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"ABSTRAKBackground: obesity and osteoarthritis have strong inter-relationship with multi-factorial mechanism thatcaused pain and leads to decreased quality of life. Exercise has been identified as prevention and managementagainst obesity and joint pain. This systematic review aims to assess the effect between exercises compared to dietgroup for chronic pain management, physical and mental function in obese patients with chronic musculoskeletalproblem. Methods: we performed a systematic search of Randomized Control Trial studies from Cochrane CentralRegister of Controlled Trials (CENTRAL); MEDLINE; EBSCO; SCIENCEDIRECT (Elsevier); SCOPUS, greyliterature, trial registry, ongoing study for published studies, and from the ClinicalTrial.gov, thesis of rehabilitationmedicine in RSCM, and proceeding books for unpublished studies that was last updated on November 2016. Riskof bias was assessed using Cochrane risk-of-bias tool and data were analyzed using Review Manager 2014.Results: one study showed no difference in pain reduction (assessed using VAS) between two groups. Two studiesshowed improvement in physical function measured using 6MWT in exercise group at 6 and 18 months with meandifference 28.12 [11.20, 45.04] and 26.21 [9.01, 43.41]. There was no significant effects observed for Mental andPhysical Function based on SF-36 after 6 months (1 study) and 18 months (2 studies) observation, with meandifference 1.10 [-0.79, 2.99] and 0.08 [-1.53, 1.70] respectively for Mental Function score and -0.30 [-2.54, 1.94]and -0.36 [-2.30, 1.57] respectively for Physical Function score. Conclusion: exercise can improve physicalfunction objectively, but could not reduce pain in obese patients with chronic musculoskeletal problem subjectively.Keywords: exercises intervention, chronic pain management, functional score, quality of life, systematic review."

"The purpose of this study was to provide a reference of chronic diabetes complications by investigating the prolonged hyperglycemia effects on hematological, biochemical and histopathological changes (liver, kidney, spleen, cardiac muscle, adrenal gland, and endocrine pancreas) in diabetic rats induced by streptozotocin.

Methods: Ten adult female Sprague-Dawley of uniform age were divided into two Groups. Group 1 was made diabetic by single intraperitoneal injection of streptozotocin (60 mg/kg/bw) whereas Group 2 served as control. After six months, the rats were anesthetized using pentobarbital. Cardiac puncture was performed to get 3 ml of the blood sample; following 12 hours of an overnight fast. Serum chemistry test and complete blood analysis for lipid profile and blood glucose test; liver and renal functions were performed. Tissue specimens of liver, kidney, spleen, cardiac muscle, adrenal gland, and endocrine pancreas were fixed in 10% formal saline and processed for histological study.

Results: There were severe histopathological changes in the affected organs; and the presence of a significant abnormality of lipid profile, liver, and renal functions.

Conclusions: The presence of histopathological changes with abnormal biochemical changes is related to the chronic absence of insulin production in the destroyed β ?cells which reflect the diabetic complications in a human being."

"Pulmonary tuberculosis is a chronic lung disease which has a physical as well as psychosocial impact on the patients.Until recently, existing government programs still focus on the treatment and contamination prevention of the disease.The current existing program is not directed towards solving the patients’ psychosocial problems, although the impactthereof is very influential towards the discipline in undergoing treatment and the prognosis of Tuberculosis (TB) as adisease in patients. This research aims to analyze factors that are most influential in fulfilling the psychosocial needs ofTB patients in the city of Cirebon. This research uses a corelational descriptive method. 171 pulmonary TB patientsinvolved in this research were chosen through consecutive sampling from 10 public health centers in the City andRegion of Cirebon. The psychosocial needs of pulmonary TB patients are measured by instruments developed by theresearchers. Prior to using the instrument, a validity and reliability test has been conducted. The result indicates thatthere are three dominant factors that are closely related to the patients’ satisfaction in meeting their psychosocial needs.These factors are the psychological condition during the last week, duration of treatment and supporting services,whereas demographic factors are not related to their satisfaction in meeting their psychosocial needs. The result of thisresearch can be considered by the government to provide supporting services at Public Health Centers in order to fulfillthe psychosocial needs of pulmonary TBC patients and avoid drop out cases.Analisis Kebutuhan Psikososial Penderita Tuberkulosis Paru. Tuberkulosis paru adalah penyakit paru-paru kronisyang berdampak secara fisik dan psikososial bagi penderitanya. Hingga saat ini program-program pemerintah yang adamasih berfokus pada pengobatan dan pencegahan penularan penyakit. Program yang ada belum mengarah padapemecahan masalah psikososial penderita, padahal dampak masalah psikososial sangat besar pengaruhnya terhadapkepatuhan berobat dan prognosis penyakit penderita Tuberculosis (TB). Penelitian ini bertujuan menganalisis faktoryang paling mempengaruhi pemenuhan kebutuhan psikososial penderita TB di kota Cirebon. Penelitian inimenggunakan metode deskriptif korelasional. Sejumlah 171 orang penderita TB paru yang terlibat dalam penelitian inidipilih dengan cara consecutive sampling dari sepuluh puskesmas di Kota dan Kabupaten Cirebon. Kebutuhanpsikososial penderita TB paru diukur dengan alat ukur yang dikembangkan sendiri oleh peneliti. Sebelum digunakan,instrumen tersebut sudah diuji validitas dan reliabilitasnya. Hasil penelitian menunjukkan bahwa ada tiga faktordominan yang paling berhubungan dengan tingkat kepuasan pasien terhadap pemenuhan kebutuhan psikososial mereka.Faktor tersebut adalah kondisi psikologis dalam seminggu terakhir, lama pengobatan, dan layanan pendukung.Sementara itu, faktor demografi tidak berhubungan dengan kepuasan mereka terhadap pemenuhan kebutuhanpsikososial. Hasil penelitian ini dapat dijadikan pertimbangan bagi pemerintah untuk mengadakan layanan pendukungdi puskesmas sehingga kebutuhan psikososial penderita TB paru bisa terpenuhi dan kasus drop out bisa dicegah."

"The majority of female batik workers uses non-ergonomic chairs (dingklik) that pose risks of musculoskeletal disorders.This study aimed to design an ergonomic chair and evaluate its effectiveness in reducing musculoskeletal disordersamong the workers. This is a quasi-experimental study (using one group pre and post-test design) on 50 female batikworkers selected by quota sampling. Musculoskeletal disorders were measured among the samples before and after theuse of the designed ergonomic chair which they were asked to use for two months. T-test, ANCOVA, Wilcoxon test,McNemar test and Chi Square test were used for the analysis. The study found statistical significant differences of riskfactor against musculoskeletal disorders among the workers before and after their use of the designed ergonomic chair(p< 0.05); and of musculoskeletal disorders before and after using the ergonomic chair (p= 0,035). Body Mass Index(BMI) was identified as a confounding factor, and statistical significant difference of musculoskeletal disorders werealso found among the workers with <25 and >25 BMI even before and after using the ergonomic chair (p=0.033 andp=0.015 respectively). By ANCOVA statistical test, after controlling BMI, another statistical difference ofmusculoskeletal disorders was also identified before and after using the ergonomic chair (p=0.033). It is concluded thatthe designed ergonomic chair is effective to reduce the risk of musculoskeletal disorders."

"The aim of this study was to analyse differences in bone density and vitamin D and calcium concentrationsbetween pregnant and non-pregnant women. Methods: This was an analytical, cross-sectional study of women aged 30years or over, residing in the Puskesmas Bangkalan district. The sample population was chosen at random and included10 pregnant women in their third trimester and 10 non-pregnant women. This observational study consisted of aninterview, a blood test, and a 24-hour recall. The concentration of serum vitamin D (25(OH)D) was measured by GasChromatography and a Photometric Test measured the concentration of serum calcium. Participant’s bone density wasmeasured by bone ultra sonometer. The data was analysed using the Mann-Whitney test and assessed ultraviolet-Bexposure, bone density values, and consumption of vitamin D, calcium, energy, and protein. The Student t-test wasused to analyse serum vitamin D and calcium concentrations. Results: There were no differences between the groups’serum vitamin D concentrations (p = 0.946). However, there were significant differences between the groups’ serumcalcium concentrations (p = 0.047) and bone density values (p = 0.019). Conclusions: A high prevalence of vitamin Ddeficiency (25(OH)D < 50 nmol/L) and insufficiency (25(OH)D < 80 nmol/L) was observed in both groups. The meanserum calcium concentrations and bone density values were lower in pregnant subjects than non-pregnant subjects."

"Latar Belakang: Pekerja kantor dengan komputer berisiko untuk mengalami nyeri leher dan bahu. Bila nyeri leher dan bahu ini tidak ditangani dengan baik akan dapat mengganggu aktivitas pekerja baik di tempat kerja maupun di luar pekerjaan. Oleh karena itu diperlukan suatu penanganan yang tepat pada kasus nyeri leher dan bahu ini. Laporan ini dibuat untuk memperoleh bukti apakah latihan leher dan bahu efektif dalam mengurangi nyeri leher dan bahu pada pekerja kantor dengan komputer.Metode: Pencarian literatur dilakukan secara online dengan menggunakan database Pubmed dan Cohrane library. Judul dan abstrak yang didapatkan kemudian ditapis berdasarkan kriteria inklusi dan eksklusi. Telaah kritis dilakukan dengan menggunakan kriteria oleh Center-for Evidence Based Medicine, University of Oxford yang mencakup validity, importance dan applicability.Hasil: Didapatkan enam artikel yang relevan. Semua studi merupakan randomized controlled trial. Secara keseluruhan semua studi cukup valid, walaupun ada studi yang memiliki angka drop-out yang tinggi. Dari enam studi, aspek importance hanya dapat dinilai pada tiga studi karena tidak diketahui berapa effect size pada tiga studi lainnya. Pada tiga studi yang dapat dinilai aspek importance, walaupun ada hasil yang menunjukkan efek perbaikan yang bermakna secara statistik, namun efeknya secara klinis hanya minimal sampai sedang. Oleh karena tingkat kepentingannya yang rendah, maka tidak dilanjutkan lagi penilaian applicability.Kesimpulan: Belum ditemukan bukti yang cukup kuat bahwa latihan leher dan bahu efektif dalam mengurangi nyeri leher dan bahu pada pekerja kantor dengan komputer. Oleh karena itu kita belum dapat menyarankan latihan leher dan bahu ini sebagai terapi untuk mengurangi nyeri leher dan bahu pada pekerja kantor dengan komputer.

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Background: Computer office workers are at risk to have neck and shoulder pain. If neck and shoulder pain is not controlled properly, it can disrupt the worker?s activities both at work and outside work. Therefore proper treatment is needed for neck and shoulder pain. This report aims to obtain evidence whether neck and shoulder training is effective in reducing neck and shoulder pain among computer office workers.

Method: A literature search was conducted online using database of Pubmed and Cochrane library. Titles and abstracts were obtained and then screened based on inclusion and exclusion criteria. Critical appraisal was conducted using criteria by Center-for Evidence Based Medicine, University of Oxford include validity, importance and applicability.

Results: Six articles were found to be relevant. All studies are randomized controlled trials. Overall, all studies are quite valid although there are studies which have high drop-out rate. From six studies, aspect of importance only can be assessed in three studies because the effect size in three other studies was unknown. In the three studies where aspect of importance could be assessed, although there are outcomes that were statistically significant, the clinically improvement were only minimal to moderate. Because the level of importance is low, assesment of applicability was not conducted.

Conclusion: No sufficient evidence was found that neck and shoulder training is effective in reducing neck and shoulder pain among computer office workers. Therefore neck and shoulder training as therapy for reducing neck and shoulder pain among computer office workers can not be recommended."

"Graves disease is an autoimmune disorder which affect thyroid gland. Graves disease is the most common cause of hyperthyroidism and thyrotoxicosis. Understanding of disease pathophysiology, diagnostic and treatment strategies, and prevention of disease relapse are important for all clinicians especially internal medicine specialist to give optimal and comprehensive management for Graves disease patients. This article highlights clinical points to treat Graves disease patients from reviews and latest guidelines from American Thyroid Association (ATA), European Thyroid Association (ETA), and Japan Thyroid Association/ Japan Endocrine Society."

"AbstrakDeclining environmental quality is one of population caused by household consumption behavior. Some of the highest contaminant contributions are domestic waste, waste, and company waste. Waste contamination will lead to dead fish, decreased water quality and disease transmission. Community approach can be done to solve the waste problem, especially at the household level. This study uses quantitative methods to analyze the effect of intervention and waste management training on changes in household waste management knowledge and practices. This type of research uses quasi experiment with one group of pre and post test design. The results showed that there was an increase of knowledge about waste management after being given intervention by the researcher because the p value ≤ 0,05. The results also show that there is an increasing practice on waste management after being given intervention by researchers because the p value ≤ 0.05. Based on the research results, it can be concluded that the provision of intervention is effective for improving knowledge and practice in the household waste management."

"The district of Lumajang in the year 2005 has launched a policy which was named halty community development movement (GERBANGMAS) and implementated throught integrated health post...."