group was given intraperitoneal doxorubicin (total dose 15 mg/kg) and the normal group was given normal saline 0.9%. Mangiferin (doses of 30 and 60 mg/kg) was administered orally for seven weeks to the treatment gtoups (both DOX and MAG were given). After seven weeks-off, testes of mice were collected for analysis of biochemical parameters i.e. oxidative stress levels of MDA and SOD activity, histology and apoptosis of the caspase-9 and of the caspase-12. The results showed that administration of doxorubicin for two-weeks can cause damage to Sertoli, spermatogenic cells and shrinking of diameter of testicular seminiferous tubules, increasing the levels of MDA, increasing in the expression of caspase-9 on the luminal side in the treatment group was given doxorubicin. This possibility of the doxorubicin dose given is too toxic to the testes in this study. Mangiferin dose administration of 30 and 60 mg / kg for seven-weeks can reduce the damage of Sertoli and spermatogenic cells of the testicular seminiferous tubules, decrease levels of MDA, reduce Sertoli, spermatogenic cell and diameter of the testicular seminiferous tubulus damage, decrease caspase-9 expression only on luminal side of the seminiferus tubulus in the groups given both of doxorubicin and mangiferin. these parameters indicate that mangiferin, which has antioxidant?s activity, provides protective effects against oxidative damage in spematogenic and Sertoli cell testicular seminiferous tubules of mice given doxorubicin, Doxorubicin, one of the anthracycline anticancer class, is effective especially in blood malignancy. However, as in the general use of the conventional anticancer-drugs. Doxorubicin can cause various side effects in other organs, such as the testes so that its use in clinical become limited. This is because of the anticancer mechanism can cause cytotoxicity on testes. The increased oxidative stress is the main mechanism that can be the causal. Mangiferin as a natural antioxidant substance, contained in Mangifera Indica L., is expected to reduce the toxicity. The Antioxidants are expected to reduce the toxicity of the testes. But until now, no studies have explored the effects of mangiferin protection against oxidative damage induced testicular doxorubicin. This study used male Sprague Dawley rats, which were divided into four groups. Each group consisted of six mice. Rats in the negative control group was given intraperitoneal doxorubicin (total dose 15 mg/kg) and the normal group was given normal saline 0.9%. Mangiferin (doses of 30 and 60 mg/kg) was administered orally for seven weeks to the treatment gtoups (both DOX and MAG were given). After seven weeks-off, testes of mice were collected for analysis of biochemical parameters i.e. oxidative stress levels of MDA and SOD activity, histology and apoptosis of the caspase-9 and of the caspase-12. The results showed that administration of doxorubicin for two-weeks can cause damage to Sertoli, spermatogenic cells and shrinking of diameter of testicular seminiferous tubules, increasing the levels of MDA, increasing in the expression of caspase-9 on the luminal side in the treatment group was given doxorubicin. This possibility of the doxorubicin dose given is too toxic to the testes in this study. Mangiferin dose administration of 30 and 60 mg / kg for seven-weeks can reduce the damage of Sertoli and spermatogenic cells of the testicular seminiferous tubules, decrease levels of MDA, reduce Sertoli, spermatogenic cell and diameter of the testicular seminiferous tubulus damage, decrease caspase-9 expression only on luminal side of the seminiferus tubulus in the groups given both of doxorubicin and mangiferin. these parameters indicate that mangiferin, which has antioxidant’s activity, provides protective effects against oxidative damage in spematogenic and Sertoli cell testicular seminiferous tubules of mice given doxorubicin]

Abstrak :
LATAR BELAKANG: Metode preparasi spermatozoa yang sering digunakan untuk reproduksi berbantu saat ini adalah metode swim-up dan density-gradient centrifugation. Namun demikian masih banyak didapatkan pertentangan mengenai metode mana yang lebih aman dan dapat menyeleksi spermatozoa dengan kualitas yang lebih baik. Pada penelitian ini dilakukan penilaian kembali pada kedua metode preparasi spermatozoa tersebut terutama dalam hal menyeleksi spermatozoa dengan tingkat integritas DNA tinggi dan apoptosis yang rendah. BAHAN DAN CARA KERJA: Sampel berjumlah 15 pasien yang menjalani preparasi spermatozoa untuk program inseminasi intra uterus di Klinik Yasmin RSCM Kencana, Jakarta. Sampel diambil sebelum dan setelah pencucian spermatozoa untuk dilakukan pemeriksaan konsentrasi dan motilitas spermatozoa menggunakan Makler®. Tingkat integritas DNA spermatozoa dinilai dengan indeks fragmentasi DNA spermatozoa (IFD) yang dilakukan dengan metode SCD. Pemeriksaan konfirmasi berupa viabilitas spermatozoa dengan eosin-Y dan analisis ekspresi protein kaspase 3 dilakukan dengan western blot yang dilanjutkan dengan analisis densitas pita kaspase 3 menggunakan ImageJ. HASIL: Penelitian ini menunjukkan penurunan tidak bermakna pada kelompok IFD > 15% dan peningkatan tidak bermakna pada kelompok IFD ≤ 15%. Ditambah pula, rerata viabilitas spermatozoa menunjukkan peningkatan tidak bermakna setelah pencucian. Aktivitas kaspase menunjukkan penurunan densitas tidak bermakna setelah dilakuan pencucian. Metode preparasi DGC dan SU dapat meningkatkan spermatozoa progresif dan viabilitas spermatozoa serta menurunkan aktivitas kaspase 3. KESIMPULAN: Metode swim-up dan density-gradient centrifugation berhasil menyeleksi spermatozoa dengan tingkat apoptosis dan fragmentasi DNA yang rendah. Metode DGC lebih baik daripada SU dalam hal penurunan aktivitas kaspase.

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BACKGROUND: The common methods for sperm preparation prior to assisted reproductive technique are swim-up (SU) and density gradient centrifugation (DGC). However, controversies regarding advantages and disadvantages of these two methods have been reported by many studies. The aim of this study was to reevaluate both methods in selecting better sperm in term of their quality, DNA integrity and apoptotic levels. MATERIAL AND METHOD: Fifteen samples from insemination patients at Klinik Yasmin RSCM Kencana, Jakarta were used in this study. Samples were taken before and after preparation with SU and DGC. Makler® counting chamber and Eosin Y staining were used to analyze motility and viability, respectively. Sperm chromatin dispersion assay was used to determine sperm DNA integrity, while apoptotic levels was determined by Western immunoblotting. RESULTS: This study showed no significant decrease in the group IFD> 15% and a non-significant increase in group IFD ≤ 15% after preparation with SU and DGC. Plus, the average viability of spermatozoa showed improvement after preparation with SU and DGC. Caspase activity was lower when spermatozoa was prepared with SU. DGC and SU preparation method can improve progressive motility and viability of spermatozoa and reduce the caspase activity. CONCLUSIONS: Both swim-up and density-gradient centrifugation selected better sperm motility and viability. Furthermore. these two methods separated spermatozoa with low level of apoptotic and higher DNA integrity. DGC method is better than SU in reduce caspase activity

Abstrak :
Cryptococcus merupakan khamir bersimpai yang menyebabkan kriptokokosis dan pada era HIV/A1DS jumfah kasus meningkat tajam. Manifestasi klinik kriptokokosis berbeda sesuai dengan spesies dan serotipe, sehingga identifikasi menjadi sangat penting. Selain itu penerapan spesies pe;nting untuk studi epidemiologis kriptokokosis. Penelitian ini merupakan penelltian deskriptif untuk mengidentifikasi spesies dan serotipe serta virulensi jarnur. Seiai itu ingin diketahui penyebaran penyakit di Jabodetabek. Bahan yang diperiksa adalah 40 lsolat koleksi Departemen P.arasitologi FKUI dan 25 isolat dari cairan otak kulit dan darah. Metode pemeriksaan terdiri ata:s uji asimilasi (kit API 20C AUX), uji pembentukan germ tube, biakan pada medium CGB dan CDBT dan NSA. Penyebaran kasus kriptokokosis diadapatkan berdasarkan domisili pasien. Hasil uji asimilasi didapatkan Cr. neoformans (64 isolat), Cr. lat:rentii var. laurentfi (l isolat). Hasil uji pembentukan germ tube didapatkan bahwa jamur yang diteliti bukan golongan Candida. Penetapan spesies dengan medium CGB didapatkan seluruh isolat adaiah Cr. neoformans. Hasil penetapan serotipe dengan median CDBT didapatkan seluruh isoiat adalah Cr. neoformans serotipe A. Uji virulensi dengan medium NSA memperlihatkan pembentukan pigmen melanin pada semua isofat. Data demografis menunjukkan distribusi penderita kriptokokosis di Jim a wilayah DKI,.Bogor dan Bandung. ......Cryptococcus is encapsulated yeast that caused Cryptococcosis in human. In the era of HIV/AIDS there is an increased number of cryptococcosis. Its clinical manifestation varied according to the species, so species idcntif1calion is quite important. Furthermore species identification is also important in epidemiology study. This descriptive study aimed to identify species and stereotype of Cryptococcus and also its virulence. The study also aimed to know the distribution of Cryptococcosis in Jabodetabek. There wex 40 isolates from the collection of Department of Parasitology FKUl. and other 25 isolates were isolated from spinal fluid, blood and skin. The study Vas done using API 20C AUX, germ tube fonnation test, CGB for the differentiation of Cryptococcus. gattii and Cryptococcus neoformans. and, CDBT for serotyping and melanine production by plating the isolates on niger seed agar. The study on the distribution of the disease was based on patients residence. The results were, 64 isolates of Cr. neoformans and 1 Cr. laurentii. Germ tube formation test is negative. Identification of species with CGB agar showed all isolates were Cr. neoformans. Stereotype identification with CDBT were all stereotype A. All isolate were capable of forming melanin when growth on NSA. Demographic data of the patients shows a wide distribution including 5 areas of DKI, Bogor and Bandung.