IN INFANT WITH ACUTE DIARRHEA, NUTRITIONAL STATUS HAS CORRELATION WITH DEHYDRATION DEGREE, BUT NOT WITH MOTHER'S EDUCATION AND BREASTFEEDING (AIfina Multaza Rahmi, Alpha Fardah, Budiono) THE USE OF ANTIBIOTICS IN PATIENTS WITH URINARY TRACT INFECTION (Muh

Vol. 5O No. 3 July

-

SePtember 2OL4

HEAVY METAL CONTAMINATION MAY HAVE A ROLE IN NEGATIVE CORRELATION BETWEEN SEAFOOD
CONSUMPTION AND VISUO-MOTOR OEVELOPMENT OF'I.3 YEAR.OLD CHILDREN IN SUBOISTRICT

BULAK, SUMBAYA
(Dwi Susanti, Djeuhar lsmall, Abdul Wahab)
DETECTION OF gyrA GENE MUTATION REGION lN FLUOROQUINOLONE RESISTANT
Mycobaclerlum tubercurosE ISOLATE FROM SURABAYA INDoNESIA
Kusumaningrum, Ni Made Mertaniasih, NurulWiqoyah
ISTRATION DECREASES NITRIC OXIDE SERUM LEVEL
(lswinarno Doso Sapulro, Lobredia zarasade, Bobby Swadharma Putra).
THE OVERVIEW OF MAGROPHAGE, MAST cELL, AND LYMPHOCYTE ACTIVITY lN THE EFFICACY
DISTINCTION OF PAIN REOUCTION FOR DRY AND WET CUPPING THERAPIES
(lmam Subadi, Hening Laswati Putra, lndrayuni LukitE Wardhani)
EFFECTIVENESS OF FOSFOMYCIN ON PREVENTION OF SURGICAL SITE INFECTION OF CLOSED
BRAIN INJURY PATIENTS AFTER CRANIOTOMY IN EMERGENCY UNIT DR. SOETOMO HOSPITAL

(Nuril Auliya Husna, Yulistiani, Joni Wahyuhadi, Ni Made Mertaniasih)
SOOT PARTICULATE MATTER EXPOSURE INCREASES INTERLEUKIN 6 LEVELS
IN THE MECHANISM OF CARDIOVASCULAR DISORDERS
(Rerdin Julario, Muhammad Aminuddin)
ELECTRIC SHOCK INCREASES VCAM AND MCP IN MICE ENOOTHELIAL BLOOD VESSEL
(Binti Yunariyah)
MAGNESIUM AND POTASSIUM PARENTERAL SUPPLEMENTATION DOES NOT PRODUCE
SIGNIFICANT EFFECT ON MAGNESIUM AND POTASSIUM SERUM LEVEL OF CERVICAL CANCER
PATIENTS RECEIVING CISPLATIN CHEMOTHERAPY
(Elisabeth Kasih, Suhatno, Yulistiani, Muhammad Yahya)
EFFECT OF G-CSF ON ANC LEVEL lN ALL (Acute Lymphoblastic Leukemia) PATIENT WITH
NEUTROPENIA AND FEBRILE NEUTROPENIA DURING CHEMOTHERAPY
(Siti Nur Asiyah, Bambang Pemono, Yullstiani, Mariyatul Qibtiyah)
COMPARATIVE EFFECTIVENESS OF PARACETAMOL AND METAMIZOL AS ANTIPYRETICS
IN PATIENTS WITH MODERATE AND SEVERE BRAIN INJURY IN DR. SOETOMO HOSPITAL,

SURABAYA
(Nasruhan A, Suhaiono Joni Wahyuhadi)
ANALYSIS OF COMPLICATED FACTORS AFFECTING THERAPY EFFECTIVENESS
IN URINARY TRACT INFECTIONS

(Mlza Junando, Achmad Taruna, Didik Hasmono)
IN INFANT WITH ACUTE DIARRHEA, NUTRITIONAL STATUS HAS CORRELATION WITH

DEHYDRATION DEGREE, BUT NOT WITH MOTHER'S EDUCATION AND BREASTFEEDING
(AIfina Multaza Rahmi, Alpha Fardah, Budiono)

THE USE OF ANTIBIOTICS IN PATIENTS WITH URINARY TRACT INFECTION
(Muhammad Tharlq Nadhafi, Budi Suprapti, Agung DwiWahyu widodo, Bambang wahjupra]itno)

International Online Distribution by ProQuest'"
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FOLIA MEDICA INDONESIANA
rssN 2355-8393
Vol. 5O no. 3 July - September 2Ot4
Medical journal, published by Airrangga university schoor of Medicine, surabaya, pubrishing
original basic medical and clinical articles presented as research artacles and review
articles

Editor-in Chief

Prof Dr Suhartono Taat Putra, dr, MS

Deputy Ediror-in-Chief
I Dewa Gede Ugrasena, dr, SpA(K)

Editorial Board
ProfBambang Permono, dr, SpA(K)
Prof Pumomo Suryohudoyo, dr
ProfDr Doddy M Soebadi, dr, SpB, SpU(K)
ProfSoehartono DS, dr, SpOC(K)
Prof Dr Harjanto, dr, AIF
Dr FM Judajana, dr, SppK
Prof Soetjipto, dr, MS, phD
Prof Dr Suharto, dr, MSc, DTM&H, SppD-KTI
Prof Dr Subijanto Marto Soedarrno, dr, SpA(K)
Prof Dr Kuntaman, dr, MS, SpMK
Dr Anang Endaryanto, dr, SpA(K)
Edhi Rianto, dr, MS

Managing Editor

Ahmad Suryawan, dr, SpA(K)
Dr I Ketut Sudiana, drs, MSi
Dr Nyilo Purnarni, dr, SpTHT-KL(K)
Viskasari Pintoko Kalanjati, dr, MKes, phD
Purwo Sri Rejeki, dr, MKes
Dr Gondo Mastutik, drh, MKes
Mia Ratwita Andarsini, dr, SpA
Wita Saraswati, dr, SpOG
Dr Ahmad Yudianto, dr, SpF
Linda Dewanti, dr, MKes, HMsc, phD

Secretariat
Mochamrrad Zuhdy, S.Sos
Firriya Niken Ariningsih, S.Sos
Athfi yatul Fatati, S.Ant

Published by

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:

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E-mail: foliamedica@grnail.comb

FOLIA MEDICA INDONESIANA
rssN 2355-8393
Vol. 50 no. 3 July - September 2014

CONTENTS
HEAVY METAL CONTAMINATION MAY HAVE A ROLE IN NEGATIVE CORRELATION BETWEEN SEAFOOO
CONSUMPTION AND VISUO.MOTOR DEVELOP}IENT OF 1,3 YEAROLD CHILDREN II{ SUBDISTRICT

BULAK, SURABAYA

(Dwi Susanti, D,auhar lsmail, Abdut Wahab)

131

DETECTION OF gyTA GENE MUTATIoN REGIoiI IN FLUoRoQUINoLoI{E
Mycobacteium tubercurosrs TSOLATE FRoM SURABAYA |NDONES|A
(Deby Kusumaningrum, Ni Made Mertaniasih, N'rrutWiqoyah)

y'

-

138

RESISTANT

139- 1a2

rNTMvENous vtrAMtN c ADM|NtsrRATtoN DECREASEs NtrRtc oxtoE sERUit LEVEL
IN SEVERE BURN INJURY

tls-'ttt /

(lswimmo 0060 Ssputo, Lobredia Zarasade, Eobby Swadharma putra)
THE OVERVIEW OF MACROPHAGE, MAST CELL, AND LYMPHOCYTE ACTIVITY IN THE EFFICACY
DISTINCTION OF PAIN REDUCTION FOR DRY AND WET CUPPING THERAPIES
(ham Subadi, Hening Laswati Putra, lndrayuni Lukitra Wadhani)
EFFECTIVENESS OF FOSFOMYCIiI ON PREVENTION OF SURGICAL SITE INFECTION OF CLOSED
BRAIN INJURY PATIENTS AFTER CMI{IOTOMY IN EMERGENCY UNIT DR. SOETOMO HOSPITAL
(Nuril Auliya Husna, Yutisliani, Joni Wahyuhadi, Ni Made Mertaniasih)

SOOI PARTICULATE iIATTER EXPOSURE INCREASES INTERLEUKIN

IN THE MECHANISM OF CARDIOVASCULAR DISORDERS
(Rerdin Julario, [ruhammad Aminuddin)

14 -

13;2

l5:l

-

159

r80-

16:t

6 LEVELS

ELECTRIC S}IOCK INCREASES VCAITI ANo McP IN MIcE ENDoTHELIAL BLooD vEssEL

1

-171

MAGNESIUM AND POTASSIUM PARENTERAL SUPPLEMENTATION DOES NOT PRODUCE
SIGNIFICANT EFFECT ON MAGNESIUM AND POTASSIUM SERUM LEVEL OF CERVICAL CANCER
PATIE TS RECEIVITIG CISPLATIN CHEMOTHERAPY
(Elisabeth Kasih, Suhatno, Yulistiani, Ntuhammad Yahya)

172

-

17A

EFFECT OF G-CSF ON ANc LEVEL tN ALL (Acute Lyhphobtasttc L6u*smta) PAT|ENT wlTH
NEUTROPENIAAND FEBRILE IiIEUTROPENIADURING CHEMOTHERAPY
(Sili NurAsiyah, Bambang Permono, yirtisliani, Mariyalut eibliyah)

t7s

-

186

(BinliYunariyah)

COMPARATIVE EFFECTIVENESS OF PARACETAMOL AND MEIAMEOL AS ANTIPYRETICS
IN PATIENTS UIITH MODERATE AND SEVERE BRAIN INJURY IN DR. SOETOiIO HOSPITAL,

SURABAYA

(Nasruhan A, Suha.jono, Joni Wahyuhadi)

187- t00

ANALYSIS OF COT PLICATED FACTORS AFFECTING THERAPY EFFECTIVENESS
IN URINARY TRACT INFECTIOI,IS

(l'riza Junando, Achmad Taruna, Didik Hasmono)

191- t96

IN INFANTwlTH ACUTE DIARRHEA. NUTRITIONAL STATUS HAS CORRELATION WITH
DEHYDRATIOiT DEGREE, BUT NOT wlTH MOTHER'S EOUCATION AND BREASTFEEDIiIG
(Alfina l,4ultaza Rahmi, Alpha Fardah, Budiono)

197- 203

THE USE OF ANTIBIOTICS IN PATIENTS wlTH URINARY TRACT INFECTION
(Muhammad Thariq Nadha,i, BudiSuprapti, Agung Dwiwahyu Widodo, aambang Wahjuprajitno)

20ll-2lO

lntravenous VitamiD C Administration Decreases Nitric Oxide S€rum Level in Severe Bum Injury

Gswinmo Doso Saputro

et L

INTRAVENOUS VITAMIN C ADMINISTRATION DECREASES NITRIC OXIDE SERUM LEVEL

IN SEVERE BURN INJURY

Iswinarno Doso Soputro!Lobredia Zarasade, Bobby Swadharma putra
Department of Plastic and Reconstructive Surgery, Dr. Soetomo Hospital, Faculty of Medicine,
Universitas Airlangga, Surabaya

ABSTRAK
Oksido nilrat (NO) dapat menyebabkan hipolensi sislemik dan apoptosis, mengakibatkan kereakanjaringan don kegagalan organ
pada luka bakar, yang meningkatkan qktivitds enzim Nitric Oxide Syntue (NOS) don pelepuan Nb. Siikin proinjaiui terlibat
dqlam induksi NOS dan aktivui dan pelepasqn NO Yitamin C minekan produlsi sitikin'proinjlamalory, sehingga produlai NO
dihambqt Penelilion ini bertuiuan untuk meninjau intravena vitanin C 3000 mg elek paaa NO kiaar serim datoiTukq bakar yang
paroh Penelitian ini menggunakan rondomized prelest and post-test controilea group daign di 12 pasien luka bokor di Unit Luka
Bqkqr, RSUD Dr. Soetomo, Surobaya- NO diperiksa pada 12 posien yang dibagi menioii 2 ketinpok. Kelonpok kontrol (Kl)
menerima vitamin C 2 x 400 mg/24 iom selamo 72 jon dan kelompok perlokuon (K2) menerimo inrtt iitanin C 3000 ng selana 72
iam NO dianbil dori semm darah dan diamati dengan melode Greose Huil dianalisis dengan Paired T-Tqt don tes stalistik
dengan p 0 05). While the levels of albumin in
the control group \uas (Kl) significantly decreasing with
p :0.04 (p < 0.05). Vitamin C group (IC), the amount
ofleukocytes decreased significantly p:0.01 (p < 0.05)
in the fourth day compared to the first day. While the
levels of semm creatinine, BUN, blood pH and albumin
are encountered insigniticant difference. Prior to the
statistical test, the normality tests on the levels ofNitric
Oxide (NO) were made before and after keatment.
Nomality test is used to determine whether clinical or

3,0
2,0
1,0

0,0

H1
Figure

4. Diagram analysis of

the mean NO group

vitamin C.
8
5

4
2

laboratory parameter data distributed normally.
Normality test of levels of NO were done using the

0
-2

Kolmogorov-Sminov techniques. The results According

-4

to the table, serum levels of NO in the control group
(Kl) and vitamin c group (K2), in the first and fourth
day normally distributed with p > 0.05. Using paired t
test analysis to analyze changes in the levels of Nitric

Figure

145

r

H4

5.

Diagram Analysis ofthe results ofthe shrdy
conhol group (Kl) and the vitamin C (K2).

Folia Medica Indonesiana Vol 50No. 3 July - September20l4 : 143-147

Independent

t

test was done to analyze the

Transcription factor NF-rB has a crucial role in the
inflammatory process. NF-xIi is a transcription factor
that triggers the production of cytokines. Administering
of LPS can activates the NF-rB which increases the
production of inflammatory mediators such as IL-8,

mean

difference between the control group (Kl) with Vitamin
C 3000 mg group. The control group gained an increase
in the average levels of Nitric Oxide (NO) as much as
1.8 + 3.1 pM levels from 4.7 +3.2 pM before treatment
to 6.5 + 3.3 pM after treatment. The vitamin C 3000mg
obtained a decrease of -2.6 + 2.7 pM from 3.1 + 6.6 pM
levels before treatment to 3.8 + 1.4 pM after treatment.

Analysis

of NO

difference (Delta NO) showed

TNF-a, intercellular adhesion molecule (ICAM)

dancyclooxygenase-2. Vitamin C as an antiinflammatory is also able to suppress the activation of
the transcription factor nuclear factor rB (NF-rB) and
inhibit tumor necrosis factor o (TNF-or) NF-rB is a
transcription factor that is responsible for the fonnation
of several proinflammatory clokines sucb as TNF-cr,
interleukin-l (IL-l), IL-6, and IL-S (Fmis 2005).

a

significant reduction in the value ofp :6.9, (p < 0.05)
in the comparison between the NO on the vitamin C
(K2) with NO in the control group (Kl).

Observations showed that leukocyte levels ofthe group

DISCUSSION

given 3000 mg of vitamin C decline significantly in the
fourth day compared to the first day. As an antioxidant,
vitamin C can react with ROS produced by neutrophils
and macrophages in the inflammatory phase, converting

Local and systemic changes are caused by inflammatory

mediators. Severe bums also cause depression of
cellular and humoral immune response and phagocytes
aspects of blood-borne macrophages. Burns initiate
systemic inflammatory reaction caused by toxins and

bums oxygen radicals and evenfually lead

free radicals to more inert form. Arachidonic acid
wilt be cut so that
the inflammatory reaction will stop. Therefore, the anticascade, which is activated by ROS

to

peroxidation. Reactive oxygen metabolites cause
destruction or damage to the cell membrane by lipid

inflammatory effects allegedly associated with vitamin
C as an antioxidant nature (Lima et al 2009). Galley et
al (1996) discovered in his study of vitamin C
concentration of total pre-infusion in septic patients is
lower than healthy subjects. This study indicated that
patients in sepsis syndrome had a quite much lower total
vitamin C than normal controls, and it was consistent
with previous studies that found low levels of ascorbic
acid in the group ofpatients at critical illness, as well as
the decrease in the ratio of ascorbic acid to
dehidroascorbic. Low concentration of Vitamin C levels
in patients with sepsis noted that subjects likely

peroxidation. The relationship between the number of
products of oxidative metabolism and free radical
scavenger naturally detemine the result of local and
systemic tissue damage, also organ failure subsequent to
the bum (Horton 2003). The release of proinflammatory cytokines (TNF-c, IL-l and IL-6) is an
important mechanism in the regulation of the acute
phase response to bums. TNF-c is a triggering cytokine
that induce a cascade of secondary cytokines and
humoral factors then lead to systemic and local sequele.

And then TNF-c is involved in the development of
conditions such as shock associated with bums and
sepsis (Qakir & Ye[en 2004).

Nitric oxide is a biological molecule produced

susceptible to oxidant stress

study, the result of vitarrin C 3000 mg
administration showed insignifi cant decreasing of sen:m
NO levels on day four compared to day one. This
insignificant decreasing might be because the drug

In this

by

different cell types, have a good and bad effect as well
to the blood vessels and cellular level. NO is an
important key to the pathogenesis of sepsis. INOS
activation would lead to the formation of large numbers
NO and showed that L-arginine is available in sullicient
quantities (Chen et al 1999). Schorah et al (1996)
reported a study conducted on patients admitted in the
ICU that showed lower levels of total vitamin C,
ascorbic acid and dehydroascorbic acid than in patients
with gastritis, diabetes, and healthy people. Long et al
(2003) found that patient's ascorbic acid plasma levels
on parenteral dose of 300 mg/day ofascorbic acid for 2
days is unresponsive. Plasma levels began to rise at
1000 mglday in 2 days but still below normal levels, it
takes 3 days or more after the parenteral dose 3000

administration period is too short. But there is a
significant decrease in the levels ofNO in the fourth day
of fiom the first day (delta NO) in the group given a
vitamin C 3000 mg (K2) compared with the group
without vitamin C (K1). Antioxidants are the body's
protective system against free radical activity generated
both endogenous and exogenous which is owned by
every normal cells.

Antioxidants are defined as components that can protect
itself against oxidation process that can him it into free
radicals despite the very small amount when compared
to other components. Giving high doses of vitamin C
will cause dianhea, kidney stones and kidney
dysfunction. In this shrdy there was no significant

mg/day to achieve normal plasma levels.

r46

Intmvenous Vitamin C Administmtion Decrcases

Nitric Oxide Serum Level in Severe Bum Injury (lswinamo Doso Saputro

treating photoaging and other

dermatologic
conditions. Dermatol Surg 31, 814-817
Galley HF, Davies MJ, Webster NR (1996). Ascorbyl

radical formation in patients with sepsis: effect of

ascorbate loading. Free Radic Biol Med 20' 139-143
Horton JW (2003). Free radicals and lipid peroxidation
mediated injury in bum hauma: the role of antioxidant
therapy. ToxicologY I 89, 75-88
Lima CC, Pereira AP, Silva JR, Oliveira LS, Resck MC,
Grechi CO, Bemardes MT, Olimpio FM, Santos AM,
lncerpi EK, Garcia JA (2009). Ascorbic acid for the
healing ofskin wounds in rats. Braz J Biol 69, 1195-

determined time.

CONCLUSION

C administration

decreases nitric

1201

oxide serum level in severe bum injury.

Long CL, Maull KI, Krishnm RS, Laws HL, Geiger
JW, norghesi L, Franks W, Lawson TC, Sauberlich
HE (2003). Ascorbic acid dynamics in the seriously ill

REFERENCES
Qakir B and Yelen BC (2004). Systemic responses

al)

Fanis PK (2005). Topical vitamin C: a useful agent for

ofBUN and serum creatinin Ievels in the group
received 3000 mg of vitamin C in the fourth day
compared to the first day. This study has several
limitations such as NO examination cannot be
performed in Dr. Soetomo hospital, and it is difficult to
achieve the number of sample of new severe bums
patients which matched the inclusion criteria in
increase

Intravenous vitamin

et

and injured. J Surg Res 109, 144-148
Schorah CJ, Downing C, Piripitsi A, Gallivan L, A1Hazaa AH, Sanderson MJ, Bodenham A (1996). Total
vitamin C, ascorbic acid, and dehydroascorbic acid
concentrations in plasma of critically ill patients. Am J

to

bum injury. Turk J Med Sci34,2l5-226
Chen LW, Hsu CM, Cha MC, Chen JS, Chen SC
(1999). Changes in gut mucosal nitric oxide synthase
(NOS) activity after thermal injury and its relation

Clin Nuh 63, 760-765

with barrier failure. Shock I 1, 104-l 10

t
:

I
t
141