Alamat Redaksi
Gedung KALBE
Jl. Letjen. Suprapto Kav. 4
Cempaka Putih, Jakarta 10510
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Fax: 021-4287 3685
E-mail: cdk.redaksi@yahoo.co.id
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Nomor Ijin
151/SK/DITJEN PPG/STT/1976 Tanggal 3 Juli 1976
Penerbit
Kalbe Farma
Pencetak
PT. Temprint
Susunan Redaksi
Ketua Pengarah
Dr. Boenjamin Setiawan, PhD
Pemimpin Umum
Dr. Erik Tapan
Ketua Penyunting
Dr. Budi Riyanto W.
Manajer Bisnis
Nofa, S.Si, Apt.
Dewan Redaksi
Prof. Dr. Sjahbanar Soebianto Zahir, MSc.
Dr. Michael Buyung Nugroho
Dr. Karta Sadana
Dr. Sujitno Fadli
Drs. Sie Djohan, Apt.
Ferry Sandra, Ph.D.
Budhi H. Simon, Ph.D.
Tata Usaha
Dodi Sumarna
CDK 174/vol.37 no.1/Januari - Februari 2010
5
ISSN: 0125-913 X
http://www.kalbe.co.id/cdk
ENGLISH SUMMARY
HIV and AIDS has become pandemic.
More than 30 millions are HIV infected,
particularly in Sub-Sahara Region. The
disease once known for its high mortality
rate, but has decreased substantially since
the introduction of Highly Active Anti Retro-
viral Therapy (HAART). HAART has changed
the status of AIDS to a chronic disease
like hypertension and diabetes mellitus.
Morbidity and mortality decrease leads to
significant quality-of-life increase among
people living with HIV and AIDS (PLWHA).
But adverse events emerges from long-
term use of ARVs. Lipodystrophy is one of
the notorious metabolic complications
and altered fat distribution, mostly found
among patients treated by combination
therapy of nucleoside analogues and
protease inhibitors (PIs). The prevalence of
lipodystrophy is between 30-50%; but
the relationship between PIs and lipodys-
trophy is not clear yet. It is advised to
switch to "non-lipodistrophy-inducing"
ARVs.
Keywords: HIV and AIDS, HAART, lipodys-
trophy, metabolic syndrome
CDK 2010; 37(1) : 17-20
Lipodystrophy Caused
by Anti Retroviral Drugs
Abraham Simatupang
Dept. of Pharmacology and Center for HIV Studies
and Care Faculty of Medicine, Christian University
of Indonesia, Jakarta, Indonesia
Erectile dysfunction (ED) is one of the sexual
dysfunctions that disturbs many men and
their partners all over the world. The inci-
dence of ED increases with age.
Basically causes of ED are divided into two
groups: physical factors and psychogenic
factors. There are 4 groups in physical
factors: endocrine, neurogenic, arterial,
venous, and iatrogenic factors. The psycho-
genic factors include all psychological factors
that can inhibit the mechanism of erection.
The 2
nd
International Consultation on
Erectile and Sexual Dysfunction recommen-
ded the use of erection hardness score (EHS)
for erectile function assessment as a part of
diagnostic evaluation for men with erectile
disorder.
According to IIEF-5, score 1 is equivalent to
Severe Erectile Dysfunction (IIEF 6-0), score 2
is equivalent to Moderate Erectile Dys-
function (IIEF 11-15), score 3 is equivalent
to Mild Erectile Dysfunction (IIEF 16-20),
and score 4 is equivalent to normal erectile
function (21-25).
The diagnosis of ED is established by sexual
history, medical history, clinical examination,
laboratory tests, and additional specialistic
tests.
The principles of ED management are :
1. Diagnose ED, differentiate with other
sexual
dysfunctions
2. Find the etiology
3. Treat the etiology
4. Recover the erectile function:
· Sexual counseling and sex therapy
· Oral erectogenic: PDE-5 inhibitor
· Local therapy: intracavernosal injection,
transurethral application, vacuum
constriction
device
·
Surgery
The goal of ED treatment is to achieve
optimal erection. A recent retrospective
data analysis on 26 randomized controlled
trials demonstrated that improved erection
hardness correlated with significant improve-
ments in sexual intercourse enjoyment,
sexual relationship satisfaction, and confi-
dence in erections for satisfactory sexual
activity.
After eleven years in worldwide market
and ten years in Indonesia, the role of
sildenafil citrate (Viagra
®
) is still dominant.
The following conclusions have been noted:
1. Most ED patients were satisfied with 50
mg Viagra
®
to achieve optimal erection. 2.
Partners of ED patients were also satisfied
with the quality of erection after taking
Viagra
®
. 3. Only very few patients have
adverse effects : headache, flushing, nasal
congestion. No drop out because of adverse
effects. 4. Many ED patients recover their
erectile function and do not have to take
Viagra
®
, at least for a period of time,
CDK 2010; 37(1) : 21-24
The quality of every human life is determined
by early nutrition status. Without sufficient
intake of micronutrient either through diet,
fortification or supplementation, one will
suffer tremendous but avoidable, lifelong
hardship. The need is great, with up to two
billion people suffer from micronutrients
deficiency.
Despite many causes of deficiencies and
great challenges posed by the sheer number
of people, proven and cost effective solution
exist. Fund and commitment, supported by
partnership, will expand the reach of micro-
nutrient interventions.
CDK 2010; 37(1) : 34-38
Management of
Erectile Dysfunction
Wimpie Pangkahila
Dept. of Andrology and Sexology, Center for
Study of Anti-Aging Medicine, Medical Faculty,
Udayana University, Denpasar, Indonesia
Solving Mineral and
Vitamin Deficiencies are
Investments in Human
Capital
Yekti Hartati, Mira Dewi, Darwin Karyadi
Department of Public Nutrition, Faculty of Human
Ecology, Bogor Agricultural Institute, Bogor,
Indonesia
6
CDK 174/vol.37 no.1/Januari - Februari 2010
Redaksi Kehormatan
Prof. Drg. Siti Wuryan A Prayitno, SKM, MScD, PhD
Bagian Periodontologi, Fakultas Kedokteran Gigi Universitas Indonesia, Jakarta
Prof. Dr. Abdul Muthalib, SpPD KHOM
Divisi Hematologi Onkologi Medik
Departemen Ilmu Penyakit Dalam Fakultas Kedokteran Universitas Indonesia/
RSUPN Dr. Cipto Mangunkusumo, Jakarta
Prof. Dr. Djoko Widodo, SpPD-KPTI
Departemen Ilmu Penyakit Dalam Fakultas Kedokteran Universitas Indonsia/
RSUPN Dr. Cipto Mangunkusumo, Jakarta
Prof. DR. Dr. Charles Surjadi, MPH
Pusat Penelitian Kesehatan Unika Atma Jaya Jakarta
Prof. DR. Dr. H. Azis Rani, SpPD, KGEH
Departemen Ilmu Penyakit Dalam Fakultas Kedokteran Universitas Indonesia/
RSUPN Dr. Cipto Mangunkusumo, Jakarta
Prof. DR. Dr. Sidartawan Soegondo, SpPD, KEMD, FACE
Departemen Ilmu Penyakit Dalam Fakultas Kedokteran Universitas Indonesia/
RSUPN Dr. Cipto Mangunkusumo, Jakarta
DR. Dr. Abidin Widjanarko, SpPD-KHOM
Fakultas Kedokteran Universitas Indonesia/RS Kanker Dharmais, Jakarta
DR. Dr. med. Abraham Simatupang, MKes
Bagian Farmakologi, Fakultas Kedokteran Universitas Kristen Indonesia, Jakarta
Prof. Dr. Sarah S. Waraouw, SpA(K)
Dekan Fakultas Kedokteran Universitas Sam Ratulangi, Manado
Prof. DR. Dr. Rully M.A. Roesli, SpPD-KGH
Bagian Ilmu Penyakit Dalam Fakultas Kedokteran Universitas Padjadjaran/
RSUP Dr. Hasan Sadikin, Bandung
Dr. Aucky Hinting, PhD, SpAnd
Bagian Biomedik Fakultas Kedokteran Universitas Airlangga Surabaya
DR. Dr. Yoga Yuniadi, SpJP
Departemen Kardiologi dan Kedokteran Vaskular FKUI/
Pusat Jantung Nasional Harapan Kita, Jakarta
Prof. DR. Dra. Arini Setiawati
Bagian Farmakologi Fakultas Kedokteran Universitas Indonesia, Jakarta
Prof. Dr. Faisal Yunus, PhD, SpP(K)
Departemen Pulmonologi & Ilmu Kedokteran Respirasi Fakultas Kedokteran
Universitas Indonesia/SMF Paru RS Persahabatan, Jakarta
Prof. DR. Dr. Rianto Setiabudy, SpFK
Bagian Farmakologi Fakultas Kedokteran Universitas Indonesia, Jakarta
Dr. R.M. Nugroho Abikusno, MSc., DrPH
Fakultas Kedokteran Universitas Trisakti, Jakarta
Prof. DR. Dr. Wimpie Pangkahila, SpAnd, FAACS
Fakultas KedokteranUniversitas Udayana Denpasar, Bali
Prof. DR. Dr. Ignatius Riwanto, SpB(K)
Bagian Bedah Fakultas Kedokteran Universitas Diponegoro/
RS Dr. Kariadi, Semarang
Dr. Tony Setiabudhi, SpKJ, PhD
Universitas Trisakti/ Pusat Kajian Nasional Masalah Lanjut Usia, Jakarta
Prof. DR. Samsuridjal Djauzi, SpPD, KAI
Sub Dept. Alergi-Imunologi, Dept. Ilmu Penyakit Dalam Fakultas Kedokteran
Universitas Indonesia/RSUPN Dr. Cipto Mangunkusumo, Jakarta
Dr. Prijo Sidipratomo, SpRad(K)
Departemen Radiologi FKUI/RSUPN Dr. Cipto Mangunkusumo, Jakarta
Prof. DR. Dr. Johan S. Masjhur, SpPD-KEMD, SpKN
Departemen Kedokteran Nuklir Fakultas Kedokteran Universitas Padjadjaran/
RSUP Dr. Hasan Sadikin, Bandung
Dr. Hendro Susilo, SpS(K)
Dept. Neurologi Fakultas Kedokteran Universitas Airlangga/RS Dr. Soetomo,
Surabaya
Prof. DR. Dr. Darwin Karyadi, SpGK
Institut Pertanian Bogor, Bogor, Jawa Barat
Dr. Ike Sri Redjeki, SpAn KIC, M.Kes
Bagian Anestesiologi & Reanimasi Fakultas Kedokteran Universitas Padjadjaran/
RSUP Dr. Hasan Sadikin, Bandung