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Abstrak :
This randomized double-blind placebo-controlled trial aimed to compare the efficacy of daily iron supplementation and multi-micronutrient supplementation both daily and weekly basis on increasing iron status among 284 apparently healthy Indonesian infants aged 6-12 mo. Infants were randomly assigned to receive either daily 1 RDA multi micronutrient supplement (n = 72), weekly 2 RDA multi micronutrient supplement (n = 70), daily ferrous sulphate 10 mg (n = 72), or placebo (n = 70) for wk. Blood hemoglobin, plasma ferritin, plasma zinc, and plasma C-reactive protein concentrations were measured prior to intervention and after 23 wk of supplementation. At baseline, 58.1% of subjects were anemic, 28.2% were iron deficient, and 11.2% were zinc deficient. After 23 wk of supplementation, both daily 1 RDA multi micronutrient and iron supplemented groups had significantly increased blood hemoglobin and plasma ferritin concentration, furthermore reducing the percentage of anemia and iron deficiency. However, the changes of hemoglobin were not significantly different among the treatment groups. Changes of hemoglobin were significantly higher in daily 1 RDA multi micronutrient group than in placebo group when initial blood hemoglobin was low. The change of plasma ferritin concentration in both daily 1 RDA multi micronutrient and iron groups was significantly higher than in other groups. Hemoglobin and ferritin concentrations of weekly 2 RDA multi micronutrient group were not significantly increase, but there were significantly increased in the subjects with low concentration of blood hemoglobin or plasma ferritin. Proportion of infants with zinc deficiency was increased significantly in iron group Daily I RDA multi micronutrient and daily iron supplementation are efficacious in improving the concentration of blood hemoglobin and plasma ferritin and reducing the percentage of infants with anemia and iron deficiency of Indonesian infants aged 6-12 months in a rural community. However, there was an increasing proportion of infants with zinc deficiency in daily iron supplementation. The efficacy of daily 1 RDA multi micronutrient supplementation was higher among the children with blood hemoglobin < 110 g/L Efficacy of weekly 2 RDA multi micronutrient supplementation on the concentration of blood hemoglobin and plasma ferritin of all subjects was not found, but it affected in children with low concentration of blood hemoglobin or plasma ferritin.

Abstrak :
Malnutrition has been responsible, directly or indirectly, for 60% of the 10.9 million deaths annually among children under five. Over two-thirds of these deaths, which are often associated with inappropriate feeding practices, occur during the first year of life (WHO, 2003). In UNICEF conceptual framework, two immediate causes of malnutrition are inadequate dietary intakes and diseases, and the underlying causes that lead to those two are inadequate access to food in the household, insufficient health services and an unhealthy environment, and inadequate care for children and women (UNICEF, 1998). Inadequate dietary intake is influenced by inappropriate feeding practice. Children who are not breastfed have repeated infections and grow less well than children who at least receive some breast milk (Daelmans and Saadeh, 2003). From six months onward, a child must have complementary food at six-month point, since breast milk alone no longer meets all nutritional needs. Delaying the switch over much beyond six months of age can cause a child's growth to falter. Thus, for optimal growth and development, a child needs to be fed frequently with energy-rich, nutrient-dense foods (UNICEF, 1998). However, the complementary foods do not easily fulfill the nutrient requirement a child needs. Problem nutrients are those for which there is the greatest discrepancy between their content in complementary foods and the estimated amount required by the child (WHO, 1998). Three strategies for obtaining needed amounts of problem nutrients are: optimization of nutrient intake from locally available food, micronutrient supplementation, and fortification of processed complementary foods (Dewey and Brown, 2003). The 541" World Health Assembly in 2001 not only recommended exclusive breastfeeding for six months as a global public health recommendation, but also recommended the widest possible use of indigenous nutrient-rich foodstuffs to improve complementary foods and feeding practice (Daelmans and Saadeh, 2003). In response to that recommendation, this study was aimed to develop a feasible dietary guideline for complementary feeding of infants aged 6-11 months that will used local food available. There have been some researches about developing dietary guideline in other countries for certain age group. This study was planned to develop a dietary guideline in one area of Indonesia where many of its children in the age group of 6-11 month were under nourished.

Abstrak :
Latar Belakang : Angka kejadian reseksi anastomosis pada kasus intususepsi masih sangat tinggi. Hal ini dikarenakan masih seringnya pasien datang terlambat setelah 72 jam, kurangnya SDM untuk melakukan reduksi non operatif, dan kurangnya penunjang seperti USG untuk menegakkan diagnosa. Penting untuk memperhatikan presisi, tehnik dan mempertimbangkan usus yang tersisa dalam melakukan reseksi anastomosis. Hingga saat ini belum ada standar operasi khusus yang dapat menjadi panduan bagi para dokter bedah dalam melakukan reseksi akibat intususepsi. Karena itu, peneliti tertarik untuk mencari batas reseksi yang diperlukan untuk menghasilkan suatu anastomosis end-to-end yang optimal dan rendah tingkat kebocorannya. Penelitian akan dilakukan kepada tikus sebagai pilot study sebelum dilakukan penelitian lebih lanjut. Tujuan : Mengetahui batas reseksi usus yang optimal dinilai dari kebocoran anastomosis berdasarkan grading kolagen pada batas reseksi tersebut. Metode : Penelitian ini merupakan penelitian eksperimental dengan hewan coba tikus putih Sprague Dawley. Tikus putih dilakukan intususepsi dengan menggunakan stylet, dari proksimal ke distal. Setelah 45 menit, intususepsi di reduksi.Tikus putih dikelompokkan dalam tiga kelompok sesuai batas reseksi anastomosis, yang kemudian batas reseksi ini dilakukan pemeriksaan grading kolagen. Setelah 5 hari, dilakukan laparotomi untuk menilai kebocoran anastomosis. Hasil : Pada perbandingan grading kolagen dengan reseksi usus didapatkan grading terbanyak pada batas 1 adalah grading 2 (57,1 %), pada batas 2 grading 2 (71,4 %) ,batas 3 grading 3 (71,4%).Perforasi terbanyak ditemukan pada grading 2 sebanyak 5 sampel. Pada perbandingan batas reseksi dengan perforasi didapatkan perforasi terbanyak pada batas 1 (85,7 %) Simpulan : Terdapat perbedaaan grading kolagen pada batas reseksi usus dimana batas kelompok batas 3 memiliki grading kolagen yang lebih baik ( grade 3 dan 4) sehingga kelompok batas 3 lebih direkomendasikan secara histopatologis. Grading kolagen dapat dinilai untuk melihat kemungkinan perforasi hasil anastomosis. Terdapat faktor-faktor lain yang dapat mempengaruhi kejadian perforasi selain grading kolagen. ......Background : There is still high presentation of intussuseption cases with resection and anastomose, caused of multi factors as : patient delay more than 72 hours, less on profesional expert to do non operative reduction and less of examination such as ultra sound to make a diagnose. That is important to take attention with pretition, tehniques and less of intestine when do the resection. There is still no operative standard about the boundary of resection cause of intussuseption, thats why the author want to do the experimental to find the optimal part of resection with minimal leakage. The experimental will do on rat as a pilot study. Aim : How to get the optimal part of resection compared with anastomotic leakege based on collagen grading. Method : The experimental test using a Sprague Dawley rat. We make a intussuseption on gut rat using a styleth from proximal to distal. The release do after 45 minutes. The rats then separated into three boundaries group, and did resection-anastomose with each gut from groups were performed a histopatologic test to count collagen grading. Leakage of anastomose were examinated after 5 days Result : In comparison between collagen grading and the extent of resection obtained the highest grading in group 1 is grade 2 (57,1%), group 2 is grade 2 (71,4%), group 3 (71,4%). The highest Leakage can be found on grade 2 (5 sample).in comparison the extent of resection and leakage,the highest is group 1 (85,7%). Summary : There are differences about collagen gradingin the extent of bowel resection which is the third group of resection has higher collagen grading (3 and 4 ) and then more recommended as histopatologic exam. Collagen grading could be marked to see possibilities of anastomotic leakage. There is some factors that affect a leakage besides collagen grading.

Abstrak :
Artritis reumatoid AR adalah penyakit autoimun yang saat ini telah diketahui menunjukkan manifestasi klinis bukan hanya intraartikular, tetapi juga ekstraartikular. Kejadian kardiovaskular baik subklinis maupun klinis ditemukan lebih tinggi pada penderita AR. Mediator inflamasi aterogenik pada AR seperti interleukin-6 IL-6 diduga menjadi salah satu faktor risiko nontradisional kardiovaskular yang berkontribusi meningkatkan penanda disfungsi endotel seperti E-Selectin. Penelitian ini bertujuan mengetahui peran mediator inflamasi dalam kejadian disfungsi endotel, khususnya korelasi IL-6 dan E-selectin, pada pasien artritis reumatoid tanpa faktor risiko kardiovaskular. Studi potong-lintang dilakukan pada 40 pasien AR di Poliklinik Reumatologi RSUPN Dr. Cipto Mangunkusumo, Indonesia, pada bulan September-November 2017. Pemeriksaan IL-6 dan E-Selectin dilakukan dengan teknik enzyme-linked immunosorbent assay ELISA. Analisis korelasi bivariat dilakukan untuk menemukan korelasi kedua penanda tersebut. Rerata usia subjek penelitian ini adalah 44,9 13,1 tahun dan median durasi sakit adalah 36 bulan. Korelasi kadar IL-6 dengan kadar E-Selectin memiliki kekuatan korelasi lemah tetapi tidak bermakna secara statistik r = 0.232, p=0,149. Tidak terdapat korelasi antara IL-6 dengan E-Selectin pada pasien AR tanpa faktor risiko tradisional kardiovaskular. ......Rheumatoid arthritis RA is an autoimmune disease which has recently been recognized to manifest as not only intraarticular but also extraarticular symptoms. Cardiovascular events, presented either subclinically or clinically, were discovered more in AR patients. Atherogenic inflammatory mediator in AR including interleukin-6 IL-6 was thought to be one of nontraditional cardiovascular risk factor contributing to increase the endothelial dysfunction biomarker such as E-Selectin. This study was purposed to determine the correlation between inflammatory mediator and endothelial dysfunction event, especially between IL-6 and E-Selectin, in RA patient without traditional cardiovascular risk factor. A cross-sectional study was performed to 40 RA patients of Rheumatology Clinic of Cipto Mangunkusumo National General Hospital, Indonesia from September to November 2017. Measurement of the level of IL-6 and E-Selectin were performed using enzyme-linked immunosorbent assay ELISA. Bivariate correlation analysis was performed to determine the correlation between those two biomarkers. The mean age of this study subjects was 44.9 13.1 years and median of disease duration was 36 months. This study showed weak correlation between IL-6 and E-Selectin level, but not statistically significant.232, p=0.149 . There is no correlation between IL-6 and sE-Selectin in rheumatoid arthritis patient without traditional risk factor cardiovascular.

Abstrak :
Studi cross sectional ini bertujuan untuk melakukan evaluasi kjnerja program komunikasi tabur gizi di Praya Tengah, Kabupaten Lombok Tengah. Hasil studi menunjukkan bahwa program komunikasi tabur gizi sebagai suatu sistem tidak berjalan dengan baik. Hal ini berdampak pada rendahnya tingkat kepatuhan sasaran, yaitu ibu/pengasuh dan anaknya, terhadap penggunaan tabur gizi. Selain itu, kepatuhan ibu untuk menggunakan tabur gizi lebih dipengaruhi oleh kesukaan anak terhadap produk tersebut, daripada program komunikasi itu sendiri. Manajer kesehatan di level kabupaten, dan Puskesmas, Serta kder Posyandu beranggapan bahwa masalah ketidakpatuhan sasaran disebabkan oleh anak balita tidak menyukai makanan yang telah diberi tabur gizi, dan para ibu/pengasuh tidak mau memaksa anaknya untuk mengkonsumsi rnakanan tersebut, serta anggapan ibu bahwa produk tersebut menyebabkan diare dan demam. Alasan lainnya adalah lemahnya aspek manajemen. ......This cross sectional study aimed to conduct a performance evaluation on the micronutrients powder (MNP) communication program in Praya Tengah, Lombok Tengah District. The study found that as a system MNP communication program did not well function and it might not reach its potential benefit yet, As a result it leads to low compliance of the beneficiaries on the MNP. Also, the caregiver?s compliance was influence by their children?s compliance, instead of comMunication program. The health managers and Posyandu cadres have perceived several reasons as problem on that program, i.e. most of the under five children did not like MNP, and the caregivers refuse to force feed their child to eat the food when it mix with MNP and also they perceive it might cause of diarrhea and fever. Other reasons that might hamper the program were lack of resources and poor management.

Abstrak :
ABSTRAK
PT.X adalah pabrik Keramik perlengkapan makan dengan sistem produksi terintegrasi yang menghasilkan produk mulu kualitas eksport. Pemakaian bahan baku dan mekanisme peralatan kerja di industri keramik pada umunmya menggunakan panas tinggi Serta bahan baku yang dapat menimbulkan pajanan debu di tempat kerja. Dampak dari debu di tempat kerja salah satunya dapat menyebabkan gangguan pada mata berupa Konjungtivitis dengan keluhan mata terasa gatal, pedih, rasa berpasir, silau serta mata merah dan berair. Penelitian dilakukan dengan menggunakan studi pengamatan, terhadap |96 orang pekerja bagian produksi sebagai responden selama 8 jam. Pengumpulan data dilakukan dengan cara pengisian kuesioner , pemeriksaan mata dan hasil pengukuran Tes Schirmer Serta pengukuran lingkungan. Hasil penelitian dari responden pada PT.X didapatkan insidens Konjungtivitis sebesar l4,8% dari seluruh populasi. Dari 196 responden , yang terdiri dari Iaki-laki dan wanita , didapmkan tiga keluhan terbanyak yaitu mata terasa gatal (35,2%), mam terasa pedih (34,7%), dan mata terasa silau (25,5%) clan tanda-tanda pada mata merah pada konjungtiva (35,7%) Serta mata berair (20,4%). Hasil analisa slatistik multivariat didapatkan responden dengan nilai tes Schirmer yang abnormal (5 10 mm) dan mempunyai riwayat alergi mempunyai risiko yang lebih besar mengalami Konjungtivitis .

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Abstract
The ?X? Factory manufacturing tablewares ceramic with integrated system production. The Ceramic raw material substances, machinery and the ceramic process exposed airbome dust which hazardous to worker?s health. The employee who suffered by those exposed dust will cause Conjunctivitis. The Research method is Observational Cohort, toward 196 employee as sample in 8 hours time work. The source data were collected with a self rating questionnaire. The workers were surveyed and screened with physical examination on eyes, Schrimer?s test and environment measurement. The result show the ?X? factory insidens of Conjunctivitis is about l4,8% of total population. From |96 respondents amongst male and female workers, the most common affecting inconvenience are itching eye (35,2%), pain eye (34,7%), and photofobhia (25,5%), Conjunctiva injection or red eye (35,7%) and watering eye (20,4%). Workers who have an abnormal values of Schrimer?s test (5 10mm), working under high temperature and exposure of dust in working area , suffered more risks of Conjunctivitis.

Abstrak :
Pola kerja gilir serta berbagai karakteristik pekerja minyak berisiko menimbulkan insomnia pada pekelja. Penelitian ini bertujuan mengetahui prevalensi insomnia dan faktor-faktor yang berhubungan, terutama pola krja gilir. Metode penelitian Desain penelitian ini adalah potong lintang. Pemilihan subyek dengan teknik total popularion sampling pada pekemja yang on board saat studi dilakukan. Setiap responden mengisi kuesioner, formulir SCL-90 dan Insomnia Rating Scale-KSBPJ. Hasil Dari hasil 129 responden didapatkan 66 (5l,2 %) mengalami insomnia., 95% nya tergolong insomnia berderajat ringan. Masa kerja terbanyak di atas 5 tahun (4l,l%} dan pola kenja non kelja gilir (43,4%). Faktor risiko yang berhubungan dengan insomnia adalah dugaan gangguan jiwa (Acyusred OR=2,47 95% C1 1,06 - 5,80 dan p=0,03). Sedangkan variable lainnya tidak bermakna. Kesimpulan Dari peneiitian ini dapat disimpulkan bahwa risiko yang paling berperan pada terjadinya insomnia adalah gangguan jiwa. Kerja gilir tidak terbukti mempengaruhi insomnia.

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Background Shift work and others characteristic of oil company workers contribute to the risk of insomnia. This study showed the prevalence of insomnia and its related factors among workers in an on shore oil company. Method The study design was cross sectional. Total population sampling technique was applied to recruit participants. Every respondent was asked to fill a questionnaire, SCL-90 form, and Insomnia Rating Scale form, translated by Kelompok Studi Psikiatri Biologi Jakarta. Results One hundred and twenty nine respondent participated in the study. Prevalence of insomnia was 5l,2%, mostly mild insomnia(95%). Most of the participants had worked for more than live years (4l,1%) and dominated with non-shift pattern (43,4%). The result showed only suspected mental disorder workers (Adjusted 0R=2,47 95% CI 1,06 - 5,30, p=0.03) had significant association with insomnia. Conclusion The contributed risk factor of insomnia in this study was only suspected mental disorder. There wasn?t proved that shift work contributed to insomnia.

Abstrak :
Latar belakang. Pekerjaan angkat angkut merupakan aktivitas fisik berat di tempat kerja. Sistem kerja yang berulang dan dengan beban keija yang berat dapat menimbulkan masalah kesehatan yang berakibat penurunan ketahanan kardiorespirasi. Penelitian ini bertujuan mengetahui variasi status ketahanan kardiorespirasi dan faktor-faktor yang berhubungan pada pekerja angkat angkut. Metode. Disain penelitian menggunakan metode potong lintang. Subyek penelitian berasal dari bagian distribusi. Aktivitas fisik diternpat keija diketahui dari kuesioner dengan mengidentifikasi jenis pekerjaan, jenis kemasan, lama kerja, pekeijaan sampingan, lama istirahat kecil dan jumlah rit per bari. Tingkat ketahanan kardiorespirasi diukur menggunakan metode YM'CA·3Minute step test. Hasil. Subyek penelitian adalah I 05 pekerja angkat angkut berumur antara 20 - 50 tahun. Sebanyak 59,1 % subyek rnemiliki ketahanan kardiorespirasi yang kurang. Faktor risiko yang berkaitan dengan status ketahanan kardiorespirasi kurang adalah jumlah anak. Faktor demografi, risiko pekeijaan aktivitas rurnah tangga, kebiasaan olahraga, indeks brinkman, indeks massa tubuh, dan pvstur tubuh tidak terbukti mempertinggi risiko ketahanan kardiorespirasi kurang. Status ketahanan kardiorepirasi tidak berhubungan dengan aktivitas fisik berat di tempat keija. Faktor lainnya yaitu kebiasaan olahraga sedikit mempengaruhi ketahanan kardiorepirasi.. Subyek yang tidak mempunyai anak, mempunyai resiko 9.38 kali terhadap risiko ketahanan kardiorespirasi kurang (OR:9,38 ; CI 95 % : 1,06- 82,95). Kesimpulan. Status ketahanan kardiorepirasi tidak berhubungan dengan aktivitas fisik berat di tempat kerja. Faktor lainnya yaitu kebiasaan olahraga sadikit mempengaruhi ketahanan kardiorepirasi.

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Background. Loading unloading worker had heavy occupational physical activity. System of work and repeated heavy work load may cause health problems that result in a decrease in cardiorespiratory fitness. This study aims to find out the variation of cardiorespiratory fitness and related factors. Methods. In this cross sectional study, subject were invited and choose purposely from distribution department. Heavy occupational physical activity with a note from the questionnaire by identify the type of job, type of packaging, work period, side job, mini break and work trip . Cardiorespiratory fitness was measured using YMCA-3 minute step test method. Results. The subject of this study were 105 loading worker aged 20 - 50 years old. We noted that 59,1 % of the subject had low cardiorespiratory fitness. Risk factors that related to low cardiorespiratory fitness were demographic factor, risk of work, household physical activities, sport activities, Brinkmann index, body mass index and posture rating score were not likely correlated to low cardioreSpiratory fitness. Cardiorespiratory fitness is not related to the heavy occupational physical activity. Other factors such as exercise habits were less likely related to cardiorespiratory fitness. Subject that does not have any children have 9.38 times to low cardiorespiratory fitness (OR=9,38 ; CI 95 % : 1,06 - 82,95). Conclusion. Cardiorespiratory fitness is not related to the heavy occupational physical activity. Other factors such as exercise habits were less likely related to cardiorespiratory fitness.