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"Latar Belakang : Proses kognitif diartikan sebagai proses pengolahan informasi, yang diubah, disimpan, dan kemudian digunakan. Gangguan kognitif dapat terjadi akibat berbagai macam proses penyakit tem1asuk gangguan pada pembuluh darah di otak. Penelitian terdahulu menunjukkan penyandang Hipertensi memiliki skor kognitif yang lebih rendah dibanding individu normal. Kekerapan gangguan kognitif pada penyandang hipertensi meningkat 7-9%, bila tekanan darah tidak terkontrol. Tujuan : Penelitian ini bertujuan mengetahui hubungan antara tekanan darah dengan gangguan kognitif pada penyandang hipertensi yang bermanfaat untuk pencegahan, deteksi dini dan tatalaksana sehingga bila ditemukan gangguan kognitif ringan dapat segera diambil langkah-langkah untuk mencegah berlanjutnya komplikasi. Metode : Penelitian menggunakan disain analisis potong lintang deskriptif. Dilakukan pada pasien hipertensi yang datang berobat ke beberapa puskesmas di Jakarta, dengan 106 sampel yang memenuhi kriteria inklusi, dilakukan anamnesis dan identifikasi catatan medis, selanjutnya dilakukan pemeriksaan fisik umum (tekanan darah sistolik dan diastolik, pengukuran berat badan dan tinggi badan) dan pemeriksaan neurologi rutin (pemeriksaan fisik, skor Hamilton, MMSE dan funduskopi). Subyek yang memenuhi kiteria inklusi dilakukan tes MoCA-lna. Variabel-variabel yang diduga berperan dalam gangguan kognitif pada hipertensi diuji statistik menggunakan analisis bivariat dan multivariat dan uji mutlak Fisher. Hasil: Dari 106 pasien hipertensi didapatkan perbandingan jumlah laki-laki dengan perempuan adalah I : I ,6 dengan jumlah terbanyak pada kelompok usia 51-60 tahun (40.6%) diikuti kelompok usia 40-50 tahun (34.9%), dan~ 61 tahun (24.5%) dengan 54 subjek (50.9%) berpendidikan rendah, 28 subjek (26.4%) berpendidikan sedang dan 24 subjek (22.6%) dengan pendidikan tinggi. Variabel pendidikan memiliki perbedaan proporsi yang signifikan bila dihubungkan dengan gangguan kognitif dari 106 subjek, dengan persentase 19.8% yang mengalami gangguan kognitif (skrining MoCA-lna) dengan gangguan paling dominan pada domain visuospasial sebanyak 43.4% disusul oleh domain bahasa (34.9%). Dari ke-6 domain MoCA-lna terdapat hubungan bermakna dengan beberapa variabel yang diteliti yaitu: fungsi eksekutif, atensi, konsentrasi dan working memory memiliki hubungan bermakna dengan variabel tingkat pendidikan; fungsi visuospasial terdapat hubungan bermakna dengan variabel grade hipertensi dan tingkat pendidikan; dan fungsi short term memory recall memiliki hubungan bermakna dengan variabel onset hipertensi. Dari data sekunder pun didapatkan -hubungan yang signifikan an tara grade hipertensi dan onset hipertensi bila dihubungkan dengan gambaran funduskopi. Kesimpulan : Terdapat 19.8% gangguan kognitif pada penyandang hipertensi dengan gambaran berupa gangguan fungsi visuospasial dan terdapat hubungan bermakna dengan beberapa variabel yang diteliti.

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Background: cognitive process is defined as a process of converting, storing, and then using of information. Cognitive impairment can occur due to various disease including disorders of the blood vessels in the brain. Previous research has shown people with hypertension have a lower cognitive scores than normal individuals. In an uncontrolled blood pressure condition, frequency of cognitive impairment in people with hypertension increased 7-9%. Objective: To determine the relationship between blood pressure and cognitive impairment in people with hypertension. The aims are for the prevention, early detection and management of complication of mild cognitive impairment in hypetension. Methods: A cross-sectional descriptive analysis design. Performed in hypertensive patients who come for treatment to some centers in Jakarta, with 106 samples that met the inclusion criteria, conducted medical history and identification records, then performed a general physical examination (systolic and diastolic blood pressure, weight and height) and a routine neurological examination (physical examination, Hamilton score, MMSE and fundoscopy). Subjects who met inclusion criteria were conducted MOCA-Ina tests. The variables which were significant in cognitive impairment in hypertensive were statistically tested using bivariate and multivariate analysis and Fisher's absolute test. Results: Of 106 patients with hypertension the ratio between men and women was 1: 1.6 with the highest number in the age group was 51-60 years (40.6%) followed by 40-50 years age group (34.9%), and :2: 61 years (24.5%) with 54 subjects (50.9%) of low-educated, 28 subjects (26.4%) moderately educated and 24 subjects were well educated (22.6%). Education were significant proportion of the difference when linked with cognitive impairment in 106 subjects, with percentage of 19.8% who experienced cognitive impairment (screening MOCA-Ina) with predominant disturbance in as many as 43.4% visuospasial domains followed by domain language (34.9%). Executive function, attention, concentration and working memory are significantly associated with level of education; visuospasial functions are significantly associated with grade of hypertension and level of education; and short term memory recall function is significantly associated with onset of hypertension. From the secondary data there were significant relationship between hypertension grade and onset of hypertension with funduscopic. Conclusion: There were 19.8% cognitive impairment (visospatial dysfunction) in people with hypertension with and there were significant association between variables studied."

"Resistensi antibiotik merupakan ancaman terbesar di dunia kesehatan. Penyebab resistensi diantaranya yaitu penggunaan antibiotik yang berlebihan dan tidak tepat. Penelitian ini bertujuan mengevaluasi kualitas dan kuantitas penggunaan antibiotik di beberapa Puskesmas Kabupaten Tegal sebelum dan sesudah dilakukan intervensi edukasi. Desain penelitian pre eksperimental (pre - post intervension design) menggunakan data peresepan pasien rawat jalan periode 1 Juni 2018 - 31 Januari 2019 dan Laporan Penggunaan dan Lembar Permintaan Obat (LPLPO) di lima Puskesmas Kabupaten Tegal. Intervensi edukasi diberikan kepada seluruh penulis resep. Kualitas peresepan dinilai dengan membandingkan pemilihan obat, dosis pemberian, frekuensi pemberian dan durasi pemberian antara yang tertulis pada resep dan Panduan Praktik Klinis Fasilitas Kesehatan Primer 2014. Kuantitas penggunaan obat dihitung dalam satuan DDD / 1000 Kunjungan Pasien Rawat Jalan (KPRJ)/ hari. Diperoleh sampel kualitas peresepan sebanyak 1204 resep pada pre intervensi dan 1254 resep pada post intervensi. Ketidaksesuaian dalam durasi terapi memiliki proporsi kejadian yang paling tinggi (56,72%). Secara keseluruhan terjadi penurunan yang bermakna pada ketidaksesuaian peresepan antibiotik dari 98.08% pada pre intervensi menjadi 81.26% post intervensi (p value : 0.012). Faktor yang mempengaruhi peresepan antibiotik diantaranya kualifikasi penulis resep dan pengalaman penulis resep. Kuantitas penggunaan Antibiotik mengalami penurunan dari 14, 960 DDD / 1000 KPRJ/ hari pada pre intervensi menjadi 9, 375 DDD / 1000 KPRJ / hari pada post intervensi. Namun, penurunan bersifat tidak signifikan (p value : 0, 062).

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Antibiotic resistance has posed a serious threat to global health, and one of the reasons for such resistance is the inappropriate use of antibiotics as well as antibiotic overuse. This study aimed to evaluate the quantity and quality of antibiotic use in a number of primary healthcare centers in the District of Tegal prior to and after a health education intervention was provided. This pre-experimental research (pre-post intervention design) employed the outpatient prescribing data over the period of 1 June 2018 through 31 January 2019 and Drug Use Report and Request Form (LPLPO) in five (5) primary healthcare centers in the District of Tegal. A health education intervention was provided for each prescriber. The prescribing quality was assessed by drawing a comparison between the drug selection, dosage of administration, frequency of administration, and duration of administration in the prescriptions and those advised in the Clinical Practice Guidelines for Primary Healthcare Facilities 2014. The quantity of drug use was calculated in a unit of DDD/1000 of Outpatient/day. For the prescribing quality analysis, 1204 prescriptions in the pre-intervention phase and 1254 prescriptions in the post-intervention phase were obtained. Inappropriate duration of administration reached the highest percentage (56.72%). Overall, the inappropriateness of antibiotic prescribing decreased significantly from 98.08% during the pre-intervention phase to 81.26% in the post-intervention phase (p value : 0.012). The contributing factors of antibiotic prescribing included the qualification of prescribers and their experience in prescribing. There was a decrease in the quantity of antibiotic use from 14,960 DDD/1000 of KPRJ/day in pre-intervention to 9,375 DDD/1000 of KPRJ/day in post-intervention. However, the reduction was unsignificant (p value: 0.062)."