KARAKTERISASI ISOLAT AKTIF DAUN SIRSAK (Annona muricata L.) DAN UJI SITOTOKSISITAS ISOLAT AKTIFNYA TERHADAP SEL HeLa

Vector Stephen Dewangga. S901308006. 2015. Karakterisasi Isolat Aktif Daun Sirsak (Annona muricata L.) dan Uji Sitotoksisitas Isolat Aktifnya terhadap Sel HeLa. Tesis. Pembimbing I: Prof. Dr. Okid Parama Astirin, M.S, Pembimbing II: Dr. Tetri Widiyani, M.Si. Program Studi Biosain. Program Pascasarjana Universitas Sebelas Maret. ABSTRAK Indonesia merupakan negara kedua di dunia setelah Cina yang memiliki penderita kanker serviks terbanyak, kanker ini disebabkan oleh infeksi dari Human Papilloma Virus (HPV). Sebagian besar obat-obat kemoterapi kanker memiliki efek samping berupa kerusakan-kerusakan pada jaringan yang masih sehat. Penelitian in vitro mengenai ekstrak kasar dan fraksi dari daun sirsak (Annona muricata L.) telah menunjukkan hasil yang efektif dalam menghambat pertumbuhan kanker serviks. Tujuan penelitian ini ialah untuk mengetahui nilai Inhibition Concentration 50 (IC50) dari isolat teraktif yang diujikan pada sel HeLa dan menemukan struktur kimia dari isolat teraktif dari A. muricata L. yang dideteksi dengan Fourier Transform Infra Red (FT-IR) dan spektrofotometer Ultraviolet-Visible (UV-Vis). Pencarian isolat teraktif daun A. muricata L. diawali dengan metode perkolasi menggunakan pelarut etanol 96%. Perkolat kemudian difraksinasi dengan kloroform-etil asetat (9:1 v/v), hingga diperoleh bercak tunggal pada KLT yang menandai keberadaan isolat teraktif. Isolat teraktif dikarakterisasi dengan menggunakan FT-IR dan spektrofotometer UV-Vis. Selanjutnya dilakukan uji sitotoksisitas isolat teraktif pada sel HeLa untuk dapat diketahui nilai IC50. Hasil penelitian menunjukkan keberadaan metabolit sekunder terpenoid dan steroid pada fraksi teraktif daun A. muricata L. Dari FT-IR dijumpai 16 titik serapan, serapan pada 1.743,72 cm -1 menunjukkan keberadaan gugus lakton yang berasal dari gugus C=O pada γ–butirolakton. Dari spektrofotometer UV-Vis, dijumpai titik absorbansi maksimal pada panjang gelombang 210 nm, 213 nm dan 216-234 nm, yang menunjukkan adanya gugus ketolakton dari ikatan rangkap C=C, C=O, serta ikatan tunggal C-O yang menunjukkan adanya gugus tetrahidrofuran yang berasal dari ikatan C-O-C. Isolat teraktif fraksi kloroform-etil asetat daun A. muricata L. memiliki nilai IC50 sebesar 77,096 µg/ml terhadap sel HeLa, yang berarti potensial untuk menghambat proliferasi sel HeLa. Kata Kunci: fraksi teraktif daun Annona muricata L., FT-IR, spektrofotometer UV-Vis, sel HeLa, IC50

Monitoring and evaluating the impact of national school-based deworming in Kenya: study design and baseline results.

BACKGROUND: An increasing number of countries in Africa and elsewhere are developing national plans for the control of neglected tropical diseases. A key component of such plans is school-based deworming (SBD) for the control of soil-transmitted helminths (STHs) and schistosomiasis. Monitoring and evaluation (M&E) of national programmes is essential to ensure they are achieving their stated aims and to evaluate when to reduce the frequency of treatment or when to halt it altogether. The article describes the M&E design of the Kenya national SBD programme and presents results from the baseline survey conducted in early 2012. METHODS: The M&E design involves a stratified series of pre- and post-intervention, repeat cross-sectional surveys in a representative sample of 200 schools (over 20,000 children) across Kenya. Schools were sampled based on previous knowledge of STH endemicity and were proportional to population size. Stool (and where relevant urine) samples were obtained for microscopic examination and in a subset of schools; finger-prick blood samples were collected to estimate haemoglobin concentration. Descriptive and spatial analyses were conducted. The evaluation measured both prevalence and intensity of infection. RESULTS: Overall, 32.4% of children were infected with at least one STH species, with Ascaris lumbricoides as the most common species detected. The overall prevalence of Schistosoma mansoni was 2.1%, while in the Coast Province the prevalence of S. haematobium was 14.8%. There was marked geographical variation in the prevalence of species infection at school, district and province levels. The prevalence of hookworm infection was highest in Western Province (25.1%), while A. lumbricoides and T. trichiura prevalence was highest in the Rift Valley (27.1% and 11.9%). The lowest prevalence was observed in the Rift Valley for hookworm (3.5%), in the Coast for A. lumbricoides (1.0%), and in Nyanza for T. trichiura (3.6%). The prevalence of S. mansoni was most common in Western Province (4.1%). CONCLUSIONS: The current findings are consistent with the known spatial ecology of STH and schistosome infections and provide an important empirical basis on which to evaluate the impact of regular mass treatment through the school system in Kenya

Analysing and Recommending Options for Maintaining Universal Coverage with Long-Lasting Insecticidal Nets: The Case of Tanzania in 2011.

Tanzania achieved universal coverage with long-lasting insecticidal nets (LLINs) in October 2011, after three years of free mass net distribution campaigns and is now faced with the challenge of maintaining high coverage as nets wear out and the population grows. A process of exploring options for a continuous or "Keep-Up" distribution system was initiated in early 2011. This paper presents for the first time a comprehensive national process to review the major considerations, findings and recommendations for the implementation of a new strategy. Stakeholder meetings and site visits were conducted in five locations in Tanzania to garner stakeholder input on the proposed distribution systems. Coverage levels for LLINs and their decline over time were modelled using NetCALC software, taking realistic net decay rates, current demographic profiles and other relevant parameters into consideration. Costs of the different distribution systems were estimated using local data. LLIN delivery was considered via mass campaigns, Antenatal Care-Expanded Programme on Immunization (ANC/EPI), community-based distribution, schools, the commercial sector and different combinations of the above. Most approaches appeared unlikely to maintain universal coverage when used alone. Mass campaigns, even when combined with a continuation of the Tanzania National Voucher Scheme (TNVS), would produce large temporal fluctuations in coverage levels; over 10 years this strategy would require 63.3 million LLINs and a total cost of $444 million USD. Community mechanisms, while able to deliver the required numbers of LLINs, would require a massive scale-up in monitoring, evaluation and supervision systems to ensure accurate application of identification criteria at the community level. School-based approaches combined with the existing TNVS would reach most Tanzanian households and deliver 65.4 million LLINs over 10 years at a total cost of$449 million USD and ensure continuous coverage. The cost of each strategy was largely driven by the number of LLINs delivered. The most cost-efficient strategy to maintain universal coverage is one that best optimizes the numbers of LLINs needed over time. A school-based approach using vouchers targeting all students in Standards 1, 3, 5, 7 and Forms 1 and 2 in combination with the TNVS appears to meet best the criteria of effectiveness, equity and efficiency

Polimorfisme Gen FTO Rs9939609 Terhadap Konsentrasi Trigliserida Pada Subyek Obesitas Sentral

Obesitas sentral merupakan keadaan bagian perut bagian tengah terdapat lemak yang berlebih. Penumpukan lemak berlebihan mengakibatkan peningkatan jumlah asam lemak bebas yang dihidrolisis LPL endotel. Free Fatty Acid (FFA) dilepaskan karena adanya penimbunan lemak yang berlebihan juga menghambat lipogenesis sehingga menghambat klirens serum triasilgliserol dan terjadinya hipertrigliseridemia. Gen FTO (fat mass and obesity associated) rs9939609 banyak dikaitkan dengan massa lemak dan obesitas. Tujuan penelitian untuk mengetahui gambaran polimorfisme gen FTO rs9939609 dan faktor risiko polimorfisme gen FTO rs9939609 terhadap konsentrasi trigliserida. Penelitian analitik observasional (pendekatan cross sectional) menggunakan 50 subjek obesitas sentral. Pemeriksaan polimorfisme gen FTO rs9939609 dengan metode RT-PCR dan konsentrasi trigliserida dengan metode GPO- PAP. Analisis statistik Chi-Square untuk mengetahui kesetimbangan Hardy Weinberg, uji Kruskal-Wallis untuk perbedaan variabel klinis terhadap kelompok genotipe dan alel variasi gen FTO rs9939609 dan faktor risiko variasi gen FTO rs9939609 terhadap konsentrasi trigliserida darah dengan Odds Ratio. Hasil penelitian didapatkan prevalensi alel T 55% dan alel A 45%, genotipe TT 30%, AT 50% dan AA 20%. Terdapat perbedaan yang signifikan lingkar perut dan konsentrasi trigliserida darah pada kelompok alel A gen FTO rs9939609 (p=0,036). Kesimpulan penelitian ini subyek dengan alel A gen FTO rs9939609 berisiko terjadi peningkatan trigliserida darah sebesar 3,448 kali

UJI RESISTENSI BAKTERI PADA URIN PENDERITA ISK TERHADAP ANTIBIOTIK LEVOFLOXACIN DAN CIPROFLOXACIN DI LABORATORIUM KLINIK PRODIA MAKASSAR

ABSTRACTUrinary tract infection (UTI) is a clinical condition due to the proliferation of microorganisms that cause inflammation in the urinary tract and cause bacteriuria. Bacterial resistance to antibiotics continues to change, so research is carried out on the level of resistance to certain antibiotics in order to facilitate the treatment of UTI. Urine culture examination includes culturing the suspect bacteria, identifying and testing the antibiotics ciprofloxacin and levofloxacin. This study uses a descriptive research design. The sample of this study was 27 samples taken from patients who had been diagnosed with UTI and underwent therapy from a doctor. The results of the study of bacteria causing UTI resistance to the antibiotic levofloxacin 41%, and to the antibiotic ciprofloxacin 44%. Streptococcus agalactiae bacteria were found to be antibiotic resistant to levofloxacin and ciprofloxacin 37.5%, Escherichia coli was found to be antibiotic resistant to levofloxacin and ciprofloxacin 50%, Staphylococcus aureus was to be antibiotic resistant to levofloxacin 0% and ciprofloxacin 25%, and to floxacin to the antibiotic floxacin 25%, to be antibiotic resistant to floxacin. Streptococcus pyeogenes was found to be 0% resistant to levofloxacin and ciprofloxacin antibiotics, and to Klebsiella oxytoca and Enterococcus faecalis were found to be 100% resistant

Comparative Field Evaluation of Combinations of Long-Lasting Insecticide Treated Nets and Indoor Residual Spraying, Relative to Either Method Alone, for Malaria Prevention in an Area where the main Vector is Anopheles Arabiensis.

Long-lasting insecticidal nets (LLINs) and indoor residual spraying (IRS) are commonly used together in the same households to improve malaria control despite inconsistent evidence on whether such combinations actually offer better protection than nets alone or IRS alone. Comparative tests were conducted using experimental huts fitted with LLINs, untreated nets, IRS plus untreated nets, or combinations of LLINs and IRS, in an area where Anopheles arabiensis is the predominant malaria vector species. Three LLIN types, Olyset®, PermaNet 2.0® and Icon Life® nets and three IRS treatments, pirimiphos-methyl, DDT, and lambda cyhalothrin, were used singly or in combinations. We compared, number of mosquitoes entering huts, proportion and number killed, proportions prevented from blood-feeding, time when mosquitoes exited the huts, and proportions caught exiting. The tests were done for four months in dry season and another six months in wet season, each time using new intact nets. All the net types, used with or without IRS, prevented >99% of indoor mosquito bites. Adding PermaNet 2.0® and Icon Life®, but not Olyset® nets into huts with any IRS increased mortality of malaria vectors relative to IRS alone. However, of all IRS treatments, only pirimiphos-methyl significantly increased vector mortality relative to LLINs alone, though this increase was modest. Overall, median mortality of An. arabiensis caught in huts with any of the treatments did not exceed 29%. No treatment reduced entry of the vectors into huts, except for marginal reductions due to PermaNet 2.0® nets and DDT. More than 95% of all mosquitoes were caught in exit traps rather than inside huts. Where the main malaria vector is An. arabiensis, adding IRS into houses with intact pyrethroid LLINs does not enhance house-hold level protection except where the IRS employs non-pyrethroid insecticides such as pirimiphos-methyl, which can confer modest enhancements. In contrast, adding intact bednets onto IRS enhances protection by preventing mosquito blood-feeding (even if the nets are non-insecticidal) and by slightly increasing mosquito mortality (in case of LLINs). The primary mode of action of intact LLINs against An. arabiensis is clearly bite prevention rather than insecticidal activity. Therefore, where resources are limited, priority should be to ensure that everyone at risk consistently uses LLINs and that the nets are regularly replaced before being excessively torn. Measures that maximize bite prevention (e.g. proper net sizes to effectively cover sleeping spaces, stronger net fibres that resist tears and burns and net use practices that preserve net longevity), should be emphasized

PENGHAMBATAN PERTUMBUHAN Klebsiella pneumoniae DENGAN EKSTRAK ETANOL DARI LIMBAH KULIT PISANG KEPOK (Musa paradisiaca L.)

Pisang kepok (Musa paradisiaca L.) adalah buah yang mudah ditemukan, akan tetapi kulit buahnya selama ini jarang dimanfaatkan. Pada kulit buah M. paradisiaca L. terkandung flavonoid, alkaloid, tanin, saponin, dan terpenoid yang berperan sebagai senyawa antibakteri. Penelitian ini bertujuan untuk mengetahui apakah ekstrak etanol limbah kulit M. paradisiaca L. mampu menghambat pertumbuhan Klebsiella pneumoniae. Metode penelitian yang digunakan adalah analitik eksperimental, sampel kulit M. paradisiaca L. diperoleh dari pedagang keripik pisang kepok di Kabupaten Karanganyar. Ekstrak etanol 96% kulit M. paradisiaca L. dibuat dengan menggunakan metode perkolasi, sedangkan uji aktivitas antibakteri dilakukan dengan metode Kirby-Bauer. Hasil penelitian menunjukkan bahwa ekstrak etanol 96% limbah kulit M. paradisiaca L. mampu menghambat pertumbuhan bakteri K. pneumoniae, pada konsentrasi 20%; 40%; 60%; 80% dan 100%, dengan rata-rata zona hambat berturut-turut 6,10 mm; 6,35 mm; 6,95 mm; 7,35 mm; dan 7,80 mm. Ekstrak etanol 96% kulit M. paradisiaca L. mampu membentuk zona hambat radikal pada semua konsentrasi terhadap pertumbuhan K. pneumoniae, namun tidak mampu menghasilkan zona hambat radikal setara dengan  kriteria sensitif antibiotik ciprofloxacin 5 µg berdasarkan CLSI 2018 terhadap pertumbuhan K. pneumoniae.   Banana kepok (Musa paradisiaca L.) is a fruit that is easily found, but the peel of the fruit has rarely been used. The peel of M. paradisiaca L. contains flavonoids, alkaloids, tannins, saponins, and terpenoids which act as antibacterial compounds. This study aims to determine whether the ethanol extract of M. paradisiaca L. peel can inhibit the growth of Klebsiella pneumoniae. The research method used was an experimental analytic, M. paradisiaca L. peel samples were obtained from banana chips traders in Karanganyar. Ethanol extract 96% of the skin of M. paradisiaca L. was prepared using the percolation method, whereas the antibacterial activity test was carried out by the Kirby-Bauer method. The results showed that the 96% ethanolic extract of M. paradisiaca L.peel was able to inhibit the growth of K. pneumoniae in 20%; 40%; 60%; 80% and 100% concentrations, with mean inhibitory zones in order 7,46 mm; 7,52 mm; 7,60 mm; 8,52 mm; dan 8,98 mm. 96% of ethanolic extract M. paradisiaca L. skin was able to form radical inhibitory zones at all concentrations of K. pneumoniae growth, but was unable to produce radical inhibitory zones equivalent to the 5µg ciprofloxacin antibiotic sensitive criteria based on CLSI 2018 on the growth of K. pneumoniae