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Abstrak :
Latar Belakang: Target angka keberhasilan pengobatan TB MDR/TB RR 2015 adalah ≥ 75 %. Angka keberhasilan pengobatan menurut WHO tahun 2013 adalah 52%. Kesenjangan antara target dan pencapaian masih sangat besar. Metode: Penelitian cross sectional/potong lintang berdasarkan data rekam medis pasien TB MDR yang sudah ada hasil pengobatan sejak Januari 2013 sampai dengan Desember 2016. Hasil: Dari 409 pasien TB MDR di RSUP Persahabatan keberhasilan pengobatan 61,4% dengan hasil akhir pengobatan sembuh 243 subjek (59,4%), pengobatan lengkap 8 subjek (2%), meninggal 44 subjek (10,8%), loss to follow up 106 subjek (25,9%) dan gagal 8 subjek (2%). Pada penelitian ini 243 subjek (59,4%) laki-laki dengan rerata umur 38,79 ± 11,887 tahun, mayoritas gizi kurang dan terdapat pengobatan TB sebelumnya, resistensi terbanyak RHES dan efek samping terbanyak efek samping sedang (kelompok 2). Faktor umur, riwayat penggunaan alkohol dan komorbid DM mempunyai hubungan bermakna terhadap hasil akhir pengobatan (p<0,05). Riwayat penggunaan alkohol merupakan faktor yang paling berpengaruh terhadap hasil akhir pengobatan. Kesimpulan: Keberhasilan pengobatan TB MDR di RSUP Persahabatan adalah sebesar 61,4% dan faktor yang berhubungan bermakna adalah umur, riwayat penggunaan alkohol dan terdapatnya komorbid DM.

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Background: The target of treatment success rate of MDR TB/RR TB in 2015 is ≥ 75 %. The success rate in WHO 2013 is 52%. The gap between target and achievement is still very large. Method: A cross sectional design based on medical record data of MDR TB patients who have been treatment outcomes from January 2013 to December 2016. Result: Of a total 409 MDR TB patients at Persahabatan Hospital succes rate of treatment is 61,4% with the final outcome consist of cured 243 subjects (59,4%), complete treatment 8 subjects (2%), death 44 subjects (10,8%), loss to follow up 106 subjects (25,9%) dan failed 8 subjects (2%). Patients in this study were male 243 subjects (59,4%) with mean age of subjects 38,79 ± 11,887 years old, majority is malnutrition and had previous TB treatment, the most resistance is RHES and the most side effects is moderate. The age, alcohol user and comorbid DM were found to have significant relationship to treatment outcomes (p<0,05). The alcohol user is the most influential factor to the treatment outcomes. Conclusion: The success rate of treatment outcome of MDR TB in Persahabatan hospital is 61,4% and associated factors is the age, alcohol user dan comorbid DM.

Abstrak :
Tujuan : (1) mengetahui perubahan kadar gala darah dalam 5 hari pasca serangan stroke; (2) rengetahui faktor risiko, status gizi, asupan energi dan karbohidrat serta pemberian insulin selama dirawat; (3) mengetahui hubungan antara perubahan kadar gula darah dengan faktor risiko, indeks massa tubuh, asupan energi dan karbohidrat serta pemberian insulin pada pasien hiperglikemia. Tempat : Ruang rawat inap Rumah Sakit Umum Pusat Nasional Dr. Cipto Mangunkusumo. Metodologi : Sebanyak 103 pasien diambil dengan diagnosa stroke iskemik dan hemoragik yang memenuhi kriteria penerimaan. Dilakukan pengukuran antropometri yaitu berat badan dan tinggi badan. Pemeriksaan laboratorium yang dilakukan yaitu kadar gula darah sewaktu hari 1 dan kadar gula darah puasa hari 2 - 5. HbA1. diperiksa pada pasien hiperglikemia. Data asupan energi dan karbohidrat melalui oral, enteral dan parenteral selama 24 jam pads hari I diambil secara recall dan hari 2 -- 5 secara record, hasil dianalisis dengan program food processor II. Perubahan kadar gula darah di uji dengan uji Friedman I uji Wilcoxon. Hubungan antara perubahan kadar gula darah dengan faktor risiko diuji dengan uji Mann Whitney. Hubungan antara perubahan kadar gula darah dengan indeks massa tubuh diuji dengan uji Kruskal Wallis. Korelasi antara perubahan kadar gula darah dengan asupan energi dan karbohidrat di uji dengan korelasi Spearman rank. Hasil : Hasil penelitian yang diperoleh 51,5% stroke iskernik dan 49,5% stroke hemoragik. Faktor risiko yang di dapat adalah hipertensi, DM, kelainan jantung dan dislipidernia. Faktor risiko dibagi menjadi DM dan non DM. Median asupan energi dan karbohidrat masih dibawah kebutuhan. Pada stroke non DM kadar gula darah puasa tertinggi hari 2, terjadi penurunan bermakna hari 3, dan stabil hari 4 dan 5 sedangkan pads DM tidak ada perbedaan bermakna. Terdapat perbedaan bermakna kadar gula darah antara kelompok stroke iskemik dan hemoragik pads stroke non DM dan tidak bermakna pads DM. Terdapat perbedaan bermakna kadar gula darah puasa antara penderita stroke dengan DM dan non DM. Tidak terdapat perbedaan bermakna antara kadar gula darah puasa dengan indeks massa tubuh.,Terdapat korelasi lemah sampai sedang negatif antara kadar gula darah dengan asupan energi dan karbohidrat pada penderita non DM dan korelasi lemah sampai sedang positif pada DM. Pemberian insulin sesuai dengan pedoman dapat menurunkan kadar gula darah pada beberapa pasien stroke dengan DM. Kesimpulan Penelitian ini menunjukkan terdapat perubahan kadar gula darah pads pasien stroke. Kadar gula darah puasa tertinggi hari 2 menurun bermakna hari 3 dan stabil hari 4 dan 5. Tidak ada perbedaan bermakna antara kadar gula darah dengan indeks massa tubuh. Terdapat korelasi lemah sampai sedang negatif antara kadar gula darah dengan asupan energi dan karbohidrat pada pasien stroke non DM.

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The Changes Of Fasting Glucose And Associated Factors In Stroke Patiens In Ciptomangunkusumo General Hospital 2002Objective : (1) to investigate the changes of blood glucose within 5 days after stroke, (2) to observe the risk factors, body mass index, energy and carbohydrate intake (3) to analyze the correlation between blood glucose with the risk factors, body mass index, energy and carbohydrate intakes and insulin to hyperglycemia patients. Location: Cipto Mangunkusumo General Hospital, Jakarta. Subject and methods : One hundred and three patients with acute stroke were recruited as the subjects of the study. Antropometric assessments i.e. body weight and height were assessed in the 1 0 day of admission. Laboratory assessment i.e. blood glucose at the time in the 1 °' day and fasting blood glucose in the 2nd - 5th days, HbAic to patients with hyperglycemia. Energy and carbohydrate intakes from parenteral, enteral and oral route were calculated in the 10 day by recall and 2"d - 5th day by record and analyzed by food processor II program. The changes of fasting blood glucose was tested using Friedman I Wilcoxon test The correlation between changes of blood glucose with risk factors was tested using Mann Whitney U test The correlation between changes of blood glucose with body mass index was tested using Kruskal Wallis test. The correlation between change of blood glucose with energy and carbohydrate intake was tested using Spearman rank correlation. Results : The type of stroke determined by clinical diagnosis and CT scan were ischemic stroke 51,5% and hemorrhagic stroke 48,5%. Risk factors found were : hypertension, diabetes mellitus, cardiac disease, dislipidemia and unknown risk factors. The risk factors were grouped into 2 categories : DM and non. DM. The median intake of energy and carbohydrate were below the requirement. Fasting blood glucose higher in the 2nd day, significant decrease in the 3`d day, and constant in the 4t- 5th day in non DM patient whereas in DM not significant There were significant difference in changes of fasting blood glucose between ischemic and hemorrhagic stroke in non DM patient whereas DM no significant There were no significant difference between changes of fasting blood glucose with body mass index. There was weak to moderate negative correlation between of fasting blood glucose and energy and carbohydrate intake using Spearman rank correlation in non DM patient. Insulin to decrease blood glucose for several DM stroke patients. Conclusions : the current study indicates that there was changes of blood glucose in the stroke patients. There were higher in the 2"' day significant decrease in the 3`d day and constant in the 4d' - 5d' day. There was no significant difference in the changes of blood glucose fasting with body mass index. There was weak to moderate negative correlation between fasting blood glucose and energy and carbohydrate intake in non DM stroke patients.

Abstrak :
Tujuan dari penelitian ini adalah diketahuinya proporsi pemberian ASI eksklusif 6 bulan dan faktor-faktor yang berhubungan di Wilayah Kerja Puskesmas Kemiri Muka Kota Depok Jawa Barat tahun 2011. Penelitian ini menggunakan disain crossectional dengan responden adalah ibu yang mempunyai bayi berumur 6 bulan sampai dengan 12 bulan sejumlah 172 responden. Penelitian dilakukan pada Bulan Oktober 2011. Hasil penelitian didapatkan persentase pemberian ASI eksklusif 6 bulan masih rendah yaitu hanya 25,6%. Faktor predisposisi yang berhubungan bermakna dengan pemberian ASI eksklusif 6 bulan adalah paritas (p=0,043, OR=2,333, 95% CI=1,084-5,022). Faktor pemungkin yang berhubungan bermakna adalah inisiasi menyusu dini (IMD) (p=0,024, OR=2,368, 95% CI=1,174-4,780) dan rawat gabung (p=0,009, OR=3,180, 95% CI=1,369-7,388). Faktor penguat yang berhubungan bermakna adalah dukungan suami (p=0,001, OR=3,737, 95% CI=1,737-8,040), dukungan sarana dan tenaga kesehatan (p=0,000, OR=3,974, 95% CI=1,896-8,329), dukungan teman (p=0,009, OR=3,388, 95% CI=1,402-8,189), dan dukungan keluarga (ibu dan ibu mertua) (p=0,002, OR=4,111, 95% CI=1,705-9,912). Hasil analisis multivariat menunjukkan bahwa dukungan keluarga (ibu dan ibu mertua) merupakan faktor yang paling dominan dalam hubungannya dengan pemberian ASI eksklusif 6 bulan (p=0,001, OR=5,606, 95% CI=2,086-15,068). Saran untuk Dinas Kesehatan Kota Depok adalah adanya pengawasan dari Dinas Kesehatan agar seluruh sarana kesehatan di Kota Depok untuk menerapkan 10 langkah menuju keberhasilan menyusui. Sedangkan untuk Puskesmas Kemiri Muka adalah disarankan agar membuat klinik menyusui di puskesmas, dan memberikan penjelasan kepada ibu hamil dan menyusui, suami ibu hamil dan menyusui, dan keluarga ibu hamil dan menyusui tentang pentingnya dan manfaat pemberian ASI eksklusif 6 bulan.

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The objectives of this study was to asses the proportion of practice of exclusive breastfeeding for 6 months and their associated factors. This study used a crossectional design study. Respondents are mothers who had babies aged 6 to 12 months a number of 172. The study was conducted in October 2011. The study found the percentage of practice exclusive breastfeeding for 6 months was still low at only 25.6%. The predisposing factors significantly associated with exclusive practice breastfeeding for 6 months is parity (p=0,043, OR=2,333, 95% CI=1,084-5,022). The enabling factors significantly related are early initiation of breastfeeding (p=0,024, OR=2,368, 95% CI=1,174-4,780) and rooming in (p=0,009, OR=3,180, 95% CI=1,369-7,388). The reinforcing factors significantly associated are support of her husband (p=0,001, OR=3,737, 95% CI=1,737-8,040), support of facilities and health workers (p=0,000, OR=3,974, 95% CI=1,896-8,329), support of friends (p=0,009, OR=3,388, 95% CI=1,402-8,189), and family support (mother and mother-in-law) (p=0,002, OR=4,111, 95% CI=1,705-9,912). The results of multivariate analysis showed that the support of family (mother and mother-inlaw) is the most dominant factor in association with exclusive breastfeeding 6 months (p=0,001, OR=5,606, 95% CI=2,086-15,068). Suggestions for Depok City Health Office who developed policy of oversight to all health facilities in Depok City to apply the 10 steps to successful breastfeeding. For Kemiri Muka Public Health Center, it is recommended make breastfeeding clinic, and deliver information to pregnant and lactating mothers, her husband and families on the importance and benefits of exclusive breastfeeding 6 months.