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"ABSTRAK Latar Belakang : Malnutrisi merupakan faktor independen yang berhubungan dengan morbiditas, mortalitas dan tingginya biaya pengobatan sirosis hati. Kekuatan Genggam Tangan (KGT) merupakan suatu metode yang sering digunakan untuk mendeteksi malnutrisi dan menilai prognosis pasien. Hubungan KGT dengan Skor Child Pugh (CP) dan massa otot masih dalam kontroversi. Indonesia sampai saat ini belum memiliki data tersebutMetode : Studi potong lintang pada pasien sirosis hati di poliklinik hepatobilier RSCM dari Februari-Juni 2015. Status nutrisi dinilai berdasarkan KGT. Massa otot diukur menggunakan bioimpedans. Analisis statistik menggunakan uji korelasi spearmanHasil : Terdapat 115 pasien yang kontrol di poliklinik hepatobilier RSCM, 112 pasien memenuhi kriteria penelitian, terdiri dari 79 laki-laki dan 33 perempuan. Usia pasien rata-rata 54,15±10,55 tahun, median skor CP 6(5-13) dengan median KGT 26(11-50) kgF, rata-rata massa otot 44,43±8,12 kg. Median asupan energi 1334,82(604,75-3023,7) kkal, median protein 45,87(19-114,5) gram. Prevalensi malnutrisi berdasarkan KGT ditemukan sebanyak 33%. Kekuatan genggam tangan tidak berkorelasi dengan skor CP (p 0,046, r=-0,19) namun berkorelasi dengan massa otot (p <0,001, r= 0,70) Simpulan Terdapat 33% kasus malnutrisi berdasarkan KGT pada pasien sirosis rawat jalan. KGT tidak berkorelasi dengan skor Child Pugh namun berkorelasi dengan massa otot pasien sirosis hati.ABSTRACT Background : Malnutrition is independent factor related to morbidity, mortality and high cost of treatment in liver cirrhosis. Hand grip strength (HGS) is one of the method use for malnutrition detection and prognosis evaluation. The correlation of HGS with liver function (Child Pugh or CP score) and muscle mass is controversial. These important evaluation is not yet avalaible in Indonesia.Method : This is a cross-sectional study in liver cirrhosis patients at Hepatobiliary clinic of Cipto Mangunkusumo Hospital from February to June 2015. Nutritional status was assessed by HGS. Muscle mass was obtained from bioimpedance. Data were analyzed using Spearman correlation test. Results : There were 115 patients liver cirrhosis at Hepatobiliary clinic of Cipto Mangunkusumo Hospital, 112 patients who fit the inclusion criteria, consisted of 79 men and 33 women with mean age 54,15±10,55 years, median CP score 6(5-13) with median HGS 26 (11-50) kgF, mean muscle mass 44,43±8,12 kg. The median intake of energy 1334,82(604,75-3023,7) kkal, median protein 45,87(19-114,5) gram. Prevalence of malnutrition according HGS was 33%. Hand grip strength is not correlated with CP score (p 0,046, r=-0,19) however it is correlated with muscle mass (p<0,001, r= 0,70) Conclusion There are 33% malnutrition cases based on HGS in out patient liver cirrhosis. There is no correlation between hand grip strength with Child Pugh score however HGS is correlated with muscle mass in liver cirrhosis.;Background : Malnutrition is independent factor related to morbidity, mortality and high cost of treatment in liver cirrhosis. Hand grip strength (HGS) is one of the method use for malnutrition detection and prognosis evaluation. The correlation of HGS with liver function (Child Pugh or CP score) and muscle mass is controversial. These important evaluation is not yet avalaible in Indonesia.Method : This is a cross-sectional study in liver cirrhosis patients at Hepatobiliary clinic of Cipto Mangunkusumo Hospital from February to June 2015. Nutritional status was assessed by HGS. Muscle mass was obtained from bioimpedance. Data were analyzed using Spearman correlation test. Results : There were 115 patients liver cirrhosis at Hepatobiliary clinic of Cipto Mangunkusumo Hospital, 112 patients who fit the inclusion criteria, consisted of 79 men and 33 women with mean age 54,15±10,55 years, median CP score 6(5-13) with median HGS 26 (11-50) kgF, mean muscle mass 44,43±8,12 kg. The median intake of energy 1334,82(604,75-3023,7) kkal, median protein 45,87(19-114,5) gram. Prevalence of malnutrition according HGS was 33%. Hand grip strength is not correlated with CP score (p 0,046, r=-0,19) however it is correlated with muscle mass (p<0,001, r= 0,70) Conclusion There are 33% malnutrition cases based on HGS in out patient liver cirrhosis. There is no correlation between hand grip strength with Child Pugh score however HGS is correlated with muscle mass in liver cirrhosis.;Background : Malnutrition is independent factor related to morbidity, mortality and high cost of treatment in liver cirrhosis. Hand grip strength (HGS) is one of the method use for malnutrition detection and prognosis evaluation. The correlation of HGS with liver function (Child Pugh or CP score) and muscle mass is controversial. These important evaluation is not yet avalaible in Indonesia.Method : This is a cross-sectional study in liver cirrhosis patients at Hepatobiliary clinic of Cipto Mangunkusumo Hospital from February to June 2015. Nutritional status was assessed by HGS. Muscle mass was obtained from bioimpedance. Data were analyzed using Spearman correlation test. Results : There were 115 patients liver cirrhosis at Hepatobiliary clinic of Cipto Mangunkusumo Hospital, 112 patients who fit the inclusion criteria, consisted of 79 men and 33 women with mean age 54,15±10,55 years, median CP score 6(5-13) with median HGS 26 (11-50) kgF, mean muscle mass 44,43±8,12 kg. The median intake of energy 1334,82(604,75-3023,7) kkal, median protein 45,87(19-114,5) gram. Prevalence of malnutrition according HGS was 33%. Hand grip strength is not correlated with CP score (p 0,046, r=-0,19) however it is correlated with muscle mass (p<0,001, r= 0,70) Conclusion There are 33% malnutrition cases based on HGS in out patient liver cirrhosis. There is no correlation between hand grip strength with Child Pugh score however HGS is correlated with muscle mass in liver cirrhosis."

"Latar belakang. Malnutrisi berkaitan dengan memburuknya kondisi selama di perawatan dan berkaitan dengan keluaran yang buruk. Kehilangan berat badan akan menyebabkan penurunan kekuatan otot yang akan menimbulkan penurunan fungsi. Kekuatan genggam tangan mungkin bermanfaat sebagai indikator status nutrisi khususnya bilamana pengukuran antropometri gagal untuk membedakan nutrisi kurang dengan orang yang berat badan kurang. Sampai saat ini belum ada data mengenai kekuatan genggam tangan dengan status nutrisi pasien yang dirawat di bangsal penyakit dalam di Indonesia. Tujuan Penelitian. Mendapatkan perbedaan rerata kekuatan genggam tangan pasien nutrisi kurang dan nutrisi baik di bangsal penyakit dalam. Metodologi. Studi potong lintang pada pasien di ruang perawatan penyakit dalam. Pemilihan subyek dengan cara konsekutif Pasien dinilai dengan Subjective Global Assessment, pengulcuran indeks massa tubuh dan pemeriksaan kekuatan genggam tangan. Basil. Pada bulan Juli - Nopember 2008 telah didapatkan 140 subyek yang memenuhi kriteria. Subyek terdiri dari 70 laki-Iaki dan 70 perempuan. Sebaran umur pada kelompok laki-laki berkisar 18 - 57 tahun dengan rerata umur 39,4 ± 11,4 tahun dan pada kelompok perempuan berkisar 19 - 59 tahun dengan rerata umur 40,1±12,4 tahun. Untuk menentukan perbedaan rerata digunakan uji t test. Rerata kekuatan genggam tangan kelompok laki-laki nutrisi kurang 19,5 ± 7,7 kg, nutrisi baik 29,5 ± 6,7 kg dan rerata kekuatan genggam tangan kelompok perempuan nutrisi kurang 10,2 ± 3,6 kg dan nutrisi baik 14,2 ± 3,7 kg. Penelitian mendapatkan perbedaan rerata yang bermakna pada subyek nutrisi kurang, baik pada kelompok laki-Iaki ataupun perempuan (kelompok lakilaki t = 5,805, P = 0,00 95% IK 6,6; 13,5, kelompok perempuan t = 4,555, P = 0,00 95% IK 2,2;5,7). Simpulan. Penelitian ini mendapatkan perbedaan kekuatan genggam tangan yang bermakna pada subyek kelompok nutrisi kurang dan nutrisi baik.

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Background. Malnutrition is associated with a deterioration of clinical condition during hospitalization hence a poor outcome. A weight loss will cause a decrease of muscle strength thus the function. Handgrip may be useful as an indicator of the nutritional status, especially when the anthropometric measurement fails to differentiate malnutrition with a less than normal body weight person. Up to now, there has been no data regarding the correlation of handgrip and the nutritional status of patients confined at the internal medicine ward in Indonesia. Objective. To obtain a difference of the mean value of handgrip in patients with malnutrition and a good nutrition at the internal medicine ward. Methodology. This is a cross-sectional study of patients confined at the internal medicine ward. Subjects were consecutively included. Patients were evaluated using Subjective Global Assessment, body mass index calculation and handgrip. Result. From July to November 2008, there were 140 subjects who fulfilled the criteria. 70 were male and 70 were female. The range age for the male group was 18-57 years old with means 39,4 ± 11,-1 years old, and the female group was 19-59 years old with means 40, 1±12,4 years old. A t test was used to determine the difference of m~ value. Means handgrip in male subject with malnutrition was 19,5 ± 7,7 kg and good nutrition was 29,5 ± 6,7 kg. Means handgrip in female subject with malnutrition was 10,2 ± 3,6 kg and good nutrition was 14,2 ± 3,7 kg. This study showed a significant difference of mean value in subjects with malnutrition, both male and female groups (male t = 5,805, P = 0,00 95% CI 6,6;13,5, female group t = 4,555, P = 0,00 95% CI 2,2;5,7). Conclusion. This study showed a significant difference means handgrip in subjects with malnutrition."

"protein-energy malnutrition is common in patients with liver cirrhosis , especially in advanced and severe stage. Liver cirrchosis patients with malnutrition have increasing risk to get post-operative complication and mortality...."

"Gizi kurang merupakan salah satu masalah kesehatan balita yang memiliki keterkaitan dengan masalah infeksi. Upaya preventif diperlukan dalam menangani infeksi untuk mengatasi masalah gizi kurang. Intervensi keperawatan unggulan berupa pendidikan kesehatan Perilaku Hidup Bersih dan Sehat dan melatih kemampuan psikomotor cuci tangan dengan sabun. Tujuannya mengurangi angka kejadian infeksi dalam keluarga. Evaluasi terjadi peningkatan kemampuan kognitif, afektif, dan psikomotor keluarga dalam praktik Perilaku Hidup Bersih dan Sehat, peningkatan berat badan anak dari 7 kg menjadi 7,8 kg, serta teratasinya masalah infeksi. Intervensi Perilaku Hidup Bersih dan Sehat ini dapat digunakan oleh perawat komunitas/keluarga sebagai upaya menangani masalah gizi kurang di masyarakat.

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Malnutrition was one of the urban health problems for toddler that had being related to infection. Some prevention efforts needed to handle the infection in overcome malnutrition. The excellence nursing intervention such as health education about the healthy and clean life behavior practice and psychomotor skill training in hand washing with soap. It's aimed to decrease the number of infection in family. Evaluation shown the increase ability of kognitive, affective, and psychomotoric skills of family in run the healthy and clean life behavior practice, the increase of body weight of child from 7 kg to 7,8 kg, and the overcome of infection problems. Intervention of the healthy and clean life behavior practice could be used by the community nurses as an efforts in overcome malnutrion in society."

"Gizi buruk merupakan kekurangan gizi tingkat berat terutama pada anak-anak dibawah umur lima tahun (balita) dan merupakan salah satu masalah gizi utama di Indonesia yang perlu ditanggulangi karena berdampak terhadap kesehatan dan Human Devolopment Index manusia Indonesia 15-20 tahun yang akan datang. Masalah gizi memiliki dimensi yang luas, tidak hanya merupakan masalah kesehatan tetapi juga meliputi masalah sosia}, ekonomi, budaya, pola asuh, pendidikan dan lingkungan. Faktor pencetus munculnya masalah gizi dapat berbeda antara wilayah ataupun antara kelompok masyarakat, bahkan akar masalah ini dapat berbeda antara kelompok usia balita. Kondisi krisis ekonomi sejak tahun 1997 dan terus berkelanjutan sampai saat ini, menyebabkan daya beli pada masyarakat secara umum menjadi menurun, karena disatu pihak relatif banyak yang kehilangan sumber mata pencaharian sementara dipihak lain adanya peningkatan harga barang dan jasa. Hal ini dapat mengakibatkan dampak buruk terhadap kesehatan dan gizi masyarakat, terutama balita. Masalah gizi pada anak balita di provinsi Riau dari tahun ke tahun cenderung meningkat. Penelitian ini bertujuan untuk mengetahui hubungan antara faktor status ekonomi keluarga dengan terjadinya kasus gizi buruk pada anak balita umur 6 bulan sampai < 5 tahun di Kabupaten Kampar Riau tahun 2002, dengan variabel kovariatnya yaitu riwayat diare, pendidikan ayah, pendidikan ibu, umur balita, jenis kelamin, jumlah anggota keluarga, pekerjaan ayah, pekerjaan ibu, pengetahuan ibu, dan pemberian ASI ekslusif. Penelitian ini merupakan penelitian bservasional dengan metoda kasus kontrol. Responden dalam penelitian ini adalah ibu-ibu yang mempunyai anak balita umur 6-59 bulan dengan status gizi buruk saat penelitian, dan sebagai kontrolnya adalah ibu dengan balita gizi baik (148 kasus dan 148 kontrolnya). Penelitian dilakukan di Kabupaten Kampar Riau. Analisis data dilakukan dengan uji kai kuadrat dan analisis multivariat menggunakan regresi logistik. Hasil uji analisis logistik diketahui ada hubungan yang signifikan antara status ekonomi keluarga dengan terjadinya kasus gizi buruk pada anak balita di Kabupaten Kampar Riau (p=0,0001) dengan OR 2,8599 (95% CI: 1,7176 - 4,7619 ). Dari hasil perhitungan dampak potensial diketahui bahwa status eknomi keluarga (keluarga miskin) mempunyai kontribusi sebesar 47% sebagai faktor risiko terjadinya gizi buruk balita, artinya jika faktor ini dihilangkan maka akan dapat dicegah terjadinya gizi buruk pada balita sebesar 47%. Disimpulkan bahwa status ekonomi keluarga mempunyai hubungan yang signifikan dengan terjadinya gizi buruk pada anak balita, untuk itu dalam upaya penanggulangan dan pencegahan masalah gizi agar memberikan perhatian dan penekanan kepada variabel status ekonomi keluarga (kemiskinan), dengan melakukan upaya terpadu. Dalam pemilihan dan perencanaan upaya yang berkaitan dengan masalah gizi buruk ini agar mempertimbangkan ukuran dampak potensial yang berkontribusi terhadap terjadinya kasus gizi buruk pada anak balita.

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The Relationship Between Family Economical Status and The Incidence of Severe Malnutrition Cases Among Children of Under five Years in Kabupaten Kampar Riau Province 2002Severe Malnutrition is the chronic nutrient deficiency, which usually occurs at under five years old children. It also the main nutrient problems in Indonesia that should have to decline and reducing its effects to health and Indonesians Human Development Index for the next 15 - 20 years.

The nutrition problem has a very wide dimension, not just public health problems but also social, economic, culture, care, education, and environment. The ignitions of nutrition problems in one region or society to another could be different, in fact the occurrence among under five years old children could be different.

Indonesia's economic crisis conditions in 1997 and still continuing today caused public's purchasing power decreasing generally, as effect of un-employments and the raise of goods and services prices. Those conditions could make worst for public's health and nutrients, especially toddlers. Nutrient problems in Riau Province inclination increase years after years.

The goals of this research is to determines the connection between economical status factors and severe malnutrition incidences, age between 6 months - 5 years old, at Kabupaten Kampar Riau in 2002; with diarrheic, parents educational, toddlers age, gender, numbers of family members, parents works, mother's maternity knowledge, and breast feeding, as the covariate variables.

This research is an observational research with case control method. The respondents of this research are the mothers that have children of under five years, which have severe malnutrition, and as the controls are the mothers that have good nutrition (148 cases and 148 controls). The research took place at Kabupaten Kampar Riau (p = 0,0001) with OR 2, 8599 (95% CI: 1,7176 - 4,7619).

According to potential effect formula, had known that the family's economical status (poor family) have 47% contributions as risk factor of severe malnutrition cases , that mean if we can eliminate this factor, we can reduce the toddlers bad nutrient cases to 47%.

The conclusion of the research, that family's economical status has a significant connection to incidence severe malnutrition cases, therefore any dealing and prevention acts with public's nutrients and health problems should pay attention to family's economical status variable by doing full planning works. In determining and planning acts to prevent the nutrient problems, we have to considering the potential effect values that make contributions to severe malnutrition cases."

"Balita merupakan kelompok resiko terhadap masalah sulit makan. Penelitian ini bertujuan mengetahui hubungan praktik pemberian makan dalam keluarga dengan kejadian sulit makan pada populasi balita. Desain deskriptif korelasi dengan pendekatan cross sectional dilakukan pada keluarga yang memiliki balita. Hasil menunjukkan ada hubungan bermakna kontrol makanan, model peran, keterlibatan anak, edukasi makanan, penyediaan makanan dan pengenalan Makanan Pendamping Air Susu Ibu (MP-ASI) dengan p value < 0,05 terhadap sulit makan balita. Program prevensi primer, sekunder dan tersier untuk menyediakan pelayanan kesehatan masyarakat terkait praktik pemberian makan pada anggota keluarga dan penelitian selanjutnya tentang faktor predisposisi lain dan pemungkin sulit makan direkomendasikan.

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Under-five children is a risk group for eating rejection habit. This study aims to determine the influence of feeding practice in family to eating rejection habit in Under-five children. A cross sectional design with descriptive correlation approach applied to 190 family with under-five children. It showed meaningful relationship of food control, role models, the involvement of children, food education, food provision and the introduction of food after breast feeding (p value < 0,05) with a difficult eating toddlers. Primary to tertiary prevention program through Community Health Nursing Program as well as further study on another predisposing and enabling factors are recommended."

"Kurang Energi dan Protein (KEP) pada bayi disebabkan beberapa faktor. Penelitian ini bertujuan mengetahui hubungan antara berat lahir, asupan makan bayi (energi dan protein), umur dan jenis kelamin bayi, imunisasi, penyakit infeksi, pendidikan ibu, pekerjaan ibu dan jumlah anggota rumah tangga dengan keadaan KEP pada bayi. Desain yang digunakan adalah cross sectional. Data yang digunakan merupakan data sekunder dari Riskesdas 2007. Populasi adalah bayi di wilayah penelitian Provinsi Lampung dan sampel adalah bayi yang memiliki datadata yang lengkap sesuai dengan tujuan penelitian ini dan terpilih sebanyak 148 bayi. Analisis statistik yang digunakan adalah univariat, bivariat dengan chi square dan untuk melihat faktor yang paling dominan digunakan uji regresi logistik. Proporsi bayi yang menderita KEP sebesar 12,2%. Hasil penelitian menunjukkan faktor paling dominan berhubungan dengan KEP pada bayi adalah penyakit infeksi (p value = 0,009) dengan nilai OR 4,265 setelah dikontrol berat lahir, asupan protein, pendidikan ibu dan jumlah anggota rumah tangga. Bayi yang pernah menderita penyakit infeksi berpeluang 4,265 kali lebih besar dibandingkan bayi yang tidak pernah menderita infeksi.

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Protein Energy Malnutrition (PEM) on infants due to several factors. This study aims to determine corelated between birth weight, nutrient intake (energy and protein), age and sex, immunisation, infectious disease, maternal education, maternal employments and the number of household members with PEM in infants in Province of Lampung Year 2007.

This study was using cross sectional design. The data use are secondary data from Riskesdas 2007. Population are infants in the research area Province of Lampung and the samples were infants who had complete data in accordance with the aims of this study and was selected as many as 148 infants. Data were analyzed by univariate analysis, bivariate analysis with chi square and multivariate analysis with logistic regression. The proportion of infant with PEM were 12,2%.

Results showed the most dominant factor associated with PEM on infants in Province of Lampung Year 2007 is an infectious disease after being controlled by the variable of birth weight, protein intake, maternal education and number of household members. Infants with infectious disease were 4,265 times more likely to have PEM than there with no infectious disease."

"Status gizi kurang yang dialami pasien selama rawat inap di rumah sakit akan berdampak pada rendahnya penyembuhan pasien dari penyakit yang diderita dan berujung pada hari rawat yang lebih lama, angka kesakitan dan biaya rawat meningkat. Kejadian gizi kurang pasien penyakit dalam masih cukup tinggi, penelitian di Universitas Alabama 46% pasien menderita kurang gizi dan di RSCM berkisar 34.2-51.4% mengalami hal yang sama.Penilitian ini merupakan penelitian primer yang dilakukan di ruang rawat Penyakit Dalam kelas III Rumah Sakit Dr. Cipto Mangunkusumo, dengan tujuan untuk mengetahui hubungan antara asupan makan dengan status gizi pasien rawat inap penyakit dalam RSCM. Dilaksanakan pada bulan April hingga Awal Juni 2006. Responden adalah pasien rawat inap penyakit dalam usia 18-60 tahun yang memenuhi kriteria inklusi dan eksklusi. Desain penelitian dengan analitik potong lintang, terpilih 91 sampel laki-laki dan perempuan secara purposive. Pengolahan dan analisis data menggunakan program FP2 dan SPSS.Penilaian asupan makan yang diterjemahkan kedalam energi dan protein dinilai dengan food recall 2x24 jam. Adapun penilaian status gizi dengan melakukan pengukuran antropometri, albumin serum dan pemeriksaan SGA (subjective global assessment). Penilaian selera makan dengan wawancara, jenis penyakit dan obat didapat dari rekarn medis.Hasil penelitian menunjukkan bahwa sebanyak 47 responden (51.6%) asupan makan kurang dari kebutuhan dan sebanyak 44 responden (48.4%) asupan makan cukup. Penilaian status gizi dengan 3 pengukuran yaitu antropometri (IMT), SGA dan albumin serum ditemukan status gizi kurang masing-masing 45.1%, 53.8%, dan 61.5%.Dengan uji kai kuadrat didapatkan adanya hubungan yang bermakna antara asupan makan dengan status gizi kecuali dengan parameter albumin serum. Analisis multivariat regresi logistik didapatkan hasil, responden dengan asupan makan kurang berisiko mengalami status gizi kurang 3.143 kali dibandingkan responden dengan asupan makan eukup setelah dikontrol variabel jenis kelamin dan selera makan.Didapatkan hubungan yang bermakna antara selera makan dengan status gizi. Data yang didapat tidak dapat membuktikan adanya hubungan antara penyakit, obat, jenis kelamin, dan usia terhadap status gizi.Bertitik tolak dari hasil penelitian yang diperoleh disarankan kepada manajemen rumah sakit untuk mengadakan standar makanan tinggi kalori tinggi protein dan perlu adanya dukungan gizi (nutritional support) bagi pasien rawat inap penyakit dalam, dalam bentuk makanan enteral maupun lainnya. Menyertakan diagnosis status gizi pasien berdasar SGA kedalam diagnosis penyakit. Bagi unit penyelenggara makanan rumah sakit untuk meningkatkan cita rasa masakan.

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Undernourished status of in-patient in hospital will have an impact on the low rate of recovery from the disease one suffers and end up with longer stay in hospital, increase in morbidity and cost. Incidence of undernourished among in-patient of internal medicine ward is high. Study by University of Alabama 46% of patient suffer from undernourished and in RSCM is around 34.2 - 51.4%.

This study is primarily study conducted in Internal Medicine Ward CIass III, RSCM. The aim of the study was to know the relationship between food intake and nutritional status of in-patient of internal medicine ward, RSCM. The study was conducted from April to early June 2006. Respondent was patient of in-patient internal medicine ward aged 18-60 years with certain inclusive and exclusive criteria. The study design was analytic cross-sectional with 91 male and female respondent selected purposively. Data processing and analysis was using FP2 and SPSS.

Calculation of food intake that translated into energy and protein was from food recall 2x24 hours method. Nutritional status was based on anthropometric measurement, albumin serum and examination of Subjective Global Assessment (SGA). Examination of appetite was by interview, type of disease and medicine were noted from medical record.

The results show that 47 respondent (51.6%) had food intake less than daily requirement. Nutritional status using 3 (three) assessments i.e. anthropometric which is Body Mass Index (BMI), SGA and albumin serum was found that 45.1%, 53.8%, and 61.5% respectively under normal.

Statistical test (chi-square) showed a significant relationship between food intake and nutritional status except with albumin serum. Multivariate analysis showed that patient with food intake less than daily requirement had 3.143 times risk of undernourished after controlling sex and appetite.

There was a relationship between appetite and nutritional status. However, there was no relationship between disease, medicine, sex and age with nutritional status.

From these findings it is recommended that hospital management to take some measures on food standard for high calorie and high protein and need nutritional support for in-patient of internal medicine ward in the form of enteral food or others. Additional diagnosis of nutritional status using SGA was needed in the disease diagnosis. For hospital food management unit it is recommended to increase food taste."

"Latar Belakang: Stroke merupakan penyakit neurologi yang sering dijumpai dengan disabilitas dan mortalitas yang tinggi. Defisiensi vitamin D sering dijumpai pada pasien stroke dan berhubungan dengan meningkatnya risiko stroke serta luaran klinis yang buruk. Terapi medik gizi termasuk pemberian vitamin D diperlukan untuk membantu proses penyembuhan dan memberikan luaran klinis yang baik pada pasien stroke iskemik.Kasus: Serial kasus ini membahas empat pasien stroke iskemik yaitu dua pasien laki-laki dan dua pasien perempuan dengan usia 46-86 tahun. Tiga pasien didiagnosis sebagai malnutrisi berat secara klinis dan satu pasien dengan berat badan berlebih. Empat pasien tersebut memiliki kadar vitamin D yang rendah yaitu tiga pasien dengan defisiensi vitamin D dan satu pasien dengan insufisiensi vitamin D. Pasien mendapatkan tatalaksana nutrisi selama perawatan di rumah sakit dan rawat jalan.Hasil: Durasi perawatan rumah sakit pada empat pasien tersebut antara 22-59 hari. Dua pasien stroke iskemik dengan defisiensi vitamin D mengalami kematian saat perawatan di rumah sakit. Dua pasien yang hidup hingga akhir pemantauan mendapatkan suplementasi vitamin D dan didapatkan perbaikan kadar vitamin D. Pasien tersebut menunjukkan perbaikan klinis berupa perbaikan status gizi dan kapasitas fungsional.Kesimpulan: Tatalaksana medik gizi yang adekuat dan suplementasi vitamin D dapat memperbaiki luaran klinis pasien stroke iskemik.

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Background: Stroke is a neurological disease with high disability and mortality. Vitamin D deficiency is common in stroke patients and is associated with increased risk of stroke and poor clinical outcome. Nutritional medical therapy is needed to help the healing process and provide a good clinical outcome in ischemic stroke patients.

Methods: This case series discusses four ischemic stroke patients, consist of two male patients and two female patients with aged 46-86 years. Three patients were diagnosed as clinically severe malnutrition and one patient was overweight. Four patients had low vitamin D levels, consist of three patients with vitamin D deficiency and one patient with vitamin D insufficiency. The patients received nutritional management during hospitalization and outpatient treatment.

Results: The length of stay of these four patients was 22-59 days. Two ischemic stroke patients with vitamin D deficiency were died during hospitalization. Two patients who lived until the end of monitoring received vitamin D supplementation and had improvement in vitamin D levels. These patients showed clinical improvement in nutritional status and functional capacity.

Conclusions: Adequate nutritional medical management and vitamin D supplementation can improve the clinical outcome of ischemic stroke patients."

"Penelitian ini bertujuan mengetahui efektifitas PERGIZI dilihat dari komponen input, proses, output dan outcome. Penelitian kualitatif dengan rancangan RAP (Rapid Assesment Procedure), dilakukan minggu keempat bulan Mei 2013 dengan informan kepala seksi gizi, petugas gizi, kader, bidan di desa, ibu balita dan tokoh masyarakat. Hasil penelitian menunjukkan PERGIZI efektif untuk menanggulangi gizi buruk di Puskesmas Sepatan. dengan indikator meningkatnya status gizi sebesar 69,1%, hanya komponen input yakni dana yang disebagian besar pos gizi masih kurang, sedangkan dari komponen proses dan output telah dapat mencapai tujuan yang ditetapkan. Agar mengoptimalkan penanggulangan gizi buruk di wilayah Puskesmas Kabupaten Tangerang dengan PERGIZI.

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The aims of this study was to determine the effectiveness of the PERGIZI program viewed by its component such as inputs, process, outputs and outcomes. A qualitative research with RAP (Rapid Assessment Procedure) design was conducted at fourth week of May 2013. The data collection methods used an indepth interview and focused group discussion. With the informants 42 persons consisting of section head of nutrition, nutrition workers, cadres, village midwives, mothers of under five children and community leaders. This could be seen from change of nutritional status from the under five children as much as 69,1%. From the input component the mean barrier was funding both component process and output was considered successfull and achieving the predetermined goal. It is recomended to solve existing under five nutritional problem in the district of Tangerang using the PERGIZI approach."