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"Latar belakang. Dislipidemia merupakan salah satu faktor resiko berkembangnya gagal jantung dan telah menjadi masalah kesehatan diseluruh dunia. Penelitian mengenai hubungan dislipidemia dan penyakit jantung belum banyak dilakukan di Indonesia.Tujuan. Mengetahui karakteristik pasien gagal jantung akut dan mengidentifikasi hubungan antara riwayat dislipidemia dengan mortalitas pasien gagal jantung akut selama perawatan.Metode. Penelitian dilakukan dengan desain potong lintang serta menggunakan 268 data sekunder dari studi Acute Decompensated Heart Failure Registry (ADHERE) di lima rumah sakit di Indonesia pada bulan Desember 2005 - 2006.Hasil. Pasien gagal jantung akut dalam penelitian ini dibagi kedalam dua kelompok. Kelompok pertama merupakan pasien dengan dislipidemia (88,8% dan kelompok kedua meupakan pasien tanpa dislipidemia (12,2%). Angka mortalitas pada kelompok pertama mencapai 3,0% dan pada kelompok kedua 0%. Melalui analisis bivariat tidak didapatkan hubungan bermakna antada riwayat dislipidemia dengan mortaitas pasien gagal jantung akut (p=0,603; OR: 0,828; CI: 0,101-6,759).Kesimpulan. Tidak terdapat hubungan bermakna antara riwayat dislipidemia dengan angka mortalitas gagal jantung akut selama perawatan di lima rumah sakit di Indonesia pada bulan Desember 2005 - 2006.

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Background. Dyslipidemia can promote the development of heart failure and has become one of global health problem. The study about associatin between dyslipidemia and in-hospital mortality of acute heart failure has never been done before in Indonesia.Objective. To define the characteristic of patient and to identify the association between dyslipidemia and in-hospital mortality of acute heart failure.Method. The design of this study was cross sectional with onsecutive sampling. This study used 976 acute heart failure patients from Acute Decompensated Heart Failure Registry (ADHERE) of 5 hospital in Indonesia from December 2005-2006.Result. Patiens with acute heart failure in this study were categorized in two groups. The first group was patients with dyslipidemia (88,8%) and the second was group wihout dyslipidemia (12,2%). The mortality rate of the first group was 3,0% and from the second was 0%. The bivariat analysis showed that there is no association between dyslipidemia and in-mortality of AHF patients (p=0,603; OR: 0,828; CI: 0,101-6,759).Conclusion. There is no significant association between Dyslipidemia and Inhospital Mortality of Acute Heart Failure in Five Hospital in Indonesia on December 2005 -2006."

"Keberhasilan penanggulangan penyakit menular seksual (PMS) tidak hanya tergantung pada mutu pelayanan, tetapi juga tergantung pada faktor manusianya terutama perilaku pencegahan dan perilaku pencarian pengobatan. Salah satu faktor yang panting diperhatikan adalah perilaku pencarian pengobatan, karena kegiatan penanggulangan PMS terutama adalah penemuan penderita secara dini dan segera diobati. Hal ini disebabkan karena PMS dapat bersifat merusak kesehatan dan dapat berakibat fatal serta komplikasi. Selain itu PMS mempermudah penularan virus HIV dari seorang ke orang lain. Sebaliknya infeksi HIV menyebabkan seseorang lebih mudah` terserang PMS dan lebih sukar diobati.Dari beberapa hasil survei menunjukkan bahwa banyak penderita PMS yang tidak mencari pengobatan sehingga meinungkinkan terjadinya penularan kepada orang lain atau kepada pasangan mereka. Selain itu penderita yang tidak berobat memungkinkan terjadinya peningkatan kasus HIV. Penderita PMS yang mencari pengobatan sendiri memungkinkan terjadinya resistensi penyakit tersebut terhadap obat antibiotik yang digunakan secara tidak teratur, atau obat yang digunakan hanya antiseptik dan jamu diragukan kesembuhannya.Tujuan penelitian untuk menentukan faktor-faktor yang berhubungan dengan perilaku pencarian pengobatan pada penderita PMS di Kabupaten Indramayu. Penelitian ini menggunakan jenis desain potong lintang (cross sectional), dengan sampel adalah sebagian dari pria/klien yang menderita penyakit menular seksual dalam 1 (sate) tahun. terakhir yang berkunjung ke lokalisasi/tempat prostitusi yang ada di wilayah Kabupaten Indramayu.Dari basil penelitian diperoleh bahwa dari 384 responden yang pernah mengalami PMS dalam 1 (satu) tabu' terakhir sewaktu dilaksanakan penelitian, sebanyak 22 responden (5,7%) tidak mencari pengobatan dan 362 responden (94,3%) mencari pengobatan. Dari 362 responden tersebut pengobatan pertama yang dilakukannya adalah dengan melakukan pengobatan sendiri 121 responden (33,4%) dan yang ke pelayanan kesehatan 241 responden (66,6%).Faktor-faktor yang berhubungan bermakna antara yang tidak mencari pengobatan dan yang mencari pengobatan adalah variabel persepsi sakit (OR 14,40; 95%CI 3,77-55,01) dan biaya pengobatan (OR 19,71; 95% CI 6,17-62,95). Faktor-faktor yang berhubungan bermakna antara yang mengobati sendiri dan yang ke pelayananan kesehatan adalah variabel-variabel status perkawinan (OR 2,27; 95 CI 1,11-4,64), persepsi sakit (OR 6,24; 95% CI 3,30 - 11,79), dan anjuran berobat (OR 2,11 ; 95% CI 1,30 -3,41).Disarankan untuk meningkatkan pengetahuan penderita PMS dengan memberikan penyuluhan, terutama dalam meningkatkan pemahaman bahwa pengobatan dengan antiseptik dan jamu bukanlah obat yang tepat untuk pengobatan PMS. Selain itu perlu ditingkatkan penyuluhan tentang bahaya PMS dan upaya-upaya pencegahan yang mungkin dilakukan untuk mengurangi risiko penularan PMS. Melalui upaya pencegahan seperti menggunakan kondom, diharapkan dapat mengurangi biaya pengobatan.

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Related Factors to Health Seeking Behavior on Sexual Transmitted Disease Clients That Visited to Prostitution Area in Indramayu District in Year 2000The successful prevention of sexual transmitted disease (STD) does not only depend on quality of services but also depends an human factors in particular health seeking behavior and prevention. One of the most important factors is health seeking behavior, because the most important STD prevention activity is to find patients and to cure them immediately. This is because STD could damage person health and could be fatal and complicated. Beside that, STD facilitate HIV including complication and fatal outcome. In contrary, HIV infection easily contracted to infected STD but difficult to cure.

Several surveys, show that many STD patients do not seek for treatment, and will infect to other person including their spouses. Beside that, untreated STD patients will increase the number of HIV cases. Patients who is seek self treatment will cause resistance STD drugs due to irregular intake. The patients only use antiseptic drugs and traditional medicine of which the efficacy is questionable.

The objective of this research is to analysis related factors to health seeking behavior in STD patients in Indramayu District. This research is based on cross sectional design method of patients with sexual transmitted disease that visited existing prostitution area in Indramayu District during one year.

In the study was found that 384 respondents has suffered from STD during the year 362 respondents (94.3%) did seek treatment and 22 did not (5.7%). 121 respondents (33.4%) preferred self-treatment initially and, 241 respondents (66.6%) went to health facilities.

Factors that significantly influence health seeking behavior (treatment or non treatment) are disease perception variable (OR 14.40; 95%CI 3.77-55.01) and treatment cost (OR 19.81; 95%CI 6.17-62.95). Related factors influencing the choice between and seeking treatment at health facilities are marital status variables (OR 2.27; 95%CI 1.11-4.64), disease perception (OR 6.24; 95%CI 3.30-11.79), and advice by others to take treatment (OR 2.11; 95%CI 1.30-3.41).

In conclusion, it is recommended to increase knowledge to STD patients by giving health education in particular to increase their understanding that antiseptic treatment and traditional medicine is not an appropriate method for STD treatment. Beside that it is necessary to increase knowledge on dangers of STD and intensify efforts to decrease the risk of STD infection (by condom use). These efforts will lower treatment costs."

"ABSTRAKNon-alcoholic fatty liver disease (NAFLD) adalah penyakit hati kronik yang ditandai dengan akumulasi lemak berlebihan di hati. Elastografi Transien (ET) dan metode Controlled Attenuation Parameter (CAP) merupakan metode pemeriksaan non-invasif untuk menilai derajat fibrosis dan steatosis, namun tidak tersedia di seluruh rumah sakit di Indonesia. Rasio Neutrofil Limfosit (RNL) merupakan penanda peradangan sederhana yang berpotensi memprediksi luaran penyakit. Tujuan : Mengetahui nilai diagnostik RNL sebagai indikator derajat keparahan steatosis dan fibrosis NAFLD. Metode : Penelitian ini adalah studi potong lintang menggunakan data sekunder dari data rekam medis tahun 2016-2018. Analisis statistik deskriptif dan analitik berupa uji korelasi, Receiver Operating Curve (ROC) dan Area Under The Curve (AUC) dipakai untuk mengetahui luaran studi. Hasil : Dari 106 subjek penelitian, kebanyakan pasien adalah perempuan (62,3%) berusia rata-rata 57,29 tahun dan menderita sindrom metabolik (77,4%). Sebagian besar pasien memiliki derajat steatosis sedang-berat (66%) dengan rerata ET 6,14 (2,8-18,2). Terdapat korelasi antara nilai CAP (r=0,648; p<0,001) dan ET (r=0,621; p<0,001) dengan RNL. Penggunaan RNL untuk menilai derajat steatosis sedang-berat memiliki titik potong 1,775 dengan sensitivitas, spesifisitas, NDP dan NDN sebesar 81,5%, 80,6%, 89,1%, dan 69,1%; titik potong 2,150 untuk menilai fibrosis signifikan dengan sensitivitas, spesifisitas, NDP dan NDN berurutan sebesar 92,3 %; 87,5%; 70,6%; dan 97,2%. Simpulan : RNL memiliki korelasi positif dan signifikan terhadap derajat steatosis (CAP) dan fibrosis (ET) dengan sensitivitas dan spesifisitas yang cukup tinggi.

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ABSTRACT

Non-alcoholic fatty liver disease (NAFLD) is a chronic inflammatory disease with excessive fat accumulation in the liver. Transient Elastography (TE) with Controlled Attenuation Parameter (CAP) is a device and method to examine the degree of fibrosis and steatosis. However, this device is not widely available across Indonesia. Neutrophil and Lymphocyte Ratio (NLR) is a simple marker for inflammation which has a potency to predict disease outcome. This study aims to know the diagnostic value of NLR as the indicator of steatosis and fibrosis severity. Methods: This was a cross-sectional study with consecutive sample collection. We used secondary data from medical record, starting from 2016-2018. A descriptive and analytic statistic, including correlation test, multivariate linear regression, t test, Receiver Operating Curve (ROC) and Area Under the Curve (AUC) were done to know the outcome of the study. Statistical analyses were performed using Statistical Package for Social Sciences (SPSS) Version 20.0 (SPSS Inc, Chicago, Illinois). A P value <0.05 was considered as statistically significant. Results: Out of 106 subjects, 62.3% patients were women with the mean of age 57.29 years old and 77.4% had metabolic syndrome. Most patients had moderate to severe steatosis degree (66%) with the mean of ET mean 6.14 (2.8-18.2). There was a positive correlation between CAP and TE compared with NLR with r=0.647 (p<0.001) and r=0.621 (p<0.001) respectively. The use of RNL to assess moderate-severe steatosis has a cutoff point of 1.775 with sensitivity,  specificity, PPV and NPV respectively at 81,5%, 80,6%, 89,1%, and 69,1%; cutoff point 2,150 to assess significant fibrosis with sensitivity, specificity, PPV and NPV of 92.3 %, 87.5%, 70.6%, and 97.2% respectively. Conclusion: NLR has a positive and significant correlation with the degree of steatosis and fibrosis with high sensitivity and specificity in comparison with TE/CAP."

"Intracoronary thrombosis plays an important role in the pathogenesis of acute coronary syndrome. It occurs due to a rupture of an atherosclerotic plaque, which may be spontaneous, as in the case of acute coronary syndrome, or due to procedures such as percutaneous intervention (PCI). Atherosclerotic plaque rupture causes exposure of thrombogenic subendothelial components and initiates platelet aggregation, which then initiates the coagulation cascade. In stable angina, the formation of platelet thrombus is the most important tiling to occur on plaque progressiveness as a result of rupture and episodic formation of thrombi.' Arterial thrombi contain many platelets. Anti-platelet agents are greatly beneficial in acute and chronic coronary heart disease. This paper discusses the use of anti-platelet agents in coronary heart disease."