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"ABSTRAKPenelitian dengan rancangan uji klinis paralel acak tersamar ganda ini bertujuanmengetahui perubahan kadar apo B pada penyandang obes I setelah suplementasiserat psyllium husk (PH) 8,4 g/hari dan diet rendah kalori seimbang (DRKS) 1200kkal/hari selama 4 minggu. Berdasarkan kriteria penelitian, didapat 31 orangsubyek yang dibagi menjadi dua kelompok, 15 orang kelompok perlakuan (KP)dan 16 orang kelompok kontrol (KK). Subyek KP mendapat PH 8.4 g/hari danDRKS, sedangkan KK mendapat plasebo dan DRKS. Data yang diperolehmeliputi sebaran dan karakteristik subyek, asupan energi, makronutrien, serat, danair, serta kadar apo B awal dan akhir penelitian. Analisis data menggunakan uji ttak berpasangan dan Mann-Whitney, batas kemaknaan 5%. Sejumlah 28 subyekdapat mengikuti penelitian hingga selesai (KP dan KK masing-masing 14). Tidakdilaporkan efek samping berbahaya selama perlakuan. Sebagian besar subyekperempuan, median usia subyek KP dan KK berturut-turut 35,0 (30−45) tahun dan34,50 (30−48) tahun, IMT 28,0 ± 1,1 kg/m2 dan 27,2 ± 1,4 kg/m2. Jumlah asupanenergi total subyek KP 1130,9 ± 221,9 kkal/hari lebih tinggi signifikan (p = 0,02)daripada KK 1024,3 ± 269,9 kkal/hari. Karbohidrat sederhana pada KP (35,6(8,3−69,9)) g/hari lebih tinggi signifikan dibandingkan KK (13,8 (3,4−55,5))g/hari. Asupan serat subyek belum mencukupi anjuran (20–35 g/hari), yaitu KP17,2 ± 2,8 g/hari dan KK 8,6 (5,2−15,2) g/hari walaupun dengan suplementasiPH. Asupan protein, lemak total, dan kolesterol dalam rentang yang dianjurkan,tetapi tidak pada asupan asam lemak tak jenuh tunggal dan jamak. Penurunankadar apo B pada KK (-6,1 ± 8,9 mg/dL) lebih besar tidak signifikan (p = 0,13)dibandingkan pada KP (-1,3 ± 7,3 mg/dL). Dari penelitian ini disimpulkansuplementasi PH 8,4 g/hari dan DRKS 1200 kkal/hari selama 4 minggu tidaklebih baik dalam menurunkan kadar apo B dibandingkan plasebo dan DRKS 1200kkal/hari penyandang obes I.

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ABSTRACTThis double blind randomized clinical trial aims to investigate the change of apoB level in obese I after given supplementation psyllium husk (PH) 8.4 g/day andlow-calorie balanced diet (LCBD) for 4-weeks. By study criteria, 31 subjects wererandomly allocated to one of two groups; 15 subjects for treatment (T) group and16 subjects for plasebo (P) group. The T subjects received psyllium husk (PH) 8.4g/day and LCBD 1200 kcal/day and the P subjects received placebo and LCBD1200 kcal/day. Data collected in this study consist of subject distribution andcharacteristic, intake of energy, macronutrient, fiber, water and apo B level thatassessed before and after treatment. Level of statistical analyses significance was5%, independent t-test and Mann-Whitney. A total 28 subjects (14 subjects ineach group) had completed the intervention. There were no serious adverse eventswere reported along the intervention. Mean of age in T and P groups respectivelywas 35.0 (30.0−45.0) years and 34.5 (30.0−48.0) years, and BMI was 28.0 ± 1.1kg/m2 and 27.2 ± 1.4 kg/m2. The energy intake in T group 1130.9 ± 221.9 kcal/daywas significantly higher (p = 0.02) than P group 1024.3 ± 269.9 kcal/day. Simplecarbohydrate intake in T group (35.6 (8.3−69.9) g/day) was significantly higher (p<0.000) than in P group (13.8 (3.4−55.5) g/day). Intake of dietary fiber in T groupwas 17.2 ± 2.8 g/day had significantly higher than P group 8.6 (5.2−15.2) g/day,even adding PH supplementation cannot meet the recommendation of fiber intake(20-35 g/day). Intake protein and fat in both groups was meet recommendation,differ for intake of mono and polyunsaturated fatty acids. Decreasing of apo Blevel in P group was -6.1 ± 8.9 mg/dL that statistically insignificant difference (p= 0.13) with T group -1.3 ± 7.3 mg/dL. As a conclusion in this study shows, thatPH supplementation 8.4 g/day and LCBD 1200 kcal/day in obese I for 4 weekswasn’t proven to decrease the apo B level."

"ABSTRAKLatar Belakang: Tuberkulosis merupakan penyakit infeksi kronik yang tetap menjadi masalah kesehatan global terutama di negara berkembang dan menjadi penyebab kematian kedua terbesar pada kelompok penyakit menular. Selain paru, kuman tuberkulosis dapat menginvasi hingga ke organ ektrapulmoner salah satunya usus. Infeksi kuman pada mukosa usus karena tuberkulosis usus dapat menyebabkab ulserasi hingga nekrosis lapisan mukosa yang akan memengaruhi absorpsi nutrisi. Malabsorpsi dan anoreksia dapat menjadi penyebab malnutrisi pada tuberkulosis usus. Terapi medik gizi bertujuan untuk menyediakan nutrisi adekuat, meningkatkan status gizi, menurunkan risiko kematian, memperpendek lama rawat inap, mencegah terjadinya penurunan massa otot, mendukung proses kesembuhan penyakit, memenuhi kebutuhan mikronutrien yang adekuat, dan meningkatkan sistem imunitas. Metode:Pada serial kasus ini, dilaporkan 4 kasus tuberkulosis usus pada pasien laki-laki dan perempuan yang berusia antara 24-31 tahun, dengan 1 pasien koinfeksi HIV. Keempat pasien mengalami malnutrisi, 3 diantaranya adalah malnutrisi berat dan juga didiagnosis kaheksia. Pada 3 kasus awal, tatalaksana tuberkulosis usus disertai dengan pembedahan akibat komplikasi obstruksi usus mekanik, perdarahan, dan fistula sedangkan kasus terakhir hanya diberikan AOT. Masalah nutrisi terjadi pada keempat kasus terkait dengan perubahan anatomi saluran cerna, fungsi fisologis, dan pemberian mikronutrien yang kurang adekuat. Terapi medik gizi telah diberikan sesuai rekomendasi untuk pasien dengan tuberkulosis usus dengan malnutrisi. Hasil :Kasus pertama dan keempat mengalami perbaikan keadaan klinis hingga diperbolehkan rawat jalan. Namun, kasus kedua dan ketiga meninggal dunia masing-masing pada hari perawatan ke-54 dan 28 akibat sepsis dan perdarahan. Kesimpulan:Terapi medik gizi yang diberikan telah membantu perbaikan kondisi klinis pada pasien tuberkulosis usus dengan malnutrisi.

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ABSTRACTBackground:Tuberculosis is a chronic infection that remains a global health problem especially in developing countries and become the second leading cause of death in infectious diseases. Beside lung organ, the Mycobacterium tuberculosis can invade up to an extrapulmonary organ such as intestine. Infections in the intestinal mucosa due to intestinal tuberculosis may cause ulceration to necrosis of the intestinal mucose that will be affected to nutrient absorption. Malabsorption and anorexia can be the cause of malnutrition in intestinal tuberculosis. Nutritional medical therapy aims to provide adequate nutrition, improve nutritional status, reduce the risk of death, shorten the length of stay, prevent the decrease of muscle mass, support the wound healing, giving adequate micronutrients, and improve the immune system. Methods: In this series of cases, 4 cases of intestinal tuberculosis were reported in male and female patients between 24 and 31 years old, with 1 patient co-infected with HIV. The four patients were malnourished, 3 of them with severe malnourished and also diagnosed with cachexia. In the third initial cases, management of intestinal tuberculosis was surgery due to complications mechanical bowel obstruction, hemorrhage, and fistulas while the last one was given only DOT. Nutrition problems occur in all four cases associated with altered gastrointestinal anatomy, physiological function, and inadequate micronutrient administration. Medical nutrition therapy has been given as recommended for patients with intestinal tuberculosis with malnutrition. Result: The first and fourth cases had an improvement on clinical conditions. However, the second and third cases died on the 54th and 28th day of treatment due to sepsis and bleeding. Conclusion: Medical nutritional therapy has been provided to improve clinical conditions in intestinal tuberculosis patients with malnutrition. "