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"Diabetics occasionally need enteral nutrition-either as supplement or in situations necessitating total dependency on enteral nutrition to fulfill their energy requirements. Enteral nutrition specifically designed fordiabet-ics is not yet available in our hospital, as sugar is often added to enteral nutrition preparations, subsequently affecting the blood glucose profiles of the patients.

This study was done to determine the glycemic index of 4 kinds of enteraf feeding formulas, conducted among ambulatory diabetics attending the Diabetic Clinic of the Dr Cipto Mangunkusumo General Central National Hospital.

Twenty samples were purposively chosen among the Diabetic Clinic attendees. They were well-controlled non-pregnant diabetics; none of them were having either kidney or liver problems, and were otherwise healthy. Each of the diabetic studied was given 50-g glucose syrup (200 Kcal) as a standard load. With a 3 to 4 days interval, the patients were consecutively given several enteral feeding formulas, i.e., the standard hospital enteral feeding formula (MC-FRS I), a newly developed diabetic formula (MC-FRS II), a frequently-used commercially avai 1-ablepredigested/elemental enteral feeding formula {MC-FK I = Isocal), and a new predigested/elemental enteral feeding formula specifically designed for diabetics (MC-FK II=Diabetasol). All of the formulas tested contained energy equal to 50-g glucose (200 Kcal). Blood glucose was measured with an Accutrend-Ames® glucometer in fasting condition and subsequently 30,60,90 and 120 minutes after the load. Any glucose/enteral feeding loading was given 30 minutes after. Data were presented as a blood glucose curve and glycemic index were calculated as area under the blood glucose curve of each food load compared to the standard glucose load, presented as percentage.

In all the enteral feedings studied, the blood glucose response curves went up and the peaks achieved in 60 minutes, thereafter declined to points above the initial fasting blood glucose values. The glycemic index of the MC-FRS I, MC-FRS II, MC-FK I and MC-FK II were 39.6%, 25%, 45% and 52.1% respectively.

The sugar that was added to the MC-FRS I and MC-FK I did not give rise to higher blood glucose levels as compared to the other non-glucose-added food. All of the enteral feeding formula tested showed low glycemic index (Miller, less than 55%). The difference glycemic index among the formulas studied might be due to different food composition (predigested/elemental component in the commercial enteral feeding formula; no sugar added and higher fiber in MC-FRS II as compared to MC-FRS I; higher fat content in MC-FK 1 as compared to MC-FK II). Glycemic index of enteral feeding formula was particularly determined by the total carbohydrate, total fat and total protein content of the food, as well as the presence of fiber and antinutrient in the food studied."

"Penulisan karya ilmiah akhir ini bertujuan untuk mengaplikasikan Model Konservasi Myra E Levine dalam pemenuhan kebutuhan nutrisi pada bayi prematur Nutrisi pada bayi prematur penting untuk kelangsungan hidup dan tumbuh kembang yang optimal Tantangan dalam pemberian nutrisi pada bayi prematur adalah adanya imaturitas organ Cara pemberian nutrisi pada bayi prematur tergantung pada keadaan klinis dan usia gestasi Nutrisi pada bayi prematur dapat diberikan secara enteral maupun parenteral Selama menjalani perawatan tiga dari lima bayi prematur dalam uraian karya ilmiah akhir ini menunjukkan status kardiopulmonal yang stabil tidak terdapat instabilitas suhu dan peningkatan berat badan masih dalam rentang normal yaitu 10 15 gram hari

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The aim of this final scientifict report was to apply Myra E Levine Conservation Model rsquo s in feeding intervention preterm infants Nutrition is important for survival optimal growth and development of preterm infants The challenge in feeding preterm infants is the organ immaturity Feeding in preterm infants depends on clinical status and gestasional age Nutrition in preterm infants can be provides by enteral and total parenteral nutrition During treatments three of five preterm infants in this final scientifict report showed cardiopulmonal stability status stability of body temperature and increase of body weights was in the normal range of 10 15 gram day "

"Background: Community acquired pneumonia (CAP) in the elderly is still a major problem due to its high morbidity and mortality. There is considerable variability in ?the result of various studies on prognostic factors. The prognostic factors in Indonesia have not been identified.Methods: We performed a prospective cohort study on 147 elderly patients hospitalized with CAP in the internal medicine ward of Cipto Mangunkusumo National Central General Hospital, Jakarta from September 2002 to March 2003. We calculated the survival rate during hospitalize-tion. We used Cox proportional-hazard regression analysis to examine factors associated with mortality in the first 48 hours of hospitalization. .Results: There were 34 deaths (23.1) associated with CAP in 1471 person-days. The survival rate at day 5, 10 and 15 were 88.9%, 77.2 and 67.2% respectively. Severe. pneumonia, an serum albumin of d"3.5 g/dL, reducedconsciousness, temperature > 37.0"C, and a hemoglobin level of d" 9.0 g/dL demonstrated a tendency towards increased mortality rate. Other factors such as age, sex, immobilization, swollen disorders, co-morbidities, leukocyte count, and serum creatinine level demonstrated no significant relationship with mortality.Conclusion: Severe pneumonia, low serum albumin, decreased consciousness, high temperature and low hemoglobin level in the first 48 hours hospitalization were found to be worse prognostic factors. Early identification and modification of these factors are recommended."

"Di Indonesia umumnya pasien kanker serviks datang berobat pada stadium lanjut (62 %) sehingga kanker serviks merupakan 66 % dari penyebab kematian ginekologik.1 Tujuan penelitian ini adalah untuk mengetahui faktor-faktor yang berhubungan dengan keterlambatan pasien kanker serviks memeriksakan diri. Penelitian menggunakan metode kuantitatif dan kualitatif dengan sampel yang diambil dari seluruh pasien baru kanker serviks tahun 2000 dan 2001 yang datang berkunjung kembali ke RSUPN Dr. Cipto Mangunkusumo Jakarta pada bulan Agustus sampai dengan Oktober 2001. Kesimpulan : Variabel yang berhubungan secara signifikan dengan waktu memeriksakan diri ialah pengetahuan, sikap, ketersediaan pelayanan Pap smear dan dukungan suami. Ketersediaan pelayanan Pap smear merupakan variabel yang dominan. (Med J Indones 2003; 12: 162-5)

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In Indonesia, most cervical cancer patients seek medical help after the cancer has reached advanced stage (62 %). This has caused cervical cancer to contribute to 66 % of gynecological deaths.1 The objective of this study is to find out factors related to the delay of cervical cancer patients in seeking for medical help. This research employs quantitative and qualitative methods. Samples were obtained from all of the new cervical cancer patients who came for the first time between 2000 to 2001 and returned to the Dr. Cipto Mangunkusumo National Central General Hospital Jakarta from August until October 2001. It is concluded that variables significantly correlated with the delay for medical check up are knowledge, attitude, the availability of Pap smear service and husband support. The availability of Pap smear plays as dominant variabel. (Med J Indones 2003; 12: 162-5)"

"Latar Belakang: Kekuatan gigit merupakan salah satu indikator status fungsional dalam sistem pengunyahan yang diperankan oleh gerakan otot-otot pengunyahan pada proses biomekanik kraniomandibula. Pengukuran nilai kekuatan gigit dapat menggambarkan status fungsional sistem pengunyahan pada individu yang dihasilkan oleh gerakan otot- otot rahang pada proses biomekanik kraniomandibular. Tindakan reseksi mandibula yang disebabkan kondisi patologis dapat menurunkan nilai kekuatan gigit pascaoperasi dengan cara menghasilkan ketidakseimbangan pada otot-otot pengunyahan, gerakan mandibula dan penurunan tekanan kunyah. Prosedur rekonstruksi diperlukan untuk mengembalikan fungsi menelan, fungsi bicara dan fungsi kunyah yang dapat dinilai dari kekuatan gigit. Tujuan Penelitian: Mengetahui perbedaan nilai kekuatan gigit pascareseksi rekonstruksi menggunakan vascular fibula graft, pelat rekonstruksi dibandingkan dengan nilai kekuatan gigit subyek normal di Rumah sakit Ciptomangunkusumo Jakarta Periode 2015- 2020 Metode Penelitian: 45 subjek penelitian diambil dari pasien Rumah Sakit Ciptomangunkusumo. Setelah dilakukan informed consent, subjek penelitian dibagi menjadi 3 kelompok, yaitu kelompok kontrol, kelompok vascular fibula graft dan kelompok pelat rekonstruksi. Subjek penelitian diukur kekuatan gigit menggunakan alat bite force meter sebanyak 3 kali dan diambil nilai tertinggi. Data kekuatan gigit selanjutnya diuji statistik menggunakan Oneway Anova. Hasil: Terdapat perbedaan bermakna nilai kekuatan gigit antara kelompok kontrol (535.1N), kelompok vaskular fibula graft (241.8N) dan kelompok pelat rekonstruksi (148,9N) dengan nilai Sig.0.000 (p<0.05) pada uji Oneway Anova. Nilai kekuatan gigit dipengaruhi oleh jenis kelamin pada kelompok kontrol Sig.0.015 (p<0.05), dan tipe defek mandibula pada kelompok vaskular fibula graft Sig 0.009 (p<0.05) Kesimpulan: Terdapat perbedaan nilai kekuatan gigit pascareseksi dan rekonstruksi mandibula dibandingkan dengan nilai kekuatan gigit subjek normal di Rumah sakit Ciptomangunkusumo Jakarta Periode 2015-2020.

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Background: Bite force is an indicator of functional status of the masticatory system, which is controlled by the movement of the masticatory muscles in the craniomandibular biomechanical processes. The measurement of the bite force value can describe the functional status of the masticatory system in individuals produced by the movement of the jaw muscles in the craniomandibular biomechanical processes. Mandibular resection caused by pathological conditions can reduce the value of postoperative bite force due to imbalances in the masticatory muscles, mandibular movement, and a decrease in masticatory load. Reconstructive procedures are needed to restore swallowing, speech and chewing functions which can be assessed by the bite force. Aim: To investigate the differences of the bite force values post mandibular resection reconstructed with vascular fibula grafts, reconstruction plate, and of normal subjects at Ciptomangunkusumo Hospital, Jakarta in 2015-2020. Methods: 45 research subjects were recruited from Ciptomangunkusumo Hospital patients according to the inclusion and exclusion criteria. After informed consent, the research subjects were divided into 3 groups, namely the control group, the vascular fibula graft group, and the plate reconstruction group. The bite force values of the research subjects were measured three times using a bite force meter, and the highest value was taken. The bite force data was then statistically compared using Oneway Anova. Results: Significant differences were found in the bite force values between the control group (535.1N), the fibula graft vascular group (241.8N) and the plate reconstruction group (148.9N) with a Sig. 0.000 (p<0.05) value in Oneway Anova test. The value of the bite force was influenced by sex in the control group Sig.0.015 (p<0.05), and the type of mandibular defects in the vascular fibula graft with Sig.0.009 (p<0.05). Conclusion: Statistically significant differences were found in the value of the bite force post resection and reconstruction of the mandible compared to that of normal subjects at Ciptomangunkusumo Hospital, Jakarta in 2015-2020."

"Latar Belakang: Kekuatan gigit merupakan salah satu indikator status fungsional dalam sistem pengunyahan yang diperankan oleh gerakan otot-otot pengunyahan pada proses biomekanik kraniomandibula. Pengukuran nilai kekuatan gigit dapat menggambarkan status fungsional sistem pengunyahan pada individu yang dihasilkan oleh gerakan otot-otot rahang pada proses biomekanik kraniomandibular. Tindakan reseksi mandibula yang disebabkan kondisi patologis dapat menurunkan nilai kekuatan gigit pascaoperasi dengan cara menghasilkan ketidakseimbangan pada otot-otot pengunyahan, gerakan mandibula dan penurunan tekanan kunyah. Prosedur rekonstruksi diperlukan untuk mengembalikan fungsi menelan, fungsi bicara dan fungsi kunyah yang dapat dinilai dari kekuatan gigit. Tujuan Penelitian: Mengetahui perbedaan nilai kekuatan gigit pascareseksi rekonstruksi menggunakan vascular fibula graft, pelat rekonstruksi dibandingkan dengan nilai kekuatan gigit subyek normal di Rumah sakit Ciptomangunkusumo Jakarta Periode 2015-2020. Metode Penelitian: 45 subjek penelitian diambil dari pasien Rumah Sakit Ciptomangunkusumo. Setelah dilakukan informed consent, subjek penelitian dibagi menjadi 3 kelompok, yaitu kelompok kontrol, kelompok vascular fibula graft dan kelompok pelat rekonstruksi. Subjek penelitian diukur kekuatan gigit menggunakan alat bite force meter sebanyak 3 kali dan diambil nilai tertinggi. Data kekuatan gigit selanjutnya diuji statistik menggunakan Oneway Anova. Hasil: Terdapat perbedaan bermakna nilai kekuatan gigit antara kelompok kontrol (535.1N), kelompok vaskular fibula graft (241.8N) dan kelompok pelat rekonstruksi (148,9N) dengan nilai Sig.0.000 (p<0.05) pada uji Oneway Anova. Nilai kekuatan gigit dipengaruhi oleh jenis kelamin pada kelompok kontrol Sig.0.015 (p<0.05), dan tipe defek mandibula pada kelompok vaskular fibula graft Sig 0.009 (p<0.05). Kesimpulan: Terdapat perbedaan nilai kekuatan gigit pascareseksi dan rekonstruksi mandibula dibandingkan dengan nilai kekuatan gigit subjek normal di Rumah sakit Ciptomangunkusumo Jakarta Periode 2015-2020.

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Background: Bite force is an indicator of functional status of the masticatory system, which is controlled by the movement of the masticatory muscles in the craniomandibular biomechanical processes. The measurement of the bite force value can describe the functional status of the masticatory system in individuals produced by the movement of the jaw muscles in the craniomandibular biomechanical processes. Mandibular resection caused by pathological conditions can reduce the value of postoperative bite force due to imbalances in the masticatory muscles, mandibular movement, and a decrease in masticatory load. Reconstructive procedures are needed to restore swallowing, speech and chewing functions which can be assessed by the bite force.

Aim: To investigate the differences of the bite force values post mandibular resection reconstructed with vascular fibula grafts, reconstruction plate, and of normal subjects at Ciptomangunkusumo Hospital, Jakarta in 2015-2020.

Methods: 45 research subjects were recruited from Ciptomangunkusumo Hospital patients according to the inclusion and exclusion criteria. After informed consent, the research subjects were divided into 3 groups, namely the control group, the vascular fibula graft group, and the plate reconstruction group. The bite force values of the research subjects were measured three times using a bite force meter, and the highest value was taken. The bite force data was then statistically compared using Oneway Anova.

Results: Significant differences were found in the bite force values between the control group (535.1N), the fibula graft vascular group (241.8N) and the plate reconstruction group (148.9N) with a Sig. 0.000 (p<0.05) value in Oneway Anova test. The value of the bite force was influenced by sex in the control group Sig.0.015 (p<0.05), and the type of mandibular defects in the vascular fibula graft with Sig.0.009 (p<0.05).

Conclusion: Statistically significant differences were found in the value of the bite force post resection and reconstruction of the mandible compared to that of normal subjects at Ciptomangunkusumo Hospital, Jakarta in 2015-2020."

"Background: the incidence of acute kidney injury (AKI) in intensive care units is associated with increased mortality, post AKI morbidity and high treatment costs. Research on factors related to mortality of AKI patients in intensive care units in Indonesia, especially Cipto Mangungkusumo General Hospital has never been done. This study aims to determine the prevalence of AKI, mortality rate of AKI patients, and the factors associated with increased mortality of AKI patients in intensive care units in ICU Cipto Mangunkusumo General Hospital. Methods: this is a retrospective cohort study of all patients diagnosed with AKI in the intensive care unit at Cipto Mangunkusumo General Hospital, January 2015 - December 2016. An analysis of bivariate relationships with multvariate with STATA Statistics 15.0 between age > 60 years, sepsis, use of ventilator, ventilator duration, dialysis, oligoanuria, and APACHE II scores at admission with mortality. Results: the prevalence of AKI patients in the intensive care unit was 12.25% (675 of 5511 subjects) and 220 subjects (32.59%) of the 675 analyzed subjects died in the intensive care unit. Factors related to increased mortality in multivariate analysis were sepsis (OR 6,174; IK95% 3,116-12,233), oligoanuria (OR 4,173; IK95% 2,104-8,274), use of ventilator (OR 3,085; IK95% 1,348-7,057),(scores APACHE II at admission) 1/2 [OR 1,597; IK95% 1.154-2.209], and the duration of the ventilator (OR 1.062; IK95% 1.012-1.114). Conclusion: the prevalence of AKI patients and their mortality rate in the intensive care unit of Cipto Mangunkusumo General Hospital obtained 12.25% and 32.59%. Sepsis, oligoanuria, ventilators (APACHE II score at admission) 1/2, and ventilator duration are factors that are significantly associated with increased mortality of AKI patients in intensive care units.

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Latar belakang: kejadian acute kidney injury (AKI) di unit perawatan intensif berhubungan dengan peningkatan mortalitas, morbiditas pasca AKI dan biaya perawatan tinggi. Penelitian mengenai faktor-faktor yang berhubungan dengan mortalitas pasien AKI di unit perawatan intensif di Indonesia khususnya RSUPN dr. Cipto Mangungkusumo belum pernah dilakukan. Penelitian ini bertujuan untuk mengetahui prevalensi AKI, angka mortalitas pasien AKI, dan faktor- faktor yang berhubungan dengan peningkatan mortalitas pasien AKI di unit perawatan intensif di ICU RSUPN dr. Cipto Mangunkusumo.

Metode: penelitian kohort retrospektif terhadap seluruh pasien AKI di unit perawatan intensif di RSUPN Cipto Mangunkusumo periode Januari 2015 – Desember 2016. Dilakukan analisis hubungan bivariat sampai dengan multvariat dengan STATA Statistics 15.0 antara faktor usia >60 tahun, sepsis, ventilator, durasi ventilator, dialisis, oligoanuria, dan skor APACHE II saat admisi dengan mortalitas.

Hasil: prevalensi pasien AKI di unit perawatan intensif didapatkan 12,25% (675 dari 5511 subjek) dan sebanyak 220 subjek (32,59%) dari 675 subjek yang dianalisis meninggal di unit perawatan intensif. Faktor-faktor yang berhubungan dengan peningkatan mortalitas pada analisis multivariat adalah sepsis (OR 6,174; IK95% 3,116-12,233), oligoanuria (OR 4,173; IK95% 2,104-8,274), ventilator (OR 3,085; IK95% 1,348-7,057), (skor APACHE II saat admisi)1/2 [OR 1,597; IK95% 1,154-2,209], dan durasi ventilator (OR 1,062; IK95% 1,012-1,114).

Kesimpulan: prevalensi pasien AKI dan angka mortalitasnya di unit perawatan intensif RSUPN dr. Cipto Mangunkusumo didapatkan sebesar 12,25% dan 32,59%. Sepsis, oligoanuria, ventilator, (skor APACHE II saat admisi)1/2, dan durasi ventilator merupakan faktor-faktor yang berhubungan bermakna dengan peningkatan mortalitas pasien AKI di unit perawatan intensif."