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"Latar Belakang : Wabah pneumonia akibat Corona Disesase 2019 (COVID-19) masih menjadi perhatian nasional maupun global. Wanita hamil termasuk dalam kelompok risiko tinggi/rentan terhadap infeksi COVID-19. Adanya badai sitokin akibat infeksi COVID-19 menyebabkan gejala klinis yang semakin berat. Zinc sebagai salah satu mikronutrien penting yang berpengaruh dalam regulasi produksi sitokin oleh sistem imun tubuh. Kondisi defisiensi zinc pada wanita hamil yang terinfeksi COVID-19 dapat menyebabkan disregulasi dari sistem imun dan menghasilkan badai sitokin yang mengakibatkan sindrom ancaman gagal napas akut dan kematian. Tujuan : Meneliti hubungan kadar zinc serum maternal terhadap kadar sitokin pro- inflamasi interleukin-6 (IL-6) dan interferon gamma (IFN-) pada wanita hamil yang terkonfirmasi COVID-19 dengan gejala ringan-sedang dan berat. Metode : Penelitian observasional dengan desain studi cross-sectional. Subyek penelitian adalah wanita hamil yang terkonfirmasi COVID-19 dengan gejala ringan-sedang dan berat. Faktor yang diteliti meliputi kadar zinc, IL-6 dan IFN- serum maternal dan hubungannya kadar zinc serum terhadap kadar IL-6 dan IFN- serum maternal.Hasil : Jumlah total subyek sebanyak 48 orang dibagi menjadi 28 subyek untuk kelompok wanita hamil yang terkonfrimasi COVID-19 gejala ringan-sedang dan 20 subyek dengan gejala berat. Rata-rata usia responden 30,61 tahun untuk kelompok gejala ringan-sedang dan 32,9 tahun untuk kelompok gejala berat. Rata-rata usia kehamilan pada kelompok gejala ringan-sedang lebih tua dibanding kelompok gejala berat (38,1 minggu vs 34,5 minggu).Lama perawatan kelompok dengan gejala berat lebih lama dibanding kelompok gejala ringan-sedang. 60% subyek dari kelompok gejala berat berakhir dengan kematian maternal. Semua subyek dalam penelitian ini mengalami defisiensi zinc. Tidak terdapat perbedaan bermakna kadar zinc serum maternal pada kedua kelompok yaitu 54,0 (34-78) μg/dl untuk kelompok gejala ringan-sedang dan 52,0 (38-97) μg/dl untuk kelompok gejala berat. Terdapat perbedaan bermakna antara kelompok gejala ringan-sedang dengan kelompok gejala berat terhadap kadar IL-6 serum (5,8 (1,5-69,6) pg/ml vs 18,6 (3,8-85,3) pg/ml) dan kadar IFN- serum (0,9 (0,1-16,8) pg/ml vs 9,0 (0,9-21,1) pg/ml). Tidak ada korelasi antara kadar zinc serum maternal dengan kadar IL-6 dan IFN- serum maternal. Kesimpulan : Kadar zinc serum maternal tidak berbeda bermakna diantara kedua kelompok penelitan. Kadar IL-6 dan IFN- serum kelompok gejala berat lebih tinggi dibanding kelompok gejala ringan-sedang. Tidak ada korelasi antara kadar zinc serum dengan kadar IL-6 dan IFN- serum maternal.

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Bacground : The outbreak of Corona Disesase 2019 (COVID-19) is still a national and global concern. Pregnant women are included in the highrisk/susceptibility group for COVID-19 infection. The presence of a cytokine storm due to COVID-19 infection causes increasingly severe clinical symptoms. Zinc is one of the important micronutrients that influence the regulation of cytokine production by the immune system. Zinc deficiency in pregnant women with confirmed COVID-19 can cause dysregulation of the immune system and produce a cytokine storm that results in acute respiratory distress syndrome and maternal death. Objective: To evaluate the relationship between maternal serum zinc levels and the pro- inflammatory cytokines interleukin-6 (IL-6) and interferon-gamma (IFN-) in pregnant women with confirmed COVID-19 with mild-moderate and severe symptoms. Methods: A cross-sectional was adopted in this study. The subjects of the study were pregnant women with confirmed COVID-19 with mild-moderate and severe symptoms. We measure the maternal serum zinc levels, serum IL-6 and IFN- levels, then we evaluate the relation between the maternal serum zinc levels and the maternal serum IL- 6 and IFN- levels.

Results: The total number of subjects was 48 patiens, divided into 28 subjects for the pregnant women with confirmed COVID-19 with mild-moderate symptoms and 20 subjects with severe symptoms. The average age of the respondents was 30.61 years for the mild-moderate group and 32.9 years for the severe group. The mean gestational age in the mild-moderate group was older than in the severe one (38.1 weeks vs. 34.5 weeks). The length of stay of subjects with severe symptom was longer than the mild-moderate group. 60% cases from the severe group ended in maternal death. All the participants in this study suffered zinc deficiency. There was no significant difference in maternal serum zinc levels between the two study groups (54.0 (34-78) g/dl in mild-moderate group vs 52.0 (38-97) g/dl in severe group). There was a significant difference between mild- moderate vs severe groups in which the serum IL-6 levels were (5.8 (1.5-69.6) pg/ml vs 18.6 (3.8-85.3) pg/ ml) and the serum IFN- levels were (0.9 (0.1-16.8) pg/ml vs. 9.0 (0.9- 21.1) pg/ml). There is no correlation between maternal serum zinc level and maternal serum IL-6 and IFN- levels. Conclusion: The maternal serum zinc levels were not significantly different between the two study groups. The maternal serum IL-6 and IFN- levels in the severe group were higher than in the mild-moderate group. There is no correlation between maternal serum zinc level and maternal serum IL-6 and IFN- levels."

"Latar Belakang: Defisiensi vitamin A pada kehamilan adalah masalah kesehatan di masyarakat. Namun hipervitaminosis A juga memiliki potensi teratogenik pada kehamilan. Tujuan dari penelitian ini adalah untuk mengetahui hubungan antara asupan vitamin A dan kadar vitamin A serum pada kehamilan trimester pertama. Metode: Desain penelitian adalah studi potong-lintang. Data adalah data sekunder yang diambil dari penelitian primer pada ibu hamil di Jakarta. Kadar vitamin A diperolah dari hasil pemeriksaan laboratorium. Asupan vitamin A diperoleh dari pengisian food frequency questionaire oleh responden. Data yang diperoleh diolah dengan perangkat lunak SPSS for windows v.20.0. Hasil: Hasil uji deskriptif memperlihatkan 97,4% memiliki kadar vitamin A serum yang cukup dan tidak ada subjek yang mengalami defisiensi vitamin A. Sebanyak 57,9% subjek mendapat asupan vitamin A yang memadai. Uji korelasi antara kadar vitamin A serum pada wanita hamil trimester pertama dan asupan vitamin A menunjukan nilai p 0,542. Kesimpulan: Tidak ada korelasi yang berbeda bermakna antara kadar vitamin A subjek dan asupan vitamin A. Jumlah asupan vitamin A harian pada wanita hamil trimester pertama tidak perlu diatur dengan ketat.

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Background: Vitamin A deficiency in pregnancy is a health problem in society. However, hypervitaminosis A is also has a teratogenic potency in pregnancy, The objective of this research is to find out the relation between vitamin A intake with serum vitamin A level in Pregnant Women in 1st Trimester.

Method: This is a cross-sectional study using secondary data from primary research done to pregnant women in Jakarta. The data of vitamin A intake are obtained from the food frequency questionnaire filled by the respondent. The data of serum vitamin A level are obtained by laboratory examination. The data is then analyzed by using SPSS for windows v.20.0 software.

Result: The test shows that 97.4% of the subject already have appropriate serum vitamin A level and no subject suffers from vitamin A deficiency. It is also found that 57.9% of the subject have adequate vitamin A intake. Correlation test has been done on serum vitamin A level in pregnant woman in 1st Trimester and the vitamin A intake shows p value of 0.542.

Conclusion: No Relation found beetween serum vitamin A level of the subject and the vitamin A intake. The amount of daily vitamin A intake in pregnant women in 1st Trimester should not be regulated strictly."

"Salah satu faktor yang menentukan BB lahir bayi adalah asupan nutrisi ibu yang adekuat. Beberapa nutrien diketahui memiliki efek terhadap BB lahir bayi di antaranya adalah protein dan seng. Desain penelitian ini adalah cross-sectional dan dilakukan di 10 puskesmas kecamatan di Jakarta Timur sejak Februari hingga April 2015 dengan subjek ibu hamil berusia 19–44 tahun dengan usia kehamilan 32–37 minggu. Data asupan protein didapatkan dengan metode 24-hour recall, sedangkan asupan seng dengan metode Semi Quantitative Food Frequency Questionnaire dan 24-hour recall. Pengambilan darah dilakukan sebelum ibu melahirkan dan diperiksa dengan metode Atomic Absorption Spectrophotometry. Berat badan lahir bayi diukur segera setelah bayi lahir. Sebanyak 116 subjek mengikuti penelitian hingga akhir. Analisis statistik menunjukkan tidak terdapat korelasi antara asupan protein dengan kadar seng serum (r = 0,042, p = 0,653), tidak terdapat korelasi antara asupan seng dengan kadar seng serum (r = 0,155, p = 0,096), tidak terdapat korelasi antara asupan seng dengan BB lahir bayi (r = - 0,09, p = 0,303), dan tidak terdapat korelasi antara kadar seng serum dengan BB lahir bayi (r = -0,116, p = 0,215). Penelitian ini belum berhasil menemukan hubungan antara asupan protein, seng, dan kadar seng serum dengan BB lahir bayi.

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One of the factors affecting birth weight is mother’s adequate nutrient intake. Several nutrients are known to its effect to birth weight, which among them are protein and zinc. A cross-sectional study was conducted in 10 district public health centres in East Jakarta since Februari until April 2015. Subjects of the study were pregnant mothers aged 19–44 years old whose gestational age between 32–37 weeks.

Protein intake was computed based on 24-hour recall method, while zinc intake was computed based on Semi Quantitative Food Frequency Questionnaire and 24-hour recall method. Blood specimens were collected before giving birth and being assesed by Atomic Absorption Spectrophotometry method. Birth weight was measured soon after the baby was born. One hundred and sixteen subjects followed the study until the end.

Statistical analysis showed there were no correlation between protein intake and maternal zinc serum (r = 0,042, p = 0,653), no correlation between zinc intake and maternal zinc serum (r = 0,155, p = 0,096), no correlation between zinc intake and birth weight (r = -0,09, p = 0,303), and no correlation between maternal zinc serum and birth weight (r = - 0,116, p = 0,215). This study has not been able to prove any relationship between maternal intake of protein, zinc, zinc serum and birth weight."

"LATAR BELAKANG : Gangguan implantasi pada awal kehamilan menyebabkanIskemia plasenta dan dapat berakibat preeklamsia pada kemudian hari. Pada tahapselanjutnya iskemia plasenta menghasilkan radikal bebas dan berakibat stres oksidatif.Preeklamsia merupakan hasil dari ketidakseimbangan antara produksi radikal bebasdengan antioksidan sehingga terjadi reaksi inflamasi berlebihan pada kehamilan yangberakibat disfungsi endotel. Antioksidan dan inflamasi dalam tubuh ditentukan oleh statusgizi seseorang yang dinilai dari kadar serum ibu seperti seng, selenium, besi dan tembaga.Oleh karena itu perlu penelitian untuk menilai status gizi mikro dengan preeklamsia. TUJUAN : Diketahuinya perbedaan kadar seng, selenium, besi tembaga, danrasio tembaga seng serum maternal pada preeklamsia dibandingkan kehamilan normal. METODE : Penelitian ini merupakan studi potong lintang dengan jumlah sampel30 preeklampia dan 30 normal yang melakukan persalinan di RS Cipto Mangunkusumodan RSUD Tangerang. Pasien diambil darah untuk kemudian diproses menjadi serum danlalu diukur kadarnya. Setelah itu data disajikan dalam tabel dan dianalisis dengan uji ttidakberpasangan. Penelitian ini sudah lolos kaji etik dan mendapat persetujuanpelaksanaan dari Komite Etik Penelitian Kesehatan FKUI-RSCM. HASIL : Kadar serum seng pada preeklamsia dan normal adalah 45,03?10,84dan 41,37?10,59 ?g/dl dengan p=0,868, IK 95 3,66 -1,87-9,21 . Kadar seleniumadalah 84,93?13,67 dan 65,03?15,28 ?g/l dengan p=0,445, IK 95 19,9 12,4-27,39 .Kadar besi 115,77?49,14 dan 75,63?43,79 ?g/dl dengan p=0,409, IK 95 40,13 16,0964,17 .Kadar tembaga 219,85?45,92 dan 207,98?47,66 ?g/dl dengan p=0,73 IK 95 118,63 -123,25-360,52 dan rasio tembaga seng 5,15?1,54 dan 4,96?1,62 dengan p=0,803 1,9 IK 95 -6,25-10,06. KESIMPULAN : Terdapat perbedaan rerata kadar selenium dan besi pada preeklamsiadengan kehamilan normal namun tidak berbeda bermakna secara statistik. Tidak terdapatperbedaan rerata kadar seng, tembaga dan rasio tembaga seng pada preeklamsia dengankehamilan normal.

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BACKGROUND: Poor implantation in early pregnancy lead to placental ischemia wasthe pathogenesis of preeclampsia. On further stage, placenta ischemia generated oxidativestress. Preeclampsia was a manifestation of the free radical and antioxidant imbalanceresulting inflammation and endothelial dysfunction. Antioxidant dan inflammation wasdetermined by nutrition status that measured in maternal serum such zinc, selenium, ironand copper. Therefore, measuring micronutritional status in preeclampsia was needed.

OBJECTIVE: Investigate the mean difference of zinc, selenium, iron, copper, andcopper zinc ratio of maternal serum in preeclampsia comparing healthy pregnancy.

METHOD: This was a cross sectional study enrolled 30 preeclampsia patientsand 30 healthy pregnancy visiting Cipto Mangunkusumo and Tangerang Hospital. Bloodwas withdrawed from vein for further processed. Data was presented in table and wasanalyzed by unpaired t test. This study had been granted ethical clearence and approvedby Ethical Committee for Health Research Faculty of Medicine University of IndonesiaCipto Mangunkusumo Hospital.

RESULTS: The zinc maternal serum level in preeclampsia and healthypregnancy were 45.03 10.84 and 41.37 10.59 g dl, p 0.868, 95 CI 3.66 1.87 9.21 respectively. Selenium level were 84.93 13.67 and 65.03 15.28 g l, p 0.445, 95 CI19.9 12.4 27.39 . Iron level were 115.77 49.14 and 75.63 43.79 g dl, p 0.409, 95 CI40.13 16.09 64.17 . Copper level were 219.85 45.92 dan 207.98 47.66 g dl, p 0.7395 CI 118.63 123.25 360.52 and copper to zinc ratio were 5.15 1.54 and 4.96 1.62dengan p 0.803, 1.9 95 CI 6.25 10.06.

CONCLUSION: Selenium and iron level in preeclampsia and healthy pregnancy weresignificantly difference. However, it was not significance statistically. Zinc, copper andcopper to zinc ratio were not significantly different."

"Saat hamil terjadi peningkatan kebutuhan berbagai mikronutrien salah satunya adalah seng. Asupan seng yang adekuat selama kehamilan berperan dalam kesehatan janin. Namun, defisiensi seng sebagai akibat dari asupan yang tidak adekuat atau bioavailabilitas seng yang rendah masih menjadi masalah bagi negara berkembang seperti Indonesia. Penelitian ini bertujuan untuk mengetahui bagaimana hubungan antara asupan seng dalam diet dengan kadar seng serum ibu hamil trimester satu dalam rangka menurunkan angka defisiensi seng di Indonesia. Penelitian ini menggunakan studi potong lintang dengan jumlah subjek penelitian adalah 62 ibu hamil trimester satu dipilih melalui simple random sampling. Dari penelitian ini diperoleh nilai media asupan seng pada ibu hamil trimester satu adalah 2.26 (0.3-51.8) mg/hari. Sebanyak 90.3% subjek penelitian tidak memenuhi asupan seng sesuai rekomendasi AKG. Nilai median kadar seng serum ibu hamil trimester satu dalam penelitian ini adalah 61.29 (39.0-102.0) ug/dL. Terdapat korelasi negatif lemah dan bermakna secara statistik antara kadar seng serum dan asupan seng dalam diet ibu hamil trimester satu (r = -0.266, p = 0.037). Dari penelitian ini dapat disimpulkan bahwa kadar seng serum perlu dipertahankan dalam interval normal, antara lain dengan kecukupan asupannya dari makanan dan suplementasi, khususnya selama masa kehamilan

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There is an increasing need in micronutrient including zinc as adequate zinc intake plays role in fetal health. Nevertheless, zinc deficiency as a result of insufficient intake or low bioavailability is a problem in developing countries including Indonesia. This research observe the association between zinc intake and the serum level of zinc in first trimester pregnancy with the goal to reduce zinc deficiency in Indonesia. There are 62 subjects of first trimester pregnant women and this study is done using cross-sectional design with simple random sampling.

It is found that the median of zinc intake in first trimester pregnant women is 2,26 (0,3-51,8) mg/day. This research found that 90,3% of subjects did not fulfill the recommended dietary allowances for zinc intake. The median serum level of zinc in first trimester pregnant women is 61,29 (39,0-102,0) ug/dL. There is weak inverse correlation that is significant statistically between zinc serum level and zinc intake in first trimester pregnant women (p = 0,037, r = -0,266). It is concluded that zinc serum level must be maintained in the normal interval, such as an adequate intake and supplementation, especially during pregnancy"

"[ABSTRAKPada kehamilan dibutuhkan asupan zat gizi yang adekuat untuk menunjangpembelahan sel dan pertumbuhan yang cepat. Seng merupakan kofaktor dari hampirsekitar 200 enzim yang berperan penting dalam embryogenesis. Defisiensi sengberhubungan dengan komplikasi pada ibu selama kehamilan dan persalinan sertagangguan pertumbuhan dan kelainan kongenital pada janin. Konsentrasi sengserum menurun sejak kehamilan trimester pertama hingga ketiga. Penelitian inimerupakan penelitian dengan desain potong lintang yang bertujuan untukmengetahui korelasi antara konsentrasi seng serum maternal dengan tali pusat padakehamilan trimester ketiga. Penelitian dilakukan di 10 puskesmas di Jakarta Timurpada bulan Maret 2015 sampai bulan April 2015. Pengambilan subyek dilakukandengan cara konsekutif dan didapatkan 63 orang subyek yang memenuhi kriteriapenelitian. Data dikumpulkan melalui wawancara meliputi data usia, usiakehamilan, paritas, pajanan rokok, pendapatan rumah tangga, pendidikan maternal,serta asupan protein, besi, tembaga dan seng dengan metode Food FrequencyQuestionnaire (FFQ) semikuantitatif. Pengukuran antropometri untuk menilaistatus gizi dan pemeriksaan laboratorium yang meliputi konsentrasi seng serum dantali pusat. Didapatkan rerata usia 27,63 ± 4,96 tahun dan sebagian besar subjekberada dalam kategori pendidikan tinggi dan pendapatan tinggi. Asupan sengmenunjukkan 98,4% subjek memiliki asupan seng kurang dari Angka KecukupanGizi (AKG) Indonesia. Nilai median konsentrasi seng serum maternal 53,70 (28.18-67,61) μg/dL dan 82,5% subyek tergolong dalam kategori adekuat. Nilai mediankonsentrasi seng serum tali pusat adalah sebesar 85,11(57.54 - 154,88) μg/dL, sedangkan 65,1% subjek tergolong dalam kategori tidakadekuat. Didapatkan rasio di antaranya 0,63 dengan korelasi tidak bermakna antarakonsentrasi seng serum maternal dengan tali pusat (r=0,04, p=0,78).

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ABSTRACTPregnancy is a period of rapid growth and cell differentiation, when both of themother and the fetus are very susceptible to alterations in dietary supply, especiallyof nutrients which are marginal under normal circumstances. Zinc is required forcellular division and differentiation, and is an essential nutrient for normalembryogenesis. Zinc deficiency has been associated with complications ofpregnancy and delivery, as well as growth retardation and congenital abnormalitiesin the fetus. It has been found that zinc levels keep decreasing during pregnancyfrom first trimester to third trimester. The aim of this cross sectional study was tofind the correlation between serum maternal and cordblood zinc level during thirdtrimester. Data collection was conducted during March 2015 to April 2015 on 10selected primary health service in East Jakarta. Subjects were obtained usingconsecutive sampling method. A total of 63 pregnant subjects had met the studycriteria. Data were collected through interviews including age, gestation age, parity,tobacco exposure, household income, maternal education, zinc intake, proteinintake, iron intake, and copper intake. Anthropometry measurements to assess thenutritional status and laboratory examination i.e blood levels of maternal andcordblood zinc. Mean age was 27.63 ± 4.96 years and majority of the subjects werehigh-educated and well-income. Intake of zinc showed 98.4% of the subjects wereless than recommended dietary allowances (RDA). Median of serum maternal zinclevels was 53.95 (27.97 ? 74.93) μg/dL, while 82.5% the of subjects werecategorized as adequate zinc levels. Median of serum cordblood zinc levels was84.92 (56.95 ? 155.86) μg/dL. No significant correlation was found between serummaternal and cordblood zinc (r=0.04, p=0.78) with the ratio between serummaternal and cordblood zinc was 0.63, Pregnancy is a period of rapid growth and cell differentiation, when both of themother and the fetus are very susceptible to alterations in dietary supply, especiallyof nutrients which are marginal under normal circumstances. Zinc is required forcellular division and differentiation, and is an essential nutrient for normalembryogenesis. Zinc deficiency has been associated with complications ofpregnancy and delivery, as well as growth retardation and congenital abnormalitiesin the fetus. It has been found that zinc levels keep decreasing during pregnancyfrom first trimester to third trimester. The aim of this cross sectional study was tofind the correlation between serum maternal and cordblood zinc level during thirdtrimester. Data collection was conducted during March 2015 to April 2015 on 10selected primary health service in East Jakarta. Subjects were obtained usingconsecutive sampling method. A total of 63 pregnant subjects had met the studycriteria. Data were collected through interviews including age, gestation age, parity,tobacco exposure, household income, maternal education, zinc intake, proteinintake, iron intake, and copper intake. Anthropometry measurements to assess thenutritional status and laboratory examination i.e blood levels of maternal andcordblood zinc. Mean age was 27.63 ± 4.96 years and majority of the subjects werehigh-educated and well-income. Intake of zinc showed 98.4% of the subjects wereless than recommended dietary allowances (RDA). Median of serum maternal zinclevels was 53.95 (27.97 – 74.93) μg/dL, while 82.5% the of subjects werecategorized as adequate zinc levels. Median of serum cordblood zinc levels was84.92 (56.95 – 155.86) μg/dL. No significant correlation was found between serummaternal and cordblood zinc (r=0.04, p=0.78) with the ratio between serummaternal and cordblood zinc was 0.63]"

"COVID-19 merupakan penyakit penyebab pandemi pada akhir 2019. Perbedaan manifestasi klinis pada infeksi SARS-CoV-2 ini memicu banyak pertanyaan di kalangan peneliti dan medis. Perbedaan klinis COVID-19 tersebut dapat dipicu oleh faktor hospes, patogen maupun lingkungan. Infeksi SARS-CoV-2 terutama melalui saluran napas atas, tempat kolonisasi mikroba komensal dan patogen. Bagaimana interaksi antara mikroba yang berkolonisasi dengan SARS-CoV-2 dalam menimbulkan respons inflamasi di saluran napas atas masih belum diketahui dengan jelas. Penelitian ini bertujuan menganalisis hubungan antara karakteristik mikrobiota, serta rasio kadar sitokin pro- dan anti-inflamasi dari saluran napas atas dengan beratnya COVID-19.Penelitian ini merupakan studi potong lintang menggunakan 74 swab nasofaring dan orofaring di dalam viral transport medium (VTM) dari pasien COVID-19 berusia 18–64 tahun. Profil mikrobiota di saluran napas atas dan kadar IL-6, IL-1β, IFN-γ, TNF-α dan IL-10 diperiksa dengan metode sekuensing 16S ribosomal RNA dan Luminex assay, secara berurutan. Selanjutnya dilakukan analisis hubungan antara beratnya COVID-19 dengan OTU, keragaman alfa dan beta dari mikrobiota saluran napas atas.Lima filum terbanyak di saluran napas pasien COVID-19 di Indonesia berusia 18-64 tahun adalah Firmicutes (32,3%), Bacteroidota (27,1%), Fusobacteriota (15,2%), Proteobacteria (15,1%) dan Actinobacteria (7,1%). Analisis indeks Shannon dan ACE menunjukkan bahwa tidak ada penurunan keragaman microbiota saluran napas atas dengan bertambah beratnya penyakit. Namun, ada perbedaan bermakna keragaman beta pada mikrobiota saluran napas atas antara COVID-19 ringan dan berat. Keberlimpahan filum Firmicutes (p = 0,012), dan genus Streptococcus (p = 0,033) dan Enterococcus (p = 0,031) lebih tinggi pada COVID-19 berat dibandingkan yang ringan, sedangkan keberlimpahan filum Fusobacteriota (p = 0,021), Proteobacteria (p = 0,030), Campilobacterota (p = 0,027), genus Neisseria (p = 0,008), dan Fusobacterium (p = 0,064), spesies Porphyromonas gingivalis (p = 0,018), Fusobacterium periodonticum (p = 0,001) dan Fusobacterium nucleatum (p = 0,022) lebih tinggi pada COVID-19 ringan dibandingkan berat. Keberadaan bakteri Prevotella buccae (p = 0,005) dan Prevotella disiens (p = 0,043) lebih rendah pada COVID-19 berat. Rasio TNF-α/IL-10 lebih tinggi pada COVID-19 berat (p < 0.05). Selanjutnya, rasio IL-6/IL-10, IFN-γ/IL-10, dan IL-1β/IL-10 juga lebih tinggi pada COVID-19 berat, namun tidak berbeda bermakna jika dikaitkan dengan beratnya penyakit.Penelitian ini mendukung adanya hubungan antara karakteristik mikrobiota di saluran napas atas dengan beratnya COVID-19 pada pasien dewasa. Studi lebih lanjut diperlukan untuk memeriksa mekanisme bagaimana mikrobiota mencegah beratnya COVID-19. Rasio TNF-α/IL-10 dari saluran napas dapat menjadi prediktor beratnya penyakit dan sebagai alternatif pemeriksaan kadar sitokin pada COVID-19 yang kurang invasif dibandingkan serum.

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COVID-19 is a disease that caused a pandemic at the end of 2019. Clinical manifestations difference in SARS-CoV-2 infection has raised many questions in research and medical provider. The clinical differences in COVID-19 can be triggered by host, pathogen and environmental factors. SARS-CoV-2 mainly enters through the upper airway, with colonization of commensal and pathogenic microbes. How the interaction between colonized microbes and SARS-CoV-2 in causing an inflammatory response in the upper airway is still not clearly known. Therefore, we examined the association between the diversity of microbiota, pro- and anti-inflammatory cytokines ratio of upper respiratory and COVID-19 severity.

This research is an observational cross-sectional study using 74 nasopharyngeal and oropharyngeal swabs in viral transport medium from COVID-19 patients aged 18-64 years. We examined microbiota profile in the upper airway using 16S ribosomal RNA sequencing method and levels of IL-6, IL-1β, IFN-γ, TNF-α and IL-10 were examined by Luminex assay. We also examined the association between COVID-19 severities with OTU analysis, alpha and beta diversity of upper respiratory microbiota.

The top five phyla in upper respiratory tract of Indonesian COVID-19 patients with aged of 18–64 years old were Firmicutes (32,3%), Bacteroidota (27,1%), Fusobacteriota (15,2%), Proteobacteria (15,1%) and Actinobacteria (7,1%). Shannon and ACE index analysis showed no decline of microbiota diversity in upper airway with the increase of disease severity. However, there were significant differences of beta diversity in the upper airway microbiota between mild and severe COVID-19. The abundance of the Firmicutes phylum (p = 0,012), Streptococcus (p = 0,033) and Enterococcus (p = 0,031) genera were significantly higher in severe COVID-19 than mild, while the abundance of the Fusobacteriota (p = 0,021), Proteobacteria (p=0,030), and Campilobacterota (p = 0,027) phyla, Neisseria (p = 0,008), and Fusobacterium (p = 0,064) genera, Porphyromonas gingivalis (p = 0,018), Fusobacterium periodonticum (p = 0,001) and Fusobacterium nucleatum (p = 0,022) species were significantly higher in mild. The presence of Prevotella buccae (p=0.005) and Prevotella disiens (p=0.043) bacteria was lower in severe COVID-19. The TNF-α/IL-10 ratio was significantly higher in severe COVID-19 (p < 0.05). Furthermore, IL-6/IL-10, IFN-γ/IL-10, and IL-1β/IL-10 ratio was also higher in severe, but those were not significantly related to the disease severity.

This research supports the relationship between the severity of COVID-19 and microbiota diversity in the upper airway in adults. Further studies are needed to examine the mechanism by which microbiota prevents the COVID-19 severities. The ratio of TNF-α/IL-10 from upper airway swab may be as a predictor of disease severity and alternative for examining cytokine levels in COVID-19 which is less invasive than serum."

"Latar Belakang : Preeklamsia terjadi akibat adanya gangguan pada proses implantasi dan desidualisasi pada awal kehamilan. Vitamin D memainkan peranan penting pada proses desidualisasi, implantasi dan plasentasi. Penelitian terbaru menunjukkan bahwa kadar 25(OH)D yang rendah dalam serum merupakan faktor risiko preeklamsia. Bukti terbaru mendukung peran suplementasi vitamin D yang dimulai pada saat sebelum, awal dan selama kehamilan dalam mengurangi risiko preeklamsia. Tujuan penelitian ini adalah untuk mengetahui peranan suplementasi vitamin D 5000 IU/hari pada implantasi dan plasentasi melalui pemeriksaan PI A. Uterina dan PlGF serum maternal pada wanita hamil trimester pertama.Metode : Uji klinis paralel acak tersamar tunggal. Subjek wanita hamil usia 7-11 minggu yang dibagi 2 kelompok, yaitu normal dan risiko tinggi berdasarkan kriteria risiko tinggi ACOG. Tiap kelompok dibagi lagi menjadi kontrol yang hanya mendapat obat standar dan perlakuan yang mendapat vitamin D 5000 IU/hari. Semua pasien diperiksa kadar 25(OH)D awal, kemudian diberikan intervensi selama 1 bulan dan diperiksa ulang kadar 25(OH)D akhir, PlGF serum maternal dan PI. A. Uterina. Menilai perbandingan kenaikan kadar 25(OH)D, PlGF, dan PI A. Uterina diantara semua kelompokHasil : Subjek awal berjumlah 92 orang, dieksklusi sebanyak 12 orang dan tersisa 80 subjek yang menyelesaikan penelitian. Semua subjek mengalami defisiensi vitamin D. Dibandingkan pasien kontrol kenaikan kadar 25(OH)D pada kelompok perlakuan normal masih lebih tinggi dibandingkan dengan kelompok perlakuan risiko tinggi yaitu 12,33±6,26 ng/mL dan 10,45±5,09 ng/mL dengan nilai p<0,001. Kelompok normal, penurunan PI A. Uterina dibandingkan antara kontrol dan perlakuan bermakna sebesar 0,57±0,36 dan 1,08±0,29 (p<0,001) sedangkan kadar PlGF juga berbeda bermakna antara kontrol (84,27±10,02) dan perlakuan (107,87±31,97) dengan nilai p 0,005. Pada kelompok risiko tinggi, perbadingan rerata kadar PlGF pada kontrol dan perlakuan berbeda bermakna yaitu 37,59±9,67 dan 70,53±18,32) nilai p<0,001. Pada pasien intervensi baik kelompok normal dan risiko tinggi rerata penurunan PI A. Uterina (1,08±0,29 vs 0,43±0,26; nilai p<0,001) dan kadar PlGF (107,87±31,97 vs 70,53±18,32; nilai p<0,001) berbeda bermakna.

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Background : Preeclampsia occurs due to disruption of the implantation and decidualization in early pregnancy. Vitamin D plays an important role in decidualization, implantation, and placentation. Recent evidence supports the role of vitamin D supplementation initiated before, early and during pregnancy in reducing the risk of preeclampsia. The study aim is to determine the effect of vitamin D supplementation of 5000 IU/day on implantation and placentation through examination of Uterine Artery PI (UtA-PI) and maternal serum PlGF in first trimester pregnant women.

Methods: Using a single-blind, randomized parallel clinical trial. Subjects were pregnant women 7-11 weeks gestation and divided into 2 groups, normal and high risk, based on ACOG preeclampsia high risk criteria. Each group was further divided into controls who received the standard drug and interventions who received 5000 IU of vitamin D/day. Subjects were examined for 25(OH)D levels before and after the 1 month intervention, including maternal serum PlGF and UtA-PI levels. Both groups were compared for the difference of 25(OH)D levels, mean PlGF, and UtA-PI.

Results: We have 80 subjects who have vitamin D deficiency. The normal and high-risk intervention group showed the increase of 25(OH)D levels, 12.33±6.26 ng/mL and 10.45±5.09 ng/mL with p<0.001 accordingly. For the normal group, the decrease of UtA-PI compared between control and intervention was significant 0,57±0,36 and 1,08±0,29 (p<0.001) while PlGF levels were also significantly different between control (84,27±10,02) and intervention (107,87±31,97) with p<0.05. While in high-risk group, the PlGF levels of control and intervention were significantly different, 37.59±9.67 and 70.53±18.32 with p<0.001. In intervention patients, both normal and high-risk groups, the decrease of UtA-PI (1.08±0.29 vs 0.43±0.26; p<0.001) and PlGF levels (107.87±31.97 vs 70.53±18.32; p<0.001) were significantly different."

"ABSTRAKLatar Belakang: Zink merupakan merupakan salah satu mikronutrien esensial sehingga defisiensi zink dalam tubuh menyebabkan ukuran lingkar kepala dan perkembangan kognitif pada bayi tidak sesuai dengan seusianya. Tujuan: Penelitian ini bertujuan untuk mengetahui hubungan kadar zink dengan ukuran lingkar kepala dan perkembangan kognitif bayi. Metode: Penelitian ini menggunakan desain penelitian poteng lintang terhadap 97 subjek yang memenuhi kriteria penelitian Variabel-variabel dianalisis dengan dengan uji Kolmogorov-Smirnov. Korelasi antara kadar zink dan ukuran lingkar kepala dilakukan dengan uji korelasi Pearson sedangkan hubungan kadar zink dan perkembangan kognitif dilakukan dengan uji T independen hubungan bermakna.

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ABSTRACTBackground Zinc is one of the essential micronutrients for human body. Zinc deficiency could lead to smalerl head circumference and late of cognitive development. Objective This study is aimed to seek the relationship between serum zinc level with head circumference and cognitive development in children. Method This study used cross sectional model in 97 subjects that suitable to the criteria. Variabels are then analysed with Kolmogorov Smirnov test. Correlation between serum zinc level and head circumference is analysed with Pearson correlation formula, and relation between serum zinc level and cognitive development is analysed with T independent formula significant correlation."

"Latar Belakang: Persalinan preterm adalah persalinan sebelum usia kehamilan 37 minggu lengkap. Persalinan preterm ini masih menjadi masalah di seluruh dunia. Pada laporan World Health Organization WHO , Indonesia menduduki peringkat kelima negara dengan persalinan preterm terbanyak yakni 675.700 persalinan pada tahun 2010. Berbagai faktor dihubungkan dengan penyebab terjadinya persalinan preterm, termasuk salah satunya adalah gangguan nutrisi selama kehamilan, terutama seng, selenium, besi dan tembaga. Tujuan: Penelitian ini membandingkan kadar seng, selenium, besi dan tembaga pada serum maternal ibu hamil normal dan preterm. Metode: Penelitian dilakukan dengan uji potong-lintang dengan subjek penelitian ibu hamil baik preterm maupun aterm yang akan melaksanakan persalinan di RSUPN Dr. Cipto Mangunkusumo dan RS Budi Kemuliaan Jakarta pada Januari hingga April 2017. Penelitian dilakukan dengan membandingkan kadar masing-masing mikronutrien pada kedua kelompok subjek. Hasil: Dalam jangka waktu Januari hingga April 2017 didapatkan 53 subjek penelitian yakni 30 ibu hamil normal dan 23 ibu dengan kehamilan preterm. Seluruh subjek dimasukkan dalam analisis data. Kadar seng, selenium, besi dan tembaga pada ibu dengan kehamilan preterm secara berurutan adalah 42 g/dL, 72,39 g/L, 74 g/L, dan 2144,52 g/dL. Sedangkan kadar seng, selenium, besi dan tembaga pada ibu hamil normal secara berurutan adalah 42 g/dL, 67,27 g/L, 70,5 g/L, dan 2221 g/dL. Tidak ada perbedaan bermakna kadar mikronutrien pada kedua kelompok subjek. Kesimpulan: Penelitian ini menyimpulkan bahwa tidak ada perbedaan kadar seng, selenium, besi dan tembaga pada ibu hamil normal dan ibu dengan kehamilan preterm.

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Background: Preterm labor is delivery before 37 weeks of gestation. This preterm labor is still a worldwide burden. According to World Health Organization WHO report in 2010, Indonesia was ranked the fifth among other countries, with 675.700 preterm deliveries. Various factors were associated with the cause of preterm labour, including nutritional disorder in pregnancy, such as zinc, selenium, iron and copper.

Objective: The aim of this study is to compare zinc, selenium, iron and copper levels in maternal serum of normal and preterm pregnancy.

Methods: It is a cross sectional study with preterm and normal pregnant woman who will carry delivery in Dr. Ciptomangunkusumo National Hospital and Budi Kemuliaan Jakarta Hospital from January to April 2017. This study was conducted by comparing the levels of each micronutient in both groups of subjects.

Result: From January until April 2017, there were 53 subjects divided into 30 normal pregnant women and 23 preterm pregnant women. The levels of zinc, selenium iron and copper in preterm pregnancy were 42 g dL, 72,39 g L, 74 g L, and 2144,52 g dL. Levels of zinc, selenium, iron and copper ini normal pregnant women were 42 g dL, 67,27 g L, 70,5 g L, and 2221 g dL. There was no difference in micronutrients level in both groups.

Conclusion: This study concluded that there was no difference in zinc, selenium, iron and copper levels in normal and preterm pregnancy."