BACKGROUND: Tumor Necrosis Factor-alpha (TNF-α) is a pro-inflammatory cytokine that plays a role in immune response against tuberculosis (TB) infection. Polymorphism in TNF-α gene may be associated with susceptibility to pulmonary TB (PTB).
AIM: The purpose of this study was to investigate whether TNF-α-308G/A gene polymorphism is associated with susceptibility to PTB in Medan city, Indonesia.
METHODS: This is a case–control study with 100 PTB patients and 100 healthy control. TNF-α polymorphism genotyping was performed by polymerase chain reaction fragment length polymorphism method.
RESULTS: There were 200 participants enrolled in this study. Most of the participants were male and were in the age range of 20–39 years. Genotyping examination revealed that in the TB group, AG and GG genotype was found in 80 people (80%) and 20 people (20%), respectively. There were no TB patients with AA genotypes. Whereas, in the control group, subjects with AA, AG, and GG genotypes were 2 (2%), 47 (47%), and 51 (51%), respectively. Statistical analysis showed that there was a significant relationship between TNF-α-308 G/A polymorphism and PTB, in which individuals with AG genotypes were 4.3 times more likely to suffer PTB compared to GG genotype (p < 0.001, 95% confidence interval (CI) 2.31–8.15). Further analysis showed that A allele increased the risk of TB incidence by 1.94-fold compared to the G allele (p = 0.002, 95% CI 1.27–2.98).
CONCLUSIONS: There was a significant relationship between TNFα-308 G/A gene polymorphism and the susceptibility to PTB and A allele increases the risk of pulmonary TB compared to G allele.
Introduction: Multidrug-resistant tuberculosis (MDR-TB) has become a new problem in the world. Many factors have been associated with MDR-TB occurrence. Some studies have demonstrated a role of vitamin D level and vitamin D receptor (VDR) gene polymorphism in MDR-TB. The aim of this study is to explore the role of FokI polymorphisms of the VDR gene and vitamin D level in MDR-TB occurrence in Medan city, Indonesia. Material and methods: This is a case-control study. Cases were 43 MDR-TB patients from the MDR-TB polyclinic Adam Malik Hospital in Medan, Indonesia. The control group comprised 56 new pulmonary TB cases with positive AFB sputum smear. Patients who were HIV positive, known to have diabetes mellitus or other severe disease, taking immunosuppressive drugs and vitamin D were excluded for both groups. Genetic polymorphisms of the VDR gene were analyzed using PCR-RFLP. Vitamin D level was analyzed using the ELISA procedure. Results: The frequencies of FokI genotypes were FF 39.5%, Ff 53.5%, ff 7.0% for MDR-TB patients and FF 39.3%, Ff 46.4.% and ff 14.3% for controls. There was no significant association between FokI genotype of the VDR gene and MDR-TB. Vitamin D level in MDR-TB was 53.5% sufficient, 39.5% insufficient and 7.0% deficient. Vitamin D level was 41.1% sufficient, 46.4% insufficient and 12.5% deficient in TB non-MDR. There was no significant association between vitamin D level and MDR-TB. Conclusions: No role of FokI polymorphism of the VDR gene and vitamin D level in MDR-TB occurrence was found.
AbstrakMakalah ini memaparkan bagaimana menerapkan character education dalam kelasdengan menggunakan keterampilan membaca teks hortatory. Pada awal pembelajaran,guru memodelkan salah satu karakter yang perlu dimiliki siswa kemudian agar siswamempunyai kreatifitas dalam berfikir, guru menampilkan sebuah gambar dan memintapendapat mereka tentang gambar tersebut. Setelah itu, guru memberikan sebuah tekshortatory yang berkaitan dengan gambar dan character education di dalamnya. Gurumembimbing siswa untuk bisa memahami isi teks dan berdiskusi tentang apa yangdibahas di dalam teks dengan melibatkan atau memperkenalkan beberapa charactereducation dalam proses pengajarannya. Untuk membuat siswa lebih paham terhadapteks yang mereka baca, guru menyuruh siswa untuk berdiskusi dengan kelompoknyamembuat sebuah tulisan tentang kesimpulan dari isi teks tersebut dengan menggunakanbahasa mereka sendiri dan melaporkannya di depan kelas. Selain itu, guru juga dapatmemperkenalkan character education tersebut melalui langkah pembelajaran yangditerapkan. Kata Kunci: Character Education, Membaca dan Teks Hortatory
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