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"Konsumsi suplemen memiliki manfaat bagi performa olahraga. Meskipun demikian, banyak dari pengguna pusat kebugaran yang mengonsumsi suplemen tanpa panduan tenaga profesional seperti nutrisionis/dietisien. Hal ini meningkatkan risiko penggunaan suplemen yang kurang tepat, sehingga berpotensi menimbulkan dampak negatif. Penelitian ini bertujuan untuk mengetahui gambaran konsumsi suplemen serta faktor-faktor yang berhubungan dengannya pada pengguna pusat kebugaran terpilih di Jakarta. Penelitian ini dilakukan menggunakan metode cross-sectional pada 116 pengguna pusat kebugaran dari 3 pusat kebugaran di Jakarta. Variabel independen yang diteliti yaitu Muscle Dysmorphia, Exercise Addiction, self-esteem, citra tubuh, usia, jenis kelamin, durasi latihan, pengalaman latihan, intensitas latihan, dan paparan media sosial. Hasil yang didapatkan adalah prevalensi konsumsi suplemen adalah sebesar 67,2%. Sumber informasi terkait suplemen paling umum didapatkan dari teman atau internet. Uji chi-square menunjukkan adanya hubungan antara jenis kelamin (OR = 3,055; 95% CI: 1,298—7,188), pengalaman latihan 7—12 bulan (OR = 5,4; 95% CI: 1,621—17,991) dan >1 tahun (OR = 5,091; 95% CI: 1,910—13,571) dengan konsumsi suplemen. Oleh karena itu, intervensi disarankan untuk dilakukan pada laki-laki atau orang yang sudah berolahraga di pusat kebugaran lebih dari 6 bulan. Pengguna pusat kebugaran juga disarankan untuk berkonsultasi dengan nutrisionis/dietisien sebelum memutuskan untuk menggunakan suplemen.

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Supplement consumption provides many potential benefits for exercise performance. However, many gym members use supplements without consulting professionals such as nutritionist/dietitian. This increases the risk of inappropriate supplement consumption, which in turn increases the potential of getting negative side effects. This study aims to describe the consumption of supplements and the factors associated with them among users of selected fitness centers in Jakarta. This is a cross-sectional study conducted on 116 fitness center users from 3 fitness centers in Jakarta. The independent variables studied were Muscle Dysmorphia, Exercise Addiction, self-esteem, body image, age, gender, exercise duration, exercise experience, exercise intensity, and social media exposure. Results showed that 67,2% of the respondents had used supplements. The main source of information were friends and internet. The chi-square test showed a significant relationship between gender (OR = 3,055; 95% CI: 1,298—7,188), exercise experience of 7—12 months (OR = 5,4; 95% CI: 1,621—17,991) and >1 year (OR = 5,091; 95% CI: 1,910—13,571) with supplement consumption. Intervention is recommended for men or people who have been exercising at the fitness center for more than 6 months. Fitness center members are also advised to consult a nutritionist/dietitian before deciding to use supplements."

"Pelayanan Kefarmasian adalah pelayanan langsung dan bertanggung jawab kepada pasien terkait sediaan farmasi dengan tujuan untuk memperoleh hasil yang pasti guna meningkatkan kualitas hidup pasien. Pelaksanaan pelayanan kefarmasian dapat dilakukan di fasilitas pelayanan kesehatan, salah satunya adalah Apotek. Apotek merupakan suatu jenis bisnis eceran (retail) yang tidak lepas dari kegiatan pemasaran, salah satunya penjualan vitamin dan suplemen. Salah satu upaya untuk meningkatkan jumlah konsumen dalam membeli suplemen dan vitamin maka harus dilakukan pemasaran terhadap produk farmasi dengan menerapkan strategi pemasaran yang baik. Strategi pemasaran yang digunakan pada tugas khusus ini adalah bauran pemasaran (marketing mix). Bauran pemasaran adalah sekumpulan kegiatan yang saling berhubungan, disusun dengan tujuan untuk mengetahui kebutuhan konsumen, mengembangkan barang yang dibutuhkan, menentukan harganya, mendistribusikan, dan mempromosikannya. Metode yang digunakan pada tugas khusus ini adalah secara non eksperimental yaitu deskriptif kualitatif dengan menggunakan pendekatan secara deskriptif normatif untuk mencari kesesuaian antara teori pemasaran farmasi dengan penerapan strategi bauran pemasaran pada pemasaran produk suplemen dan vitamin di Apotek Kimia Farma 143 Margonda. Berdasarkan hasil penerapan strategi bauran pemasaran yang telah dilakukan, diketahui bahwa produk suplemen dan vitamin yang telah terjual selama periode tugas khusus ini yaitu sebanyak tujuh (7) produk dengan omset penjualan Rp1.970.325,00. Dapat dikatakan strategi bauran pemasaran cukup efektif meningkatkan omset penjualan, dimana dengan menerapkan empat elemen bauran pemasaran yang meliputi 4P yaitu product (produk), price (harga), promotion (promosi), dan place (tempat).

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Pharmaceutical care are direct and responsible services to patients related to pharmaceutical dosage form with the aim of obtaining definite results to improve the quality of life of patients. The implementation of pharmaceutical care can be carried out in health service facilities, on of which is a pharmacy. Pharmacy is a type of retail business that cannot be separated from marketing activites, one of which is the sale of vitamins and supplements. One effort to increase the number of consumers in buying supplements and vitamins must be done marketing of pharmaceutical products by implementing a good marketing strategy. The marketing strategy used on this task is the marketing mix. The marketing mix is a set of interconnected activities, structured with the aim of working the needs of consumers, developing the goods needed, determining their prices, distributing and promoting them. The method used on this task is non experimental, namely qualitative dexcriptive by using a normative descriptive approach to find compatibility between pharmaceutical marketing theory and the application of marketing mix strategies in marketing supplement and vitamin products at Apotek Kimia Farma 143 Margonda. Based on the results od the implementation of the marketing mix strategy that has been carried out, it is known that the supplement and vitamin products that have been sold during this task period as many as seven products with a sales turnover of Rp, 1,970,325.00. It can be conclude that the marketing mix strategy is quite effective in increasing sales turnover, where by applying four elements of the marketing mix which include the 4Ps, namely product, price, promotion, and place."

"Hipertensi merupakan penyakit tidak menular yang menjadi salah satu penyebab kematian di dunia. Globalisasi pada masyarakat perkotaan dengan perubahan gaya hidup perkotaan meningkatkan faktor risiko hipertensi. Apabila hal tersebut dilanjutkan, akan terjadi peningkatan prevalensi dan prognosis hipertensi di wilayah perkotaan. Salah satu upaya nonfarmakologi penatalaksanaan hipertensi adalah manajemen stress dengan relaksasi otot progresif (ROP). Tujuan penelitian ini untuk menganalis keefektifan penerapan relaksasi otot progresif terhadap penurunan tekanan darah penderita hipertensi. Metode praktik melakukan intervensi ROP sederhana selama 30 menit dilakukan 2 kali sehari dalam 5 hari. Intervensi dikombinasikan dengan pendidikan kesehatan, patuh minum obat, pengaturan diet dan peningkatan aktivitas. Setelah pemberian intervensi terjadi penurunan tekanan darah dari hipertensi derajat II menjadi I dengan rata-rata penurunan sistolik 3 mmHg dan diastolik 3,8 mmHg setelah ROP. ROP direkomendasikan dapat diaplikasikan secara mandiri di rumah dengan membuat media yang dapat disebarluaskan baik dalam bentuk poster ataupun leaflet melalui program KPLDH di wilayah DKI Jakarta.

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Hypertension is a non-communicable disease which is one of the causes of death in the world. Globalization in urban communities with changes in urban lifestyles increases the risk factors for hypertension. If this is continued, there will be an increase in the prevalence and prognosis of hypertension in urban areas. One of the non-pharmacological efforts to manage hypertension is stress management with progressive muscle relaxation (ROP). The purpose of this study was to analyze the effectiveness of the application of progressive muscle relaxation in reducing blood pressure in patients with hypertension. The practical method of conducting a simple ROP intervention for 30 minutes is done 2 times a day for 5 days. The intervention was combined with health education, adherence to medication, diet management and increased activity. After the intervention, there was a decrease in blood pressure from hypertension grade II to I with an average decrease in systolic of 3 mmHg and diastolic of 3.8 mmHg after ROP. It is recommended that ROP can be applied independently at home by making media that can be disseminated either in the form of posters or leaflets through the KPLDH program in the DKI Jakarta area. "

"Latar Belakang: Gejala vagina dan berkemih berdampak buruk pada kesehatan seksual dan kualitas hidup wanita usia premenopause atau menopause/sindrom genitourinari menopause (SGM). Terapi laser vagina menawarkan pemulihan dan regenerasi jaringan dan organ berupa mengencangkan dan menebalkan jaringan mukosa vagina. Laser vagina diharapkan dapat memperbaiki gejala vagina, berkemih wanita, serta menguatkan kontraksi otot dasar panggul.Objektif: Mengetahui perbaikan gejala vagina dan berkemih serta kekuatan kontraksi otot dasar panggul pasca terapi laser di RS YPK Mandiri, tahun 2017 – 2021.Metode : Penelitian ini menggunakan studi kuasi eksperimental dengan mengambil data sekunder dari rekam medis.Hasil: Total didapatkan 54 subjek penelitian dengan rerata usia 45,5 (SD = 11,67) tahun. Sebanyak 70,4 % wanita belum menopause, dan 29,6 % tergolong SGM. Gejala vagina kering didapatkan mengalami perbaikan pasca terapi laser dengan presentase 95 % (p = 0,006), sedangkan presentase perbaikan gejala beser, inkontinensia urin tipe tekanan dan vagina longgar berurutan sebesar 78,2 %, 84,0 %, dan 60,0 %. Kekuatan kontraksi otot dasar panggul meningkat 3 bulan pasca terapi laser dari 25,00 (interquartile range (IQR) = 15,0) cmH2O menjadi 39,33 (IQR = 11,1) cmH2O (p = < 0,001). Demikian, kekuatan kontraksi otot dasar panggul berdasarkan skor Modified Oxford Scale (MOS) didapatkan 79,6 % (43 subjek) mengalami peningkatan 1 derajat MOS.Kesimpulan: Terapi laser vagina dapat menjadi terapi alternatif untuk melembabkan lubrikasi vagina, dan meningkatkan kekuatan kontraksi otot dasar panggul. 

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Background: Vaginal and urinary symptoms often have adverse impact on the sexual health and quality of life of pre-menopausal or post-menopausal age women known as genitourinary syndrome of menopause (GSM). Vaginal laser offers tissue and organ restoration and regeneration by tightening and thickening vaginal mucosal tissue. Vaginal laser expected to improve vaginal symptoms, urination symptoms, and strengthen levator ani muscle.

Objective: To know the improvement of vaginal and urinary symptoms and levator ani muscle contraction after laser therapy at YPK Mandiri Hospital, 2017-2021.

Method: Quasi-experimental study by taking secondary data form medical records.

Result: Total sample 54 subjects were obtained with mean age of 45,5 (SD = 11,67) years. 70,4 % of women are pre-menopausal, and 29,6 % are classified GSM. Dry vaginal symptoms were found to have improved after laser therapy with a percentage of 95 % (0,006), while the percentage of improvement in incontinence symptoms, stress urinary incontinence, and vaginal laxity respectively were 78,2 %, 84,0 %, and 60,0 %. The strength of levator ani muscle contraction increased 3 months after laser therapy from 25,00 (interquartile range (IQR) – 15,0) cmH2O to 39,33 (IQR = 11,1) cmH2O (p < 0,001). Thus, the strength of levator ani muscle contraction based on the Modified Oxford Scale (MOS) score was found to be 79,6 % (43 subjects) experiencing an increase of 1 - degree MOS.

Conclusion: Vaginal laser therapy can be an alternative therapy to moisturize vaginal lubrication, and increase the strength of levator ani muscle contraction."

"Tujuan: Mengetahui dosis terapi vitamin D yang optimal untuk ibu hamil dengan defisiensi dan insufisiensi vitamin DMetode: Uji klinis acak terkontrol dilakukan Juni 2019–Desember 2022 di RSUPN Cipto Mangunkusumo dan RSUD Koja, Jakarta. Subjek adalah wanita hamil usia kehamilan ≤14 minggu dengan defisiensi atau insufisiensi vitamin D (25(OH)D<30 ng/ml). Subjek dibagi menjadi 2 kelompok, kelompok pertama mendapatkan terapi vitamin D3 50.000 IU/minggu dan kelompok kedua mendapatkan terapi vitamin D3 5.000 IU/hari. Intervensi diberikan selama 4 minggu. Pengukuran kadar 25(OH)D dan 1,25(OH)2D dilakukan pada awal dan akhir intervensi.Hasil: Subjek awal berjumlah 60 orang, dan 8 subjek mengalami drop out. Karakteristik dasar subjek pada kedua kelompok setara. Kadar awal 25(OH)D tidak menunjukkan perbedaan bermakna di antara kedua kelompok (p=0,552). Pemberian terapi vitamin D3 50.000 IU/minggu selama 4 minggu meningkatkan kadar 25(OH)D secara signifikan (dari 14,5±4,3 menjadi 27,9±9,3 ng/mL, p<0,001) dan meningkatkan kadar 1,25(OH)2D namun secara statistik tidak signifikan (p=0,257). Pemberian terapi vitamin D3 5.000 IU/hari selama 4 minggu meningkatkan kadar 25(OH)D secara signifikan (dari 15,3±4,7 ng/mL menjadi 26,9±6,1 ng/mL, p<0,001) dan juga meningkatkan kadar 1,25(OH)2D secara signifikan (p=0,042). Namun tidak didapatkan perbedaan yang bermakna baik pada delta 25(OH)D (p=0,694), maupun delta 1,25(OH)2D di antara kedua kelompok dosis (p=0,641).Kesimpulan: Terapi vitamin D3 50.000 IU/minggu selama 4 minggu sama efektifnya dengan vitamin D3 5.000 IU/hari dalam meningkatkan kadar 25(OH)D serum pada wanita hamil dengan defisiensi dan insufisiensi vitamin D. Kedua dosis tersebut juga aman dan dapat ditoleransi oleh ibu hamil.

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Objective: To determine the optimal therapeutic dose of vitamin D for pregnant women with insufficiency or deficiency of Vitamin D

Methods: A randomized controlled trial was conducted from June 2019 to December 2022 at Cipto Mangunkusumo National Center General Hospital and Koja District Hospital in Jakarta, Indonesia. Subjects were ≤14 weeks gestation pregnant women with insufficiency or deficiency of Vitamin D (25(OH)D<30 ng/ml]. Two intervention groups were randomly assigned: 5,000 IU vitamin D3 daily or 50,000 IU weekly. Maternal blood samples were collected before and after four weeks of interventions to assess changes in serum concentrations of 25(OH)D and 1,25(OH)2D).

Result: Sixty subjects were randomized into two groups, and eight subjects were dropped out. The basic demographics of subjects in both groups were equivalent. There were no differences in baseline levels of 25(OH)D between two groups (p=0.552). In the 50,000 group, 25(OH)D levels increased from 15.3 ± 4.7 ng/mL to 26.9 ± 6.1 ng/mL (p<0.001). The 1,25(OH)2D levels increased however, the increase is not statistically significant. While in the 5,000 group, the 25(OH)D levels increased from 14.5 ± 4.3 ng/mL to 27.9 ± 9.3 ng/mL (p<0.001) and the 1,25(OH)2D levels increased significantly (p=0.042). However, the increment 25(OH)D and 1,25(OH)2D were not statistically significant between two groups.

Conclusion: Vitamin D3 50,000 IU weekly is equally effective and safe as 5,000 IU daily in increasing 25(OH)D serum levels in pregnant women with insufficiency or deficiency of Vitamin D."

"Abstract

The Effect of Vitamin C and E Suplementations on Serum CReaetive Protein Level in Moderate-Severe Bum Patients.

To study the effect of vitamin C 1000 mg i.v and E 400 mg oral supplementation on serum c-reactive protein level as parameter of inflammation in bum patients.

This study was a one group pre post test that gave i. v 1000 mg vitamin C and ond 400 mg vitamin E supplementations to thirteen moderate-severe bum patients, with percentage of bum less than 60%, in bum unit Cipto Mangunkusumo Hospital. Data were collected using questionnaire, medical record, anthropometric measurement, dietary assessment using fol.lf consecutive days food record. Laboratory test for serum vitamin C, E and serum c-reactivc protein levels were evaluated before and after supplementations. Differences in mean values were assessed by Wilcoxon for the not normal distribution.

Results Among thirteen subjects, seven (53.80%) subjects were female, median of age 35 (18-55) years. Body mass index in most subjects (69.2%) were categorized as normal. The median percentages of bum injury 22 (5-57}%, and the frequency of severe bum was 61.50%, while the most cause of bum was flame (76.9%). Level of vitamin C after treatment was increased, but not significant. Level of vitamin E after treatment was significantly increased (!Pi),OI6). Level of CRP after supplementation significantly increased (!Pi).04).

Conclusion There was significantly reduced of level serum CRP after four days vitamin CI 000 mg i. v dan E 400 mg ond supplementations."

"Ansietas merupakan masalah psikososial yang paling banyak dialami klien hipertensi. Hal ini terkait dengan respon klien terhadap kondisi kronis kesehatannya. Dampak dari ansietas akan mengganggu produktivitas dan kualitas hidup jika tidak dilakukan penatalaksanaan sedini mungkin. Penelitian ini bertujuan untuk mengetahui pengaruh PMR dan CBT terhadap ansietas klien hipertensi, Desain penelitian quasi experimental pre-test dan post-test with control group dengan jumlah sampel 64 responden. Hasilnya adalah penurunan ansietas, peningkatan kemampuan relaksasi serta kemampuan mengubah pikiran dan perilaku negatif pada kelompok yang mendapatkan PMR dan CBT p value < 0.05 . PMR dan CBT direkomendasikan sebagai terapi spesialis keperawatan pada ansietas klien hipertensi.

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Anxiety is the most widely psychosocial problems experienced in people with hypertension. The impact arising from the anxiety would interfere with productivity and quality of life. This study aims to determine the effect of PMR and CBT for anxiety clients with hypertension. Quasi experimental research design pre test and post test with control group with a sample of 64 respondents. The results is decrease in anxiety, increase relaxation capability and the ability to change negative thoughts and behaviors that are in the group of clients who get PMR and CBT p value."

"Hipertensi merupakan faktor utama penyebab kematian lansia secara global. Berbagai upaya telah dilakukan namun belum optimal. Kondisi tersebut mendorong para ilmuwan untuk mengembangkan terapi non farmakologis guna melengkapi terapi farmakologis salah satunya dengan relaksasi otot progresif dan terapi musik. Tujuan penelitian ini adalah untuk mengetahui pengaruh RESIK terhadap tekanan darah pada lansia dengan hipertensi di Kota Depok. Penelitian ini menggunakan desain quasi eksperiment dengan pendekatan pre-post test with control group. Seratus lansia dengan hipertensi dibagi menjadi dua kelompok menggunakan stratified random sampling dan purposive sampling. Setelah dilakukan 11 sesi terapi RESIK dalam 6 hari, analisis t-test menunjukkan adanya penurunan tekanan darah sebesar 29,2 mmHg pada tekanan darah sistolik dan 16,2 mmHg pada tekanan darah diastolik. Kesimpulannya, RESIK dapat menurunkan tekanan darah sistolik (p value = 0,000; α = 0,05) namun tidak signifikan menurunkan tekanan darah diastolik (p value = 0.167; α = 0,05). Terapi ini disarankan untuk diterapkan sesuai dengan prosedur dan dilakukan secara rutin untuk mendapatkan pengaruh yang maksimal.

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Hypertension is a major factor causes the death of older people globally. Various efforts have been made but are not optimal. These conditions encouraged scientists to develop nonpharmacological therapies to complement pharmacological therapy, one of them was progressive muscle relaxation and music therapy. The purpose of this study was to determine the influence of RESIK toward blood pressure in older people with hypertension in Depok. This study used quasi experimental design with pre-post test with control group approach. One hundred older people with hypertension divided into two groups using stratified random sampling and purposive sampling. After 11 RESIK therapy sessions in 6 days, t-test analysis showed the decrease of blood pressure in 29.2 mmHg at systolic blood pressure and in 16.2 mmHg at diastolic blood pressure. In conclusion, RESIK could decrease systolic blood pressure (P value = 0,000; α = 0,05) but it could not significantly decrease diastolic blood pressure (P value = 0.167; α = 0,05). This therapy was recommended to be applied in accordance with the procedure and done regularly to get the maximum influence."

"Picky eating atau perilaku pilih-pilih makanan merupakan suatu kondisi dimana anak menolak makan, atau mengalami kesulitan saat mengonsumsi makanan dan minuman. Prevalensi kejadian picky eating di Indonesia masih cukup besar, yakni sebanyak 45.5%. Anak dengan perilaku picky eating juga banyak ditemukan di kota-kota besar, salah satunya di Jakarta dengan prevalensi sebesar 33.6%. Kesulitan makan pada anak yang dibiarkan terjadi dalam jangka waktu yang lama, akan menimbulkan beberapa dampak negatif, seperti dehidrasi, ketidakseimbangan elektrolit, kekurangan vitamin, dan mineral, serta defisiensi zat gizi. Kecenderungan perilaku picky eating erat hubungannya dengan cara orang tua memberikan makan kepada anak, pola asuh, pengetahuan gizi, orang tua pendapatan, dan ketersediaan makanan. Tujuan dari penelitian ini adalah untuk melihat hubungan dari beberapa faktor tersebut dengan perilaku picky eating, yang dilakukan dengan menggunakan metode kuantitatif dan desain studi cross-sectional. Penelitian ini menggunakan data primer dari pengisian kuesioner secara daring yang melibatkan 127 responden yang merupakan ibu dari anak usia 2-5 tahun yang berdomisili di DKI Jakarta. Hasil penelitian menunjukkan bahwa terdapat 27.6% anak usia 2-5 tahun di DKI Jakarta yang memiliki perilaku picky eating dan dapat disimpulkan bahwa terdapat adanya hubungan riwayat penerapan responsive feeding dengan perilaku picky eating (p-value = 0.016). Variabel lain yang berhubungan secara signifikan (p-value < 0.05) yakni pola asuh, pengetahuan gizi, dan ketersediaan makanan. Sementara itu, tidak ditemukan adanya hubungan yang signifikan (p-value > 0.05) antara pendapatan orang tua dengan perilaku picky eating. Dengan demikian, orang tua diharapkan dapat memperhatikan faktor-faktor tersebut untuk dapat mencegah dan mengatasi kejadian picky eating pada anak.

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Picky eating or picky eating behavior is a condition where a child refuses to eat, or has difficulty consuming food and drink. The prevalence of picky eating in Indonesia is still quite large (45.5%). Children with picky eating behavior are also commonly found in big cities, one of which is in Jakarta, with a prevalence of 33.6%. Eating difficulties in children that are allowed to occur for a long time will cause several negative impacts, such as dehydration, electrolyte imbalance, vitamin and mineral deficiencies, and nutritional deficiencies. The tendency for picky eating behavior is closely related to the way parents feed their children, parenting patterns, nutritional knowledge, parents' income, and food availability. The purpose of this study was to examine the relationship between these factors and picky eating behavior, which was carried out using quantitative methods and a cross-sectional study design. This study uses primary data from filling out online questionnaires involving 127 respondents who are mothers of children aged 2-5 years who live in DKI Jakarta. The results showed that there are 27.6% of children aged 2-5 years in DKI Jakarta who have picky eating behavior and it can be concluded that there is a relationship between a history of implementing responsive feeding and picky eating behavior (p-value = 0.016). Other variables that were significantly related (p-value < 0.05) were parenting patterns, nutritional knowledge, and food availability. Meanwhile, there was no significant relationship (p-value > 0.05) between parents' income and picky eating behavior. Thus, parents are expected to pay attention to these factors to be able to prevent and overcome the incidence of picky eating in children"

"Defisiensi vitamin D sering terjadi pada penyakit autoimun, termasuk pemfigus vulgaris (PV) dan systemic lupus erythematosus (SLE). Sementara itu, terapi nutrisi dan suplementasi vitamin D masih belum rutin dilakukan dalam tata laksana PV dan SLE. Serial kasus ini melaporkan terapi nutrisi dan suplementasi vitamin D pada empat kasus penyakit autoimun yang mengalami kekambuhan. Serial kasus terdiri atas dua pasien laki-laki PV dan dua pasien perempuan SLE dengan defisiensi vitamin D yang putus obat akibat pandemi corona virus disease 2019 (COVID-19). Keempat pasien mengalami malnutrisi berat secara klinis, karena penurunan asupan makanan dan berat badan dengan berbagai komplikasi obat imunosupresan jangka panjang, yaitu meningkatnya risiko infeksi, sepsis, sarkopenia, deposisi lemak, diabetes mellitus diinduksi steroid, dislipidemia, hipertensi, dan depresi. Asupan energi secara bertahap ditingkatkan secara enteral melalui nasogatric tube (NGT) dan/atau rute oral untuk memenuhi kebutuhan energi dan protein total. Kebutuhan energi total menggunakan Formula Harris-Benedict dengan faktor stres yang disesuaikan dengan profil klinis dan metabolik masing-masing pasien. Kebutuhan protein ditetapkan 1,5–2,0 g/kg BB/hari untuk pasien PV dan 0,8–1,2 g/kg BB/hari untuk pasien SLE dengan keterlibatan ginjal. Lemak dan karbohidrat (KH) disesuaikan dengan komposisi seimbang, yaitu 45–60% KH, 25 g serat, dan <5% added sugar serta 25–30% lemak dengan <7% asam lemak jenuh, ~20% asam lemak tak jenuh tunggal, dan ~ 10% asam lemak tak jenuh jamak. Dua pasien PV mengalami insufisiensi (16,4 ng/mL dan 22,1 ng/mL) dan dua pasien SLE mengalami defisiensi (6,6 ng/mL dan 9,1 ng/mL). Keempat pasien mendapatkan kolekalsiferol 6000 IU/hari selama 8 minggu berturut-turut. Setelah 1 bulan suplementasi vitamin D dan terapi nutrisi adekuat, serum vitamin D serta status nutrisi dan skor Karnofsky meningkat. Kualitas hidup yang dinilai dengan Dermatology Life Quality Index (DLQI) untuk pasien PV dan Lupus quality of life (LupusQoL) untuk pasien SLE juga meningkat. Serial kasus ini menyimpulkan bahwa tata laksana komprehensif yang menyertakan terapi nutrisi adekuat dan evaluasi serum vitamin D dapat meningkatkan kondisi klinis dan metabolik, status gizi, kapasitas fungsional, dan kualitas hidup pasien autoimun kambuh.

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Vitamin D deficiency is common in autoimmune disease, including pemphigus vulgaris (PV) and systemic lupus erythematosus (SLE). Meanwhile, nutrition therapy and vitamin D supplementation are still not routines in comprehensive management of PV and SLE. In this case series, we report nutrition therapy and vitamin D supplementation of four cases of relapse autoimmune disease. This series consist of two males of PV and two females of SLE with vitamin D deficiency that dropped out of treatment due to corona virus disease 2019 (COVID-19) pandemic. Patients became clinically severe malnutrition because of reduced food intake and body weight with various long-term immunosuppressant drug complications, ie increased risk of infections, sepsis, sarcopenia, fat deposition, steroid induced diabetes mellitus, dyslipidemia, hypertension, and depression. Energy intake was gradually increased enterally via nasogatric tube (NGT) and/or oral route to meet total energy and protein requirement. Total energy requirement was calculated by Harris-Benedict Formula with stress factor adjusted by clinical and metabolic profile of each patient. Protein requirement set by 1.5–2.0 g/kg BW/day for PV and 0,8–1,2 g/kg BW/day for SLE with renal involvement. Fat and carbohydrate (CHO) were tailored by balance composition, ie 45–60% CHO, 25 g fiber, and <5% added sugar and 25–30% fat with <7% saturated fatty acid, ~20% monounsaturated fatty acid, and ~10% polyunsaturated fatty acid. Two PV patients were insufficiency (16,4 ng/mL and 22,1 ng/mL) and two SLE patients were deficiency (6,6 ng/mL and 9,1 ng/mL). Cholecalciferol 6000 IU/day was prescribed for 8 weeks. After 1 month vitamin D supplementation and an adequate nutrition therapy, serum vitamin D was increased as well as nutritional state and Karnofsky’s score. Dermatology Life Quality Index (DLQI) for PV and LupusQoL for SLE were also enhanced. Finally, comprehensive management along with an adequate nutrition therapy and vitamin D evaluation improved clinical and metabolic condition, nutritional status, functional capacity, and quality of life of relapse autoimmune patient."