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Abstrak :
Tujuan: Mendeteksi perubahan kerusakan saraf optik pada penderita TB paru yang diterapi dengan Etambutol setelah diberikan suplementasi ion Zinc peroral. Desain: Uji klinik eksperimental secara acak dan tersamar ganda. Metode: duapuluh dua penderita tuberkulosis paru dengan anti tuberkulosis mendapatkan suplementasi 20 mg ion Zinc (kelompok perlakuan) begitupula duapuluh dua penderita tuberkulosis pare mendapatkan anti tuberkulosis dan plasebo (kelompok kontrol) satu kali sehari selama 4 minggu. Pemeriksaan P 100 [atensi VEP dilakukan pra dan paska suplementasi. Hasil: Pada kelompok perlakuan dan kelompok kontrol tidak terdapat perbedaan bermakna pada variabel usia, jenis kelamin dan VEP awal. Sehingga kedua kelompok setara untuk dibandingkan. Sebesar 18 penderita (81,8%) pads kelompok kontrol dan hanya sebesar 5 penderita (22,7%) pada kelompok perlakuan mengalami perubahan nilai P 100 latensi abnormal (p< 0.05). Rerata perubahan nilai P 100 latensi abnormal pada kelompok perlakuan sebesar 4A5 + 1.18 msec dan pada kelompok kontrol sebesar 5.21 + 1.49 msec (p< 0.05). Kesimpulan: VEP dapat mendeteksi neuropati optik subklinis sehingga dapat dipakai sebagai alat ukur memonitor efek toksik dari anti tuberkulosis. Suplementasi Ion Zinc mampu berperan sebagai neuroproteksi terhadap efek toksik Etambutol.

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Treated with Etambutol and ion Zinc supplementation orally. Design: Randomized, double blind experimental clinical trial. Methods: Twenty two tuberculosis pulmonary patients treated with anti tuberculosis and 20 mg ion Zinc (subject group) while other twenty two patients were treated with anti tuberculosis and placebo (control group) once daily for 4 weeks. P 100 latency examination was done before and after the treatment. Result: There were no significant difference on both groups in age,gender, and early VEP examination. Both groups can be compare statistically. Eighteen patients (81.8%) of the control group and only 5 patients (22.7%) of the subject group resulted abnormal changes on P 100 latency ( p< 0.05). In the subject group, the abnormal mean of P 100 latency was 4.15 + 118 msec and in the control group was 5.21 + 1.49 msec ( p<0.05). Conclusion: VEP could be use to detect subclinic optic neuropathy in monitoring anti tuberculosis toxic effect. Ion Zinc supplementation could be use as neuroprotector to the Ethambutol toxic effect.

Abstrak :
Latar Belakang: Keluhan iritasi mata banyak terdapat pada pekerja emping yang terpajan asap pembakaran kayu. Keluhan yang dirasakan adalah mata perih, gatal, merah dan berair. Pekerja masih menggunakan tungku lama. Penelitian ini bertujuan mengkaji pengaruh desain tungku terhadap penurunan derajat iritasi mata akibat asap pembakaran kayu. Metode Penelitian: Desain kuasi eksperimen dua kelompok, menggunakan intervensi desain tungku baru untuk mengeliminir asap pembakaran kayu. Dilakukan pada 44 orang pekerja emping perempuan. Data dikumpulkan dengan wawancara, pemeriksaan fisik mata. Subyek penelitian mempunyai kriteria inklusi masa kerja ≥ 1 tahun dan bersedia menjadi responden dengan menandatangani informed consent, kriteria eksklusinya adalah tidak mengalami penyakit mata merah lainnya selain iritasi mata akibat kerja, mempunyai riwayat atopi dan menggunakan obat yang dapat mempengauhi air mata, seperti antihistamin, antiglaukoma, AINS dan antipsikotropica. Hasil: Hasil menunjukkan adanya penurunan derajat iritasi mata pada kelompok studi setelah intervensi selama 14 hari sebesar 89% (Tabel 4.6). Terdapat perbedaan bermakna antara kelompok studi dan kontrol dalam perubahan iritasi mata dengan nilai p = 0,000 (Tabel 4.7). Kesimpulan. Kelompok kontrol mempunyai kemungkinan 8 kali untuk mengalami iritasi mata yang buruk dibandingkan dengan kelompok studi, p = 0,000, RR = 8, CI 95% (2,08 ? 30,74). Hipotesis terbukti bahwa terjadi penurunan derajat iritasi mata sebesar 89% pada pekerja emping setelah menggunakan desain tungku baru selama empat belas hari. ...... Background: There are many eye irritation complaints in workers exposed to the wood burning smoke. Perceived grievances are eye sore, itchy, red and watery. Workers are still using the old furnace. This study aims to examine the influence of furnace design to decrease the degree of eye irritation caused by the smoke of burning wood. Method: Quasi-experimental design of the two groups, using a new furnace design interventions to reduce wood burning smoke. Conducted on 44 female workers emping. Data were collected through interviews, observation and physical examination eye. The respondents were met the inclusion criteria and did not meet exclusion. The inclusion criteria were age ≥ 1 year of work and willing to be the subject of research. Exclusion criteria were having red eyes besides eye irritation due to work, have history of atopy and is undergoing treatment thay may influence the tears, like antiglaucoma, NSAIDs, antihistamines and antipsikotropica. Determination of the control group and the study is base on cluster random sampling with consideration of psychosocial and RT boundaries. Each group consisted of 22 respondents. Results: The proportion of poor eye irritation in the study group preintervensi 81.8%, day 7th intervention 13.6% and 9.1% intervention 14th day (Table 4.6), meaning that a decrease in the degree of eye irritation with the use of a new furnace. Changes in eye irritation scores in the study group had occurred on the 7th day of the intervention by 83.3%, from preintervensi until the 14th day of the intervention of 88.9% and from day 7 until day 14 of 33.3 interventions %. Table 4.7 shows there is a significant difference between the control and study groups in terms of changes in the degree of eye irritation with p = 0.000. Conclusion: The group that has the possibility of using the old furnace 8 times more likely to experience changes in eye irritation bad compared to the group using a new furnace with a value of p = 0.000, RR = 8.00, 95% CI (2.08 to 30.74). Hypothesis is proved that a decline in the degree of eye irritation of 88.9% in workers emping after using the new furnace design for fourteen days.

Abstrak :
Pendahuluan: Glaukoma primer sudut tertutup akut (GPSTA) adalah penyakit mata yang disebabkan oleh tertutupnya seluruh anyamari trabekulum oleh pangkal iris secara mendadak. GPSTA menycbabkan kcbutaan yang bersifat permanen. Penanganan cepat dan segera adaiah mutlak untuk mencegah kebutaan. Penatalaksanaan awal adaiah menurunkan TIO secepat mungkin dengan pemberian medikamentosa gabungan inisial atau parasentesis yang dilanjutkan dngan Iridektomi Perifer Laser (IPL). Proses infiamasi ras Asia Iebih berat dan TGP-B2 dan TNF-a merupakan petanda iskemia dan inflamasi. Tujuan: (1) Menilai rcspons parasentesis pada pasien GPSTA; (2) Membandingkan kadar TGP-B2 dan TNF-a humor akuos pasien GPSTA dengan pasien katarak; (3) Menilai efek pemberian deksametason terhadap kadar TGP-B2 dan TNF-a humor akuos pasien GPSTA; (4) Memperhitungkan faktor risiko terhadap suksesnya IPL pada pasien GPSTA. Bahan dan Cara: Penelitian ini merupakan studi prospektif dengan uji pra-pasca untuk menilai respons parasentesis dan studi komparatif belah lintang untuk membandingkan kadar TGP-B2 dan TNF-a humor akuos pasien GPSTA dengan pasien katarak. Untuk menilai efek deksametason terhadap kadar TGF-B2 dan TNF-a humor akuous dilakukan studi ldinis acak terkontrol tersamar ganda. Untuk mencari faktor risiko yang mempengaruhi keberhasilan IPL dilakukan perhitungan bivariat, dilanjutkan regresi logistik. Subjek penelitian adalah semua pasien GPSTA dengan Iama serangan di bawah 1 bulan. Hasil penelitian analisis pada 45 mata pasien GPSTA yang menjalani parasentesis, TIO awal turun. Kadar TGF-B2 dan TNF-a humor akuos pasien GPSTA, rnasing-masing, 4 kali dan 3 kali dari pasien katarak. Setelah IPL dan randomisasi antara kelompok kontrol dan deksametason, deksametason menurunkan kadar TGF-B2 dan TNF-a pasien GPSTA secara tidak signifikan. Faktor risiko yang mempengaruhi keberhasilan IPL adalah respons TIO pascaparascntesis dan luas SAP. Inflamasi tidak berpengaruh terhadap IPL, tetapi sekuele yang diakibatkannya mempengaruhi tindakan tersebut, yaitu SAP. Selain itu, faktor respons terhadap tindakan parasentesis juga turut berperan secara signifikan. Kesimpulan: Tindakan parasentesis menurunkan TIO awal pasien GPSTA. Kadar TGF-B2 dan TNF-a humor akuos tinggi pada pasien GPSTA. Pengaruh deksametason menurunkan kadar TGP-B2 dan TNF-a secara tidak signifikan. Keberhasilan tindakan IPL adalah 95% pada pasien GPSTA yang mempunyai respons baik terhadap parasentesis dengan luas SAP di bawah 4 jam. Sebaliknya, bila pasien GPSTA tidak memberi respons baik pascaparasentesis dan luas SAP 9-12 jam, maka keberhasilan IPL hanya 5%.

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Introduction: Acute primary angle closure glaucoma (APACG) is an eye disease caused by sudden closure of trabecular meshwork by the iris root. APACG could cause permanent blindness. Rapid management was essential in preventing blindness. Early management of this disease was done by reducing IOP as quickly as possible by the administration of initial combined medications or paracentesis, followed by laser peripheral iridectomy. Inflammatory process in the Asian race was more severe and TGP-B2 and TNF-a. constituted the signs of ischemia and inflammation. Objective: (1) To evaluate the response to paracentesis in APACG patients; (2) to compare the TGP-B2 and TNF-a levels of aquous humor in APACG patients and cataract patients; (3) to analyze the effects of the administration of dexamethasone on the TGF-B2 and TNF-a levels of aquous humor in APACG patients; (4) to calculate the risk factors against the success of laser peripheral iridectomy in APACG patients. Material and methods: This study was a prospective study with pre-post tests design to evaluate the response to paracentesis. Cross-sectional comparative study was perfomied to compare the TGF-B2 and TNF-a. levels of aquous humor in APACG patients and cataract patients. To evaluate the effects of dexamethasone on the TGF-B2 and TNF-a levels of aquous humor, a double-mask, randomized controlled trial was performed. To identify the risk factors affecting the success of laser peripheral iridectomy, a bivariate calculation was done, followed by logistic regression calculation. The subjects of the study were all APACG patients with the duration of attack under one month. Results: Analysis in 45 eyes of APACG patients undergoing paracentesis showed t.hat early IOP decreased by 49%. The TGF-B2 and TNF-a levels of aquous humor in APACG patients were four and three times as high as those in cataract patients respectively. After laser peripheral iridectomy and randomization between the control group and dexamethasone group, it showed that dexamethasone reduced the TGF-B2 and TNF-a levels of APACG patients insignificantly. The risk factors affecting the success of laser peripheral iridectomy was the response to IOP after paracentesis and the size of peripheral anterior synechiae (PAS). Inflammation did not affect laser peripheral iridectomy; however, the sequele that it caused affected the intervention, i.e. PAS. In addition, the response factor inparacentesis also played a significant role. Conclusion: Paracentesis could reduce early IOP in APACG patients. The TGF-B2 and TNF-a levels of aquous humor were high in APACG patients. The effect of dexamethasone in reducing the TGF-B2 and TNF-a levels was not significant. The success rate of laser peripheral iridectomy was 95% in APACG patients with good response to paracentesis with the size of PAS under 4 hours. By contrast, if APACG patients did not give a good response to paracentesis and the size of PAS was 9-12 hours, the success rate of laser peripheral iridectomy was only 5%.