Poster Session : PS 0359 ; Epidemiology and Public Health : The Prevalence of Unidentifi ed Disease in Cipto Mangunkusumo National Hospital Year 2010 and Sociodemographic Factors Related

( Nanda Lucky Prasetya ),( Muchtaruddin Mansyur ),( Andy Omega ),( Adam Prabata ),( Aghnia Permatasari ),( Ayudhia Kartika ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1

Background: Diagnosing is a main verb in medicine. Diagnosis is set based on clinical reasoning. Factors contributing in clinical reasoning are clinical competency and other factors related with physician; sociodemographical factor and others related with patients; diagnostic facility and others related to health policy. Methods: This descriptive-analytic cross sectional research was done in 904 medical record of adult polyclinic patient, using proportional random sampling and chi square analysis to show how many disease could not be identifi ed, and what factors signifi cantly contribute. Results: Although Cipto Mangunkusumo Hospital is a referral centre and national hospital, our research found that there is 5, 60% (n =51) of polyclinic cases are diagnosed as Unidentifi ed Disease (ICD10: R69), ranked at 4th after Senile Cataract, Hypertension, and DM Type 2. Their 84, 30% (n=43) are from Internal Medicine Department, mainly from Unspecifi ed Division (patient of more than one division or unmentioned) for 63% (n=27), and Pulmonology Division for 33% (n=14). At this research also, we were going to fi nd the connection between Unidentified Disease and one of the factors contributing in clinical reasoning: Sociodemographical Factors. The variables are age, gender, educational level, employment, and health insurance. We found no variable is signifi cantly related to Unidentifi ed Disease (all p>0, 05). Conclusions: Hence, the other factors beside Sociodemographical Factors have contribution to clinical reasoning that is set up to Unidentifi ed Disease: physician`s factors (clinical competency and others), diagnostic facility, and others. However, which one defi nitely contributing is still questionable as CM Hospital is educational hospital; have thousands of doctors consist of consultants, residents, and others; one of the most complete diagnostic facility in nation. Further research shall be done to defi ne this relatively big number of disease which still being unidentifi ed in national referral hospital.

Poster Session : PS 0362 ; Epidemiology and Public Health : Education-Oriented Control Book for Patients with Hypertension in Primary Health Care

( Gemalasari Novita Liman ),( Chici Pratiwi ),( Muchtaruddin Mansyur ),( Nadira Susilo ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1

Background: Based on program evaluation conducted at a hypertension primary health care, we found that the major problem of this clinic was lack of medication and control compliance of the patients. The chosen solution to solve this problem was developing an education-oriented control book for hypertensive patients in primary health care. Methods: This qualitative study lasted for nine days in a hypertension primary health care clinic in Central Jakarta, Indonesia. It consisted of six stages: the project design, development of control book, development of communicative educational messages, pretesting, revision, and evaluation by health professionals. Health staffs working at the clinic participated in fi lling the ten-question questionnaire of evaluation for previous control book and education-oriented control book. The mean scores were compared using t-test or Mann-Whitney U test. Discrimination was validated by the area under the curve (AUC) of receiver operating characteristic (ROC) curve analysis. Results: The education-oriented control book has 20 pages, 20. 5 cm X 14. 5 cm in size. The second page (after the title page) until the sixth page contains communicative educational messages. The seventh-the nineteenth page consist of patient`s health care records and the last page was for blood pressure chart. From the analysis, we found total mean scores for previous control book and education-oriented control book were 29. 2 ± 1. 64 and 34. 2 ± 1. 64 (p<0. 001). ROC curve analysis showed statistically signifi - cant power of discrimination in education-oriented control book (AUC = 0. 881). Conclusions: The education-oriented control book presented a signifi cant discrimination in our population and has potential for clinical applications as a part of health promotion media in hypertension primary health services.

Survival of isolated human preantral follicles after vitrification: Analyses of morphology and Fas ligand and caspase-3 mRNA expression

Wiweko, Budi,Soebijanto, Soegiharto,Boediono, Arief,Mansyur, Muchtaruddin,Siregar, Nuryati C,Suryandari, Dwi Anita,Aulia, Ahmad,Djuwantono, Tono,Affandi, Biran The Korean Society for Reproductive Medicine 2019 Clinical and Experimental Reproductive Medicine Vol.46 No.4

Objective: This study aimed to examine the effect of vitrification on apoptosis and survival in human preantral follicles after thawing. Methods: This experimental study was conducted at an acute tertiary care hospital from March 2012 to April 2013. Ovaries were sliced into 5 × 5 × 1-mm pieces and divided into the following three groups: preantral follicle isolation, ovarian tissue vitrification-warming followed by follicle isolation, and immunohistochemistry of fresh ovarian tissue. For statistical analyses, the Student t-test, chi-square test, Kruskal-Wallis test, and Kaplan-Meier survival analysis were used. Results: A total of 161 preantral follicles (70% secondary) were collected from ovarian cortex tissue of six women between 30 and 37 years of age who underwent oophorectomy due to cervical cancer or breast cancer. There were no significant differences in the follicular morphology of fresh preantral follicles and vitrified follicles after thawing. The mean Fas ligand (FasL) mRNA expression level was 0.43 ± 0.20 (relative to β-actin) in fresh preantral follicles versus 0.51 ± 0.20 in vitrified follicles (p= 0.22). The mean caspase-3 mRNA expression level in fresh preantral follicles was 0.56 ± 0.49 vs. 0.27 ± 0.21 in vitrified follicles (p= 0.233). One vitrified-thawed secondary follicle grew and developed to an antral follicle within 6 days of culture. Conclusion: Vitrification did not affect preantral follicle morphology or mRNA expression of the apoptosis markers FasL and caspase-3. Further studies are required to establish whether vitrification affects the outcomes of in vitro culture and the maturation of preantral follicles.

Correcting of pronated feet reduce skeletal muscle injury in young women with biomechanical abnormalities

Maria Regina Rachmawati,Angela B. M. Tulaar,Suzana Immanuel,A. Purba,Muchtaruddin Mansyur,Ratna Darjanti Haryadi,Ismail Hadisoebroto,Amin Husni,Nurhadi Ibrahim 대한해부학회 2016 Anatomy & Cell Biology Vol.49 No.1

Biomechanical abnormalities of pronated feet accompanied by functional leg length disparity may increase the risk of skeletal muscle injury. Objective of the study is to prove that correction of pronated feet by the foot orthoses will reduce the creatine kinase-MM (CK-MM) concentrations as the muscle injury indicator. The design study was double blind randomized clinical trials with control. Research subjects were divided into two groups, group 1 used the foot orthoses while group 2 did not used the foot orthoses. The whole subject examined the concentrations of the CK-MM enzyme before, and 24–72 hours after the walking test. The walking test was conducted 15 minutes with maximum speed. The concentration of the CK-MM enzyme before walking test on treatment group was 70.07±15.33 International Unit (IU), similar with the control group was 69.85±17.03 IU (P=0.971). The increased in CK-MM enzyme concentrations 45 hours after the walking test was lower in the treatment group (7.8±9 IU) than the control group (22.0±11.5 IU) (P=0.001). The CK-MM enzyme concentrations continued to decline in the treatment group after the second walking test (77.21±17.47 IU), and after the third walking test (69.86±11.88 IU) (P=0.018). The foot orthoses for correcting the pronated feet on the young women with biomechanical abnormalities is able to reduce the degree of the skeletal muscle injury after walking activity.

The Role of CYP2B6*6 Gene Polymorphisms in 3,5,6-Trichloro-2-pyridinol Levels as a Biomarker of Chlorpyrifos Toxicity Among Indonesian Farmers

Jen Fuk Liem,Dwi A. Suryandari,Safarina G. Malik,Muchtaruddin Mansyur,Dewi S. Soemarko,Aria Kekalih,Imam Subekti,Franciscus D. Suyatna,Bertha Pangaribuan 대한예방의학회 2022 예방의학회지 Vol.55 No.3

Objectives: One of the most widely used pesticides today is chlorpyrifos (CPF). Cytochrome P450 (CYP)2B6, the most prominent catalyst in CPF bioactivation, is highly polymorphic. The objective of our study was to evaluate the role of CYP2B6*6, which contains both 516G>T and 785A>G polymorphisms, in CPF toxicity, as represented by the concentration of 3,5,6-trichloro-2-pyridinol (TCPy), among vegetable farmers in Central Java, Indonesia, where CPF has been commonly used. Methods: A cross-sectional study was conducted among 132 vegetable farmers. Individual socio-demographic and occupational characteristics, as determinants of TCPy levels, were obtained using a structured interviewer-administered questionnaire and subsequently used to estimate the cumulative exposure level (CEL). TCPy levels were detected with liquid chromatography-mass spectrometry. CYP2B6*6 gene polymorphisms were analyzed using a TaqMan® SNP Genotyping Assay and Sanger sequencing. Linear regression analysis was performed to analyze the association between TCPy, as a biomarker of CPF exposure, and its determinants. Results: The prevalence of CYP2B6*6 polymorphisms was 31% for *1/*1, 51% for *1/*6, and 18% for *6/*6. TCPy concentrations were higher among participants with CYP2B6*1/*1 than among those with *1/*6 or *6/*6 genotypes. CYP2B6*6 gene polymorphisms, smoking, CEL, body mass index, and spraying time were retained in the final linear regression model as determinants of TCPy. Conclusions: The results suggest that CYP2B6*6 gene polymorphisms may play an important role in influencing susceptibility to CPF exposure. CYP2B6*6 gene polymorphisms together with CEL, smoking habits, body mass index, and spraying time were the determinants of urinary TCPy concentrations, as a biomarker of CPF toxicity.