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"[ABSTRAKLatar Belakang. Obat Anti Epilepsi (OAE) generasi lama banyak digunakan di Rumah Sakit sebagai terapi epilepsi. Beberapa studi terdahulu telah mengonfirmasi bahwa terapi OAE generasi lama terasosiasi dengan penurunan rerata kadar serum asam folat. Penurunan kadar serum asam folat ini berhubungan dengan anemia, defisit kognitif, penyakit vaskular, kanker, gangguan psikiatri, aborsi spontan dan malformasi kongenital. Oleh karena itu, maka dilakukan penelitian mengenai kadar serum folat pada ODE yang menggunakan OAE generasi lama di Indonesia. Metode. Desain penelitian adalah potong lintang untuk mengetahui gambaran kadar serum asam folat ODE pengguna OAE generasi lama (fenitoin, fenobarbital, karbamazepin dan asam valproat) jika dibandingkan dengan populasi normal serta kaitan dengan asupan. Subyek penelitian sejumlah 75 orang didapatkan di poli rawat jalan RSUPN Cipto Mangunkusumo dan Yayasan Epilepsi Indonesia yang dibandingkan dengan 76 orang populasi normal. Dilakukan wawancara pola makan melalui metode food recall, pemeriksaan laboratorium kadar folat. Hasil. Didapatkan kadar rerata serum asam folat sebesar 9.95 + 3.61 ng/mL pada ODE pengguna OAE generasi lama. Populasi normal didapatkan kadar rerata 4.59 + 2.4 ng/mL (p=<0.001). Rerata asupan diet setara folat kelompok studi 119.7 (28.4-340) microgram, kelompok kontrol 104.65 (38-510) microgram (p=0.095). Simpulan. Rerata kadar serum asam folat ODE yang menggunakan OAE generasi lama lebih tinggi dari rerata kadar serum asam folat populasi normal secara bermakna. Hanya terdapat 2,7% ODE dengan kadar asam folat rendah secara bermakna. Tidak ada perbedaan bermakna antara jumlah asupan diet folat dengan klasifikasi kadar serum asam folat pada ODE.

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ABSTRACTBackground. Antiepileptic drugs (AEDs) are frequently used in the treatment of epilepsy, psychiatric diseases, and pain syndromes. Studies have established that chronic anticonvulsant therapy can lead to folate deficiency. Anti-convulsant-induced folate deficiency has been associated with megaloblastic anemia, cognitive decline, vascular diseases, cancer, psychiatric comorbidity, spontaneous abortion and teratogenesis. Thus, patients with epilepsy are a suitable population to investigate the association of AED treatment with folate serum levels in comparison with normal population. Method. This is comparative cross-sectional study focusing on the level and intake of folate in relation with AED (phenytoin, phenobarbital, carbamazepine, valproic acid) in epileptic patients in outpatient clinic of Neurology Cipto Mangunkusumo General Hospital and Indonesia Epilepsy Foundation, with comparison to normal population. Seventy five epileptic patients and seventy six healthy people were recruited with food recall interview and their serum folate were measured. Results. The mean folate serum of study group were 9.95 + 3.61 ng/mL and the mean folate serum of control group were 4.59 + 2.4 ng/mL (p=<0.001). The mean dietary folate of study group were 119.7 (28.4-340) microgram and the mean dietary folate of control group 104.65 (38-510) microgram (p=0.095). Conclusion. The mean folate serum in study group were significant much more higher compare with the control group. As many as 2.7% of study group with significantly low folate serum level. There were no any significant association of dietary folate with folate serum classification of study group. ;Background.. Antiepileptic drugs (AEDs) are frequently used in the treatment of epilepsy, psychiatric diseases, and pain syndromes. Studies have established that chronic anticonvulsant therapy can lead to folate deficiency. Anti-convulsant-induced folate deficiency has been associated with megaloblastic anemia, cognitive decline, vascular diseases, cancer, psychiatric comorbidity, spontaneous abortion and teratogenesis. Thus, patients with epilepsy are a suitable population to investigate the association of AED treatment with folate serum levels in comparison with normal population. Method. This is comparative cross-sectional study focusing on the level and intake of folate in relation with AED (phenytoin, phenobarbital, carbamazepine, valproic acid) in epileptic patients in outpatient clinic of Neurology Cipto Mangunkusumo General Hospital and Indonesia Epilepsy Foundation, with comparison to normal population. Seventy five epileptic patients and seventy six healthy people were recruited with food recall interview and their serum folate were measured. Results. The mean folate serum of study group were 9.95 + 3.61 ng/mL and the mean folate serum of control group were 4.59 + 2.4 ng/mL (p=<0.001). The mean dietary folate of study group were 119.7 (28.4 ? 340) microgram and the mean dietary folate of control group 104.65 (38-510) microgram (p=0.095). Conclusion. The mean folate serum in study group were significant much more higher compare with the control group. As many as 2.7% of study group with significantly low folate serum level. There were no any significant association of dietary folate with folate serum classification of study group. , Background.. Antiepileptic drugs (AEDs) are frequently used in the treatment of epilepsy, psychiatric diseases, and pain syndromes. Studies have established that chronic anticonvulsant therapy can lead to folate deficiency. Anti-convulsant-induced folate deficiency has been associated with megaloblastic anemia, cognitive decline, vascular diseases, cancer, psychiatric comorbidity, spontaneous abortion and teratogenesis. Thus, patients with epilepsy are a suitable population to investigate the association of AED treatment with folate serum levels in comparison with normal population. Method. This is comparative cross-sectional study focusing on the level and intake of folate in relation with AED (phenytoin, phenobarbital, carbamazepine, valproic acid) in epileptic patients in outpatient clinic of Neurology Cipto Mangunkusumo General Hospital and Indonesia Epilepsy Foundation, with comparison to normal population. Seventy five epileptic patients and seventy six healthy people were recruited with food recall interview and their serum folate were measured. Results. The mean folate serum of study group were 9.95 + 3.61 ng/mL and the mean folate serum of control group were 4.59 + 2.4 ng/mL (p=<0.001). The mean dietary folate of study group were 119.7 (28.4 – 340) microgram and the mean dietary folate of control group 104.65 (38-510) microgram (p=0.095). Conclusion. The mean folate serum in study group were significant much more higher compare with the control group. As many as 2.7% of study group with significantly low folate serum level. There were no any significant association of dietary folate with folate serum classification of study group. ]"

"Kadar vitamin D dapat menurun pada penggunaan OAE lebih dari 6 bulan karena mengaktivasi pregnane x receptor (PXR) yang selanjutnya akan meningkatkan regulasi 24-hydroxylase. Hal ini dapat memicu perubahan vitamin D menjadi metabolit inaktif. Karbamazepin (CBZ), fenitoin (PHT), fenobarbital (PHB) dan asam valproat (VPA) merupakan jenis OAE generasi pertama yang banyak digunakan di RSCM. Tujuan penelitian ini adalah mengetahui gambaran kadar vitamin D dan faktor-faktor yang mempengaruhi penggunaan OAE generasi tunggal Metode. Desain penelitian berupa studi potong lintang dengan pengambilan sampel secara konsekutif. Subyek penelitian adalah orang dengan epilepsi yang mengkonsumsi CBZ, PHT, PHB dan VPA minimal 6 bulan dan memenuhi kriteria inklusi dan eksklusi. Pada subyek dilakukan wawancara, pengisian kuesioner, pemeriksaan fisik, recall makanan dan pengambilan darah vena untuk pemeriksaan kadar vitamin D. Hasil. Dari 59 subyek diperoleh subyek lelaki : perempuan (1,4:1). Sebagian besar subyek menggunakan karbamazepin (45,8%) dengan durasi penggunaan OAE berkisar 6 bulan – 35 tahun. Lebih banyak subyek yang mendapatkan paparan sinar matahari yang cukup lebih banyak dibandingkan yang kurang. Prevalensi kadar vitamin D rendah, yaitu, 30,5%. Median vitamin D yaitu, 36,9 ng/ml. Kesimpulan. Kadar vitamin D pada penggunaan OAE generasi pertama tunggal lebih dari 6 bulan adalah normal. Kadar vitamin D tidak dipengaruhi oleh jenis OAE, durasi penggunaan OAE dan asupan vitamin D. Namun kadar vitamin D pada orang dengan epilpesi dipengaruhi oleh jumlah paparan sinar matahari.

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Level of vitamin D can be decreased by first generation anti epileptic anti epileptic drugs (AEDs) due to pregnane x receptor (PXR) activated and increase of 24-hydroxylase regulation. Carbamazepine (CBZ), phenytoin (PHT), phenobarbital (PHB) or valproic acid (VPA) are first generation AEDs that are common used at Cipto Mangunkusumo Hospital. Therefore, the aim of this study is knowing vitamin D level in patients that have been treated by those AEDs more than 6 months.

Method. This was a cross-sectional study with consecutive sampling. Subjects were people with epilepsy taking CBZ, PHT, PHB, or VPA for at least 6 months and fulfilled both inclusion and exclusion criteria. All subjects were interviewed, food recalled and underwent physical examination and measurements of vitamin D level.

Result. Among 59 subjects, male:female ratio is 1.4:1. Most subjects using carbamazepine (45.8%) with duration of OAE therapy is 6 months - 35 years. Prevalence of hipovitaminosis D is 30.5%. Median of vitamin D is 36.1 ng / ml.

Conclusion. Vitamin D level is normal among people with epilepsy (PWE) and not influenced by AEDs type, duration of medication and food intake. However, vitamin D level is influenced by sun exposure in PWE."

"Latar belakang: Defisiensi vitamin B12dan asam folat dapat menyebabkan anemia yang selanjutnya dapat mempengaruhi tumbuh kembang anak. Penelitian ini bertujuan untuk mengetahui kadar folat serum bayi usia 6-8 bulan dan korelasinya terhadap indikator status gizi bayi dan pengetahuan-sikap-perilaku ibu tentang pola makan bayi.Metode: Rancangan penelitian potong lintang dilakukan pada 55 bayi usia 6-8 bulan yang memenuhi kriteria penelitian dan ibunya sebagai responden. Data yang dikumpulkan meliputi usia, jenis kelamin, panjang badan, berat badan, asupan kalori, protein dan folat (menggunakan metoda food frequency questionnaire semiâ??kuantitatif dan recall 24 jam), sedangkan pada responden meliputi usia, tingkat pendidikan, penghasilan keluarga, status bekerja dan pengetahuan, sikap, perilaku terkait pemberian makan bayi (ASI dan MPASI).Hasil: Penelitian ini mendapatkan median kadar folat serum adalah 43,05 nmol/L dengan kadar terendah 19,92 nmol/L dan kadar tertinggi 104,24 nmol/L. Diantara faktor-faktor terkait yang diteliti, didapatkan korelasi positif bermakna antara kadar folat serum dengan asupan protein dan asupan folat.Kesimpulan: Disarankan agar bayi sejak usia 6 bulan mendapatkan makanan pendamping ASI yang kaya akan protein folat sehingga diharapkan dapat mempertahankan kadar normal folat serum. (Med J Indones 2011; 20:138-42).

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AbstractBackground: Vitamin B12 and folate defi ciency can cause anemia which may lead growth and development impairments. This study was aimed to determine serum folate levels among infants aged 6-8 months and the relation to infants' nutritional indicators and maternal knowledge-attitude-practice about infant feeding.Methods: A cross sectional design was implemented in infants aged 6â??8 months and their mothers as respondents who met the study criteria. Data collected among the infants included sex, age, length, weight, intake of energy, protein and folate (based on a one month semi quantitative FFQ and a 24â??hour food recall), serum folate and hemoglobin levels. Data collected among the mothers included age, education level, income based on average minimum monthly wage, knowledge, attitude and behavior concerning infants feeding, i.e. breast milk and complementary feeding practices.Results: This study found that the median of serum folate levels was 43.05 nmol/L with values ranging from 19.92 nmol/L to 104.24 nmol/L. Serum folate level had a strong positive correlation with its related factors, protein and folate intake.Conclusions: Protein-folate-rich complementay food should be provided to infants aged 6 months and over to maintain serum folate level. (Med J Indones 2011; 20:138-42)."

"Tujuan : Mengetahui pengaruh suplementasi vitamin B6, B12 dan asam folat terhadap kadar homosistein plasma pada lansia dalam rangka mengurangi risiko terjadinya aterosklerosis.Tempat : Panti werdha Santa Anna - Jakarta.Bahan dan cara : penelitian eksperimental pra dan pasca suplementasi vitamin B6 (10 mg), B12 (400 µg) dan asam folat (1 mg) yang diberikan per oral, sekali sehari selama 6 minggu, terhadap 10 subyek lansia (60 tahun) yang telah memenuhi kriteria penerimaan dan penolakan. Data yang dikumpulkan meliputi data non nutrisi, data nutrisi, data antropametri, status vitamin B6, kadar vitamin B12 serum dan asam folat serum dan kadar homosistein plasma.Hasil : Pada pra suplementasi, diketahui prevalensi subyek dengan hiperhomosisteinemia tipe ringan sebesar 70%. Prevalensi defisiensi vitamin B6 (KA ASATE>I,40), 812 (<258 pmol/L) dan asam folat (<15 nmo/L) adalah 30%,30% dan 90%. Prevalensi defisiensi vitamin B6, B12 dan asam folat pada subyek dengan hiperhomosisteinemia adalah 14%, 43% dan 85%. Pada pasca suplementasi didapatkan perbaikan pada seluruh hasil pemeriksaan laboratorium secara bermakna (p<0,05) yaitu penurunan KA ASATE 11,68%, kenaikan kadar vitamin B12 serum 111,75%, kenaikan kadar asam folat serum 139,05% dan penurunan kadar homosistein plasma 36,68%.Kesimpulan : Suplementasi vitamin B6, B12 dan asam folat terbukti secara efektif dan elision dapat memperbaiki status vitamin dan menurunkan kadar homosistein plasma secara bermakna pada seluruh subyek penelitian.

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Objective : To identify the effect of vitamin B6, B12 and folate supplementation to plasma homocysteine concentration of elderly people in respect of minimizing atherosclerosis risks.Place :Panri werdha Santa Anna - Jakarta.Materials and Methods :Experimental study of pre and post oral supplementation of vitamin B6 (10 mg), B12 (400 }1g) and folate (1 mg), once a day for 6 weeks continuously applied to 10 elderly subjects NO years) passing through pre-defined inclusion criteria. Relevant information and data was collected through questionnaire, field observation and laboratory measurement which comprise of ages, sex, education, anthropometrics, dietary intake, food frequency amount, food habits, vitamin B6, B12 and folate status and finally plasma homocysteine concentration.Results :During pre-supplementation, 70% of subjects was classified as moderate hyperhomocysteinemia. Cut off points to define deficiency vitamin status are erytrocyte aspartate aminotransferase activity coefficient (EAST-AC) >1,40 for vitamin B6 , serum vitamin B12 and folate concentrations were <258 pmol/L and <15 nmol/L respectively. The overall prevalence of deficiencies vitamin B6, B12 and folate status were 30%, 30% and 90% respectively. The prevalence of deficiencies vitamin B6, B12 and folate status in hyperhomocysteinemia subjects were 14%, 43% and 85% respectively. During post supplementation, no more vitamins deficiencies subjects was detected. Post supplementation laboratory measurement indicate the following significant improvement (p<0,05) on EAST-AC reduction 11,68%, serum vitamin B12 concentration improvement to 111,75%, serum folate concentration improvement to 139,05% and reduction of plasma homocysteine concentration of 36,68%.Conclusion :Supplementation of vitamin B6, B12 and folate are effectively and significantly improve both vitamin status and plasma homocysteine concentration level of all subjects."

"Penelitian ini merupakan sebuah studi cross sectional yang bertujuan melihat hubungan pendidikan orang tua, pola konsumsi susu saat balita, dan faktor-faktor lain dengan status gizi (TB/U) serta dampak TB/U terhadap prestasi belajar. Penelitian melibatkan 96 anak kelas satu di SDN Kedung Waringin 02 dan 03, data-data diperoleh dari pengukuran tinggi badan secara langsung, pengisian kuesioner oleh ibu, dan nilai rapor dari sekolah. Hasil penelitian menunjukkan rata-rata tinggi badan anak laki-laki (115.85cm ± 5.14) lebih rendah dibandingkan anak perempuan (117.45cm ± 5.75). Terdapat hubungan yang bermakna secara statistik antara pendidikan ibu, pendidikan ayah, dan pola konsumsi susu saat balita dengan TB/U pada anak kelas satu. Tidak ditemukan hubungan yang bermakna secara statistik antara TB/U dengan prestasi belajar, akan tetapi anak dengan tubuh yang pendek (Z-score TB/U < -2SD) cenderung memiliki rata-rata prestasi belajar yang lebih rendah (71.94) daripada anak dengan tubuh yang tidak pendek (Z-score TB/U ≥ -2SD) (76.40). Pendidikan ibu dan ayah, dan pola konsumsi susu saat balita yang baik merupakan faktor-faktor yang dapat mendukung tercapainya status gizi (TB/U) yang baik.

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This study was a cross sectional study that examines the relationships of parental education, the pattern of consumption of milk in toddler, and other factors with nutritional status (H/A) and the impact of H/A on learning achievement. The study involved 96 children in first class at SDN Kedung Waringin 02 and 03, the data obtained from direct measurements of height, filling out maternal questionnaires, and school report scores.

The results showed the average height of boys (115.85cm ± 5.14) lower than girls (117.45cm ± 5.75). There are statistically significant relationships between mother's education, father's education, and the toddler pattern of milk consumption with H/A on first-grade children. Found no statistically significant association between H/A with school learning achievement, but children with short stature (Z-score H/A <-2SD) tend to have average lower learning achievement (71.94) than children without short stature (Z-score H/A ≥-2SD) (76.40). Maternal and paternal educations, and patterns of milk consumption in toddler that good are all factors that can support the achievement of good nutritional status (H/A)."

"Stroke merupakan abnormal fungsi sistem saraf pusat akibat suplai darah ke otak terhenti. Manifestasi klinis yang menyertai pasien stroke adalah disfagia. Penatalaksanan gangguan proses menelan adalah kegiatan mengunyah agar mengembalikan fungsi motorik volunter yang cedera. Tujuan umum mengetahui pengaruh kegiatan mengunyah terhadap asupan nutrisi dan lama perbaikan fungsi menelan pada pasien stroke dengan disfagia. Penelitian menggunakan desain Randomized Control Trial dengan rancangan pretest-posttest with control group. Total sampel adalah 30 responden dibagi atas 2 kelompok. Hasil penelitian dinyatakan ada perbedaan yang signifikan asupan nutrisi dan lama perbaikan fungsi menelan sesudah diberikan kegiatan mengunyah, dengan p value 0,001 (α =0,05). Pemberian kegiatan mengunyah terbukti dapat meningkatkan asupan nutrisi dan mempercepat perbaikan fungsi menelan pada pasien stroke dengan disfagia.

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Stroke is an abnormal function of the central nervous system caused by inadekuat blood supply to the brain. Clinical manifestations that often accompanies stroke patients is dysphagia. Swallowing disorder process, the intervention form of chewing activity. Chewing activities aimed to restoring voluntary motor function.

This study aims to determine the effect of chewing activities to nutrition intake and the time of swallow function recovery of stroke patients with dysphagia. This study uses a Randomized Control Trial design. Total sample used by 30 respondents divided in 2 group. Each group consist of 15 respondents.

Results of this study revealed that there are significant differences intake nutrition and the time of swallow function recovery after chewing activities, with a p value of 0.001 (α = 0,05). Giving chewing activities proven to increase the intake of nutrients and accelerate the improvement of swallowing function of stroke patients with dysphagia."

"ABSTRAKMahasiswa keperawatan merupakan role model bagi mahasiswa lainnya dalam mempromosikan gaya hidup sehat. Penelitian sebelumnya menyebutkan pengetahuan, sikap, dan perilaku dalam pemenuhan nutrisi mahasiswa keperawatan belum cukup baik. Salah satu faktor yang mempengaruhi hal tersebut adalah lingkungan. Keberadan orang tua tentu akan mempengaruhi dukungan sosial dalam pemenuhan nutrisi. Penelitian ini bertujuan mengetahui perbandingan pengetahuan, sikap, dan perilaku pemenuhan nutrisi pada mahasiswa FIK UI tahun 2015 yang tinggal bersama orang tua dengan yang tidak. Jenis penelitian adalah kuantitiatif dengan desain penelitian deskriptif komparatif, pengambilan sampel menggunakan metode random sampling dengan jumlah 192 responden. Hasil penelitian adalah tidak terdapat perbedaan pengetahuan dan perilaku dalam pemenuhan nutrisi pada mahasiswa yang tinggal bersama orang tua dengan yang tidak. Tetapi pada variabel sikap didapatkan bahwa ada perbedaan antara kedua responden dimana nilai p value 0.019 (α < 0.05). Keseluruhan tingkat pengetahuan baik (53.1%), sikap negatif (57.8%), dan perilaku baik (50.0%). Diharapkan meningkatkan pengetahuan terkait pemenuhan nutrisi gizi seimbang sehingga dapat membentuk sikap dan perilaku pemenuhan nutrisi yang lebih baik.

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ABSTRACTNursing students are a role model for other students to promote a healthy life style. The previous studies stated that nursing students? knowledge of attitude and behavior in nutrition fulfillment was not good enough. Neighborhoods become one of the reasons. Parents became a good social effect in fulfillment of nutrients. This study aimed to know the comparison of nutrition fulfillment?s knowledge, attitude, and behavior on Nursing students who living with parents and those who do not. This research was quantitative with descriptive comparative research design. The sample was chosen by random sampling method, consisted of 192 participants. Results showed, there was no difference in knowledge and behaviors in nutrition fulfillment of nutrients on who living with parents and those who do not, but there was a difference in variable of attitude which p value 0.019 (α < 0.05). The overall level of good knowledge (53.1%), negative attitude (57.8%), and good behavior (50.0%). Nursing students are expected to improve their knowledge that related to nutritional balanced, so they will have a good attitude and behavior of nutrition fulfillment."

"Latar belakang : Jumlah kelahiran hidup bayi prematur di RSCM adalah 507 dan 112 diantaranya lahir pada usia gestasi 28-32 minggu atau disebut bayi baru lahir sangat prematur (BBLSP). Data RSCM menunjukkan bahwa BBLSP memiliki angka kesintasan 58,9%. Pemberian nutrisi yang agresif dengan diet tinggi protein pada BBLSP diperlukan untuk mempercepat kejar tumbuh. Diet tinggi protein memberikan beban metabolisme pada ginjal BBLSP yang sedang berkembang. Ginjal BBLSP memiliki jumlah nefron fungsional yang lebih sedikit dan imaturitas yang ditandai dengan rendahnya laju filtrasi glomerulus serta kemampuan pemekatan urin yang rendah. Diet tinggi protein menginduksi hipertrofi ginjal, proteinuria, dan sklerosis glomerular melalui single nephron glomerular hyperfiltration (SNGHF) sehingga menyebabkan cedera glomerulotubular yang dapat dideteksi dengan biomarka Neutrophil gelatinase-associated lipocalin urin (uNGAL). Tujuan : Mengetahui pengaruh asupan protein terhadap cedera glomerulotubular pada BBLSP. Metode : Penelitian ini adalah penelitian pada BBLSP yang dilakukan dengan desain kohort prospektif yang dilakukan di ruang rawat perinatologi Departemen Ilmu Kesehatan Anak RS Cipto Mangunkusumo dan RS Bunda Menteng pada periode 1 Juni 2019 hingga Mei 2020. Pengambilan sampel urin dilakukan sebanyak 3 kali yaitu usia 0-48 jam (T1), 72 jam (T2), dan usia 21 hari (T3). Dilakukan pemeriksaan rasio NGAL dan kreatinin urin (uNGAL/Cr). Cedera glomerulotubular didefinisikan sebagai uNGAL/Cr  1 SB. Data karakteristik subyek dan asupan protein diambil dari rekam medik. Rerata asupan protein enteral dicatat sejak usia 14-21 hari sesuai asupan di rekam medik. Kadar protein di ASI diukur dengan human milk analyzer. Asupan tinggi protein adalah kadar asupan protein 3 g/kg/hari. Hasil : Total subyek penelitian adalah 59 BBLSP pada saat rekruitmen dan terdapat 39 subyek menyelesaikan penelitian hingga usia 21 hari. Proporsi BBLSP yang mengalami cedera glomerulotubular pada pemberian kadar asupan tinggi protein 5/29 subyek, sedangkan pada pemberian kadar asupan rendah protein adalah 4/10 subyek. Kadar uNGAL/Cr pada BBLSP yang mendapatkan kadar asupan tinggi protein dibandingkan rendah protein adalah 3,54 (0,69-89,16) ng/mg dan 6,88 (0,32-66,64) ng/mg. Kadar uNGAL/Cr pada usia 48 jam, 72 jam, dan 21 hari tidak menunjukkan korelasi yang bermakna dengan kadar asupan protein (p=0,80; 0,58; 0,07).Simpulan : Sebanyak 5/29 subyek yang mendapatkan kadar asupan tinggi protein mengalami cedera glomerulotubular. Kadar uNGAL/Cr pada BBLSP yang mendapat asupan tinggi protein maupun rendah protein cenderung meningkat pada usia 72 jam dan menurun pada usia 21 hari. Pemberian asupan tinggi protein pada BBLSP tidak menyebabkan cedera glomerulotubular pada bayi sangat prematur.

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Background: Absolute preterm birth rate in Cipto Mangunkusumo Hospital (CMH) was 507 in 2018, 112 amongst were born very preterm (28-32 weeks of gestational age). The survival rate was approximately 58.9%. Early aggressive nutrition by administration of high protein intake is needed for catch up growth. High protein produces high metabolic load to the kidney. Kidney in the very preterm neonates have fewer amount of functional nephron. Furthermore, the immaturity of the kidney was shown in lower glomerular filtration rate and ability to dilute urine. High protein intake induces nephron hypertrophy,

proteinuria, and glomerular sclerosis through single nephron glomerular hyperfiltration (SNGHF) which lead to glomerulotubular injury. Urine neutrophil gelatinase-associated lipocalin to creatinine ratio (uNGAL/Cr) is a biomarker used to detect glomerulotubular injury.

Aim : To analyze the correlation of high protein intake and glomerulotubular injury in very preterm neonates.

Method: A prospective cohort study was conducted in very preterm infants admitted to neonatology ward of CMH and Bunda Hospital Menteng during 1 June 2019 to May 2020. Urine sample were taken in 3 points of time: age 0-48 hours, 72 hours, and 21 days postnatal. Urine NGAL and creatinine (uNGAL/Cr) were examined. Glomerulotubular injury was defined as uNGAL/Cr level 1 SD. Subject characteristic data and protein intake were obtained from medical record. Enteral protein intake was recorded daily from medical record since age 14-21 days postnatal. Protein level in the breastmilk was measured by using human milk analyzer. High protein intake is recorded if the average intake was  3/kg/day.

Results: This study recruited 59 very preterm neonates and 39 of them survived until the end of the study. Proportion of very preterm neonates who had glomerulotubular injury after high protein intake vs low protein intake was 5/29 vs 4/10 subjects. Median of uNGAL/Cr level in high protein intake group compare to low protein intake group were 3,54 (0,69-89,16) ng/mg and 6,88 (0,32-66,64) ng/mg. Protein intake is not correlated to uNGAL/Cr level at 0-48 hours, 72 hours, and 21 days postnatal age (p=0,80; 0,58; 0,07).

Conclusion: There were 5/29 subjects experienced glomerulotubular injury in high protein intake administration. In very preterm neonates, uNGAL/Cr level was increased at the age of 72 hours and decreased in 21 days on both high and low protein intake group. High protein intake had no correlation to glomerulotubular injury in the very preterm neonates. "

"DXA, Densitometry, Hydrometry, Magnetic Resonance Imaging (MRI), dan Bioelectrical Impedance Analysis (BIA) merupakan metode pengukuran yang akurat untuk menilai komposisi tubuh. Namun metode ini mahal, rumit dan tidak aplikatif jika digunakan masyarakat. Pengukuran antropometri adalah pengukuran yang lebih sederhana, murah dan mudah digunakan untuk evaluasi status gizi. Tujuan dari penelitian ini adalah untuk mendapatkan pengukuran yang lebih sederhana namun akurat dalam mengevaluasi kasus obesitas dengan gold standard BIA. Penelitian ini dilaksanakan pada bulan Mei-April 2015 dengan jumlah total responden 18 laki-laki dan 79 perempuan yang merupakan PNS Dinas Kesehatan Kota Depok Tahun 2015. Desain studi yang digunakan yaitu cross sectional dengan mengukur variabel independen yaitu persen lemak tubuh serta variabel bebas meliputi IMT, lingkar pinggang, lingkar panggul, skinfold tricep, ILT dan RLPP. Hasil penelitian menunjukkan bahwa RLPP memiliki nilai koefisien korelasi paling tinggi yaitu (0,938) dibandingkan dengan pengukuran lainnya. Namun berdasarkan kurva ROC IMT memiliki performa uji paling baik untuk digunakan pada semua jenis kelamin dengan (AUC 0,948; Se = 90,9,5%; Sp = 85,7%; NPP 90%; NPN 85%; LR+ 6,35; LR- 0,10) pada laki-dengan cut off 25,5 kg/m2 sedangkan pada perempuan (AUC 0,943; Se = 81,5%; Sp = 96,2%; NPP 91%; NPN 90%; LR+ 21,4; LR- 0,19) dengan cut off 26,5 kg/m2. Akan tetapi masih diperlukan studi validasi lain dengan mempertimbangkan beberapa faktor seperti usia, jenis kelamin dan etnis.

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DXA, Densitometry, Hydrometry, Magnetic Resonance Imaging (MRI), and Bioelectrical Impedance Analysis (BIA) are accurate measurement methods to assess body composition. However, these methods are expensive, complicated, and not applicative if used by society. Anthropometric measurement is a measurement that is more simple, inexpensive and easy to use for the evaluation of nutritional status.

This study aims to procure simpler measurement but accurate in evaluating cases of obesity used BIA as a gold standard. This study was conducted in May-April 2015 with a total number of respondents are 18 male and 79 female who are Civil Servants from Depok Health Departement in 2015. The study used cross sectional design with measure of independent variables which is body fat percentage as well as independent variables include BMI, waist circumference, hip circumference, triceps skinfold, ILT and waist to hip ratio.

The result of this study showed that waist to hip ratio had a highest correlation coeffisient (0,938) compared with other measurements. However based on ROC curve, IMT has the best test performance for use on all genders with (AUC 0.948; Se = 90,9,5%; Sp = 85.7%; 90% NPP; NPN 85%, LR + 6.35; LR- 0 , 10) in men with cut-off of 25.5 kg/m2, while the test performence on women (AUC 0.943; Se = 81.5%; Sp = 96.2%; 91% NPP; NPN 90%; LR + 21.4; LR - 0.19) with cut-off 26.5 kg/m2. However another similiar studies were still needed to validate several factors such as age, gender and ethnicity."

"Tujuan: Mengetahui efek pemberian nutrisi enteral dua jam pra sectio caesarea terhadap perubahan kadar hsIL-6 pasca sectio caesarea Metode: Penelitian ini merupakan uji klik paralel, yang subyek penelitiannya dipilih secara consecutive sampling, yang dibagi menjadi dua kelompok melalui randomisasi blok masing-masing terdiri dari 10 orang subyek. Data karakteristik awal penelitian meliputi usia, indikasi SC, status gizi berdasarkan KMS ibu hamil dan LiLA, asupan energi dan protein pra SC, lama operasi, jumlah perdarahan, dan hsIL-6 prabedah adalah homogen. Untuk melihat perbedaaan perubahan kadar hsIL-6 dilakukan pemeriksaan hsIL-6 setelah 6 jam pasca insisi. Analisis data dilakukan dengan menggunakan uji t. Batas kemaknaan 5%. Hasil: Peningkatan rerata dan simpang baku kadar hsIL-6 meningkat pada kedua Kelompok. Peningkatan kadar hsIL-6 ( p <0,05) dan perubahan kadar hsIL-6 lebih besar bermakna pada kelompok kontrol dibandingkan kelompok perlakuan (p <0,05). Simpulan: Pemberian nutrisi enteral dua jam pra secfio caesarea dapat menekan peningkatan kadar hsIL-6.

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Objective: To investigate the effect of enteral nutrition that given two hour before caesarean section on changes hsIL-6 levels after caesarean section.

Methods: The design study was a parallel clinical trial, in which the subject were selected by consecutive sampling, each proup consisted of ten subjects. The subject were divided into two groups using block randomization. Data collected including age, indication of CS, nutritional status based on MUAC and KMS chart in pregnancy, energy and protein intakes, duration of surgery, amount of blood loss during surgery, and hsIL-6 serum preoperative, were matched at baseline. To investigated the changes of hsIL-6 levels, the concentrations to assessed six hours post CS. Statistical analysis was measured by t-test. The significance levcl was 5%.

Results: There was a significant increasc of hsIL-6 levels (p = 0,001) in both groups. The increased and changes of hsIL-6 levels in the control group was significantly higher than in the treatment group. (p<0.05, and p <0,05 respectively).

Conclusion: Enteral nutrition that was given two hour before caesarean section can suppress the increased of hsIL-6 levels. "