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"Penelitian ini bertujuan untuk membandingkan pengaruh tipe penyalaan kontrol jarak sama dan kontrol sudut sama pada penyearah tiga phasa terkendali dengan melihat harmonisa yang ditimbulkan pada input tegangan. Kemudian menghitung efisiensi penyearah dan perbandingan faktor kerja dari kedua tipe kontrol tersebut. Rangkaian penyearah menggunakan filter pasif dengan beban tahanan sebesar 11 ohm dan dianalisis dengan menggunakan simulasi program PSPICE versi 7.Hasil penelitian menunjukkan bahwa penggunaan kontrol jarak sama menimbulkan harmonisa arus masukan pada orde ke-5 dan ke-7 sedangkan pada kontrol sudut sama menimbulkan harmonisa pada orde ke-3, 5 dan ke-7. Pada sisi keluaran tipe kontrol jarak sama menimbulkan riak tegangan pada orde 6, sedangkan pada tipe kontrol sudut sama menimbulkan riak tegangan pada orde ke-2 dan ke-6.Hasil perhitungan riak tegangan yang terjadi sebesar 3,5% dengan efisiensi 99,8% pada kontrol jarak sama, sedangkan pada kontrol sudut sama diperoleh riak tegangan sebesar 4% dengan efisiensi 99.7%. Selanjutnya pada sudut penyalaan 300 diperoleh input THD sebesar 50,26% dengan faktor kerja sebesar 0,89 pada tipe kontrol jarak sama, sedangkan pada tipe kontrol sudut sama diperoleh input THD sebesar 53,831% dengan faktor kerja sebesar 0,87. Dari hasil ini menunjukkan bahwa penyalaan thyristor dengan tipe kontrol jarak sama lebih baik dibandingkan dengan tipe sudut sama.

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Analysis of three phase controlled rectifier with the same distance control as compared to the same angle control. This research aim to compare the firing of the same distance and the same angle control at three phase controlled rectifier with seen generated harmonic at input (AC side). Then calculate of rectifier efficiency and power factor comparison from both the control type. The rectifier use passive filter with resistance 11 ohm and is analysed with program simulation using PSPICE version 7.1.Result of research indicate that use of the same distance control generates the 5th and 7th harmonics, while the same angle control generates the 3rd , 5th and 7th harmonics at the input (AC side). At the output (DC side), the same distance control type generates the 6th voltage ripples, while the same angle control generates the 2nd, and 6th voltage ripples.The result of calculation of voltage ripples that happened equal to 3.5% with efficiency 99.8% at same distance control, while at the same angle control obtained voltage ripples equal to 4% with efficiency 99.7% . At the firing angle 300 obtained by THD input equal to 50.26% with power factor equal to 0.89 at same distance control type, while the same angle control obtained by THD input equal to 53,831% with power factor to 0,87. From this result indicate that the firing of thyristor with the same distance better then is the same angle control."

"Latar Belakang: Insidensi dan prevalensi diabetes melitus tipe 2 (DMT2) terus meningkat. Penurunan imunitas yang terjadi pada DMT2 dapat meningkatkan risiko infeksi. Kontrol gula darah yang baik bermanfaat dalam pengendalian infeksi dan pencegahan komplikasi makro dan mikrovaskuler tetapi penelitian yang melibatkan pasien DMT2 usia lanjut masih belum konklusif. Serial kasus ini dilakukan untuk melihat efektivitas kontrol gula darah terhadap kesintasan pasien DMT2 yang dirawat di rumah sakit, dan untuk implementasi tatalaksana nutrisi sesuai kebutuhan dan kondisi klinis pasien. Metode: Pasien pada serial kasus ini berusia antara 47 ? 65 tahun. Penyulit infeksi pada keempat pasien ini yaitu gangren diabetikum, selulitis, dan sepsis dengan infeksi paru dan infeksi saluran kemih. Tatalaksana nutrisi pasien dilakukan sesuai dengan rekomendasi American Diabetes Association dan Therapeutic Lifestyle Changes disesuaikan dengan kondisi klinis dan toleransi pasien. Perhitungan kebutuhan nutrisi menggunakan rekomendasi untuk perawatan pasien sakit kritis bagi pasien yang dirawat di intensive care unit (ICU), dan menggunakan perhitungan dengan formula Harris-Benedict bagi yang dirawat di ruangan dengan faktor stres sesuai derajat hipermetabolisme pasien. Pasien dipantau selama 7 ? 11 hari. Edukasi diberikan kepada pasien dan keluarga selama perawatan dan saat akan pulang. Hasil: Dalam pemantauan, tiga pasien menunjukkan perbaikan klinis, toleransi asupan, dan laboratorium, dan dapat dipulangkan, sedangkan satu pasien meninggal dunia. Kesimpulan: Kontrol gula darah, asupan nutrisi yang adekuat, dan edukasi yang sesuai, dapat meningkatkan kesintasan pasien DMT2 dengan penyulit infeksi yang dirawat di rumah sakit. ......Background: The incidence and prevalence of type 2 diabetes mellitus (T2DM) is increasing. Immune disfunction in T2DM patient may increase the risk of infection. The appropriate blood glucose control has a benefit in infection control and macro and microvascular complication prevention. The Studies of glycaemic control included older patients did not find convincing evidence. The aim of this case series is to assess the association between glycaemic control and clinical outcome of hospitalized T2DM patient with comorbid infection, and to provide appropriate nutrition therapy based on individual nutrition needs. Method: Patients in this case series were between 47 - 65 years old. There of those patients were diagnosed T2DM with comorbid gangrenous diabeticum, cellulitis, and sepsis with lung infection and urinary tract infection. Two patients need intensive care in ICU, and another patients in the ward. Two patients received nutrition therapy as critically ill condition, and the rest as American Diabetic Association recommendation, with basal calorie requirement were calculated using Harris-Benedict formula and stress factor suitable for metabolic changes. Monitoring was done for 7 - 11 days. Education was done for the patient and family during hospitalization and discharge planning. Results: Three patients showed the improvement of clinical conditions, intake tolerance, and laboratory results, whatever one patient was pass away. Conclusion: Glycaemic control, adequate nutrition intake, and intensive education, may improve survival rate in hospitalized T2DM patient with infection as comorbid."

"Latar belakang Diabetes Mellitus (DM) merupakan salah satu masalah kesehatan utama di negara berkembang maupun negara maju.1 Pada tahun 2007, sekitar 23,6 juta orang Amerika menderita DM, dimana sebagian besar adalah pekerja.2 Penelitian oleh Poulsen (2014) menemukan bahwa 3,5% petugas kesehatan menderita DM selama periode pengamatan 7 tahun.3 Informasi mengenai dampak kerja shift terhadap kontrol glikemik pada pada pekerja yang memiliki DM tipe 2 masih belum banyak diketahui. Metode Kasus wanita berusia 52 tahun bekerja sebagai perawat di rumah sakit, mengikuti jadwal shift malam dan telah didiagnosis DM tipe 2 sejak 7 tahun lalu. Pencarian literatur dilakukan melalui pencarian elektronik (PubMed dan ProQuest) serta hand searching dengan kata kunci “kontrol glukosa darah”, “diabetes mellitus tipe 2”, “kerja shift” dan “kerja shift malam” yang memenuhi kriteria inklusi dan eksklusi. Hasil Hasil pencarian didapatkan 92 studi dan 3 studi yang relevan ditemukan dengan desain potong lintang. Studi oleh Manodpitipong (2017) menunjukkan bahwa kerja shift malam dikaitkan dengan HbA1c yang lebih tinggi (p = 0,044) dibandingkan dengan kerja siang hari. Studi oleh Chalernvanichakorn (2008) memberikan hasil kontrol glikemik yang baik secara signifikan lebih tinggi pada pekerja harian dibandingkan pekerja shift (28,3% vs 15,8%) dengan p = 0,02. Studi oleh Ghazawy (2013) menunjukkan bahwa HbA1c lebih tinggi di antara pekerja dengan diabetes yang melakukan kerja shift dibandingkan dengan pekerja yang hanya bekerja siang hari (p = 0,01). Kerja shift sendiri berpengaruh signifikan terhadap pengendalian diabetes (p = 0,04), dengan OR = 3,83 (1,02 – 14,34). Kesimpulan Bukti penelitian menunjukkan adanya hubungan antara kerja shift malam dengan kontrol glikemik yang buruk pada pekerja dengan DM tipe 2. Pekerja shift malam berisiko 2-3 kali memiliki kontrol glikemik yang buruk daripada pekerja non-shift. Bukti yang ditemukan dalam studi Manodpitipong dan Chalernvanichakorn dapat diterapkan pada pasien ini karena karakteristik subjek penelitian yang sama.......Background Diabetes Mellitus (DM) is considered to be one of a major problem in both developing and industrialized countries.1 As of 2007, approximately 23.6 million Americans have diabetes, most of whom are or wish to be participating members of the workforce.2 Research by Poulsen et al., (2014) found that 3.5% of health workers had diabetes during the 7-year observation period.3 A person with diabetes should be individually assessed to determine whether or not that person can safely and effectively perform the particular duties of the job in question.2 Shift work is considered to be disruptive to normal diurnal biological rhythms and has been associated with many health problems.4 Observational studies revealed that night-shift work is associated with increased risk of prevalent diabetes and incident diabetes.7 Information regarding the impact of shift work on blood glucose control or glycemic state in workers who have a history of type 2 diabetes is still not widely known. Method The case is about a 52-year-old female who worked as a nurse in non-intensive ward of government hospital and performed night shift work. She has been diagnosed with type 2 Diabetes Mellitus for seven years . A literature search was conducted through PubMed and ProQuest and also performed with the hand searching method. The inclusion criteria of this search strategy were systematic review, cohort study, worker with type 2 DM, shift work, blood glucose control and glycemic control. The exclussion criteria were articles not in english and inaccessible full text article. Then, they were critically appraised based on Center of Evidence- Based Medicine, Oxford University, Critical Appraisal for Etiology. Result Three relevant studies were found through literature searching and all of those studies were cross sectional design. The first study by Manodpitipong, et al.(2017) showed that night shift work was associated with significantly higher haemoglobin A1c (p = 0.044) compared with day work. While there were no differences between unemployed participants and day workers (p = 0.572). The second study conducted by Chalernvanichakorn, et al.(2008) give result that good glycemic control was significantly higher in day workers versus shift workers (28.3% vs 15.8%) with p = 0.02. A higher proportion of shift workers had hypoglycemic symptoms compared to day workers (42.5% vs. 26.7%). The third study by Ghazawy, et al.(2013) showed that HbA1c was significant higher levels among diabetic shift workers compared to diabetic day-time workers (p=0.01), where mean of current shift workers and former shift workers were 7.8±1.9 and 8.4±2.6, compared to 6.3±1.1. Shift work itself has a significant effect on control of diabetes (p = 0.04), with an OR = 3.83 (1.02 – 14.34), whereas age, duration of diabetes, BMI and waist circumference had no significant effect. Conclusion The research evidence found from the three studies above shows that there is association between night shift work and poor glycemic control in workers with type 2 DM. But the causation effect between the two variables cannot be determined yet, because there are many confounding factors that influence it. Night shift workers are two to three times more likely to have poor glycemic control than non-shift workers. The evidence found in the two study (Manodpitipong and Chalernvanichakorn) can be applied to our patient because of the same characteristic: female, diabetic worker, involved in night shift work. For future studies, cohort research should be conducted to find causality between shift work and glycemic control. Recommendation to our patient is to pay more attention to diet and adhere to treatment. It is necessary to inform the doctor that she is involved in shift work so that the doctor will provide a suitable regimen and diet for the patient."