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Abstrak :
Latar belakang: tumor kelenjar liur merupakan tumor yang jarang pada keganasan kepala leher. Histopatologinya sangat heterogen demikian juga kejadian dan klinik epidemiologinya. Perbedaan karakteristik dari tumor parotis di banyak pusat kesehatan memengaruhi survival rate. Metode: penelitian ini adalah uji retrospektif analitik dengan uji kesintasan. Data didapatkan dari rekam medik pasien tumor parotis ganas yang dirawat di RSUPNCM periode Januari 2005 sampai Desember 2011. Hasil: ada 75 kasus tumor parotis ganas. Laki-laki lebih banyak dibandingkan perempuan, dengan umur rata-rata 50 tahun. Delapan puluh persen ditemukan dalam stadium klinis lanjut. Mukoepidermoid karsinoma merupakan histopatologi yang paling sering ditemukan. Pembedahan merupakan terapi pilihan utama. Enam puluh persen kasus ditemukan penurunan indeks masa tubuh (IMT). Komplikasi tersering adalah paralisis nervus fasialis sekitar 30,7%. Mortalitas dalam 1 tahun didapati sebesar 25,3%. Rekurensi ditemukan sebesar 17,3%. Analisis bivariat antara tatalaksana dengan morbiditas menunjukkan signifikan dengan nilai p=0.001, dan dalam hubungannya dengan mortalitas didapati signifikan dengan tatalaksana, sedangkan stadium klinis dan histopatologi tidak. Histopatologi signifikan dalam hubungannya dengan rekurensi. Pada analisis multivariat antara stadium klinis I-II dengan status nutrisi dan mortalitas menunjukkan hubungan yang signifikan dengan nilai p = 0.006. Terdapat hubungan signifikan antara tatalaksana dengan survival rate, sedangkan untuk jenis kelamin, usia, histopatologi dan stadium klinis tidak ditemukan hubungan yang signifikan. Disease free survival untuk kasus keganasan ini adalah 61,5%. Kesimpulan: karakteristik tumor parotis ganas di RSUPNCM tidak berbeda dengan yang ditemukan pada literatur, hubungan yang signifikan ditemukan antara histopatologi dan tatalaksana sebagai faktor prognosis survival rate.

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Background: salivary gland tumor is a rare case found in head and neck tumor. The histopathology is very heterogeneous, as well as the incident and clinical epidemiology. Different characteristics of parotid gland tumor in many health centers affecting survival rate. Method: This is a survival study with retrospective analytical method. Data is obtained from medical record in Cipto Mangunkusumo Hospital in period of January 2005 to December 2011. Results: There are 75 patients with malignant parotid gland tumor. Male is affected more than female, the mean age is 50 years old. 80% of cases found are in late stage. Mucoepidermoid carcinoma is the most frequent histopathology found. Surgery remains the treatment of choice. 60% patients experienced a decreased of body mass index. Postoperative complication such as facial nerve paralysis occurred in 30.7%. One year mortality is found in 25.3% cases. Recurrence is found in 17,3%. Bivariate analysis between clinical management and morbidity has a significant correlation with p=0,001, and significant also found between clinical management with mortality but not for tumor stage and histopathology. Histopathology found significant in correlation with recurrence. Multivariate analysis between nutritional status and tumor stage showed significancy with p = 0.006 in stage I-II. There is significant relationship between clinical management and survival rate, but there is no significancy between sex, age, histopathology, and tumor stage. Disease Free Survival is among 61,5%. Conclusion: malignant parotid gland tumor in Cipto Mangunkusumo Hospital contributes the same characteristics with those found in publications. There is significant relationship between variables from survival analysis of prognostic factors.

Abstrak :
Introduction: This study aims to know the performance of the Vascular – Physiological and Operative Severity Score for Enumeration of Mortality and Morbidity (V-POSSUM) score as a predictor of 30-day mortality after the Endovascular Aortic Aneurysm Repair (EVAR) – Thoracic Endovascular Aortic Repair (TEVAR) procedure in Abdominal Aortic Aneurysms (AAA) and Thoracic Aortic Aneurysms (TAA) patients in Cipto Mangunkusumo Hospital. Method: This was a retrospective cohort study using data from medical records. Data were taken according to the variables contained in the V-POSSUM scoring system in the patient who undergone EVAR – TEVAR procedure, on the period of 2013 to July 2018. Results: The study involved 85 patients who met the study requirements. It was known that physiological scores, morbidity risk, and mortality risk could be used as a model to predict mortality outcomes because they had good accuracy and discrimination performance, while the severity of the operation score cannot. The result of the goodness of fit model’s physiological score, morbidity risk, and mortality risk was significant (p <0.001), while the severity score of the operation was 0.18 (p >0.05). The Area Under the Curve (AUC) was 94%, 93%, 93%, with the cut points at 31, 68.8, and 10.6 for the physiological score, morbidity risk, and mortality risk, respectively. Conclusion: The V-POSSUM score had good accuracy and discrimination for the physiological score, morbidity risk, and mortality risk.

Abstrak :
ABSTRACT
The study aimed to investigate the impact of 12 weeks supplementation with multi-micronutrient and iron-folate supplements on hematological status, morbidity and work productivity. Female factory workers were selected as the subjects because: high prevalence of anemia found in this group which might have health and economic consequences since anemia was related to decrease work productivity and decrease resistance to infection, and the increasing number of female workers in developing country.

A preliminary study was conducted to investigate the bioavailability of iron from a multi~micronutrient supplement compared to watery ferrous(II)-sulfate solution. In a randomized cross over design, 14 volunteers received 108 mg elemental iron as four tablets of multi-micronutrient supplements (each tablet contained 27 mg elemental iron) or as a solution of 537.60 mg Ferrous(Il)-sulfate. Serum iron concentrations were measured at 0, 2, 4, 6 and 8 hours after dosing. The maximum serum iron level was significantly lower with multi-micronutrient supplement compared to ferrous sulfate solution but the time to reach the peak" serum iron level was not significantly different between those two treatments. The median relative bioavailability of iron in multi-micronutrient supplement was 32.22%

The main study was conducted in a shoe factory, West Java. A total of 308 subjects were selected and divided randomly into three groups that respectively received multi-micronutrient (each tablet contained 27 mg elemental iron), iron-folate supplements (each tablet contained 200 mg ferrous sulfate equal to 60 mg elemental iron) and placebo. Multimicronutrient supplements and placebo were given time times per week and iron-folate supplements were given once a week. All of the supplementations were supervised and last for 12 weeks. Hematological assessed in sub sample of each group based on Willingness; making a total of 140 subjects.

Significant increments in the levels of hemoglobin, serum ferritin, and serum retinol were observed in multi-micronutrient group (0.6 g/dl, 13.44 ug/l, and 0_6 pmol/l respectively) and iron-folate group (0.3 g/dl, 11.26 ug/l, and 0.4 umolfl respectively); the increments were higher in multi-micronutrient group but not statistically different from iron-folate group. In the placebo group, hemoglobin level was decreased by 0_3 g/dl, serum ferritin was increased by 4.28 ug/1, and serum retinol was relatively constant. The prevalence of anemia and low iron status were decreased after treatment with multi-micronutrient (7% and 20.5%, respectively) or iron-folate supplements (91% and 12.8%, respectively). The anemia prevalence in placebo group was increased by 6.6% while the prevalence of low iron status was decreased by 2.5%. The morbidity was increased in all groups with the lowest increment was observed in multi-micronutrient group (65% in multi-micronutrient group compared to 14.1% in iron group and 22.4% in placebo group). The work productivity was increased by 6.3% in iron group and 3.6% in multi-micronutrient group while it was relatively constant in placebo group. In conclusion, multi-micronutrient supplement had better impact on hematological status and reducing morbidity level compared to iron-folate supplement that had better impact on work productivity.

Abstrak :
ABSTRAK
Latar belakang: Penelitian ini bertujuan untuk mengetahui mortalitas dan morbiditas pada pasien elektif dalam daftar tunggu serta gambaran waktu tunggu pasien elektif dalam daftar tunggu operasi bedah pintas koroner dikaitkan dengan ketersediaan sumber daya (sistem, sumber daya manusia dan fasilitas) UPF Bedah Jantung Dewasa, RS Jantung dan Pembuluh Darah Harapan Kita. Metode : Penelitian ini menggunakan desain studi kuantitatif dan kualitatif. Data kuantitatif dikumpulkan secara prospektif selama 2 bulan sejak bulan Agustus- September 2010. Hasil : Dari 58 pasien tersebut, 1 pasien meninggal selama menunggu dan 1 pasien terkena stroke selagi menunggu. Tidak terdapat sistem khusus atau skoring untuk menentukan waktu tunggu pada pasien. Belum terdapat sistem penjadwalan, termasuk metode memasukan pasien kedalam daftar, memutuskan status kegawatan, menjadwalkan tanggal masuk dan memindahkan pasien dari daftar yang adekuat. Kesimpulan : Kejadian mortalitas dan morbiditas selama waktu tunggu tidak ditemukan sebagai kejadian yang sering terjadi selama menunggu operasi bedah pintas koroner pada studi ini. Namun sulit mengabaikan kerjadian yang terjadi pada kedua pasien pada penemuan, apalagi hasil penelitian menguatkan bahwa belum terdapat sistem penentuan waktu tunggu dan penjadwalan yang adekuat di UPF Bedah Jantung dan Intermediate Bedah Dewasa RS.Jantung dan Pembuluh Darah Harapan Kita walaupun sementara ini sumber daya yang ada (baik fisik maupun sumber daya manusia) masih dirasakan cukup mengakomodir jumlah kasus yang ada.

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ABSTRACT
Background: This study is aimed to find out mortality and morbidity in elective patient while waiting and description of waiting time in elective patient related to resources needed (system, human resources and facility) at department of cardiovascular surgery, Harapan Kita Hospital. Method : This study is use quantitative and qualitative desain study. The quantitative data collected prospectively within 2 months since August until September 2010. Result : From 58 patients, 1 patient was died while waiting and 1 fall into stroke. There?s no adequate system in scheduling patient, including put the patient into the list of que, decide the urgency and remove the patient from the list. Conclusion : It?s known that morbidity and mortality is not found as a significant event happened while waiting for CABG in this study. It?s difficult to ignore the things happened to the 2 patient, especially after knowing there?s no adequate system to decide wait time and scheduling at Department of cardiovascular surgery, Harapan Kita Hospital, while resources is still

Abstrak :
Kekurangan gizi dapat mempengaruhi pertumbuhan fisik, intelektual dan juga dianggap sebagai penyebab utama morbiditas dan mortalitas pada anak. Penelitian ini bertujuan untuk mengetahui faktor dominan yang berhubungan dengan kejadian underweight pada anak usia 6-23 bulan di Kecamatan Babakan Madang, Kabupaten Bogor. Desain penelitian yang digunakan adalah cross-sectional. Penelitian ini menggunakan data sekunder yang diperoleh dari penelitian payung Hibah PITTA B tahun 2019. Hasil penelitian menunjukkan bahwa 17,3% anak usia 6-23 bulan di Kecamatan Babakan Madang mengalami underweight, dan 6,1% di antaranya mengalami severly underweight. Dari 214 anak, 63,6% anak berusia 12-23 bulan, 50,5% laki-laki, 7% mengalami BBLR, 75,7% lahir dari ibu berpendidikan rendah, 47,7% memiliki ibu dengan pengetahuan kurang, 68,7% tidak memperoleh ASI eksklusif, 25,2% mengalami diare, 46,7 % mengalami defisit energi, dan 46,7% defisit protein. Hasil analisis chi-square menunjukkan bahwa tidak satupun variabel berhubungan dengan kejadian underweight. Namun, hasil uji regresi logistik menunjukkan bahwa usia anak (p value = 0,014), pendidikan ibu (p value =0,029) berhubungan signifikan dengan kejadian underweight. Adapun pengetahuan ibu (p value = 0,004) berhubungan terbalik dengan kejadian underweight. Pendidikan ibu merupakan faktor dominan kejadian underweight pada anak usia 6-23 bulan di Kecamatan Babakan Madang tahun 2019 (OR= 3,259, 95% CI ; 1,132-9,382). Peneliti menyarankan Kepada Dinas Kesehatan Kabupaten Bogor untuk memberikan sosialisasi dan edukasi kepada masyarakat, khususnya ibu yang memiliki anak usia 6-23 bulan tentang gizi bayi dan balita, gejala dan dampak dari kekurangan gizi, pentingnya perilaku hidup bersih dan sehat, beserta faktor-faktor lainnya yang dapat menyebabkan kekurangan gizi pada anak. ......Malnutrition can affect to physical and intellectual growth as well as considered a major cause of children morbidity and mortality. This study aims to determine the dominant factors associated with the underweight cases in children aged 6-23 months in Babakan Madang District, Bogor Regency. The research design was cross-sectional. This study used secondary data obtained from the PITTA B umbrella study in 2019. The results showed that 17.3% of children aged 6-23 months in Babakan Madang District were underweight and 6.1% of them were severelyly underweight. Among 214 children, there were 63.6% children aged 12-23 months, 50.5% were male, 7% experienced LBW, 75.7% raised by mothers with low education, 47.7% had mothers with poor knowledge, 68.7% did not receive exclusive breastfeeding, 25.2% had diarrhea, 46.7% had an energy deficit, and 46.7% had a protein deficit. The results of the chi-square analysis showed that none of the variables associated with the underweight problem. However, the logistic regression test results showed that the children age (p value = 0.014), mothers’ educational background (p value = 0.029) were significantly associated with underweight. Meanwhile, maternal knowledge (p value = 0.004) was inversely related to underweight. Maternal education is the dominant factor in children underweight problem aged 6-23 months in Babakan Madang District in 2019 (OR = 3.259,95% CI; 1,132-9,382). The researcher suggested the Bogor District Health Office to provide socialization and education to the community, especially mothers who have children aged 6-23 months in regard to nutrition for infants and toddlers, symptoms and impacts of malnutrition, the importance of clean and healthy living habits, and other factors which can cause malnutrition in children.

Abstrak :
Penyakit kolestasis pada bayi dan anak memberikan dampak negatif bagi status nutrisi, pertumbuhan serta perkembangan sehingga berdampak pada mortalitas. Sistem imunitas pada bayi dan anak yang lemah meningkatkan morbiditas dan berdampak pada status nutrisi sehingga meningkatkan angka mortalitas pada anak kolestasis. Penelitian ini dilakukan dengan menggunakan data rekam medis pasien bayi dan anak kolestasis yang dirawat inap serta rawat jalan di Rumah Sakit Cipto Mangunkusumo tahun 2010-2015. Dengan menggunakan desain cohort retrospektif, penelitian ini bertujuan untuk mengetahui hubungan status nutrisi dan morbiditas pada anak dengan kolestasis di Rumah Sakit Cipto Mangunkusumo. Hasil penelitian pengukuran status nutrisi berdasarkan lingkar lengan atas per umur (n=37) didapatkan, status gizi normal 10(27%), gizi kurang 10(27%), dan gizi buruk 17(46%). Dengan pengukuran indeks lingkar lengan atas per umur (LLA/U), hubungan morbiditas common cold memiliki hubungan yang bermakna p<0,05. Namun morbiditas terhadap status nutrisi berdasarkan tinggi badan per umur (TB/U) p>0,05.

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Cholestasis disease in infants and children adversely affects nutritional status, growth and development which impact on mortality. The weak immune system in infants and children can increase morbidity and nutritional status thus increasing the mortality rate in children with cholestasis. This research was conducted using data from medical records patients of infants and children with cholestatic who are hospitalized and given outpatient treatment at Rumah Sakit Cipto Mangunkusumo 2010-2015. By using a retrospective cohort design, this research aims to determine the relationship of nutritional status and morbidity in children with cholestasis in Rumah Sakit Cipto Mangunkusumo. Research results measuring of nutritional status with the index mid upper arm circumference for age (n=37), normal nutritional status 10(27%), under nutrition 10(27%) and severe nutrition 17(46%). With the index mid upper arm circumference for age (MUAC/A), morbidity relationship common cold against nutritional status has a significant relationship p<0.05. However, the morbidity of the nutritional status based high for age (H/A) p> 0.05.